Current classification systems for adult degenerative scoliosis

2013 ◽  
Vol 97 (1) ◽  
pp. 1-8 ◽  
Author(s):  
C. Faldini ◽  
A. Di Martino ◽  
M. De Fine ◽  
M. T. Miscione ◽  
C. Calamelli ◽  
...  
Keyword(s):  
Classification Systems ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
Current Classification

scholarly journals Second sacral sacralalar‐iliac (S2AI) screw placement in adult degenerative scoliosis (ADS) patients: an imaging study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bing Wu ◽  
Kai Song ◽  
Junyao Cheng ◽  
Pengfei Chi ◽  
Zhaohan Wang ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Imaging Study ◽  
Outer Diameter ◽  
Degenerative Scoliosis ◽  
Female Patients ◽  
Lateral Angle ◽  
Adult Degenerative Scoliosis ◽  
Imaging Characteristics ◽  
Starting Point ◽  
Trajectory Length

Abstract Background The imaging characteristics of sacral sacralalar-iliac (S2AI) screw trajectory in adult degenerative scoliosis (ADS) patients will be determined. Methods S2AI screw trajectories were mapped on three-dimensional computed tomography (3DCT) reconstructions of 40 ADS patients. The starting point, placement plane, screw template, and a circle centered at the lowest point of the ilium inner cortex were set on these images. A tangent line from the starting point to the outer diameter of the circle was selected as the axis of the screw trajectory. The related parameters in different populations were analyzed and compared. Results The trajectory length of S2AI screws in ADS patients was 12.00 ± 0.99 cm, the lateral angle was 41.24 ± 3.92°, the caudal angle was 27.73 ± 6.45°, the distance from the axis of the screw trajectory to the iliosciatic notch was 1.05 ± 0.81 cm, the distance from the axis of the screw trajectory to the upper edge of the acetabulum was 1.85 ± 0.33 cm, and the iliac width was 2.12 ± 1.65 cm. Compared with females, the lateral angle of male ADS patients was decreased, but the trajectory length was increased (P < 0.05). Compared to patients without ADS in previous studies, the lateral angle of male patients was larger, the lateral angle of female patients was increased, and the caudal angle was decreased (P < 0.05). Conclusions There is an ideal trajectory of S2AI screws in ADS patients. A different direction should be noticed in the placement of S2AI screws, especially in female patients.

scholarly journals Outcomes of Short Fusion versus Long Fusion for Adult Degenerative Scoliosis: A Systematic Review and Meta-analysis

2017 ◽  
Vol 9 (4) ◽  
pp. 342-349 ◽  
Author(s):  
Kevin Phan ◽  
Joshua Xu ◽  
Monish M Maharaj ◽  
Julian Li ◽  
Jun S Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis

CLASSIFICATION SYSTEMS FOR ADOLESCENT AND ADULT SCOLIOSIS

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A16-A24 ◽  
Author(s):  
Justin S. Smith ◽  
Christopher I. Shaffrey ◽  
Charles Kuntz ◽  
Praveen V. Mummaneni
Keyword(s):  
Health Care Providers ◽  
Research Society ◽  
Classification Systems ◽  
Adult Scoliosis ◽  
Care Providers ◽  
Classification Schemes ◽  
Scoliosis Research Society ◽  
Adult Degenerative Scoliosis ◽  
Spinal Abnormality

ABSTRACT OBJECTIVE To review current classification systems for adolescent and adult scoliosis. METHODS The literature was reviewed in reference to scoliosis classification systems for adolescent and adult scoliosis. RESULTS There are multiple classification systems for scoliosis. Classification of scoliosis is dependent on patient age, spinal abnormality, scoliotic curve, and global spinal alignment. To date, classification systems have focused predominantly on adolescent idiopathic scoliosis or adult/degenerative scoliosis; a single classification system evaluating scoliotic deformities of different ages and spinal abnormalities has not been identified. CONCLUSION The importance of scoliosis classification schemes lies in their ability to standardize communication among health care providers. With regard to the classification of adolescent scoliosis, the Lenke system has addressed many of the significant limitations of the King system and is now the standard classification scheme. Classification schemes for adult scoliosis have been reported only recently, and each offers specific advantages (the simple pathogenesis-based system of Aebi, the strong clinical relevance of the Schwab system, and the richly descriptive Scoliosis Research Society system). This article highlights the salient features of currently used scoliosis classification systems.

scholarly journals Detailed Quantification of Glomerular Structural Lesions Associates with Clinical Outcomes and Transcriptomic Profiles in Nephrotic Syndrome

2021 ◽  
Author(s):  
Jeffrey B. Hodgin ◽  
Laura H. Mariani ◽  
Jarcy Zee ◽  
Q Liu ◽  
Abigail R. Smith ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Disease Progression ◽  
Clinical Outcomes ◽  
Messenger Rna ◽  
Structural Changes ◽  
Classification Systems ◽  
Molecular Heterogeneity ◽  
Biologically Relevant ◽  
Current Classification ◽  
Over Time

ABSTRACTThe current classification system for focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) does not fully capture the complex structural changes in kidney biopsies, nor the clinical and molecular heterogeneity of these diseases. The Nephrotic Syndrome Study Network (NEPTUNE) Digital Pathology Scoring System (NDPSS) was applied to 221 NEPTUNE FSGS/MCD digital kidney biopsies for glomerular scoring using 37 descriptors. The descriptor-based glomerular profiles were used to cluster patients with similar morphologic characteristics. Glomerular descriptors and patient clusters were assessed for association with time to proteinuria remission and disease progression by using adjusted Cox models, and eGFR measures over time by using linear mixed models. Messenger RNA from glomerular tissue was used to assess differentially expressed genes (DEG) between clusters and identify genes associated with individual descriptors driving cluster membership. Three clusters were identified: X (N=56), Y (N=68), and Z (N=97). Clusters Y and Z had higher probabilities of proteinuria remission (HR [95% CI]= 1.95 [0.99, 3.85] and 3.29 [1.52, 7.13], respectively), lower hazards of disease progression 0.22 [0.08, 0.57] and 0.11 [0.03, 0.45], respectively), and greater loss of eGFR over time compared with X. Cluster X had 1920 DEGs compared to Y+Z, which reflected activation of pathways of immune response and inflammation. Six individual descriptors driving the clusters individually correlated with clinical outcomes and gene expression. The NDPSS allows for characterization of FSGS/MCD patients into clinically and biologically relevant categories and uncovers histologic parameters associated with clinical outcomes and molecular signatures not included in current classification systems.TRANSLATIONAL STATEMENTFSGS and MCD are heterogeneous diseases that manifest with a variety of structural changes often not captured by conventional classification systems. This study shows that a detailed morphologic analysis and quantification of these changes allows for better representation of the structural abnormalities within each patient and for grouping patients with similar morphologic profiles into categories that are clinically and biologically relevant.

Robotic Sacroiliac Fixation Technique for Triangular Titanium Implant in Adult Degenerative Scoliosis Surgery: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Connor Berlin ◽  
Parantap Patel ◽  
Isador Lieberman ◽  
Mark Shaffrey ◽  
Avery Buchholz
Keyword(s):  
Back Pain ◽  
Sacroiliac Joint ◽  
Titanium Implants ◽  
Leg Pain ◽  
Definitive Treatment ◽  
Scoliosis Surgery ◽  
Corrective Surgery ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
K Wires

Abstract Corrective surgery remains a definitive treatment for adult spinal deformity, improving pain and disability. With these cases, instrumentation to the pelvis with iliac fixation is recommended. Whether iliac or S2-Alar-Iliac (S2AI) trajectories are used, sacroiliac joint pain and long-term sacroilitis can be common after long-fusion constructs.1-3 Sacroiliac fusion with triangular titanium implants during fusion can reduce back pain associated with sacroiliac joint degeneration,3 provides reduction in sacroiliac joint motion and stress when added to S2AI screws, and potentially enhances mechanical stability of fusion constructs.4 Here, we present a technique for placing triangular titanium sacroiliac implants (iFuse BedrockTM; SI-BONE Inc, Santa Clara, California) alongside S2AI screws using a robotic platform (Mazor X; Medtronic Sofamor Danek, Medtronic Inc, Dublin, Ireland). Navigated robotics allows reduction in human error with implant placement, and potentially decreased operative time/fluoroscopy.5-7 Key surgical steps include placement of K wires for S2AI and bilateral SI-implants, tapping, replacing SI-implant K wires with guide pins, placing S2AI screws, and finally placing the SI-implant. Final placement is verified with intraoperative fluoroscopy. The patient described is a 61-yr-old woman with worsening adult degenerative scoliosis, lower back pain, left leg radicular pain, and mild right leg pain who failed conservative treatment. Examination revealed diminished strength in both legs. Imaging was significant for moderate sigmoid scoliosis, discogenic disease, and osteoarthritis at all levels. She consented to undergo corrective surgery. Postoperatively, the patient experienced resolution of her leg weakness and pain. Imaging demonstrated appropriate positioning of hardware. Prospective studies on the efficacy of the SI-implant are underway.

Adult Degenerative Scoliosis

2013 ◽  
pp. 247-258
Author(s):  
Joshua Ellwitz ◽  
Munish Gupta
Keyword(s):  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis
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