Correction surgery for adult spinal deformity improves not only spinopelvic alignment but also the three-dimensional alignment of the lower extremities

2020 ◽  
Vol 25 (6) ◽  
pp. 946-952 ◽  
Author(s):  
Yusuke Sato ◽  
Kazuhiro Hasegawa ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Yoshinori Ishii ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Three Dimensional ◽  
Lower Extremities ◽  
Spinopelvic Alignment ◽  
Correction Surgery

scholarly journals BIPLANAR IMAGING WITH TRIDIMENSIONAL CAPABILITIES: APPLICABILITY OF THIS NEW EXAMINATION TO SPINAL DEFORMITIES

2020 ◽  
Vol 19 (1) ◽  
pp. 67-70
Author(s):  
RAPHAEL DE REZENDE PRATALI ◽  
MURILO TAVARES DAHER ◽  
ROBERT MEVES
Keyword(s):  
Spinal Deformity ◽  
Imaging System ◽  
Adult Spinal Deformity ◽  
Three Dimensional ◽  
Entire Body ◽  
Spinal Deformities ◽  
Compensatory Mechanisms ◽  
Level Of Evidence ◽  
The Individual ◽  
Bone Structures

ABSTRACT This study presents details about the applicability of the new image acquisition system, called the biplanar imaging system, with three-dimensional capabilities (EOS®) to the treatment of spinal deformities. This system allows radiographic acquisition of the entire body, with a great reduction in the dose of radiation absorbed by the patient and three-dimensional (3D) stereoradiographic image reconstruction of bone structures, including the spine. In the case of adolescent idiopathic scoliosis, the analysis of the spinal deformity with 3D reconstruction allows better understanding of the deformity and surgical planning. In the case of adult spinal deformity, full-body analysis allows an evaluation of the spinopelvic deformity, including loss of sagittal alignment, in addition to an evaluation of compensatory mechanisms recruited by the individual in an attempt to maintain the sagittal balance. Level of evidence III; Descriptive Review.

scholarly journals Comparison of Radiographic And Clinical Outcomes Observed After Adult Spinal Deformity Correction Using Iliac Screw Versus S2-Alar-Iliac Screw

2021 ◽  
Author(s):  
Qiang Luo ◽  
Yong-Chan Kim ◽  
Ki-Tack Kim ◽  
Kee-Yong Ha ◽  
Joonghyun Ahn ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spinal Deformity ◽  
Lumbar Lordosis ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Postoperative Change ◽  
Iliac Screw ◽  
Vas Scores ◽  
Correction Surgery

Abstract Background: To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.Methods: A retrospective review of consecutive patients underwent deformity correction surgery for ASD between 2013 and 2017 was performed. Patients were divided into two groups based on whether IS or S2AI fixation was performed. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Demographics, intraoperative and clinical data were analyzed between the two groups. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change <5°. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared.Results: A total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. The IS group (65.6 ± 26, 39.8 ± 13.8) showed a significantly higher change in lumbar lordosis (LL) and upper lumbar lordosis (ULL) than the S2AI group (54.4 ± 17.9, 30.3 ± 9.9) (p<0.05). In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° (p<0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%, p<0.05) and (16.1% vs 3.6%, p<0.05).Conclusions: IS fixation showed a greater change in LL and ULL than S2AI fixation in ASD surgery. PI may be changed under certain circumstances.

Patient Expectations of Adult Spinal Deformity Correction Surgery

2020 ◽  
Author(s):  
Won Hyung A. Ryu ◽  
Andrew Platt ◽  
John E. O'Toole ◽  
Ricardo Fontes ◽  
Richard G. Fessler
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Patient Expectations ◽  
Correction Surgery

Prediction of satisfaction after correction surgery for adult spinal deformity: differences between younger and older patients

2020 ◽  
Vol 29 (12) ◽  
pp. 3051-3062
Author(s):  
Kazunori Hayashi ◽  
◽  
Louis Boissière ◽  
Daniel Larrieu ◽  
Anouar Bourghli ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Older Patients ◽  
Adult Spinal Deformity ◽  
Correction Surgery

137. Surgical overcorrection relative to ideal spinopelvic alignment reduces rates of pelvic nonresponse for severely malaligned adult spinal deformity patients

2019 ◽  
Vol 19 (9) ◽  
pp. S66-S67
Author(s):  
Peter G. Passias ◽  
Cole Bortz ◽  
Haddy Alas ◽  
Avery Brown ◽  
Katherine E. Pierce ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinopelvic Alignment

scholarly journals Three-Dimensional Printing for Preoperative Planning and Pedicle Screw Placement in Adult Spinal Deformity: A Systematic Review

2020 ◽  
pp. 219256822094417
Author(s):  
Cesar D. Lopez ◽  
Venkat Boddapati ◽  
Nathan J. Lee ◽  
Marc D. Dyrszka ◽  
Zeeshan M. Sardar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Screw Placement ◽  
Spinal Deformities ◽  
Three Dimensional Printing ◽  
Significant Difference ◽  
Dimensional Printing

Study Design: Systematic review. Objectives: This current systematic review seeks to identify current applications and surgical outcomes for 3-dimensional printing (3DP) in the treatment of adult spinal deformity. Methods: A comprehensive search of publications was conducted through literature databases using relevant keywords. Inclusion criteria consisted of original studies, studies with patients with adult spinal deformities, and studies focusing on the feasibility and/or utility of 3DP technologies in the planning or treatment of scoliosis and other spinal deformities. Exclusion criteria included studies with patients without adult spinal deformity, animal subjects, pediatric patients, reviews, and editorials. Results: Studies evaluating the effect of 3DP drill guide templates found higher screw placement accuracy in the 3DP cohort (96.9%), compared with non-3DP cohorts (81.5%, P < .001). Operative duration was significant decreased in 3DP cases (378 patients, 258 minutes) relative to non-3DP cases (301 patients,272 minutes, P < .05). The average deformity correction rate was 72.5% in 3DP cases (245 patients). There was no significant difference in perioperative blood loss between 3DP (924.6 mL, 252 patients) and non-3DP cases (935.6 mL, 177 patients, P = .058). Conclusions: Three-dimensional printing is currently used for presurgical planning, patient and trainee communication and education, pre- and intraoperative guides, and screw drill guides in the treatment of scoliosis and other adult spinal deformities. In adult spinal deformity, the usage of 3DP guides is associated with increased screw accuracy and favorable deformity correction outcomes; however, average costs and production lead time are highly variable between studies.

scholarly journals Neuromonitoring During Surgery for Paediatric Spinal Deformity in Canada (2007)

2009 ◽  
Vol 36 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Jonathan Norton ◽  
Douglas Hedden
Keyword(s):  
Spinal Deformity ◽  
Motor Evoked Potentials ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Standard Of Care ◽  
National Standards ◽  
Spinal Deformity Surgery ◽  
Correction Surgery ◽  
Training Programmes ◽  
Spinal Cord Function

Background:Neuromonitoring during paediatric (and adult) spinal deformity surgery helps to reduce the risk of both permanent and short term neurological damage. A shortage of neurophysiologists and technicians limits the availability of this service. Not all surgeons believe neuromonitoring offers neuroprotection during spinal surgery. This study aimed to document the degree to which paediatric patients undergoing spinal deformity correction surgery have their spinal cord function monitored.Methods:A questionnaire was sent electronically to all of the surgical members of the Canadian Paediatric Spinal Deformity Study Group.Results:Results were received from 9/9 centres indicating that monitoring was performed in 7/9 centres, with one further centre awaiting staffing. Whilst half of those centres that do monitor only monitor sensory and motor evoked potentials, the remaining centres also use EMG and EEG to assess the state of the patient intraoperatively.Conclusions:Despite a shortage of staff, most paediatric spinal deformity surgeons in Canada who wish to, are able to neurophysiologically monitor their surgical cases. Neuromonitoring appears to be becoming a standard of care, at least for paediatric spinal deformity surgery. There is an urgent need for the establishment of national standards for both technologists and interpreters, as well as training programmes for both these groups.

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