Loss of Correction After Removal of Spinal Implants in Congenital Scoliosis

2020 ◽  
Vol 144 ◽  
pp. e916-e925
Author(s):  
Lin-nan Wang ◽  
Bo-wen Hu ◽  
Xi Yang ◽  
Lei Wang ◽  
Peng Xiu ◽  
...  
Keyword(s):  
Congenital Scoliosis ◽  
Loss Of Correction ◽  
Spinal Implants

Comparison of metal artifact reduction techniques in magnetic resonance imaging of carbon-reinforced PEEK and titanium spinal implants

2021 ◽  
pp. 028418512110290
Author(s):  
Georg Osterhoff ◽  
Florian A Huber ◽  
Laura C Graf ◽  
Ferdinand Erdlen ◽  
Hans-Christoph Pape ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pedicle Screws ◽  
Artifact Reduction ◽  
Metal Artifact ◽  
Metal Artifact Reduction ◽  
Signal Loss ◽  
Resonance Imaging ◽  
Spinal Implants ◽  
Titanium Screws

Background Carbon-reinforced PEEK (C-FRP) implants are non-magnetic and have increasingly been used for the fixation of spinal instabilities. Purpose To compare the effect of different metal artifact reduction (MAR) techniques in magnetic resonance imaging (MRI) on titanium and C-FRP spinal implants. Material and Methods Rod-pedicle screw constructs were mounted on ovine cadaver spine specimens and instrumented with either eight titanium pedicle screws or pedicle screws made of C-FRP and marked with an ultrathin titanium shell. MR scans were performed of each configuration on a 3-T scanner. MR sequences included transaxial conventional T1-weighted turbo spin echo (TSE) sequences, T2-weighted TSE, and short-tau inversion recovery (STIR) sequences and two different MAR-techniques: high-bandwidth (HB) and view-angle-tilting (VAT) with slice encoding for metal artifact correction (SEMAC). Metal artifact degree was assessed by qualitative and quantitative measures. Results There was a much stronger effect on artifact reduction with using C-FRP implants compared to using specific MRI MAR-techniques (screw shank: P < 0.001; screw tulip: P < 0.001; rod: P < 0.001). VAT-SEMAC sequences were able to reduce screw-related signal loss artifacts in constructs with titanium screws to a certain degree. Constructs with C-FRP screws showed less artifact-related implant diameter amplification when compared to constructs with titanium screws ( P < 0.001). Conclusion Constructs with C-FRP screws are associated with significantly less artifacts compared to constructs with titanium screws including dedicated MAR techniques. Artifact-reducing sequences are able to reduce implant-related artifacts. This effect is stronger in constructs with titanium screws than in constructs with C-FRP screws.

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

scholarly journals Novel FGFR1 Variants Are Associated with Congenital Scoliosis

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1126
Author(s):  
Shengru Wang ◽  
Xiran Chai ◽  
Zihui Yan ◽  
Sen Zhao ◽  
Yang Yang ◽  
...  
Keyword(s):  
Protein Function ◽  
Hypogonadotropic Hypogonadism ◽  
Congenital Scoliosis ◽  
Wild Type ◽  
Conservation Analysis ◽  
Gene Assay ◽  
Protein Expressions ◽  
Patient Series ◽  
Reduced Activity

FGFR1 encodes a transmembrane cytokine receptor, which is involved in the early development of the human embryo and plays an important role in gastrulation, organ specification and patterning of various tissues. Pathogenic FGFR1 variants have been associated with Kallmann syndrome and hypogonadotropic hypogonadism. In our congenital scoliosis (CS) patient series of 424 sporadic CS patients under the framework of the Deciphering disorders Involving Scoliosis and COmorbidities (DISCO) study, we identified four unrelated patients harboring FGFR1 variants, including one frameshift and three missense variants. These variants were predicted to be deleterious by in silico prediction and conservation analysis. Signaling activities and expression levels of the mutated protein were evaluated in vitro and compared to that of the wild type (WT) FGFR1. As a result, the overall protein expressions of c.2334dupC, c.2339T>C and c.1261A>G were reduced to 43.9%, 63.4% and 77.4%, respectively. By the reporter gene assay, we observed significantly reduced activity for c.2334dupC, c.2339T>C and c.1261A>G, indicating the diminished FGFR1 signaling pathway. In conclusion, FGFR1 variants identified in our patients led to only mild disruption to protein function, caused milder skeletal and cardiac phenotypes than those reported previously.

scholarly journals Survey to describe variability in early onset scoliosis cast practices

2018 ◽  
Vol 12 (4) ◽  
pp. 406-412 ◽  
Author(s):  
A. Grzywna ◽  
A. McClung ◽  
J. Sanders ◽  
P. Sturm ◽  
L. Karlin ◽  
...  
Keyword(s):  
Early Onset ◽  
Congenital Scoliosis ◽  
Patient Characteristics ◽  
Study Groups ◽  
Early Onset Scoliosis ◽  
Radiographic Evaluation ◽  
Level Of Evidence ◽  
Major Curve ◽  
Radiographic Measurements ◽  
Multicentre Research

Purpose To investigate paediatric orthopaedists’ cast practices for early onset scoliosis regarding patient selection, cast application, radiographic evaluation, treatment cessation and adjunctive bracing. Methods A casting survey was distributed to all paediatric orthopaedists in Children’s Spine and Growing Spine Study Groups (n = 92). Questions included physician and patient characteristics, technique, treatment, outcomes, radiographic measurements and comparison to other treatments. A total of 55 orthopaedists (60%) responded, and descriptive statistics were calculated on the subset who cast (n = 45). Results A majority of respondents use cast treatment for idiopathic and syndromic scoliosis patients, but not for neuromuscular or congenital scoliosis patients. Major curve angle ranked most important in orthopaedists’ decision to commence cast treatment, in comparison with rib-vertebra angle difference or clinical observations. The major curve angle threshold to initiate casting was a median of 30° (20° to 70°), and the minimum patient age was median ten months (3 to 24). First in-cast and out-of-cast radiographs are taken standing, supine, awake, under anesthesia and/or in traction. In all, 58% consistently cast over or under the arm, while 44% vary position by patient. Respondents were divided about the use of a brace after cast treatment: 22% do not prescribe a brace, 31% always do and 36% do in some patients. Conclusions Future multicentre research studies must standardize radiographic practices and consider age and major curve angle at cast initiation and termination, scoliosis aetiology, shoulder position and treatment duration. Practices need to be aligned or compared in these areas in order to distinguish what makes for the best cast treatment possible. Level of Evidence V, Expert opinion

scholarly journals Postoperative spinal infection mimicking systemic vasculitis with titanium-spinal implants

Scoliosis ◽  
2011 ◽  
Vol 6 (1) ◽  
Author(s):  
Vasileios I Sakellariou ◽  
Erato Atsali ◽  
Konstantinos Starantzis ◽  
Chrysanthi Batistaki ◽  
Triantafyllia Brozou ◽  
...  
Keyword(s):  
Systemic Vasculitis ◽  
Spinal Infection ◽  
Spinal Implants

scholarly journals Sim2 Mutants Have Developmental Defects Not Overlapping with Those of Sim1 Mutants

2002 ◽  
Vol 22 (12) ◽  
pp. 4147-4157 ◽  
Author(s):  
Eleni Goshu ◽  
Hui Jin ◽  
Rachel Fasnacht ◽  
Mike Sepenski ◽  
Jacques L. Michaud ◽  
...  
Keyword(s):  
Genetic Interaction ◽  
Expression Patterns ◽  
Gene Mutations ◽  
Congenital Scoliosis ◽  
Developmental Defects ◽  
Lung Inflation ◽  
Left And Right ◽  
Temporal And Spatial ◽  
Cns Midline ◽  
Midline Cells

ABSTRACT The mouse genome contains two Sim genes, Sim1 and Sim2. They are presumed to be important for central nervous system (CNS) development because they are homologous to the Drosophila single-minded (sim) gene, mutations in which cause a complete loss of CNS midline cells. In the mammalian CNS, Sim2 and Sim1 are coexpressed in the paraventricular nucleus (PVN). While Sim1 is essential for the development of the PVN (J. L. Michaud, T. Rosenquist, N. R. May, and C.-M. Fan, Genes Dev. 12:3264-3275, 1998), we report here that Sim2 mutant has a normal PVN. Analyses of the Sim1 and Sim2 compound mutants did not reveal obvious genetic interaction between them in PVN histogenesis. However, Sim2 mutant mice die within 3 days of birth due to lung atelectasis and breathing failure. We attribute the diminished efficacy of lung inflation to the compromised structural components surrounding the pleural cavity, which include rib protrusions, abnormal intercostal muscle attachments, diaphragm hypoplasia, and pleural mesothelium tearing. Although each of these structures is minimally affected, we propose that their combined effects lead to the mechanical failure of lung inflation and death. Sim2 mutants also develop congenital scoliosis, reflected by the unequal sizes of the left and right vertebrae and ribs. The temporal and spatial expression patterns of Sim2 in these skeletal elements suggest that Sim2 regulates their growth and/or integrity.

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