Use of Temporary Rod and Intraoperative Neuroimaging for Correction of Adolescent Idiopathic Scoliosis: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Jamal McClendon ◽  
Evelyn L Turcotte ◽  
Manish G Pai ◽  
Tanmoy Maiti ◽  
Rohin Singh ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Treatment Options ◽  
Spinal Curvature ◽  
Growth Spurt ◽  
3 Dimensional ◽  
Video Recordings ◽  
Before And After ◽  
Lateral Curvature

Abstract Adolescent idiopathic scoliosis (AIS) is an abnormal lateral curvature of the spine that arises during the pubescent growth spurt. AIS mainly affects females in the age group of 10 to 16 yr, with a prevalence of about 1% to 3% in the at-risk population.1 Treatment options vary depending on disease presentation and severity. Mild curvature mainly requires periodic observation for disease progression, whereas more moderate curvature can necessitate bracing or corrective surgery.2  Here, we present the use of a temporary rod and neuroimaging for the correction of Lenke type 1 spinal curvature in an AIS patient. An inferior facetectomy is performed, and a Lenke probe is used for entry into the pedicle and vertebral body. The channel is sounded before and after tapping to check for adequate walls prior to insertion of the pedicle screw. The ARTIS pheno is brought into the field, which uses fluoroscopy to create a 3-dimensional (3D) representation of the instrumentation within the spine. A temporary rod is placed in the concavity, and a combination of corrective techniques, including a rod roll, apical translation, and reduction, is performed to bring up the concavity, derotate the spine, and translate the spine. The permanent rod is then placed in the convexity, and compression is performed to bring down the scapular prominence. The temporary rod is then removed, and a final rod is placed to complete the 3D correction.  The patient consented to the procedure, and an informed written consent was obtained from the patient to use her photographs and video recordings for publication.

scholarly journals Study of the pressures applied by a Chêneau brace for correction of adolescent idiopathic scoliosis

2008 ◽  
Vol 32 (3) ◽  
pp. 345-355 ◽  
Author(s):  
V. M. Pham ◽  
A. Houilliez ◽  
A. Schill ◽  
A. Carpentier ◽  
B. Herbaux ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Mean Value ◽  
Spinal Curvature ◽  
Curve Pattern ◽  
Reference Position ◽  
Natural Tendency ◽  
Before And After ◽  
The Right ◽  
Thoracolumbar Curve

We performed a study on 32 idiopathic scoliotic patients (30 females, 2 males) treated with a Chêneau brace. Eighteen patients had a single right thoracic curve and 14 had a single right thoracolumbar curve. We used the TekScan® system (ClinSeat Type 5315 Sensor, TekScan, Boston MA, USA) to measure pressures at the skin-brace interface, assess the effect of strap tension and analyze the variation of these pressures with position and activity. The TekScan® device enabled identification of the pressure areas corresponding to the brace's three loading points. The pressure under the main pad had a greater mean value than the pressure under the two counter-pads. Tightening the straps led to a significant increase in the pressures, whatever the position studied or the curve pattern. Compared with the standing (reference) position, we observed significantly higher pressures during maximal inspiration ( p < 0.001) and lower pressures during maximal expiration, in the prone position and after having risen from a lying position, for both thoracic curves ( p < 0.001) and thoracolumbar curves ( p < 0.01). The pressures for thoracolumbar curves were lower than those for thoracic curves, whatever the position studied and both before and after strap adjustment. For lying positions, lying on the right side produced the greatest increase pressure. Even though the TekScan® system does not provide direct information on the correction of spinal curvature, it appears to be a useful tool in the treatment of scoliotic patients. Strap adjustment clearly influences the applied pressures – particularly those on the rib cage. During activity, there is a natural tendency to decrease the pressure; this justifies efforts to maintain strap tensions in general and during day wear in particular.

scholarly journals Can infrared camera images be used for screening in Adolescent Idiopathic Scoliosis?

2021 ◽  
Author(s):  
Oi Ka Natalie Lam ◽  
James Cheng Peng ◽  
Teng Zhang ◽  
Joanne Yip ◽  
Queenie Fok ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Curvature ◽  
Data Matrix ◽  
Growth Spurt ◽  
Screening Methods ◽  
X Rays ◽  
Ir Thermography ◽  
Ir Camera ◽  
Measure Surface Temperature

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis, and affects up to 4% of adolescents in early stages. The deformity can develop during any of the rapid periods of growth in children, and the time of pubertal growth spurt also plays a role in spinal curve progression. Hence it is crucial to detect the disease early, to provide timely intervention. Detection of scoliosis when it is mild or before the growth spurt can be conducted via various screening methods. Adam's forward bend test (FBT) and scoliometer measurement of the angle of trunk rotation (ATR) are commonly used, to observe lateral bending and rotation of the spine, causing a visible rib hump. Moire topography can also be used, but is reserved for second tier due to some degree of ambiguity. X-rays (XR) remain the best way to diagnose scoliosis, as it provides a clear image of the spine and allows measurement of Cobb angle; however it has risks associated including requirement of the use of ionising radiation. Infrared (IR) thermography can be used to measure surface temperature and is performed with an IR camera. The temperature distribution and data matrix can be visualised into a thermal map, which has previously been studied and associated with the thermal asymmetry in paraspinal muscles, as well as significant temperature differences between the convex and concave side of the spinal curvature for idiopathic scoliotic patients. We hypothesize that such asymmetry and temperature differences may produce a detectable pattern on IR thermography, which would prompt further confirmatory investigations to reach a fast and non-radiation screening of AIS.

scholarly journals Normal Age-Adjusted Sagittal Spinal Alignment Is Achieved with Surgical Correction in Adolescent Idiopathic Scoliosis

2017 ◽  
Vol 11 (5) ◽  
pp. 770-779 ◽  
Author(s):  
Subaraman Ramchandran ◽  
Norah Foster ◽  
Akhila Sure ◽  
Thomas J. Errico ◽  
Aaron J. Buckland
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Surgical Correction ◽  
Sagittal Vertical Axis

<sec><title>Study Design</title><p>Retrospective analysis.</p></sec><sec><title>Purpose</title><p>Our hypothesis is that the surgical correction of adolescent idiopathic scoliosis (AIS) maintains normal sagittal alignment as compared to age-matched normative adolescent population.</p></sec><sec><title>Overview of Literature</title><p>Sagittal spino-pelvic alignment in AIS has been reported, however, whether corrective spinal fusion surgery re-establishes normal alignment remains unverified.</p></sec><sec><title>Methods</title><p>Sagittal profiles and spino-pelvic parameters of thirty-eight postsurgical correction AIS patients ≤21 years old without prior fusion from a single institution database were compared to previously published normative age-matched data. Coronal and sagittal measurements including structural coronal Cobb angle, pelvic incidence, pelvic tilt, thoracic kyphosis, lumbar lordosis, sagittal vertical axis, C2–C7 cervical lordosis, C2–C7 sagittal vertical axis, and T1 pelvic angles were measured on standing full-body stereoradiographs using validated software to compare preoperative and 6 months postoperative changes with previously published adolescent norms. A sub-group analysis of patients with type 1 Lenke curves was performed comparing preoperative to postoperative alignment and also comparing this with previously published normative values.</p></sec><sec><title>Results</title><p>The mean coronal curve of the 38 AIS patients (mean age, 16±2.2 years; 76.3% female) was corrected from 53.6° to 9.6° (80.9%, <italic>p</italic>&lt;0.01). None of the thoracic and spino-pelvic sagittal parameters changed significantly after surgery in previously hypo- and normo-kyphotic patients. In hyper-kyphotic patients, thoracic kyphosis decreased (<italic>p</italic>=0.003) with a reciprocal decrease in lumbar lordosis (<italic>p</italic>=0.01), thus lowering pelvic incidence-lumbar lordosis mismatch mismatch (<italic>p</italic>=0.009). Structural thoracic scoliosis patients had slightly more thoracic kyphosis than age-matched patients at baseline and surgical correction of the coronal plane of their scoliosis preserved normal sagittal alignment postoperatively. A sub-analysis of Lenke curve type 1 patients (n=24) demonstrated no statistically significant changes in the sagittal alignment postoperatively despite adequate coronal correction.</p></sec><sec><title>Conclusions</title><p>Surgical correction of the coronal plane in AIS patients preserves sagittal and spino-pelvic alignment as compared to age-matched asymptomatic adolescents.</p></sec>

scholarly journals Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

2020 ◽  
Author(s):  
Yiwei Zhao ◽  
Wubo Liu ◽  
Suomao Yuan ◽  
Yonghao Tian ◽  
Xinyu Liu
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screws ◽  
Vertebral Rotation ◽  
Concave Side ◽  
Convex Side ◽  
X Rays ◽  
Group A ◽  
Group B

Abstract Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

scholarly journals Shear wave elastography of lumbar annulus fibrosus in adolescent idiopathic scoliosis before and after surgical intervention

2019 ◽  
Vol 30 (4) ◽  
pp. 1980-1985
Author(s):  
Claudio Vergari ◽  
Lucas Chanteux ◽  
Raphael Pietton ◽  
Tristan Langlais ◽  
Raphael Vialle ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Shear Wave ◽  
Annulus Fibrosus ◽  
Surgical Intervention ◽  
Shear Wave Elastography ◽  
Before And After

scholarly journals Risks and outcomes of spinal deformity surgery in Chiari malformation, Type 1, with syringomyelia versus adolescent idiopathic scoliosis

2015 ◽  
Vol 15 (9) ◽  
pp. 2002-2008 ◽  
Author(s):  
Jakub Godzik ◽  
Terrence F. Holekamp ◽  
David D. Limbrick ◽  
Lawrence G. Lenke ◽  
T.S. Park ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Chiari Malformation ◽  
Spinal Deformity Surgery ◽  
Chiari Malformation Type 1

scholarly journals Intraoperative Computed Tomography versus Perdriolle and Scoliometer Evaluation of Spine Rotation in Adolescent Idiopathic Scoliosis

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Rafal Pankowski ◽  
Szymon Wałejko ◽  
Marek Rocławski ◽  
Marcin Ceynowa ◽  
Tomasz Mazurek
Keyword(s):  
Computed Tomography ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Scoliosis Surgery ◽  
Significant Discrepancy ◽  
Indirect Methods ◽  
Rib Hump ◽  
Intraoperative Computed Tomography ◽  
Scoliosis Correction ◽  
Before And After

Numerous indirect methods for apical vertebral rotation (AVR) measurement have been reported and none of them seems to be as accurate as computed tomography evaluation. The aim of this study was to compare spinal rotation changes during innovative technique of intraoperative computed tomography (ICT) evaluation with indirect methods such as Perdriolle and clinical evaluation with scoliometer. We examined 42 adolescent idiopathic scoliosis (AIS) patients treated with posterior scoliosis surgery (PSS). The mean age at the time of surgery was 16 years. ICT evaluation was performed before and after scoliosis correction in prone position. Clinical rib hump measure with scoliometer and radiographic Perdriolle were performed before and after surgery. There was 71,5% of average rib hump correction with scoliometer but only 31% of correction with ICT (P=0,026) and there was no significant correlation between them (R=0,297,p=0,26). Mean postcorrectional Perdriolle AVR had a decrease of 16,5°. The average ICT AVR had a decrease of only 1,2° (P=0,003). There was no significant statistic correlation between ICT and Perdriolle AVR evaluation (R=0,297,p=0,2). There is a significant discrepancy in AVR and rib hump assessment between scoliometer and Perdriolle methods and ICT evaluation, which seems to be the most accurate tool for spinal derotation measurement.

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