Mortality in Neuromuscular Early Onset Scoliosis Following Spinal Deformity Surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hiroko Matsumoto ◽  
Adam N. Fano ◽  
Elizabeth T. Herman ◽  
Brian Snyder ◽  
Benjamin D. Roye ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Early Onset ◽  
Early Onset Scoliosis ◽  
Spinal Deformity Surgery

Optimizing Safety and Outcomes in Spinal Deformity Surgery: Early-Onset Scoliosis

2012 ◽  
Vol 1 (1) ◽  
pp. 53-63 ◽  
Author(s):  
Behrooz A. Akbarnia ◽  
Robert M. Campbell ◽  
Richard E. McCarthy
Keyword(s):  
Spinal Deformity ◽  
Early Onset ◽  
Early Onset Scoliosis ◽  
Spinal Deformity Surgery

Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”?

2017 ◽  
Vol 51 (2) ◽  
pp. 79-83
Author(s):  
Nirmal R Gopinathan ◽  
Vibhu K Viswanathan
Keyword(s):  
Spinal Deformity ◽  
Treatment Modality ◽  
Early Onset ◽  
Early Onset Scoliosis ◽  
Definitive Treatment ◽  
Complication Rates ◽  
Serial Casting ◽  
Current Article ◽  
Chest Deformities

ABSTRACT Casting as a treatment of scoliosis has been practiced since 1800s. However, the practice fell into disfavor following the serious chest deformities and thoracic constrictions secondary to casting, as well as tremendous improvements in the surgical modalities. Recently, there has been a resurgence of this technique in early-onset scoliosis (EOS) and it has been considered to be a definitive treatment modality and a delaying tactic prior to the inevitable surgery. It carries the triple advantages including correction of the spinal deformity, allowing spinal growth uninterruptedly as well as low complication rates. The current article elaborately discusses the role of serial casting in EOS. How to cite this article Viswanathan VK, Gopinathan NR. Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”? J Postgrad Med Edu Res 2017;51(2):79-83.

The Vertical Expandable Prosthetic Titanium Rib in the treatment of spinal deformity due to progressive early onset scoliosis

2009 ◽  
Vol 18 (4) ◽  
pp. 197-203 ◽  
Author(s):  
Norman Ramirez ◽  
John M. Flynn ◽  
Jose Anibal Serrano ◽  
Simon Carlo ◽  
Alberto S. Cornier
Keyword(s):  
Spinal Deformity ◽  
Early Onset ◽  
Early Onset Scoliosis

scholarly journals Treatment strategies for early-onset scoliosis

2018 ◽  
Vol 3 (5) ◽  
pp. 287-293 ◽  
Author(s):  
Ilkka J. Helenius
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Spinal Deformity ◽  
Early Onset ◽  
Treatment Strategies ◽  
Congenital Scoliosis ◽  
Early Onset Scoliosis ◽  
Growing Rods ◽  
Paediatric Orthopaedic ◽  
Short Spine

Early-onset scoliosis (EOS) is defined as a spinal deformity occurring before the age of ten years. Untreated EOS or early spinal fusion resulting in a short spine is associated with increased mortality and cardiopulmonary compromise. EOS may progress rapidly, and therefore prompt clinical diagnosis and referral to a paediatric orthopaedic or spine unit is necessary. Casting under general anaesthesia can be effective and may prevent or delay the need for surgery in curves of less than 60°. ‘Growing’ rods (traditional or magnetically-controlled) represent the standard surgical treatment in progressive curves of 45° or greater. Children with congenital scoliosis associated with fused ribs benefit from surgery with a vertical titanium prosthetic rib. Surgery with growth-friendly instrumentation is associated with a high risk of complications.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170051

Characteristics of false-positive alerts on transcranial motor evoked potential monitoring during pediatric scoliosis and adult spinal deformity surgery: an “anesthetic fade” phenomenon

2020 ◽  
Vol 32 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Hiroki Ushirozako ◽  
Go Yoshida ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
False Positive ◽  
Adult Spinal Deformity ◽  
False Positive Rate ◽  
Multivariate Logistic Regression Analysis ◽  
Motor Evoked Potential ◽  
Scoliosis Surgery ◽  
True Negative ◽  
Duration Of Surgery ◽  
Spinal Deformity Surgery

OBJECTIVETranscranial motor evoked potential (TcMEP) monitoring may be valuable for predicting postoperative neurological complications with a high sensitivity and specificity, but one of the most frequent problems is the high false-positive rate. The purpose of this study was to clarify the differences in the risk factors for false-positive TcMEP alerts seen when performing surgery in patients with pediatric scoliosis and adult spinal deformity and to identify a method to reduce the false-positive rate.METHODSThe authors retrospectively analyzed 393 patients (282 adult and 111 pediatric patients) who underwent TcMEP monitoring while under total intravenous anesthesia during spinal deformity surgery. They defined their cutoff (alert) point as a final TcMEP amplitude of ≤ 30% of the baseline amplitude. Patients with false-positive alerts were classified into one of two groups: a group with pediatric scoliosis and a group with adult spinal deformity.RESULTSThere were 14 cases of false-positive alerts (13%) during pediatric scoliosis surgery and 62 cases of false-positive alerts (22%) during adult spinal deformity surgery. Compared to the true-negative cases during adult spinal deformity surgery, the false-positive cases had a significantly longer duration of surgery and greater estimated blood loss (both p < 0.001). Compared to the true-negative cases during pediatric scoliosis surgery, the false-positive cases had received a significantly higher total fentanyl dose and a higher mean propofol dose (0.75 ± 0.32 mg vs 0.51 ± 0.18 mg [p = 0.014] and 5.6 ± 0.8 mg/kg/hr vs 5.0 ± 0.7 mg/kg/hr [p = 0.009], respectively). A multivariate logistic regression analysis revealed that the duration of surgery (1-hour difference: OR 1.701; 95% CI 1.364–2.120; p < 0.001) was independently associated with false-positive alerts during adult spinal deformity surgery. A multivariate logistic regression analysis revealed that the mean propofol dose (1-mg/kg/hr difference: OR 3.117; 95% CI 1.196–8.123; p = 0.020), the total fentanyl dose (0.05-mg difference; OR 1.270; 95% CI 1.078–1.497; p = 0.004), and the duration of surgery (1-hour difference: OR 2.685; 95% CI 1.131–6.377; p = 0.025) were independently associated with false-positive alerts during pediatric scoliosis surgery.CONCLUSIONSLonger duration of surgery and greater blood loss are more likely to result in false-positive alerts during adult spinal deformity surgery. In particular, anesthetic doses were associated with false-positive TcMEP alerts during pediatric scoliosis surgery. The authors believe that false-positive alerts during pediatric scoliosis surgery, in particular, are caused by “anesthetic fade.”

Seromas Following Pediatric Spinal Deformity Surgery

2020 ◽  
Vol 40 (4) ◽  
pp. e277-e282
Author(s):  
James Yu ◽  
Anne M. Dumaine ◽  
Connie Poe-Kochert ◽  
George H. Thompson ◽  
R. Justin Mistovich
Keyword(s):  
Spinal Deformity ◽  
Spinal Deformity Surgery

scholarly journals Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

2020 ◽  
pp. 219256822097822
Author(s):  
Muyi Wang ◽  
Liang Xu ◽  
Bo Yang ◽  
Changzhi Du ◽  
Zezhang Zhu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Recurrent Infection ◽  
Implant Removal ◽  
Site Infection ◽  
Initial Surgery ◽  
Spinal Deformity Surgery ◽  
Solid Fusion ◽  
Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

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