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.

Perforation Rate of Pedicle Screws Using Hybrid Operating Room Combined With Intraoperative Computed Tomography Navigation for Adolescent Idiopathic Scoliosis

Spine ◽  
2020 ◽  
Vol 45 (20) ◽  
pp. E1357-E1364
Author(s):  
Hiroki Oba ◽  
Shota Ikegami ◽  
Shugo Kuraishi ◽  
Masashi Uehara ◽  
Takashi Takizawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Operating Room ◽  
Pedicle Screws ◽  
Hybrid Operating Room ◽  
Perforation Rate ◽  
Intraoperative Computed Tomography

scholarly journals Gerinckorrekciós műtétek háromdimenziós hatékonysági vizsgálata serdülőkori idiopathiás gerincferdülésben

2021 ◽  
Vol 162 (39) ◽  
pp. 1573-1578
Author(s):  
Kristóf József ◽  
István Márkus ◽  
Csaba Bogyó ◽  
Miklós Tunyogi Csapó ◽  
Ádám Tibor Schlégl
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Age Groups ◽  
The Elderly ◽  
Vertebral Rotation ◽  
Three Dimensions ◽  
Coronal Plane ◽  
Apical Vertebral Rotation ◽  
Scoliosis Correction ◽  
Before And After

Összefoglaló. Bevezetés: Nincs egységesen elfogadott álláspont, hogy a serdülőkori idiopathiás gerincferdülés sebészi korrekcióját melyik életkorban optimális elvégezni. Világszerte 11 éves kortól akár (kezeletlen esetben) 50–60 éves korig végeznek fúziós műtétet a betegségben, 63–83%-os átlagos koronális síkú korrekciós hatékonysággal. Célkitűzés: Célul tűztük ki, hogy felmérjük a gerinckorrekciós műtétek hatékonyságát három dimenzióban, illetve a páciens életkorának függvényében. Módszerek: A vizsgálatba 23, serdülőkori idiopathiás gerincferdüléssel diagnosztizált beteget (12 fő 17 évnél fiatalabb, 11 fő 17 évnél idősebb) vontunk be. Minden betegnél csavaros derotációt és spondylodesist végeztünk, és a beavatkozás előtt és után EOS 2D/3D felvételeket, majd sterEOS 3D rekonstrukciókat készítettünk. A következő paramétereket számítottuk: Cobb-fok, háti kyphosis, ágyéki lordosis, apicalis csigolyarotáció, maximális csigolyarotáció. A különböző életkorú csoportok közötti különbséget kétmintás t-próbával, illetve Wilcoxon-féle próbával vizsgáltuk. Eredmények: A gerinckorrekciós műtétek során a koronális síkú eltérést 78,2%-ban (átlagosan 55,1 Cobb-fokról 12,0 Cobb-fokra), az apicalis csigolyarotációt 56,7%-ban (átlagosan 21,0 fokról 9,1 fokra) tudtuk korrigálni. A 17 éves életkor után operált páciensek esetén átlagosan 79,2%-os Cobb-fok-csökkenést értünk el, míg a fiatalabb betegcsoportban 77,0%-ban korrigáltuk a koronális főgörbületet (p = 0,614). Az idősebb betegcsoportban szignifikánsan kevésbé sikerült az apicalis csigolyarotáció korrekciója (átlagosan 38,1%; 21,8 fokról 12,4 fokra), mint a fiatalabb pácienseknél (átlagosan 68,5%; 20,2 fokról 6,2 fokra; p = 0,016). Következtetés: Összességében a nemzetközi publikációknak megfelelő korrekciót értünk el. A koronális síkban közel azonos korrekciós hatékonyság figyelhető meg a különböző életkorú betegcsoportok között, a csigolyarotáció azonban 17 éves életkor előtt hatékonyabban korrigálható. Orv Hetil. 2021; 162(39): 1573–1578. Summary. Introduction: There is no clear recommendation for the optimal age to perform corrective surgery in adolescent idiopathic scoliosis. Fusion surgery is performed from the age of 11 to 50–60 years, with an average coronal plane correction efficiency of 63–83%. Objective: We aimed to evaluate the effectiveness of correction surgeries in three dimensions in adolescent idiopathic scoliosis. In addition, our objective was to examine the influence of the patient’s age on the correction. Methods: The study included 23 patients with adolescent idiopathic scoliosis (12 patients younger than 17 years, 11 patients older than 17 years). All patients underwent screw-derotation and spondylodesis and underwent EOS 2D/3D imaging before and after the operation, followed by sterEOS 3D reconstructions. The following parameters were calculated: Cobb degree, thoracic kyphosis, lumbar lordosis, apical vertebral rotation, maximal vertebral rotation. Differences between different age groups were examined by paired-sample t-test and Wilcoxon rank sum test. Results: The mean efficiency of correction surgeries was 78.2% in the coronal plane (from an average of 55.1 Cobb degrees to 12.0 Cobb degrees) and 56.7% in the axial plane (from an average of 21.0 degrees to 9.1 degrees). We achieved an average 79.2% reduction of Cobb angle in patients operated after the age of 17 years, which was 77.0% in the younger group (p = 0.614). Apical vertebral rotation correction was significantly less successful in the elderly group (mean 38.1%; from 21.8 degrees to 12.4 degrees) than in patients operated before the age of 17 years (mean 68.5%; from 20.2 degrees to 6.2 degrees; p = 0.016). Conclusion: We achieved scoliosis correction in line with the international publications. Nearly the same correction efficiency was observed between different age groups of patients in the coronal plane. However, vertebral rotation can be derotated more effectively before the age of 17 years. Orv Hetil. 2021; 162(39): 1573–1578.

RADIOGRAPHIC PARAMETERS OF SPINE CORONAL PLANE BEFORE AND AFTER THE SURGICAL ADOLESCENT IDIOPATHIC SCOLIOSIS CORRECTION

2016 ◽  
Vol 22 (2) ◽  
pp. 152-157
Author(s):  
Kęstutis Saniukas ◽  
Giedrius Bernotavičius ◽  
Irena Karmonaitė ◽  
Rimantas Zagorskis
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Coronal Plane ◽  
Microsoft Excel ◽  
Radiographic Parameters ◽  
Scoliosis Correction ◽  
Before And After

Reikšminiai žodžiai: koronarinis balansas, jaunatvinė idiopatinė skoliozė, žemiausio fiksuoto slankstelio nuokrypis, viršūninio slankstelio pasivertimas, Kobo kampas. Skoliozė – tai trijų dimensijų stuburo deformacija, apibūdinama kaip šoninis stuburo iškrypimas koronarinėje plokštumoje daugiau kaip 10°. Operacinis gydymas rekomeduojamas jaunuoliams, kai Kobo kampas viršija 45°–50°. Chirurginio gydymo esmė – saugi derotacija, lemianti stuburo balanso atkūrimą, o ne maksimali stuburo korekcija koronarinėje plokštumoje. Tikslas. Įvertinti radiologinius stuburo koronarinės plokštumos parametrus prieš ir po chirurginio jaunatvinės idiopatinės skoliozės (Lenke 1 tipo) gydymo. Tyrimo medžiaga ir metodai. Tiriamieji – 46 pacientai, chirurgiškai gydyti dėl jaunatvinės idiopatinės skoliozės (Lenke 1 tipo) bei stebėti 2 metus. Visi operuoti vienoje ligoninėje. Dviejų krypčių rentgenogramos stovint buvo atliktos prieš operaciją ir iškart po jos bei praėjus 1,3 mėnesio ir 2 metams po operacijos. Naudojantis jomis ir norint įvertinti stuburo išsilyginimą koronarinėje plokštumoje, buvo apskaičiuotas Kobo kampas, koronarinis balansas ir šoninio lenkimo testo, kuris atliktas tik prieš operaciją, rezultatai. Norint įvertinti nefiksuotų slankstelių pokyčius po operacijos, vertintas žemiausio fiksuoto slankstelio kampas ir viršutinis viršūninio slankstelio pasivertimas. Duomenys apdoroti SAS ir „Microsoft Excel 2013“ programomis. Rezultatai. 40 moterų ir 6 vyrai, sergantys jaunatvine idiopatine skolioze, buvo įtraukti į šią studiją. Vidutinis pacientų amžius – 14,1 metų. Vidutinė korekcija po operacijos krūtininėje stuburo dalyje buvo 32,76° (santykinė korekcija 65,04 proc.), juosmeninėje – 27,41° (69,66 proc.). Per dvejus metus po operacijos buvo prarasta 0,27° ± 4,52° (tai 1,53 proc. pasiektos korekcijos, p < 0,05) pasiektos krūtininėje stuburo dalyje bei 1,61° ± 5,55° (13,48 proc., p < 0,05) juosmeninėje. Korekcija krūtininėje stuburo dalyje buvo 38,85 proc. didesnė (p < 0,05) nei prognozuota pagal šoninio lenkimo testo rezultatus. Koronarinis balansas buvo pagerintas 3,62 mm pacientų su subalansuotu stuburu prieš operaciją grupėje, bet suprastėjo 7,67 mm pacientų, prieš operaciją buvusių su subalansuotu stuburu, grupėje. Buvo rasta silpna koreliacija (rs = 0.34668 ir p-valu = 0.0183) tarp žemiausio fiksuoto slankstelio kampo bei nefiksuotų slankstelių skaičiaus. Išvados. Pooperacinės Lenke 1 tipo skoliozės gydymo išeitys negali būti nustatytos pagal linkio kryptį. Laikotarpiu po operacijos dalis per operaciją pasiektos korekcijos prarandama, žymiau tai pastebima juosmeninėje stuburo dalyje. Matuoti koronarinį balansą iš karto po operacijos nėra būtinybės, nes tai kliniškai nėra svarbu. Fiksuotas segmentas virš nefiksuoto segmento gali pakeisti nefiksuoto segmento biomechaniką. Šoninio lenkimo testas galėtų turėti vertės prognozuojant būsimos operacijos rezultatus juosmeninėje dalyje, tačiau krūtininėje dalyje šis testas prognostiškai nepatikimas, nes pasiekiama didesnė, nei tikėtasi, korekcija.

scholarly journals Does Posterior Scoliosis Correction Improve Respiratory Function in Adolescent Idiopathic Scoliosis? A Systematic Review and Meta-analysis

2018 ◽  
Vol 9 (8) ◽  
pp. 866-873
Author(s):  
So Kato ◽  
Jean-Christophe Murray ◽  
Mario Ganau ◽  
Yongyao Tan ◽  
Yasushi Oshima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Respiratory Function ◽  
Meta Analysis ◽  
Scoliosis Surgery ◽  
Scoliosis Correction ◽  
Predicted Values

Study Design: A systematic review and meta-analysis. Objectives: Pulmonary dysfunction is often advocated among the indications for surgical correction of adolescent idiopathic scoliosis (AIS). Previous studies have discussed the effect of scoliosis correction on respiratory function without reaching a definitive conclusion: Some showed that the respiratory function can improve after scoliosis surgery without defining the precise role of anterior, posterior, and combined approaches on this improvement; furthermore, the majority of these studies did not take normal growth into account. As a result, the role of surgery remains to be clarified. The object of the present study was to synthesize the current knowledge regarding changes in respiratory function after posterior corrective surgery for AIS. Methods: A comprehensive systematic search was performed to identify all relevant studies in the following electronic databases: MEDLINE, EMBASE, CINAHL (EBSCO). We focused on the studies (1) that discussed posterior fusion surgery for AIS without thoracoplasty, (2) that discussed comparisons of pre- and postoperative percent-predicted values of forced vital capacity (%FVC) or forced expiratory volume (%FEV), and (3) with minimum 2-year follow-up. Forest plots were depicted and Z value was calculated as a test for overall effect. Results: Ten studies (6 prospective and 4 retrospective studies) met our inclusion criteria. The overall effect showed that there was no significant difference in %FVC or %FEV between pre- and postoperative measurements (very low evidence). Conclusions: Posterior correction surgery for mild to moderate AIS patients showed no significant improvement of postoperative respiratory function measured by relative, percent-predicted values at minimum 2-year follow-up.

scholarly journals An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery

2016 ◽  
Vol 98 (5) ◽  
pp. 320-323 ◽  
Author(s):  
B van Herwijnen ◽  
NR Evans ◽  
CJ Dare ◽  
EM Davies
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surgical Site Infection ◽  
Povidone Iodine ◽  
High Risk Patient ◽  
Scoliosis Surgery ◽  
Site Infection ◽  
Scoliosis Correction ◽  
Vancomycin Powder ◽  
Baseline Characteristics

Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients’ baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups.

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