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 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 Halo-gravity traction in the treatment of complex spinal deformities in children with respiratory dysfunctions

2021 ◽  
pp. 10-14
Author(s):  
A.F. Levytskyi ◽  
◽  
V.O. Rogozinskyi ◽  
M.M. Dolianytskyi ◽  
L.V. Duda ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
World Literature ◽  
Three Dimensional ◽  
Pulmonary Insufficiency ◽  
Spinal Deformities ◽  
Scoliotic Deformity ◽  
Life Prognosis ◽  
Ventilation Failure ◽  
Safe Technique ◽  
Grade 3

HGT is a safe technique as the world literature describes complications in the form of loosening of the pins or superficial infections of the skin around the pins, which are not significant and do not pose a threat to the patient’s life. Purpose – to improve the results of the ventilation function of the lungs in patients with complex spinal deformities through the preliminary use of halo gravity traction and to introduce an effective and safe method for the treatment of complex spinal deformities in children with respiratory dysfunctions. Materials and methods. 64 children with complex spinal deformities (>100°) were treated in the orthopedic and traumatology department of the Okhmatdet NSPU using halo gravity traction during the period from 2003 until 2018. Of these, 38 are boys and 26 are girls. The average age of the patients was 11.6 years. The average Risser score was 3.8 (P>0.01). Results. According to the data of spirography performed, 46% of patients had moderate ventilation disorders and 54% – severe ventilation disorders (FVC<60% – grade 3 and 4 of ventilation failure). Mixed type disorders were recorded in 83% of patients, and restrictive type disorders in 17% (8/48) of children. After HGT, there was an improvement in pulmonary function indicators: an increase in FVC from 63.19% to 71.77% and FEV1 from 54.71% to 65.46%, Tiffeneau-Pinelli index – from 74.59% to 85.33%. Compared with the initial level of indicators, the improvement in FVC was 13.6% after HGT and 14.6% in dynamics during the year, and FEV1 – 19.6% and 21.6%, respectively. The results obtained indicate a significant improvement in the ventilation function of the lungs, especially due to the degree of FEV1 increase, which correlates with the degree of improvement in performance, mortality and life prognosis. Conclusions. The use of HGT makes it possible to improve the results of the final correction of spinal deformity, which in turn significantly improves the ventilation function of the lungs, which in turn helps to reduce the risks of mortality due to pulmonary insufficiency in adulthood. The choice of the appropriate methods of surgical correction for complex deformity of the spine is a prerequisite for successful treatment and the achievement of three-dimensional correction of the spine to maximally approximate its parameters to the physiological norm. The indication for halo gravity traction is a rigid scoliotic deformity of the spine with a deformity angle (>100°). This study was conducted in accordance with the principles of the Helsinki Declaration. The research protocol was approved by the Local Ethics Committee of the institutions mentioned in the work. Informed parental agreement was obtained for the research. No conflict of interests was declared by the authors. Key words: spinal deformity, respiratory dysfunctions, halo-gravity traction.

Radiological severity of hip osteoarthritis in patients with adult spinal deformity: the effect on spinopelvic and lower extremity compensatory mechanisms

2018 ◽  
Vol 27 (9) ◽  
pp. 2294-2302 ◽  
Author(s):  
Louis M. Day ◽  
Edward M. DelSole ◽  
Bryan M. Beaubrun ◽  
Peter L. Zhou ◽  
John Y. Moon ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Hip Osteoarthritis ◽  
Compensatory Mechanisms

scholarly journals A novel integrated global coronal aligner helps prevent post-operative standing coronal imbalance in adult spinal deformity patients fused to pelvis: technical notes and preliminary results

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jiandang Zhang ◽  
Pengfei Chi ◽  
Junyao Cheng ◽  
Zheng Wang
Keyword(s):  
Regression Analysis ◽  
Spinal Deformity ◽  
Odds Ratio ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
The Novel ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Coronal Balance ◽  
Coronal Imbalance

Abstract Background Chieving postoperative coronal balance in adult spinal deformity correction surgeries can be challenging. Even with T square rod technique, there were still some cases with good intraoperative coronal alignment but unsatisfactory post-operative standing coronal imbalance. Thus, the novel techniques to obtain global coronal balance are still in great needs. The purpose of this study was to describe a novel integrated global coronal aligner (IGCA) and evaluate its efficacy on avoidance of post-operative coronal imbalance in adult spinal deformity patients fused to pelvis. Methods A detailed description of IGCA technique was presented. 52 ASD patients fused to pelvis were divided into two groups (IGCA group, n = 27; and non-IGCA group, n = 25) according to whether intraoperative IGCA was used or not. Preoperative demographics and postoperative outcomes were compared. Results There were no significant differences regarding coronal balance difference (CBD) and imbalance/balance ratio between IGCA and non-IGCA groups preoperatively. After surgery, CBD in IGCA group was significantly improved from 24.7 ± 20.3 mm preoperatively to 12.6 ± 6.4 mm postoperatively (t = 3.185 p = 0.004), and imbalance/balance ratio decreased significantly from 55.6% (15/27) preoperatively to 11.1% (3/27) postoperatively (χ2 = 12.000, p = 0.001), while CBD and imbalance/balance ratio in non-IGCA group were not significantly improved. Compared to non-IGCA group, the amount of correction in CBD was significantly larger in IGCA group (t = 3.274, P = 0.002), and imbalance/balance ratio in IGCA group was significantly lowered (χ2 = 8.606 p = 0.003). Further logistic regression analysis revealed IGCA technique was associated with increased odds ratio for postoperative coronal balance (odds ratio: 7.385; 95% confidence interval 1.760–30.980; P = 0.006). Conclusions The novel intraoperative IGCA technique could help improve CBD and reduce imbalance/balance ratio. It could help prevent post-operative coronal imbalance in adult spinal deformity patients fused to pelvis. Level of evidence 3

scholarly journals Can Proximal Junctional Kyphosis After Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change With 3D Gait Analysis? A Case–control Study

2021 ◽  
Author(s):  
Tomoyuki Asada ◽  
Kousei Miura ◽  
Masao Koda ◽  
Hideki Kadone ◽  
Toru Funayama ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Thoracic Spine ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Multiple Logistic Regression Analysis ◽  
Three Dimensional ◽  
Proximal Junctional Kyphosis ◽  
Corrective Surgery ◽  
Spinal Alignment ◽  
Junctional Kyphosis

Abstract PurposeTo investigate whether preoperative dynamic spinal alignment that worsened during gait as detected by three-dimensional (3D) gait analysis can be a predictive factor for proximal junctional kyphosis (PJK) after corrective surgery for adult spinal deformity (ASD) with a minimum 1-year follow-up.MethodWe included 27 patients with ASD who underwent 3D gait analysis before corrective surgery and had >1-year follow-up. Dynamic spinal alignment parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK) with reflective markers. Spinal alignment was assessed in each region and pelvic alignment was assessed with surface markers. Patients were asked to walk for as long as possible around an oval walkway. We obtained the averaged dynamic parameters in the final lap and compared them between patients with PJK(+) and those with PJK(–).ResultsPJK occurred in 7 patients (26%). Preoperative angle between the thoracic spine and the pelvis was larger in patients with PJK(+) than in those with PJK(–) (32.3 ± 8.1 vs 18.7 ± 13.5, P = 0.020) with sufficient sample size. Multiple logistic regression analysis identified the angle between the thoracic spine and pelvis as an independent risk for PJK.ConclusionPreoperative thoracic kyphosis exacerbated by gait as determined in 3D gait analysis is a preoperative independent risk factor of PJK in patients undergoing ASD corrective surgery.

scholarly journals ADAPTATION OF THE FRAILTY INDEX FOR BRAZILIAN PORTUGUESE IN ADULT SPINE DEFORMITY SURGERY

2020 ◽  
Vol 19 (3) ◽  
pp. 168-171
Author(s):  
RAPHAEL R PRATALI ◽  
CARLOS F W E ROMERIO ◽  
MURILO T DAHER ◽  
RODRIGO AMARAL ◽  
IGOR M CARDOSO ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Frailty Index ◽  
Brazilian Population ◽  
Original Version ◽  
Consensus Building ◽  
Spine Deformity ◽  
Level Of Evidence ◽  
New Variables ◽  
Adult Spine

ABSTRACT Objectives To adapt the adult spinal deformity frailty index (ASD-FI), which was presented as an instrument for stratification of risk of surgical complications, for application in the Brazilian population. Methods This is a consensus-building study, following the Delphi method, in which a team of six Brazilian spine surgery specialists worked alongside the International Spine Study Group (ISSG), the group responsible for preparing the original version of the ASD-FI, in order to adapt the index for the Brazilian population. The variables to be included in the new version, as well as the translation of the terminology into Portuguese, were evaluated and a consensus was considered to have been reached when all (100%) of the Brazilian experts were in agreement. Results A version of the ASD-FI was created, composed of 42 variables, with the inclusion of two new variables that were not included in the original version. The new version was then back translated into English and approved by the ISSG members, resulting in the adapted version of the ASD-FI for the Brazilian population. Conclusion This study presents an adapted version of the adult spinal deformity frailty index for the Brazilian population, for the purpose of risk stratification in the surgical treatment of these complex deformities. Level of evidence II; Study of adaptation of a valid score.

scholarly journals Three-Dimensional Imaging of the High Sea-State Wave Field Encompassing Ship Slamming Events

2010 ◽  
Vol 27 (4) ◽  
pp. 737-752 ◽  
Author(s):  
A. Brandt ◽  
J. L. Mann ◽  
S. E. Rennie ◽  
A. P. Herzog ◽  
T. B. Criss
Keyword(s):  
Wave Field ◽  
Imaging System ◽  
Three Dimensional ◽  
Sea State ◽  
Incoming Wave ◽  
Ship Slamming ◽  
Wave Slamming ◽  
Wave Heights ◽  
Surface Wave Field ◽  
The Individual

Abstract Understanding and modeling ship wave slamming necessitates characterizing the surface wave field that results in slamming events. Shipboard measurements of the incoming wave field were made during sea trials of the twin-hull Sea Fighter (FSF-1), using a three-dimensional (3D), stereo-optic imaging system. The data obtained were processed using an image matching algorithm resulting in 3D video sequences of the incoming wave field at forward speeds of 16–40 kt in head seas at sea state 4. Six wave slamming events were captured, characterized, and compared to the average wave field properties. It was found that the salient properties of the individual waves that resulted in ship slamming occurred in groups of two or more, were approximately 30% larger than the significant wave heights during the ∼2-min period encompassing the slamming events, and had wave slopes at least 2 times that of the preceding wave slope. Additionally, wave slamming corresponded to large ship pitching motions resulting from the incident waveforms.

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