scholarly journals Horizontal Correction of Scoliotic Deformity with High-Density Pedicle Screw Constructs: A Retrospective Analysis of 40 Patients

2020 ◽  
pp. 1-8
Author(s):  
Charlotte Debaud ◽  
Charlotte Debaud ◽  
Adrien Felter ◽  
Georges Hayek ◽  
Christian Garreau de Loubresse
Keyword(s):  
Pedicle Screw ◽  
Mean Amplitude ◽  
High Density ◽  
Surgical Correction ◽  
Scoliosis Surgery ◽  
3D Analysis ◽  
Global Level ◽  
3D Reconstructions ◽  
Scoliotic Deformity ◽  
Scoliosis Correction

Purpose: To report radiologic outcomes in the horizontal plane after scoliosis correction with high-density pedicle screw constructs through a sterEOS®-3D analysis. Methods: We conducted a retrospective monocentric study on scoliotic patients who underwent a surgical correction with high-density constructs. SterEOS®-3D reconstructions were modelled from pre and postoperative EOS® acquisitions. Amplitude of surgical correction and residual deformity were analysed for rotational parameters (vertebrae vectors coordinates, apical vertebral rotation (AVR), intervertebral rotations, Torsion Index) and transversal offset parameters (Spread of Coronal Offsets (SCO), mean of coronal offsets (CO), T9 and L3 to Gravity Line (GL) CO, T9/L3 Transverse Gravitational Deviation Index (TGDI), T9/L3 TGDI θ categories). Results: 80 sterEOS®3D reconstructions were analysed. Paired t-test comparisons between pre and postoperative values showed a significant reduction for Cobb angles (p<0.0001) and AVR (p = 0.0024) but not for TI (p = 0.69). 51% of the curves with a preoperative AVR > 10° were corrected at a segmental level with an average de-rotation amplitude of 19.3° +/- 8° and 56% at a global level with an average de-torsion index of 54% +/- 30%. Correction of SCO was effective for 95% of patients with a mean amplitude of 30mm +/- 10mm and was associated with a significant reduction in T9 and L3 to GL CO (34mm ± 24mm and 7.6mm +/-10mm respectively). Conclusion: Horizontal corrections achieved with high-density constructs in scoliosis surgery are more significant on translation than rotation at a segmental and global level.

scholarly journals Progressive Scoliosis and Syringomyelia - Questions of Surgical Approach

Folia Medica ◽  
2018 ◽  
Vol 60 (2) ◽  
pp. 261-269 ◽  
Author(s):  
Mikhail Mikhaylovskiy ◽  
Vyacheslav Stupak ◽  
Vadim Belozerov ◽  
Nikolay Fomichev ◽  
Anatoliy Lutsik ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Surgical Correction ◽  
Neurological Deficits ◽  
Spinal Deformities ◽  
Loss Of Correction ◽  
Scoliotic Deformity ◽  
Scoliosis Correction ◽  
The Moment ◽  
Comparison Of The Results

Abstract Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.

scholarly journals INTRA- AND INTEROBSERVER ANALYSIS OF PEDICLE SCREW PLACEMENT IN SCOLIOSIS CORRECTION

2020 ◽  
Vol 19 (3) ◽  
pp. 172-175
Author(s):  
CAÍQUE JAUHAR DE CASTRO ◽  
LUIS EDUARDO CARELLI TEIXEIRA DA SILVA ◽  
LUIZ EDUARDO ALMEIDA ◽  
ALDERICO GIRÃO CAMPOS DE BARROS ◽  
ROBSON TEIXEIRA VITAL ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pedicle Screw ◽  
Kappa Coefficient ◽  
Screw Placement ◽  
Scoliosis Surgery ◽  
Pedicle Screw Placement ◽  
Level Of Evidence ◽  
Thoracic Pedicle Screw ◽  
Strong Conclusion ◽  
Scoliosis Correction

ABSTRACT Objective To establish the statistical interobserver and intraobserver concordance of thoracic pedicle screw placement in scoliosis surgery, with a 4-week interval between the two analyses. Methods Of 55 patients that evaluated the intra- and interobserver concordances of the screw positions (according to the Abul-Kasim classification) using the Kappa coefficient. Results The intraobserver concordance ranged from a Kappa coefficient of 0.516 to 0.889 (“moderate” to “almost perfect”) between the two analyses performed four weeks apart. Interobserver concordance ranged from 0.379 to 0.633 (“reasonable” to “strong”). Conclusion The intraobserver concordance was always greater than the interobserver concordance. No concordance coefficient was classified as “insignificant” or “weak”. Level of Evidence III; Retrospective study.

Accuracy Analysis of Pedicle Screw Placement in Posterior Scoliosis Surgery

Spine ◽  
2007 ◽  
Vol 32 (14) ◽  
pp. 1543-1550 ◽  
Author(s):  
Yoshihisa Kotani ◽  
Kuniyoshi Abumi ◽  
Manabu Ito ◽  
Masahiko Takahata ◽  
Hideki Sudo ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Scoliosis Surgery ◽  
Accuracy Analysis ◽  
Pedicle Screw Placement

scholarly journals Reducing Allogenic Blood Transfusion in Pediatric Scoliosis Surgery:: Reporting 15 Years of a Multidisciplinary, Evidence-Based Quality Improvement Project

2019 ◽  
Vol 9 (8) ◽  
pp. 843-849
Author(s):  
Alastair G. Dick ◽  
Richard J. Pinder ◽  
Shirley A. Lyle ◽  
Tom Ember ◽  
Claire Mallinson ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Spinal Surgery ◽  
Care Pathway ◽  
Allogenic Blood Transfusion ◽  
Blood Transfusions ◽  
Scoliosis Surgery ◽  
Improvement Project ◽  
Allogenic Blood ◽  
Intraoperative Cell Salvage ◽  
Scoliosis Correction

Study Design: Retrospective review of prospectively collected spinal surgery and transfusion databases. Objectives: To evaluate the efficacy of a care pathway developed at our institution since 2003 with a focus on reducing the need for blood transfusions in children undergoing scoliosis correction surgery. The care pathway includes nurse-led clinics facilitating preoperative hemoglobin optimization, intraoperative cell salvage, the use of tranexamic acid, and a transfusion criteria awareness program. Methods: Retrospective review of our institution’s prospectively recorded spinal surgery and transfusion databases including all cases of scoliosis surgery in patients 18 years and younger between 2001 and 2015. Results: A total of 1039 procedures were included in the analysis. Overall, 24.4% of patients received a transfusion. The proportion of patients transfused was 89.2% in 2001-2003, 39.6% in 2004-2006, 16.5% in 2007-2009, 15.6% in 2010-2012, and 20.1% in 2013-2015. The volume of blood products transfused in those undergoing transfusion was 9.1 units in 2001-2003, 4.8 units in 2004-2006, 5.0 units in 2007-2009, 2.3 units in 2010-2012, and 2.1 units in 2013-2015. A multivariate logistic regression demonstrated adjusted odds ratios for the probability of receiving any transfusion of 5.45 (95% confidence interval 3.62-8.11) for patients with neuromuscular diagnoses and 11.17 (5.02-24.86) for those undergoing combined anterior and posterior surgical approach. Conclusions: We have demonstrated over a 15-year period that the introduction of a multifaceted, multidisciplinary pathway can dramatically and sustainably reduce the need for blood transfusions and their attendant risks in pediatric scoliosis surgery. This data lends weight to the adoption of such a care pathway in pediatric scoliosis surgery.

scholarly journals Management of spinal cord injury–related scoliosis using pedicle screw–only constructs

2015 ◽  
Vol 22 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Steven W. Hwang ◽  
Mina G. Safain ◽  
Joseph J. King ◽  
Jeff S. Kimball ◽  
Robert Ames ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Shoulder Balance ◽  
Radiographic Outcomes ◽  
Cord Injury ◽  
Scoliosis Correction ◽  
Almost All

OBJECT Almost all pediatric patients who incur a spinal cord injury (SCI) will develop scoliosis, and younger patients are at highest risk for curve progression requiring surgical intervention. Although the use of pedicle screws is increasing in popularity, their impact on SCI-related scoliosis has not been described. The authors retrospectively reviewed the radiographic outcomes of pedicle screw–only constructs in all patients who had undergone SCI-related scoliosis correction at a single institution. Methods Medical records and radiographs from Shriner's Hospital for Children–Philadelphia for the period between November 2004 and February 2011 were retrospectively reviewed. Results Thirty-seven patients, whose mean age at the index surgery was 14.91 ± 3.29 years, were identified. The cohort had a mean follow-up of 33.2 ± 22.8 months. The mean preoperative coronal Cobb angle was 65.5° ± 25.7°, which corrected to 20.3° ± 14.4°, translating into a 69% correction (p < 0.05). The preoperative coronal balance was 24.4 ± 22.6 mm, with a postoperative measurement of 21.6 ± 20.7 mm (p = 1.00). Preoperative pelvic obliquity was 12.7° ± 8.7°, which corrected to 4.1° ± 3.8°, translating into a 68% correction (p < 0.05). Preoperative shoulder balance, as measured by the clavicle angle, was 8.2° ± 8.4°, which corrected to 2.7° ± 3.1° (67% correction, p < 0.05). Preoperatively, thoracic kyphosis measured 44.2° ± 23.7° and was 33.8° ± 11.5° postoperatively. Thoracolumbar kyphosis was 18.7° ± 12.1° preoperatively, reduced to 8.1° ± 7.7° postoperatively, and measured 26.8° ± 20.2° at the last follow-up (p < 0.05). Preoperatively, lumbar lordosis was 35.3° ± 22.0°, which remained stable at 35.6° ± 15.0° postoperatively. Conclusions Pedicle screw constructs appear to provide better correction of coronal parameters than historically reported and provide significant improvement of sagittal kyphosis as well. Although pedicle screws appear to provide good radiographic results, correlation with clinical outcomes is necessary to determine the true impact of pedicle screw constructs on SCI-related scoliosis correction.

scholarly journals Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

2016 ◽  
Vol 7 (04) ◽  
pp. 550-553 ◽  
Author(s):  
Sohail Rafi ◽  
Naseem Munshi ◽  
Asad Abbas ◽  
Rabia Hassan Shaikh ◽  
Imtiaz Hashmi
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Scoliosis Surgery ◽  
Hybrid Instrumentation ◽  
System Versus ◽  
Cobb’S Angle

ABSTRACT Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb’s angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb’s angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.

scholarly journals Feasibility of Single-Staged Bilateral Anterior Scoliosis Correction in Growing Patients

2019 ◽  
Vol 11 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Alice Baroncini ◽  
Luis Rodriguez ◽  
Kushagra Verma ◽  
Per D. Trobisch
Keyword(s):  
Learning Curve ◽  
Retrospective Analysis ◽  
Pulmonary Complications ◽  
Future Research ◽  
Scoliosis Surgery ◽  
Complication Rates ◽  
Scoliosis Correction ◽  
Double Curve ◽  
Thoracic Approach ◽  
A Minor

Study Design: Retrospective analysis. Objectives: The objective of this study was to analyze the feasibility of correcting double-curve scoliosis using dynamic scoliosis correction (DSC, also known as vertebral body tethering), which requires a bilateral anterior approach with deflation of both lungs. Typically, this approach falls under the exclusionary criteria for the eligibility for anterior scoliosis surgery. No data exists on the feasibility of single-staged bilateral DSC. Methods: A retrospective analysis was performed utilizing the data from 25 patients who underwent a bilateral anterior thoracic approach and instrumentation. Thirty-day postoperative complication rates were analyzed. A learning curve subanalysis was also performed to compare the first 12 patients to the remainder of the 13 patients, with a T-test ( P ≤ .05). Results: Of the 25 patients treated, there was 1 intraoperative event: After performing lumbar DSC, the contralateral DSC was abandoned due to unexpected pleural scarring and staged selective thoracic fusion was performed. We observed 4 postoperative complications: 2 patients had recurrent pleural effusions, 1 patient was diagnosed with pneumonia, and 1 patient had a minor pulmonary embolism without cardiopulmonary consequences (after an international 24 hour flight). All patients recovered well. We observed a significant influence of learning curve on surgical time (328 vs 280 min, P = .03) and blood loss (480 vs 197 mL, P = .03). Conclusion: Data suggests that bilateral, single-stage surgery for DSC is feasible albeit with an elevated complication rate that may partially attributable to the learning curve. Future research should focus on the cause of pulmonary complications and include a matched comparative analysis with traditional posterior fusion.

Surgical Correction and Fusion Using Posterior-Only Pedicle Screw Construct for Neuropathic Scoliosis in Patients With Cerebral Palsy

Spine ◽  
2009 ◽  
Vol 34 (11) ◽  
pp. 1167-1175 ◽  
Author(s):  
Hitesh N. Modi ◽  
Jae-Young Hong ◽  
Satyen S. Mehta ◽  
S Srinivasalu ◽  
Seung-Woo Suh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Pedicle Screw ◽  
Surgical Correction
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