scholarly journals Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities

Author(s):  
S. V. Kolesov ◽  
M. L. Sazhnev ◽  
A. A. Snetkov ◽  
A. I. Kaz’Min

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.

2016 ◽  
Vol 23 (3) ◽  
pp. 28-32
Author(s):  
S. V Kolesov ◽  
M. L Sazhnev ◽  
A. A Snetkov ◽  
A. I Kaz’min

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.


2017 ◽  
Vol 43 (6) ◽  
pp. E9 ◽  
Author(s):  
David B. Bumpass ◽  
Lawrence G. Lenke ◽  
Jeffrey L. Gum ◽  
Christopher I. Shaffrey ◽  
Justin S. Smith ◽  
...  

OBJECTIVEAdolescent spine deformity studies have shown that male patients require longer surgery and have greater estimated blood loss (EBL) and complications compared with female patients. No studies exist to support this relationship in adult spinal deformity (ASD). The purpose of this study was to investigate associations between sex and complications, deformity correction, and health-related quality of life (HRQOL) in patients with ASD. It was hypothesized that male ASD patients would have greater EBL, longer surgery, and more complications than female ASD patients.METHODSA multicenter ASD cohort was retrospectively queried for patients who underwent primary posterior-only instrumented fusions with a minimum of 5 levels fused. The minimum follow-up was 2 years. Primary outcomes were EBL, operative time, intra-, peri-, and postoperative complications, radiographic correction, and HRQOL outcomes (Oswestry Disability Index, SF-36, and Scoliosis Research Society-22r Questionnaire). Poisson multivariate regression was used to control for age, comorbidities, and levels fused.RESULTSNinety male and 319 female patients met the inclusion criteria. Male patients had significantly greater mean EBL (2373 ml vs 1829 ml, p = 0.01). The mean operative time, transfusion requirements, and final radiographic measurements did not differ between sexes. Similarly, changes in HRQOL showed no significant differences. Finally, there were no sex differences in the incidence of complications (total, major, or minor) at any time point after controlling for age, body mass index, comorbidities, and levels fused.CONCLUSIONSDespite higher EBL, male ASD patients did not experience more complications or require less deformity correction at the 2-year follow-up. HRQOL scores similarly showed no sex differences. These findings differ from adolescent deformity studies, and surgeons can counsel patients that sex is unlikely to influence the outcomes and complication rates of primary all-posterior ASD surgery.


2005 ◽  
pp. 020-024
Author(s):  
Aleksandr Timofeyevich Khudyaev ◽  
Oksana Germanovna Prudnikova ◽  
Ivanna Aleksandrovna Mescheriagina ◽  
Yulia Antonocna Mushtaeva

Objective. To define the most effective assemblies of external transpedicular fixator for correction of kyphotic and scoliotic deformities of the spine. Material and Methods. Treatment results in 108 adolescents with different kinds of III–IV degree scoliosis and kyphosis were studied. The spine deformation degree was assessed in accordance with V.D. Chaklin’ classification. Neurological examination have shown the absence of major neurological disorders. Deformation correction was performed with device consisting of transpedicular rods which were fixed to anchorage plates and coupled into support bases. Results. The application of the fixator with additional lateral traction is optimal to correct C-shaped scoliosis and the frame with damping device allows correcting the curvatures of S-shaped deformities within a short time, in some cases even hypercorrection can be achieved. The application of additional fixing rod is fruitful in kyphosis correction. Conclusion. The application of the external transpedicular fixator under radiological and clinical control allows the correction of various spine deformities without neurological deficit with the account of spine biomechanics.


2021 ◽  
pp. 1-10
Author(s):  
Ki Young Lee ◽  
Jung-Hee Lee ◽  
Kyung-Chung Kang ◽  
Sang-Kyu Im ◽  
Hae Seong Lim ◽  
...  

OBJECTIVERestoring the proper sagittal alignment in adult spinal deformity (ASD) can improve radiological and clinical outcomes, but pseudarthrosis including rod fracture (RF) is a common problematic complication. The purpose of this study was to analyze the methods for reducing the incidence of RF in deformity correction of ASD.METHODSThe authors retrospectively selected 178 consecutive patients (mean age 70.8 years) with lumbar degenerative kyphosis (LDK) who underwent deformity correction with a minimum 2-year follow-up. Patients were classified into the non-RF group (n = 131) and the RF group (n = 47). For predicting the crucial factors of RF, patient factors, radiographic parameters, and surgical factors were analyzed.RESULTSThe overall incidence of RF was 26% (47/178 cases), occurring in 42% (42/100 cases) of pedicle subtraction osteotomy (PSO), 7% (5/67 cases) of lateral lumbar interbody fusion (LLIF) with posterior column osteotomy, 18% (23/129 cases) of cobalt chrome rods, 49% (24/49 cases) of titanium alloy rods, 6% (2/36 cases) placed with the accessory rod technique, and 32% (45/142 cases) placed with the 2-rod technique. There were no significant differences in the incidence of RF regarding patient factors between two groups. While both groups showed severe sagittal imbalance before operation, lumbar lordosis (LL) was more kyphotic and pelvic incidence (PI) minus LL (PI-LL) mismatch was greater in the RF group (p < 0.05). Postoperatively, while LL and PI-LL did not show significant differences between the two groups, LL and sagittal vertical axis correction were greater in the RF group (p < 0.05). Nonetheless, at the last follow-up, the two groups did not show significant differences in radiographic parameters except thoracolumbar junctional angles. As for surgical factors, use of the cobalt chrome rod and the accessory rod technique was significantly greater in the non-RF group (p < 0.05). As for the correction method, PSO was associated with more RFs than the other correction methods, including LLIF (p < 0.05). By logistic regression analysis, PSO, preoperative PI-LL mismatch, and the accessory rod technique were crucial factors for RF.CONCLUSIONSGreater preoperative sagittal spinopelvic malalignment including preoperative PI-LL mismatch was the crucial risk factor for RF in LDK patients 65 years or older. For restoring and maintaining sagittal alignment, use of the cobalt chrome rod, accessory rod technique, or LLIF was shown to be effective for reducing RF in ASD surgery.


2015 ◽  
Vol 22 (2) ◽  
pp. 66-75
Author(s):  
M. V Mikhailovskiy ◽  
V. V Novikov ◽  
I. G Udalov

Widely used in clinical practice surgical interventions directed to the correction of severe kyphotic spine deformities, i.e. Ponte osteotomy, Smith-Peterson osteotomy, pedicle subtraction osteotomy and vertebral column resection are presented. Surgical techniques, surgery planning based on spinal and pelvic sagittal contour parameters, treatment results are described.


2021 ◽  
Author(s):  
Qiang Luo ◽  
Yong-Chan Kim ◽  
Ki-Tack Kim ◽  
Kee-Yong Ha ◽  
Joonghyun Ahn ◽  
...  

Abstract Background: To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.Methods: A retrospective review of consecutive patients underwent deformity correction surgery for ASD between 2013 and 2017 was performed. Patients were divided into two groups based on whether IS or S2AI fixation was performed. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Demographics, intraoperative and clinical data were analyzed between the two groups. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change <5°. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared.Results: A total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. The IS group (65.6 ± 26, 39.8 ± 13.8) showed a significantly higher change in lumbar lordosis (LL) and upper lumbar lordosis (ULL) than the S2AI group (54.4 ± 17.9, 30.3 ± 9.9) (p<0.05). In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° (p<0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%, p<0.05) and (16.1% vs 3.6%, p<0.05).Conclusions: IS fixation showed a greater change in LL and ULL than S2AI fixation in ASD surgery. PI may be changed under certain circumstances.


2015 ◽  
Vol 15 (10) ◽  
pp. S126-S127
Author(s):  
International Spine Study Group ◽  
Gregory M. Mundis ◽  
Jay D. Turner ◽  
Vedat Deviren ◽  
Juan S. Uribe ◽  
...  

2012 ◽  
Vol 19 (4) ◽  
pp. 42-46
Author(s):  
S. Yu Berezhnoy ◽  
A. I Protsenko ◽  
V. V Kostyukov

Results of the analysis of repeated surgical interventions (34 patients, 43 feet) after previously performed surgeries for forefoot static deformities are presented. In all cases various percutaneous techniques were used. Mean follow up was 6 months (3 months — 4 years). Surgical results were assessed using patient satisfaction criterion. Satisfaction with treatment results was recorded in 95% ofpatients. It was shown that potentialities ofpercutaneous technique enabled to solve the majority offorefoot static deformityrevision surgery problems. The conclusion was made that strict order of patient management after reconstructive foot operations enabled to perform early reoperations before severe complications development.


2010 ◽  
Vol 63 (11-12) ◽  
pp. 855-858
Author(s):  
Elizabeta Popova-Ramova ◽  
Milica Lazovic

Introduction. The spine deformities tend to increase, and in 90% of children they change the quality of life. The aim of this study was to determine the percents of spinal deformity in our population of adolescents, and long bad posture in and out of school as a factor for its increase. Material and methods. The study included 124 adolescents attending High Musical School in Bitola and Skopje, who underwent four standard spine tests and an interview. Results. According to the test 3, 50% of the examined adolescents in Bitola and 69% in Skopje had the postural spine deformity, the average being 59.5%. The results obtained by the questionnaire showed that 50% of adolescents did not have any physical activity out of school, the longest daily activity, lasting four hours, in 48% of the examinees was practising their musical instruments; 40% of the examinees spent two hours watching TV or using the computer, whereas 18% did not use any of them at all. Conclusion. The bad spine posture tends to deteriorate in adolescents and the factor influencing this result should be established by studies aimed at determining the effects of physical activity on reducing such deformities, since the specific type of their education induces the risk of developing pain and early degenerative changes of the spine, which are predominant in the professionals.


Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A78-A85 ◽  
Author(s):  
Hamidreza Aliabadi ◽  
Gerald Grant

ABSTRACT CONGENITAL THORACOLUMBAR SPINAL deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. Here we review a variety of congenital anomalies and address the maldevelopments associated with each, as well as the appropriate evaluation of such patients including nonoperative and operative approaches. Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.


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