Objective Outcomes in Lateral Osteotomy Through Anterior-to-Psoas for Severe Adult Degenerative Spine Deformity Correction

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.

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Pregnancy and delivery in patients with idiopathic scoliosis

Hirurgiâ pozvonočnika ◽

10.14531/ss2020.2.15-22 ◽

2020 ◽

Vol 17 (2) ◽

pp. 15-22

Author(s):

A. A. Snetkov ◽

S. V. Kolesov ◽

D. S. Gorbatyuk ◽

A. A. Panteleyev ◽

V. V. Shvets ◽

...

Keyword(s):

Idiopathic Scoliosis ◽

Spinal Anesthesia ◽

Anesthetic Management ◽

Mode Of Delivery ◽

Deformity Correction ◽

Reproductive Age ◽

Lumbar Pain ◽

Spine Deformity ◽

Before And After ◽

Pregnancy And Delivery

Objective. To analyze the course of pregnancy and delivery that occurred before and after surgical correction of idiopathic scoliosis with instrumented fixation of the spine.Material and Methods. The paper presents a retrospective randomized study of 100 patients of reproductive age (18–35 years) with Lenke type 2–6 idiopathic scoliosis. The following aspects of pregnancy were analyzed: the possibility of independent conception, the pain severity according to VAS during each of the three trimesters of pregnancy, and the mode of delivery (naturally or by C-section). A comparative analysis of the data of patients operated on for the spine deformity correction before and after pregnancy and delivery was carried out. Data was collected using a questionnaire survey of patients. Detection and analysis of differences between groups were carried out using the χ 2 criterion.Results. A statistical relationship was found between the presence of instrumentation installed before delivery (during or before pregnancy) and the need for C-section. It was revealed that the lower the caudal end of instrumentation within the L3–S1 region, the higher the C-section occurrence. Predominantly thoracic scoliosis (Lenke types 2–4) is characterized by higher likelihood of independent conception and lower lumbar pain intensity during pregnancy than predominantly lumbar scoliosis (Lenke types 5–6). There are also certain difficulties in conducting spinal anesthesia in patients with installed instrumentation, which negatively affects the possibility of its use.Conclusion. The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons who supervise them. The solution to this issue is impossible without cooperation with obstetrician gynecologists and anesthetists planning and administering anesthetic management during delivery (which is especially important in case of impossibility or significant restriction of spinal anesthesia use in such patients).

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Variants of Spine Deformity Correction in Children with Idiopathic Scoliosis of Thoracic Localization

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto2012039-13 ◽

2012 ◽

Vol 19 (3) ◽

pp. 9-13

Author(s):

S. V Vissarionov ◽

D. N Kokushin ◽

A. P Drozdetsky ◽

S. M Belyanchikov

Keyword(s):

Deformity Correction ◽

Frontal Plane ◽

Spine Deformity ◽

3D Ct ◽

Treatment Results ◽

Dorsal Approach ◽

Apical Vertebra ◽

Vertebral Bone ◽

Bone Structures ◽

Main Arch

Treatment results for 24 patients (21 girls and 3 boys), aged 14—17 years, with idiopathic thoracic scoliosis are presented. In all cases right-side type of deformity was observed. The main arch of curvature ranged from 52° to 92° by Cobb. The operation was performed from dorsal approach with application of metallic devices with transpedicular supporting elements using 3D-CT navigation. Depending on anatomical and anthropometric peculiarities of vertebral bone structures within the curvature arch, two variants of surgical correction were applied. Correction of the first type was performed in 18 patients; second type of correction was applied in 6 children. Second type of deformity correction differed from the first one by the sequence of rods implantation relative to the sides of main arch and corrective maneuvers at deformity correction. In the first group postoperative deformity correction in frontal plane made up 92—99%, derotation correction of the apical vertebra from 72 to 94% versus 91—100% and from 11,4 to 29,4% in the second group.

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Letter to the editor concerning “Vertebral growth modulation by posterior dynamic deformity correction device in skeletally immature patients with moderate adolescent idiopathic scoliosis” by Floman et al., Spine Deformity, 2021, https://doi.org/10.1007/s43390-020–00189-z

Spine Deformity ◽

10.1007/s43390-021-00308-4 ◽

2021 ◽

Author(s):

Steven de Reuver ◽

Tom P. C. Schlösser ◽

Moyo C. Kruyt ◽

René M. Castelein

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Deformity Correction ◽

Spine Deformity ◽

Skeletally Immature ◽

Growth Modulation ◽

Letter To The Editor ◽

Vertebral Growth

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Bilateral use of the vertical expandable prosthetic titanium rib attached to the pelvis: a novel treatment for scoliosis in the growing spine

Journal of Neurosurgery Spine ◽

10.3171/2008.12.spine08427 ◽

2009 ◽

Vol 10 (4) ◽

pp. 287-292 ◽

Cited By ~ 26

Author(s):

Amer F. Samdani ◽

Ashish Ranade ◽

Henry J. Dolch ◽

Reed Williams ◽

Tricia St. Hilaire ◽

...

Keyword(s):

Cobb Angle ◽

Early Onset ◽

Deformity Correction ◽

Early Onset Scoliosis ◽

Spine Deformity ◽

Complication Rates ◽

Novel Device ◽

Age At Surgery ◽

Growing Spine

Object Few options exist for the treatment of severe, early onset scoliosis. Goals of treatment include stabilizing curve progression while allowing for normal spine, chest, and lung growth. The vertical expandable prosthetic titanium rib (VEPTR) is a novel device designed to control the spine deformity while permitting lung and spine growth. In this paper the authors report their experience with using bilateral VEPTRs from the ribs to the pelvis for children with severe, early onset scoliosis. Methods Eleven children were identified who had been treated with bilateral VEPTRs from the ribs to the pelvis. The authors conducted a retrospective review and collected the following data: clinical diagnosis, age at surgery, number of lengthening procedures, and complications. In addition, pre- and postoperative radiographs were reviewed to measure maximum Cobb angle (both thoracic and lumbar), thoracic height, total spine height as measured from T-1 to S-1, thoracic kyphosis (T2–12), and lumbar lordosis (L1–S1). Results The average patient age at surgery was 71 months; the mean preoperative thoracic Cobb angle was 81.7°. This angle was corrected to 50.6° immediately postoperatively, and this correction was maintained; at the most recent follow-up the curves averaged 58°. Similarly, the preoperative kyphosis (T2–12) angle measured 43° preoperatively, 23° immediately postoperatively, and 37° at the most recent follow-up evaluation. The patients underwent a total of 41 lengthening procedures (average 3.7 lengthening procedures per patient), and overall spine length increased from 23.1 cm preoperatively, to 27.3 cm immediately postoperatively, to 29.4 cm at the final follow-up (an average of 25 months). Four (36.4%) of the 11 patients experienced complications. Conclusions The VEPTR offers a viable treatment option for children with severe, early onset scoliosis. It achieves and maintains spinal deformity correction, while allowing for continued spine and chest-wall growth. Complication rates are similar to those reported for other growing systems.

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Male sex may not be associated with worse outcomes in primary all-posterior adult spinal deformity surgery: a multicenter analysis

Neurosurgical FOCUS ◽

10.3171/2017.9.focus17475 ◽

2017 ◽

Vol 43 (6) ◽

pp. E9 ◽

Cited By ~ 4

Author(s):

David B. Bumpass ◽

Lawrence G. Lenke ◽

Jeffrey L. Gum ◽

Christopher I. Shaffrey ◽

Justin S. Smith ◽

...

Keyword(s):

Sex Differences ◽

Spinal Deformity ◽

Operative Time ◽

Adult Spinal Deformity ◽

Deformity Correction ◽

Spine Deformity ◽

Complication Rates ◽

Female Patients ◽

Male Patients

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.

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Surgical treatment of gross posttraumatic deformations in thoracic spine

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors5380-87 ◽

2017 ◽

Vol 5 (3) ◽

pp. 80-86

Author(s):

Aleksei E. Shul’ga ◽

Vladimir V. Zaretskov ◽

Galina A. Korshunova ◽

Aleksei A. Smol'kin ◽

Dmitrii Yu. Sumin

Keyword(s):

Surgical Treatment ◽

Thoracic Spine ◽

Deformity Correction ◽

High Energy ◽

Fracture Dislocation ◽

Spine Deformity ◽

Surgical Trauma ◽

Spine Stabilization ◽

Spine Deformities ◽

Post Traumatic

Rigid severe post-traumatic thoracic spine deformities result from frequent, recent high-energy trauma in children with an increasing frequency due to a variety of reasons. These types of injuries are commonly followed by spinal cord anatomic injury; therefore, the treatment of these patients warrants special attention from the ethical viewpoint. Generally, the only indication for surgical intervention is spinal dysfunction. Considering this and the patients’ ordinary severe somatic state, surgical trauma should be minimized as much as possible. However, for adequate deformity correction, effective spine stabilization and restoration of liquorodynamics is necessary. Recent studies have reported the successful use of different methods of dorsal interventions (P/VCR) in cases with unstable damages in children. Here, we present the case of a 15-year-old boy who underwent surgical treatment for coarse post-traumatic thoracic spine deformity with chronic fracture-dislocation of Th7 vertebra.

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