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Pereira-Duarte M, Dionne A, Joncas J, Parent S, Labelle H, Barchi S, Mac-Thiong JM. A classification algorithm for prioritizing surgery in Pediatric patients with idiopathic scoliosis when Long Surgical delays are expected. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024:10.1007/s00586-024-08405-4. [PMID: 39096388 DOI: 10.1007/s00586-024-08405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 07/08/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE To identify the clinical phenotypes associated with the rate of progression while waiting for surgery and propose a classification scheme for identifying subgroups of patients to prioritize for surgery when long surgical delays are expected. METHODS We reviewed the clinical and radiographic data of a prospective cohort of patients scheduled for IS surgery from 2004 to 2020 with a minimum 1-year wait prior to surgery. Candidate predictors consisted of age, sex, Risser sign, menarchal status, angle of trunk rotation, scoliotic curve type, and main Cobb angle at baseline when scheduled for surgery. Univariate and Regression Tree analysis were performed to identify predictors associated with the annual curve progression rate in the main Cobb angle between baseline and surgery. RESULTS There were 214 patients (178 females) aged 15 ± 2 years, with a Risser sign 3.4 ± 1.6 and a main Cobb angle 55°±10° at baseline. The average wait prior to surgery was 1.3 ± 0.4 years. Only the Risser sign, menarchal status and sex were significantly associated with the annual progression rate. We have identified 3 clinically and significantly different groups of patients presenting slow (3 ± 4°/yr if Risser sign 3 to 5), moderate (8 ± 4°/yr if female with Risser sign 0 to 2 and post-menarchal), and fast (15 ± 10°/yr if Risser sign 0 to 2 and premenarchal or male) progression rates. CONCLUSION We present an evidence-based surgical prioritization algorithm for pediatric idiopathic scoliosis that can easily be implemented in clinical practice when long surgical delays are expected.
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Affiliation(s)
- Matias Pereira-Duarte
- Université de Montréal, Montréal, Canada
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | | | - Julie Joncas
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Stefan Parent
- Université de Montréal, Montréal, Canada
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Hubert Labelle
- Université de Montréal, Montréal, Canada
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Soraya Barchi
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Jean-Marc Mac-Thiong
- Université de Montréal, Montréal, Canada.
- Research Center, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
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Akazawa T, Kotani T, Sakuma T, Iijima Y, Torii Y, Ueno J, Umehara T, Iinuma M, Yoshida A, Tomochika K, Orita S, Eguchi Y, Inage K, Shiga Y, Nakamura J, Matsuura Y, Suzuki T, Niki H, Ohtori S, Minami S. Health-Related Quality of Life of Patients With Adolescent Idiopathic Scoliosis at Least 40 Years After Surgery. Spine (Phila Pa 1976) 2023; 48:501-506. [PMID: 36730533 DOI: 10.1097/brs.0000000000004545] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/13/2022] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVE The aim was to clarify the health-related quality of life (QOL) of patients who had adolescent idiopathic scoliosis (AIS) at a minimum of 40 years after surgery. SUMMARY OF BACKGROUND DATA The postoperative health-related QOL of middle-aged patients with AIS has been reported to be good, but that of middle-aged and older patients with AIS has yet to be completely explored. MATERIALS AND METHODS We included 179 patients with AIS who underwent spinal fusion(s) between 1968 and 1982. We conducted three surveys in 2009, 2014, and 2022. Patients self-administered both the Scoliosis Research Society-22 and the Roland-Morris Disability questionnaires three times (in 2009, 2014, and 2022) and the Oswestry Disability Index (ODI) questionnaire was self-administered in 2014 and 2022. We considered patients who responded to all three surveys in 2009, 2014, and 2022. RESULTS For the Scoliosis Research Society-22 questionnaires, no significant differences were detected among the three time points (2009, 2014, and 2022) for total scores, function domain, pain domain, self-image domain, mental domain, or satisfaction domain. The results of the Roland-Morris Disability Questionnaire were also not significantly different among the surveys over time. The ODI questionnaires revealed a significant worsening of the 2022 results compared with the 2014 results. Eight patients (29.6%) who had an ODI deterioration of 10% or more had numerically fewer mobile lumbar disks than those with <10% deterioration of the ODI, although the difference did not reach statistical significance. CONCLUSION Among patients with AIS who underwent spinal fusion(s) between 1968 and 1982, we found health-related QOL to be maintained over the last 13 years. Relatively good QOL was appreciated in this population of patients who are now middle-aged and older.
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Affiliation(s)
- Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Yasushi Iijima
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Yoshiaki Torii
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Jun Ueno
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Tasuku Umehara
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Masahiro Iinuma
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Atsuhiro Yoshida
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Ken Tomochika
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
- Spine Center, St. Marianna University Hospital, Kawasaki, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yawara Eguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Matsuura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shohei Minami
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
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Lander ST, Thirukumaran C, Saleh A, Noble KL, Menga EN, Mesfin A, Rubery PT, Sanders JO. Long-Term Health-Related Quality of Life After Harrington Instrumentation and Fusion for Adolescent Idiopathic Scoliosis: A Minimum 40-Year Follow-up. J Bone Joint Surg Am 2022; 104:995-1003. [PMID: 35648066 DOI: 10.2106/jbjs.21.00763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite its importance for clinical decisions, the long-term consequences of posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS), particularly in the lower lumbar spine, remain unclear. This study evaluates the long-term health-related quality of life and the need for a further surgical procedure in patients treated with Harrington instrumentation from 1961 to 1977 according to the lowest instrumented vertebra (LIV) and in comparison with age-matched norms. METHODS A search was performed to identify and contact the 314 identified patients with AIS treated with PSIF by Dr. L.A. Goldstein. The assessment included identified subsequent spine surgery, the Oswestry Disability Index (ODI), Scoliosis Research Society-7 (SRS-7), EuroQol-5 Dimensions (EQ-5D), and Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29). The health-related quality of life was compared with U.S. norms and, within the cohort, was compared by patient factors, LIV, and subsequent spine surgery. RESULTS In this study, 134 patients (42.7%) were identified; 24 (7.6%) had died, 81 (25.8%) consented to participate in the study, and 29 (9.2%) declined participation. The mean follow-up was 45.4 years (range, 40 to 56 years). There were 81 patients who completed the surveys, 77 patients who completed the SRS-7, 77 patients who completed the ODI, and 76 patients who completed the PROMIS-29 and EQ-5D. There were 12.8% of patients with LIV L3 or proximal and 36.4% with LIV L4 or distal who had an additional surgical procedure (odds ratio, 3.98). Comparing the ODI of patients who had undergone an additional surgical procedure with those who had not showed 42% and 73% minimal disability, 53% and 23% moderate disability, and 5% and 2% severe disability. Of the patients who had not undergone an additional surgical procedure, those with LIV L3 or proximal had mean scores of 14.12 points for the ODI and 23.3 points for the SRS-7 and those with LIV L4 or distal had mean scores of 17.9 points for the ODI and 22.7 points for the SRS-7; these differences were not significant. The mean PROMIS-29 and EQ-5D scores were not different from normal U.S. age-based means. CONCLUSIONS Patients with AIS treated with PSIF at a mean 45-year follow-up and LIV L4 or distal had a higher rate of undergoing an additional surgical procedure than those with LIV L3 or proximal. Patients undergoing an additional surgical procedure had lower health-related quality of life than those who did not. Despite this, there was no difference in health-related quality of life for patients with LIV L4 or distal compared with patients with LIV L3 or proximal. This cohort of patients with AIS treated with PSIF demonstrates normal self-reported health-related quality of life compared with the age-matched general population. These long-term outcomes of PSIF for AIS are encouraging. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Sarah T Lander
- University of Rochester Medical Center, Rochester, New York
| | | | - Ahmed Saleh
- Maimonides Medical Center, Brooklyn, New York
| | - Krista L Noble
- University of Rochester Medical Center, Rochester, New York
| | | | - Addisu Mesfin
- University of Rochester Medical Center, Rochester, New York
| | - Paul T Rubery
- University of Rochester Medical Center, Rochester, New York
| | - James O Sanders
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Complications following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study using the modified Clavien-Dindo-Sink system. Spine Deform 2022; 10:607-614. [PMID: 35112274 DOI: 10.1007/s43390-021-00468-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Published complication rates after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) range from 1 to 22%. Complications are often minor and may be underestimated in registries. This study describes complications of PSF for AIS, classifies them according to a Clavien-Dindo-Sink (CDS) system, and investigates risk factors for occurrence of a complication. METHODS This retrospective cohort study at two academic centers included all AIS patients aged 10-18 who underwent primary PSF 4/2014-12/2019. Data included demographics, comorbidities, curve magnitude, Lenke classification, levels osteotomized/fused, implant density, 90-day emergency department visits, readmissions, reoperations, and complications as defined by Harms Study Group. RESULTS Among 424 patients, mean age was 14.7, mean BMI 22, 77% were female, and 57% had no comorbidities. There were 270 complications (0.64 per patient); 198 patients (47%) had ≥ 1 complication; and 63 patients (15%) had CDS grade ≥ II complications (deviation from standard postoperative course). Complications not related to persistent pain occurred in 103 patients (24%). Ninety-three percent of complications did not require readmission or reoperation (CDS I-II). Within 90 days, 8% presented to an ED, 2% required readmission, and 2% required reoperation. Common complications were back pain > 6 weeks postoperatively (26%), surgical site complications (7%), and ileus/prolonged constipation (3%). Risk factors for experiencing any complication were BMI ≥ 34 (OR 3.44) and Lenke 6 curve (OR 1.95). CONCLUSION One in four AIS patients experiences a complication not related to persistent pain after primary PSF, higher than rates published from self-reported registries. Obesity and Lenke 6 curve may increase risk. While most do not require readmission or surgery, 15% of patients have their postoperative course altered by complications. LEVEL OF EVIDENCE III-retrospective cohort study.
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Importance of lowest instrumented vertebra on clinical and radiological outcomes in patients with Lenke type 3C adolescent idiopathic scoliosis: a minimum 4-year follow-up. J Pediatr Orthop B 2020; 29:580-589. [PMID: 31856040 DOI: 10.1097/bpb.0000000000000696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The purpose of this retrospective study was to determine the most appropriate distal fusion level in terms of clinical results and radiological changes in Lenke 3C adolescent idiopathic scoliosis (AIS). Between June 2010 and May 2014, a total of 90 consecutive patients who underwent surgery for Lenke 3C AIS were divided into three groups as L2, L3, and L4 according to the fusion levels and compared in terms of functional and radiological outcomes. Patients were evaluated with Scoliosis Research Society 22 (SRS 22) and the Oswestry disability index (ODI) at the final follow-up. Preoperative standard posteroanterior and lateral whole-spine radiographs and lateral bending radiographs were used to evaluate the curves. All patients were also assessed with lumbar MRI at the final follow-up, and classified for each patient in terms of disc degeneration (DD) and facet joint degeneration (FJD). There was a statistically significant difference between the groups in terms of ODI category (P = 0.001). The rate of minimal disability in the L3 group, moderate disability in the L2 group, and severe disability in the L4 group were higher. Statistically significant differences were observed between the groups in terms of pain, body image, mental health, and total score distribution from the SRS-22 domains (P < 0.05). No significant difference was observed between the groups in terms of DD and FJD in MRI (P = 0.263). Although the preoperative functional scores could not be evaluated due to the retrospective nature of the study, it was observed that the only significant difference between the groups was the SRS-22 score. The best SRS-22 score was obtained in patients in whom fusion was stopped at L3.
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Ramo B, Tran DP, Reddy A, Brown K, Niswander C, Erickson M, Garg S. Delay to Surgery Greater Than 6 Months Leads to Substantial Deformity Progression and Increased Intervention in Immature Adolescent Idiopathic Scoliosis (AIS) Patients: A Retrospective Cohort Study. Spine Deform 2019; 7:428-435. [PMID: 31053313 DOI: 10.1016/j.jspd.2018.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/16/2018] [Indexed: 10/26/2022]
Abstract
DESIGN A retrospective, multi-institution series of adolescent idiopathic scoliosis (AIS) patients whose date of surgery exceeded six months from date of surgical recommendation were identified. A case-matched comparison of surgical outcomes of skeletally immature patients who delayed surgery versus a cohort of nondelayed patients. OBJECTIVES We sought to identify 1) whether patients at risk for significant curve progression when delaying surgery could be identified with available clinical and radiographic data and 2) whether patients who delay surgery have longer fusions/more complex procedures. BACKGROUND Multiple factors can lead to a delay in treatment of AIS once surgical treatment is recommended, and larger Cobb magnitudes have been associated with a more complex surgery. METHODS 143 AIS patients who delayed surgery had deformity progression (major Cobb angle change over time) analyzed by Risser grade, triradiate cartilage (TRC) status, and menarche status. Comparison of at-risk patients with regard to surgical outcomes to a cohort of matched patients who had not delayed surgery. RESULTS Risser 0 patients (n = 34) had a greater major Cobb progression than Risser 1-5 patients (n = 109): mean 1.6°/mo versus 0.4°/mo, p < .001. Twenty-eight premenarchal patients had significantly greater increases in Cobb angle measures than their postmenarchal counterparts (n = 86) (13.2° vs. 4.3°, p < .001). An open TRC also conferred increasing rate of progression. Radiographic variables of stable vertebra and last vertebra touched by central sacral vertical line were more likely to change in immature patients, but we did not demonstrate longer fusions or higher estimated blood loss as a result when compared to nondelayed, age-matched peers. CONCLUSION AIS patients who are premenarchal, TRC open, or Risser 0 who delay surgery greater than 6 months risk clinically significant Cobb angle progression, which is statistically greater than their more mature peers. Clinical ramifications of this remain unclear. Skeletally mature patients do not progress rapidly, allowing elective timing of surgical intervention. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Brandon Ramo
- Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
| | - Dong-Phuong Tran
- Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA
| | - Anil Reddy
- Texas Tech Health Science Center, Paul L. Foster School of Medicine, 5001 El Paso Dr, El Paso, TX 79905, USA
| | - Kaitlyn Brown
- Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA
| | - Cameron Niswander
- Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, USA
| | - Mark Erickson
- Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, USA
| | - Sumeet Garg
- Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, USA
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Ferrero E, Mazda K, Simon AL, Ilharreborde B. Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2165-2174. [PMID: 29693200 DOI: 10.1007/s00586-018-5591-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/09/2018] [Accepted: 04/07/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Preoperative planning of scoliosis surgery is essential in the effective treatment of spine pathology. Thus, precontoured rods have been recently developed to avoid iatrogenic sagittal misalignment and rod breakage. Some specific issues exist in adolescent idiopathic scoliosis (AIS), such as a less distal lower instrumented level, a great variability in the location of inflection point (transition from lumbar lordosis to thoracic kyphosis), and sagittal correction is limited by both bone-implant interface. Since 2007, stereoradiographic imaging system is used and allows for 3D reconstructions. Therefore, a software was developed to perform preoperative 3D surgical planning and to provide rod's shape and length. The goal of this preliminary study was to assess the feasibility, reliability, and the clinical relevance of this new software. METHODS Retrospective study on 47 AIS patients operated with the same surgical technique: posteromedial translation through posterior approach with lumbar screws and thoracic sublaminar bands. Pre- and postoperatively, 3D reconstructions were performed on stereoradiographic images (EOS system, Paris, France) and compared. Then, the software was used to plan the surgical correction and determine rod's shape and length. Simulated spine and rods were compared to postoperative real 3D reconstructions. 3D reconstructions and planning were performed by an independent observer. RESULTS 3D simulations were performed on the 47 patients. No difference was found between the simulated model and the postoperative 3D reconstructions in terms of sagittal parameters. Postoperatively, 21% of LL were not within reference values. Postoperative SVA was 20 mm anterior in 2/3 of the cases. Postoperative rods were significantly longer than precontoured rods planned with the software (mean 10 mm). Inflection points were different on the rods used and the planned rods (2.3 levels on average). CONCLUSION In this preliminary study, the software based on 3D stereoradiography low-dose system used to plan AIS surgery seems reliable for preoperative planning and precontoured rods. It is an interesting tool to improve surgeons' practice, since 3D planning is expected to reduce complications such as iatrogenic malalignment and to help for a better understanding of the complications, choosing the location of the transitional vertebra. However, further work is needed to improve thoracic kyphosis planning. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Emmanuelle Ferrero
- Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris 7 University, AP-HP, 48 boulevard Sérurier, 75019, Paris, France.
| | - Keyvan Mazda
- Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris 7 University, AP-HP, 48 boulevard Sérurier, 75019, Paris, France
| | - Anne-Laure Simon
- Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris 7 University, AP-HP, 48 boulevard Sérurier, 75019, Paris, France
| | - Brice Ilharreborde
- Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris 7 University, AP-HP, 48 boulevard Sérurier, 75019, Paris, France
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Sagittal balance and idiopathic scoliosis: does final sagittal alignment influence outcomes, degeneration rate or failure rate? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:48-58. [DOI: 10.1007/s00586-018-5472-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/20/2017] [Accepted: 01/07/2018] [Indexed: 10/18/2022]
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CORR Insights ®: Preventing Fusion Mass Shift Avoids Postoperative Distal Curve Adding-on in Adolescent Idiopathic Scoliosis. Clin Orthop Relat Res 2017; 475:1461-1462. [PMID: 28251474 PMCID: PMC5384931 DOI: 10.1007/s11999-017-5256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 01/17/2017] [Indexed: 01/31/2023]
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