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For: Delman C, Cage JM, Lausé G, Roberto R, Gupta MC, Klineberg E. Anterior and Posterior Fusion for Large, Rigid Idiopathic Scoliosis: Does Implant Density Matter? World Neurosurg 2019;134:e37-e45. [PMID: 31470168 DOI: 10.1016/j.wneu.2019.08.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 10/26/2022]

For:	Delman C, Cage JM, Lausé G, Roberto R, Gupta MC, Klineberg E. Anterior and Posterior Fusion for Large, Rigid Idiopathic Scoliosis: Does Implant Density Matter? World Neurosurg 2019;134:e37-e45. [PMID: 31470168 DOI: 10.1016/j.wneu.2019.08.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 10/26/2022]

Number

Cited by Other Article(s)

Chang PL, Chen MJW, Hsiao PH, Lin CY, Lo YS, Tseng C, Li LY, Lai CY, Chen HT. Navigation-Assisted One-Staged Posterior Spinal Fusion Using Pedicle Screw Instrumentation in Adolescent Idiopathic Scoliosis-A Case Series. MEDICINA (KAUNAS, LITHUANIA) 2024;60:300. [PMID: 38399587 PMCID: PMC10889939 DOI: 10.3390/medicina60020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]

Abstract

Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent three-dimensional spinal disorder, with a multifactorial pathogenesis, including genetics and environmental aspects. Treatment options include non-surgical and surgical treatment. Surgical interventions demonstrate positive outcomes in terms of deformity correction, pain relief, and improvements of the cardiac and pulmonary function. Surgical complications, including excessive blood loss and neurologic deficits, are reported in 2.27-12% of cases. Navigation-assisted techniques, such as the O-arm system, have been a recent focus with enhanced precision. This study aims to evaluate the results and complications of one-stage posterior instrumentation fusion in AIS patients assisted by O-arm navigation. Materials and Methods: This retrospective study assesses 55 patients with AIS (12-28 years) who underwent one-stage posterior instrumentation correction supported by O-arm navigation from June 2016 to August 2023. We examined radiological surgical outcomes (initial correction rate, loss of correction rate, last follow-up correction rate) and complications as major outcomes. The characteristics of the patients, intraoperative blood loss, operation time, number of fusion levels, and screw density were documented. Results: Of 73 patients, 55 met the inclusion criteria. The average age was 16.67 years, with a predominance of females (78.2%). The surgical outcomes demonstrated substantial initial correction (58.88%) and sustained positive radiological impact at the last follow-up (56.56%). Perioperative complications, including major and minor, occurred in 18.18% of the cases. Two patients experienced a major complication. Blood loss (509.46 mL) and operation time (402.13 min) were comparable to the literature ranges. Trend analysis indicated improvements in operation time and blood loss over the study period. Conclusions: O-arm navigation-assisted one-stage posterior instrumentation proves reliable for AIS corrective surgery, achieving significant and sustained positive radiological outcomes, lower correction loss, reduced intraoperative blood loss, and absence of implant-related complications. Despite the challenges, our study demonstrates the efficacy and maturation of this surgical approach.

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Affiliation(s)

Pao-Lung Chang Department of Education, China Medical University Hospital, China Medical University, Taichung 404, Taiwan;
Michael Jian-Wen Chen Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
Pang-Hsuan Hsiao Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
Chia-Yu Lin Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
Yuan-Shun Lo Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan Department of Orthopedic Surgery, China Medical University Beigang Hospital, China Medical University, Yunlin County 651, Taiwan Graduate Institute of Precision Engineering, National Chung Hsing University, Taichung 402, Taiwan
Chun Tseng Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan Department of Orthopedic Surgery, China Medical University Beigang Hospital, China Medical University, Yunlin County 651, Taiwan Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan
Ling-Yi Li Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
Chien-Ying Lai Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
Hsien-Te Chen Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung 404, Taiwan; (M.J.-W.C.); (P.-H.H.); (C.-Y.L.); (Y.-S.L.); (C.T.); (L.-Y.L.); (C.-Y.L.) Spine Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan Department of Sport Medicine, College of Health Care, China Medical University, Taichung 404, Taiwan

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Miyagi M, Saito W, Mimura Y, Nakazawa T, Imura T, Shirasawa E, Uchida K, Ikeda S, Kuroda A, Inoue S, Yokozeki Y, Tanaka Y, Akazawa T, Takaso M, Inoue G. Posterior Spinal Fusion Surgery for Neuromuscular Disease Patients with Severe Scoliosis Whose Cobb Angle Was over 100 Degrees. MEDICINA (KAUNAS, LITHUANIA) 2023;59:1090. [PMID: 37374294 DOI: 10.3390/medicina59061090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]

Abstract

Background and objectives: Patients with neuromuscular diseases usually have progressive neuromuscular scoliosis (NMS), requiring invasive surgery. Some patients present with severe scoliosis at the time of consultation and are difficult to treat. Posterior spinal fusion (PSF) surgery combined with anterior release and pre- or intraoperative traction would be effective for severe spinal deformities but would be invasive. This study aimed to evaluate the outcomes of PSF-only surgery for patients with severe NMS with a Cobb angle > 100°. Materials and Methods: Thirty NMS patients (13 boys and 17 girls; mean age 13.8 years) who underwent PSF-only surgery for scoliosis with a Cobb angle > 100° were included. We reviewed the lower instrumented vertebra (LIV), duration of surgery, blood loss, perioperative complications, preoperative clinical findings, and radiographic findings, including Cobb angle and pelvic obliquity (PO) in the sitting position pre- and postoperatively. The correction rate and correction loss of the Cobb angle and PO were also calculated. Results: The mean duration of surgery was 338 min, intraoperative blood loss was 1440 mL, preoperative %VC was 34.1%, FEV1.0 (%) was 91.5%, and EF was 66.1%. There were eight cases of perioperative complications. The Cobb angle and PO correction rates were 48.5% and 42.0%, respectively. We divided the patients into two groups: the L5 group, in which the LIV was L5, and the pelvis group, in which the LIV was the pelvis. The duration of surgery and PO correction rate in the pelvis group were significantly higher than those in the L5 group. Conclusions: Patients with severe NMS demonstrated severe preoperative restrictive ventilatory impairments. PSF surgery without anterior release or any intra-/preoperative traction showed satisfactory outcomes, including acceptable scoliosis correction and improved clinical findings, even in patients with extremely severe NMS. Instrumentation and fusion to the pelvis for severe scoliosis in patients with NMS showed good PO correction and low correction loss of Cobb angle and PO, but a longer duration of surgery.

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Comparison of four correction techniques for posterior spinal fusion in adolescent idiopathic scoliosis. 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 2022;31:1028-1035. [PMID: 35224673 DOI: 10.1007/s00586-022-07145-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/21/2022] [Accepted: 02/07/2022] [Indexed: 10/19/2022]