Comprehensive Assessment of Outcomes From Patients With Severe Early-onset Scoliosis Treated With a Vertebral Column Resection: Results From an SRS Global Outreach Site (FOCOS) in Ghana

Verma, Kushagra; Slattery, Casey; Duah, Henry Ofori; Yankey, Kawdwo P; Boachie-Adjel, Oheneba

doi:10.1097/bpo.0000000000001195

Cited by 8 publications

(19 citation statements)

References 16 publications

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“…The included articles revealed four leading global outreach organizations that served as HIC partners in their respective collaborations. The SRS-GOP and the Foundation of Orthopedics and Complex Spine (FOCOS), two organizations focused on spinal deformity care and education of local surgeons, were involved as HIC partners together in six studies (32%) [ 12 , 14 , 16 , 18 , 20 , 23 ]. SRS-GOP also featured in one other article as a HIC partner alongside Project Perfect World (PPW), an organization aiming to improve pediatric orthopedic care in Ecuador [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

Lin,

Halvorsen,

Win

et al. 2023

PLoS ONE

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Background Clinical collaboration between spine professionals in high-income countries (HICs) and low-and-middle-income countries (LMICs) may provide improvements in the accessibility, efficacy, and safety of global spine care. Currently, the scope and effectiveness of these collaborations remain unclear. In this review, we describe the literature on the current state of these partnerships to provide a framework for exploring future best practices. Methods PubMed, Embase, and Cochrane Library were queried for articles on spine-based clinical partnerships between HICs and LMICs published between 2000 and March 10, 2023. This search yielded 1528 total publications. After systematic screening, nineteen articles were included in the final review. Results All published partnerships involved direct clinical care and 13/19 included clinical training of local providers. Most of the published collaborations reviewed involved one of four major global outreach organizations with the majority of sites in Africa. Participants were primarily physicians and physicians-in-training. Only 5/19 studies reported needs assessments prior to starting their partnerships. Articles were split on evaluative focus, with some only evaluating clinical outcomes and some evaluating the nature of the partnership itself. Conclusions Published studies on spine-focused clinical partnerships between HICs and LMICs remain scarce. Those that are published often do not report needs assessments and formal metrics to evaluate the efficacy of such partnerships. Toward improving the quality of spine care globally, we recommend an increase in the quality and quantity of published studies involving clinical collaborations between HICs and LICs, with careful attention to reporting early needs assessments and evaluation strategies.

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Section: Resultsmentioning

confidence: 99%

“…All six articles in which SRS-GOP and FOCOS worked together as HIC partners centered around care provided at the FOCOS Orthopedic Hospital in Accra, Ghana [ 12 , 14 , 16 , 18 , 20 , 23 ]. WSC partnerships occurred in Botswana, Dominican Republic, Ghana, and India [ 1 , 10 , 25 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

Lin,

Halvorsen,

Win

et al. 2023

PLoS ONE

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“…The technique has improved since, with VCR currently consisting of a three-column circumferential osteotomy involving the vertebral body, intervening disks, pedicles, and all the dorsal elements to create a segmental defect with sufficient instability to require provisional instrumentation (115,116,117). Current indications include short angular deformities when other methods are not technically possible, typical of congenital scoliosis (CS) or congenital kyphosis at an early age (63,115). The most common pathology for CS is hemivertebrae, with a known poor prognosis (118).…”

Section: Vertebral Column Resectionmentioning

confidence: 99%

“…Hemivertebrae resection has become the gold standard for CS caused by hemivertebrae with great results in terms of curve correction (61,119). Traditionally, it was performed through an anterior-posterior approach, but due to extensive operative times, significant blood loss, and high complication rates, more recently, a tendency toward a posterolateral approach has been observed (115,116,119). Despite improvement in operation times and blood loss with a posterolateral approach, concerns remain about its technical difficulty, blood loss, and high complication rates, especially neurologic complications.…”

Section: Vertebral Column Resectionmentioning

confidence: 99%

Early-onset scoliosis: a narrative review

et al. 2022

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Early-onset scoliosis (EOS) is defined as any spinal deformity that is present before 10 years old, regardless of etiology. Deformity must be evaluated based on the intercorrelation between the lungs, spine, and thorax. Curvatures of early-onset have increased risk of progression, cardiorespiratory problems, and increased morbidity and mortality. Progression of the deformity may produce thoracic insufficiency syndrome, where a distorted thorax is unable to support normal respiratory function or lung growth. Management and treatment of EOS should pursue a holistic approach in which the psychological impact and quality of life of the patient are also taken into consideration. Growth-friendly surgical techniques have not met the initial expectations of correcting scoliotic deformity, promoting thoracic growth, and improving pulmonary function.

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“…The Foundation of Orthopedics and Complex Spine (FOCOS) Hospital in Ghana is a prime example of how to safely develop a long-term global outreach effort that specializes in performing complex spine procedures. 12 However, the FOCOS Hospital is unique and has not been replicated to date. For visiting surgeons, sometimes the correct ethical decision may involve choosing a less aggressive intervention in order to attain a more predictable and safer outcome.…”

Section: Informed Consent and Ethical Patient Carementioning

confidence: 99%

First Do No Harm: Ethical Considerations of Pediatric Orthopaedic Global Outreach

Bovid¹,

Brooks²,

Heffernan³

2021

Journal of the Pediatric Orthopaedic Society of North America

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The purpose of this editorial is to introduce the ethical considerations surrounding pediatric orthopaedic global outreach and stimulate discussion about how to best approach this work. Bidirectional exchange with partner surgeons in low- and middle-income countries forms the foundation of successful outreach. Fostering these relationships and approaching outreach with humility and curiosity allows for a genuine needs assessment. The outreach program can then be designed to address the needs of the target community. Success should not only be defined as the number of surgeries performed, but also the number of healthcare workers trained and sustainable programs created at the host site. Remember that nurses, physical therapists, and surgical technologists also desire training. Finally, it is important to understand and identify any implicit or explicit bias before pursuing global outreach as that may hinder successful outcomes and bidirectional exchange with host surgeons.

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Comprehensive Assessment of Outcomes From Patients With Severe Early-onset Scoliosis Treated With a Vertebral Column Resection: Results From an SRS Global Outreach Site (FOCOS) in Ghana

Abstract: Level IV-case series.

Cited by 8 publications

References 16 publications

Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

Clinical spine care partnerships between high-income countries and low-and-middle-income countries: A scoping review

Early-onset scoliosis: a narrative review

First Do No Harm: Ethical Considerations of Pediatric Orthopaedic Global Outreach

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