Isolated Pedicle Screw Instrumented Correction for the Treatment of Thoracic Congenital Scoliosis

Şarlak, Ahmet Yılmaz; Atmaca, Halil; Tosun, Bilgehan; Musaoğlu, Resul; Buluç, Levent

doi:10.1097/bsd.0b013e3181c2f51b

Cited by 15 publications

(19 citation statements)

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“…Sarlak et al . 7 and Yaszay et al . 8 reported 40–50% correction rate for treating CS patients in this technique.…”

Section: Discussionmentioning

confidence: 95%

Comparison of osteotomy versus non‐osteotomy approach for congenital scoliosis: a retrospective study of three surgical techniques

Liu

et al. 2014

ANZ Journal of Surgery

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BackgroundCurrently, there are many reports about congenital scoliosis (CS) treatment, but there are still controversies existing with respect to selecting its surgical methods.MethodsRetrospective analyses were conducted on 31 CS patients. The surgical treatments included the following: posterior instrumentation (10 patients; group 1), pedicle subtraction osteotomy (11 patients; group 2) and vertebral column resection (10 patients; group 3).ResultsAll patients had remarkable improvements in morphology, image findings, visual analogue scale and American Spinal Injury Association classification. Groups 2 and 3 had greater preoperative sagittal Cobb's angle (25.0, 62.2 and 9.2°, respectively), greater intra-operative blood loss (604.5, 620.0 and 460.0 mL, respectively) and fewer fused segments (5.8, 6.3 and 9.2, respectively) than group 1. As compared with group 1, groups 2 and 3 had greater correction rate of coronal Cobb's angle (79.6 ± 12.8, 78.2 ± 10.1% versus 56.1 ± 11.1%), and coronal trunk inclination (77.6 ± 14.2, 85.2 ± 11.0% versus 45.0 ± 42.5%). The sagittal Cobb's angle correction rates of three groups were 67.7 ± 42.9, 79.3 ± 27.6, 84.3 ± 12.1%, respectively, which showed no significant difference (P = 0.461). With an average follow-up of 3.5, 3.2 and 4.0 years, the correction loss rate of coronal Cobb's angle in group 1 was higher than those of groups 2 and 3.ConclusionFor CS patients, osteotomy procedure had less fused segments, along with a greater correction rate and lower correction loss, which were more advantageous for those with severe deformity in sagittal plane or nerve decompression requirements.

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“…Sarlak et al . 7 and Yaszay et al . 8 reported 40–50% correction rate for treating CS patients in this technique.…”

Section: Discussionmentioning

confidence: 95%

Comparison of osteotomy versus non‐osteotomy approach for congenital scoliosis: a retrospective study of three surgical techniques

Liu

et al. 2014

ANZ Journal of Surgery

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“…We have demonstrated safety and overall good results in these patients using standard distraction based growing rods [10,11]. While the authors would not suggest anterior spinal fusion in these children given their underlying pulmonary issues [4,20,[61][62][63], surgical variables such as increased frequency of lengthening (using magnetically controlled devices) [64], three-column fixation (pedicle screws) [65][66][67][68] or stiffer instrumentation [69] might provide strategies to prevent the hypokyphosis from occurring. Thus, moving forward, it will be important for the spinal deformity surgeon to be aware of these potential sagittal compensations and to determine the best intervention to prevent them.…”

Section: Discussionmentioning

confidence: 97%

Sagittal Plane Deformities in Children with SMA2 following Posterior Spinal Instrumentation

et al. 2021

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This is a retrospective radiographic review to assess post-operative sagittal plane deformities in patients with Spinal Muscular Atrophy type 2 that had been treated with posterior spinal instrumentation. Thirty-two patients with a history of either spinal fusion (N = 20) or growing rods (N = 12) were identified with an average of 7.6 (2.1–16.6) years post-operative follow-up. Forty percent (13/32) of the patients were identified as having obvious “tucked chin” (N = 4), “tipped trunk” (N = 9), or both (N = 3). Sacral incidence was the only parameter that was statistically significant change between pre-operative or immediate post-operative measurements (66.9° vs. 55.2° p = 0.03). However, at final follow-up, the post-operative thoracic kyphosis had decreased over time in those that developed a subsequent sagittal deformity (24.2°) whereas it increased in those that did not (44.7°, p = 0.008). This decrease in thoracic kyphosis throughout the instrumented levels, resulted in a greater lordotic imbalance (30.4° vs. 5.6°, p = 0.001) throughout the instrumented levels in the group that developed the subsequent cervical or pelvic sagittal deformities. In conclusion, sagittal plane deformities commonly develop outside the instrumented levels in children with SMA type 2 following posterior spinal instrumentation and may be the result of lordotic imbalance that occurs through continued anterior growth following posterior instrumentation.

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“…Surgical operation remains the primary treatment for most cases of congenital scoliosis. Pedicle screw instrumentation has been widely adopted for the treatment of scoliosis due to its superior correction e cacy [8,9]. At present, the freehand surgical approach with uoroscopic control remains the most commonly used method of screw placement [10] but has the risk of pedicle screw misplacement [11,12].…”

Section: Introductionmentioning

confidence: 99%

The 3D Printed Template Assists Accuracy and Safety of Screw Placement in the Treatment of Pediatric Congenital Scoliosis: A Case Control Retrospective Study

Cao

Zhang

Liu

et al. 2021

Preprint

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Background: Three-dimensional (3-D) printed templates are increasingly applied in spinal surgery, but are rarely used in the treatment of congenital scoliosis. This study aimed to evaluate the accuracy and safety of 3D printed template-assisted screw placement in the treatment of congenital scoliosis.Methods: A total of 67 patients with congenital scoliosis treated in our hospital between January 2017 to January 2019 were retrospectively included (mean age= 4.13±2.66 years, range: 2-15) and divided into the template-assistant group (n=34) and the freehand group (n=33) according to the screw placement method. The accuracy rate of pedicle screw placement, surgical outcomes, and incidence of complications were compared between groups.Results: Although the good accuracy (grade 0+ grade 1) rate of pedicle screw placement was comparable between the two groups, the excellent accuracy (grade 0) rate was significantly higher in the template-assistant group than in the freehand group (96.10% vs. 88.64%, P=0.007). The main curve Cobb's angle and Kyphosis' angle significantly decreased after surgery in both groups but without a significant intergroup difference. The template-assistant group had a significantly lower postoperative complication rate than the freehand group (0% vs. 18.18%; P=0.009). The 4 patients with postoperative complications in the freehand group all received revision surgery.Conclusion: The 3D printed templates can improve the excellent accuracy rate of screw placement and reduce postoperative complications in the treatment of congenital scoliosis, thereby improving the therapeutic efficacy.

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Isolated Pedicle Screw Instrumented Correction for the Treatment of Thoracic Congenital Scoliosis

Abstract: In the neglected thoracic congenital deformities of the aged, with posterior pedicle instrumented fusion, an acceptable correction can be achieved with relatively low morbidity.

Cited by 15 publications

References 0 publications

Comparison of osteotomy versus non‐osteotomy approach for congenital scoliosis: a retrospective study of three surgical techniques

Comparison of osteotomy versus non‐osteotomy approach for congenital scoliosis: a retrospective study of three surgical techniques

Sagittal Plane Deformities in Children with SMA2 following Posterior Spinal Instrumentation

The 3D Printed Template Assists Accuracy and Safety of Screw Placement in the Treatment of Pediatric Congenital Scoliosis: A Case Control Retrospective Study

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