Publications by authors named "Daniel Sucato"
Article Synopsis
- The study examines the impact of implant density on outcomes in posterior spinal fusion surgery for adolescent idiopathic scoliosis (AIS), revealing limited differences between high-density and moderate-density screw constructs.
- A total of 1865 patients were analyzed, showing similar age, sex distribution, and radiographic results, with slight advantages for high-density constructs in curve correction.
- Overall, the findings suggest that moderate-density constructs can be effectively used in routine AIS surgeries, as both densities resulted in comparable patient-reported and radiographic outcomes after two years.
Aims: There has been limited literature regarding outcomes of acetabular rim syndrome (ARS) with persistent acetabular os in the setting of acetabular dysplasia. The purpose of this study was to characterize a cohort of adolescent and young adult patients with ARS with persistent os and compare their radiological and clinical outcomes to patients with acetabular dysplasia without an os.
Methods: We reviewed a prospective database of patients undergoing periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia between January 1999 and December 2021 to identify hips with preoperative os acetabuli, defined as a closed triradiate cartilage but persistence of a superolateral os acetabulum.
Purpose: Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.
Methods: A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up.
Background: Salter osteotomy (SO) and Pemberton acetabuloplasty (PA) are procedures to treat skeletally immature patients with developmental dysplasia of the hip (DDH). The purpose of this study was to compare the radiographic results and rate of residual dysplasia (RD) after treatment with SO and with PA.
Methods: This was a retrospective analysis of pediatric patients treated with either SO or PA for DDH between 1980 and 2013 who were skeletally mature at the time of follow-up.
Study Design: Biomechanical Testing.
Objective: Investigate the optimal construct for stabilization of the spine during vertebral column resection (VCR).
Summary Of Background Data: VCR is a powerful technique for achieving correction in severe cases of spinal deformity.
Article Synopsis
- * A study involving eight patients with Beals syndrome showed significant improvement in spinal curvature after surgery, with corrections averaging from 82.3° to 42.1° at final follow-up.
- * While no patients experienced permanent neurological deficits post-surgery, 25% required additional operations for complications like implant dislodgement, highlighting the complexity of surgical management in this population.
Study Design: Retrospective multicenter cohort study.
Objective: To investigate the impact of night-time bracing (NTB) and full-time bracing (FTB) on the sagittal profile in adolescent idiopathic scoliosis (AIS) patients.
Summary Of Background Data: Recent studies have shown that FTB in AIS patients may induce hypokyphosis.
Purpose: To examine if coronal deformity angular ratio (C-DAR) serves as a predictor for progression to surgical magnitude in patients with Adolescent Idiopathic Scoliosis (AIS) treated with thoracolumbar sacral orthosis (TLSO).
Methods: Patients with AIS, prescribed a full-time TLSO, Cobb angle 20-40°, Risser 0-2, who wore the brace ≥ 12.9 h and reached skeletal maturity/surgery were included retrospectively.
The understanding and treatment of prearthritic hip disease has evolved remarkably over the past 20 years. The principal investigator and the multicenter Academic Network of Conservational Hip Outcomes Research (ANCHOR) group have had a key role in improving the quality of care for these patients suffering from the three most common prearthritic conditions: femoroacetabular impingement, developmental dysplasia of the hip, and residual Legg-Calve-Perthes Disease. We aim to demonstrate that based on the six quality of care dimensions as defined by Donabedian, our 20-year academic journey has markedly improved the quality of care for young patients with prearthritic hip disease.
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- The study aimed to compare the modified Dunn procedure (MDP) and delayed Imhauser osteotomy (DIO) for treating moderate to severe stable slipped capital femoral epiphysis (SCFE) to determine which method leads to better outcomes and less joint damage over time.
- Results showed that MDP provided greater correction of deformities and required fewer reoperations compared to DIO, although both procedures had similar clinical outcomes based on Heyman-Herndon scores.
- The study suggests that MDP may be more effective in preventing additional complications and ensuring better alignment of the hip, highlighting its potential as a preferable option for managing SCFE.
Background: Trendelenburg gait describes contralateral pelvic drop during single leg stance (SLS) with occasional lateral trunk lean compensation over the stance limb. However, quantitative research on 'uncompensated Trendelenburg' gait (pelvic drop independent of lateral trunk lean) remains sparse among populations that commonly utilize this gait pattern, such as adolescent hip pathology patients.
Research Question: How prevalent is uncompensated Trendelenburg among various adolescent hip pathologies and how is it related to hip load, hip abduction strength, and self-reported hip pain?
Methods: Gait, strength, and pain data were collected among 152 pre-operative patients clinically diagnosed with acetabular hip dysplasia, femoroacetabular impingement, Legg-Calvé-Perthes, or slipped capital femoral epiphysis (SCFE).
Background: There is significant debate regarding the indications of staged surgery for severe adolescent spinal deformity, and the factors associated with the decision to perform staged compared to same-day surgery have not been previously investigated. Thus, the purpose of this study was to determine which factors were most strongly associated with this decision.
Methods: A prospective multicenter registry of adolescent patients with severe spinal deformity was reviewed.
Background: Severe adolescent idiopathic scoliosis (AIS) can be treated with instrumented fusion, but the number of anchors needed for optimal correction is controversial.
Methods: We conducted a multicenter, randomized study that included patients undergoing spinal fusion for single thoracic curves between 45° and 65°, the most common form of operatively treated AIS. Of the 211 patients randomized, 108 were assigned to a high-density screw pattern and 103, to a low-density screw pattern.
Background: Vertebral column resection (VCR) is a powerful corrective technique for the management severe, rigid spinal deformities but does carry a relatively high complications rate. One of the feared complications is pseudarthrosis which places the patient at risk for implant failure. We present a single-center experience with post-operative computed tomography (CT) imaging at the osteotomy site to screen for impending pseudarthrosis.
View Article and Find Full Text PDFPurpose: To introduce a novel uniplanar clamp-hinge (Uni-CH) correction system designed for vertebral column resection (VCR) of severe angular kyphosis and test its efficacy using a sawbone simulating model.
Methods: The Uni-CH was introduced and its functionality was demonstrated on a sawbone model simulating severe angular kyphosis. An 83° thoracolumbar angular kyphosis with the apex at T11 was simulated in the sawbone spine model.
Background: Management of femoroacetabular impingement (FAI) through an arthroscopic or surgical hip dislocation (SHD) approach has been shown to have similar clinical success and patient-reported outcomes. However, there are limited data comparing functional outcomes. The purpose of this study was to compare gait and functional outcomes of adolescent/young adult patients with FAI treated by either an arthroscopic or open SHD approach.
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- The study investigates the necessity of screening ultrasounds for developmental dysplasia of the hip (DDH) in premature versus full-term infants with risk factors like breech presentation or a family history of DDH.
- The research involved 244 hips from 122 patients, comparing premature babies (born <37 weeks) with full-term babies (born ≥37 weeks) during ultrasound screenings conducted between 5 and 8 weeks of age.
- Findings indicate no significant differences between groups in sex distribution, age at ultrasound, or referral reasons, despite the premature group having a lower gestational age.
Background: Socioeconomic disparities in musculoskeletal care are increasingly recognized, however, no studies to date have investigated the role of the insurance carrier on outcomes after posterior spinal fusion (PSF) with segmental spinal instrumentation for adolescent idiopathic scoliosis (AIS).
Methods: A US insurance dataset was queried using the PearlDiver Mariner software for all patients aged 10 to 18 undergoing PSF for a primary diagnosis of AIS between 2010 and 2020. Age, sex, geographic region, number of levels fused, and baseline medical comorbidities were queried.
Article Synopsis
- Children with autism spectrum disorder (ASD) and idiopathic scoliosis (IS) were evaluated in a study to compare their radiographic and clinical outcomes post-surgery.
- A total of 30 patients with ASD showed a higher percent curve correction and improved curve magnitude at a 2-year follow-up compared to IS patients, despite initial differences in lumbar lordosis.
- The findings indicate that while ASD patients had lower lumbar lordosis preoperatively, their surgical outcomes were at least as good as those of IS patients, with no significant difference in complication rates.
Purpose: To evaluate intraoperative monitoring (IOM) alerts and neurologic deficits during severe pediatric spinal deformity surgery.
Methods: Patients with a minimum Cobb angle of 100° in any plane or a scheduled vertebral column resection (VCR) with minimum 2-year follow-up were prospectively evaluated (n = 243). Preoperative, immediate postoperative, and 2-year postoperative neurologic status were reported.
Background: Full-thickness acetabular cartilage lesions are common findings during primary surgical treatment of femoroacetabular impingement (FAI).
Purpose: To evaluate clinical outcomes after acetabular microfracture performed during FAI surgery in a prospective, multicenter cohort.
Study Design: Cohort Study; Level of evidence, 3.
Purpose: This study evaluated whether early brace treatment of curves < 25° decreased the prevalence of curve progression and surgery.
Methods: In a retrospective review, patients with idiopathic scoliosis Risser stages 0 to 2 braced at < 25° were followed until brace discontinuation, skeletal maturity, or surgery. Patients with predominantly primary thoracolumbar/lumbar curves were prescribed nighttime braces (NTB) and thoracic curves were prescribed fulltime braces (FTB).
Purpose: To test whether multiple-level unilateral thoracic spinal nerves (TSN) resection can induce the initial thoracic cage deformity to cause early onset thoracic scoliosis in an immature porcine model; and 2) to create an early onset thoracic scoliosis in a large animal model that can be used to evaluate growth-friendly surgical techniques and instruments in growing spine researches.
Methods: Seventeen one-month-old pigs were assigned to 3 groups. In group 1 (n = 6), right TSN were resected from T7 to T14 with the contralateral (left) paraspinal muscle exposing and stripping.