Interatrial septum dissection, severe aortic stenosis, and paravalvular mitral regurgitation: A rare combination and their hemodynamic interrelationship.

Left atrial wall dissection is a rare entity with controversial management approaches. We report the case of an 85-year-old woman with a mitral bioprosthetic admitted for heart failure. Diagnosis of atrial septum dissection, severe aortic stenosis, and paravalvular mitral regurgitation was established.

Practical Echocardiographic Approach of the Regurgitant Mitral Valve Assessment.

Mitral regurgitation is the second-most frequent valvular heart disease in Europe after degenerative aortic stenosis. It is associated with significant morbidity and mortality, and its prevalence is expected to increase with population aging. Echocardiography is the first diagnostic approach to assess its severity, constituting a challenging process in which a multimodality evaluation, integrating quantitative, semiquantitative and qualitative methods, as well as a detailed evaluation of the morphology and function of both left ventricle and atria is the key.

Severe adolescent idiopathic scoliosis: posterior staged correction using a temporary magnetically-controlled growing rod.

Purpose: A two-staged posterior correction, using a temporary magnetically controlled growing rod (MCGR), was employed to gradually and safely correct severe adolescent idiopathic scoliosis (AIS). The aim of the study is illustrating the results of this procedure.

Methods: A retrospective review of a consecutive series of 17 severe AIS.

SeRUN® study: Development of running profiles using a mixed methods analysis.

Objective: To determine profiles of urban runners based on socio-demographic, health, motivational, training characteristics and running-related beliefs and behaviours.

Methods: Mixed, exploratory, sequential study with two stages: 1) quantitative, using an online survey; and 2) qualitative, using semi-structured interviews with runners from the previous stage. Participants were recruited via: running routes commonly attended by runners, eight races, previous databases and social media networks.

Segmental vs non-segmental thoracic pedicle screws constructs in adolescent idiopathic scoliosis: is there any implant alloy effect?

Purpose: The aim of this study is to understand how many anchor sites are necessary to obtain maximum posterior correction of idiopathic scoliotic curve and if the alloy of instrumentation, stainless steel or titanium, may have a role in the percent of scoliosis correction.

Methods: We reviewed 143 consecutive patients, affected by AIS (Lenke 1-2), who underwent a posterior spinal fusion with pedicle screw-only instrumentation between 2002 and 2005. According to the implant density and alloy used we divided the cohort in four groups.

Intraoperative monitoring of somatosensory (SSEPs) and transcranial electric motor-evoked potentials (tce-MEPs) during surgical correction of neuromuscular scoliosis in patients with central or peripheral nervous system diseases.

Purpose: Combined intraoperative monitoring (IOM) of transcranial electric motor-evoked potentials (tce-MEPs) and somatosensory-evoked potentials (SSEPs) is safe and effective for spinal cord monitoring during scoliosis surgery. However, the literature data regarding the reliability of spinal cord monitoring in patients with neuromuscular scoliosis are conflicting and need to be confirmed.

Methods: We reviewed IOM records of 40 consecutive patients with neuromuscular scoliosis related to central nervous system (CNS) (29 pts) or peripheral nervous system (PNS) (11 patients) diseases, who underwent posterior fusion with instrumentation surgery for spinal deformity.

Does hybrid fixation prevent junctional disease after posterior fusion for degenerative lumbar disorders? A minimum 5-year follow-up study.

Purpose: Medium- to long-term retrospective evaluation of clinical and radiographic outcome in the treatment of degenerative lumbar diseases with hybrid posterior fixation.

Methods: Thirty patients were included with the mean age of 47.8 years (range 35 to 60 years).

Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients-Is It Effective?

Study Design. A retrospective study. Purpose.

Degenerative lumbar scoliosis in elderly patients: dynamic stabilization without fusion versus posterior instrumented fusion.

Background Context: Posterolateral fusion with pedicle screw instrumentation is currently the most widely accepted technique for degenerative lumbar scoliosis in elderly patients. However, a high incidence of complications has been reported in most series. Dynamic stabilization without fusion in patients older than 60 years has not previously been compared with the use of posterior fusion in degenerative lumbar scoliosis.

Apical vertebral derotation in the posterior treatment of adolescent idiopathic scoliosis: myth or reality?

Introduction: Direct apical vertebral rotation represents an important goal of posterior surgery for thoracic adolescent idiopathic scoliosis (AIS), so as to obtain a better cosmetic effect and to avoid posterior thoracoplasty. However, the real effectiveness in correction of vertebral rotation, using posterior only procedures, is still open to debate. The aim of the present study is to compare the correction of axial apical rotation obtained with direct rotation procedure versus simple concave rod rotation, in patients treated by posterior fusion for thoracic AIS using pedicle screw-only construct.

Complications incidence in the treatment of early onset scoliosis with growing spinal implants.

Early onset scoliosis (EOS) surgery based on growing spinal implants can lead to several complications. Aim of the study was to identify strategies to prevent those complications. A retrospective review was conducted to identify all pediatric patients affected by EOS surgically treated with growing rod or Vertical Expandable Prosthetic Titanium Rib (VEPTR) at our division between 2006 and 2011.

Surgical treatment for scoliosis associated with rare disease.

This is a retrospective study of 11 patients, 7 females and 4 males, treated at Our Department for an early onset scoliosis (EOS) associated with rare syndromes with growing spinal implants (Growing Rod or VEPTR-like) from 2006 to 2011. Mean follow-up was 24 months (range, 12 to 36). The mean age at surgery was 7.

Surgical treatment of neuromuscular scoliosis: current techniques.

41 consecutive patients surgically treated at Our Department by posterior only instrumented fusion from January 1995 to January 2009 were reviewed. There were 20 females and 21 males with a mean age of 15.8 years (range, 10 to 38).

Ex vivo observation of human intervertebral disc tissue and cells isolated from degenerated intervertebral discs.

Purpose: Disc degeneration, and associated low back pain, are a primary cause of disability. Disc degeneration is characterized by dysfunctional cells and loss of proteoglycans: since intervertebral tissue has a limited capacity to regenerate, this process is at present considered irreversible. Recently, cell therapy has been suggested to provide more successful treatment of IVD degeneration.

Late-developing infection following posterior fusion for adolescent idiopathic scoliosis.

This study is a retrospective case series review of patients with adolescent idiopathic scoliosis (AIS) who were revised more than 1 year after the index procedure, due to a late-developing deep wound infection, to determine onset, bacteriology, possible influence of implant alloy (titanium vs. stainless-steel) and treatment outcome of patients. From a total of 540 patients who underwent posterior-only fusion for AIS from 1993 through 2005 at our institution, 15 cases (2.

Thoracic pedicle subtraction osteotomy in the treatment of severe pediatric deformities.

The traditional surgical treatment of severe spinal deformities, both in adult and pediatric patients, consisted of a 360° approach. Posterior-based spinal osteotomy has recently been reported as a useful and safe technique in maximizing kyphosis and/or kyphoscoliosis correction. It obviates the deleterious effects of an anterior approach and can increase the magnitude of correction both in the coronal and sagittal plane.

The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring.

Iatrogenic spinal cord injury is the most feared complication of scoliosis surgery. The importance of combined somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) monitoring during spine surgery is well known. The current authors retrospectively evaluated the results of neurophysiological intraoperative monitoring (IOM) in a large population of patients who underwent surgical treatment for spinal deformity.

Treatment of scoliosis in patients affected with Prader-Willi syndrome using various techniques.

Background: The incidence of spinal deformity in children with Prader-Willi syndrome (PWS) is high, with 86% of these patients found to have a significant structural scoliosis; however, there are very few case reports describing surgical treatment for this deformity.

Methods: The authors reviewed a case series consisting of 6 patients who underwent spine surgery for scoliosis. Children's mean age at index surgery was 12 years and 10 months (range, 10 to 15 yrs).

Dynamic stabilization for degenerative lumbar scoliosis in elderly patients.

Study Design: A retrospective study.

Objective: To analyze outcomes after dynamic stabilization without fusion in degenerative lumbar scoliosis in elderly patients.

Summary Of Background Data: Frequent complications of posterolateral instrumented fusion have been reported after treatment of degenerative lumbar scoliosis in elderly patients.

Two-level total lumbar disc replacement.

Total lumbar disc replacement (TDR) has been widely used as a treatment option for 2-level symptomatic degenerative disc disease. However, recent studies have presented conflicting results and some authors concluded that outcome deteriorated when disc replacement was performed bisegmentally, with an increase of complications for bisegmental replacements in comparison with monosegmental disc arthroplasty. The goal of the present retrospective study is to investigate results in a group of patients who have received bisegmental TDR with SB Charitè III artificial disc for degenerative disc disease with a minimum follow-up of 3 years, and to compare the results of 2-level disc replacement versus 1-level patients treated with the same prosthesis.

Selective thoracic surgery in the Lenke type 1A: King III and King IV type curves.

Pedicle screw fixation enables enhanced three-dimensional correction of spinal deformities and effectively shortens the distal fusion level. However, the choice of distal fusion level is still controversial in single thoracic idiopathic scoliosis with the lumbar compensatory curve not crossing the middle line (Lenke type 1 with modifier A or King type III and IV curves).The authors retrospectively analyzed 31 patients treated by segmental pedicular instrumentation alone, affected by a single thoracic adolescent idiopathic scoliosis with a compensatory lumbar curve not crossing the midline (Lenke 1A), with an average age of 16.

Thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis.

A consecutive series of 40 adolescents surgically treated between 1998-2001, by posterior spinal fusion and thoracoplasty were compared with a similar group of 40 adolescents treated in the same period by posterior only segmental fusion. Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Minimum five years follow-up was requested.

Posterior fusion only for thoracic adolescent idiopathic scoliosis of more than 80 degrees: pedicle screws versus hybrid instrumentation.

The treatment of thoracic adolescent idiopathic scoliosis (AIS) of more than 80 degrees traditionally consisted of a combined procedure, an anterior release performed through an open thoracotomy followed by a posterior fusion. Recently, some studies have reassessed the role of posterior fusion only as treatment for severe thoracic AIS; the correction rate of the thoracic curves was comparable to most series of combined anterior and posterior surgery, with shorter surgery time and without the negative effect on pulmonary function of anterior transthoracic exposure. Compared with other studies published so far on the use of posterior fusion alone for severe thoracic AIS, the present study examines a larger group of patients (52 cases) reviewed at a longer follow-up (average 6.

Complications of thoracic pedicle screws in scoliosis treatment.

Study Design: A retrospective study.

Objective: To analyze complications with thoracic pedicle screws in scoliosis treatment at our Department over a 3-year period (1999-2001).

Summary Of Background Data: The use of pedicle screws remains controversial for thoracic scoliosis for fear of complications.