Neuromuscular lordoscoliosis: an unusual response to post-operative halo-gravity traction.

Purpose: To report the results of prolonged post-operative halo-gravity traction in a patient in whom the surgery had to be interrupted unexpectedly and for whom subsequently specific clinical circumstances contraindicated completion of the surgical procedure.

Methods: The patient was a 15-year-old male with severe cervico-dorsolumbar lordoscoliosis who was being studied for associated diffuse axonal injury. He performed halo-gravity traction for 12 weeks.

Histiocytosis in the pediatric spine: a clinical and radiographic analysis of 50 patients.

Study Design: Descriptive, retrospective. Scientific level of evidence IV.

Objectives: The aim of this study was to evaluate a consecutive case series of 50 pediatric patients with LCH of the spine.

Surgical treatment of segmental spinal dysgenesis: a report of 19 cases.

Study Design: Retrospective review.

Objective: To describe clinical presentation, surgical management, long-term results, and complications in patients with segmental spinal dysgenesis (SSD). In addition, we sought to emphasize early surgery for this complex congenital abnormality.

Long-term results of hemivertebra excision: How does the spine behave after the peak of puberty?

Introduction: Early hemivertebra (HV) excision and posterior spinal fusion (PSF) is advocated as the treatment of choice in congenital kyphoscoliosis. We assessed global spinal balance and spinal deformity status once the pubertal peak has taken place, in children with a history of HV excision and PSF at age younger than 5 years.

Methods: Twenty-seven children with congenital kyphoscoliosis without co-existing proximal/distal congenital spinal abnormalities who underwent HV excision and PSF of ≤ 5 levels at age younger than 5 years and who had reached the peak of puberty at the last follow-up visit were evaluated.

Selective Fusion in Lenke 1 B/C: Before or After Menarche?

Study Design: A retrospective, comparative study.

Objective: To determine the radiological behavior of the lumbar curve in selective fusions in premenarchal girls with adolescent idiopathic scoliosis (Lenke 1 B/C).

Methods: A retrospective, comparative study was conducted.

Scoliosis in spinal muscular atrophy: is the preoperative magnetic resonance imaging necessary?

Purpose: To determine the prevalence of intraspinal alterations in scoliosis due to Spinal Muscular Atrophy (SMA).

Methods: Cross-sectional, observational, descriptive study. Fifty-six patients with SMA diagnosis required surgical treatment due to scoliosis.

Antibiotic prophylaxis in high-risk pediatric spine surgery: Is cefazolin enough?

Study Design: Retrospective study.

Objective: To describe pathogens found in SSI during pediatric-instrumented spine surgery, and to assess the relationship between pathogens and the etiology of the spinal deformity. Surgical site infection (SSI) after pediatric spine fusion is a well-known complication with incidence rates between 0.

Inpatient versus outpatient halo-gravity traction in children with severe spinal deformity.

Study Design: A retrospective, comparative study.

Objective: To compare the results, complications, and costs of preoperative halo-gravity traction in in- and outpatient settings.

Background Data: Surgical management of severe spinal deformities remains complex and controversial.

Clinical Manifestations and Surgical Management of Spinal Lesions in Patients With Mucopolysaccharidosis: A Report of 52 Cases.

Study Design: Descriptive retrospective cohort of 52 pediatric patients with mucopolysaccharidosis (MPS) and spinal cord disease and surgical outcomes in a reference hospital.

Objectives: To describe clinical manifestations and surgical management and outcomes of spinal lesions.

Methods: All medical records of 52 patients with mucopolysaccharidosis (I, II, III, IV, and VI) diagnosed between 1992 and 2011 were identified and followed at a single spine center of a pediatric hospital.

Quality of life and patient satisfaction in bracing treatment of adolescent idiopathic scoliosis.

Background: Bracing is used as a valid non-surgical treatment for adolescent idiopathic scoliosis (AIS) to avoid progression of the deformity and thereby surgery. The effect of bracing treatment on quality of life of patients with AIS has been a topic of interest in the international literature. The aim of this study was to evaluate the quality of life and patient satisfaction during bracing treatment for AIS of a pediatric hospital.

Surgical Treatment With Pedicle Screws of Scoliosis Associated With Osteogenesis Imperfecta in Children.

Study Design: Retrospective study.

Objective: To assess results of posterior instrumented fusion using pedicle screws in 12 children with osteogenesis imperfecta (OI) with spinal deformity at a single institution from 2001 to 2012.

Summary Of Background Data: This is the first case series of OI patients who underwent non-cement augmented screw-rod instrumented fusion published in the literature.

Neurophysiological Monitoring in Radiofrequency Ablation of Spinal Osteoid Osteoma With a Progressive Time and Temperature Protocol in Children.

Study Design: Retrospective. Level IV Evidence.

Objective: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children.

Hemivertebra Resection With Instrumented Fusion by Posterior Approach in Children.

Study Design: We conducted a retrospective study of patients with congenital scoliosis due to hemivertebra (HV) and performed resection with instrumentation through posterior approach-only with long term follow-up.

Objectives: The objective of this study was to assess results of HV resection by posterior approach-only with instrumentation between 2002 and 2011.

Summary And Background Data: Hemiepiphysiodesis, arthrodesis in situ and resection without instrumentation had been performed in the past with different results.

Right adolescent idiopathic thoracic curve (Lenke 1 A and B): does cost of instrumentation and implant density improve radiographic and cosmetic parameters?

In adolescent idiopathic scoliosis (AIS) there has been a shift towards increasing the number of implants and pedicle screws, which has not been proven to improve cosmetic correction. To evaluate if increasing cost of instrumentation correlates with cosmetic correction using clinical photographs. 58 Lenke 1A and B cases from a multicenter AIS database with at least 3 months follow-up of clinical photographs were used for analysis.

Sotos syndrome and scoliosis surgical treatment: a 10-year follow-up.

Sotos syndrome is caused by a gene deletion with an autosomal dominant pattern of inheritance. Cerebral gigantism, hypotonia and joint hyperextensibility are characteristic features of this syndrome. A percentage of these patients develop progressive scoliosis early in life.

Subjective evaluation of treatment outcomes of instrumentation with pedicle screws or hybrid constructs in Lenke Type 1 and 2 adolescent idiopathic scoliosis: what happens when judges are blinded to the instrumentation?

Superiority of pedicle screws over hybrid/hook instrumentation or vice versa in the treatment of Lenke Type 1 and 2 adolescent idiopathic scoliosis (AIS) remains unresolved for moderate curves. Our objective was therefore to compare the assessment of pedicle screw and hybrid/hooks instrumentation with special attention to cosmesis and uninstrumented spine using novel assessment methods. We carried out a retrospective study of radiographs and clinical photos of 40 cases of thoracic AIS between 40 degrees and 70 degrees of Cobb angle Lenke Type 1 and 2, treated with either pedicle screws or hybrid/hooks.

Experience with an online prospective database on adolescent idiopathic scoliosis: development and implementation.

Considerable variability exists in the surgical treatment and outcomes of adolescent idiopathic scoliosis (AIS). This is due to the lack of evidence-based treatment guidelines and outcome measures. Although clinical trials have been extolled as the highest form of evidence for evaluating treatment efficacy, the disadvantage of cost, time, lack of feasibility, and ethical considerations indicate a need for a new paradigm for evidence based research in this spinal deformity.