The fate of the malrotated elbow supracondylar fractures in children: is varus really a problem?

Purpose: To evaluate the functional and cosmetic effects of elbow supracondylar fractures (SCF) in children with residual rotational deformity.

Methods: Retrospective review cohort of patients with evidence of malrotation after treatment for SCF. An analysis of the postoperative X-ray of 305 consecutive SCF type 3 treated surgically during five years identified 46 elbows with rotational deformity that fulfilled the selection criteria and were recalled for review; only 27 patients agreed to participate.

Intra-articular Radial Head Fractures: A Deceptive Type of Injury.

Background: Isolated intra-articular radial head (IARH) fractures in skeletally immature patients represent a rare injury. Despite their initial benign radiologic appearance, these fractures are at risk for progressive radial head subluxation and may end with degenerative irreversible changes of the radiocapitellar joint. The aim of this study is to highlight the seriousness of these injuries and the importance of early diagnosis and a proper follow-up to achieve optimal outcomes.

Cervical and thoracic sagittal misalignment after surgery for adolescent idiopathic scoliosis: a comparative study of all pedicle screws versus hybrid instrumentation.

Study Design: A comparative study of 2 cohort series of surgically treated patients with adolescent idiopathic scoliosis (AIS) who were retrospectively analyzed, with level III evidence.

Objective: To compare the effect on the cervical sagittal balance of 2 AIS correction constructs, namely, all pedicle screws and hybrid instrumentation using hooks and pedicle screws.

Summary Of Background Data: An inverse relationship between cervical and thoracic kyphosis in AIS has been found in pediatric patients after concave derotation using hybrid constructs with pedicle screws and hooks.

Influence of hypotension and nerve root section on the ability to mobilize the spinal cord during spine surgery. An experimental study in a pig model.

Background Context: The correction of severe spinal deformities by an isolated posterior approach often involves cord manipulation together with hypotensive anesthesia. To date, the efficiency of methods to increase the tolerance of the cord to displacement and the influence of hypotension on this tolerance is yet to be assessed.

Purpose: The objective of this study was to determine the limits of cord displacement before the disappearance of neurophysiologic signals.

Safe pedicle screw placement in thoracic scoliotic curves using t-EMG: stimulation threshold variability at concavity and convexity in apex segments.

Study Design: A cross-sectional study of nonconsecutive cases (level III evidence).

Objective: In a series of young patients with thoracic scoliosis who were treated with pedicle screw constructs, data obtained from triggered electromyography (t-EMG) screw stimulation and postoperative computed tomographic scans were matched to find different threshold limits for the safe placement of pedicle screws at the concavity (CC) and convexity (CV) of the scoliotic curves. The influence of the distance from the medial pedicle cortex to the spinal cord on t-EMG threshold intensity was also investigated at the apex segment.

Comparing the clinical and radiological outcomes of pedicular transvertebral screw fixation of the lumbosacral spine in spondylolisthesis versus unilateral transforaminal lumbar interbody fusion (TLIF) with posterior fixation using anterior cages.

Study Design: This study retrospectively compares the clinical and radiologic outcomes of unilateral transforaminal lumbar interbody fusion (TLIF) with those of transvertebral screw fixation of the lumbosacral spine in high-grade spondylolisthesis.

Objective: To examine the outcome and perioperative complications of unilateral TLIF and compare those results with Transvertebral Screw Fixation in the treatment of high-grade spondylolisthesis.

Summary Of Background Data: High-grade spondylolisthesis has been associated with a high complication and failure rate regardless of the method of treatment.

Vertebral coplanar alignment: a standardized technique for three dimensional correction in scoliosis surgery: technical description and preliminary results in Lenke type 1 curves.

Study Design: Prospective multicentric study.

Objective: To present the preliminary results of an innovative method for standardized correction of scoliosis, vertebral coplanar alignment (VCA), based on a novel concept: the relocation of vertebral axis in a single plane.

Summary Of Background Data: Normal standing spine has no rotation in coronal or transverse planes, therefore X and Z axis of vertebrae are in the same plane: they are coplanar.

Using triggered electromyographic threshold in the intercostal muscles to evaluate the accuracy of upper thoracic pedicle screw placement (T3-T6).

Study Design: A prospective clinical study of high thoracic pedicle screws monitored with triggered electromyographic (EMG) testing.

Objective: To evaluate the sensitivity of recording intercostal muscle potentials to assess upper thoracic screw placement.

Summary Of Background Data: Triggered EMG testing from rectus muscle recordings, which are innervated from T6 to T12, has identified medially placed thoracic pedicle screws.