Bone substitutes in adolescent idiopathic scoliosis surgery using sublaminar bands: is it useful? A case-control study.

Introduction: In order to avoid pseudarthrosis in adolescent idiopathic (AIS) patients, it is recommended to bring additional bone graft or substitute. Modern rigid instrumentations have been shown to provide less pseudarthroses even without bone substitutes. The aim of our study was to determine the impact of using bones substitutes on fusion rates in adolescent idiopathic scoliosis patients undergoing PSF with sublaminar bands.

Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis.

The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM) scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP) and muscular dystrophy (DMD).

The lateral wedge augmentation trochleoplasty in a pediatric population: a 5-year follow-up study.

Patellofemoral instability in children requires surgery when recurrent dislocation occurs. The aim of this study is to report the 5-year clinical and radiographic outcomes following lateral wedge augmentation trochleoplasty of the femoral trochlea. This is a review of 23 (mean age: 12.

Intraoperative spinal cord monitoring in children under 4 years old.

Purpose: The purpose was to study intraoperative spinal cord monitoring (IOM) particularities and performances in children under 4 years old with congenital spinal deformities. IOM is characterized by specific difficulties due to the immaturity of sensory-motor pathways in such young patients. To the best of our knowledge, this study is the largest dedicated to IOM in this challenging population.

Postural spinal balance defined by net intersegmental moments: Results of a biomechanical approach and experimental errors measurement.

Aim: To describe initial results and experimental error measurement of a protocol analyzing Human posture through sagittal intersegmental moments.

Methods: Postural analysis has been recently improved by development of three-dimensional radiographic imaging systems. However, in various situations such as global sagittal anterior malalignment interpretation of radiographs may not represent the real alignment of the subject.

Pelvic incidence: a predictive factor for three-dimensional acetabular orientation-a preliminary study.

Acetabular cup orientation (inclination and anteversion) is a fundamental topic in orthopaedics and depends on pelvis tilt (positional parameter) emphasising the notion of a safe range of pelvis tilt. The hypothesis was that pelvic incidence (morphologic parameter) could yield a more accurate and reliable assessment than pelvis tilt. The aim was to find out a predictive equation of acetabular 3D orientation parameters which were determined by pelvic incidence to include in the model.

Circumferential fusion using a custom-made screw in the management of high-grade spondylolisthesis.

Purpose: Management of high-grade spondylolisthesis is challenging and to date no therapeutic consensus is available. Various surgical procedures have been described using unique or double approach. The aim of the study is to describe an original technique using a posterior-only approach to achieve a circumferential lumbosacral fusion with a custom-made screw.

Small bone islands: unusual clinical symptomatology.

Bone islands are usually considered benign, stable, nonprogressive lesions, radiographically characterized by an ovoid, round, or oblong homogeneously dense and sclerotic focus in the spongiosa, with a preference for the long bones and the pelvis. Benign solitary bone islands are usually believed to be asymptomatic, with no necessity for treatment. Symptomatic bone islands reported in the literature are characterized by a diameter greater than 2 cm, belonging to the category of giant bone islands.

Complications in pediatric spine surgery using the vertical expandable prosthetic titanium rib: the French experience.

Study Design: Multicenter retrospective study of 54 children.

Objective: To describe the complication rate of the French vertical expandable prosthetic titanium rib (VEPTR) series involving patients treated between August 2005 and January 2012.

Summary Of Background Data: Congenital chest wall and spine deformities in children are complex entities.

Use of the Universal Clamp in adolescent idiopathic scoliosis for deformity correction and as an adjunct to fusion: 2-year follow-up.

Purpose: Among posterior surgical techniques for treating adolescent idiopathic scoliosis (AIS), hybrid constructs with pedicle-screw fixation in the lumbar spine and other anchors in the thoracic spine have been reported to provide to be of more physiological value in postoperative thoracic kyphosis than all-screw constructs. The Universial Clamp (UC) equipped with a soft sublaminar band is a relatively new thoracic anchor that can be used in hybrid constructs. A dedicated reduction tool that applies traction to the sublaminar band permits gentle translation of the thoracic curve to the precontoured fusion rods, which have been previously anchored distally by pedicle screws and proximally by hooks in a claw configuration.

Do adolescent idiopathic scoliosis (AIS) neglect proprioceptive information in sensory integration of postural control?

Introduction: It has been reported that AIS rely much more on ankle proprioception to control the amplitude of the balance control commands as compared to age-matched healthy adolescents. Our hypothesis was that AIS do not neglect proprioceptive information to control posture probably because of their vestibular deficits. We investigated the proprioceptive contribution to postural control in AIS which expresses spinal deformity during a crucial transitional period of ontogenesis.

Dynamic equinus with hindfoot valgus in children with hemiplegia.

In children with hemiplegia, it is important to distinguish between equinus with hindfoot varus (equinovarus) or valgus (equinovalgus). Premature onset of medial gastrocnemius (GM) EMG in individuals with equinus is well documented. Premature onset of Peroneus longus (PL) EMG has been described in neurologically impaired adults with equinovalgus, but not in children.

Siblings with vascular involvement associated with hereditary multiples exostosis.

Multiple hereditary exostoses are frequently observed in children, but vascular complications from exostoses in siblings are rare. We report the case of a 10-year-old boy, admitted for dyspnea and chest pain related to a hemothorax due to a right eighth rib exostosis. He was successfully treated by costal resection and chest tube drainage.

Beyond the classic correction system: a numerical nonrigid approach to the scoliosis brace.

Background Context: Adolescent idiopathic scoliosis (AIS) causes a spine and rib cage three-dimensional (3D) deformity previously treated by bracing. Whatever the manufacturing process, this rigid system acts biomechanically on the patient through the "three-point bending" mechanical principle. It applies corrective forces to a limited area and acts especially in the frontal plane.

Progressive anterior vertebral bars: a study of 16 cases.

Study Design: In a retrospective study, we report on 16 patients with congenital kyphosis due to progressively ossifying anterior unsegmented bars.

Objective: To specify the therapeutic strategy in such malformation.

Summary Of Background Data: Congenital kyphosis due to progressively ossifying anterior unsegmented bars is a particular and uncommon entity of congenital kyphosis.

Anterior dislocation of the sacroiliac joint in children: a new technique for pelvic fixation.

Pelvic injuries in children and especially sacroiliac anterior dislocation are uncommon lesions. In this study, we present an original technique for the fixation of such lesions by a custom-made frame through a single posterior approach. The case of a 12-year-old girl is reported here and advantages of this technique are described.

Intraoperative monitoring in pediatric orthopedic spinal surgery: three hundred consecutive monitoring cases of which 10% of patients were younger than 4 years of age.

Study Design: Analysis of a prospective series of 300 consecutive cases undergoing intraoperative monitoring in pediatric orthopedic spinal surgery, of which 10% were children younger than 4 years.

Objective: Determine feasibility and performance of intraoperative monitoring in children younger than 4 years. Analyze distinct physiopathologic mechanisms of relevant alerts.

Hexapodal external fixation in the management of children tibial fractures.

Some tibial fractures in children require surgical osteosynthesis, mostly achieved by an internal fixation. Indications for external fixation in the management of tibial fractures in children are limited to specific clinical situations when conventional treatments are contraindicated. The aim of this study is to report the results of tibial fractures management by hexapodal external fixation.

Idiopathic scoliosis and balance organisation in seated position on a seesaw.

The aim was to determine the biomechanical processes involved in postural regulation when self-imposed disturbances occur in the seated position in the antero-posterior direction. Twelve female adolescents with right thoracic scoliosis (SG) (Cobb = 30.4 degrees +/- 9.

Use of the Universal Clamp for deformity correction and as an adjunct to fusion: preliminary results in scoliosis.

Purpose: Evaluation of a novel instrumentation device for adolescent idiopathic scoliosis.

Methods: A new osteosynthesis implant (Universal Clamp) primarily consisting of a sublaminar band and titanium clamp was prospectively studied in 32 patients (average age, 15 years) with a major thoracic curve.

Results: The Universal Clamp was used without anterior release to reduce and maintain correction of the thoracic curve, which improved from 55.

Congenital abnormalities associated with hemivertebrae in relation to hemivertebrae location.

Numerous congenital abnormalities have been reported in association with hemivertebrae (HV). No data exist about their incidence depending on the location of the HV. From 1980 to 2003, 75 patients with 80 HV responsible for evolutive congenital scoliosis were managed by HV resection using a double approach and short anterior and posterior convex fusion.

Femoral lengthening over elastic stable intramedullary nailing in children using the monolateral external fixator.

The authors report preliminary results of femoral lengthening performed with monolateral external fixation over elastic stable intramedullary nailing in children. Seven femoral lengthenings were performed in six patients, at a mean age at surgery of 6.6 years (range 1.

Severe hip infection after a prophylactic contralateral fixation in slipped upper femoral epiphysis: a case report.

The rate of infection is extremely low after a prophylactic contralateral fixation in slipped upper femoral epiphysis, and exclusively involves superficial wound infection. We report an unusual case of hip infection after a prophylactic pinning with a single cannulated screw. The evolution was unfavorable, with necrosis and epiphysiolysis of the femoral head.

Surgical management of type II tibial intercondylar eminence fractures in children.

The objective of this study was the evaluation of the therapeutic options in type II tibial intercondylar eminence fractures. Seventeen children were treated surgically. Open reduction, curettage of the fracture area and internal fixation were performed.