Publications by authors named "Jason Cheung"

Background: Every year, hundreds of thousands of patients receive an orthopaedic or dental implant containing metals such as cobalt, chromium and titanium. Since the European Chemicals Agency (2020) classified pure cobalt metal as a Category 1B carcinogen, manufacturers of products containing ≥ 0.1% of this metal must perform a risk assessment and justify that there are no viable alternatives.

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Background: Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity among teenagers worldwide. Vertebral body tethering (VBT) is an innovative, minimally invasive technique developed to address spinal curvature by modulating vertebral growth. However, the existing body of evidence regarding the effectiveness and safety of VBT in treating AIS is fragmented and requires thorough consolidation and critical assessment.

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Study Design: Reliability study.

Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.

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Returning to activity after spinal deformity surgery is vital for patient recovery and long-term health, yet there is significant variability in postoperative protocols among surgeons worldwide. This paper aims to define guidelines for returning to activity across diverse patient groups: early onset scoliosis (EOS), adolescent idiopathic scoliosis (AIS), young adults, adult spinal deformity (ASD), elite athletes, and general sports participants. This paper provides guidelines to foster a unified approach to postoperative care, improving outcomes and ensuring patients can safely and effectively resume their activities.

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Purpose: Vertebral body tethering (VBT) is a new growth-modulating surgery for adolescent idiopathic scoliosis (AIS) requiring a distinct skillset and intraoperative setup. We compared perioperative details and outcomes of VBTs performed in a public pediatric orthopedic hospital and a general private hospital setting.

Methods: We identified all patients receiving VBT for AIS from 1/2020 to 12/2023 with ≥ 6 months post-operative follow-up, with surgeries performed by the same senior surgeons.

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Article Synopsis
  • The study aimed to identify key variables for machine learning algorithms to predict which lung cancer patients are at high risk for bone metastasis.
  • A total of 1864 lung cancer patients were analyzed, considering 25 risk factors, with results indicating that specific features like AJCC staging and the use of EGFR inhibitors significantly raise the risk of bone metastasis, while older age lowers it.
  • The developed machine learning model can be integrated into clinical systems to provide real-time predictions, helping clinicians tailor treatment plans for their patients based on the metastatic risk assessment.
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Aims: Developmental cervical spinal stenosis (DcSS) is a well-known predisposing factor for degenerative cervical myelopathy (DCM) but there is a lack of consensus on its definition. This study aims to define DcSS based on MRI, and its multilevel characteristics, to assess the prevalence of DcSS in the general population, and to evaluate the presence of DcSS in the prediction of developing DCM.

Methods: This cross-sectional study analyzed MRI spine morphological parameters at C3 to C7 (including anteroposterior (AP) diameter of spinal canal, spinal cord, and vertebral body) from DCM patients (n = 95) and individuals recruited from the general population (n = 2,019).

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Metastasis frequently targets bones, where cancer cells from the primary tumour migrate to the bone marrow, initiating new tumour growth. Not only is bone the most common site for metastasis, but it also often marks the first site of metastatic recurrence. Despite causing over 90% of cancer-related deaths, effective treatments for bone metastasis are lacking, with current approaches mainly focusing on palliative care.

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Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A total of 65 patients were analyzed.

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Background: The prognosis of surgically treated subjects with early onset scoliosis (EOS) into adulthood has been lacking. We aimed to investigate the patients' perspectives on satisfaction with surgical treatment.

Methodology: We included all surgical candidates with EOS who had undergone index spinal surgery for scoliosis correction between 2009 and 2013.

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Ossification of the posterior longitudinal ligament (OPLL) is a common cause of degenerative cervical myelopathy (DCM) in Asian populations. Characterization of OPLL progression following laminoplasty remains limited in the literature. 29 patients with OPLL received cervical laminoplasty and a minimum of 2-years follow-up.

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Article Synopsis
  • The study investigates the impact of different lengthening intervals for the Magnetically Controlled Growing Rod (MCGR) in treating Early Onset Scoliosis (EOS) patients and assesses patient-perceived outcomes using the validated EOS 24-Item Questionnaire (EOSQ).
  • A cohort of 133 subjects, observed over an average of 3.5 years, was divided into high, medium, and low lengthening interval subgroups, with analysis revealing that the medium interval group had significantly better scores in fatigue, emotion, and parental impact domains.
  • Ultimately, results suggest that all lengthening intervals are well tolerated by patients and their families, showing no negative effects on overall health-related quality of life.
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The nucleus pulposus (NP) in the intervertebral disc (IVD) arises from embryonic notochord. Loss of notochordal-like cells in humans correlates with onset of IVD degeneration, suggesting that they are critical for healthy NP homeostasis and function. Comparative transcriptomic analyses identified expression of progenitor-associated genes (GREM1, KRT18, and TAGLN) in the young mouse and non-degenerated human NP, with TAGLN expression reducing with aging.

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Article Synopsis
  • A clinical trial evaluated the effects of gradual vs. immediate brace weaning protocols on curve stability and health-related quality of life (HRQoL) in patients with adolescent idiopathic scoliosis (AIS).
  • The study involved 369 eligible patients, randomized into two groups: one continued wearing the brace gradually before stopping completely, while the other removed the brace immediately.
  • Results measured changes in spinal curvature and truncal balance at various intervals, with additional assessments of HRQoL over a 24-month period.
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Congenital scoliosis (CS), affecting approximately 0.5 to 1 in 1,000 live births, is commonly caused by congenital vertebral malformations (CVMs) arising from aberrant somitogenesis or somite differentiation. While Wnt/ß-catenin signaling has been implicated in somite development, the function of Wnt/planar cell polarity (Wnt/PCP) signaling in this process remains unclear.

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Background: Metal implants have been preferentially used in THA due to its biocompatibility, mechanical stability and durability. Yet concerns have emerged regarding their potential to release metallic ions, leading to long-term adverse effects, including carcinogenicity. This study aimed to investigate the risk of cancer development in patients with orthopaedic metal implants in total hip arthroplasty (THA).

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Most lumbar quantitative assessment methods can only analyze the image from one view and require laborious manual annotation. We aim to develop an unsupervised pipeline for 3D quantitative assessment of the lumbar spine that can assess the MRI with different views. We combine rule-based and deep learning methods to generate multi-tissue segmentation, and parameters can be measured from segmentation results using the anatomical and geometric prior.

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The highly organized collagen network of human lumbar annulus fibrosus (AF) is fundamental to preserve the mechanical integrity of the intervertebral discs. In the healthy AF, fibers are embedded in a hydrated matrix and arranged in a crosswise fashion, giving an anisotropic structure capable to undergo large strains. For finite element analysis (FEA) of spine, modelling a realistic intervertebral disc geometry has always been a challenge.

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Aims: This systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis.

Methods: A comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included "adolescent idiopathic scoliosis","3D", and "progression".

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Objectives: (1) Compare the cross-sectional thickness (CST) and shear wave speed (SWS) of paraspinal muscles (PSM) in adolescent idiopathic scoliosis (AIS) with and without curve progression; (2) investigate the relationship between CST/SWS and radiographic characteristics in AIS with curve progression; (3) compare the CST/SWS between AIS and non-scoliosis controls.

Methods: This cross-sectional study analyzed the CST and SWS of PSM in 48 AIS with mild to moderate curvature and 24 non-scoliosis participants. Participants with scoliosis greater than 45° of Cobb angles were excluded.

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Study Design: A retrospective cohort study.

Objective: To evaluate the mid-term effect of intervertebral disc degeneration (DD) in patients with adolescent idiopathic scoliosis (AIS) who underwent pedicle screw instrumentation (PSI) and rod derotation (RD) with direct vertebral rotation (DVR).

Summary Of Background Data: Posterior spinal fusion is a mainstay of surgical treatment in AIS, and DVR is considered a main corrective maneuver for vertebral rotation.

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Aims: To systematically evaluate whether bracing can effectively achieve curve regression in patients with adolescent idiopathic scoliosis (AIS), and to identify any predictors of curve regression after bracing.

Methods: Two independent reviewers performed a comprehensive literature search in PubMed, Ovid, Web of Science, Scopus, and Cochrane Library to obtain all published information about the effectiveness of bracing in achieving curve regression in AIS patients. Search terms included "brace treatment" or "bracing," "idiopathic scoliosis," and "curve regression" or "curve reduction.

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Objective: Using whole spine sagittal T2 MRI, we aimed to compare the severity and prevalence of disc degeneration (DD) in axial SpA patients the general population and to determine any association between spinal inflammation, structural changes, mobility and DD among SpA patients.

Methods: Two prospectively collected cohorts of SpA patients ( = 411) and the general population ( = 2007) were recruited. Eventually, 967 participants from the populational cohort and 304 participants from the SpA cohort were analysed.

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