Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review.

The restoration of sagittal alignment is fundamental to the surgical correction of adolescent idiopathic scoliosis (AIS). Despite established techniques, some patients present with inadequate postoperative thoracic kyphosis (TK), which may increase the risk of proximal junctional kyphosis (PJK) and imbalance. There is a lack of knowledge concerning the effectiveness of patient-specific rods (PSR) with measured sagittal curves in achieving a TK similar to that planned in AIS surgery, the factors influencing this congruence, and the incidence of PJK after PSR use.

Enhanced recovery following posterior spinal fusion for adolescent idiopathic scoliosis: A medical and economic study in a French private nonprofit pediatric hospital.

Introduction: Little data exist on the efficacy of enhanced recovery after surgery (ERAS) protocols in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).

Hypothesis: ERAS reduces hospital costs (HC) and length of stay (LOS) without increasing pain or complications.

Materials And Methods: This was a retrospective comparative medical and economic study of 2 cohorts of patients who underwent PSF for AIS: a prospective group who underwent surgery with an ERAS protocol without a specially assigned care coordinator from 2020 to 2021 (n=30) and a retrospective group (control) who received standard care from 2017 to 2018 (n=30).

Adolescent and Juvenile Idiopathic Scoliosis: Which Patients Obtain Good Results with 12 Hours of Cheneau-Toulouse-Munster Nighttime Bracing?

Background: The results of 12 h nighttime Cheneau-Toulouse-Munster (CTM) brace wear on adolescent idiopathic scoliosis are poorly described.

Objective: The main objective was to analyze the efficiency of 12 h nighttime CTM brace wear on adolescent idiopathic scoliosis. The secondary objective was to identify the factors influencing good results.

Comparison of four correction techniques for posterior spinal fusion in adolescent idiopathic scoliosis.

Introduction: When performing posterior spinal fusion for adolescent idiopathic scoliosis (AIS), it is of major importance to address both coronal and sagittal deformities. Although several techniques have been described, few data exist comparing them. Our objective was to compare four techniques (in situ bending (ISB), rod derotation (RD), cantilever (C) and posteromedial translation (PMT)) for the correction of spinal deformity in AIS including thoracic deformity.

Surgical increase in thoracic kyphosis predicts increase of cervical lordosis after thoracic fusion for adolescent idiopathic scoliosis.

Purpose: The modification of cervical lordosis (CL) after adolescent idiopathic scoliosis (AIS) surgery is influenced by the correction of thoracic hypokyphosis. The quantification of the increase of CL as a function of the increase of thoracic kyphosis (TK) has never been calculated.

Methods: A total of 92 consecutive AIS patients who underwent a posterior thoracic selective fusion, corrected by simultaneous translation on 2 rods technique, with minimum 24-month follow-up, were analyzed from a prospective database.

Clinical predictive model of lumbar curve Cobb angle below selective fusion for thoracic adolescent idiopathic scoliosis: a longitudinal multicenter descriptive study.

Purpose: To implement a clinically applicable, predictive model for the lumbar Cobb angle below a selective thoracic fusion in adolescent idiopathic scoliosis.

Methods: A series of 146 adolescents with Lenke 1 or 2 idiopathic scoliosis, surgically treated with posterior selective fusion, and minimum follow-up of 5 years (average 7) was analyzed. The cohort was divided in 2 groups: if lumbar Cobb angle at last follow-up was, respectively, ≥ or < 10°.

Proximal junctional kyphosis is a rebalancing spinal phenomenon due to insufficient postoperative thoracic kyphosis after adolescent idiopathic scoliosis surgery.

Purpose: Many authors tried to explain proximal junctional kyphosis (PJK) after adolescent idiopathic scoliosis (AIS) surgery by looking for risk factors. Latest publications focus on sagittal alignment. Each healthy adolescent has a specific thoracic kyphosis (TK) depending on their pelvic parameters and lumbar lordosis (LL).

Prevention of surgical site infections in pediatric spines: a single-center experience.

Purpose: To describe the potential issues in the methodology of surgical site infection (SSI) prevention and how it was investigated and corrected in a single institution.

Methods: A pediatric orthopedic unit experienced an increase of SSI, concerning up to 10% of scoliosis surgery cases from 2011 to 2013. An institutional procedure of multimodal and interdisciplinary risk evaluation was initiated, including a review of the literature, a morbi-mortality meeting, internal and external audits concerning the hygiene conditions in the operating room, the antibiotic prophylaxis, patients, and sterile material pathways.

Lumbopelvic parameters can be used to predict thoracic kyphosis in adolescents.

Purpose: Distal thoracic kyphosis (DTK) equivalent to proximal lumbar lordosis (PLL) is the sum of pelvic tilt (PT) and the difference (Δ) between lumbar lordosis (LL) and pelvic incidence (PI): PLL = DTK = PT + Δ. With the assumption that proximal thoracic kyphosis (PTK) is similar to DTK, we propose the equation TK = 2(PT + LL - PI) to express the relationship between thoracic kyphosis (TK) and pelvic parameters. The objective of this work is to verify this relationship in a normal population.

Patient-specific rods for thoracic kyphosis correction in adolescent idiopathic scoliosis surgery: Preliminary results.

Introduction: Restoring a degree of kyphosis consistent with good sagittal alignment of the spine is a key concern when performing surgery to correct adolescent idiopathic scoliosis (AIS). The objective of this study was to assess the preliminary outcomes of posterior fusion for AIS using patient-specific rods that were pre-contoured based on pelvic incidence. The primary evaluation criterion was thoracic kyphosis at last follow-up.

Can Gartland II and III supracondylar humerus fractures be treated using Blount's method in the emergency room?

Background: Studies have established that Blount's method is reliable for treating extension supracondylar fractures (SCFs) in paediatric patients. Reduction in the emergency room (ER) under procedural sedation followed by orthopaedic treatment is increasingly used for many fracture types. The primary objective of this study was to determine whether SCF reduction in the ER was feasible, by determining the failure rate.

Surgical increase in thoracic kyphosis increases unfused lumbar lordosis in selective fusion for thoracic adolescent idiopathic scoliosis.

Purpose: In adolescent idiopathic scoliosis (AIS), there is a close relationship between thoracic kyphosis (TK) and proximal lumbar lordosis (PLL). The hypothesis states correction of hypokyphosis increases lumbar lordosis (LL) through increase in PLL after surgical correction of TK.

Methods: 111 consecutive thoracic AIS, Lenke 1 or 2 who underwent posterior selective thoracic fusion with reduction by simultaneous translation on 2 rods and 2 years follow-up have been prospectively selected and analyzed.

Cobalt-chrome and titanium alloy rods provide similar coronal and sagittal correction in adolescent idiopathic scoliosis.

Background: Cobalt-chrome (CoCr) and the titanium alloy TA6V (Ti) are the materials most widely used for spinal instrumentations in patients with adolescent idiopathic scoliosis (AIS). The objective of this work was to compare the effectiveness of CoCr and Ti rods in terms of coronal and sagittal correction by pedicle screw constructs in patients with AIS.

Hypothesis: Correction is similar with CoCr and Ti rods in patients with AIS.

Proximal junctional kyphosis in thoracic adolescent idiopathic scoliosis: risk factors and compensatory mechanisms in a multicenter national cohort.

Introduction: Proximal junctional kyphosis (PJK) is a frequent complication, up to 46%, in adolescent idiopathic scoliosis surgical treatment (AIS). Several risk factors have been evoked but remain controversial. The purpose of this study was to analyze the incidence of PJK in a multicenter cohort of AIS patient and to determine risk factor for PJK.

Influence of Derotation Connectors on 3D Surgical Correction of Adolescent Idiopathic Scoliosis.

Study Design: Monocentric study comparing results of simultaneous translation on 2 rods (ST2R) with derotation connectors (prospective series) or without derotation connectors (retrospective series) in Adolescent Idiopathic Scoliosis (AIS) surgery.

Objective: The objective of this study was to assess if derotation connectors influence axial, coronal, and sagittal results in AIS surgery.

Summary Of Background Data: Conventional reduction techniques remain limited in their ability to reduce axial torsion.

Infantile myofibromatosis of the iliac bone.

Introduction: Solitary infantile myofibromatosis (IM) of bone is a rare benign osseous tumor of childhood with low rate of recurrence. Well documented within the multicenter form, its solitary intraosseous location is less well described.

Case Report: We present a rare case of intraosseous myofibromatosis arising the iliac bone of a 11-year-old girl, who was operated at 2 months of life for a retroauricular subcutaneous MF with unbalanced translocation t(9;16).

Prognostic Role of Rib Hump in Overlying Thoracic Curve Correction Above Selective Fusion for Lenke 5 Idiopathic Adolescent Scoliosis.

Study Design: Prospective study.

Objective: To assess whether rib hump is a prognostic factor of final thoracic Cobb angle.

Summary Of Background Data: Correction of thoracolumbar/lumbar curve, preoperative thoracic curves angle, thoracic curves angle on bending, the thoracolumbar-lumbar angle/thoracic curves angle ratio, thoracic kyphosis, and growth stage influences spontaneous correction of uninstrumented thoracic curves angle above selective fusion for Lenke 5 Adolescent Idiopathic Scoliosis.

Advanced containment methods for Legg-Calvé-Perthes disease: triple pelvic osteotomy versus Chiari osteotomy.

Introduction: The goal of intervention in Legg-Calvé-Perthes disease (LCPD) is to prevent femoral head deformation by containing the head within the acetabulum. Currently, surgical containment methods are the mainstay of treatment, and pelvic osteotomies have been shown to be successful. They include triple pelvic osteotomy (TPO), Salter osteotomy, Chiari osteotomy and shelf procedure.

Legg-Calvé-Perthes disease: classifications and prognostic factors.

Introduction: Legg-Calvé-Perthes Disease (LCPD) represents idiopathic avascular necrosis of femoral head in pediatric population. Indications for treatment depend mostly on prognosis about femoral head sphericity and hip congruence at the end of growth. The aim of this review is to highline prognostic factors of LCPD.

Restoration of thoracic kyphosis by simultaneous translation on two rods for adolescent idiopathic scoliosis.

Introduction: Sagittal and axial corrections of the three-dimensional deformity characteristic of scoliosis remain challenging.

Materials And Method: The author developed a new technique for scoliosis correction consisting of the translation of vertebrae simultaneously towards two rods, which are pre-bent to the correct sagittal profile. Using two rods ensures both reduction and stabilization of the curve.

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis.

Purpose: Sagittal spine and pelvic alignment of adolescent idiopathic scoliosis (AIS) is poorly described in the literature. It generally reports the sagittal alignment with regard to the type of curve and never correlated to the thoracic kyphosis. The objective of this study is to investigate the relationship between thoracic kyphosis, lumbar lordosis and sagittal pelvic parameters in thoracic AIS.

Simultaneous translation on two rods is an effective method for correction of hypokyphosis in AIS: radiographic results of 24 hypokyphotic thoracic scoliosis with 2 years minimum follow-up.

Recent publications confirm that moderate correction of thoracic hypokyphosis can be achieved by posterior instrumentation with hooks or pedicle screws. Twenty-four prospective and consecutive thoracic adolescent scoliosis patients with hypokyphosis (<20°) were operated on by posterior spinal fusion (PSF) with a specific method of reduction: Simultaneous translation on two rods (ST2R), performed by the same surgeon using stable anchorages such as screws or self-stabilizing claws. Radiographic parameters were measured preoperatively, at 1 month, 1 year and at 2 years minimum follow-up.

Simultaneous translation on two rods to treat adolescent idiopathic scoliosis: radiographic results in coronal, sagittal, and transverse plane of a series of 62 patients with a minimum follow-up of two years.

Study Design: Retrospective analysis of a consecutive cohort of 62 adolescent patients treated by posterior spinal fusion (PSF) with a minimum follow-up of 2 years.

Objective: To present sagittal and coronal results of a specific method of reduction: the simultaneous translation on 2 rods (ST2R).

Summary Of Background Data: The long-term outcome of surgically treated scoliosis is dependent not only on the coronal correction but also on restoration of sagittal curves.

Restoration of thoracic kyphosis by posterior instrumentation in adolescent idiopathic scoliosis: comparative radiographic analysis of two methods of reduction.

Study Design: A retrospective comparison of radiographic results for 2 consecutive series of patients treated for adolescent idiopathic scoliosis (AIS) by posterior instrumentations with thoracic screws using 2 methods of reduction: sequential approximation by cantilever reduction (CR) and simultaneous translation technique on 2 rods (ST2R).

Objective: To compare correction of thoracic hypokyphosis and coronal radiographic results between the 2 methods of reduction.

Summary Of Background Data: Publications concerning AIS confirm the moderate correction of thoracic hypokyphosis by posterior instrumentation with hooks and also with pedicle screws.