What factors are associated with a better restoration of pelvic version after adult spinal deformity surgery?

Introduction: Poor restoration of pelvic version after adult spinal deformity (ASD) surgery is associated with an increased risk of mechanical complications and worse quality of life. We studied the factors linked to the improvement of postoperative pelvic version.

Materials And Methods: This is a retrospective analysis of a prospective multicenter ASD database.

Total vertebrectomy and immunochemotherapy for chondrosarcoma colliding with intraosseous lymphoma.

A 59-year-old woman diagnosed with a Grade I chondrosarcoma in T7 underwent total vertebrectomy. Analysis of the surgical piece established diagnosis of a Grade 1 chondrosarcoma confined to T7. Surprisingly, an infiltration with diffuse large B-cell lymphoma was found.

The post-surgical transition in adolescents who have idiopathic scoliosis. A qualitative study.

Objective: To know the process experienced by adolescents suffering from idiopathic scoliosis when undergoing surgery to correct the physical deformity.

Method: Qualitative study with a symbolic interactionism approach. 22 semi-structured interviews were conducted with adolescents who underwent posterior spinal fusion in a third-level hospital in Madrid between May 2019 and January 2021.

Sagittal realignment: surgical restoration of the global alignment and proportion score parameters: a subgroup analysis. What are the consequences of failing to realign?

Introduction: The Global Alignment and Proportion (GAP) score incorporates three domains directly modified with surgery (relative pelvic version-RPV, relative lumbar lordosis-RLL, lumbar distribution index-LDI) and one indirectly restored (relative spinopelvic alignment-RSA). We analyzed our surgical realignment performance and the consequences of domain-specific realignment failure on mechanical complications and PROMs.

Materials And Methods: From an adult spinal deformity prospective multicenter database, we selected patients: fused to pelvis, upper instrumented vertebra at or above L1, and 2 years of follow-up.

Does the use of postoperative brace help preventing mechanical complications following adult deformity surgery?

Purpose: There is scarce information regarding the effectiveness of postoperative braces in decreasing mechanical complications and reinterventions following adult deformity surgery.

Methods: Retrospective matched cohort study from a prospective adult deformity multicenter database. We selected operated patients, fused to the pelvis, > 6 instrumented levels, and minimum 2 year follow-up.

Total spondylectomy in the treatment of postoperative chronic osteomyelitis: a case report.

Background: Infection of the spine after surgical procedures is one of the most dreaded complications of spinal fusion surgery. Treatment goals are to eradicate the necrotic and infected tissue and to obtain a correct spinal profile. Traditionally many authors have recommended the posterolateral or double approach, anterior and posterior.

Cardiac Cement Embolism After Thoracic Kyphoplasty: Successful Conservative Treatment With 4-Year Follow-Up.

Background: The present case report describes a complication after a percutaneous spine surgery technique that is highly uncommon in clinical practice: a bone cement cardiac embolism. This rare complication emphasizes the importance of this case, which is also interesting considering the midterm follow-up. Documented cardiac embolisms published in the literature (which are scarce) describe the acute phase of these cases but lack follow-up.

Adult Congenital Spine Deformity: Clinical Features and Motivations for Surgical Treatment.

Background: There is scarce information available about adult congenital spine deformity (ACSD) in the literature, especially its impact after the pediatric age. The aim was to define ACSD characteristics and to establish the drivers for surgical intervention.

Methods: Cross-sectional study of data collected in an adult deformity multicenter database.

Compensatory mechanisms recruited against proximal junctional kyphosis by patients instrumented from the thoracolumbar junction to the iliac.

Purpose: The compensatory mechanisms recruited by un-instrumented patients against sagittal imbalance are well documented. However, there is a lack of information regarding instrumented patients.

Material And Methods: We performed a retrospective analysis of data collected prospectively in a multicenter adult spinal deformity database.

How to Select the Lower Instrumented Vertebra in Traditional Growing Rods Index Surgery.

Background: There are still no consensus criteria on how to select the lower instrumented vertebra (LIV) for traditional growing rods (TGRs) at index surgery. The aim was to evaluate whether the criteria used for adolescent idiopathic scoliosis fusion adapts to early onset scoliosis (EOS).

Methods: Retrospective analysis of prospectively longitudinal collected data in a consecutive cohort of patients with EOS treated with TGR, expanding from index surgery to 2 years after graduation.

Median Sacral Artery Rupture as a Complication of Posterior-Only Approach of L4 Total En Bloc Spondilectomy: A Case Report.

Case: A 6-year-old patient with Ewing sarcoma at L4 who was treated with total en bloc spondilectomy (TES) through a posterior-only approach. During the dissection of the anterior L4 body, there was uncontrollable bleeding from an unknown origin, which needed packing, massive transfusion, and urgent laparotomy. A median sacral artery (MSA) rupture was identified as the cause of this massive bleeding.

Limiting spread of COVID-19 in an orthopaedic department-a perspective from Spain.

Besides national and international recommendations, orthopaedic departments face significant changes in daily activity and serious issues to maintain their standards in musculoskeletal care during the pandemic Covid-19 crisis that we are facing. This report retrospectively addresses measures that were progressively put in place to modify in a week time the activity of a busy orthopaedic department in a large tertiary university hospital in face of the pandemic. Surgical priorities and surgical outcomes are key aspects to consider.

Ideal sagittal profile restoration and ideal lumbar apex positioning play an important role in postoperative mechanical complications after a lumbar PSO.

Study Design: Retrospective analysis of prospectively collected data.

Objective: To determine the influence of postoperative ideal lordosis distribution and ideal sagittal harmony on mechanical complications in patients undergoing one-level lumbar pedicle subtraction osteotomy (L-PSO). Many variables have been associated with mechanical complications after L-PSO.

Midterm Results of Hemivertebrae Resection and Transpedicular Short Fusion in Patients Younger Than 5 Years: How Do Thoracolumbar and Lumbosacral Curves Compare?

Study Design: Retrospective case series with comparative analysis.

Objective: To analyze a consecutive cohort of very young patients operated for congenital scoliosis secondary to a single hemivertebra (HV) and compare thoracolumbar (TL) versus lumbosacral (LS) curve results.

Summary Of Background Data: Despite the published successful results regarding early hemivertebra resection and short fusion for congenital hemivertebrae, literature lacks midterm results, especially in very young children.

Surgical Treatment of Scoliosis Developed After Extended Chest Wall Resection Due to Askin Tumor During Childhood.

Study Design: Report of four cases.

Objective: To describe a series of pediatric patients with surgical scoliosis after chest wall resections due to Askin tumors.

Summary Of Background Data: Askin tumors are a rare type of chest wall solid tumors that can develop in children.

Decision Making of Graduation in Patients With Early-Onset Scoliosis at the End of Distraction-Based Programs: Risks and Benefits of Definitive Fusion.

Study Design: Retrospective comparative analysis.

Objective: Study early-onset scoliosis (EOS) graduated patients to establish founded criteria for graduation decision making and determine the risks and benefits of definitive fusion.

Summary Of Background Data: EOS is treated by growth-friendly techniques until skeletal maturity.

Intraspinal metalloma causing lumbar stenosis after interbody fusion with cylindrical titanium cages.

Intraspinal metallomas are rare. The authors present a case after implantation of two titanium threaded interbody cages at the L4L5 level, without posterior instrumentation. To their knowledge this is the first case due to intervertebral cages.

Proximal junctional vertebral fracture-subluxation after adult spine deformity surgery. Does vertebral augmentation avoid this complication? A case report.

Background: To report to the orthopedic community a case of vertebral fracture and adjacent vertebral subluxation through the upper instrumented vertebra after thoracolumbar fusion with augmentation of the cranial level.

Methods: This report reviewed the patient`s medical record, her imaging studies and related literature. The possible factors contributing to this fracture are hypothesized.

Severe restrictive lung disease and vertebral surgery in a pediatric population.

The aim of this study is to describe the outcome of surgical treatment for pediatric patients with forced vital capacity (FVC) <40% and severe vertebral deformity. Few studies have examined surgical treatment in these patients, who are considered to be at a high risk because of their pulmonary disease, and in whom preoperative tracheostomy is sometimes recommended. Inclusion criteria include FVC <40%, age <19 years and diagnosis of scoliosis.