Comparison of 5-year outcomes between pedicle screw and hybrid constructs in adolescent idiopathic scoliosis.

Object: Pedicle screw fixation has been theorized to provide better correction of scoliotic deformity, but controversy over the benefits of pedicle screw-only constructs remains, and the longer-term impact of pedicle screw fixation as compared with hybrid constructs is unclear. In this study, a retrospective review of a prospectively collected database was conducted to determine the longer-term impact of pedicle screw fixation as compared with hybrid constructs in patients with adolescent idiopathic scoliosis (AIS).

Methods: The authors retrospectively reviewed a multicenter database of pediatric patients (ages ≤ 18) from 1995 to 2006 and identified 127 patients with Lenke Type 1-4 AIS curves with a minimum 5 years of follow-up.

Reduction in radiation (fluoroscopy) while maintaining safe placement of pedicle screws during lumbar spine fusion.

Study Design: Prospective, randomized, controlled study.

Objective: To report the results of using the PediGuard (SpineGuard, Inc., San Francisco, CA), a local electrical conductivity measurement device, to reduce radiation exposure while drilling the pilot hole for pedicle screw placement.

Is larger scoliosis curve magnitude associated with increased perioperative health-care resource utilization?: a multicenter analysis of 325 adolescent idiopathic scoliosis curves.

Background: The treatment of patients with large adolescent idiopathic scoliosis curves has been associated with increased surgical complexity. The purpose of this study was to determine whether surgical correction of larger adolescent idiopathic scoliosis curves increased the utilization of health-care resources and to identify potential predictors associated with increased perioperative health-care resource utilization.

Methods: A nested cohort of patients with adolescent idiopathic scoliosis with Lenke type 1A and 1B curves were identified from a prospective longitudinal multicenter database.

Outcomes of Chiari I-associated scoliosis after intervention: a meta-analysis of the pediatric literature.

Purpose: Various series have reported successful management of scoliosis after surgical treatment of the associated Chiari malformation, syrinx, or bracing. Multiple factors have been associated with curve progression, but interpretation of outcomes is confounded by the wide range of reported results and size of individual series. We attempted to evaluate the outcomes of Chiari I-associated scoliosis by performing a meta-analysis of currently published data.

Efficacy and safety of quinine loading dose in patients with severe falciparum malaria at a tertiary care hospital in Pakistan.

Objective: To compare the clinical outcomes of a loading dose regimen of quinine with a uniform dose regimen in patients with severe falciparum malaria.

Methods: A retrospective chart review of 315 patients admitted with severe falciparum malaria and treated with quinine at a tertiary care teaching hospital of Karachi, Pakistan during 1999-2006 was conducted. Group A with 103 patients (32.

Diffusion tensor imaging of the normal pediatric spinal cord using an inner field of view echo-planar imaging sequence.

Background And Purpose: DTI in the brain has been well established, but its application in the spinal cord, especially in pediatrics, poses several challenges. The small cord size has inherent low SNR of the diffusion signal intensity, respiratory and cardiac movements induce artifacts, and EPI sequences used for obtaining diffusion indices cause eddy-current distortions. The purpose of this study was to 1) evaluate the accuracy of cervical spinal cord DTI in children using a newly developed iFOV sequence with spatially selective 2D-RF excitations, and 2) examine reproducibility of the DTI measures.

Direct vertebral body derotation, thoracoplasty, or both: which is better with respect to inclinometer and scoliosis research society-22 scores?

Study Design: Prospective, longitudinal cohort (nonrandomized).

Objective: To compare thoracoplasty (Th), direct vertebral body derotation (DVBD), and Th and DVBD with respect to correction of the rib prominence and Scoliosis Research Society (SRS) self-image scores in patients undergoing surgery for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Rib prominence correction is one of the main goals of AIS surgery.

The impact of segmental and en bloc derotation maneuvers on scoliosis correction and rib prominence in adolescent idiopathic scoliosis.

Object: Idiopathic scoliosis is a pathological process influencing the spinal column in 3 dimensions. Initial surgical treatment focused primarily on correction in the coronal plane, and with improved instrumentation, increasing attention has targeted balancing the sagittal profile. Newer surgical techniques now permit operative corrective forces to also directly address axial rotation.

Diffusion tensor imaging in pediatric spinal cord injury: preliminary examination of reliability and clinical correlation.

Study Design: The design was a nonexperimental, repeated measures design.

Objective: To examine the reliability of repeated diffusion tensor imaging (DTI) values of the pediatric cord and to compare DTI values with values obtained on the clinical examination and findings from conventional magnetic resonance imaging (MRI).

Summary Of Background Data: DTI quantifies the diffusion of water molecules in directions parallel and transverse to the plane of neuronal axons.

[Non-operative treatment for severe forms of infantile idiopathic scoliosis].

Introduction: Infantile idiopathic scoliosis (IIS) is a rare orthopaedic condition. Braces and casts are popular options in the treatment of IIS but there is a paucity of studies commenting on the outcome of non-operative treatment. The purpose of this study was to analyse failure and success after non-operative treatment for severe forms of IIS.

Homozygous frame shift mutation in ECM1 gene in two siblings with lipoid proteinosis.

Background: The extracellular matrix protein 1 (ECM1) is a glycoprotein, expressed in skin and other tissues. Loss-of-function mutation in ECM1 causes a rare autosomal recessive disorder called lipoid proteinosis. Lipoid proteinosis is presented by varying degrees of skin scars, beaded papules along the eyelid margins, variable signs of hoarseness of voice and respiratory disorders.

Effect of direct vertebral body derotation on the sagittal profile in adolescent idiopathic scoliosis.

Purpose: We sought to clarify the effect of applying derotation maneuvers in the correction of adolescent idiopathic scoliosis (AIS) on the sagittal plane.

Methods: We retrospectively queried a large, multicenter, prospectively collected database for patients who underwent surgical correction of AIS. All patients had at least 2 years of follow-up and documentation as to whether or not a derotation maneuver was performed during surgery.

Cognitive testing of the spinal appearance questionnaire with typically developing youth and youth with idiopathic scoliosis.

Background: The Spinal Appearance Questionnaire (SAQ) underwent initial psychometric studies, which suggested good reliability and discriminative ability. Although the SAQ is used as a self report of appearance, our center was concerned about its use with youth owing to complex words and vague questions. We conducted this cross-sectional study to evaluate the readability, comprehension, and interpretation of items on the SAQ.

Interrater reliability of the international standards for neurological classification of spinal cord injury in youths with chronic spinal cord injury.

Objectives: To evaluate the interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in children with chronic spinal cord injury (SCI), and to define the lower age limit at which the examinations have clinical utility.

Design: Repeated measures, multicenter reliability study.

Setting: Two U.

Cervical sagittal plane decompensation after surgery for adolescent idiopathic scoliosis: an effect imparted by postoperative thoracic hypokyphosis.

Object: Several studies have characterized the relationship among postoperative thoracic, lumbar, and pelvic alignment in the sagittal plane. However, little is known of the relationship between postoperative thoracic kyphosis and sagittal cervical alignment in patients with adolescent idiopathic scoliosis (AIS) treated with all pedicle screw constructs. The authors examined this relationship and associated factors.

Description of sensory preservation in children and adolescents with incomplete spinal cord injury.

Background/objective: This cross-sectional, multicenter cohort study describes patterns of preserved sensation in persons with American Spinal Injury Association (ASIA) Impairment Scale (AIS) B (sensory incomplete, or SI) and AIS C/D (motor incomplete, or MI).

Methods: A total of 93 subjects with incomplete spinal injuries (58 with tetraplegia and 35 with paraplegia) were included for analysis. Sensation was based on the International Standards for Neurological Classification of SCI (ISNCSCI).

Detection of filaggrin gene mutation (2282del4) in Pakistani Ichthyosis vulgaris families.

The aim of this study was to detect an 811 bp filaggrin (FLG) gene fragment known to carry a mutation 2282del4 which causes ichthyosis vulgaris. Seven clinically examined ichthyosis vulgaris families were included in this study. An 811 bp FLG gene fragment was targeted in the genomic DNA of all the members of the seven families by PCR amplification using known primers RPT1P7 and RPT2P1.

Vertebral body stapling as an alternative in the treatment of idiopathic scoliosis.

Objective: Unilateral vertebral body stapling as a fusionless alternative to control curvature progression in patients with idiopathic scoliosis (IS).

Indications: Skeletally immature patients (Risser 0 or 1) with IS measuring 20-45° and correction of the curvature <20° on side-bending X-rays.

Contraindications: Congenital scoliosis, curvature above T4 or below L4, thoracic kyphosis >40°.

Impact of direct vertebral body derotation on rib prominence: are preoperative factors predictive of changes in rib prominence?

Study Design: Multicenter retrospective review of prospectively collected data.

Objective: To determine the extent of rib deformity correction that can be expected with direct vertebral body derotation (DVBD) and investigate factors that may correlate with improved rib deformity correction.

Summary Of Background Data: DVBD is a powerful tool in the surgical correction of axial rotation in adolescent idiopathic scoliosis.

Postoperative trunk shift in Lenke 1 and 2 curves: how common is it? and analysis of risk factors.

The goal of surgical treatment for adolescent idiopathic scoliosis (AIS) is to achieve a solid fusion in a balanced spine. While many previous studies analyzed coronal balance, there is a paucity of studies that comment on postoperative trunk shift, which has shown to have impact on clinical outcome. The purpose of this retrospective, multicenter data analysis was to analyze the incidence of postoperative trunk shift in patients with surgical treatment for AIS.

Intraoperative disc herniation during posterior spinal fusion for correction of Scheuermann's Kyphosis.

Study Design: A retrospective case report.

Objective: To report a previously unpublished complication associated with surgical correction of Scheuermann's kyphosis (SK).

Summary Of Background Data: Recently, a review of a large Scoliosis Research Society database reported a 1.

Diffusion tensor imaging of the pediatric spinal cord at 1.5T: preliminary results.

Background And Purpose: Recent studies suggest that pediatric subjects as old as 8-years-of-age may have difficulty with the ISNCSCI examinations. Our aim was to investigate DTI parameters of healthy spinal cord in children with noncervical IS for comparison with children with SCI and to prospectively evaluate reliability measures of DTI and to correlate the measures obtained in children with SCI with the ISNCSCI.

Materials And Methods: Five controls with thoracic and lumbar IS and 5 children with cervical SCI were imaged twice by using a single-shot echo-planar diffusion-weighted sequence.

Clinical outcomes of nitinol staples for preventing curve progression in idiopathic scoliosis.

Summary Of Background Data: Although bracing for idiopathic scoliosis is moderately successful, its efficacy has been called into question and it carries associated psychosocial ramifications. In this study we report the background, rationale, indications, surgical techniques, and early results of vertebral body stapling (VBS) in patients with idiopathic scoliosis.

Methods: We reviewed the literature on growth modulation of the growing spine and the concepts behind the use of VBS as a fusionless strategy.

Triggered electromyography for placement of thoracic pedicle screws: is it reliable?

Reliable electromyography (EMG) thresholds for detecting medial breaches in the thoracic spine are lacking, and there is a paucity of reports evaluating this modality in patients with adolescent idiopathic scoliosis (AIS). This retrospective analysis evaluates the ability of triggered EMG to detect medial breaches with thoracic pedicle screws in patients with AIS. We reviewed 50 patients (937 pedicle screws) undergoing posterior spinal fusion (PSF) with intraoperative EMG testing.