Publications by authors named "V Sarwahi"

Purpose: In congenital scoliosis, the surgical strategy approach of hemivertebra excision, with or without instrumentation and fusion, is a common approach to correction of scoliosis. However, hemivertebra excisions are technically challenging, with potential complications including spinal cord injury, nerve root injury and cerebrospinal fluid leak. The purpose of this study was to determine whether correction of congenital scoliosis can be achieved using a posterior instrumentation/fusion-only approach without the need for hemivertebra excision.

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Study Design: Retrospective Cohort Study.

Objective: This study aimed to compare outcomes in AIS patients that underwent PSF using either freehand with occasional fluoroscopic assistance (FOFA), computer assisted surgery/navigation (CAS), or technique and technology (T&T).

Summary Of Background Data: Pedicle screw insertion in scoliosis is challenging due to abnormal pedicle morphology.

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Article Synopsis
  • The study is a retrospective cohort analysis comparing outcomes of posterior spinal fusion surgery in patients with Rett syndrome (RS) and cerebral palsy (CP) for neuromuscular scoliosis.
  • Results indicate that while complication rates are similar between RS and CP patients, those with CP experience higher estimated blood loss, longer surgical times, and worse postoperative spinal alignment.
  • Overall, findings suggest that RS patients have better surgical and postoperative outcomes compared to those with CP.
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The posterior minimally invasive spine surgery (MISS) approach-or the paraspinal muscle approach-for posterior spinal fusion and segmental instrumentation in adolescent idiopathic scoliosis (AIS) was first reported in 2011. It is less invasive than the traditionally used open posterior midline approach, which is associated with significant morbidity, including denervation of the paraspinal muscles, significant blood loss, and a large midline skin incision. The literature suggests that the MISS approach, though technically challenging and with a longer operative time, provides similar levels of deformity correction, lower intraoperative blood loss, shorter hospital stays, better pain outcomes, and a faster return to sports than the open posterior midline approach.

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Posterior spinal fusion and segmental spinal instrumentation using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique. None of these techniques are recognized as the gold standard.

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