1,271 results match your criteria Neuromuscular Scoliosis


Characterizing Use of Growth-friendly Implants for Early-onset Scoliosis: A 10-Year Update.

J Pediatr Orthop 2020 May 27. Epub 2020 May 27.

Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.

Background: Growth-friendly treatment of early-onset scoliosis (EOS) has changed with the development and evolution of multiple devices. This study was designed to characterize changes in the use of growth-friendly implants for EOS from 2007 to 2017.

Methods: We queried the Pediatric Spine Study Group database for patients who underwent index surgery with growth-friendly implants from July 2007 to June 2017. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001594DOI Listing

Nonanesthetized Alternatively Repetitive Cast and Brace Treatment for Early-onset Scoliosis.

J Pediatr Orthop 2020 May 27. Epub 2020 May 27.

Department of Orthopedics and Spine Surgery, Meijo Hospital, Nagoya.

Background: Use of cast is a standard treatment (Tx) choice for early-onset scoliosis. Recently, toxicity from repetitive use of general anesthesia has received attention by the Food and Drug Administration (FDA). We introduce a nonanesthetized cast Tx protocol called alternatively-repetitive-cast-and-brace (ARCB) that we have used since 1995 and have conducted an extensive follow-up on these patients to verify the efficacy of this protocol. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001598DOI Listing

Blood Management and Risk Assessment for Transfusion in Pediatric Spinal Deformity Surgery.

Adv Hematol 2020 7;2020:8246309. Epub 2020 May 7.

Orthopedic Department, University Hospital of Santa Maria, Lisbon, Portugal.

Objectives: Evaluate the impact of a Quality and Safety Program (QSP) on the reduction of blood loss and transfusion needs in pediatric spinal deformity surgery, while defining risk factors for transfusion.

Background: Multimodal plan aiming to minimize transfusion needs has been shown to reduce transfusions and index rates in spinal deformity surgery. Anticipating blood loss and transfusion may help direct resources to patient needs or encourage reconsideration of the surgical plan. Read More

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http://dx.doi.org/10.1155/2020/8246309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229536PMC

Sympathetic outflow disturbance following posterior deformity correction: A rare complication.

World Neurosurg 2020 May 11. Epub 2020 May 11.

Department of Spine Services, Indian Spinal Injuries Centre, Vasant kunj, Sector C, New Delhi. Pin: 110070.

Introduction: Sympathetic system injury is a known but rare complication in scoliosis deformity correction. It is not common following posterior correction. We report case of diastematomyelia with neuromuscular scoliosis with unusual complication of sympathetic outflow disturbance, after posterior instrumented correction. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.05.039DOI Listing

Perioperative Halo-Gravity Traction in the Treatment of Scoliosis with Intraspinal Anomalies.

World Neurosurg 2020 May 11. Epub 2020 May 11.

Department of Spinal Surgery, HongHui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Xi'an, Shaanxi, 710054, China. Electronic address:

Purpose: To investigate the efficacy and safety of preoperative halo-gravity traction and one-stage posterior surgery for the treatment of scoliosis with intramedullary anomalies.

Methods: A total of 11 scoliosis patients with intramedullary anomalies were evaluated. All patients were treated with preoperative halo-gravity traction and one-stage posterior surgery. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.04.242DOI Listing

One stage or two? A cohort analysis of anterior-posterior spinal fusions for severe pediatric scoliosis.

Spine Deform 2020 May 12. Epub 2020 May 12.

Division of Pediatric Orthopedics, Rainbow Babies and Children's Hospitals/ University Hospitals Cleveland Medical Center; Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH, 44106, USA.

Study Design: Retrospective case-series study of prospectively collected data.

Objective: We sought to identify the differences in outcomes between one-stage (single surgical episode) and two-stage (separate day) anterior and posterior spinal fusion and segmental spinal instrumentation surgeries in severe non-idiopathic and idiopathic scoliosis cases.

Background: Patients with severe pediatric spine deformity may require combined anterior and posterior fusion procedures. Read More

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http://dx.doi.org/10.1007/s43390-020-00128-yDOI Listing

Distraction-to-Stall Versus Targeted Distraction in Magnetically Controlled Growing Rods.

J Pediatr Orthop 2020 May 8. Epub 2020 May 8.

Department of Orthopedics and Scoliosis Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, TX.

Background: Consensus is lacking regarding the lengthening procedures in magnetically controlled growing rods (MCGR), and no studies have compared the outcome between different distraction principles. The purpose of the present study was to compare distraction-to-stall with targeted distraction and identify variables associated with achieved distraction.

Methods: We performed a 2-center retrospective study of all children treated with MCGR from November 2013 to January 2019, having a minimum of 1-year follow-up and undergoing a minimum of 3 distractions. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001585DOI Listing

BMI change following spinal fusion for neuromuscular scoliosis surgery.

Spine Deform 2020 May 11. Epub 2020 May 11.

Shriners Hospital for Children, Philadelphia, PA, USA.

Study Design: Retrospective descriptive, multi-center study.

Objectives: We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery. Cachexia and low body mass index is common among children with cerebral palsy (CP). Read More

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http://dx.doi.org/10.1007/s43390-020-00109-1DOI Listing

Precise Pulmonary Function Evaluation and Management of a Patient With Freeman-Sheldon Syndrome Associated With Recurrent Pneumonia and Chronic Respiratory Insufficiency.

Ann Rehabil Med 2020 Apr 29;44(2):165-170. Epub 2020 Apr 29.

Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Freeman-Sheldon syndrome (FSS) is a rare distal arthrogryposis syndrome. There are few reports on the respiratory insufficiency of FSS. Additionally, there is no detailed information on pulmonary functional evaluation. Read More

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http://dx.doi.org/10.5535/arm.2020.44.2.165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214134PMC

SCO-Spondin Defects and Neuroinflammation Are Conserved Mechanisms Driving Spinal Deformity across Genetic Models of Idiopathic Scoliosis.

Curr Biol 2020 Apr 23. Epub 2020 Apr 23.

Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, The University of Toronto, Toronto, ON M5S 1A8, Canada. Electronic address:

Adolescent idiopathic scoliosis (AIS) affects 3% to 4% of children between the ages of 11 and 18 [1, 2]. This disorder, characterized by abnormal three-dimensional spinal curvatures that typically develop during periods of rapid growth, occurs in the absence of congenital vertebral malformations or neuromuscular defects [1]. Genetic heterogeneity [3] and a historical lack of appropriate animal models [4] have confounded basic understanding of AIS biology; thus, treatment options remain limited [5, 6]. Read More

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http://dx.doi.org/10.1016/j.cub.2020.04.020DOI Listing

Preclinical model systems of ryanodine receptor 1-related myopathies and malignant hyperthermia: a comprehensive scoping review of works published 1990-2019.

Orphanet J Rare Dis 2020 May 7;15(1):113. Epub 2020 May 7.

National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, 20892, USA.

Background: Pathogenic variations in the gene encoding the skeletal muscle ryanodine receptor (RyR1) are associated with malignant hyperthermia (MH) susceptibility, a life-threatening hypermetabolic condition and RYR1-related myopathies (RYR1-RM), a spectrum of rare neuromuscular disorders. In RYR1-RM, intracellular calcium dysregulation, post-translational modifications, and decreased protein expression lead to a heterogenous clinical presentation including proximal muscle weakness, contractures, scoliosis, respiratory insufficiency, and ophthalmoplegia. Preclinical model systems of RYR1-RM and MH have been developed to better understand underlying pathomechanisms and test potential therapeutics. Read More

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http://dx.doi.org/10.1186/s13023-020-01384-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204063PMC

Surgical site infection prevention protocol for pediatric spinal deformity surgery: does it make a difference?

Spine Deform 2020 Apr 30. Epub 2020 Apr 30.

Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, USA.

Study Design: Retrospective.

Objective: Can a standardized, hospital-wide care bundle decrease surgical site infection (SSI) rate in pediatric spinal deformity surgery? SSI is a major concern in pediatric spinal deformity surgery.

Methods: We performed a retrospective review of our primary scoliosis surgeries between 1999 and 2017. Read More

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http://dx.doi.org/10.1007/s43390-020-00120-6DOI Listing

The Use of Metal Sublaminar Wires in Modern Growth-Guidance Scoliosis Surgery: A Report of 4 Cases and Literature Review.

Int J Spine Surg 2020 Apr 30;14(2):182-188. Epub 2020 Apr 30.

Department of Orthopaedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, The Netherlands.

Background: To avoid early fusion and allow residual growth of the spine in early onset scoliosis (EOS) treatment, growth-guided scoliosis surgery can be performed. Four patients with EOS are presented in which a growth-guidance instrumentation is used with sliding titanium (Ti) sublaminar cables. Residual growth of the spine can be preserved using metal sublaminar wiring; however, several drawbacks of this technique and type of material are illustrated. Read More

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http://dx.doi.org/10.14444/7017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188087PMC

The Value of a Modified Wiltse Approach for Deformity Correction in Neuromuscular Scoliosis.

Int J Spine Surg 2020 Apr 30;14(2):170-174. Epub 2020 Apr 30.

University of Oxford, Division of Spinal Surgery, Oxford, England.

Background: Wiltse approaches have been shown to reduce operative blood loss and enhance recovery in lumbar spinal surgery; however, their efficacy in neuromuscular scoliosis (NMS) deformity correction has never been assessed. Thus, the purpose of this study was to compare the outcomes of deformity correction requiring pelvic fixation in NMS performed through a Wiltse approach in contrast to a standard midline approach.

Methods: This is a retrospective review of 24 consecutive children with NMS undergoing deformity correction by a single surgeon in our institution. Read More

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http://dx.doi.org/10.14444/7023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188105PMC

What Factors can Influence Massive Blood Loss in the Surgical Treatment of Neuromuscular Scoliosis?

Rev Bras Ortop (Sao Paulo) 2020 Apr 6;55(2):181-184. Epub 2020 Apr 6.

Departamento de Ortopedia e Traumatologia, Centro Hospitalar São João, Porto, Portugal.

 The aim of the present study is to identify the incidence, predisposing factors and prognostic impact of blood loss in patients with neuromuscular scoliosis submitted to corrective surgery.  Retrospective cohort study, including pediatric patients diagnosed with neuromuscular scoliosis undergoing instrumentation and posterior vertebral fusion in a university hospital. Patient characteristics were collected from the hospital information system. Read More

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http://dx.doi.org/10.1055/s-0039-3400527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186074PMC

Seasonal Variation in the Volume of Posterior Spinal Arthrodesis Procedures for Pediatric Scoliosis.

Spine (Phila Pa 1976) 2020 Apr 23. Epub 2020 Apr 23.

Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.

Study Design: Retrospective review of the Healthcare Cost and Utilization Project's Kids' Inpatient Database.

Objective: The aim of this study was to investigate variations in surgical case volume in the US for spinal arthrodesis for pediatric patients with scoliosis.

Summary Of Background Data: Approximately 38,000 spinal arthrodesis procedures are performed each year in the United States for pediatric patients with scoliosis. Read More

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http://dx.doi.org/10.1097/BRS.0000000000003517DOI Listing

MRI utilization and rates of abnormal pretreatment MRI findings in early-onset scoliosis: review of a global cohort.

Spine Deform 2020 Apr 24. Epub 2020 Apr 24.

Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, USA.

Study Design: Retrospective review OBJECTIVES: To report the frequency of pretreatment magnetic resonance imaging (MRI) utilization and rates and types of intra-spinal abnormalities identified on MRI in patients with early-onset scoliosis (EOS). MRI can help identify spinal cord abnormalities in patients with EOS.

Methods: We reviewed data from patients enrolled from 1993-2018 in an international EOS registry. Read More

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http://dx.doi.org/10.1007/s43390-020-00115-3DOI Listing

Probability of severe frailty development among operative and nonoperative adult spinal deformity patients: an actuarial survivorship analysis over a 3-year period.

Spine J 2020 Apr 20. Epub 2020 Apr 20.

Rocky Mountain Scoliosis and Spine, Denver, CO, USA.

Background: Little is known of how frailty, a dynamic measure of physiological age, progresses relative to age or disability status. Operative treatment of adult spinal deformity (ASD) may play a role in frailty remediation and maintenance.

Purpose: Compare frailty status, severe frailty development, and factors influencing severe frailty development among ASD patients undergoing operative or nonoperative treatment. Read More

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http://dx.doi.org/10.1016/j.spinee.2020.04.010DOI Listing
April 2020
2.426 Impact Factor

Serial Casting in Neuromuscular and Syndromic Early-onset Scoliosis (EOS) Can Delay Surgery Over 2 Years.

J Pediatr Orthop 2020 Apr 14. Epub 2020 Apr 14.

Children's Hospital of Philadelphia.

Background: The primary goal in managing early-onset scoliosis (EOS) is delaying/preventing surgical intervention while allowing improved spinal growth and chest wall and lung development to improve life expectancy. The effectiveness of serial casting for patients with neuromuscular and syndromic EOS is unclear.

Methods: Patients from 2 multicenter registries who underwent serial casting for nonidiopathic scoliosis (NIS) were reviewed retrospectively. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001568DOI Listing

Delayed quadriparesis after posterior spinal fusion for scoliosis: a case series.

Spine Deform 2020 Apr 9. Epub 2020 Apr 9.

Nicklaus Children's Hospital, 3100 SW 62nd Ave., Miami, FL, 33165, USA.

Study Design: A multicenter retrospective IRB exempt case series analyzing clinical and radiographical data of patients treated by three surgeons over the past two decades was conducted.

Objective: To examine the factors involved in the development of quadriparesis in patients who underwent posterior spinal fusion for scoliosis. Delayed spinal cord infarcts usually present at the region of instrumentation according to reports from the Scoliosis Research Society. Read More

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http://dx.doi.org/10.1007/s43390-020-00113-5DOI Listing

Computed-tomography-guided transforaminal intrathecal nusinersen injection in adults with spinal muscular atrophy type 2 and severe spinal deformity. Feasibility, safety and radiation exposure considerations.

Eur J Neurol 2020 Apr 6. Epub 2020 Apr 6.

Second Department of Radiology, Division of Interventional Radiology, School of Medicine, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece.

Background And Purpose: The purpose was to investigate our centre's experience on computed-tomography-guided (CT-guided), transforaminal, intrathecal administration of nusinersen in adult subjects with spinal muscular atrophy (SMA) type 2 and severe spinal deformity.

Method: This is a retrospective, single-centre study investigating the feasibility and safety of CT-guided, transforaminal, lumbar puncture for the intrathecal administration of nusinersen (Spinranza®; Biogen; Cambridge, MA, USA) in a cohort of adult subjects with SMA type 2, severe neuromuscular scoliosis and previous spinal surgery. Between January 2019 and October 2019, five male, adult, SMA type 2 subjects were eligible to be treated in our centre with nusinersen. Read More

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http://dx.doi.org/10.1111/ene.14245DOI Listing

Correlation between surgical site infection and classification of early onset scoliosis (C-EOS) in patients managed by rib-based distraction instrumentation.

Spine Deform 2020 Mar 30. Epub 2020 Mar 30.

Division of Orthopaedics, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Objectives: The aim of this study is to determine risk factors for infection among EOS patients treated by rib-based distraction instrumentation, and to further assess the incidence of infection among C-EOS categories and sub-types. Despite the heterogonous nature of early onset scoliosis, the classification of early onset scoliosis (C-EOS) has proven to have excellent reliability across its major categories. C-EOS's reliability has been verified; however, little data exist on the utility of this categorization in clinical decision-making and risk assessment. Read More

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http://dx.doi.org/10.1007/s43390-020-00103-7DOI Listing

Intensive Care Unit Admission Following Surgery for Pediatric Spinal Deformity: An Analysis of the ACS-NSQIP Pediatric Spinal Fusion Procedure Targeted Dataset.

Global Spine J 2020 Apr 10;10(2):177-182. Epub 2019 Apr 10.

The Ohio State University, Wexner Medical Center, Columbus, OH, USA.

Study Design: Retrospective cohort.

Objective: To understand which patient and surgical factors are predictive of an increased odds of undergoing an admission and a prolonged stay >2 days in an intensive care unit (ICU) following corrective surgery for pediatric deformity.

Methods: The 2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric Spinal Fusion Procedure Targeted database records, merged with original 2016 ACS-NSQIP Pediatric file variables, were used for this study. Read More

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http://dx.doi.org/10.1177/2192568219841367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076600PMC

Anterior lengthening in scoliosis occurs only in the disc and is similar in different types of scoliosis.

Spine J 2020 Mar 14. Epub 2020 Mar 14.

Department of Orthopedic Surgery, University Medical Center Utrecht, P.O. Box 85500, Utrecht 3508, the Netherlands. Electronic address:

Background Context: Relative anterior spinal overgrowth was proposed as a generalized growth disturbance and a potential initiator of adolescent idiopathic scoliosis (AIS). However, anterior lengthening has also been observed in neuromuscular (NM) scoliosis and was shown to be restricted to the apical areas and located in the intervertebral discs, not in the bone. This suggests that relative anterior spinal overgrowth does not rightfully describe anterior lengthening in scoliosis, as it seems not a generalized active growth phenomenon, nor specific to AIS. Read More

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http://dx.doi.org/10.1016/j.spinee.2020.03.005DOI Listing

Cerebral palsy with dislocated hip and scoliosis: what to deal with first?

J Child Orthop 2020 Feb;14(1):24-29

Department of Orthopedic Surgery, University Medical Center Utrecht, The Netherlands.

Purpose: Hip dislocation and scoliosis are common in children with cerebral palsy (CP). Hip dislocation develops in 15% and 20% of children with CP, mainly between three and six years of age and especially in the spastic and dyskinetic subtypes. The risk of scoliosis increases with age and increasing disability as expressed by the Gross Motor Function Score. Read More

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http://dx.doi.org/10.1302/1863-2548.14.190099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043124PMC
February 2020

Bigger is better: larger thoracic height is associated with increased health related quality of life at skeletal maturity.

Spine Deform 2020 Mar 11. Epub 2020 Mar 11.

Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA.

Study Design: Cross sectional OBJECTIVES: The purpose of this study is to evaluate the association between thoracic height and health-related quality of life (HRQoL) at skeletal maturity in patients with EOS. Current literature suggests a minimum thoracic height of 18 cm to 22 cm to avoid poor pulmonary function and related health outcomes.

Methods: Patients with EOS who reached skeletal maturity from 2005 to 2018 were identified in two registries including 32 centers. Read More

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http://dx.doi.org/10.1007/s43390-020-00095-4DOI Listing

Spinal cord injury in infancy: activity-based therapy impact on health, function, and quality of life in chronic injury.

Spinal Cord Ser Cases 2020 Mar 10;6(1):13. Epub 2020 Mar 10.

Kosair Charities Center for Pediatric NeuroRecovery, University of Louisville, Louisville, KY, USA.

Introduction: Spinal cord injury (SCI) in infancy magnifies the complexity of a devastating diagnosis. Children injured so young have high incidences of scoliosis, hip dysplasia, and respiratory complications leading to poor health and outcomes. We report the medical history, progression of rehabilitation, usual care and activity-based therapy, and outcomes for a child injured in infancy. Read More

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http://dx.doi.org/10.1038/s41394-020-0261-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064539PMC

Understanding Respiratory Restrictions as a Function of the Scoliotic Spinal Curve in Thoracic Insufficiency Syndrome: A 4D Dynamic MR Imaging Study.

J Pediatr Orthop 2020 Apr;40(4):183-189

Center for Thoracic Insufficiency Syndrome, Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Over the past 100 years, many procedures have been developed for correcting restrictive thoracic deformities which cause thoracic insufficiency syndrome. However, none of them have been assessed by a robust metric incorporating thoracic dynamics. In this paper, we investigate the relationship between radiographic spinal curve and lung volumes derived from thoracic dynamic magnetic resonance imaging (dMRI). Read More

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http://dx.doi.org/10.1097/BPO.0000000000001258DOI Listing

Early and late hospital readmissions after spine deformity surgery in children with cerebral palsy.

Spine Deform 2020 Jun 4;8(3):507-516. Epub 2020 Mar 4.

Shriners Hospitals for Children-Philadelphia, 3551 N Broad Street, Philadelphia, PA, 19140, USA.

Study Design: Retrospective review of a prospectively collected multicenter registry of pediatric patients with cerebral palsy (CP) and neuromuscular scoliosis (NMS) undergoing spinal fusion.

Objective: To define risk factors for unplanned readmission after elective spinal deformity surgery. Patients with CP and NMS have high rates of hospital readmission; however, risk factors for readmission are not well established. Read More

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http://dx.doi.org/10.1007/s43390-019-00007-1DOI Listing

What Is the Cost of a "Cast Holiday" in Treating Children With Early Onset Scoliosis (EOS) With Elongation Derotation Flexion (EDF, "Mehta") Casting?

J Pediatr Orthop 2020 Feb 28. Epub 2020 Feb 28.

University of Utah, Shriners Hospitals for Children Salt Lake City.

Introduction: Serial casting of children with early onset scoliosis (EOS) is an established treatment option. A break from cast treatment often called a "cast holiday," (CH) is often allowed by some centers, particularly over the summer months. The impact of CHs on treatment duration or outcome has not been examined. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001533DOI Listing
February 2020

A detailed description of the phenotypic spectrum of North Sea Progressive Myoclonus Epilepsy in a large cohort of seventeen patients.

Parkinsonism Relat Disord 2020 03 18;72:44-48. Epub 2020 Feb 18.

Department of Neurology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, the Netherlands; Pediatrics, Department of Clinical Sciences, Lund University, Sweden. Electronic address:

Introduction: In 2011, a homozygous mutation in GOSR2 (c.430G > T; p. Gly144Trp) was reported as a novel cause of Progressive Myoclonus Epilepsy (PME) with early-onset ataxia. Read More

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http://dx.doi.org/10.1016/j.parkreldis.2020.02.005DOI Listing

Is prophylactic formal fusion with implant revision necessary in non-ambulatory children with spinal muscular atrophy and growing rods who are no longer lengthened?

Spine Deform 2020 Jun 24;8(3):547-552. Epub 2020 Feb 24.

Children's Hospital of Omaha, University of Nebraska Medical Center, 8200 Dodge St, Omaha, NE, 68114, USA.

Study Design: Single center, retrospective chart review.

Objectives: To determine if routine posterior spinal fusion (PSF) is unnecessary in non-ambulatory growing rod graduates with SMA. Most non-ambulatory children with SMA develop early-onset scoliosis (EOS). Read More

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http://dx.doi.org/10.1007/s43390-020-00077-6DOI Listing

Proximal junction kyphosis after posterior spinal fusion for early-onset scoliosis.

Spine Deform 2020 Apr 24;8(2):311-316. Epub 2020 Feb 24.

Servicio de Patología Espinal, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, C1245AAM, Buenos Aires, Argentina.

Study Design: Retrospective study.

Objective: The aim of this study was to assess the presence of proximal junctional kyphosis (PJK) in our population of children with early-onset scoliosis (EOS) and to identify the predisposing factors for the development of PJK in the postoperative period after posterior spinal fusion (PSF). Few studies have been conducted to evaluate the incidence of proximal junction kyphosis (PJK) in children after early-onset scoliosis (EOS) after posterior spinal fusion (PSF). Read More

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http://dx.doi.org/10.1007/s43390-020-00029-0DOI Listing

Growth guidance constructs with apical fusion and sliding pedicle screws (SHILLA) results in approximately 1/3rd of normal T1-S1 growth.

Spine Deform 2020 Jun 24;8(3):531-535. Epub 2020 Feb 24.

Keck School of Medicine, University of Southern California, Los Angeles, USA.

Study Design: Retrospective, multicenter.

Objective: To investigate clinical outcomes in particular T1-S1 growth in patients with SHILLA instrumentation independent of inventor's reports. Guided growth with apical fusion and sliding pedicle screws (GGC/SHILLA) is an alternative to distraction-based growing rods for the treatment of EOS. Read More

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http://dx.doi.org/10.1007/s43390-020-00076-7DOI Listing

Spinal fusion in facioscapulohumeral dystrophy for hyperlordosis: A case report.

Medicine (Baltimore) 2020 Feb;99(8):e18787

Koc University, School of Medicine, Department of Orthopaedics and Traumatology.

Rationale: Facioscapulohumeral muscular dystrophy (FSHD) is the third most common muscular dystrophy, which is associated with facial, shoulder girdle, and paraspinal muscle atrophy. Most of the patients develop hypokyphosis and hyperlordosis in the course of the disease, to preserve standing posture. Corrective fusion is contraindicated in these patients as the surgery results with loss of compensatory hyperlordosis and leads to loss of trunk balance while standing. Read More

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http://dx.doi.org/10.1097/MD.0000000000018787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034682PMC
February 2020

Health and Economic Outcomes of Posterior Spinal Fusion for Children With Neuromuscular Scoliosis.

Hosp Pediatr 2020 Mar;10(3):257-265

VA Palo Alto Health Care System, Palo Alto, California.

Objectives: Neuromuscular scoliosis (NMS) can result in severe disability. Nonoperative management minimally slows scoliosis progression, but operative management with posterior spinal fusion (PSF) carries high risks of morbidity and mortality. In this study, we compare health and economic outcomes of PSF to nonoperative management for children with NMS to identify opportunities to improve care. Read More

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http://dx.doi.org/10.1542/hpeds.2019-0153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041549PMC

Variability in length of stay following neuromuscular spinal fusion.

Spine Deform 2020 Feb 14. Epub 2020 Feb 14.

Children's Healthcare of Atlanta, 1400 Tullie Rd, Atlanta, GA, 30329, USA.

Background: Patients with neuromuscular scoliosis (NMS) who undergo posterior spinal fusion (PSF) often have long, protracted hospital stays because of numerous comorbidities. Coordinated perioperative pathways can reduce length of hospitalization (LOH) without increasing complications; however, a subset of patients may not be suited to rapid mobilization and early discharge.

Methods: 197 patients with NMS underwent PSF at a single hospital by two surgeons with a post-operative care pathway emphasizing early mobilization, rapid transition to enteral feeds, and discharge prior to first bowel movement. Read More

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http://dx.doi.org/10.1007/s43390-020-00081-wDOI Listing
February 2020

Sublaminar polyester bands for the correction of idiopathic and neuromuscular scoliosis.

Ann Transl Med 2020 Jan;8(2):32

Pediatric Surgery Department, University Hospital Estaing, Clermont-Ferrand, France.

Recent literature suggests that sublaminar bands (SB) can provide good coronal plane correction, comparable to pedicle screw constructs, as well as good correction in the sagittal plane, even in patients with preoperative hypokyphosis; comparable results have been reported in patients with adolescent idiopathic scoliosis (AIS) and in patients with neuromuscular scoliosis (NMS). Two types of SB constructs can be performed: the band-only construct, indicated for non-ambulatory patients with NMS, and the hybrid construct indicted for ambulatory patients with NMS and for patients with AIS. SB are made of polyester or acrylic material and do provide a safe alternative to sublaminar Luque-type wires (stainless steel) as well as an increased contact area between SB and bone allowing higher corrective forces and reduced laminar fracture risk; the use of SB is not associated with increased risk of neurological injury nor with an increased risk of deep postoperative infection. Read More

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http://dx.doi.org/10.21037/atm.2019.08.109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995906PMC
January 2020

The Effect of Spinopelvic Parameters on the Development of Proximal Junctional Kyphosis in Early Onset: Mean 4.5-Year Follow-up.

J Pediatr Orthop 2020 Feb 6. Epub 2020 Feb 6.

Division of Orthopaedic Surgery, IWK Health Centre, Halifax, NS.

Background: Proximal junctional kyphosis (PJK) is a major complication after posterior spinal surgery. It is diagnosed radiographically based on a proximal junctional angle (PJA) and clinically when proximal extension is required. We hypothesized that abnormal spinopelvic alignment will increase the risk of PJK in children with early-onset scoliosis (EOS). Read More

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http://dx.doi.org/10.1097/BPO.0000000000001516DOI Listing
February 2020

Reproducibility of the classification of early onset scoliosis (C-EOS).

Spine Deform 2020 Apr 6;8(2):285-293. Epub 2020 Feb 6.

Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Study Design: Reproducibility study.

Objectives: Assess the agreement and reliability of the classification of early onset scoliosis (C-EOS). C-EOS is a promising tool for patients with early onset scoliosis (EOS). Read More

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http://dx.doi.org/10.1007/s43390-019-00006-2DOI Listing

Unplanned return to OR (UPROR) for children with early onset scoliosis (EOS): a comprehensive evaluation of all diagnoses and instrumentation strategies.

Spine Deform 2020 Apr 6;8(2):295-302. Epub 2020 Feb 6.

The Children's Hospital of Philadelphia, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Study Design: Retrospective analysis of a prospectively collected multicenter database.

Objectives: Our goal was to study unplanned return to the OR (UPROR, a postoperative complication that could not be treated without an additional anesthetic) as a function of C-EOS diagnosis and implant type. Growing concerns over the impact of multiple anesthetic events on the young brain have focused attention on limiting UPROR in early onset scoliosis (EOS). Read More

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http://dx.doi.org/10.1007/s43390-019-00024-0DOI Listing

Impact of scoliosis surgery on pulmonary function in patients with muscular dystrophies and spinal muscular atrophy.

Pediatr Pulmonol 2020 Apr 3;55(4):1037-1042. Epub 2020 Feb 3.

Section of Pulmonology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.

Background: Scoliosis is a common complication of severe neuromuscular diseases. The aim of this study is to determine the impact of posterior spinal fusion on pulmonary function parameters in patients with severe neuromuscular disease at our medical center.

Methods: Retrospective chart review of all patients with severe neuromuscular disease who had posterior spinal fusion between 2012 and 2017 at Texas Children's Hospital. Read More

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http://dx.doi.org/10.1002/ppul.24664DOI Listing

Should instrumented spinal fusion in nonambulatory children with neuromuscular scoliosis be extended to L5 or the pelvis?

Bone Joint J 2020 Feb;102-B(2):261-267

Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.

Aims: It is uncertain whether instrumented spinal fixation in nonambulatory children with neuromuscular scoliosis should finish at L5 or be extended to the pelvis. Pelvic fixation has been shown to be associated with up to 30% complication rates, but is regarded by some as the standard for correction of deformity in these conditions. The incidence of failure when comparing the most caudal level of instrumentation, either L5 or the pelvis, using all-pedicle screw instrumentation has not previously been reported. Read More

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http://dx.doi.org/10.1302/0301-620X.102B2.BJJ-2019-0772.R2DOI Listing
February 2020

The Correlation of Spinopelvic Parameters With Biomechanical Parameters Measured by Gait and Balance Analyses in Patients With Adult Degenerative Scoliosis.

Clin Spine Surg 2020 Feb;33(1):E33-E39

Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Presbyterian Hospital, Plano, TX.

Study Design: A prospective cohort study.

Objective: The objective of this study was to establish the correlation between radiographic spinopelvic parameters with objective biomechanical measures of function in patients with adult degenerative scoliosis (ADS).

Summary Of Background Data: Gait and balance analyses can provide an objective measure of function. Read More

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http://dx.doi.org/10.1097/BSD.0000000000000939DOI Listing
February 2020

Comparison of T1-S1 Spine Height of Postoperative Rib-based Implant Patients With Age-matched Peers.

J Pediatr Orthop 2020 Jan 23. Epub 2020 Jan 23.

Divison of Orthopaedic Surgery.

Background: Severe early-onset scoliosis leads to deficient spine height, thoracic growth inhibition, and ultimately pulmonary compromise. Rib-based growing instrumentation seeks to correct thoracic deformities, in part by correcting the spinal deformity, adding height, increasing thoracic volume, and allowing for continual spinal growth until maturity. However, the amount of growth in these patients relative to their peers is unknown. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001514DOI Listing
January 2020

Prospectively collected surgeon indications for discontinuation of a lengthening program for early-onset scoliosis.

Spine Deform 2020 02 24;8(1):129-133. Epub 2020 Jan 24.

Shriners Hospital for Children, 3551 N Broad St, Philadelphia, PA, 19140, USA.

Introduction: At some point after children with early-onset scoliosis (EOS) undergo implantation of a distraction construct to control deformity and promote growth, a decision is made to discontinue lengthening. The purpose of this study was to evaluate surgeon indications for discontinuation of a lengthening program and to evaluate patient outcomes.

Methods: As a part of a multicenter database, surgeons prospectively completed a questionnaire at the completion of growth-friendly treatment. Read More

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http://dx.doi.org/10.1007/s43390-020-00048-xDOI Listing
February 2020

Chiari I malformations with syringomyelia: long-term results of neurosurgical decompression.

Spine Deform 2020 Apr 13;8(2):233-243. Epub 2020 Jan 13.

Department of Orthopaedic Surgery, University Hospital Cleveland Medical Center, Cleveland, OH, USA.

Study Design: Retrospective case series.

Objectives: The objective was to assess the long-term outcomes on scoliosis following Chiari-I (CM-I) decompression in patients with CM-I and syringomyelia (SM). A secondary objective was to identify risk factors of scoliosis progression. Read More

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http://dx.doi.org/10.1007/s43390-019-00009-zDOI Listing

Pedicle screw instrumentation with or without pelvic fixation in neuromuscular scoliosis: Outcome and complications in a series of 37 patients with a minimum 2-year follow-up.

Surgeon 2020 Jan 10. Epub 2020 Jan 10.

Department of Pediatric Orthopaedic Surgery, Children's Hospital Hamburg-Altona, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address:

Objective: Neuromuscular scoliosis (NMS) is often associated with rapid progressive spinal deformities. Indications, when to extend the instrumentation to the pelvis for pelvic obliquity are not generally accepted at this time. This study reports on the indications, surgical technique and results using pedicle screw instrumentation exclusively with or without pelvic fixation for spine fusion in patients with NMS. Read More

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http://dx.doi.org/10.1016/j.surge.2019.11.007DOI Listing
January 2020

Biomechanical cadaver study of proximal fixation in a minimally invasive bipolar construct.

Spine Deform 2020 02 8;8(1):33-38. Epub 2020 Jan 8.

Pediatrics Orthopedics Department, Necker Hospital, Paris Descartes University, Assistance Publique Hôpitaux de Paris, Paris, France.

Study Design: Biomechanical human cadaver study.

Objective: To determine the three-dimensional intervertebral ranges of motion (ROMs) of intact and hook-instrumented thoracic spine specimens subjected to physiological loads, using an in vitro experimental protocol with EOS biplane radiography. Pedicle screws are commonly used in thoracic instrumentation constructs, and their biomechanical properties have been widely studied. Read More

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http://dx.doi.org/10.1007/s43390-019-00014-2DOI Listing
February 2020

The value of preoperative labs in identifying "at-risk" patients for developing surgical site infections after pediatric neuromuscular spine deformity surgery.

Spine Deform 2020 Jun 8;8(3):517-522. Epub 2020 Jan 8.

Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO, USA.

Study Design: This is a retrospective cohort study via a single surgeon, two-hospital database.

Objective: PSF in NMS patients is a high-risk surgery, with rates of SSI up to 24%. There is conflicting evidence in the literature regarding a possible association between low preoperative nutritional lab values and heightened risk of SSI after PSF. Read More

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http://dx.doi.org/10.1007/s43390-019-00003-5DOI Listing