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Malays Orthop J 2019 Mar;13(1):49-53

Department of Orthopaedics, Russian Ilizarov Scientific Center, Kurgan, Russia.

Severe rigid neuromuscular scoliosis is a major challenge to the spine surgeon due to the possibilities of neurological sequelae from acute correction of the deformity. Halo gravity traction has been considered as a way of reducing the deformity before correction to prevent neurological complications. Three female patients with severe neuromuscular scoliosis aged seven to 13 years with main coronal Cobb angle of 95°-128° and Kyphotic Cobb of 47°-118° having ≤35% flexibility on traction, had between 18 to 23 days of 16 hour/day of halo gravity traction and night time supine traction with 4kg weight for 7-8 hours. Read More

J Bone Joint Surg Am 2019 Apr;101(8):675-681

Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, California.

Background: Previous studies have noted the progression of arthritis due to increased forces in articular structures adjacent to a fused joint. It is unknown whether spinal fusion generates increased forces at the hip joint causing progression to arthritis leading to total hip arthroplasty (THA). We sought to determine (1) is there a relationship between spinal fusion and THA, (2) what are risk factors for subsequent THA, and (3) is there a time interval from spinal fusion to THA?

Methods: A large patient discharge dataset was utilized to evaluate all patients who underwent spinal fusion and subsequent THA in California from 2004 through 2013. Read More

Eur Spine J 2019 Apr 8. Epub 2019 Apr 8.

Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China.

Purpose: The aim of this study was to evaluate the prevalence and risk factors for postoperative pulmonary complications (PPC) after posterior instrumentation and fusion (PIF) in patients with non-degenerative scoliosis.

Methods: We retrospectively evaluated 703 patients (224 males, 479 females) diagnosed with non-degenerative scoliosis who underwent PIF in our center from January 2010 to January 2018. Preoperative, perioperative, demographic data, surgical methods and radiographic parameters were extracted and analyzed to identify risk factors for PPC. Read More

Clin Neurol Neurosurg 2019 May 31;180:74-78. Epub 2019 Mar 31.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan. Electronic address:

Objectives: Br(E)-MsEP monitoring is widely used in spinal surgery for detection of spinal cord injury. However, Br(E)-MsEP waveform derivation requires high-intensity stimulation, and this raises a concern of adverse effects due to the immature corticospinal tract in pediatric patients. The purpose of this study is to determine the optimal stimulation intensity required for derivation of Br(E)-MsEP waveforms at baseline in pediatric spinal surgery. Read More

Am J Med Genet A 2019 Apr 2. Epub 2019 Apr 2.

Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan.

PIEZO2 encodes a mechanically activated cation channel, which is abundantly expressed in dorsal root ganglion neuron and sensory endings of proprioceptors required for light touch sensation and proprioception in mice. Biallelic loss-of-function mutations in PIEZO2 (i.e. Read More

Curr Rev Musculoskelet Med 2019 Apr 2. Epub 2019 Apr 2.

Shriner's Hospital for Children, Springfield, MA, USA.

Purpose Of Review: Spinal deformity is a common issue in pediatric patients with an underlying neurological diagnosis or syndrome. Management of neuromuscular scoliosis (NMS) is a major part of the orthopedic care of such patients, as the deformity is often progressive, and may affect gait, seating and positioning. In addition, untreated large spinal deformities may be associated with pain and/or cardiopulmonary issues over time. Read More

Orthopade 2019 Mar 21. Epub 2019 Mar 21.

Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland.

Background: It is understood that an effective brace therapy requires a primary curve angle reduction of 50% after administering the first orthotic brace.

Objectives: The aim of the study was to determine the efficacy of conservative brace therapy for scoliosis with a curve angle above 20° and to determine possible influencing factors.

Materials And Methods: The current study included a cohort of 110 scoliosis patients with conservative brace therapy. Read More

Clin Genet 2019 May 28;95(5):607-614. Epub 2019 Mar 28.

Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, Cagliari, Italy.

Crisponi/cold-induced sweating syndrome (CS/CISS) is a rare autosomal recessive disorder characterized by a complex phenotype (hyperthermia and feeding difficulties in the neonatal period, followed by scoliosis and paradoxical sweating induced by cold since early childhood) and a high neonatal lethality. CS/CISS is a genetically heterogeneous disorder caused by mutations in CRLF1 (CS/CISS1), CLCF1 (CS/CISS2) and KLHL7 (CS/CISS-like). Here, a whole exome sequencing approach in individuals with CS/CISS-like phenotype with unknown molecular defect revealed unpredicted alternative diagnoses. Read More

J Pediatr Orthop B 2019 Mar 7. Epub 2019 Mar 7.

Department of Orthopaedics and Traumatology, Yildirim Beyazit University, Ankara.

The aim of this study is to evaluate the results of the modified Kostuik transilial bar technique for neuromuscular scoliosis (NS). We reviewed the records of 21 patients treated for NS with this instrumentation. There were 14 females and seven males, with an average age of 15. Read More

J Neurosurg Spine 2019 Mar 8:1-8. Epub 2019 Mar 8.

Departments of1Neurological Surgery and.

OBJECTIVEBone morphogenetic protein (BMP) is associated with reduced rates of pseudarthrosis and has the potential to decrease the need for revision surgery. There are limited data evaluating the cost-benefit of BMP for pseudarthrosis-related prevention surgery in adult spinal deformity.METHODSThe authors performed a single-center retrospective review of 200 consecutive patients with adult spinal deformity. Read More

J Chin Med Assoc 2019 Feb;82(2):161-165

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: The health-related quality of life (HRQoL) was affected in children and adolescents with scoliosis. However, there was lack of study to compare the HRQoL among patients with different types of scoliosis. We aimed to investigate whether the HRQoL differs among patients with idiopathic, congenital, neuromuscular, and syndromic scoliosis. Read More

Spine (Phila Pa 1976) 2019 Feb 7. Epub 2019 Feb 7.

Texas Back Institute, Plano, TX.

Study Design: Prospective cohort study OBJECTIVE.: The purpose of this study is to quantify the extent of change in sway associated with maintaining a balanced posture within the cone of economy (CoE), in a group of adult degenerative scoliosis (ADS) patients' pre and post-surgery and compare them to matched non-scoliotic controls.

Summary Of Background Data: Patients with spinal deformities adopt a variety of postural changes in the spine, pelvis and lower extremities in their effort to compensate for the anterior shift in the gravity line. Read More

Clin Neurophysiol Pract 2019 25;4:11-17. Epub 2019 Jan 25.

Dept. of Anaesthetics, Perth Children's Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.

Objective: Intraoperative neurophysiology monitoring (INM) is thought to reduce the risk of postoperative neurological deficits in children undergoing scoliosis and spine deformity surgery. INM is being used increasingly despite conflicting opinions, varied results, non-standard alarm criteria and concern regarding cost effectiveness. In this paper we present our experience with INM in scoliosis and spine deformation surgery in children, propose alert criteria and preferred anaesthetics in clinical practice. Read More

J Craniovertebr Junction Spine 2018 Oct-Dec;9(4):250-253

Department of Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool, UK.

Purpose: In this study, we would like to describe a novel technique for subfascial insertion of magnetically controlled growing rods using chest drain during surgery for early-onset scoliosis.

Materials And Methods: Posterior approach, surgical dissection to the spine is performed exposing the relevant anatomy to allow placement of pedicle screws always in the distal construct and pedicle screws or hooks in the proximal construct. To allow easy passage of the Magnetic Expansion Control (MAGEC) rod, as well as easy maneuvering of the rod in either the cranial to caudal direction, we use a chest drain of size 24 French diameter as a tunnel. Read More

Pediatr Neurosurg 2019 15;54(2):108-115. Epub 2019 Feb 15.

Departments of Orthopaedic Surgery and Neurosurgery, Shriners Hospitals for Children-Philadelphia, Philadelphia, Pennsylvania, USA,

Objective: This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion.

Methods: A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months' follow-up). A sub-cohort of 60 patients with minimum 2 years of follow-up data was also analyzed. Read More

BMC Musculoskelet Disord 2019 Feb 7;20(1):54. Epub 2019 Feb 7.

Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland.

Background: The majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to assess the reliability of Cervical Rotation test (CR), Supine Angle of Trunk Rotation test (SATR), Hip Extension test (HE) and Pelvic Obliquity test (PO) developed to evaluate the musculoskeletal system in SMA individuals. Read More

Eur Spine J 2019 Apr 1;28(4):885-887. Epub 2019 Feb 1.

Department of Orthopaedics, Key Laboratory of Orthopaedics of Zhejiang Province, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xueyuan Road, Wenzhou, 325027, Zhejiang, China.

Eur Spine J 2019 Apr 24;28(4):883-884. Epub 2019 Jan 24.

Department of Spine, Shandong Provincial Hospital Affiliated to Shandong University, No. 9677, Jingshi Road, Jinan, Shandong Province, China.

Spine Deform 2019 03;7(2):304-311

Division of Orthopaedics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA. Electronic address:

Study Design: Prospective multicenter comparative study.

Objectives: We aimed 1) to survey surgeons and caregivers to rank the surgical indications for spinal fusion of pediatric patients with neuromuscular scoliosis secondary to cerebral palsy in order of importance and 2) to characterize the agreement of surgeons and caregivers on major (top three) indications.

Summary Of Background Data: Surgery for spinal deformity in children with cerebral palsy is a multifaceted and individualized decision that may lead to miscommunication during informed consent. Read More

Spine Deform 2019 03;7(2):286-292

Center for Spinal Disorders, Department of Orthopedic Surgery, Nicklaus Children's Hospital, 3100 S.W. 62nd Ave, Miami, FL 33155, USA.

Study Design: Single-center retrospective study.

Objective: To analyze two-year postoperative outcomes following spinopelvic fixation in pediatric patients using the anatomic trajectory (AT) portal for iliac screws.

Summary: Iliac fixation is crucial in situations requiring fusion to sacrum. Read More

Spine Deform 2019 01;7(1):33-39

Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.

Design: Retrospective comparative study.

Objective: The purpose of this study is to measure SSI outcomes before and after implementation of our center's multidisciplinary clinical pathway protocol for high-risk spinal surgery.

Background: Surgical site infections (SSIs) after spinal fusion harm patients and are associated with significant health care costs. Read More

Spine Deform 2019 01;7(1):158-162

Children's Healthcare of Atlanta, Scottish Rite Campus, 1001 Johnson Ferry Road NE, Atlanta, GA 30342-1605, USA. Electronic address:

Background: Children with congenital heart disease (CHD) have been reported to be at increased risk of developing scoliosis following cardiac surgery. Previous sample studies have reported that these patients may safely undergo posterior spinal fusion (PSF) with low complication rates. The goal of this study is to provide an updated analysis of the perioperative complication profile for posterior spinal fusion in a large cohort of pediatric patients with CHD, using a nationwide database. Read More

Spine Deform 2019 01;7(1):112-117

Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92123, USA.

Study Design: Retrospective review of a prospective cohort.

Objective: To identify patient and surgical factors that alter the length of postoperative intensive care unit (ICU) stays after spinal fusion/instrumentation in patients with neuromuscular scoliosis secondary to cerebral palsy (CP).

Summary Of Background Data: High perioperative complication rates in patients with CP contribute to the practice of utilizing the ICU postoperatively for monitoring. Read More

Spine Deform 2019 01;7(1):107-111

Pediatric Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.

Objective: The objective of this study is to identify preoperative laboratory values and patient factors that are associated with postoperative respiratory complications in pediatric neuromuscular scoliosis (NMS) populations undergoing posterior spinal fusion (PSF) with instrumentation.

Summary Of Background Data: PSF in NMS patients are high-risk surgeries. Respiratory complications are the most common postoperative event, with rates up to 28. Read More

Int J Mol Sci 2018 Dec 17;19(12). Epub 2018 Dec 17.

John Walton Muscular Dystrophy Research Centre, Newcastle University, Newcastle upon Tyne NE1 3BZ, UK.

The neuromuscular junction (NMJ) appears to be a site of pathology in a number of peripheral nerve diseases. Charcot-Marie-Tooth (CMT) 4C is an autosomal recessive, early onset, demyelinating neuropathy. Numerous mutations in the gene have been shown to underlie the condition often associated with scoliosis, foot deformities, and reduced nerve conduction velocities. Read More

Orv Hetil 2018 Dec;159(50):2144-2149

Fogászati és Szájsebészeti Klinika, Pécsi Tudományegyetem, Klinikai Központ Pécs, Dischka Győző u. 5., 7621.

From an anatomic and functional point of view, the stomatognathic system and the upper cervical spine are closely connected. Together with the complex neuromuscular relationships, this generates an important field of cooperation between dentists and orthopedics. The aim of this case report was to demonstrate the improvements of temporomandibular joint (TMJ) function after orthopedic surgery in case of a patient with idiopathic scoliosis. Read More

Eur Spine J 2019 Feb 27;28(2):324-344. Epub 2018 Nov 27.

, Stockholm, Sweden.

Introduction And Purpose: Little information exists on surgical characteristics, complications and outcomes with corrective surgery for rigid cervical kyphosis (CK). To collate the experience of international experts, the CSRS-Europe initiated an international multi-centre retrospective study.

Methods: Included were patients at all ages with rigid CK. Read More

Neurol Sci 2019 Feb 15;40(2):327-332. Epub 2018 Nov 15.

Child Neurology Department, the NEMO Clinical Center, Policlinico Universitario "A. Gemelli", Rome, Italy.

Nusinsersen is now available in Italy for all SMA types. We describe the experience with intrathecal treatment with nusinersen in 50 patients with SMA at the NEMO Center (NEuroMuscular Omniservice Clinical Center) in Milan, a neuromuscular patient-centered clinic hosted within Niguarda Hospital, a National Public General Hospital. Our results indicate that the pathway of care described outweighs the burden due to the repeated intrathecal injections. Read More

World J Orthop 2018 Oct 18;9(10):185-189. Epub 2018 Oct 18.

Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States.

Pelvic instrumentation for neuromuscular scoliosis has been part of neuromuscular scoliosis surgery since the era of the Luque Galveston construct. Unit Rod (Medtronic Sofamor-Danek, Nashville, TN) instrumentation brought with it the concept of cantilever correction by placing the implants in the pelvis and then gradually bringing the rod to the spine by sequentially tightening the sublaminar wires, with the goal of creating a level pelvis over a straight spine. More recently surgeons have utilized pedicle screw constructs in which the corrective strategies have varied. Read More

Spine Deform 2018 Nov - Dec;6(6):781-786

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address:

Background: Early-onset scoliosis (EOS) is a potentially life-threatening condition that requires early intervention to prevent severe deformity and pulmonary compromise. Observational studies have demonstrated that children receiving multiple procedures requiring general anesthesia are at a higher risk for adverse neurocognitive outcomes. We sought to characterize anesthetic exposure in EOS patients and to determine risk factors for increased exposure. Read More

Spine Deform 2018 Nov - Dec;6(6):736-740

Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA. Electronic address:

Study Design: Prospective consecutively enrolled cohort.

Objectives: To evaluate paraspinal muscle concentration of intravenously administered vancomycin, at predetermined time points, during posterior spinal fusion (PSF) with instrumentation in neuromuscular scoliosis (NMS).

Summary: Surgical site infection (SSI) after PSF for NMS can be a devastating complication, which may lead to prolonged antibiotic use, multiple additional surgical procedures, pseudarthroses, and sepsis. Read More

Plast Reconstr Surg 2019 Jan;143(1):152e-164e

Seoul, Republic of Korea From the Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.

Background: Single-stage latissimus dorsi neuromuscular transfer has been a valuable option for dynamic smile reanimation. However, there is a paucity of studies evaluating the potential donor morbidity in such cases. The present study aimed to comprehensively analyze the donor morbidity following functional latissimus dorsi muscle transfer. Read More

J Pediatr Orthop B 2019 Jan;28(1):10-16

Shriners Hospital for Children, Springfield, Massachusetts, USA.

Limited reports exist with regard to clinical and radiographic details of patients with early-onset spinal deformity (EOSD) undergoing definitive instrumented final fusion (FF) following implantation of a growing construct. Charts and radiographs were queried for all patients who underwent FF after management of EOSD with a distraction-based posterior construct at a single institution from 2006 to 2017. Patients managed during the growth modulation period with either proximal rib or spinal fixation were included. Read More

Spine (Phila Pa 1976) 2019 Apr;44(8):E465-E469

Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.

Study Design: A multicenter retrospective study.

Objective: The aim of this study was to compare pelvic obliquity correction and reoperation rate in neuromuscular scoliosis patients who had their pelvis included in a posterior spinal fusion (pelvic fusion, PF) at their index procedure versus revision procedures.

Summary Of Background Data: There is limited information on outcomes specific to fusing to the pelvis for neuromuscular scoliosis in a revision operation versus index surgery. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(2):89-93

Ortopedická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno.

PURPOSE OF THE STUDY The Growth Guidance System (GGS) represent a relatively new alternative to the traditional growing systems used for the treatment of early onset scoliosis. Ranking among the main aims of this surgical treatment is a three-dimensional correction of the deformity, maintenance of spinal growth and postponement of the necessity of final treatment by spondylodesis. MATERIAL AND METHODS Our study retrospectively evaluates the results of surgical correction in a group of 35 patients treated by GGS technique. Read More

Int J Spine Surg 2018 Jan 30;12(1):15-21. Epub 2018 Mar 30.

Division of Spine Surgery, Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Patients with Parkinson's disease (PD) commonly develop severe spinal deformity, including scoliosis, antecollis, camptocormia, and Pisa syndrome. The etiology of PD-associated spinal deformity is not completely understood and in most cases is likely due to multiple interrelated factors, including central dystonia and focal myopathy. Once spinal deformity has occurred, surgery is often the only modality that can correct the condition, although control of the movement disorder through medication and deep brain stimulation may slow progression. Read More

Acta Orthop Traumatol Turc 2018 Nov 27;52(6):438-441. Epub 2018 Sep 27.

Uludag University College of Medicine, Department of Orthopaedics and Traumatology, Bursa, Turkey.

Objective: The aim of this study was to examine the use of magnetically controlled growing rods as a method of providing spinal improvement while preventing thoracic insufficiency in patients with early-onset scoliosis (EOS).

Methods: Of a total of 13 patients, 4 patients underwent a dual magnetic rod implantation, while 9 patients had a single magnetic rod procedure. The study group comprised 12 (93%) female and 1 (7%) male patients. Read More

Acta Orthop Traumatol Turc 2018 Nov 25;52(6):435-437. Epub 2018 Sep 25.

Uludag University College of Medicine, Orthopedics and Traumatology Department, Bursa, Turkey. Electronic address:

Introduction: Neuromuscular scoliosis leads to a wide range of spinal disorders which disturb the musculoskeletal system. The aim of this study is to compare the clinical and radiological results of posterior spinal fusion with and without extending the instrumentation to iliac bones in treatment of neuromuscular scoliosis.

Methods: Medical records and radiographies of 36 patients with neuromuscular scoliosis who underwent posterior instrumentation between 2011 and 2015 were reviewed. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(3):194-198

Ortopedická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno 2 Klinika radiologie a nukleární medicíny Lékařské fakulty Masarykovy univerzity a Fakul.

PURPOSE OF THE STUDY Neuromuscular deformities of the spine represent surgically uneasy to solve problems as well as serious handicaps causing sitting instability, pressure ulcers as well as pain. The aim of our study is to conduct a retrospective clinical analysis of the results of surgical correction of these deformities. This paper presents the use of a recent technique of sacral-alar-iliac (S2AI) screws and its comparison with other techniques of pelvic stabilisation. Read More

J Pediatr Orthop 2018 Sep 20. Epub 2018 Sep 20.

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

Muscle Nerve 2019 Jan 26;59(1):129-133. Epub 2018 Oct 26.

Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a St, 01-211, Warsaw, Poland.

Introduction: Mutations in the TRPV4 gene are associated with neuromuscular disorders and skeletal dysplasias, which present a phenotypic overlap.

Methods: Next-generation sequencing and Sanger sequencing were used to analyze the TRPV4 gene.

Results: We present 2 Polish families with TRPV4-related disorder harboring the same p. Read More

JB JS Open Access 2018 Mar 12;3(1):e0045. Epub 2018 Mar 12.

Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.

Background: The surgical treatment of congenital heart disease is reported to be associated with a high prevalence of scoliosis, although the detailed etiology is unknown. Surgical interventions involving the rib cage are considered to increase the risk of scoliosis. However, whether the cardiac condition or the procedure performed makes patients more susceptible to the development of spinal deformity is controversial. Read More

J Dent Anesth Pain Med 2018 Aug 28;18(4):261-265. Epub 2018 Aug 28.

Department of Anesthesiology and Reanimation, Erzincan Binali Yıldırım University, Faculty Of Medicine, Erzincan, Turkey.

Rett syndrome (RS) is a neurodevelopmental disorder characterized by loss of cognitive, motor, and social skills, epilepsy, autistic behavior, abnormal airway patterns, gastroesophageal reflux, nutritional problems, and severe scoliosis. Although girls with RS show normal or near-normal growth until 6-8 months, they lose their skills after that. The anesthetic management of these patients requires care because of all these clinical features. Read More

J Orthop Surg Res 2018 Sep 5;13(1):227. Epub 2018 Sep 5.

Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan.

Background: Intraoperative neuromonitoring using motor evoked potentials (MEP) satisfactorily detects motor tract integrity changes during spinal surgery. However, monitoring is affected by "anesthetic fade," in which the stimulation threshold increases because the waveform amplitude decreases with the accumulation of propofol. Therefore, the purpose of this study was to clarify the effect of anesthetic fade on transcranial MEPs by investigating the time-dependent changes of amplitude during spinal deformity surgeries. Read More

Spine (Phila Pa 1976) 2019 Mar;44(6):E379-E383

Department of Orthopedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, ON.

Study Design: A case report.

Objective: The aim of this study was to report the use of erector spinae plane (ESP) blocks as part of an opioid-free multimodal anesthetic regimen and its impact on postoperative pain and opioid requirements following spine surgery.

Summary Of Background Data: Posterior spinal fusion surgery is highly painful and usually requires significant amounts of opioids for adequate perioperative analgesia; this is commonly associated with adverse effects, including opioid-induced hyperalgesia, nausea, and ileus. Read More

J Child Orthop 2018 Aug;12(4):406-412

Growing Spine Foundation, Milwaukee, Wisconsin, USA.

Purpose: To investigate paediatric orthopaedists' cast practices for early onset scoliosis regarding patient selection, cast application, radiographic evaluation, treatment cessation and adjunctive bracing.

Methods: A casting survey was distributed to all paediatric orthopaedists in Children's Spine and Growing Spine Study Groups (n = 92). Questions included physician and patient characteristics, technique, treatment, outcomes, radiographic measurements and comparison to other treatments. Read More

Eur Spine J 2019 Mar 24;28(3):567-580. Epub 2018 Aug 24.

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

Background: Neuromuscular scoliosis is often treated with posterior spinal fusion, with or without anterior release, and either a same-day or staged, 2-day procedure.

Methods: We retrospectively reviewed 222 patients from a prospectively collected, multi-center database of patients with cerebral palsy scoliosis with 2-year follow-up. Baseline characteristics, perioperative, radiographic, and HRQoL measures were compared in six sub-analyses: (1) staged versus same-day surgeries, (2) posterior-only fusion (PSF) versus anterior-posterior spinal fusion (APSF), (3) same-day versus staged PSF, (4) staged versus same-day APSF, (5) same-day PSF versus same-day APSF, (6) staged PSF versus staged APSF. Read More

Spine Deform 2018 Sep - Oct;6(5):607-613

Riverside County Regional Medical Center, 26520 Cactus Ave., Moreno Valley, CA 92555, USA.

Objectives/summary Of Background Data: Segmental sublaminar spinal instrumentation without fusion results in guided growth and correction of deformity in early-onset scoliosis (EOS). The purpose of this study is to report the outcomes of a series of children with low-tone EOS that were treated surgically with a modification of a Luque trolley technique.

Methods: This study is a retrospective chart and radiographic review of a single-center series of 13 consecutive children who met inclusion criteria with documented progression of scoliosis greater than 25°. Read More