European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Review Meta Analysis
Does image guidance decrease pedicle screw-related complications in surgical treatment of adolescent idiopathic scoliosis: a systematic review update and meta-analysis.
Surgical treatment of severe adolescent idiopathic scoliosis (AIS) with posterior spinal instrumentation and fusion with pedicle screws is common, requiring careful screw insertion to prevent pedicle breaches and neurologic complications. Image guidance has been suggested to improve breach rates, though the radiation risk for AIS precludes its common usage. The purpose of this systematic review and meta-analysis was to compare the breach rates and screw-related complications for AIS patients undergoing spine surgery with pedicle screws between freehand screw insertion and image guidance methods. ⋯ Meta-analyzed breach rates show moderate evidence of decreased breaches with CT navigation compared with freehand methods. Complication rates remain unknown due to the low complication rates from small sample sizes. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
Does image guidance decrease pedicle screw-related complications in surgical treatment of adolescent idiopathic scoliosis: a systematic review update and meta-analysis.
Surgical treatment of severe adolescent idiopathic scoliosis (AIS) with posterior spinal instrumentation and fusion with pedicle screws is common, requiring careful screw insertion to prevent pedicle breaches and neurologic complications. Image guidance has been suggested to improve breach rates, though the radiation risk for AIS precludes its common usage. The purpose of this systematic review and meta-analysis was to compare the breach rates and screw-related complications for AIS patients undergoing spine surgery with pedicle screws between freehand screw insertion and image guidance methods. ⋯ Meta-analyzed breach rates show moderate evidence of decreased breaches with CT navigation compared with freehand methods. Complication rates remain unknown due to the low complication rates from small sample sizes. These slides can be retrieved under Electronic Supplementary Material.
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Distal radius and ulna (DRU) classification scheme has been proposed for predicting skeletal maturity in patients with idiopathic scoliosis (IS). However, the utilization of DRU classification scheme in the assessment of growth peak and curve progression in IS was still inconclusive. This study aimed to correlate the distal radius and ulna stages with several indicators for growth potential and to evaluate the predictive value of DRU system for curve progression in braced female IS patients. ⋯ Both distal radius and ulna scores correlate with the longitudinal growth potential, and thus, the DRU scoring scheme is an alternative predictor for growth potential and curve progression in girls with IS. These slides can be retrieved under Electronic Supplementary Material.
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In addition to changes in the skeletal system after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other systemic changes associated with the patients' quality of life were reported. The purpose of this study was to conduct a systemic review of the literature to determine systemic changes associated with patients' quality of life following correction of kyphotic deformity secondary to ankylosing spondylitis. ⋯ In addition to skeletal changes after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other changes were reported. Spine surgeons should pay more attention to these life quality-related changes and be aware of potential risks when performing surgery for advanced-stage AS patients. These slides can be retrieved under Electronic Supplementary Material.
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In addition to changes in the skeletal system after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other systemic changes associated with the patients' quality of life were reported. The purpose of this study was to conduct a systemic review of the literature to determine systemic changes associated with patients' quality of life following correction of kyphotic deformity secondary to ankylosing spondylitis. ⋯ In addition to skeletal changes after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other changes were reported. Spine surgeons should pay more attention to these life quality-related changes and be aware of potential risks when performing surgery for advanced-stage AS patients. These slides can be retrieved under Electronic Supplementary Material.