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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Preoperative planning of scoliosis surgery is essential in the effective treatment of spine pathology. Thus, precontoured rods have been recently developed to avoid iatrogenic sagittal misalignment and rod breakage. Some specific issues exist in adolescent idiopathic scoliosis (AIS), such as a less distal lower instrumented level, a great variability in the location of inflection point (transition from lumbar lordosis to thoracic kyphosis), and sagittal correction is limited by both bone-implant interface. Since 2007, stereoradiographic imaging system is used and allows for 3D reconstructions. Therefore, a software was developed to perform preoperative 3D surgical planning and to provide rod's shape and length. The goal of this preliminary study was to assess the feasibility, reliability, and the clinical relevance of this new software. ⋯ In this preliminary study, the software based on 3D stereoradiography low-dose system used to plan AIS surgery seems reliable for preoperative planning and precontoured rods. It is an interesting tool to improve surgeons' practice, since 3D planning is expected to reduce complications such as iatrogenic malalignment and to help for a better understanding of the complications, choosing the location of the transitional vertebra. However, further work is needed to improve thoracic kyphosis planning. These slides can be retrieved under Electronic Supplementary Material.
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The purpose of this study was to develop a stratification scheme for surgical spinal care to serve as a framework for referrals and distribution of patients with spinal disorders. ⋯ This study introduces a five-level stratification scheme for the surgical care of spinal disorders. This stratification may provide input into the Global Spine Care Initiative care pathway that will be applied in medically underserved areas and low- and middle-income countries. These slides can be retrieved under Electronic Supplementary Material.
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Surgical treatment of AIS aims to correct the coronal and sagittal alignment of the spine. The global alignment of the spine may be normalized through reciprocal changes between the fused spine and adjacent segments. We propose a new classification system describing the specific sagittal patterns induced by AIS to define reproducible guidelines for the surgical strategy. ⋯ This new classification summarizes all the pathological scenarios of the sagittal alignment of AIS into four patterns. A specific surgical planning can be extrapolated for each pattern. In type 1, the objective is to preserve the sagittal shape. In type 2, the objective is to restore thoracic kyphosis. In type 2b, TL junction should be straightened. In type 3, the objective is to reshape the lower arc of thoracic sagittal angle and straighten the TL junction. These slides can be retrieved under Electronic Supplementary Material.
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The objective of this retrospective chart and radiographic review was to present the clinical outcomes and complication rate of a staged approach to modern dual growing-rod (GR) surgery when treating children with severe early onset scoliosis. ⋯ Staged insertion of dual GR systems permits strong distraction, with acceptable correction of severe deformities and minimal complications. These slides can be retrieved under Electronic Supplementary Material.
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The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. ⋯ The GSCI participants have broad professional experience and wide international distribution with no discipline dominating the deliberations. The GSCI believes this set of papers has the potential to inform and improve spine care globally. These slides can be retrieved under Electronic Supplementary Material.