My Orthopedic Surgery

Long-Term Outcome for Patients With Split Cord Malformation
from Neurosurg Focus 10(1), 2001
Mark R. Proctor, M.D., and R. Michael Scott, M.D, Department of Neurosurgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts
Conclusions. The primary conclusion is that patients with SCM generally tolerate surgery well and experience few complications. Neurological deterioration is rare except in cases in which retethering occurs, (two patients in this series). Although impaired bowel and bladder function was stabilized or improved and pain was reliably relieved post-operatively, preexisting vertebral column deformities usually progressed after surgery and, in most cases, required spinal fusion.

Poster Board Number: P285 Spine Keith H Bridwell, MD Saint Louis MO (a - Medtronic Sofamor Danek) Sigurd H Berven, MD San Francisco CA (e - Medtronic Sofamor Danek) William C Horton III, MD Atlanta GA (a,e - Medtronic Sofamor Danek) Frank J Schwab, MD Brooklyn NY (n) Steven D Glassman, MD Louisville KY (a,c,e - Medtronic Sofamor Danek) Sagittal balance should be thoroughly assessed in adults with spinal deformity as symptoms increase with progressive sagittal imbalance.

: Safe, Accurate and Simple Paper No: 299 Friday, February 25, 2005 12:12 PM - 12:18 PM Se-Il Suk, MD Seoul Korea, Republic of (n) Ewy-Ryong Chung, MD Seoul Korea, Republic of (n) Jin Hyok Kim, MD Seoul Korea, Republic of (n) Sang-Min Lee, MD Seoul Korea, Republic of (n) Sung Soo Kim, MD Seoul Korea, Republic of (n) Moderator(s): Edward D Simmons, MD Buffalo NY Susan E Stephens, MD Cleveland OH Spine The X-ray assist with K-wires technique of thoracic pedicle screw insertion is a reliable and convenient method for spinal deformities

Autologous Rib Strut Graft for Pediatric Spinal Deformity: Is a Vascularized Graft Necessary? Paper No: 417 Friday, March 24, 2006 11:54 AM - 12:00 PM Location: McCormick Place S501
Daniel J Sucato, MD Dallas TX (n) Nathan F Gilbert, MD Dallas TX (n) Moderator(s): Richard E Bowen, MD Los Angeles CA Lori A Karol, MD Dallas TX
Pediatrics Vascularized rib strut graft does not appear to offer significant advantages to a nonvascularized graft for pediatric spinal deformity.

From Neurosurg Focus. 2006;20(2):E2. Posted 03/28/2006
Daniel R. Fassett, M.D., M.B.A.; Randy Clark, M.S.; Douglas L. Brockmeyer, M.D.; Meic H. Schmidt, M.D.
Abstract Postoperative sagittal-plane cervical spine deformities are a concern when laminectomy is performed for tumor resection in the spinal cord. These deformities appear to occur more commonly after resection of intramedullary spinal cord lesions, compared with laminectomy for stenosis caused by degenerative spinal conditions. Postlaminectomy deformities are most common in pediatric patients with an immature skeletal system, but are also more common in young adults (<25 years of age) in comparison with older adults. The extent of laminectomy and facetectomy, number of laminae removed, location of laminectomy, preoperative loss of lordosis, and postoperative radiation therapy in the spine have all been reported to influence the risk of postlaminectomy spinal deformities. When these occur, patients should be monitored closely with serial imaging studies, because a significant percentage will have progressive deformities. These can range from focal kyphosis to more complicated swan-neck deformities. General indications for surgical intervention include progressive deformity, axial pain in the area, and neurological symptoms attributable to the deformity. Surgical options include anterior, posterior, and combined anterior-posterior procedures. The authors have reviewed the literature on postlaminectomy kyphosis as it relates to resection of cervical spinal cord tumors, and they summarize some general factors to consider when treating these patients.

Does Severity Of Spinal Deformity Correlate With Physical Function In Non-Ambulatory Cerebral Palsy? Poster Board Number: P259 Location: McCormick Place Hall B Pediatrics Michael Johnson, MD Melbourne VIC Australia (n) James G Wright, MD Toronto ON Canada (n) Kelley Williams, MD Toronto ON Canada (n) Andrew Howard, MD Toronto ON Canada (n) Douglas M Hedden, MD (n) Benjamin Alman, MD Toronto ON Canada (a- Canadian Research Chairs Program)
Contrary to our hypothesis, we found a correlation between scoliosis severity and the Pediatric Evaluation of Disability Inventory functional scores

Poster Board Number: P374 Location: McCormick Place Hall B Spine Keith H Bridwell, MD Saint Louis MO (a-Medtronic sofamor danek) Lawrence G Lenke, MD Saint Louis MO (a-Medtronic sofamor danek) Gene Cheh, MD Seoul Seoul Korea, Republic of (n) Yongjung J Kim, MD Fort Lee NJ (*)
The overall incidence of pseudarthrosis following long adult spinal deformity instrumentation and fusions to S1 was 23%. Thoracolumbar kyphosis, osteoarthritis of the hip joint, incomplete sacropelvic fixation, thoracoabdominal approach (vs. paramedian approach), and age at surgery (>55 years) significantly increased the risks of pseudarthrosis to an extent that was statistically significant. SRS-24 outcomes scores were adversely affected when pseudarthrosis developed.

Paper No: 411 Friday, March 24, 2006 11:06 AM - 11:12 AM Location: McCormick Place S501 Jose A Herrera-Soto, MD Orlando FL (n) Kelly L Vanderhave, MD Ann Arbor MI (n) Moderator(s): Richard E Bowen, MD Los Angeles CA Lori A Karol, MD Dallas TX Pediatrics Sternotomy appears to influence the spine in the sagittal plane as well as the coronal alignment.
Patients with CHD are at increased risk for scoliosis

Podium No: 108 Wednesday, February 14, 2007 04:12 PM - 04:18 PM Location: San Diego Convention Center Room 6A Michael David Daubs, MD Salt Lake City UT (n) Lawrence G Lenke, MD Saint Louis MO (a,b,e- Medtronic) Gene Cheh, MD Seoul Seoul Korea, Republic of (n) Georgia Stobbs, RN, BA Saint Louis MO (n) Keith H Bridwell, MD Saint Louis MO (a-Medtronic) Moderator(s): William J Richardson, MD Durham NC (*) Susan E Stephens, MD Gates Mills OH (*)
Major adult spinal deformity surgery in patients over the age of 60 has an overall complication rate of 37% and a major complication rate of 20%. Patients older than 69 years of age are a higher risk for complications.

Congenital Osseous Anomalies of Upper Cervical Spine in Children: A Double-Cohort Study Podium No: 272 Thursday, February 15, 2007 01:36 PM - 01:42 PM Location: San Diego Convention Center Room 6DE Harish Sadanand Hosalkar, MD Philadelphia PA (n) Wudbhav N Sankar, MD West Hollywood CA (n) Brian P Donald Wills, MD Fitchburg WI (n) John P Dormans, MD Philadelphia PA (n) Denis S Drummond, MD Philadelphia PA (n) Moderator(s): Dennis Paul Grogan, MD Tampa FL (*) Gregory A Mencio, MD Nashville TN (*)
A double-cohort study evaluating congenital osseous anomalies of the upper cervical spine in children with and without clinical syndromes to outline the risk of possible neurological compromise.

Podium No: 281 Thursday, February 15, 2007 02:48 PM - 02:54 PM Location: San Diego Convention Center Room 6DE
Michael G Vitale, MD New York NY (a - Synthes Spine) David Price Roye Jr, MD New York NY (a - Synthes Spine) Hiroko Matsumoto, MA New York NY (n) Randal R Betz, MD Ocean City NJ (a - Synthes Spine) John B Emans, MD Boston MA (a - Synthes Spine) David Lee Skaggs, MD Los Angeles CA (a - Synthes Spine) John Taylor Smith, MD Salt Lake City UT (a -Synthes Spine) Kit M Song, MD Seattle WA (a - Synthes Spine) Robert Murray Campbell Jr, MD San Antonio TX (a, c - Synthes Spine) Moderator(s): Dennis Paul Grogan, MD Tampa FL (*) Gregory A Mencio, MD Nashville TN (*)
Health related quality of life is significantly decreased in patients with Thoracic Insufficiency Syndrome, when compared with healthy peers.

Infections Following Spinal Deformity Surgery: a Twenty-Year Assessment of 2876 Patients
Poster Presentation Number: P356 Location: San Diego Convention Center, Sails Pavilion Spine
Lawrence G Lenke, MD Saint Louis MO (a,b,c,e - Medtronic) Craig Kuhns, MD Columbia MO (n) Ronald Lehman, MD Potomac MD (n) Venkat Seshadri, MD Pittsburgh PA (n) Keith H Bridwell, MD Saint Louis MO (a,b,e - Medtronic) Jacob Buchowski, MD Saint Louis MO (n)
In a review of 2876 patients who underwent deformity surgery over a twenty-year period, the overall infection rate was 2.0% and was in large part determined by the patients' underlying diagnosis.

Pedicle Subtraction Osteotomy for the Management of Fixed Spinal Deformity: Clinical Outcomes Podium No: 111 Wednesday, February 14, 2007 04:36 PM - 04:42 PM Location: San Diego Convention Center Room 6A Sigurd H Berven, MD San Francisco CA (a, e - Medtronic, DePuy, Kyphon) Erin Boyd, BS (n) Dirk Leu, BS (n) Serena S Hu, MD San Francisco CA (a, e - Medtronic, a- DePuy) Vedat Deviren, MD San Francisco CA (a - Medtronic, DePuy) Rahul Pekmezci, MD (n) Rahul V Shah, MD New Haven CT (n) David S Bradford, MD Sausalito CA (n) Moderator(s): William J Richardson, MD Durham NC (*) Susan E Stephens, MD Gates Mills OH (*)
The transpedicular wedge resection is a reliable procedure for the correction of both sagittal and coronal plane deformity. Clinical outcomes demonstrated high levels of patient satisfaction.

Results of Lumbar PSO for Fixed Sagittal Imbalance: A minimum 5 years follow-up study Podium No: 112 Wednesday, February 14, 2007 04:48 PM - 04:54 PM Location: San Diego Convention Center Room 6A Yongjung J Kim, MD Fort Lee NJ (n) Keith H Bridwell, MD Saint Louis MO (a-Medtronic Sofamor Danek) Lawrence G Lenke, MD Saint Louis MO (a-Medtronic Sofamor Danek) Gene Cheh, MD Seoul Seoul Korea, Republic of (n) Moderator(s): William J Richardson, MD Durham NC (*) Susan E Stephens, MD Gates Mills OH (*)
Pedicle subtraction osteotomy can provide satisfactory clinical and radiographic outcomes for patients with a minimum 5 year follow-up despite pseudarthrosis revision and no significant changes between 2 years and 5-8 years follow-up. Restoration and maintenance of SVA <8cm was important to the ultimate sagittal reconstruction.

Use of the S-Rod for spinal fixation to the Pelvis in Neuromuscular Spinal Deformities Podium No: 115 Wednesday, February 14, 2007 05:12 PM - 05:18 PM Location: San Diego Convention Center Room 6A Richard E McCarthy, MD Little Rock AR (n) Frances L McCullough, NP Little Rock AR (n) Wayne Lynn Bruffett, MD Little Rock AR (n) Moderator(s): William J Richardson, MD Durham NC (*) Susan E Stephens, MD Gates Mills OH (*)
The S-rod/hook offers a simple, effective method of pelvic fixation with avoidance of SI joint, decreased operative time, low implant profile, and with titanium S-hook, MRI compatibility.
In neuromuscular spinal deformities, fixation to the pelvis can be precarious and fraught with problems. The S-rod and S-hook offer effective simple zone 1 fixation to the sacral ala.