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  • 1
    Online Resource
    Online Resource
    SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Spine Vol. 48, No. 10 ( 2023-05-15), p. 683-687
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 10 ( 2023-05-15), p. 683-687
    Abstract: Retrospective cohort Objective. To examine SRS-Self Image scores at up to 10 years after surgery for adolescent idiopathic scoliosis (AIS). Summary of Background Data. Self-image is complex with implications for surgical and patient-reported outcomes after AIS surgery. Surgically modifiable factors that impact self-image are inconsistently reported in the literature with few longer-term reports. We examined the rate and durability of self-image improvement. Materials and Methods. An AIS registry was queried for patients with up to 10 years of follow-up after AIS surgery. A mixed effects model estimated change in SRS-22 Self Image from baseline to 6 weeks, 1 year, 2 years, 5 years, and 10 years. All enrolled patients contributed data to the mixed effects models. A sub-analysis of patients with 1-year and 10-year follow-up evaluated worsening/static/improved SRS-22 Self Image scores examined stability of scores over that timeline. Baseline demographic data and 1-year deformity magnitude data were compared between groups using parametric and nonparametric tests as appropriate. Results. Data from 4608 patients contributed data to the longitudinal model; 162 had 1-year and 10-year data. Mean SRS-Self Image improvement at 10-year follow-up was 1.0 (95% CI: 0.9–1.1) point. No significant changes in Self-Image domain scores were estimated from 1-year to 10-year (all P 〉 0.05) postoperative. Forty (25%) patients had SRS-Self Image worsening from 1 year to 10 years, 36 (22%) improved, and 86 (53%) were unchanged. Patients who worsened over 10 years had lower SRS-Self Image at baseline than those unchanged at enrollment (3.3 vs. 3.7, P =0.007). Neither radiographic parameters nor SRS-Mental Health were different at baseline for the enrolled patients. Conclusion. Ten years after surgery, 75% of patients reported similar or better SRS-Self Image scores than one year after surgery. Nearly 25% of patients reported worsening self-image at 10 years. Patients who worsened had lower baseline SRS-Self Image scores, without radiographic or mental health differences at baseline or follow-up.
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004620
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2002195-1
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  • 2
    Online Resource
    Online Resource
    Anterior Spinal Growth Modulation in Skeletally Immature Patients with Idiopathic Scoliosis : A Comparison with Posterior Spinal Fusion at 2 to 5 Years Postoperatively
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of Bone and Joint Surgery Vol. 102, No. 9 ( 2020-5-6), p. 769-777
    Details
    In: Journal of Bone and Joint Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 9 ( 2020-5-6), p. 769-777
    Abstract: Anterior vertebral body tethering (AVBT) has been introduced as a means of correcting scoliosis without fusion. The purpose of this study was to compare outcomes for patients with thoracic idiopathic scoliosis between a group of patients who underwent AVBT and a matched cohort of patients treated with posterior spinal fusion and instrumentation (PSF). Methods: A retrospective study of patients who underwent AVBT and PSF for idiopathic scoliosis was conducted. The inclusion criteria were determined on the basis of the AVBT cohort: primary thoracic idiopathic scoliosis with a curve magnitude between 40° and 67°, Risser stage of ≤1, age of 9 to 15 years, no prior spine surgery, index surgery between 2011 and 2016, and minimum follow-up of 2 years. Demographic, radiographic, clinical, and patient-reported outcomes and revisions were compared between groups. Results: There were 23 patients in the AVBT cohort and 26 patients in the PSF cohort. The mean follow-up (and standard deviation) was similar between groups: 3.4 ± 1.1 years for the AVBT group and 3.6 ± 1.6 years for the PSF group (p = 0.6). Preoperatively, the groups were similar in all measurements of radiographic and clinical deformity, with mean main thoracic curves of 53° ± 8° for the AVBT group and 54° ± 7° for the PSF group (p = 0.4). At the time of final follow-up, the AVBT cohort had significantly more residual deformity, with a mean thoracic curve of 33° ± 18° compared with 16° ± 6° for the PSF group (p 〈 0.001). There were 9 revision procedures in the AVBT cohort (with 3 conversions to PSF and 3 more pending) and none in the PSF cohort. Revisions occurred at a mean postoperative time of 2.3 years (range, 1.2 to 3.7 years). Twelve patients (52%) had evidence of broken tethers; of these patients, 4 underwent revision. The post-intervention patient-reported outcomes were similar. Conclusions: Both AVBT and PSF resulted in postoperative correction; however, 2-year correction was better maintained in the PSF group. There were no differences in post-intervention patient-reported outcomes. AVBT resulted in less deformity correction and more revision procedures than PSF, but resulted in the delay or prevention of PSF in the majority of patients. Level of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 0021-9355 , 1535-1386
    URL: Article
    DOI: 10.2106/JBJS.19.01176
    RVK:
    XA 52200.A
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 3
    Online Resource
    Online Resource
    Ten-Year Outcomes of Selective Fusions for Adolescent Idiopathic Scoliosis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Bone and Joint Surgery Vol. 101, No. 9 ( 2019-5-1), p. 761-770
    Details
    In: Journal of Bone and Joint Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 9 ( 2019-5-1), p. 761-770
    Abstract: Selective fusions of the structural curve remain a common treatment strategy for adolescent idiopathic scoliosis, yet long-term outcomes are not well-understood. The purpose of this study was to report 10-year prospective radiographic and patient-rated outcomes of selective fusions of the main thoracic (MT) or thoracolumbar/lumbar (TL/L) curve, with particular attention to the behavior of the uninstrumented, compensatory curve. Methods: A prospectively collected multicenter database was used to identify patients who had been followed regularly for least 10 years after a selective MT or TL/L fusion for adolescent idiopathic scoliosis. Interval radiographs were evaluated for coronal and sagittal Cobb angles as well as overall coronal balance. Scores on the Scoliosis Research Society Questionnaire (SRS-24) were catalogued and evaluated. Radiographic outcomes and SRS-24 scores were compared between preoperative and postoperative time points using repeated-measures analysis of variance. Individual patient records were screened for recent curve progression of 〉 5°, and these cases were methodically evaluated. Results: Fifty-one patients with selective fusions (21 MT and 30 TL/L) for adolescent idiopathic scoliosis who had been followed for at least 10 years were identified. The instrumented MT and TL/L curves were corrected by an average of 51% and 60%, respectively, at 10 years. The uninstrumented, compensatory curves had gradual spontaneous correction that approached the magnitude of the fused curve at 5 years postoperatively, with the correction maintained at 10 years. This led to excellent coronal balance. A subgroup of patients had recent progression of the primary curve adjacent to the prior fusion or within the instrumented segments, resulting in a compensatory progression of the uninstrumented curve. On the whole, SRS scores did not decrease during follow-up, and no patient had secondary operations. Conclusions: Selective fusion of a primary thoracic or lumbar curve in properly selected patients with adolescent idiopathic scoliosis will result in spontaneous correction of the uninstrumented curve and a durable result for at least 10 years. Level of Evidence: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 0021-9355 , 1535-1386
    URL: Article
    DOI: 10.2106/JBJS.18.01013
    RVK:
    XA 52200.A
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 4
    Online Resource
    Online Resource
    Anterior Spinal Growth Tethering for Skeletally Immature Patients with Scoliosis : A Retrospective Look Two to Four Years Postoperatively
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Bone and Joint Surgery Vol. 100, No. 19 ( 2018-10-3), p. 1691-1697
    Details
    In: Journal of Bone and Joint Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 19 ( 2018-10-3), p. 1691-1697
    Abstract: Anterior spinal growth tethering (ASGT) has been shown to alter spinal growth with the potential to correct scoliosis while maintaining spine flexibility. The purpose of this study was to report the 2 to 4-year outcomes of ASGT in skeletally immature patients with thoracic scoliosis. Methods: We conducted a retrospective review of patients with thoracic scoliosis who underwent ASGT with a minimum of 2 years of follow-up. Patient demographics, perioperative data, and radiographic outcomes are reported. A “successful” clinical outcome was defined as a residual curve of 〈 35° and no posterior spinal fusion indicated or performed at latest follow-up. Results: Seventeen patients met the inclusion criteria. The etiology was idiopathic for 14 and syndromic for 3. The mean follow-up was 2.5 years (range, 2 to 4 years). Preoperatively, all patients were at Risser stage 0, with a mean age at surgery of 11 ± 2 years (range, 9 to 14 years). There was an average of 6.8 ± 0.5 vertebrae tethered per patient. The average thoracic curve magnitude was 52° ± 10° (range, 40° to 67°) preoperatively, 31° ± 10° immediately postoperatively, 24° ± 17° at 18 months postoperatively, and 27° ± 20° at latest follow-up (51% correction; range, 5% to 118%). Revision surgery was performed in 7 patients: 4 tether removals due to complete correction or overcorrection, 1 lumbar tether added, 1 tether replaced due to breakage, and 1 revised to a posterior spinal fusion. In 3 additional patients, posterior spinal fusion was indicated due to progression. Eight (47%) of the patients had a suspected broken tether. Ten (59%) of the 17 were considered clinically successful. Conclusions: Despite most patients having some remaining skeletal growth at the time of review, the results of the current study demonstrate that at mid-term follow-up, ASGT showed a powerful, but variable, ability to modulate spinal growth and did so with little perioperative and early postoperative risk. Fusion was avoided for 13 of the 17 patients. The overall success rate was 59%, with a 41% revision rate. Understanding the parameters leading to success or failure will be critical in advancing a reliable definitive nonfusion treatment for progressive scoliosis in the future. Level of Evidence: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 0021-9355 , 1535-1386
    URL: Article
    DOI: 10.2106/JBJS.18.00287
    RVK:
    XA 52200.A
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 5
    Online Resource
    Online Resource
    EOS Imaging System is Available for Early Onset Scoliosis and Can Reduce Ionizing Radiation Exposure
    Negah Scientific Publisher ; 2019
    In:  Shafa Orthopedic Journal Vol. In Press, No. In Press ( 2019-05-11)
    Details
    In: Shafa Orthopedic Journal, Negah Scientific Publisher, Vol. In Press, No. In Press ( 2019-05-11)
    Type of Medium: Online Resource
    ISSN: 2345-296X , 2383-4315
    URL: Journal
    URL: Article
    DOI: 10.5812/soj
    DOI: 10.5812/soj.91779
    Language: Unknown
    Publisher: Negah Scientific Publisher
    Publication Date: 2019
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  • 6
    Online Resource
    Online Resource
    Defining risk factors for adding-on in Lenke 1 and 2 AR curves
    Springer Science and Business Media LLC ; 2021
    In:  Spine Deformity Vol. 9, No. 6 ( 2021-11), p. 1569-1579
    Details
    In: Spine Deformity, Springer Science and Business Media LLC, Vol. 9, No. 6 ( 2021-11), p. 1569-1579
    Type of Medium: Online Resource
    ISSN: 2212-134X , 2212-1358
    URL: Article
    DOI: 10.1007/s43390-021-00382-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2717704-X
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  • 7
    Online Resource
    Online Resource
    Long-term Patient Perception Following Surgery for Adolescent Idiopathic Scoliosis if Dissatisfied at 2-year Follow-up
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Spine Vol. 46, No. 8 ( 2021-04-15), p. 507-511
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 8 ( 2021-04-15), p. 507-511
    Abstract: Longitudinal. Objectives. To evaluate whether the rate of patients who report low health-related quality of life (HRQOL) scores at 2 years following surgical correction of adolescent idiopathic scoliosis (AIS) improves by 5 years postoperatively. Summary of Background Data. HRQOL scores are dependent upon a number of factors and even in instances of good surgical correction of a spinal deformity, are not guaranteed to be high postoperatively. Understanding how a low HRQOL score varies over the postoperative period can help surgeons more effectively counsel patients and temper expectations. Methods. A multicenter database was reviewed for patients with both 2 and 5-year follow-up after spinal fusion and instrumentation for AIS. From a cohort of 916 patients, 52 patients with low HRQOL scores at their 2-year follow-up were identified and reevaluated at 5-year follow-up. A low HRQOL outcome was defined as having SRS-22 domain or total scores less than 2 standard deviations below the mean score. Reoperations were also evaluated to determine if they were associated with HRQOL scores. Results. Of those patients with low SRS-22 HRQOL scores at 2 years postoperatively, improvements were seen in all SRS-22 domains and total scores at the 5-year time point. The greatest change was seen in the satisfaction category where 41 patients showed improvement. The rate of reoperations during this period did not significantly impact patient-reported outcomes. Conclusions. Having a low HRQOL score 2 years after surgery for AIS does not guarantee a low score 5 years after surgery. Promisingly, most patients demonstrate some improvement in all domains for patient-reported SRS-22 scores at 5-year compared to 2-year follow-up. Understanding the longer term postoperative evolution in patient-reported outcomes may help surgeons to effectively manage and counsel patients who are dissatisfied in the short term. Level of Evidence: 3
    Type of Medium: Online Resource
    ISSN: 0362-2436 , 1528-1159
    URL: Article
    DOI: 10.1097/BRS.0000000000003828
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2002195-1
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  • 8
    Online Resource
    Online Resource
    Safety of Pedicle Screws and Spinal Instrumentation for Pediatric Patients : Comparative Analysis Between 0- and 5-Year-Old, 5- and 10-Year-Old, and 10- and 15-Year-Old Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Spine Vol. 39, No. 7 ( 2014-04), p. 541-549
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 7 ( 2014-04), p. 541-549
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000000202
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 9
    Online Resource
    Online Resource
    Does Leveling the Upper Thoracic Spine Have Any Impact on Postoperative Clinical Shoulder Balance in Lenke 1 and 2 Patients?
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Spine Vol. 41, No. 14 ( 2016-07-15), p. 1122-1127
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 14 ( 2016-07-15), p. 1122-1127
    Type of Medium: Online Resource
    ISSN: 0362-2436 , 1528-1159
    URL: Article
    DOI: 10.1097/BRS.0000000000001497
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2002195-1
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  • 10
    Online Resource
    Online Resource
    Comparison of Typical Thoracic Curves and Atypical Thoracic Curves Within the Lenke 1 Classification
    Springer Science and Business Media LLC ; 2014
    In:  Spine Deformity Vol. 2, No. 4 ( 2014-07), p. 308-315
    Details
    In: Spine Deformity, Springer Science and Business Media LLC, Vol. 2, No. 4 ( 2014-07), p. 308-315
    Type of Medium: Online Resource
    ISSN: 2212-134X
    URL: Article
    DOI: 10.1016/j.jspd.2014.03.009
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2717704-X
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