Related Articles Does prior short-segment surgery for adult scoliosis impact perioperative complication rates and clinical outcome among patients undergoing scoliosis correction? J Neurosurg Spine. 2012 Jun 8; Authors: Kasliwal MK, Smith JS, Shaffrey CI, Carreon LY, Glassman SD, Schwab F, Lafage V, Fu KM, Bridwell KH Abstract Object In many adults with scoliosis, symptoms can…

Related Articles Unusual association of intraspinal extramedullary teratoma with congenital scoliosis in an elderly adult: case report and literature review. Eur Spine J. 2012 Jun 7; Authors: Jiang H, Xiao Z, Zhan X, Chen Q, He M, Lu L Abstract INTRODUCTION: Intraspinal teratomas associated with congenital scoliosis are extremely rare, especially in an elderly adult….

Related Articles Adult scoliosis. Dealing with spinal imbalance. Mayo Clin Health Lett. 2012 Apr;30(4):1-3 Authors: PMID: 22649813 [PubMed – indexed for MEDLINE]

Related Articles Axial lumbar interbody fusion (AxiaLIF) approach for adult scoliosis. Eur Spine J. 2012 May 10; Authors: Boachie-Adjei O, Cho W, King AB Abstract BACKGROUND: AxiaLIF was initially advocated as a minimally invasive, presacral lumbar fusion approach. Its use has expanded in to adult scoliosis surgeries. METHODS: Current literature about AxiaLIF for degenerative lumbar…

Comparison of aprotinin and tranexamic acid in adult scoliosis correction surgery.

Eur Spine J. 2012 Mar 9;

Authors: Khurana A, Guha A, Saxena N, Pugh S, Ahuja S

PURPOSE: A retrospective review of consecutive adult patients undergoing scoliosis correction surgery was performed to compare the effects of aprotinin and tranexamic acid in blood conservation and to define a comprehensive blood conservation strategy for such surgery. METHODS: Medical records of all patients who underwent scoliosis correction surgery in this unit between January 2003 and December 2008 were reviewed. The patients were divided into three cohorts: group 1 receiving no antifibrinolytics, group 2 aprotinin and group 3 tranexamic acid. Information was collected regarding number of vertebral levels fused, pre- and post-operative haemoglobin, intra-operative blood loss and peri-operative autologous and allogenic blood transfusion performed. RESULTS: Aprotinin was used in 28 patients (38%), tranexamic acid in 26 (36%), while 19 (26%) received no antifibrinolytics. 21 patients had anterior surgery, 34 patients had posterior surgery and 18 had combined anterior and posterior procedures. Mean blood loss in the patients who received aprotinin and tranexamic acid was 710 and 738 ml, respectively. This was significantly less than the patients receiving no antifibrinolytics (972 ml, p = 0.037). Blood transfusion was required in only two patients undergoing anterior correction surgery. CONCLUSION: Aprotinin and tranexamic acid reduce blood loss in adult spinal deformity correction surgery. With aprotinin being unavailable for clinical use, we recommend the use of tranexamic acid along with other blood conservation measures for adult spinal deformity correction surgery.

PMID: 22402839 [PubMed – as supplied by publisher]

Methods of physical treatment for a post-polio adult with scoliosis.

Scoliosis. 2012 Jan 27;7 Suppl 1:P25

Authors: Torres B

PMID: 22377184 [PubMed – as supplied by publisher]

A descriptive study of lateral spondylolisthesis in patients with adult scoliosis.

Scoliosis. 2012 Jan 27;7 Suppl 1:P13

Authors: Knott P, Thompson S, Mardjetko S

PMID: 22376839 [PubMed – as supplied by publisher]

Incidence, Risk Factors and Natural Course of Proximal Junctional Kyphosis: Surgical Outcomes Review of Adult Idiopathic Scoliosis. Minimum 5 years Follow-Up.

Spine (Phila Pa 1976). 2012 Feb 21;

Authors: Yagi M, King AB, Boachie-Adjei O

Study Design. Retrospective case series of surgically treated adult scoliosis patients.Objective. The purpose of this study is to evaluate the incidence, risk factors and natural course of proximal junctional kyphosis (PJK) in a long term follow-up of adult idiopathic scoliosis undergoing long instrumented spinal fusion.Summary of Background Data. Although recent reports have showed the prevalence, clinical outcomes and the possible risk factors of PJK, quite a few reports have showed long-term follow-up outcome.Materials and Methods. This is a retrospective review of the charts and x-rays of 76 consecutive patients with adult scoliosis treated with long instrumented spinal fusion. Radiographic measurements and demographic data were reviewed on pre-op, immediate post-op, 2yrs post-op, 5yrs post-op and at follow-up. Postoperative SRS scores and ODI were also evaluated. Means were compared with student’s t test. P value of <0.05 with confidence Interval 95% was considered significant.Results. The mean age was 48.8yrs (23-75yrs) and the average f/u was 7.3yrs (5-14yrs). PJK has been identified in 17pts. The SRS and ODI did not demonstrate significant differences between PJK group and non PJK group, 2pts had additional surgeries performed for local pain. 76% of PJK has been identified within 3months after surgery. Despite 53% of total degree of PJK was progressed within 3 months after surgery, PJK continuously progressed to the final follow-up. Pre-existing low BMD, PSF, fusion to sacrum, inappropriate global spine alignment and greater SVA change were identified as a significant risk for PJK (P = 0.04, P<0.001, P = 0.02, p<0.0001 and p = 0.01).Conclusion. In a long term review of minimum 5 yrs, 76% of PJK occurred within 3 months after surgery. Pre-existing low BMD, PSF, fusion to the sacrum, inappropriate global spine alignment and greater SVA change were significant risk for PJK. Careful long term follow-up should be done for PJK patient.

PMID: 22357097 [PubMed – as supplied by publisher]

[Correlation between intervertebral disc-endplate degeneration and bony structural parameter in adult degerative scoliosis and its significance].

Zhonghua Wai Ke Za Zhi. 2011 Dec;49(12):1123-7

Authors: Ding WY, Wu HL, Shen Y, Zhang W, Li BJ, Sun YP, Guo JK, Cao LZ

OBJECTIVES: To anylaze the correlation between intervertebral disc-endplate degeneration and bony construction parameter and to explore its roles in adult degenerative scoliosis.
METHODS: The imaging data of 79 patients with adult degenerative scoliosis from March 2005 to March 2010 were retrospectively reviewed as the study group. The imaging data of 41 patients with adolescent idiopathic scoliosis were selected as the control group. The vertebral body and intervertebral height in both sides on frontal X-ray, and the facet joint orientation in both sides on CT scan were measured respectively. The average vertebral body height, average intervertebral disc height and average facet orientation were regarded as bony structural parameters. The quantitative grading methods were used in the intervertebral disc and endplate degeneration. The relationship of bony construction parameter and intervertebral disc-endplate degeneration, and the relationship of bony construction parameter and Cobb’s angle of scoliosis were analyzed by comparing all bony construction parameters in both groups.
RESULTS: Analyzed by paired-t test, the intervertebral height, vertebral body height and facet joint orientation between convex and concave sides of the study group were of significant difference (t = 3.411, 2.623 and 2.085, P < 0.05). The intervertebral height between convex and concave sides of the control group were of significant difference (t = 3.276, P < 0.01), while the vertebral body height and the facet joint orientation were of no statistical significance (t = 1.572 and 1.493, P > 0.05). By linear correlation and regression analysis, the asymmetric degree of bony construction parameter showed good correlation with the score of intervertebral disc-endplate degeneration (-1 < r < 1, P < 0.05), which was positively correlated with Cobb’s angle of scoliosis (0 < r < 1, P < 0.05). Linear regression existed between asymmetric degree of bony construction parameter and Cobb’s angle (F = 427.342, P < 0.01). The regression function was obtained: Cobb’s angle = -8.904+8.136 × IAD + 3.274 × VAD-0.713 × FAD (IAD: intervertebral asymmetry degree, VAD: vertebral asymmetry degree, FAD: facet joint asymmetry degree).
CONCLUSIONS: The asymmetric change of bony construction exists in adult degenerative scoliosis, which significantly correlated with intervertebral disc-endplate degeneration and Cobb’s angle of scoliosis. The asymmetric bony construction parameter probably plays a biomechanical role in the progression of scoliosis, which maybe the reason for the asymmetric degeneration of intervertebral disc-endplate.

PMID: 22333456 [PubMed – in process]

Comparison between two pedicle screw augmentation instrumentations in adult degenerative scoliosis with osteoporosis.

BMC Musculoskelet Disord. 2011;12:286

Authors: Xie Y, Fu Q, Chen ZQ, Shi ZC, Zhu XD, Wang CF, Li M

BACKGROUND: The operative treatment of adult degenerative scoliosis combined with osteoporosis increase following the epidemiological development. Studies have confirmed that screws in osteoporotic spines have significant lower-screw strength with more frequent screw movements within the vertebra than normal spines. Screws augmented with Polymethylmethacrylate (PMMA) or with autogenous bone can offer more powerful corrective force and significant advantages.
METHODS: A retrospective analysis was conducted on 31 consecutive patients with degenerative lumbar scoliosis combined with osteoporosis who had surgery from December 2000. All had a minimum of 2-year follow-up. All patients had posterior approach surgery. 14 of them were fixed with pedicle screw by augmentation with Polymethylmethacrylate (PMMA) and the other 17 patients with autogenous bone. Age, sex and whether smoking were similar between the two groups. Surgical time, blood loss, blood transfusion, medical cost, post surgery ICU time, hospital day, length of oral pain medicines taken, Pre-and postoperative Oswestry disability index questionnaire and surgical revision were documented and compared. Preoperative, postoperative and final follow up Cobb angle, sagittal lumbar curve, correction rate, and Follow up Cobb loss were also compared.
RESULTS: No significant differences were found between the autogenous bone group and Polymethylmethacrylate group with regards to all the targets above except for length of oral pain medicines taken and surgery cost. 2 patients were seen leakage during operation, but there is neither damage of nerve nor symptom after operation. No revision was needed.
CONCLUSION: Both augmentation pedicle screw with Polymethylmethacrylate (PMMA) and autogenous bone treating degenerative lumbar scoliosis combined with osteoporosis can achieve a good surgical result. Less oral pain medicines taken are the potential benefits of Polymethylmethacrylate augmentation, but that is at the cost of more medical spending.

PMID: 22188765 [PubMed – in process]

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