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Egyptian Experience of Surgical Management of Early-Onset Scoliosis
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Mohammad M. El-Sharkawi, Amer Alkot
Spinal fusion after repeated surgeries for gradual lengthening is still demanding with 20% reported reoperation rate [38] and carries higher risk of complications than de novo surgery, including, infection and wound dehiscence, instrumentation failure, painful or prominent instrumentation, coronal and/or sagittal deformity, pseudarthrosis, and progressive crankshaft chest wall deformity requiring a thoracoplasty [38]. Additionally, the progressive stiffness of the spine and autofusion phenomenon [39] allow for limited additional correction and increased incidence of neurologic abnormality with any added corrective spinal osteotomy during the final spinal fusion.
Animal Models of Spinal Instability and Spinal Fusion
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Harvinder S. Sandhu, Linda E. A. Kanim, Federico Girardi, Frank P. Cammisa, Edgar G. Dawson
Biologic factors influence the success or failure of spinal fusion. The impact of biologic “tools” such as osteoinductive growth factors, which stimulate the biologic processes of skeletal repair, must also be examined rigorously in animal and procedural models wherein successful fusion is difficult to achieve. In order to examine these factors carefully, selective animal models for the study of biologic factors of spinal fusion must be used and interpreted appropriately.
Revision of failed posterior cervical fusions
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Trevor Mordhorst, Vadim Goz, William Ryan Spiker
Patients who undergo revision surgery for failed posterior cervical spinal fusion should expect to spend several days in the hospital. This time will allow staff to adequately manage the patient's pain and oversee any perioperative issues that may arise. Ice chips and clear liquids can be given to the patient in the immediate perioperative period, with advancement to a full diet as the patient tolerates, as dysphagia is possible in revision posterior spine surgery. Criteria for the patient to be discharged from the hospital are adequate pain control on oral medication, return of normal bowel function, and disposition arranged for the patient to leave to an environment that will allow them to continue healing.
A pilot feasibility and acceptability study of an Internet-delivered psychosocial intervention to reduce postoperative pain in adolescents undergoing spinal fusion
Published in Canadian Journal of Pain, 2022
Caitlin B. Murray, Anthea Bartlett, Alagumeena Meyyappan, Tonya M. Palermo, Rachel Aaron, Jennifer Rabbitts
Spinal fusion surgery is a common and painful musculoskeletal surgery performed in the adolescent population for idiopathic spinal deformities (e.g., scoliosis). Studies demonstrate that most youth undergoing spinal fusion experience moderate to high pain intensity immediately after surgery and are at risk for having persistent postsurgical pain.1–6 Of particular concern is that up to 20% of youth have persistent postsurgical pain, often accompanied by functional limitations and impairments in health-related quality of life.7–10 Identifying risk factors for persistent postsurgical pain is an active area of investigation, and studies have found that acute pain in the immediate postsurgical period as well as psychosocial risk factors predict the transition from acute to chronic postsurgical pain.7,8,11–14
Spontaneous morphological remodelling of the O-C1 joint after posterior fusion for occipitocervical dislocation
Published in International Journal of Neuroscience, 2022
Chizuo Iwai, Kazunari Fushimi, Satoshi Nozawa, Naofumi Mitsuishi, Hiroyasu Ogawa, Masato Maeda, Norishige Kuramitsu, Haruhiko Akiyama
Emergency halo-vest fixation with gentle manual reduction was performed. However, her dislocation of the O-C1 joint persisted under halo fixation. A scheduled spinal fusion was performed several days after the injury. When we released the connection of the halo ring in the supine position, her craniocervical junction was clearly unstable, and her head was whipping around (like figure skaters do), indicating severe instability of the O-C1 joint. She was gently turned into the prone position on the operation table, with stiffly kept under halo-vest fixation. Posterior reduction and spinal fusion from the occipital bone to the C2 (O-C2 fusion) were performed. Surgery was successful, without any intraoperative complications. However, complete reduction of the O-C1 joint was not achieved owing to severe instability at the O-C1 joint; hence, maintaining proper anatomical position was not possible. Final alignment was decided according to rod contour. Abundant autologous iliac crest bone and an allograft were placed in the posterior gap between the occipital bone and the lamina of the C2.
Individualized prediction of pedicle screw fixation strength with a finite element model
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Jonas Widmer, Marie-Rosa Fasser, Eleonora Croci, José Spirig, Jess G. Snedeker, Mazda Farshad
Dorsal spinal instrumentation including pedicle screws and rod constructs are frequently used in the surgical treatment of spinal disorders. Although spinal fusion is a very common intervention to achieve spine stabilization, it has also some important associated complications. Insufficient screw hold and screw loosening are the most important clinical challenges. Overall, screw loosening has been reported to occur in between 1% and 30% of fusion patients, and even more often in cases where motion-preserving instrumentation was used and where patients had osteoporosis (Esses et al. 1993; Ohlin et al. 1994; El Saman et al. 2013; Abul-Kasim and Ohlin 2014; Mohi Eldin and Ali 2014; Bredow et al. 2016). One recent study found that for vertebrae with low bone quality, the risk of screw loosening could be higher than 60% (El Saman et al. 2013; Weiser et al. 2017). Revision surgery is required in a significant part of patients affected by this complication (Bredow et al. 2016).