Idiopathic Scoliosis

 

Description:

The definitive practical reference on managing idiopathic scoliosis from world-renowned experts

Idiopathic Scoliosis: The Harms Study Group Treatment Guide, Second Edition, edited by Peter O. Newton, Amer F. Samdani, Harry L. Shufflebarger, Randal R. Betz, and Jürgen Harms and written by an impressive group of experts reflects treatment advances made in the last decade. Greater understanding of the etiology and improved 3D anatomy has resulted in significant strides in clinical management of scoliosis. This richly illustrated book presents all facets of evaluation and treatment of abnormal curvature of the spine, supported by a solid foundation of evidence-based data culled from the prestigious Harms Study Group.

Divided into four sections and 31 chapters, this one-stop reference encompasses the full spectrum of surgical and nonoperative interventions—from early treatments to modern novel growth modulation techniques. In this second edition, each chapter has been updated and several new ones have been added, reflecting current literature, practice, and expert perspective. Throughout the book, masters share clinical pearls and firsthand knowledge on managing diverse types of adolescent idiopathic spinal deformity, with the common goal of improved patient outcomes.

Key Highlights

Innovative topics include teamwork and safety in spine surgery, halo traction for large curves, anterior growth modulation, intraoperative neuromonitoring, and kyphosis restoration in scoliosis surgery

Surgical chapters follow a consistent layout, encompassing rationales, techniques, and outcomes

Postoperative chapters feature discussion of long-term clinical and radiographic outcomes, infections, complications, and rapid post-op recovery

A wealth of illustrations enhance the reader's knowledge of specific techniques

This comprehensive textbook is essential reading for orthopaedic and neurosurgical residents, fellows, and researchers. Young spine surgeons embarking on their careers and senior surgeons who wish to remain up-to-date on new techniques for treating adolescent idiopathic scoliosis will also benefit from this illuminating resource.

 

 

Table of Contents:

 

 

 

Section I Evaluation and Management

 

1 History of Scoliosis Treatment

1.1 Introduction

1.2 Lewis Sayre, the Father of Orthopaedics

1.3 Operative Treatment

1.4 Russell A. Hibbs and Frederick H. Albee

1.5 John Robert Cobb and the Cobb Angle for Scoliosis

1.6 Fusion, Casting, and Prolonged Bedrest

1.7 Paul R. Harrington

1.8 Allen F. Dwyer and Anterior Instrumentation

1.9 Zielke Instrumentation Anterior Surgery..

1.10 Kostuik–Harrington Anterior Instrumentation Utilizing Harrington Screws

1.11 Luque Segmental Fixation

1.12 Cotrel–Dubousset Instrumentation and 3D Concepts of AIS

1.13 History of Pedicle Screws and Plates: King, Boucher, Roy-Camille

1.14 Polyaxial Screws in Spine Surgery

1.15 Segmental Application of Polyaxial Screw Constructs

1.16 Suk and Harms Thoracic Screws in Deformity

1.17 Spinal Instrumentation: Rods

1.18 Scoliosis Classification Systems

1.19 Osteotomies for Kyphosis and Scoliosis.

1.19.1 Thoracoplasty for Rib Prominence

1.20 3D Understanding of Scoliosis and the Future

1.21 History of Collaborative Research in Scoliosis

1.22 Tips/Pearls

2 Etiological Theories of Idiopathic Scoliosis

2.1 Introduction

2.2 Biomechanics of the Upright Human Spine as Related to the Sagittal Profile, Dorsal Shear Loads

2.2.1 Evolution of the Human Pelvis, Pelvic Lordosis

2.2.2 Dorsal Shear Loads Acting on the Human Spine

2.2.3 Di?erences in Sagittal Spinal Alignment

2.2.4 Preexistent Rotation of the Nonscoliotic Spine

2.3 Animal Models.

2.3.1 Quadrupedal Animal Models

2.3.2 Bipedal Animal Models

2.3.3 Genetic Animal Models

2.3.4 Human Model

2.4 The Role of the Intervertebral Disc

2.5 Current Understanding of Genetics in AIS

2.5.1 Genome-Wide Association Studies

2.5.2 Di?erential Roles of Genetics and Environment Factors in Initiation/Progression of Deformity

2.5.3 Clinical Implications

2.5.4 Future Trends of Genetic Studies.

2.6 Bone Growth and Metabolism in Adolescent Idiopathic Scoliosis

2.6.1 Abnormal Skeletal Growth

2.6.2 Body Composition and Metabolic Dysfunction

2.6.3 Low Bone Mineral Density, Abnormal Bone Structure and Qualities

2.6.4 Abnormal Bone Turnover and Bone Cells Activity

2.6.5 Lifestyle Factors Associated with Low BMD and Poor Bone Quality

2.6.6 Bone Mass and Bone Qualities as Prognostic Factors of Curve Progression?

2.6.7 Potential Clinical Intervention and Lifestyle Modification Targeting Bone Health that Might A?ect the Curve Progression in Early AIS

2.7 Central Nervous System

2.7.1 Neurophysiological Dysfunction

2.7.2 Neuromorphological Changes (MRI-Based Studies).

2.8 Discussion

2.9 Tips/Pearls

3 Prevalence and Natural History

3.1 Introduction

3.2 School Screening

3.2.1 Prevalence According to Genetic Factors.

3.2.2 Prevalence by Age

3.2.3 Prevalence by Gender

3.2.4 Prevalence by Curves

3.3 Natural History

3.4 Curve Progression

3.4.1 Curve Characteristics

3.4.2 Stage of Skeletal Growth

3.5 Back Pain

3.6 Cardiopulmonary Function

3.7 Psychosocial Issues and Cosmesis

3.8 Future Insights into the Natural History of Scoliosis.

3.9 Tips/Pearls

4 Clinical and Radiographic Evaluation of Patients with Scoliosis

4.1 Introduction

4.2 History and Clinical Presentation

4.3 Physical Examination

4.4 Radiographic Evaluation

4.5 Assessment of Skeletal Maturity

4.6 Conclusion

4.7 Tips/Pearls

5 Nonoperative Management of Adolescent Idiopathic Scoliosis.

5.1 Introduction

5.2 Screening

5.3 History of Bracing

5.4 Types of Braces

5.5 Evidence for Bracing

5.6 BrAIST and Factors Impacting Brace Success

5.6.1 Factors Impacting Brace E?ectiveness

5.6.2 Psychosocial E?ects of Bracing.

5.7 The Authors’ Recommended Treatment Method

5.8 Bracing

5.9 Conclusion and Future Directions

5.10 Tips/Pearls

6 Classification of Adolescent Idiopathic Scoliosis for Surgical Intervention

6.1 Introduction

6.2 Classification

6.2.1 Historical Perspective

6.2.2 King Classification

6.2.3 Lenke Classification

6.2.4 SRS Three-Dimensional Classification System.

6.3 Conclusion

6.4 Tips/Pearls

7 Biomechanics and Correction of Scoliosis

7.1 Introduction: Three-Dimensional Morphology of Scoliosis and Spine Biomechanics

7.2 Deformity Correction Mechanics

7.3 Growth Modulation Instrumentation Mechanics

7.4 Multisegmental Correction Mechanics and Failure Modes

7.5 Bone Implant Interface Failure Mode (Pullout and Nonaxial Loads)

7.6 Long-Term Failure (Cyclic Loading)

7.7 Complex Deformity Correction Problems (Proximal Junctional Kyphosis and Proximal Junctional Failure)

7.8 Conclusion

7.9 Tips/Pearls

8 Benefits of Teams and Teamwork in Spine Surgery Quality, Safety, and Value

8.1 Introduction

8.2 Communication

8.3 Building Safety and Belonging

8.4 Team of Teams: Creating Shared Consciousness and Purpose

8.5 A Tale of Two Team Building E?orts: Children’s Hospital of Philadelphia and Children’s Hospital of New York

8.5.1 The CHOP Experience: The Value of Dedicated Surgical Teams: Bringing NASA and NASCAR Wisdom to Your Spine Operating Room

8.5.2 Improving Throughput at Children’s Hospital of New York: Leveraging a Comprehensive Unit-Based Safety Program

8.6 Tips/Pearls

9 Clinical Implications of Three-Dimensional Analysis

9.1 Introduction

9.2 History of Radiographic Analysis

9.3 Three-Dimensional Reference Plane Definitions

9.3.1 Coronal Plane

9.3.2 Sagittal Plane

9.3.3 Transverse or Axial Plane.

9.3.4 Plane of Maximum Curvature

9.3.5 The Role of MRI and CT Imaging in AIS

9.3.6 Synchronized Biplanar Radiographic 3D Reconstruction

9.4 2D Radiograph to 3D Measurement Conversion Techniques

9.5 Conclusion

9.6 Tips/Pearls

Section II Surgical Considerations

10 Selective versus Nonselective Fusion for Adolescent Idiopathic Scoliosis

10.1 Introduction

10.2 Indications and Criteria

10.3 Technical Aspects for Successful Selective Fusion.

10.3.1 Selection of Fusion Levels

10.4 Correction Mechanics and Desired Correction

10.4.1 Selective Thoracic Fusion.

10.5 Outcomes Following Selective Fusion

10.6 Complications

10.7 Conclusion

10.8 Tips/Pearls

11 Selection of Fusion Levels

11.1 Background/Historic Context 114 11.2 History and Physical Examination

11.3 Radiographic Evaluation

11.4 Operative Algorithm/Goals

11.5 Anterior Spinal Fusion Level Selection

11.6 Posterior Spinal Fusion Level Selection

11.7 UIV Selection in Posterior Fusions

11.7.1 Upper Thoracic and Main Thoracic UIV

11.7.2 Thoracolumbar Upper Instrumented Vertebra

11.8 LIV Selection in Posterior Fusions

11.8.1 Main Thoracic Lower Instrumented Vertebra

11.8.2 Thoracolumbar Lower Instrumented Vertebra

11.9 Detailed Discussion of Lenke Curve Types

11.9.1 Type 1: Main Thoracic Curves.

11.9.2 Type 2: Double Thoracic Curves.

11.9.3 Type 3: Double Major Curves

11.9.4 Type 4: Triple Major Curves

11.9.5 Type 5: Thoracolumbar/Lumbar Curves

11.9.6 Type 6: Thoracolumbar/Lumbar Main Thoracic Curves

11.10 Other Considerations

11.11 Conclusion

11.12 Tips/Pearls

12 Posterior Correction Techniques in Adolescent Idiopathic Scoliosis.

12.1 Introduction

12.2 Implant Properties.

12.3 Other Rod Materials

12.4 Correction Maneuvers

12.4.1 Compression–Distraction

12.4.2 Rod Derotation Maneuver

12.4.3 In Situ Contouring

12.4.4 Coronal and Sagittal Translation

12.4.5 En Bloc Vertebral Derotation

12.4.6 Segmental Vertebral Derotation

12.4.7 Derotation via Di?erential Rod Contouring

12.4.8 Cantilever Technique

12.4.9 Traction

12.5 The Authors’ Preferred Technique of Correction in Adolescent Idiopathic Scoliosis

12.6 En Bloc Spinal Derotation Technique

12.7 Segmental Spinal Derotation

12.8 The Authors’ Preferred Technique for Reducing Spinal Deformity

12.9 Conclusion

12.10 Tips/Pearls

13 Halo Traction in Large Idiopathic Scoliotic Curves Walter Klyce and Paul D. Sponseller

13.1 Introduction

13.2 Traction: The Risks and Benefits

13.3 Preferred Methods of Preoperative Traction

13.3.1 Halo-Femoral Traction

13.3.2 Halo-Gravity Traction

13.4 Complications and Contraindications.

13.5 Tips/Pearls

14 Indications and Techniques for Anterior Release and Fusion

14.1 Introduction

14.2 History and Evolution of Anterior Approaches

14.3 Complications

14.4 Pulmonary Function

14.5 Modern Approach

14.6 Crankshaft

14.7 Lack of Posterior Elements/Neuromuscular Scoliosis.

14.8 Techniques

14.9 Thoracotomy

14.10 Thoracoscopy

14.11 Thoracoabdominal Approach

14.12 Conclusion

14.13 Tips/Pearls

15 Posterior Releases: Pontes and Three-Column Osteotomies.

15.1 Introduction

15.2 Classification and History.

15.2.1 Classification of Posterior-Based Osteotomies

15.2.2 History of Posterior Column Osteotomies (Schwab Type 2/Ponte/Smith-Petersen)

15.2.3 Pedicle Subtraction Osteotomies (Type 3/4)

15.2.4 Vertebral Column Resections (Type 5/6)

15.3 Surgical Techniques

15.3.1 Posterior Column Osteotomies/Schwab Type 2

15.4 Complications

15.4.1 Posterior Column Osteotomy/Schwab Type 2

15.4.2 Three-Column Osteotomy/Schwab Types 3, 4, 5, and 6

15.5 Conclusion

15.6 Tips/Pearls

16 Surgical Treatment of the Right Thoracic Curve Pattern

16.1 Introduction

16.2 Deformity Classification

16.2.1 Three-Dimensional Analysis of the MT Curve

16.3 Decisions Relating to Surgical Treatment

16.3.1 Is a Surgically Instrumented Fusion Indicated?

16.3.2 The Inclusion of Minor Curves in the Fusion.

16.3.3 To What Extent Should the Thoracic Curve Be Corrected for Ideal Balance?

16.3.4 What Levels Should Be Included in the Fusion?

16.3.5 What Is the Best Approach?

16.3.6 When Is an Anterior Release Indicated?

16.4 Surgical Techniques

16.4.1 Posterior Spinal Instrumentation and Fusion.

16.4.2 Open Anterior Spinal Instrumentation and Fusion

16.4.3 Thoracoscopic Anterior Spinal Instrumentation and Fusion

16.5 Summary of Treatment

16.5.1 Recommendations for Lenke Type 1AR Curves

16.5.2 Lenke Type 1AL/1B Curves

16.5.3 Lenke Type 1C Curves

16.6 Conclusion 184 16.7 Tips/Pearls

17 Assessment and Management of Shoulder Balance

17.1 Introduction

17.2 History and Relevance of Shoulder Balance

17.2.1 Shoulder Balance in Normal Adolescents

17.2.2 Relationship of Shoulder Balance with Outcome Scores

17.3 Assessment of Shoulder Balance

17.3.1 Clinical Evaluation of Shoulder Balance.

17.3.2 Radiographic Evaluation of Shoulder Balance

17.3.3 Authors’ Recommendation

17.3.4 Relationship of Clinical and Radiographic Shoulder Balance

17.4 Curve Patterns/Factors Associated with Shoulder Imbalance

17.4.1 Magnitude and Flexibility of the Proximal Thoracic Curve

17.4.2 Preoperative Shoulder Imbalance

17.4.3 Authors’ Recommendation

17.5 Strategies to Achieve/Correct Shoulder Balance

17.5.1 Upper Instrumented Vertebra Selection

17.5.2 Technique for Deformity Correction and Impact on Shoulder Balance

17.5.3 Relationship of Proximal Thoracic to Main Thoracic Correction

17.5.4 Intraoperative Shoulder Balance Assessment

17.5.5 Authors’ Recommendation

17.6 Postoperative Shoulder Balance

17.6.1 Postoperative Changes in Alignment

17.6.2 Patient-Reported Outcomes with Shoulder Imbalance

17.7 Conclusion

17.8 Tips/Pearls

18 Surgical Treatment of Lumbar and Thoracolumbar Curve Patterns (Lenke V).

18.1 Introduction

18.2 Level Selection and Surgical Technique

18.2.1 Upper and Lower Instrumented Vertebrae

18.2.2 When Does Lenke 5 Become 6?

18.2.3 Ponte Osteotomy in Lenke 5 Curves

18.2.4 Correction Techniques in Lenke 5 Curves

18.2.5 Outcomes in Lenke 5 Curves.

18.3 Discussion

18.4 Tips/Pearls

19 The Surgical Treatment of Double and Triple Curves (Lenke Types 3, 4, and 6)

19.1 Introduction

19.2 Curve Definitions

19.3 Treatment Principles.

19.4 Recent Trends in the Surgical Decision- Making Process

19.5 Surgical Approaches

19.6 Conclusion

19.7 Tips/Pearls

20 Thoracoplasty

20.1 Introduction

20.2 Indications

20.3 Operative Technique.

20.4 Complications

20.5 Postoperative Management

20.6 The Authors’ Institutional Experience with Thoracoplasty

20.7 Conclusion

20.8 Tips/Pearls

21 Kyphosis Restoration in Adolescent Idiopathic Scoliosis

21.1 Introduction

21.2 Background

21.3 Importance of Sagittal Plane Correction

21.4 Surgical Restoration of Kyphosis

21.4.1 General

21.4.2 Curve Attributes.

21.4.3 Release of Spine: Posterior

21.4.4 Anterior Surgery/Video-Assisted Thoracoscopic Surgery

21.5 Posterior-Based Surgery

21.5.1 Type of Fixation

21.5.2 Implant Density

21.5.3 Rod Properties and Techniques

21.6 Conclusion

21.7 Tips/Pearls

Section III Postoperative Management

22 Long-Term Clinical and Radiographic Outcomes of Scoliosis

22.1 Introduction

22.2 Long-Term Clinical Questions Answered

22.2.1 Maintenance of Radiographic Correction

22.2.2 Cosmesis.

22.2.3 Pulmonary Function

22.2.4 Spine Function, Mobility, and Health

22.2.5 Health-Related Quality of Life

22.2.6 Pregnancy and Childbirth

22.2.7 Reoperations at Long-Term Follow-Up

22.2.8 Comparison to Natural History

22.3 Long-Term Clinical Questions Remaining

22.4 Future Directions

22.5 Conclusion

22.6 Tips/Pearls

23 Infection in Adolescent Idiopathic Scoliosis

23.1 Introduction

23.2 Background

23.3 Surveillance Periods for Surgical Site Infection

23.3.1 Early versus Late Surgical Site Infection

23.3.2 Deep versus Superficial Surgical Site Infection

23.4 Early Infections

23.4.1 Background and Incidence

23.4.2 Risk Factors and Prevention

23.4.3 Clinical Presentation and Evaluation

23.4.4 Treatment

23.5 Late Infections

23.5.1 Clinical Features

23.5.2 Evaluation and Initial Management

23.5.3 Surgical Management

23.5.4 Aftercare.

23.6 Conclusion

23.7 Tips/Pearls

24 Complications and Reoperations in Adolescent Idiopathic Scoliosis

24.1 Introduction

24.2 Intraoperative Complications

24.3 Early Postoperative Complications

24.4 Late Postoperative Complications

24.5 Best Practice Guidelines

24.6 Conclusion

24.7 Tips/Pearls

25 Accelerated Pathways

25.1 Introduction

25.2 Background

25.3 Preoperative Considerations

25.3.1 Nutrition

25.3.2 Pulmonary

25.3.3 Gastrointestinal

25.3.4 Patient/Parent Expectations

25.4 Postoperative Management

25.4.1 Overview

25.4.2 Pain Management

25.4.3 Nutrition and Bowel Management

25.4.4 Mobilization

25.4.5 Care Pathways.

25.5 Conclusion

25.6 Tips/Pearls

26 Untreated Late-Onset Idiopathic Scoliosis and Revision Surgery in Adults

26.1 Introduction

26.2 Untreated Adolescent Idiopathic Scoliosis

26.3 Preoperative Assessment and Nonoperative Treatment

26.4 Complications an

26.5 Proximal and Distal Junctional Kyphosis

26.6 Revision Surgery, Alignment, and HRQOL

26.7 Flatback

26.8 Long-Term Follow-up after Adolescent Fusion

26.9 Tips/Pearls

Section IV Miscellaneous Topics

27 Osteobiologic Agents for Spinal Fusion Benjamin D. Roye and Stephen G. George

27.1 Introduction

27.2 The Biology of Spinal Fusion

27.3 Osteobiologic Products and Spinal Fusion

27.3.1 Autogenous Bone Graft

27.3.2 Allogenic Bone Graft

27.3.3 Cadaveric Allograft

27.3.4 Ceramics.

27.3.5 Demineralized Bone Matrix

27.3.6 Osteoinductive Proteins

27.3.7 Platelet Concentrates

27.3.8 Growth and Di?erentiation Factor-5

27.4 Conclusion

27.5 Tips/Pearls

28 Intraoperative Neuromonitoring

28.1 Introduction

28.2 History.

28.2.1 Stagnara Wake-up Test

28.2.2 Ankle Clonus Test

28.3 Neuromonitoring

28.3.1 Somatosensory Evoked Potentials.

28.3.2 Transcranial Motor Evoked Potentials

28.3.3 Multimodality.

28.3.4 Triggered Electromyography

28.3.5 Descending Neurogenic Evoked Potentials

28.3.6 H-Reflex

28.3.7 D-Wave Monitoring

28.4 Anesthesia and Other Agents

28.4.1 Inhalational Agents

28.4.2 Total Intravenous Anesthesia

28.5 Other Considerations

28.5.1 Steroids.

28.6 Change in Intraoperative Neuromonitoring

28.6.1 Significant Change

28.6.2 Team Response to Intraoperative Neuromonitoring Alert

28.6.3 Timing of Change and Time to Return

28.6.4 Rate of Injury in Adolescent Idiopathic Scoliosis

28.6.5 Risk Factors for Changes in Intraoperative Neuromonitoring

28.6.6 Delayed Postoperative Neurologic Deficit

28.7 Case Examples

28.7.1 Case Example 1.

28.7.2 Case Example 2.

28.7.3 Case Example 3.

28.7.4 Case Example 4.

28.7.5 Case Example 5.

28.8 Conclusion

28.9 Tips/Pearls

29 Anterior Growth Modulation

29.1 Introduction

29.2 Clinical Application and Potential

29.3 Surgical Technique

29.4 Reported Outcomes

29.5 Conclusion

29.6 Tips/Pearls

30 Managing the Preadolescent Curve: Early Fusion versus Posterior Distraction

30.1 Introduction

30.2 Spinal and Thoracic Growth

30.3 Surgical Alternatives.

30.4 Growth-Friendly Techniques.

30.5 Instrumented Fusion.

30.6 Conclusion

30.7 Tips/Pearls

31 The Development and Evolution of the Harms Study Group Registry.

31.1 Introduction

31.2 Development of a Study Group

31.3 Database Evolution

31.4 Research Study Development and Evolution

31.5 Surgeon/Site Participation.

31.5.1 Data Quality Assurance

31.5.2 Study Group Strategic Plan: Formation of a 501(c)(3) Nonprofit

31.6 The Power of Large Registries: Beyond the Research

31.7 Conclusion

31.8 Tips/Pearls

Index

 

An aparitie	17 Nov. 2021
Autor	Peter Newton, Amer Samdani, Harry Shufflebarger, Randal Betz, Jürgen Harms
Dimensiuni	22.86 x 2.54 x 29.21 cm
Editura	Thieme
Format	Hardcover
ISBN	9781684200559
Limba	Engleza
Nr pag	364
Versiune digitala	DA