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Rodrigo Navarro-Ramirez, Oded Rabau, Alisson Teles, Susan Ge, Abdulaziz Bin Shebreen, Neil Saran and Jean Ouellet

Early-onset scoliosis (EOS) correction techniques have evolved slowly over the past 40 years and still remain a challenge for the spine surgeon. Avoiding spinal fusion in these patients is key to decreasing morbidity and mortality in this population.

Current treatments for EOS include both conservative and surgical options. The authors present the modified Luqué technique that has been performed at their institution for the past decade. This modified technique relies on Luqué’s principle, but with newer “gliding” implants through a less disruptive approach. The goal of this technique is to delay fusion as long as possible, with the intent to prevent deformity progression while preserving maximal growth.

Normally, these patients will have definitive fusion surgery once they have reached skeletal maturity or as close as possible. Out of 23 patients until present (close to 4-year follow-up), the authors have not performed any revision due to implant failure. Three patients have undergone final fusion as the curve progressed (one patient, 4 years out, had final fusion at age 12 years; two other patients had final fusion at 3 years). These implants, which have the CE mark in Europe, are available in Canada via a special access process with Health Canada. The implants have not yet been submitted to the FDA, as they are waiting on clinical data out of Europe and Canada.

In the following video the authors describe the modified Luqué technique step-by-step.

The video can be found here:

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Christian Fung, Mathias Balmer, Michael Murek, Werner J. Z'Graggen, Janine Abu-Isa, Christoph Ozdoba, Matthias Haenggi, Stephan M. Jakob, Andreas Raabe and Jürgen Beck

the WFNS scale is probably the most important single factor. 21 This grading may be highly relevant in the acute phase, especially for the patients with poor grades, because important management decisions like withdrawal of care are made in this early period. Up to now, the possible implication of seizures for grading of patients has not been analyzed. This report aims to highlight whether and to what extent seizures influence the grading of patients and outcome after SAH. We hypothesize that early-onset seizures (EOS) negatively influence grading of patients with

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Karl G. Helmer, Ofer Pasternak, Eli Fredman, Ronny I. Preciado, Inga K. Koerte, Takeshi Sasaki, Michael Mayinger, Andrew M. Johnson, Jeffrey D. Holmes, Lorie A. Forwell, Elaine N. Skopelja, Martha E. Shenton and Paul S. Echlin

concussion, and we can also investigate the initial burden of these clusters in each sex, how the clusters correlate with numbers of previous concussions, and how they change over time when no further concussion is reported. Methods Study Subjects A cohort of 45 adult hockey players (25 men and 20 women) underwent imaging at the beginning of the season (BOS), the end of the season (EOS), and at 72 hours, 2 weeks, and 2 months postconcussion using an SWI protocol. Data from these subjects were processed and analyzed. However, not all of the participants who

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Kiril Mladenov, Lena Braunschweig, Jennifer Behrend, Heiko M. Lorenz, Urs von Deimling and Anna K. Hell

T he negative effects of progressive early-onset scoliosis (EOS) on thoracic growth and lung function are well known as thoracic insufficiency syndrome, 5 which can lead to substantial disability and/or death if left untreated. During the last decades, enormous efforts have been made to improve life expectancy mainly by using growth-friendly implants such as growing rods, vertical expandable prosthetic titanium ribs (VEPTRs), or magnetically controlled growing rods (MCGRs). 1 , 2 , 7 , 12 , 13 Most of these implants require repetitive surgeries over the years

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Liang Xu, Yong Qiu, Zhonghui Chen, Benlong Shi, Xi Chen, Song Li, Changzhi Du, Zezhang Zhu and Xu Sun

E arly-onset scoliosis (EOS) refers to a complex 3D and rapidly progressed deformity. 4 , 15 , 23 Through periodical distraction across the nonfused portion of the deformed spine, the traditional dual growing rod (DGR) technique has been widely used in the treatment of patients with EOS due to its effectiveness in controlling coronal and sagittal deformity while also permitting pulmonary system development. 9 , 13 , 16 However, because this growth-friendly technique simply combines upper and lower instrumentation with dual rods, its limitation of lacking

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Zhonghui Chen, Song Li, Yong Qiu, Zezhang Zhu, Xi Chen, Liang Xu and Xu Sun

I n recent years, various types of spine growth–friendly instrumentation have been used with the goal of minimizing spinal deformities while maximizing spine and thoracic growth in children with early-onset scoliosis (EOS). Based on repeated distractive forces they exert on the spine, vertical expandable prosthetic titanium ribs (VEPTRs) and growing rod instrumentation (GRI) have been classified as distraction-based instrumentation by Skaggs et al. 20 As originally described by Campbell and Hell-Vocke, 5 VEPTR was applied to young children with thoracic

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Emmanuelle Ferrero, Barthelemy Liabaud, Vincent Challier, Renaud Lafage, Bassel G. Diebo, Shaleen Vira, Shian Liu, Jean Marc Vital, Brice Ilharreborde, Themistocles S. Protopsaltis, Thomas J. Errico, Frank J. Schwab and Virginie Lafage

-body images (EOS imaging), this study aims to clarify the role of pelvic translation and analyze the relationships between spinopelvic parameters and lower-extremity parameters in adults with spinal pathology. Methods Patient Demographics This study is a single-site retrospective analysis. Following institutional review board approval, records of patients who presented with spinal pathology and underwent full-body EOS radiography from head to feet between November 2012 and November 2013 were reviewed. The inclusion criteria allowed all adult patients (> 18 years

Open access

Justin S. Smith, Christopher I. Shaffrey, Michael Wang, Mohamad Bydon and Lawrence Lenke

Spinal deformity includes a broad range of pathologies and has an impact across the continuum of life, from early-onset scoliosis (EOS) in a young child to degenerative scoliosis with sagittal malalignment in the elderly. How these patients are managed clinically and surgically has advanced remarkably over recent decades, but the field remains in evolution. Surgical treatments are often complex, include techniques that are challenging, and continue to have relatively high complication rates. This issue of Neurosurgery Focus: Video provides 11 videos that

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Thomas J. Buell, Davis G. Taylor, Ching-Jen Chen, Christopher I. Shaffrey, Justin S. Smith and Shay Bess

could help create more standardized guidelines for ligamentous augmentation techniques in ASD. Again, we commend the authors on this excellent study. Disclosures Bess: research support from K2M, NuVasive, Medtronic, DePuy Synthes, ZimmerBiomet, Allosource, Orthofix, and EOS; consultant for K2M, Allosource, DePuy Synthes, Misonix, and EOS; and patent holder with K2M and Innovasis. Shaffrey: consultant for Medtronic, NuVasive, Zimmer Biomet, and K2M; and patent holder with and royalties from Medtronic, NuVasive, and Zimmer Biomet; stock holder with NuVasive. Smith

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Randy S. Bell, Alexander H. Vo, Patrick B. Cooper, Carrie L. Schmitt and Michael K. Rosner

(cells/mm) WBC (cells/mm) % EOS Raw EOS(cells/mm) WBC (10 3 /mm 3 ) % EOS 1 68 23 3622 0 0 0.00 –– –– 46 46 101 38 21 22 4.62 5 1.00 47 49 180 11900 50 5 2.50 –– –– 48 46 114 131 131 5 6.55 –– –– 52 45 82 1215 61 23 14.03 –– –– 53 –– –– 5750 19 6 1.14 –– –– 54 44 114 5975 100 14 14.00 –– –– 55 51 139 5100 87 64 55.68 6.4 13.20 57 48 96 679 53 45 23.85 –– –– 58 51 121 354