exposure are more prevalent. This concern is especially pronounced in children because of the early exposure, greater susceptibility of young tissue, and increased dose-volume ratio. 5 , 6 Studies have shown that repeated imaging studies in pediatric patients with shunts can accumulate radiation doses that reach thresholds for potential brain damage. 6 The EOS 2D/3D radio-imaging device (EOS Imaging) can produce radiographic images with a very low radiation dose. The EOS device reduces radiation by a factor of 10 in comparison to conventional radiographs and by a factor
Karen Monuszko, Michael Malinzak, Lexie Zidanyue Yang, Donna Niedzwiecki, Herbert Fuchs, Carrie R. Muh, Krista Gingrich, Robert Lark, and Eric M. Thompson
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: https://youtu.be/k0AuFa9lYXY.
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
Charlie Bouthors, Ruben Dukan, Christophe Glorion, and Lotfi Miladi
exhibiting ≥ 3 dystrophic features. 5 , 6 Dystrophic curves should be treated without a prior observation period because they always progress. 7 , 8 Spinal deformities can manifest early in NF1 patients, usually between the ages of 5 and 8 years. 9 This timeframe corresponds with that of early-onset scoliosis (EOS), in which spine deformity develops before the age of 10 years. Treatment of EOS patients is particularly challenging since spinal growth maintenance is critical for pulmonary maturation and function. 10 Although primary spinal fusion has been the mainstay of
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
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
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
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
Takafumi Chiba, Satoshi Inami, Hiroshi Moridaira, Daisaku Takeuchi, Tsuyoshi Sorimachi, Haruki Ueda, Makoto Ohe, Hiromichi Aoki, Takuya Iimura, Yutaka Nohara, and Hiroshi Taneichi
S urgical intervention is indicated in cases of progressive and severe early-onset scoliosis (EOS) that do not respond to nonoperative treatment. The surgical technique includes distraction-based systems and guided growth constructs. 1–5 A growing rod (GR) technique is a widely performed distraction-based technique that is effective in spinal deformity correction, spinal growth, and thoracic growth. 1 , 2 , 5 The postoperative complication rates of the GR technique remain high, however, and implant-related complications have been reported as the most common
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