Transcript This video presents the minimally invasive lateral approach for anterior column release. This is a powerful minimally invasive surgical technique for deformity correction, capable of restoring lumbar lordosis and improving sagittal balance. The procedure involves a lateral approach to the lumbar spine (via a transpoas approach), followed by discectomy and release of the ALL with placement of a hyperlordotic implant. The image in the middle shows a cadaveric specimen of the lumbar spine with half of the ALL sectioned. The image on the right shows a
Ifije Ohiorhenuan, Vedat Deviren and Juan S. Uribe
Vijay M. Ravindra, Kaine Onwuzulike, Robert S. Heller, Robert Quigley, John Smith, Andrew T. Dailey and Douglas L. Brockmeyer
), presence of syrinx (both holocord and number of levels affected), and directionality of the curve. Clinical characteristics included age at initial SODD operation, length of follow-up, and the presence of syndromic or chromosomal abnormalities. Surgical Interventions Surgical interventions included SODD and scoliotic deformity correction. The decision to offer thoracolumbar deformity correction with posterior spinal fusion was based on evaluation by a senior pediatric orthopedic surgeon with a practice primarily composed of deformity correction. The criteria were those
Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim and Seung-Jae Hyun
complain of intractable pain in the lower back and loss of lordosis and who experience no response to conservative management. 30 , 33 , 34 Significant improvements in patient outcome after surgical treatment of spinal deformity have been achieved with the introduction of spinal fusion and implants for stabilization of the spine. 42 Nevertheless, deformity-correction surgery is still a challenging and complex procedure with high complication rates. 35 , 42 Because of the high risk associated with this type of surgery, the poor musculoskeletal condition typically found
Suhas Udayakumaran, Sajesh K. Menon, Chiazor U. Onyia and Naveen Tahasildar
stratification of candidates for such an approach with the goal of helping to optimize outcomes. Methods This study was a retrospective analysis of all cases involving patients younger than 15 years of age who underwent both deformity correction and a neurosurgical procedure to treat the underlying cause during the same surgery at Amrita Institute of Medical Sciences and Research Centre between January 2001 and January 2011. Only patients who had simultaneous procedures for both indications were included in the study. Data regarding the demographic details, preoperative Cobb
Shannon Hann, Nohra Chalouhi, Ravichandra Madineni, Alexander R. Vaccaro, Todd J. Albert, James Harrop and Joshua E. Heller
cervical spine's role in influencing global spinal alignment, maintaining horizontal gaze, and affecting a person's productivity and QOL. These studies review cervical alignment parameters and related outcome measures after deformity correction. 1 , 14 The decision-making process involved in choosing a surgical approach in cervical deformity, however, is not well summarized in literature. While there often is no single correct answer in spinal deformity surgery, we believe having a systematic algorithm for selecting a surgical approach may be of benefit and ultimately
Tarik F. Ibrahim, Rochelle T. Sweis and Russ P. Nockels
included cortical blindness due to posterior cerebral artery occlusion or posterior reversible encephalopathy syndrome (PRES). Occipital lobe seizures resulting in complete blindness are an entity rarely reported in the literature. 3 , 7 , 10 , 12 Referred to as status epilepticus amauroticus (SEA), persistent occipital lobe seizures most often present with visual hallucinations. However, up to one-third of patients with SEA can develop ictal blindness. 1 We report a case of a staged thoracolumbar deformity correction complicated by complete cortical blindness
Liang Xu, Zhonghui Chen, Yong Qiu, Xi Chen, Song Li, Changzhi Du, Qingshuang Zhou and Xu Sun
instrumentation complications, such as broken screws, broken rods, or screw dislodgement, were found in either group. No infection or pseudarthrosis was noted. No additional revision surgery was required in either group as of the most recent follow-up. Discussion As scoliosis in AMC is unusual and the number of cases reviewed in previous studies is also relatively small, 16 there is no study that has directly compared the results of spinal deformity correction between AMC and AIS patients. This study showed that spinal deformity correction in patients with AMC differed in
Matthew J. Grosso, Roy Hwang, Thomas Mroz, Edward Benzel and Michael P. Steinmetz
applicable to deformity correction surgery. Surgeons must balance the risks of attaining increased deformity correction through more invasive surgical techniques, with the conceived benefits of greater deformity correction. In theory, improved outcomes should correlate with the degree of deformity correction, although, once again, the literature to support this is sparse and conflicting. 11 , 15 , 16 , 22 , 24 While many surgeons believe, at least in theory, that complete correction of a kyphotic spine is best, some authors argue that greater improvements are seen with
Cheerag Upadhyaya, John Ziewacs and Praveen Mummaneni
Minimally invasive surgical (MIS) approaches are gaining popularity in many surgical fields. Potential advantages include reduced blood loss, shorter length of stay, and less soft-tissue trauma. Potential disadvantages include inadequate deformity correction, increased fluoroscopy, longer operative times, and decreased posterolateral fusion surface area exposure.
This video demonstrates the key steps in our mini-open transforaminal lumbar interbody fusion (TLIF) using an expandable tubular retractor, placement of cannulated pedicle instrumentation, and subsequent deformity correction. The video demonstrates positioning, surgical opening through a midline incision, a bilateral Wiltse plane tubular approach for the TLIF, placement of bilateral cannulated pedicle screws, and deformity correction.
The video can be found here: http://youtu.be/9GH3qsCGX3E.
Girts Murans, Bengt Gustavsson and Helena Saraste
–27 nevertheless, in most cases spinal fusion still is necessary. 7 It has not been documented whether neurosurgery and deformity correction should be performed in 1 session or staged. Most commonly, those treatments are performed on separate occasions. However, the surgical approach to intraspinal anomalies is usually the same as for posterior fusion. Scar tissue formation after repeated surgery decreases the healing capacity of the wound for the second procedure. Intraspinal retethering is described in the literature. 8 , 16 , 28 , 33 Retethering following earlier surgeries