Browsing by Author "Zeller, Reinhard"
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Item Open Access Canadian Spine Society: 23rd Annual Scientific Conference, Wednesday, March 1 - Saturday, March 4, Fairmont Le Château Frontenac, Québec, Que., Canada.(Can J Surg, 2023) Birk, Manjot; Sidhu, Kara; Filezio, Marina Rosa; Singh, Vishwajeet; Ferri-de-Barros, Fabio; Chan, Vivien; Shumilak, Geoffrey; Nataraj, Andrew; Langston, Holly; Yee, Nicholas J; Iorio, Carlo; Shkumat, Nicholas; Rocos, Brett; Ertl-Wagner, Birgit; Lebel, David; Camp, Mark W; Dimentberg, Evan; Saran, Neil; Laflamme, Melissa; Ouellet, Jean A; Wenghofer, Jessica; Livock, Holly; Beaton, Luke; Tice, Andrew; Smit, Kevin; Graham, Ryan; Duarte, Matias Pereira; Roy-Beaudry, Marjolaine; Turgeon, Isabelle; Joncas, Julie; Mac-Thiong, Jean-Marc; Labelle, Hubert; Barchi, Soraya; Parent, Stefan; Gholamian, Tara; Livock, Holly; Tice, Andrew; Smit, Kevin; Yoon, Samuel; Zulfiqar, Amna; Rocos, Brett; Murphy, Anne; Bath, Natasha; Moll, Stanley; Sorbara, Julia; Lebel, David; Camp, Mark W; Nallet, Jérémie Arthur; Rocos, Brett; Lebel, David Eduard; Zeller, Reinhard; Dermott, Jennifer A; Kim, Dorothy J; Anthony, Alison; Zeller, Reinhard; Lebel, David E; Wang, Zhi; Shen, Jesse; Kamel, Youssef; Liu, Jia; Shedid, Daniel; Al-Shakfa, Fidaa; Yuh, Sung-Joo; Boubez, Ghassan; Rizkallah, Maroun; Rizkallah, Maroun; Shen, Jesse; Boubez, Ghassan; Kamel, Youssef; Liu, Jia; Shedid, Daniel; Al-Shakfa, Fidaa; Lavoie, Frederic; Yug, Sung-Joo; Wang, Zhi; Alavi, Fatemeh; Nielsen, Christopher; Rampersaud, Raja; Lewis, Stephen; Cheung, Angela M; Cadieux, Chloe; Fernandes, Renan; Brzozowski, Pawel; Zdero, Radovan; Bailey, Chris; Rasoulinejad, Parham; Cherry, Ahmed; Manoharan, Ragavan; Xu, Mark; Srikandarajah, Nisaharan; Iorio, Carlo; Raj, Aditya; Nielsen, Christopher; Rampersaud, Raja; Lewis, Stephen; Beange, Kristen; Graham, Ryan; Livock, Holly; Smit, Kevin; Manoharan, Ragavan; Cherry, Ahmed; Srikandarajah, Nisaharan; Raj, Aditya; Xu, Mark; Iorio, Carlo; Nielsen, Christopher J; Rampersaud, Y Raja; Lewis, Stephen J; Nasrabadi, Ali Asghar Mohammadi; Moammer, Gemah; Phee, John Mc; Walker, Taryn; Urquhart, Jennifer C; Glennie, R Andrew; Rampersaud, Y Raja; Fisher, Charles G; Bailey, Chris S; Herrington, Brandon J; Fernandes, Renan R; Urquhart, Jennifer C; Rasoulinejad, Parham; Siddiqi, Fawaz; Bailey, Christopher S; Urquhart, Jennifer; Fernandes, Renan R; Glennie, R Andrew; Rampersaud, Y Raja; Fisher, Charles G; Bailey, Chris S; Yang, Michael MH; Riva-Cambrin, Jay; Cunningham, Jonathan; Casha, Steven; Cadieux, Chloe N; Urquhart, Jennifer; Fernandes, Renan; Glennie, Andrew; Fisher, Charles; Rampersaud, Raja; Xu, Mark; Manoharan, Ragavan; Cherry, Ahmed; Raj, Aditya; Srikandarajah, Nish; Iorio, Carlo; Nielsen, Christopher; Lewis, Stephen; Rampersaud, Raja; Cherry, Ahmed; Raj, Aditya; McIntosh, Greg; Manoharan, Ragavan; Murray, Jean-Christophe; Nielsen, Christopher; Xu, Mark; Srikandarajah, Nisaharan; Iorio, Carlo; Perruccio, Anthony; Canizares, Mayilee; Rampersaud, Raja; El-Mughayyar, Dana; Bigney, Erin; Richardson, Eden; Manson, Neil; Abraham, Edward; Attabib, Najmedden; Small, Chris; Kolyvas, George; LeRoux, Andre; Outcomes, Canadian Spine; Investigators, Research Network; Hebert, Jeff; Baisamy, Victor; Rizkallah, Maroun; Shen, Jesse; Cresson, Thierry; Vazquez, Carlos; Wang, Zhi; Boubez, Ghassan; Lung, Tiffany; Canizares, Mayilee; Perruccio, Anthony; Rampersaud, Raja; Crawford, Eric J; Ravinsky, Robert A; Perruccio, Anthony V; Rampersaud, Y Raja; Coyte, Peter C; Bond, Michael; Street, John; Fisher, Charles; Charest-Morin, Raphaele; Sutherland, Jason M; Bartolozzi, Arthur R; Barzilai, Ori; Chou, Dean; Laufer, Ilya; Verlaan, Jorrit-Jan; Sahgal, Arjun; Rhines, Laurence D; Scuibba, Daniel M; Lazary, Aron; Weber, Michael H; Schuster, James M; Boriani, Stefano; Bettegowda, Chetan; Arnold, Paul M; Clarke, Michelle J; Fehlings, Michael G; Reynolds, Jeremy J; Gokaslan, Ziya L; Fisher, Charles G; Dea, Nicolas; Versteeg, Anne L; Charest-Morin, Raphaele; Laufer, Ilya; Teixeira, William; Barzilai, Ori; Gasbarrini, Alessandro; Fehlings, Michael G; Chou, Dean; Johnson, Michael G; Gokaslan, Ziya L; Dea, Nicolas; Verlaan, Jorrit-Jan; Goldschlager, Tony; Shin, John H; O'Toole, John E; Sciubba, Daniel M; Bettegowda, Chetan; Clarke, Michelle J; Weber, Michael H; Mesfin, Addisu; Kawahara, Norio; Goodwin, Rory; Disch, Alexander; Lazary, Aron; Boriani, Stefano; Sahgal, Arjun; Rhines, Laurence; Fisher, Charles G; Versteeg, Anne L; Gal, Roxanne; Reich, Leilani; Tsang, Angela; Aludino, Allan; Sahgal, Arjun; Verlaan, Jorrit-Jan; Fisher, Charles G; Verkooijen, Lenny; Rizkallah, Maroun; Wang, Zhi; Yuh, Sung-Joo; Shedid, Daniel; Shen, Jesse; Al-Shakfa, Fidaa; Belguendouz, Céline; AlKafi, Rayan; Boubez, Ghassan; MacLean, Mark A; Georgiopoulos, Miltiadis; Charest-Morin, Raphaele; Germscheid, Niccole; Goodwin, C Rory; Weber, Michael; International, Ao Spine; Rizkallah, Maroun; Boubez, Ghassan; Zhang, Hao; Al-Shakfa, Fidaa; Brindamour, Pamela; Boule, Danielle; Shen, Jesse; Shedid, Daniel; Yuh, Sung-Joo; Wang, Zhi; Correale, Marcia Rebecca; Soever, Leslie Jayne; Rampersaud, Raja; Malic, Claudia Cristina; Dubreuil, Melanie; Duke, Kate; Kingwell, Stephen P; Lin, Zihan; MacLean, Mark A; Julien, Lisa C; Patriquin, Glenn; LeBlanc, Jason; Green, Ryan; Alant, Jacob; Barry, Sean; Glennie, R Andrew; Oxney, William; Christie, Sean D; Sarraj, Mohamed; Alqahtani, Abdullah; Thornley, Patrick; Koziarz, Frank; Bailey, Christopher S; Freire-Archer, Millaray; Bhanot, Kunal; Kachur, Edward; Bhandari, Mohit; Oitment, Colby; Malhotra, Armaan K; Balas, Michael; Jaja, Blessing NR; Harrington, Erin M; Hofereiter, Johann; Jaffe, Rachael H; He, Yingshi; Byrne, James P; Wilson, Jefferson R; Witiw, Christopher D; Brittain, Kennedy CM; Christie, Sean; Pillai, Saranyan; Dvorak, Marcel F; Evaniew, Nathan; Chen, Melody; Waheed, Zeina; Rotem-Kohavi, Naama; Fallah, Nader; Noonan, Vanessa K; Fisher, Charles G; Charest-Morin, Raphaële; Dea, Nicolas; Ailon, Tamir; Street, John; Kwon, Brian K; Sandarage, Ryan V; Galuta, Ahmad; Ghinda, Diana; Kwan, Jason CS; TsaI, Eve C; Hachem, Laureen D; Hong, James; Velumian, Alexander; Mothe, Andrea J; Tator, Charles H; Fehlings, Michael G; Shakil, Husain; Jaja, Blessing NR; Zhang, Peng; Jaffe, Rachael; Malhotra, Armaan K; Wilson, Jefferson R; Witiw, Christopher D; Rotem-Kohavi, Naama; Dvorak, Marcel F; Dea, Nicolas; Evaniew, Nathan; Chen, Melody; Waheed, Zeina; Xu, Jijie; Fallah, Nader; Noonan, Vanessa; Kwon, Brian; Dandurand, Charlotte; Muijs, Sander; Dvorak, Marcel; Schnake, Klaus; Cumhur; Ouml Ner; Greene, Ryan; Furlong, Bradley; Smith-Forrester, Jenna; Swab, Michelle; Christie, Sean D; Hall, Amanda; Leck, Erika; Marshall, Emily; Christie, Sean; Dvorak, Marcel F; Cumhur, F; Ouml Ner; Vaccaro, Alexander R; Benneker, Lorin M; Rajasekaran, Shanmuganathan; El-Sharkawi, Mohammad; Popescu, Eugen Cezar; Tee, Jin Wee; Paquet, Jerome; France, John C; Allen, Richard; Lavelle, William F; Hirschfeld, Miguel; Pneumaticos, Spyros; Dandurand, Charlotte; Cumhur; Ouml Ner; Muijs, Sander; Schnake, Klaus; Dvorak, Marcel; Fernandes, Renan Rodrigues; Thornley, Patrick; Urquhart, Jennifer; Kelly, Sean; Alenezi, Nasser; Alahmari, Abdulmajeed; Siddiqi, Fawaz; Singh, Supriya; Rasoulinejad, Parham; Bailey, Christopher; Evaniew, Nathan; Burger, Lukas D; Dea, Nicolas; Cadotte, David W; McIntosh, Greg; Jacobs, Bradley; St-Laurent-Lebeux, Loïc; Bourassa-Moreau, Étienne; Sarraj, Mohamed; Majeed, Meerab; Guha, Daipayan; Pahuta, Markian; Laflamme, Mathieu; McIntosh, Greg; Dea, Nicolas; Bak, Alex B; Alvi, Mohammed A; Moghaddamjou, Ali; Fehlings, Michael G; Silva, Yan Gabriel Morais David; Goulet, Julien; McIntosh, Greg; Bedard, Sonia; Pimenta, Newton; Blanchard, Jocelyn; Couture, Jerome; LaRue, Bernard; Investigators, Csorn; Adams, Tyler; Cunningham, Erin; El-Mughayyar, Dana; Bigney, Erin; Vandewint, Amanda; Manson, Niel; Abraham, Edward; Small, Chris; Attabib, Najmedden; Richardson, Eden; Hebert, Jeffery; Bond, Michael; Street, John; Fisher, Charles; Charest-Morin, Raphaele; Sutherland, Jason M; Hillier, Troy; Bailey, Chris S; Fisher, Charles; Rampersaud, Raja; Koto, Prosper; Glennie, R Andrew; Soroceanu, Alex; Nicholls, Fred; Thomas, Ken; Evaniew, Nathan; Lewkonia, Peter; Bouchard, Jacques; Jacobs, Brad; Ben-Israel, David; Crawford, Eric J; Fisher, Charles; Dea, Nicolas; Spackman, Eldon; Rampersaud, Raja; Thomas, Kenneth C; Srikandarajah, Nisaharan; Murray, Jean-Christophe; Nielsen, Christopher; Manoharan, Ragavan; Cherry, Ahmed; Raj, Aditiya; Xu, Mark; Iorio, Carlo; Bailey, Chris; Dea, Nicolas; Fisher, Charles; Hall, Hamilton; Manson, Neil; Thomas, Kenneth; Canizares, Mayilee; Rampersaud, Yoga Raja; Urquhart, Jennifer; Fernandes, Renan R; Glennie, R Andrew; Rampersaud, Y Raja; Fisher, Charles G; Bailey, Chris; Yang, Michael MH; Far, Rena; Sajobi, Tolulope; Riva-Cambrin, Jay; Casha, Steven; Bond, Michael; Street, John; Fisher, Charles; Charest-Morin, Raphaele; Sutherland, Jason M; Silva, Yan; Pimenta, Newton Godoy; LaRue, Bernard; Bedard, Sonia; Oviedo, Sonia Cheng; Goulet, Julien; Couture, Jerome; Blanchard, Jocelyn; McDonald, James; Al-Jahdali, Fares; Urquhart, Jennifer; Alahmari, Abdulmajeed; Rampersaud, Raja; Fisher, Charles; Bailey, Chris; Glennie, Andrew; Evaniew, Nathan; Coyle, Matthew; Rampersaud, Y Raja; Bailey, Christopher S; Jacobs, W Bradley; Cadotte, David W; Thomas, Kenneth C; Attabib, Najmedden; Paquet, Jérôme; Nataraj, Andrew; Christie, Sean D; Weber, Michael H; Phan, Philippe; Charest-Morin, Raphaële; Fisher, Charles G; Hall, Hamilton; McIntosh, Greg; Dea, Nicolas; Malhotra, Armaan K; Davis, Aileen M; He, Yingshi; Harrington, Erin M; Jaja, Blessing NR; Zhu, Mary P; Shakil, Husain; Dea, Nicolas; Jacobs, W Bradley; Cadotte, David W; Paquet, Jérôme; Weber, Michael H; Phan, Philippe; Christie, Sean D; Nataraj, Andrew; Bailey, Christopher S; Johnson, Michael G; Fisher, Charles G; Manson, Neil; Rampersaud, Y Raja; Thomas, Kenneth C; Hall, Hamilton; Fehlings, Michael G; Ahn, Henry; Ginsberg, Howard J; Witiw, Christopher D; Wilson, Jefferson R; Althagafi, Alwalaa; McIntosh, Greg; Charest-Morin, Raphaële; Rizzuto, Michael A; Ailon, Tamir; Dea, Nicolas; Evaniew, Nathan; Jacobs, Bradley W; Paquet, Jerome; Rampersaud, Raja; Hall, Hamilton; Bailey, Christopher S; Weber, Michael; Johnson, Michael G; Nataraj, Andrew; Attabib, Najmedden; Cadotte, David W; Manson, Neil; Stratton, Alexandra; Christie, Sean D; Thomas, Kenneth C; Wilson, Jefferson R; Fisher, Charles G; Charest-Morin, Raphaele; Bak, Alex B; Alvi, Mohammed A; Moghaddamjou, Ali; Fehlings, Michael G; Bak, Alex B; Alvi, Mohammed A; Moghaddamjou, Ali; Fehlings, Michael G; Soroceanu, Alex; Nicholls, Fred; Thomas, Ken; Evaniew, Nathan; Salo, Paul; Bouchard, Jacques; Jacobs, Brad; Dandurand, Charlotte; Laghaei, Pedram Farimani; Ailon, Tamir; Charest-Morin, Raphaele; Dea, Nicolas; Dvorak, Marcel; Fisher, Charles; Kwon, Brian K; Paquette, Scott; Street, John; Soroceanu, Alex; Nicholls, Fred; Thomas, Ken; Evaniew, Nathan; Bouchard, Jacques; Salo, Paul; Jacobs, Brad; Varshney, Vishal P; Sahjpaul, Ramesh; Paquette, Scott; Osborn, Jill; Bak, Alex B; Moghaddamjou, Ali; Fehlings, Michael G; Leck, Erika; Marshall, Emily; Christie, Sean; Elkaim, Lior M; Lasry, Oliver J; Raj, Aditya; Murray, Jean-Christophe; Cherry, Ahmed; McIntosh, Greg; Nielsen, Christopher; Srikandarajah, Nisaharan; Manoharan, Ragavan; Iorio, Carlo; Xu, Mark; Perruccio, Anthony; Canizares, Mayilee; Rampersaud, Yoga Raja; Stratton, Alexandra; Tierney, Sarah; Wai, Eugene K; Phan, Philippe; Kingwell, Stephen; Magnan, Marie-Claude; Soroceanu, Alex; Nicholls, Fred; Thomas, Ken; Evaniew, Nathan; Salo, Paul; Bouchard, Jacques; Jacobs, Brad; Spanninga, Barend; Hoelen, Thomáy-Claire A; Johnson, Scott; Arts, Jacobus JC; Bailey, Chris S; Urquhart, Jennifer C; Glennie, R Andrew; Rampersaud, Y Raja; Fisher, Charles G; Levett, Jordan J; Elkaim, Lior M; Alotaibi, Naif M; Weber, Michael H; Dea, Nicolas; Abd-El-Barr, Muhammad M; Cherry, Ahmed; Yee, Albert; Jaber, Nadia; Fehlings, Michael; Cunningham, Erin; Adams, Tyler; El-Mughayyar, Dana; Bigney, Erin; Vandewint, Amanda; Manson, Neil; Abraham, Edward; Small, Chris; Attabib, Najmedden; Richardson, Eden; Hebert, Jeffery; Werier, Joel; Smit, Kevin; Villeneuve, James; Sachs, Adam; Abdelbary, Hesham; Al-Mosuli, Yusra Kassim; Rakhra, Kawan; Phan, Philippe; Nagata, Kosei; Gum, Jeffrey L; Brown, Morgan E; Daniels, Christy L; Carreon, Leah Y; Bonello, John-Peter; Koucheki, Robert; Abbas, Aazad; Lex, Johnathan; Nucci, Nicholas; Whyne, Cari; Larouche, Jeremie; Ahn, Henry; Finkelstein, Joel; Lewis, Stephen; Toor, Jay; Lee, Nathan J; Orosz, Lindsay D; Gum, Jeffrey L; Poulter, Gregory T; Jazini, Ehsan; Haines, Colin M; Good, Christopher R; Lehman, Ronald A; Crawford, Eric J; Ravinsky, Robert A; Perruccio, Anthony V; Coyte, Peter C; Rampersaud, Y Raja; Freire-Archer, Millaray; Sarraj, Mohamed; AlShaalan, Fawaz; Koziarz, Alex; Thornley, Patrick; Alnemari, Haitham; Oitment, Colby; Bharadwaj, Lalita; El-Mughayyar, Dana; Bigney, Erin; Manson, Neil; Abraham, Edward; Small, Chris; Attabib, Najmedden; Richardson, Eden; Kearney, Jill; Kundap, Uday; Investigators, Csorn; Hebert, Jeffrey; Elkaim, Lior M; Levett, Jordan J; Niazi, Farbod; Bokhari, Rakan; Alotaibi, Naif M; Lasry, Oliver J; Bissonnette, Vincent; Yen, David; Muddaluru, Varun S; Gandhi, Pranjan; Mastrolonardo, Alexander; Guha, Daipayan; Pahuta, Markian A; Christie, Sean D; Vandertuin, Trevor; Ritcey, Gillian; Rainham, Daniel; Alhawsawi, Mamdoh; Mumtaz, Rohail; Abdelnour, Mark; Qumquji, Feras; Soroceanu, Alex; Swamy, Ganesh; Thomas, Kenneth; Wai, Eugene; Phan, Philippe; Bhatt, Fenil R; Orosz, Lindsay D; Yamout, Tarek; Good, Christopher R; Schuler, Thomas C; Nguyen, Tiffany; Jazini, Ehsan; Haines, Colin M; Oppermann, Marcelo; Gupta, Shaurya; Ramjist, Joel; Oppermann, Priscila Santos; Yang, Victor XD; Levett, Jordan J; Elkaim, Lior M; Niazi, Farbod; Weber, Michael H; Ioro-Morin, Christian; Bonizzato, Marco; Weil, Alexander G; Oppermann, Marcelo; Ramjist, Joel; Gupta, Shaurya; Oppermann, Priscila S; Yang, Victor XD; Jung, Youngkyung; Muddalaru, Varun; Gandhi, Pranjan; Guha, Daipayan; Koucheki, Robert; Bonello, John-Peter; Abbas, Aazad; Lex, Johnathan R; Nucci, Nicholas; Whyne, Cari; Yee, Albert; Ahn, Henry; Finkelstein, Joel; Larouche, Jeremie; Lewis, Stephen; Toor, Jay; Dhawan, Alaina; Dhawan, Jillian; Sharma, Ajay N; Azzam, Daniel B; Cherry, Ahmed; Fehlings, Michael G; Orosz, Lindsay D; Lee, Nathan J; Yamout, Tarek; Gum, Jeffrey L; Lehman, Ronald A; Poulter, Gregory T; Haines, Colin M; Jazini, Ehsan; Good, Christopher R; Ridha, Barzany B; Persad, Amit; Fourney, Daryl; Byers, Elizabeth; Gallagher, Michelle; Sugar, James; Brown, Justin L; Wang, Zhi; Shen, Jesse; Boubez, Ghassan; Al-Shakfa, Fidaa; Yuh, Sung-Joo; Shedid, Daniel; Rizkallah, Maroun; Singh, Manmohan; Singh, Pankaj Kumar; Lawrence, Peyton Lloyd; Dell, Shevaughn; Goodluck-Tyndall, Ronette; Wade, Kevin; Morgan, Mark; Bruce, Carl; Silva, Yan Gabriel Morais David; Pimenta, Newton; LaRue, Bernard; Aldakhil, Salman; Blanchard, Jocelyn; Couture, Jerome; Goulet, Julien; Bednar, Drew A; Raj, Ruheksh; Urquhart, Jennifer; Bailey, Chris; Christie, Sean D; Greene, Ryan; Chaves, Jennyfer Paulla Galdino; Zarrabian, Mohammed; Sigurdson, Leif; Manoharan, Ragavan; Cherry, Ahmed; Iorio, Carlo; Srikandarajah, Nisaharan; Xu, Mark; Raj, Aditya; Nielsen, Christopher J; Rampersaud, Yoga Raja; Lewis, Stephen JItem Open Access Congenital Kyphosis: Progressive Correction With an Instrumented Posterior Epiphysiodesis: A Preliminary Report.(Journal of pediatric orthopedics, 2021-03) Rocos, Brett; Lebel, David E; Zeller, ReinhardPurpose
Congenital kyphosis is a rare condition. In this case series we sought to identify the outcomes and complications of posterior instrumented fusion and the resultant epiphysiodesis effect in uniplanar congenital kyphosis in pediatric patients.Method
Pediatric patients were included if treated for a uniplanar congenital kyphotic deformity treated with posterior instrumented spinal fusion between October 2006 and August 2017, with a minimum of 2 years of follow-up. Patients were excluded if a coronal deformity >10 degrees was present.Results
Six patients met the inclusion criteria. Mean age at surgery was 3.6 years. The mean kyphotic deformity before surgery was 49.7 degrees. All patients underwent posterior instrumented fusion with autogenous iliac crest graft and a cast or brace postoperatively. One patient showed a loss of motor evoked potential on prone positioning which returned to normal on supine positioning. No patient showed any postoperative neurological deficits. One patient was diagnosed with a wound infection which was successfully treated with oral antibiotics.By a follow-up of 5.4 years (range, 2.2 to 10.9 y) there was no failure of instrumentation. An epiphysiodesis effect (a difference of ≥5 degrees in the kyphotic deformity measured between the immediate postoperative and final follow-up lateral whole spine XR) of 16.2 degrees (range, 7.2 to 30.9 degrees) was seen in 5 patients. The mean annual epiphysiodesis effect was 2.7 degrees (95% confidence interval, 1.4-4.1 degrees). No kyphosis proximal to the instrumentation was observed for the duration of follow-up.Conclusion
Posterior instrumented fusion and epiphysiodesis is safe and effective. The epiphysiodesis effect occurs in 5/6 of cases, and our data suggests that the procedure is associated with an acceptable blood loss and a low incidence of neurological complications.Item Open Access Increased proximal vertebral rotation is associated with shoulder imbalance after posterior spinal fusion for severe adolescent idiopathic scoliosis.(Spine deformity, 2022-09) Machida, Masayoshi; Rocos, Brett; Lebel, David E; Zeller, ReinhardPurpose
Residual shoulder imbalance is associated with suboptimal outcomes following the surgical correction of adolescent idiopathic scoliosis (AIS) including poor patient satisfaction. In this retrospective study, we evaluate the radiographic parameters and the relationship between the global and local indices of spinal alignment with shoulder balance pre- and postoperatively utilizing EOS imaging and 3D reconstruction.Methods
A retrospective radiographic analysis was performed on patients with AIS, treated with posterior spinal fusion. Postoperative radiographs were obtained immediately following surgery, at 6 months and final follow-up over 2 years postoperatively. 3D Radiographic measurements included in the coronal plane radiographic shoulder height difference (RSHD), proximal thoracic Cobb angle (PT) and main thoracic Cobb (MT), in the sagittal plane T4-T12 kyphosis, T12-L5 lordosis, in the axial plane proximal thoracic (PT AVR) and main thoracic apical vertebral rotation (MT AVR).Results
Sixty-six patients were included (63 females) with an average main thoracic curvature of 76 degrees. RSHD averaged 14 mm ± 14 preoperatively, -15 mm ± 12 postoperatively, -8.5 mm ± 11 at 6 months, and -8.3 mm ± 8.7 at final follow-up, respectively. Statistical analysis revealed a significant correlation between RSHD and proximal thoracic Cobb angle, between RSHD and proximal thoracic apical vertebral rotation (PTAVR) (r > 0.20, p < 0.05).Conclusion
The significant correlation presented in this study suggests that PT Cobb angle and PT AVR are involved in postoperative shoulder imbalance.The level of evidence
Level 4.Item Open Access The Use of Halo Gravity Traction in Severe, Stiff Scoliosis.(Journal of pediatric orthopedics, 2021-07) Rocos, Brett; Reda, Luke; Lebel, David E; Dodds, Michael K; Zeller, ReinhardPurpose
The correction of severe, stiff scoliosis in children is challenging. One method used to reduce the risk is preoperative halo gravity traction (HGT). In this study, the authors sought to define the efficiency and safety of HGT and characterize the chronology of the correction seen.Method
A consecutive group of pediatric patients with severe spinal deformities was treated with HGT before definitive correction. A standard protocol with the daily addition of weight to 50% of body weight at 3 weeks was used. Traction remained in place until signs of impending neurological complication or 6 weeks, whichever was sooner.Results
Twenty-four patients were included with a mean age of 11.8 years. The mean coronal deformity was 123 degrees, with a T1-L5 height of 234 mm. The mean duration of traction was 42 days with a mean improvement in height of 72 mm with 82% occurring over the first 3 weeks. Hundred percent of the angular and 98% of T1-L5 height correction was reached by 6 weeks.One patient showed early signs of a cranial nerve palsy prompting early surgery and 8 patients showed pin loosening, 1 of which required revision of their halo. One patient underwent a slower progression of traction because of transitory urinary disturbance. Following fusion, angular correction of the major curve was 49%.Conclusion
HGT is a safe treatment for severe, stiff scoliosis because it can respond to early signs of impending neurological impairment. The first 3 weeks of treatment, reaching 50% of body weight as a traction force accounts for 80% of correction, with the remaining 20% in the following 2 weeks. At least 4 weeks of traction is recommended when following this protocol.Item Open Access The use of three rods in correcting severe scoliosis.(Spine deformity, 2021-07) Rocos, Brett; Rioux-Trottier, Eliane; Machida, Masayoshi; Sigal, Amit; Kennedy, Jim; Lebel, David E; Zeller, ReinhardPurpose
The three-rod technique, utilising a short apical concavity rod is an option to achieve controlled correction in severe scoliosis. We describe this technique, the complications encountered, and the long-term outcomes.Method
All paediatric patients who had at least 2 years follow-up after undergoing corrective surgery for scoliosis ≥ 100° using 3 parallel rods were included. Radiographs were assessed to evaluate the correction and clinical records examined for any loss of correction, complications, revision procedures or neuromonitoring events.Results
Twenty-five patients met the inclusion criteria. Four underwent prior anterior fusion to prevent crankshaft phenomenon. The mean angle of the deformity was 112.0° (range 100.3-137.1). Mean maximal kyphosis was 48.8° (range 11.4-78.8°) and mean curve flexibility 4.4% (range 0-37.0%). Intraoperative traction achieved an average of 70.4% (95% CI 56.6-84.1%). Nine patients (39%) showed a reduction in MEPs during definitive surgery. All returned to within 75% of baseline by the end of surgery. All patients had normal postoperative neurology. One patient underwent removal of hardware for late infection. The mean overall Cobb correction was 55.7° (95% CI 50.2-61.2°), equating to 50.2% (95% CI 44.9-55.4%) of the mean initial deformity. Thoracic kyphosis reduced by a mean of 18.2° (95% CI 12.8-23.6°).Conclusion
Our series suggests that three-rod constructs are able to safely and effectively achieve 50% correction of severe scoliosis.Item Open Access Utility of intraoperative neurophysiological monitoring in detecting motor and sensory nerve injuries in pediatric high-grade spondylolisthesis.(The spine journal : official journal of the North American Spine Society, 2023-12) Iorio, Carlo; Koucheki, Robert; Strantzas, Samuel; Vandenberk, Michael; Lewis, Stephen J; Zeller, Reinhard; Camp, Mark; Rocos, Brett; Lebel, David EBackground context
Intraoperative neuromonitoring (IONM) during surgical correction of spinal deformity has been shown to reduce iatrogenic injury in pediatric and adult populations. Although motor-evoked potentials (MEP), somatosensory-evoked potentials (SSEP), and electromyography (EMG) have been shown to be highly sensitive and specific in detecting spinal cord and nerve root injuries, their utility in detecting motor and sensory nerve root injury in pediatric high-grade spondylolisthesis (HGS) remains unknown.Purpose
We aim to assess the diagnostic accuracy and therapeutic impact of unimodal and multimodal IONM in the surgical management of HGS.Study design/setting
Retrospective cohort study.Patient sample
Pediatric patients undergoing posterior spinal fusion (PSF) for treatment of HGS.Outcome measures
Data on patient demographics, spinopelvic and spondylolisthesis parameters, and the presence of pre-and postoperative neurological deficits were collected.Methods
Intraoperative MEP, SSEP, and EMG alerts were recorded. Alert criteria were defined as a change in amplitude of more than 50% for MEP and/or SSEP, with or without change in latency, and more than 10 seconds of sustained EMG activity. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each modality and the combination of MEP and SSEP. The 95% confidence intervals (CIs) were calculated using the exact (Clopper-Pearson) method.Results
Fifty-four pediatric patients with HGS undergoing PSF between 2003 and 2021 in a single tertiary center were included. Seventy-two percent (39/54) of patients were female; the average age of patients was 13.7±2.3 years. The sensitivity of MEP in detecting new postoperative neurologic deficit was 92.3% (95% CI [64.0-99.8]), SSEP 77.8% (95% CI [40.0-97.2]), EMG 69.2% (95% CI [38.6-90.9]), and combination MEP and SSEP 100% (95% CI [73.5-100]). The specificity of MEP was 80.0% (95% CI [64.4-91.0]), SSEP 95.1% (95% CI [83.5-99.4]), EMG 65.9% (95% CI [49.4-79.9]), and combination MEP and SSEP 82.9% (95% CI [67.9-92.9]). The accuracy of SSEP was 92.0% (95% CI [80.8%-97.8%]), and the combination of MEP and SSEP was 86.8% (95% CI [74.7%-94.5%]). Twelve (22.2%) patients had a new motor or sensory deficit diagnosed immediately postoperatively. Nine patients made a full recovery, and 3 had some neurologic deficit on final follow-up.Conclusion
Unimodal IONM using SSEP and MEP alone were accurate in diagnosing sensory and motor nerve root injuries, respectively. The diagnostic accuracy in predicting motor and sensory nerve injuries in pediatric HGS improved further with the use of multimodal IONM (combining MEP and SEP). We recommend the utilization of multimodal IONM in all HGS PSF surgeries.Item Open Access What is the Optimal Surgical Method for Achieving Correction and Avoiding Neurological Complications in Pediatric High-grade Spondylolisthesis?(Journal of pediatric orthopedics, 2021-03) Rocos, Brett; Strantzas, Samuel; Zeller, Reinhard; Lewis, Stephen; Tan, Tony; Lebel, DavidBackground
Controversy persists in the treatment of high-grade spondylolisthesis (HGS). Surgery is recommended in patients with intrusive symptoms and evidence debates the competing strategies. This study compares the radiologic outcomes and postoperative complications at a minimum of 2 years follow-up for patients with HGS treated with instrumented fusion with partial reduction (IFIS) with those treated with reduction, decompression, and instrumented fusion (RIF). We hypothesize that IFIS leads to a lower rate of complication and revision surgery than RIF.Methods
A retrospective comparative methodology was used to analyze consecutive HGS treated surgically between 2006 and 2017. Patients diagnosed with ≥grade 3 spondylolisthesis treated with arthrodesis before the age of 18 years with a minimum of 2 years follow-up were included. Patients were excluded if surgery did not aim to achieve arthrodesis or was a revision procedure. Cases were identified through departmental and neurophysiological records.Results
Thirty patients met the inclusion criteria. Mean follow-up was 4 years. Ten patients underwent IFIS and the remaining 20 underwent RIF. The 2 groups showed no difference in demographics, grade of slip, deformity or presenting symptoms. Of 10 treated with IFIS, the SA reduced by a mean of 10 degrees and C7 sagittal vertical line changed by 31 mm. In the RIF cohort, SA reduced by 16 degrees and C7 sagittal vertical line reduced by 26 mm. PT was unchanged in both groups. In IFIS cohort, 2 patients showed postoperative weakness, resolved by 2 years. None required revision surgery. In the RIF group, 4 sustained dural tears and 1 a laminar fracture, 7 showed postoperative weakness or dysaesthesia, 3 of which had not resolved by 2 years. Eight patients underwent unplanned further surgery, 3 for pseudarthrosis.Conclusions
RIF and IFIS show similar radiologic outcomes. RIF shows a higher rate of unplanned return to surgery, pseudarthrosis and persisting neurological changes.Level of evidence
Level III-retrospective comparative study.