Tyler Kreitz MD Oussama Abousamra MD John Heydemann MD

Slides:

Advertisements

Similar presentations

The Safety and Effectiveness of Convex Anterior and Posterior Hemiepiphysiodesis for the Treatment of Congenital Scoliosis Andrew Thome, Jr. 1, Roshan.

Advertisements

“A Controlled Randomized Outcome Study of Femoral Ring Allograft versus BAK Instrumentation in Anterior Interbody Fusion” Dr. Donald W. Kucharzyk Dr. Michael.

Impact of sagittal plane spinal deformity on the spino-pelvic relationship and gravity line position in adults Virginie Lafage, Frank Schwab, Francisco.

Does vertebral level of Pedicle Subtraction Osteotomy correlate with degree of spinopelvic parameter correction? Schwab Frank; Lafage Virginie; Patel.

Objective Measurement for Lumbar Spinal Angels Submitted To Prof. Dr. Maher El-keblawy Professor of Basic Science Department Faculty of Physical Therapy.

Orthotic Management of the Geriatric Spine

A comprehensive clinical impact classification of Adult Scoliosis

F Schwab 1,2, JP Farcy 1,2, K Bridwell 2, S Berven 2, S Glassman 2,

Surgical treatment analysis of 809 thoracolumbar and lumbar major adult deformity cases by a new adult scoliosis classification system Zorab Symposium.

Outline Epidemiology Presentation Investigations Optimal management.

Indications and effectiveness of the open surgery in vesicoureteral reflux Suzi DEMIRBAG, MD Department of Pediatric Surgery, Gulhane Military Medical.

Surgery of Spinal Deformities Rizzoli Orthopaedic Institute Bologna, Italy Surgical options in progressive scoliosis in pediatric patients with Neurofibromatosis.

Therapeutic and diagnostic protocol for the treatment of scoliosis associated with Syringomyelia Francesco Lolli, Konstantinos Martikos, Francesco Vommaro,

Impact of Highly Active Antiretroviral Therapy on the Incidence of HIV- encephalopathy among perinatally- infected children and adolescents. Kunjal Patel,

Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides The Natural.

POSTOPERATIVE LEFT SHOULDER ELEVATION (LSE) IN PATENTS WITH NON-STRUCTURAL PROXIMAL THORACIC CURVES (PT): CAN IT BE PREVENTED IN PATIENTS WITH PREOPERATIVE.

INTERRADICULAR BONE-DISC-BONE OSTEOTOMY (BDBO): AN ALTERNATIVE TO OTHER OSTEOTOMY TYPES FOR THE CORRECTION OF THORACOLUMBAR AND LUMBAR SPINE DEFORMITIES.

Thoracogenic Spinal Deformity: A Rare Cause of Early Onset Scoliosis International Congress on Early Onset Scoliosis November 19 & 20, 2015 A. Noelle Larson,

Secondary Thoracic Insufficiency Syndrome in None Ambulatory Myelodisplastic Children.

Correction of Sagittal Plane Spinal Deformities with Unit Rod Instrumentation in Children with Cerebral Palsy by Glenn E. Lipton, Eric J. Letonoff, Kirk.

Sagittal balance in thoracolumbar or lumbar congenital kyphoscoliosis and kyphosis at a minimum of 10 years after surgery : A case series Sagittal balance.

Growth Preserving Spinal Surgery for Scoliosis in Children with Osteogenesis Imperfecta Lawrence Karlin, MD, Amer Samdani, MD, Anna McClung, BSN, RN, Michael.

Comparison of deformity correction and complications with VEPTR and early primary posterior spinal fusion in young children with idiopathic scoliosis:

John T. Wilkinson m. d. , Chad E. Songy m. d. , Frances l

Printed by Natural History of Sun Protection Behaviors in a Cohort of Children in Colorado Nancy L. Asdigian PhD,* Lori A. Crane.

SPINE ORTHOSES Michael Zlowodzki MD University of Minnesota Department of Orthopaedic Surgery.

Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Preoperative Anemia and Postoperative Mortality in Neonates Goobie SM, Faraoni D,

Super abdomen: Combination intervention for preventing and treating pregnancy related lumbopelvic pain Wan-Chun Fang May 7, 2008.

Xingye Li, Jianxiong Shen, M.D.

3D Vertebral Morphological Measurements Using Low Dose Stereoradiography Imaging: A Comparison with CT Scans Saba Pasha1, Tom Schlösser2, John Flynn1,

Matt Neal, MD Wed AM Conference 1/28/15

Objective Measurement for Lumbar Spinal Angels

Swamy Kurra Stephen Albanese Patrick Cahill Randal Betz

Evaluating the Effectiveness of Social Work Interventions:

DR. Jamlick Micheni Muthuuri

VEPTR Implantation for Children with congenital scoliosis under Age 3

Outcomes of Children with Jarcho-Levin Syndrome treated with a Vertebral Expandable Prosthetic Titanium Rib (VEPTR) Frances A. Farley, MD, Michelle C.

Retrospective Review of Shoulder Balance Comparing Adolescent Idiopathic Scoliosis (AIS) to Early Onset Scoliosis (EOS) Patrick J. Cahill William Lavelle.

Sumeet Garg, MD Jack Flynn, MD Nicole Michael, BA

Growth Friendly Surgery is Effective at Treating Scoliosis Associated with Goldenhar Syndrome Braydon Connell, Jonathan Oore, Joshua Pahys, George Thompson,

John A. Heydemann, MD; Oussama Abousamra, MD;

Abstract # Rates of Complications and Required Additional Surgical Interventions after Surgical and Nonsurgical Treatment in Lumbar Spondylosis:

Late posterior hip instability after lumbar spinopelvic fusion

Postoperative Weight Loss and its Impact on Outcomes in Patients with Adolescent Idiopathic Scoliosis after Spinal Fusion Roslyn Tarrant1,2, Mary Nugent3,

PREDICTORS IN DEVELOPMENT OF LEARING DISABILITIES INTRODUCTION-PURPOSE

Neuromuscular Scoliosis

The Effect of the Fixed Sagittal Plane caused by Spinal Instrumentation at an Early Age on the Natural Evolution of Pelvic Incidence During Growth Bekmez.

Meeting of the Balkan Excellent Centers

PELVIC OBLIQUITY CONTROL IN CHILDREN WITH NEUROMUSCULAR EARLY ONSET SCOLIOSIS TREATED WITH MAGNETICALLY-CONTROLLED GROWING RODS María del Mar Pozo-Balado,

Florence Nightingale Hospital

Scoliosis Idiopathic Scoliosis In Adolescents NEJM Feb 28, 2013: 368:9

Distraction-to-stall ensures spinal growth in Magnetically Controlled Growing Rods Benny Dahl1), Casper Dragsted2), Søren Ohrt-Nissen2), Thomas Andersen2),

Richard Schwend, MD Robert Tung, BS Division of Orthopedic Surgery

Distraction-Based Surgeries Increase Spine Length for Patients with Non-Idiopathic EOS - 5 Year Follow up Yehia ElBromboly, Jennifer Hurry, Kedar Padhye,

Late posterior hip instability after lumbar spinopelvic fusion

Providence Night-time Bracing are effective in Treatment of Adolescent Idiopathic Scoliosis, even in Curves larger than 35° Authors Ane Simony MD, PhD,

Does rod orientation and use of cross connector affect spinal height in magnetically controlled growing rod patients? Pooria Hosseini, Behrooz A. Akbarnia,

EPSDT The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit was enacted in 1967 as part of the Social Security Act to ensure that.

Sagittal alignment and mobility of the thoracolumbar spine are associated with radiographic progression of secondary hip osteoarthritis H. Tateuchi,

DEBATE Fusion vs non-fusion options

Charles E. Johnston, MD Anna McClung BSN, RN Scott Paradise

(A) Lateral radiograph of the thoracic spine showing a crush fracture of the third thoracic vertebra. (A) Lateral radiograph of the thoracic spine showing.

Garrido E†, Bermejo F†, Tucker SK†‡, Noordeen HNN†‡, Morley TR‡

John A Heflin, MD John T. Smith, MD

MYTH vs.TRUTH: Mehta Casts Always Work

Modifications on cervical spine sagittal alignment after magnetic growing rod instrumentation. Is there a correlation with proximal giunctional kyphosis?

Suken A. Shah, MD Jon Oda, MD William Mackenzie, MD

Sagittal alignment of the spine is changing!

ICEOS 2013 At What Levels Are Free-Hand Pedicle Screws More Frequently Malpositioned in Children? Mark Heidenreich, BS Yaser M.K. Baghdadi, MD Amy L. McIntosh,

Amer F. Samdani, MD Tricia St. Hilaire John Emans, MD John Smith, MD

Presentation transcript:

Thoracolumbar Kyphosis in Adolescents with Achondroplasia: Who Resolves and Who Progresses? Tyler Kreitz MD Oussama Abousamra MD John Heydemann MD William Mackenzie MD Suken Shah, MD

Background TLK 50% children with achondroplasia1 Occurs early, resolves by age 3 in 60-70% 2,3 11-15% beyond age 10 neurologic symptoms requiring surgical intervention4,5 Risk factors for progression; High TLK Apical vertebral wedging Developmental delay2,6

Purpose To define spinopelvic in children with achondroplasia and determine if these parameters may be predictive of persistent progressive TLK in children with achondroplasia

Methods 300 children 2004-2015 Minimum 2 year radiographic follow-up One standing lateral radiograph after age 10 Excluded postoperative radiographs Measured: Thoracolumbar kyphosis (T10/L2), Thoracic Kyphosis, Lumbar Lordosis, Pelvic Incidence (PI)

Methods Two groups identified; Final TLK ≥20 or <20 degrees Outcomes: Evolution of measurements within each group Comparison to detect potential risk factors for a high TLK after ten years of age.

Results 64 children 22 (31%) had TLK ≥20. Mean age at the first and last evaluations was 10.8 and 16.7 years None of their measurements changed significantly over a mean followup 5.9 years (2.1-8.9 years) except for TPA and SVA that were in clinically acceptable limits. 44 (69%) had TLK <20. Age at the first and last evaluations was 8.2 and 14.2 years. TLK was the only parameter that changed significantly (decreased) over a mean of 6 years (2-10.1 years).

Results TLK ≥2: No measurements changed over mean followup 5.9 years (2.1-8.9) TLK <20: TLK only parameter that changed (decreased) over mean 6 years (2-10.1).

Results A comparison between the two groups showed that for children who had a high final TLK, initial TLK was significantly higher and PI was significantly lower.

Conclusions After ten years of age, TLK did not show improvement over time. Lower PI was associated with high TLK. Emphasizes the importance of early radiographic follow up for thoracolumbar deformity in children with achondroplasia. Once children have increased TLK after age ten, the deformity is likely to remain, and assessment of pelvic parameters is important.

References Engberts AC, Jacobs WCH, Castelijns SJAM, Castelein RM, Vleggeert-Lankamp CLA. The prevalence of thoracolumbar kyphosis in achondroplasia: a systematic review. J Child Orthop. 2012;6(1):69-73. doi:10.1007/s11832-011-0378-7. Kopits SE. Thoracolumbar kyphosis and lumbosacral hyperlordosis in achondroplastic children. Basic Life Sci. 1988;48:241-255. Borkhuu B, Nagaraju DK, Chan G, Holmes LJ, Mackenzie WG. Factors related to progression of thoracolumbar kyphosis in children with achondroplasia: a retrospective cohort study of forty-eight children treated in a comprehensive orthopaedic center. Spine. 2009;34(16):1699-1705. doi:10.1097/BRS.0b013e3181ac8f9d. Pauli RM, Breed A, Horton VK, Glinski LP, Reiser CA. Prevention of fixed, angular kyphosis in achondroplasia. J Pediatr Orthop. 1997;17(6):726-733. Lonstein JE. Treatment of kyphosis and lumbar stenosis in achondroplasia. Basic Life Sci. 1988;48:283-292.