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"Bone-οn-Bone" surgical reconstruction of moderate severity, flexible single curve adolescent idiopathic scoliosis: continuing improvements of the technique and results in three scoliosis centers after almost twenty years of use.

Gaines RW, Min K, Zarzycki D - Scoliosis (2015)

Bottom Line: The "bone-on-bone" reconstruction for adolescent idiopathic scoliosis is reviewed in this article.Extensive use over the past 18 years has identified it's functional benefits outstanding clinical results, and very limited complications.This is an extensive update of it's application, since it's introduction, 18 years ago.

View Article: PubMed Central - PubMed

Affiliation: Columbia Orthopaedic Group, 1 South Keene Street, MO 65201 Columbia, USA.

ABSTRACT
The "bone-on-bone" reconstruction for adolescent idiopathic scoliosis is reviewed in this article. Extensive use over the past 18 years has identified it's functional benefits outstanding clinical results, and very limited complications. This is an extensive update of it's application, since it's introduction, 18 years ago.

No MeSH data available.


Related in: MedlinePlus

a: 14 year old girl with 65 degree Lenke 1 curve which bends down to 35 degrees; ideal for “bone-on-bone”. b: excellent correction in both planes, over 3 fewer fused levels than the measured Cobb angle on the standing film and entire instrumentation within the thoracic spine. It is functionally beneficial for the patient to avoid instrumentation of the thoracolumbar junction if possible, particularly if they have athletic aspirations or will engage in blue collar occupations. c: clinical photos of same patient at pre-op, 6 wk. and 2 yr. follow-up of patient in 11a and b. d: lateral profile at 6 mos and 2 yrs follow-up. e: close-up of healed 8 cm. incision used for the procedure.
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Fig11: a: 14 year old girl with 65 degree Lenke 1 curve which bends down to 35 degrees; ideal for “bone-on-bone”. b: excellent correction in both planes, over 3 fewer fused levels than the measured Cobb angle on the standing film and entire instrumentation within the thoracic spine. It is functionally beneficial for the patient to avoid instrumentation of the thoracolumbar junction if possible, particularly if they have athletic aspirations or will engage in blue collar occupations. c: clinical photos of same patient at pre-op, 6 wk. and 2 yr. follow-up of patient in 11a and b. d: lateral profile at 6 mos and 2 yrs follow-up. e: close-up of healed 8 cm. incision used for the procedure.

Mentions: From the Cobb angle on the “stretch film,” a measurement (in mm) is made from the top edge of the top vertebra to the bottom edge of the bottom end vertebra on the concave side of the curve. An identical measurement is made from the same vertebrae on the convex side of the curve. The thicknesses of the intervertebral discs were then measured on the concave and convex sides of the curve. The thicknesses of the discs were summed together on the concave and convex sides, and then subtracted from the longitudinal measurement made on the concave and convex sides of the curve. If the subtracted sums were within 5 to 10 mm of one another, then it was assumed that the reconstructed spine would approach “straight” after the discs were removed. If the difference in the subtracted measurements was more than 10 mm, this indicated the need to either add another disc to the preoperative plan or take off bony wedges from the endplates to get the spine straight.


"Bone-οn-Bone" surgical reconstruction of moderate severity, flexible single curve adolescent idiopathic scoliosis: continuing improvements of the technique and results in three scoliosis centers after almost twenty years of use.

Gaines RW, Min K, Zarzycki D - Scoliosis (2015)

a: 14 year old girl with 65 degree Lenke 1 curve which bends down to 35 degrees; ideal for “bone-on-bone”. b: excellent correction in both planes, over 3 fewer fused levels than the measured Cobb angle on the standing film and entire instrumentation within the thoracic spine. It is functionally beneficial for the patient to avoid instrumentation of the thoracolumbar junction if possible, particularly if they have athletic aspirations or will engage in blue collar occupations. c: clinical photos of same patient at pre-op, 6 wk. and 2 yr. follow-up of patient in 11a and b. d: lateral profile at 6 mos and 2 yrs follow-up. e: close-up of healed 8 cm. incision used for the procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4440536&req=5

Fig11: a: 14 year old girl with 65 degree Lenke 1 curve which bends down to 35 degrees; ideal for “bone-on-bone”. b: excellent correction in both planes, over 3 fewer fused levels than the measured Cobb angle on the standing film and entire instrumentation within the thoracic spine. It is functionally beneficial for the patient to avoid instrumentation of the thoracolumbar junction if possible, particularly if they have athletic aspirations or will engage in blue collar occupations. c: clinical photos of same patient at pre-op, 6 wk. and 2 yr. follow-up of patient in 11a and b. d: lateral profile at 6 mos and 2 yrs follow-up. e: close-up of healed 8 cm. incision used for the procedure.
Mentions: From the Cobb angle on the “stretch film,” a measurement (in mm) is made from the top edge of the top vertebra to the bottom edge of the bottom end vertebra on the concave side of the curve. An identical measurement is made from the same vertebrae on the convex side of the curve. The thicknesses of the intervertebral discs were then measured on the concave and convex sides of the curve. The thicknesses of the discs were summed together on the concave and convex sides, and then subtracted from the longitudinal measurement made on the concave and convex sides of the curve. If the subtracted sums were within 5 to 10 mm of one another, then it was assumed that the reconstructed spine would approach “straight” after the discs were removed. If the difference in the subtracted measurements was more than 10 mm, this indicated the need to either add another disc to the preoperative plan or take off bony wedges from the endplates to get the spine straight.

Bottom Line: The "bone-on-bone" reconstruction for adolescent idiopathic scoliosis is reviewed in this article.Extensive use over the past 18 years has identified it's functional benefits outstanding clinical results, and very limited complications.This is an extensive update of it's application, since it's introduction, 18 years ago.

View Article: PubMed Central - PubMed

Affiliation: Columbia Orthopaedic Group, 1 South Keene Street, MO 65201 Columbia, USA.

ABSTRACT
The "bone-on-bone" reconstruction for adolescent idiopathic scoliosis is reviewed in this article. Extensive use over the past 18 years has identified it's functional benefits outstanding clinical results, and very limited complications. This is an extensive update of it's application, since it's introduction, 18 years ago.

No MeSH data available.


Related in: MedlinePlus