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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

Why use the “stretch film”. The fundamental measurement made on the “stretch film” is the Cobb angle of the major curve while the spine is being stretched. The unique value of the “stretch film” is that is clearly identifies the area of major deformity, while the spinal column is compensated, over the pelvis, and the compensatory curves are well corrected. In the author’s experience, this type film is much easier to interpret than bending films, which, by their nature, are NOT made with the patient’s spine fully compensated and the compensatory curves minimized. Analyzing/measuring the “stretch film”. 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.
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Fig7: Why use the “stretch film”. The fundamental measurement made on the “stretch film” is the Cobb angle of the major curve while the spine is being stretched. The unique value of the “stretch film” is that is clearly identifies the area of major deformity, while the spinal column is compensated, over the pelvis, and the compensatory curves are well corrected. In the author’s experience, this type film is much easier to interpret than bending films, which, by their nature, are NOT made with the patient’s spine fully compensated and the compensatory curves minimized. Analyzing/measuring the “stretch film”. 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.

Mentions: Pre-operative x-rays are analyzed and measured. They can nicely predict the quality of correction which can be obtained during the surgical procedure. This technique was first identified and used early in the series and is extremely reliable (Figures 6, and 7).Figure 6


"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)

Why use the “stretch film”. The fundamental measurement made on the “stretch film” is the Cobb angle of the major curve while the spine is being stretched. The unique value of the “stretch film” is that is clearly identifies the area of major deformity, while the spinal column is compensated, over the pelvis, and the compensatory curves are well corrected. In the author’s experience, this type film is much easier to interpret than bending films, which, by their nature, are NOT made with the patient’s spine fully compensated and the compensatory curves minimized. Analyzing/measuring the “stretch film”. 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.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig7: Why use the “stretch film”. The fundamental measurement made on the “stretch film” is the Cobb angle of the major curve while the spine is being stretched. The unique value of the “stretch film” is that is clearly identifies the area of major deformity, while the spinal column is compensated, over the pelvis, and the compensatory curves are well corrected. In the author’s experience, this type film is much easier to interpret than bending films, which, by their nature, are NOT made with the patient’s spine fully compensated and the compensatory curves minimized. Analyzing/measuring the “stretch film”. 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.
Mentions: Pre-operative x-rays are analyzed and measured. They can nicely predict the quality of correction which can be obtained during the surgical procedure. This technique was first identified and used early in the series and is extremely reliable (Figures 6, and 7).Figure 6

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