Published study in Journal of Bone and Joint Surgery: Trunk Motion of Vertebral Body Tethering vs. Posterior Spinal Fusion
This was a study of trunk (back) motion from the Philadelphia Shriners hospital by a previous spine fellow from Washington University, Dr. Joshua Pahys. This elegant study used a motion analysis lab to quantify back motion between two groups of patients: 1) 65 patients having undergone Vertebral Body Tethering (VBT), and 2) 47 patients who […]
Thoracic Scheuermann’s Kyphosis
What is thoracic kyphosis? From the side the human spine is wavy, unlike the view from the front in which it should be straight. The only part of the spine with kyphosis is the thoracic spine, the cervical and lumbar spine are in lordosis. How much thoracic kyphosis is normal? In general normal kyphosis is […]
Decision Making, Early-Onset Scoliosis, Growth Guidance Surgery, Magnetically-Controlled Growing Rods
Talking Points for Early-Onset Scoliosis Patients: Magnetically-Controlled Growing Rods vs. Shilla Growth-Guidance
In the surgical treatment of Early-Onset Scoliosis (EOS) the options boil down to two main constructs: Distraction-Based: this encompasses both Traditional Growing Rods (TGR) and Magnetically-Controlled Growing Rods (MCGR) Growth-Guidance: this is also called the “Shilla Procedure” We will not go into detail about these two spine constructs, but ask you go […]
Blood Management During Spine Deformity Surgery
In 2022, spine deformity surgery usually requires a long incision and temporary retraction of muscles from the spine. This extensive exposure of the spine helps to loosen up the spine (to get better correction), insert pedicle screws to grip the spine and place the long rods, which moves the spine in space and maintains the […]
The Use of Internal Distraction in Severe Scoliosis
In severe scoliosis, the use of traction has demonstrated an ability to improve the spinal deformity before surgery was actually performed. There are three main methods: 1. Preoperative halo-gravity traction 2. Intraoperative halo-femoral traction 3. Intraoperative Internal Dis-Traction This post will focus on #3: Intraoperative Internal Dis-Traction To demonstrate this treatment we […]
Spinal Deformity in Neurofibromatosis Type 1 – Case #2
Surgical Case #2 The next case is a 14 year old male with NF-1. There are dystrophic changes to the spine around the thoracolumbar junction, specifically penciling of the ribs and scalloping of the vertebral bodies (red arrows). This has induced a painful kyphoscoliosis. The next pictures demonstrate there is some, but not much flexibility […]
Spinal Deformity in Neurofibromatosis Type 1 – Case #1
Surgical Case The case presented is a 13 year old male with NF-1 who has a severe, progressive, painful kyphoscoliosis. There is some inherent spinal flexibility as the thoracic kyphosis of 91 degrees improves when he lays on his back and hyperextends. The below selected MRI cuts demonstrates he does not have significant dural ectasias […]
Spinal Deformity in Neurofibromatosis Type 1
For details on Neurofibromatosis Type 1 (NF-1), I will refer you to Wikipedia: https://en.wikipedia.org/wiki/Neurofibromatosis_type_I As this blog focuses on spinal deformity in children and adolescents following is a brief summary as it relates to the musculoskeletal system (spine and extremities): 1. NF-1 causes tumors along nervous system which can grow anywhere on the body. […]
Recent Publication in The Spine Journal
Congenital Scoliosis, Osteotomies, Posterior Spinal Fusion, Three Column Osteotomy, Vertebral Column Resection
Congenital Spine Dislocation with 8 Years of Postoperative Follow-up
Congenital dislocation of the spine (CDS) is a rare congenital malformation due to failure of the spine and the spinal cord to develop at a single spinal level. The patient may be completely neurologically intact or, in severe cases, may not have any muscle function or sensation below the level of the dislocation. It is […]