Preliminary Results using Shilla guided growing rods with sublaminar fixation in Early Onset Scoliosis Samuel R. Rosenfeld, M.D. Benjamin T. Smith, D.O.

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

Cervical Kyphosis in Patients Who Have Larsen Syndrome* by CHARLES E. JOHNSTON, JOHN G. BIRCH, and JOHN L. DANIELS J Bone Joint Surg Am Volume 78(4):

Presented by: Kelsey Foster. The History The Harrington Rod was developed in the 1950’s by Dr. Paul Harrington. The Harrington Rod was the first spinal.

Location of the Vertebral Artery at C1 in Children: How Far Out Laterally Can One Safely Dissect? by Rachel Y. Goldstein, Caleb D. Sunde, Peter Assaad,

Mechanisms and Risk Factors of Brachial Plexus Injury in the Treatment of Early-Onset Scoliosis with Distraction- Based Growing Implants by Elizabeth R.A.

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

Fusionless Correction for Early Onset Scoliosis (EOS) Emma Orton BME 281.

Dysfunction of a Ventriculoperitoneal Shunt After Posterior Spinal Fusion in Children with Cerebral Palsy by Kareem Abu-Sneineh, Glenn E. Lipton, Peter.

Complications Associated with Pedicle Screws* by JOHN E. LONSTEIN, FRANCIS DENIS, JOSEPH H. PERRA, MANUEL R. PINTO, MICHAEL D. SMITH, and ROBERT B. WINTER.

Comparison of the Volume of Scoliosis Surgery Between Spine and Pediatric Orthopaedic Fellowship-Trained Surgeons in New York and California by Mark A.

Dual Growing Rods for the Treatment of Early-Onset Scoliosis by Gregory M. Mundis, Nima Kabirian, and Behrooz A. Akbarnia JBJS Essent Surg Tech Volume.

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

Scoliosis in the Adolescent

A Comparison of Patients Treated with Shilla Growing Rods for Early Onset Scoliosis 9 th International Congress on Early Onset Scoliosis November 19-20,

Patients without intraoperative neuromonitoring (IONM) alerts during implantation of rib based growing constructs did not sustain neurologic injury during.

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

In the first 5 years of Treatment, the Charges for Guided Growth Constructs are 30% less than Growing Rods Lindsay M. Andras MD 1, Liam Harris BS 1, Scott.

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

The Use of MAGEC Growing Rods as a temporary distraction rod in Severe Kyphoscoliosis: A Case Report. John T. Smith, MD Mary Scowcroft Perry Presidential.

K O B E U N I V E R S I T Y O R T H O P E D I C S A K O B E U N I V E R S I T Y O R T H O P E D I C S A Nippon Steel Hirohata Hospital Nippon Steel Hirohata.

by Robert W. Gaines J Bone Joint Surg Am Volume 82(10):

Surgical Treatment of Main Thoracic Scoliosis with Thoracoscopic Anterior Instrumentation by Peter O. Newton, Vidyadhar V. Upasani, Juliano Lhamby, Valerie.

Pulmonary Function Following Early Thoracic Fusion in Non-Neuromuscular Scoliosis by Lori A. Karol, Charles Johnston, Kiril Mladenov, Peter Schochet, Patricia.

The Rib Construct (RC) has provided secure proximal fixation for management of patients with EOS and severe thoracic hyperkyphosis Alaa Azmi Ahmad – MD.

Oncologic and Functional Outcome Following Sacrectomy for Sacral Chordoma by Christopher A. Hulen, H. Thomas Temple, William P. Fox, Andrew A. Sama, Barth.

POSTERIOR SUBTOTAL VERTEBRECTOMY FOR THE TREATMENT OF THORACIC OSTEOMYELITIS IN ELDERLY PATIENTS Meric ENERCAN, MD Cagatay OZTURK, MD Mehmet AYDOGAN, MD.

Xingye Li, Jianxiong Shen, M.D.

Olson EM, Sturm PF, Jain VV, Schultz LR, Glos DL, Bylski-Austrow DI

The OccipitoCervical Fixation

ICEOS 2016 Pelvic obliquity correction in distraction based growing spine constructs Mathew Schur BA1, Lindsay M Andras MD1, Nicholas R Gonsalves MD1,

Pediatric orthopedic surgeon – Ramallah - Palestine

Adam Margalit, BS Paul D. Sponseller, MD Richard McCarthy, MD

ICEOS 2016 Comparison of Weight Percentile Gain with Growth-Friendly Constructs in Early Onset Scoliosis Liam Harris BS1, Lindsay M Andras MD1, Paul D.

How is definitive treatment effective in early onset scoliosis treated with Growing implants? Review of one centre series Tiziana Greggi, Elena Maredi,

The surgical treatment aims to:

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,

A. Aoude, L. Simoes, S. Aldebeyan, J. Ouellet McGill University

Results of Growth Friendly Surgery Versus Casting for the Treatment of EOS in Patients with Prader-Willi Syndrome Jonathan Oore, Braydon Connell, Burt.

Pediatric orthopedic surgeon – Ramallah - Palestine

EOS Patients from A Retrospective database

Neuromuscular Scoliosis

Brian Yang BA, Jill Larson MD, Michael Glotzbecker MD

Michael J. Elliott,MD; Jesua Law, DO

The Use of MAGEC Growing Rods as a temporary distraction rod in Severe Kyphoscoliosis: 2 Case Reports. John T. Smith, MD Mary Scowcroft Perry Presidential.

Hospital Universitario La Paz, Madrid, Spain

E-Poster 159 VEPTR Implantation to Treat Children with Early Onset Scoliosis without Rib Abnormalities: A Prospective Multicenter Study Ron El-Hawary,

A, Schematic rendering of PSO

Sara K. Fuhrhop, BS Mark J. McElroy, MS Harry C. Dietz, MD

DEBATE Fusion vs non-fusion options

Noriaki Kawakami, Taichi Tsuji, Kazuyoshi Miyasaka, Tetsuya Ohara,

Imaging in Early Onset Scoliosis

Complications of Anchors in the Growing Rod Technique

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

John A Heflin, MD John T. Smith, MD

M. Bulent Balioglu, Y. Emre Akman, Yunus Atici,

Myth vs. Truth: Screws are Always Superior to Hooks for GR Foundations

Classification of EOS Treatment

Pulmonary Outcomes after VEPTR Intervention

Nicholas D. Fletcher, MD¹ Charles E. Johnston III, MD²

MAGNETICALLY CONTROLLED GROWING ROD IN EARLY ONSET SCOLIOSIS: RETROSPECTIVE REVIEW FOCUSING ON COMPLICATIONS Francesco Lolli, Elena Maredi, Konstantinos.

Anterior instrumentation and correction

VU VIET CHINH –VO QUANG ĐINH NAM – ĐO TRAN KHANH - ĐAU THE CANH

HAZEM B ELSEBAIE FRCS, MD

Scoliosis surgery with hybrid system in osteogenesis imperfecta (OI)

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

ARTHROGRYPOSIS AND VEPTR

Simultaneous Vertebral Column Resection (VCR) and Growing Rods (GR) or Shilla for Severe Early Onset Spinal Deformity (EOS) John Emans, MD; Ashley Goldthwait,

Presentation transcript:

Preliminary Results using Shilla guided growing rods with sublaminar fixation in Early Onset Scoliosis Samuel R. Rosenfeld, M.D. Benjamin T. Smith, D.O. The Shilla technique utilizes apical deformity arthrodesis combined with guided cephalad and caudad growth in open pedicle screws. This is a one year review of two patients with severe early onset scoliosis treated with the Shilla technique incorporating sublamina fixation for guided growth. Pedicle screw fixation is used for stabilization / arthrodesis of the apical deformity. Cephalad and caudad fixation utilizes sublamina Songer cables at each level. The 5.5 mm. stainless steel rods extend beyond the sublamina fixation for guided growth.

Case # 1 M.S. is a 7 year 8 month old female with Prader-Willi syndrome. She had progressive scoliosis diagnosed at 1 year of age. She underwent MRI of the entire spinal cord demonstrating no abnormalities. She had no congenital deformities with normal spinal cord. Her neurological examination was significant for diffuse low tone with normal abdominal reflexes and absent Babinski. She began independent ambulation at 21 months of age. M. S. was treated with full time TLSO from 1 year of age until 5 years of age, then bending spinal orthosis. She had progressive scoliosis T3 to T9 R 61 degrees, T9 to L3 L 77 degrees with trunk decompensation.

The surgical procedure consisted of posterior spinal arthrodesis from T9 to T12 with segmental spinal instrumentation from T2 to L3 in a guided growth construct. One year post-op, the growth from T1 to T12 was 1.4 cm., and the growth from T1 to S1 was 3.0 cm. based on Surgimap spine software (Nemeric, Inc.).

Post-op

One year post-op

Case # 2 G.S. is a 8 year 10 month old female with a history of neuroblastoma left side of chest diagnosed in 2007. She completed chemotherapy followed by resection of the tumor in 2007. She developed progressive cervicothoracic kyphotic deformity. She was complaining of esophageal pressure with nausea. She had no neurological abnormalities, except for dysesthesias left axilla and left thorax. X rays, MRI, and computed tomography follow:

The surgical procedure consisted of vertebral column resection with kyphectomy at T4, posterior spinal arthrodesis from T1 to T6, and segmental spinal instrumentation from C5 to T10 in a guided growth construct. One year post-op the growth from T1 to T12 was 0.9 cm., and the growth from T1 to S1 was 2.6 cm. based on Surgimap spine software (Nemeric, Inc.).

Post-op

One year post-op

. The Shilla technique with sublamina fixation will allow guided growth without spontaneous arthrodesis. This technique should avoid implant complications reported with the Shilla procedure. This technique should allow improved deformity correction with fixation at all instrumented levels. References Skaggs, D., Akbarnia, B.A., Flynn, J.M., et al., A Classification of Growth Friendly Spine Implants. Journal of Pediatric Orthopedics. 2014; 34(3): 260-274. Yang J.S., McElroy, M.J., Akbarnia, B.A., et al. Growing Rods for Spinal Deformity: Characterizing Consensus and Variation in Current Use. J Pediatr Orthop. 2010; 30(3): 264-7. McAfee, P., Lubicky, J, and Werner, F., The Use of Segmental Spinal Instrumentation to Preserve Longitudinal Spinal Growth: An experimental study. J Bone Joint Surg Am, 1983; 65(7): 935-42. Rinsky, L.A., J.G. Gamble, and E.E. Bleck, Segmental Instrumentation without Fusion in Children with Progressive Scoliosis. J Pediatr Orthop, 1985; 5(6): 687-90 McCarthy, R.E., Luhman, S., Lencke, L.G., The Shilla growth guidance technique for early onset spinal deformities at two year followup: a preliminary report. Spine, 2010 McCarthy, R.E., et al., Shilla growing rods in a caprine animal model: a pilot study. Clin. Orthop. 2010; 468(3): 705-710.