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

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Mechanisms and Risk Factors of Brachial Plexus Injury in the Treatment of Early-Onset Scoliosis with Distraction- Based Growing Implants by Elizabeth R.A. Joiner, Lindsay M. Andras, and David L. Skaggs J Bone Joint Surg Am Volume 95(21):e161 November 6, 2013 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The patient with her arms abducted in the typical prone position for spine surgery. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

The patient with her arms adducted, which in this case allowed detection of neurological changes that had not been apparent with the arm abducted. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Preoperative posteroanterior and lateral radiographs of a sixteen-month-old patient with congenital scoliosis, fused ribs, thoracic insufficiency syndrome, and Sprengel deformity of the left scapula who developed left upper-extremity weakness after attempte... Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Postoperative radiographs after a second surgery at the age of four years, in which the patient successfully underwent implantation of a rib-anchored growing rod (rib to spine). Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Table showing the etiologies of early-onset scoliosis in this series of patients. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Table showing the prevalence of brachial plexus injury (BPI) in patients with and without Sprengel deformity in this series. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Table showing characteristics of the patients who had a brachial plexus injury (BPI). Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Description of brachial plexus injuries. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.

Photograph showing C6 and C7 nerve roots joining to form the long thoracic nerve indicating the close proximity of the hook to the brachial plexus in a patient undergoing VEPTR instrumentation to the first rib. Elizabeth R.A. Joiner et al. J Bone Joint Surg Am 2013;95:e161 ©2013 by The Journal of Bone and Joint Surgery, Inc.