The use of computer tomography for preoperative planning and outcome assessment in surgical treatment of idiopathic scoliosis with pedicle screw based constructs – case presentation.
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2009, Vol 11, Issue 6
Abstract
Background. In recent years pedicle screw based constructs have been increasingly used in the operative management of scoliosis. The current principles of screw placement are based on normal anatomy and therefore may not be applicable in cases of severe vertebral deformity due to torsion. The aim of this study was to evaluate the usefulness of computer tomography (CT) in preoperative planning and outcome assessment in operative management of idiopathic scoliosis with severe internal vertebral deformity.Material and Methods. The study presents our own experiences based on analysis of diagnostic and therapeutic decision-making in two patients treated surgically due to Lenke type 1A idiopathic scoliosis. Due to extensive vertebral rotation and radiological appearance suggesting thin pedicles, spine CT with 3D reconstruction was performed as part of extended preoperative work-up in order to determine screw length and diameter, the point of screw introduction and angle of introduction in three planes. Vertebral rotation was evaluated according to the Aaro-Dahlborn method. Segments were also identified where pedicle screws could not be applied due to severe rotation or small pedicle diameter. Results: Preoperative planning of screw placement enabled safe and accurate screw application, as confirmed by postoperative spine CT evidence. Satisfactory correction was achieved in both patients in the coronal and frontal planes. Conclusions: CT allows detailed preoperative planning of scoliosis surgery and identification of segments in which pedicle screws cannot be safely placed. This may lower the incidence of complications associated with inaccurate pedicle screw placement.
Authors and Affiliations
Piotr Harasymczuk , Tomasz Kotwicki , Aleksander Koch , Andrzej Szulc
Keywords
Related Articles
- EP ID EP56970
- DOI -
- Views 95
- Downloads 0
Vibroarthrography in the evaluation of musculoskeletal system – a pilot study
Background. Disorders of the articular surfaces are associated with impaired quality of joint motion and joint play. Crepitations are the hallmark clinical sign. This paper aims to present the possibilities of using vibr...
Cemented primary total artrhoplasty for acetabular protrusion in patients with rheumatoid arthritis
Summary The degenerative changes in hip joints observed in patients with RA are associated with acetabular bone deficiencies. Therefore, total hip arthroplasty performed in such patients requires bone grafting to restore...
Operative technique and results of core decompression and filling with bone grafts in the treatment of osteonecrosis of femoral head
SummaryIntroduction: The aim of this paper is to present the operative technique and results of core decompression and clearing of a necrotic zone in the femoral head followed by filling the defect with impacted autologo...
Przydatność terapii czaszkowo-krzyżowej w leczeniu chorych z niespecyficznymi bólami dolnego odcinka kręgosłupa. Doniesienie wstępne.
Wstęp. Niespecyficzne zespoły bólowe dolnego odcinka kręgosłupa to coraz częstsza dolegliwość narządu ruchu człowieka. Celem pracy było zbadanie przydatności technik terapii czaszkowo-krzyżowej w leczeniu dolegliwości pr...
Role of radiotherapy in the treatment of osteolytic damage due to bone tumors
Metastasis to bone is a common event in the natural history of nearly all neoplasms, which often greatly affects the patient's quality of life. Bone metastases can cause pain and pathological fractures, or even a cord co...