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 86
- Downloads 0
Total Hip Arthroplasty in HIV-seropositive Patients – Case Study and Review of Literature
Hip arthroplasty is widely used in the treatment of osteoarthritis, especially in patients with steroid-induced osteonecrosis of the femoral head. However, this procedure in HIV-seropositive patients has not been describ...
Monitoring the treatment of low back pain using non-steroid anti-inflammatory drugs and aromatic oil components
Background. The nervous system, in reaction to pain, restrains the range of motion in the affected limb, increasing the amplitude on the healthy side. Thus the asymmetry of a given motion can be used in the quantitative...
The shape of anterior-posterior spinal curvature in post-menopausal women with osteoporosis
Background. The co-occurrence of kyphotic posture and low bone density in elderly women has never been completely explained. The aim of our study was to assess postural changes (the shape of spinal curvatures) in elderly...
Zastosowanie metody Kinesiology Taping w fizjoterapii ręki reumatoidalnej – badanie pilotażow
Wstęp. Reumatoidalne Zapalenie Stawów (RZS) najczęściej obejmuje małe stawy rąk i stóp. Do typowych deformacji wynikających z przebiegu choroby należy zaliczyć: ulnaryzację ręki, palce butonierkowate, palce „łabędziej sz...
The impact of selected metallic elements in the environment on the occurrence of osteoporosis in the voivodeship of Silesia
Background. The existence of toxic metallic elements in the environment is one of the most important factors influencing the metabolism of calcium. The aim of our study was to compare the incidence of osteoporosis in Upp...