Scoliosis surgery, long spinal fusion surgery (> 4 vertebral segments)
Definitions
Spinal fusion surgery recommended when curve magnitude > 40-45° for adolescent idiopathic scoliosis (AIS)
Adult scoliosis patient presents with lumbar back, ± leg pain, L3-L4 rotatory subluxation, L4-L5 tilt, and L5-S1 disc degeneration on radiographs
Goals: Prevent progression, restore acceptability of clinical deformity, reduce curvature
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Rushton PRP et al: Spinal lengthening with magnetically controlled growing rods: data from the largest series of explanted devices. Spine (Phila Pa 1976). 45(3):170-6, 2020
Joyce TJ et al: Analysis of explanted magnetically controlled growing rods from seven UK spinal centers. Spine (Phila Pa 1976). 43(1):E16-22, 2018
Thakar C et al: Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis. Eur Spine J. 27(9):2062-71, 2018
Canavese F et al: Surgical advances in the treatment of neuromuscular scoliosis. World J Orthop. 5(2):124-33, 2014
Cho KJ et al: Surgical treatment of adult degenerative scoliosis. Asian Spine J. 8(3):371-81, 2014
El-Hawary R et al: Update on evaluation and treatment of scoliosis. Pediatr Clin North Am. 61(6):1223-41, 2014
Sturm PF et al: Recent advances in the management of early onset scoliosis. Orthop Clin North Am. 45(4):501-14, 2014
Weiss HR et al: Rate of complications in scoliosis surgery - a systematic review of the Pub Med literature. Scoliosis. 3:9, 2008
Kim YJ et al: Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am. 88(4):721-8, 2006
Kuklo TR: Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine (Phila Pa 1976). 31(19 Suppl):S132-8, 2006
Glassman SD et al: The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 30(18):2024-9, 2005
Glattes RC et al: Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 30(14):1643-9, 2005
Kim YJ et al: Pseudarthrosis in primary fusions for adult idiopathic scoliosis: incidence, risk factors, and outcome analysis. Spine (Phila Pa 1976). 2005 Feb 15;30(4):468-74. Erratum in: Spine. 30(8):994, 2005
Rinella A et al: Late complications of adult idiopathic scoliosis primary fusions to L4 and above: the effect of age and distal fusion level. Spine (Phila Pa 1976). 29(3):318-25, 2004
Lippman CR et al: Correction of adult scoliosis via a posterior-only approach. Neurosurg Focus. 14(1):e5, 2003
Gaine WJ et al: Late operative site pain with isola posterior instrumentation requiring implant removal: infection or metal reaction? Spine (Phila Pa 1976). 26(5):583-7, 2001
Richards BR et al: Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis: revisited. Spine (Phila Pa 1976). 26(18):1990-6, 2001
Winter RB et al: A study of functional spinal motion in women after instrumentation and fusion for deformity or trauma. Spine (Phila Pa 1976). 22(15):1760-4, 1997
Swank S et al: Surgical treatment of adult scoliosis. A review of two hundred and twenty-two cases. J Bone Joint Surg Am. 63(2):268-87, 1981
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Scoliosis instrumentation (SI)
Synonyms
Scoliosis surgery, long spinal fusion surgery (> 4 vertebral segments)
Definitions
Spinal fusion surgery recommended when curve magnitude > 40-45° for adolescent idiopathic scoliosis (AIS)
Adult scoliosis patient presents with lumbar back, ± leg pain, L3-L4 rotatory subluxation, L4-L5 tilt, and L5-S1 disc degeneration on radiographs
Goals: Prevent progression, restore acceptability of clinical deformity, reduce curvature
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Rushton PRP et al: Spinal lengthening with magnetically controlled growing rods: data from the largest series of explanted devices. Spine (Phila Pa 1976). 45(3):170-6, 2020
Joyce TJ et al: Analysis of explanted magnetically controlled growing rods from seven UK spinal centers. Spine (Phila Pa 1976). 43(1):E16-22, 2018
Thakar C et al: Systematic review of the complications associated with magnetically controlled growing rods for the treatment of early onset scoliosis. Eur Spine J. 27(9):2062-71, 2018
Canavese F et al: Surgical advances in the treatment of neuromuscular scoliosis. World J Orthop. 5(2):124-33, 2014
Cho KJ et al: Surgical treatment of adult degenerative scoliosis. Asian Spine J. 8(3):371-81, 2014
El-Hawary R et al: Update on evaluation and treatment of scoliosis. Pediatr Clin North Am. 61(6):1223-41, 2014
Sturm PF et al: Recent advances in the management of early onset scoliosis. Orthop Clin North Am. 45(4):501-14, 2014
Weiss HR et al: Rate of complications in scoliosis surgery - a systematic review of the Pub Med literature. Scoliosis. 3:9, 2008
Kim YJ et al: Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am. 88(4):721-8, 2006
Kuklo TR: Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine (Phila Pa 1976). 31(19 Suppl):S132-8, 2006
Glassman SD et al: The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 30(18):2024-9, 2005
Glattes RC et al: Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 30(14):1643-9, 2005
Kim YJ et al: Pseudarthrosis in primary fusions for adult idiopathic scoliosis: incidence, risk factors, and outcome analysis. Spine (Phila Pa 1976). 2005 Feb 15;30(4):468-74. Erratum in: Spine. 30(8):994, 2005
Rinella A et al: Late complications of adult idiopathic scoliosis primary fusions to L4 and above: the effect of age and distal fusion level. Spine (Phila Pa 1976). 29(3):318-25, 2004
Lippman CR et al: Correction of adult scoliosis via a posterior-only approach. Neurosurg Focus. 14(1):e5, 2003
Gaine WJ et al: Late operative site pain with isola posterior instrumentation requiring implant removal: infection or metal reaction? Spine (Phila Pa 1976). 26(5):583-7, 2001
Richards BR et al: Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis: revisited. Spine (Phila Pa 1976). 26(18):1990-6, 2001
Winter RB et al: A study of functional spinal motion in women after instrumentation and fusion for deformity or trauma. Spine (Phila Pa 1976). 22(15):1760-4, 1997
Swank S et al: Surgical treatment of adult scoliosis. A review of two hundred and twenty-two cases. J Bone Joint Surg Am. 63(2):268-87, 1981
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