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Spine
Diagnosis
Degenerative Diseases and Arthritides
Scoliosis and Kyphosis
Scoliosis Instrumentation
Scoliosis Instrumentation
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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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

                              1. 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
                              2. 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
                              3. 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
                              4. Canavese F et al: Surgical advances in the treatment of neuromuscular scoliosis. World J Orthop. 5(2):124-33, 2014
                              5. Cho KJ et al: Surgical treatment of adult degenerative scoliosis. Asian Spine J. 8(3):371-81, 2014
                              6. El-Hawary R et al: Update on evaluation and treatment of scoliosis. Pediatr Clin North Am. 61(6):1223-41, 2014
                              7. Sturm PF et al: Recent advances in the management of early onset scoliosis. Orthop Clin North Am. 45(4):501-14, 2014
                              8. Weiss HR et al: Rate of complications in scoliosis surgery - a systematic review of the Pub Med literature. Scoliosis. 3:9, 2008
                              9. Kim YJ et al: Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am. 88(4):721-8, 2006
                              10. 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
                              11. Glassman SD et al: The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 30(18):2024-9, 2005
                              12. 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
                              13. 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
                              14. 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
                              15. Andersson DI: Persistence of antibiotic resistant bacteria. Curr Opin Microbiol. 6(5):452-6, 2003
                              16. Lippman CR et al: Correction of adult scoliosis via a posterior-only approach. Neurosurg Focus. 14(1):e5, 2003
                              17. 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
                              18. Richards BR et al: Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis: revisited. Spine (Phila Pa 1976). 26(18):1990-6, 2001
                              19. 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
                              20. 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

                                                          1. 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
                                                          2. 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
                                                          3. 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
                                                          4. Canavese F et al: Surgical advances in the treatment of neuromuscular scoliosis. World J Orthop. 5(2):124-33, 2014
                                                          5. Cho KJ et al: Surgical treatment of adult degenerative scoliosis. Asian Spine J. 8(3):371-81, 2014
                                                          6. El-Hawary R et al: Update on evaluation and treatment of scoliosis. Pediatr Clin North Am. 61(6):1223-41, 2014
                                                          7. Sturm PF et al: Recent advances in the management of early onset scoliosis. Orthop Clin North Am. 45(4):501-14, 2014
                                                          8. Weiss HR et al: Rate of complications in scoliosis surgery - a systematic review of the Pub Med literature. Scoliosis. 3:9, 2008
                                                          9. Kim YJ et al: Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am. 88(4):721-8, 2006
                                                          10. 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
                                                          11. Glassman SD et al: The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976). 30(18):2024-9, 2005
                                                          12. 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
                                                          13. 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
                                                          14. 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
                                                          15. Andersson DI: Persistence of antibiotic resistant bacteria. Curr Opin Microbiol. 6(5):452-6, 2003
                                                          16. Lippman CR et al: Correction of adult scoliosis via a posterior-only approach. Neurosurg Focus. 14(1):e5, 2003
                                                          17. 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
                                                          18. Richards BR et al: Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis: revisited. Spine (Phila Pa 1976). 26(18):1990-6, 2001
                                                          19. 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
                                                          20. 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