Bone Health

Apical Sublaminar Wires versus Pedicle Screws-Which Provides Better AIS Corrective Results? Paper No: 290 Friday, February 25, 2005 11:00 AM - 11:06 AM Lawrence G Lenke, MD Saint Louis MO (*) Moderator(s): Edward D Simmons, MD Buffalo NY Susan E Stephens, MD Cleveland OH Spine Apical SLW and PS instrumentation both safely offer similar curve correction. Although more expensive, PS constructs had significantly less blood

Poster Board Number: P301 Spine Benjamin Potter, MD Washington DC (n) Lawrence G Lenke, MD Saint Louis MO (a,e -medtronic sofamor danek) Timothy R Kuklo, MD Rockville MD (a-Medtronic Sofamor danek) We compared 20 ASF patients with Lenke type I AIS to 20 curve-matched patients treated with PSF with thoracic pedicle screws (TPS). PSF/TPS demonstrated greater MT (p=0.009) and TL-L curve correction (p=0.03), as well as greater improvement in rotation and thoracic torsion as assessed by correction of rib hump (p=0.005) and the apical vertebral body-rib ratio (p<0.0001).

Comparison of Combined ASF/PSF versus PSF Alone for the Treatment of AIS Curves> 90? Poster Board Number: P298 Spine Lawrence G Lenke, MD Saint Louis MO (n) Michael Peelle, MD Saint Louis MO (n) Keith H Bridwell, MD Saint Louis MO (n) Matthew Barrett Dobbs, MD Saint Louis MO (n) The use of PSF alone with an all pedicle screw construct provides the same correction in patients with AIS curves> 90° as the circumferential ASF/PSF approach.

Comparison of Pedicle Screw versus Hybrid Instrumentation in Adolescent Idiopathic Scoliosis Paper No: 289 Friday, February 25, 2005 10:54 AM - 11:00 AM Yong Jung Kim, MD Saint Louis MO (n) Lawrence G Lenke, MD Saint Louis MO (a - Medtronic Sofamor Danek) Keith H Bridwell, MD Saint Louis MO (a - Medtronic Sofamor Danek) Junghoon Kim, MD Saint Louis MO (n) Samuel Cho, MD Saint Louis MO (n) Moderator(s): Edward D Simmons, MD Buffalo NY Susan E Stephens, MD Cleveland OH Spine Pedicle screw instrumentation offers a significantly better major curve correction and slightly improved postoperative pulmonary function compared to hybrid constructs.

Abstract Paper No: 265 Thursday, February 24, 2005 04:42 PM - 04:48 PM George H Thompson, MD Cleveland OH (n) Behrooz A Akbarnia, MD La Jolla CA (d,e-DePuy) Patricia Nieman Kostial, RN (n) Connie Poe-Kochert, RN Cleveland OH (n) Douglas G Armstrong, MD Cleveland OH (n) Jeffrey Roh, MD New York NY (n) Robert Lowe, MD Chicago IL (n) Marc Addason Asher, MD Kansas City KS (d,e-DePuy) David S Marks, FRCS Birmingham, England United Kingdom (d,e-DePuy) Growing rod techniques using single or dual rods are effective in controlling curve progression, providing correction and allowing for some spinal growth. The results of dual rod instrumentation were better than single rod instrumentation. This is due to a stronger construct and more frequent lengthenings. The worst results occurred in those who had a short apical fusion. We feel this should no longer be utilized, as it appears to predispose to stiffening of the curve, crankshaft phenomena, less correction, and increased incidence of complications

Abstract Paper No: 300 Friday, February 25, 2005 12:18 PM - 12:24 PM Matthew J Mermer, MD Coos Bay OR (*) Oheneba Boachie-Adjei, MD New York NY (*) Bernard A Rawlins, MD New York NY (*) Melissa Peskin, BA (*) Ramil S Bhatnagar, MD Sea Girt NJ (*) Moderator(s): Edward D Simmons, MD Buffalo NY Susan E Stephens, MD Cleveland OH Spine Modular correction to the sacropelvis can reliably provide three-dimensional deformity reconstruction and achieve optimum balance in all planes.

Corrective Capacity of Monaxial versus Multiaxial Thoracic Pedicle Screws in AIS Poster Board Number: P300 Spine Benjamin Potter, MD Washington DC (n) David W Polly Jr, MD Minneapolis MN (a,b,e-medtronic sofamor danek) Lawrence G Lenke, MD Saint Louis MO (a,e-medtronic sofamor danek) Timothy R Kuklo, MD Rockville MD (a- medtronic sofamor danek) We compared 15 patients treated with monaxial versus 15 patients treated with multiaxial thoracic pedicle screws for AIS (Adolescent Idiopathic Scoliosis). Coronal curve correction was similar between the two groups (mon 61% vs. multi 62%); however, monaxial screws provided greater correction and vertebral rotation and thoracic torsion as assessed by improvement in rib hump (68% vs. 33%; p <0.0001), apical vertebral body-rib ratio (81% vs. 65%; p = 0.10), and apical rib spread difference (79% vs. 52%; p = 0.11)

Dual Growing Rods for Treatment of Progressive Early Onset Scoliosis: A Multicenter Study Paper No: 286 Friday, February 25, 2005 10:30 AM - 10:36 AM Behrooz A Akbarnia, MD La Jolla CA (c,e DePuy Spine) David S Marks, FRCS Birmingham, England United Kingdom (c,e DePuy Spine) Oheneba Boachie-Adjei, MD New York NY (c,e DePuy Spine) Alistair G Thompson, FRCS Birmingham United Kingdom (n) Marc Addason Asher, MD Kansas City KS (c,e DePuy Spine) This is the first report of patients treated surgically with dual growing rods with a minimum of 2 years follow-up. The authors believe that the dual rod technique is safe and effective, provides superior stability, reduces complications and allows continued spinal growth in this challenging patient population.

Galveston Fixation in Neuromuscular Scoliosis: The Gold Standard for New Instrumentation to Beat Poster Board Number: P291 Spine Stephen Storer, MD Hollywood FL (none) Lauren Friend, MD New Orleans LA (none) Vernon T Tolo, MD Los Angeles CA (none) David Lee Skaggs, MD Los Angeles CA (a - Depuy, a,b - Synthese spine, a,b,e - Stryker Spine) In this population of children with neuromuscular scoliosis, the Galveston technique was successful with few complications.

Poster Board Number: P209 Pediatrics Paloma Bas Hermida, MD Valencia Spain (n) Eva Llopis, MD Valencia Spain (n) Jose Luis Bas, MD Madrid Spain (n) Pilar Ferrer, MD Valencia Spain (n) Teresa Bas, MD Valencia Spain (*) The entire neural axis should be evaluated to rule out multiple level spinal cord abnormalities. Multiplanar reformatted images with MRI and specially CT improved identification of the vertebral anomaly and provide a three dimensional view of the malformation.

Paper No: 291 Friday, February 25, 2005 11:06 AM - 11:12 AM Timothy R Kuklo, MD Rockville MD (a- Medtronic Sofamor Danek) Kevin L Kirk, DO Silver Spring MD (n) Suken A Shah, MD Wilmington DE (n) Moderator(s): Edward D Simmons, MD Buffalo NY Susan E Stephens, MD Cleveland OH Spine Twenty-one AIS patients were followed for an average of 5.2 years after instrumentation removal for either pain or infection. In this series, instrumentation removal was not found to be a benign process, as this cohort of patients shows a "settling" effect in the coronal plane of the MT and TL-L curves after instrumentation removal. Interestingly, there was no change in the sagittal plane with time. Parents and patients should be counseled for this when instrumentation removal is contemplated.

Poster Board Number: P283 Spine Rafael Levin, MD New York NY (n) Amir Hasharoni, MD Tel-Aviv Israel (n) Baron Lonner, MD New York NY (n) Thomas J Errico, MD New York NY (n) David M Matusz, MD Baltimore MD (n) A retrospective review of operative and radiographic results in 45 patients who underwent either MOTA (Mini-Open Thoracotomy) or VATS (Video Assisted Thoracoscopic Surgery) for release and fusion prior to posterior instrumented fusion.

Abstract Paper No: 264 Thursday, February 24, 2005 04:30 PM - 04:36 PM Emilie V Cheung-Moore, MD Wynnewood PA (n) James T Guille, MD Wilmington DE (n) Randal R Betz, MD Ocean City NJ (n) Mary Jane Mulcahey-Hershey, OT Philadelphia PA (n) Linda P D'Andrea, MD Blue Bell PA (n) Janet Cerrone, PA-C Philadelphia PA (n) Robert Murray Campbell Jr, MD San Antonio TX (n) Charles Eugene Johnston II, MD Dallas TX (n) John Peter Lubicky, MD Chicago IL (n) Conclusion: In children with both fused ribs and congenital scoliosis, Cobb angle and shortened thoracic height progresses in severity with growth. Our results suggest that corrective osteotomy gives the best chance of improving the Cobb angle but results in the greatest reduction in thoracic spinal height.

Pelvic Fixation in Spine Surgery: Historical Overview, Indications, Biomechanical Relevance, and Current Techniques Scientific Exhibitor Number: SE067 Spine Ali Moshirfar, MD Silver Spring MD (None) Frank F Rand, MD Boston MA (e - DePuy Spine, Stryker Spine) Paul D Sponseller, MD Baltimore MD (None) Stephen J Parazin, MD Chestnut Hill MA (e - DePuy Spine, Kyphon, Smith & Nephew) A Jay Khanna, MD Baltimore MD (None) Khaled M- Kebaish, MD Baltimore MD (None) John Thomas Stinson, MD Rockville MD (None) Pelvic fixation allows for protection of distal S1 pedicle screws to prevent pseudoarthrosis in long fusions to the sacrum.
Pelvic fixation is necessary for long fusions of the spine ending at S-1. This exhibit reviews the common pathologic conditions and indications, biomechanical basis, and surgical steps necessary to place pelvic implants safely.

Paper No: 268 Thursday, February 24, 2005 05:06 PM - 05:12 PM Suken A Shah, MD Wilmington DE (n) Zhaoping He, PhD Wilmington DE (n) Kirk W Dabney, MD Wilmington DE (n) Freeman Miller, MD Wilmington DE (n) Devendra I Mehta, MD Wilmington DE (n) Postoperative acute pancreatitis is strongly associated with sepsis and wound infection within a few days after spinal surgery. The purpose of the study was to determine if postoperative pancreatitis increases a patient's risk of developing an infection.
Postoperative acute pancreatitis is strongly associated with sepsis within a few days, suggesting a causal association