Idiopathic Scoliosis

Covers the anatomy, etiology, and natural history of scoliosis - from patient evaluation and an algorithm for treatment to pulmonary function after surgical treatment and the use of instruments to evaluate surgical treatment. This new monograph focuses on the most common form of scoliosis occurring otherwise normal adolescents, affecting spinal alignment, growth, and function.

Based on over a decade of research and observation conducted by the members of the Harms Study Group and other spinal deformity experts from around the world, this must-have clinical reference provides focused coverage of the most current evaluation and treatment guidelines for idiopathic scoliosis. It draws on case studies to guide readers through specific surgical and nonoperative approaches to the multiple types of adolescent idiopathic spinal deformity, including practical information on the rationale for each approach, techniques, and results. Features: In-depth information culled from vast clinical data of world-renowned experts in the Harms Study Group Curve assessment and treatment recommendations listed by curve type and pattern - Comprehensive discussion of pathogenesis and epidemiology, osteobiologics for spinal fusion, anesthesia for scoliosis surgery, surgical complications, and more Chapters on key treatment decisions, such as the selection of fusion levels, that teach readers how to critically address clinical questions More than 600 high-quality illustrations, including numerous full-color clinical photographs, detailed line drawings, and complementary high-resolution radiographs This state-of-the-art text is ideal for orthopaedic surgeons, neurosurgeons, and spine fellows, and is an invaluable companion for any practitioner involved in the surgical and nonsurgical care of patients with spinal deformity.

This book provides comprehensive coverage of current topics in idiopathic scoliosis (IS). A three-dimensional deformity of the spine, the condition is characterized by lateral curvature combined with vertebral rotation. The primary lesion, however, lies in the median sagittal plane, taking the form of a lordosis. Although the clinical manifestations of scoliosis have been well documented, its cause and pathogenesis have not yet been determined. Research into what causes IS has focused on the structural elements of the spine, spinal musculature, collagenous structures, the endocrine system, the central nervous system, and genetics. Results of these studies have brought about a new perception of IS epiphenomena, but the main cause of IS remains unknown. Recently, several investigators have produced new hypotheses regarding the cause of IS using the developing techniques of genetics, biochemistry, and neurology. This book is a review of the various causative factors thus far proposed for IS and an introduction to the directions in which research is heading to determine the primary cause of IS.

"Idiopathic Scoliosis: The Harms Study Group Treatment Guide, Second Edition, edited by Peter O. Newton, Amer F. Samdani, Harry L. Shufflebarger, Randal R. Betz, and Jürgen Harms and written by an impressive group of experts reflects treatment advances made in the last decade. Greater understanding of the etiology and improved 3D anatomy has resulted in significant strides in clinical management of scoliosis. This richly illustrated book presents all facets of evaluation and treatment of abnormal curves of the spine, supported by a solid foundation of evidence-based data culled from the prestigious Harms Study Group. Divided into four sections and 31 chapters, this one-stop reference encompasses the full spectrum of surgical and nonoperative interventions-from early treatments to modern novel growth modulation techniques. In this second edition, each chapter has been updated and several new ones have been added, reflecting current literature, practice, and expert perspective. Throughout the book, masters share clinical pearls and firsthand knowledge on managing diverse types of adolescent idiopathic spinal deformity, with the common goal of improved patient outcomes. Key Highlights Innovative topics include teamwork and safety in spine surgery, halo traction for large curves, anterior growth modulation, intraoperative neuromonitoring, and kyphosis restoration in scoliosis surgery Surgical chapters follow a consistent layout, encompassing rationales, techniques, and outcomes Postoperative chapters feature discussion of long-term clinical and radiographic outcomes, infections, complications, and rapid post-op recovery A wealth of illustrations enhance the reader's knowledge of specific techniques"--

A comprehensive guide to modern treatment in a complex and evolving specialty FIVE STARS from Doody's Star Ratings™ Covering the spectrum of spinal deformity that occurs between birth and 10 years, early onset scoliosis (EOS) is an evolving specialty that faces unique challenges, especially in controlling the progression of the condition while allowing the growth of the developing spine, lungs and thorax. This important book was inspired by the inaugural early onset scoliosis meeting of spine surgeons and other medical professionals in Christ Church, Oxford, UK, in September 2011. It provides a complete picture of the field today, with topics ranging from spinal development and genetics to advances in medical management to breakthrough surgical techniques that offer promising new options for young patients. Special Features Provides practical, evidence-based solutions to managing the full range of congenital, idiopathic, neuromuscular and syndromic conditions that present in early onset scoliosis Describes pioneering surgical procedures, such as non-invasive, magnetically controlled growing rod systems that reduce the number of repetitive surgeries and hospitalizations Explores such complex topics as surgical strategies for sitting comfort and features of optimal heelchair seating Details treatments and outcome measures in diverse, multi-system disorders, such as early onset neuromuscular scoliosis Highlights perioperative care and the vital role of physiotherapy in children with EOS Introduces an EOS questionnaire that establishes validated, patient-reported data for outcome assessment Recognizing the importance of the multidisciplinary team approach in effective management, Early Onset Scoliosis offers the valuable international perspective of many leaders in the field. It is essential for orthopedic and pediatric surgeons, residents and trainees, who will use the book to develop a clear understanding of what EOS is, how it is best treated, and the principles that underlie effective clinical decision-making in these complex cases.

Developmental genetic studies of the spine and linkage and family-based association studies have led to recent advances in understanding the genetic etiology of idiopathic, neuromuscular, and congenital forms of scoliosis. The book is written by leaders in genetic and developmental research on scoliosis and developmental studies of the spine.

With the time available to surgeons-in-training ever dwindling, there is great emphasis placed on practical learning tools. Mirroring his earlier book on practical procedures in trauma surgery, Prof Giannoudis has produced a reference in more elective techniques. In most medical schools, most emphasis is placed on orthopaedic trauma surgery, with elective techniques often delayed until much later in a surgeon’s training.

Scoliosis is a complex three-dimensional deformity of the spine. Even though it has been known for centuries, treatment of the deformity has focused on correcting only in the frontal plane. In the last decades, the need for three-dimensional assessment regarding scoliosis has been highlighted to better understand the cause and the principles of treating scoliosis. The overall aim of this dissertation is to provide knowledge to assess scoliosis as a three-dimensional problem. The severity of scoliosis is measured with the Cobb angle from standing radiographs. Computed tomography (CT) examinations are used throughout this thesis. The first paper investigates the difference in Cobb angle measured from standing radiographs and supine CT examinations. The standing radiographs had larger Cobb angles with a mean difference of 11° and a linear correlation between the two examinations from 128 consecutive patients with adolescent idiopathic scoliosis (AIS) planned for surgery. The second paper compares the axial shape of vertebrae in 20 patients with AIS with a reference group. Clear asymmetry was observed in all vertebrae – superior and inferior end vertebrae as well as the apical vertebra – compared with corresponding vertebrae among the reference group. The asymmetry was most pronounced in the apical vertebra. A novel parameter, frontal vertebral body rotation (FVBR), was introduced to describe the internal rotation of the vertebrae in the axial plane. Pelvic incidence (PI) is a measurement of the position of the sacrum in relation to the femoral heads. This is relevant in scoliosis because PI determines the pelvic configuration acting as a foundation to the spine. PI has traditionally been measured from standing radiographs. The third study investigates PI three-dimensionally, based on low-dose CT examinations, in 37 patients with Lenke type 1 or 5 curves compared with a reference group. A significantly higher PI was observed in patients with Lenke type 5 curves compared with the reference group and patients with Lenke type 1 curves. Severe AIS is treated with corrective surgery. Two approaches are available: the predominant posterior approach and the anterior approach. In the fourth paper, these two approaches are evaluated with regard to three-dimensional correction, how well the correction is maintained over a 2-year follow-up and patient-reported outcome measures. Twenty-seven patients treated with the posterior approach and 26 patients treated with the anterior approach, all with Lenke type 1 curves, were included. Fewer vertebrae were fused in the anterior group, but the posterior group had a better correction of the deformity in the frontal plane. No difference was observed regarding three-dimensional correction and patient-reported outcome measures. AIS is truly a complex three-dimensional deformity. More research is needed to fully comprehend the complexity of the scoliotic spine.