Background:
Anterior vertebral body tethering (VBT) is a growth modulating and fusionless treatment option that is considered as a new promising method for the management of adolescent idiopathic scoliosis (AIS). This prospective cohort study aimed to present the minimum 2-year results of anterior VBT applied to 21 skeletally immature patients with AIS.
Methods:
Twenty-one skeletally immature patients with a diagnosis of AIS were included. A decision to proceed with surgery was established after the detection of curve progression despite the brace (>40 degrees) with a minimum curve flexibility of 30%.
Results:
Patients had an average age of 11.1 and an average follow-up period of 27.4 months. All patients underwent thoracoscopic placement of thoracic screws, from the convex side of curves. An average of 7.1 levels of tethering was undertaken. Average preoperative major thoracic curve magnitudes improved from 48.2 to 16 degrees on the first erect postoperative x-ray, and to 10 degrees at the last follow-up (P<0.001). Immediate postoperatively, 1 case with chylothorax was detected and treated conservatively, and another case with tether breakage was detected at the third postoperative year and replaced thoracoscopically. No other major complication was acquired.
Conclusions:
Anterior VBT as a growth modulating treatment option by allowing the correction of the scoliotic deformity and preserving coronal balance was detected to be a safe and effective option for the surgical treatment of AIS in skeletally immature patients, if applied under strict inclusion criteria. VBT by allowing preservation of spinal segmental motion is yielding promising radiographic results without causing any major complications.
Level of Evidence:
Level IV.
This study shows that inoculation of S. aureus in 10(6) CFU/10 microl concentration at the decorticated lamina after implantation of a titanium screw in rat spine is a reproducible model for spinal infection and can be used for the animal model of prophylaxis and treatment and of postoperative infection.
AIm: One of the most important causes of failed back surgery is the development of epidural fibrosis. Many methods and substances have been used to prevent the development of epidural fibrosis after laminectomy. In this study, effects of "manuka honey" on epidural fibrosis development after laminectomy was evaluated in rats. mATERIAl and mEThods: Subjects were divided into two groups:In Group-1 (n=8);only laminectomy was carried out in the L1 level; in group-2 (n=8), laminectomy was carried out in the L1 level and manuka honey was applied to the area. The related vertebral columns were removed en bloc 6 weeks later. Leveled sections with thicknesses of 6 mm were obtained from paraffin blocks.
REsulTs:In the grading made based on the fibroblast count and scar tissue degree, it was found that epidural fibrosis developed significantly less in the group-2 as compared to the group-1, and the difference was statistically significant.
CoNClusIoN:It was shown in our study that manuka honey reduces the degree of epidural fibrosis in rats following laminectomy. We believe that manuka honey, which can be used safely in the clinic for surgical wounds, can be used routinely to prevent development of epidural fibrosis following laminectomy.KEywoRds: Peridural, Epidural, Fibrosis, Laminectomy, Honey, Rat ÖZ AmAÇ: Başarısız bel cerrahisi sendromunun en önemli sebeplerinden biri epidural fibrozis (EF) gelişimidir. Laminektomi sonrası epidural fibrozis gelişimini engellemeye yönelik pek çok yöntem ve madde kullanılmıştır. Bu çalışmada, "manuka balı"nın laminektomi sonrası epidural fibrozis derecesine etkisi sıçanlarda değerlendirildi. yÖNTEm ve GEREÇlER: Denekler iki gruba ayırıldı: Grup-1'de (n=8) L1 seviyesine sadece laminektomi yapıldı, grup-2'de (n=8) L1 laminektomi yapılarak, laminektomi sahasına manuka balı uygulandı. İlgili vertebral kolonlar 6 hafta sonra en-blok olarak çıkartıldı. Parafin bloklardan 6 mm kalınlığında seviyeli kesitler alındı.BulGulAR: Skar dokusunun derecesine göre yapılan evrelemede, grup-2'de grup-1'e göre epidural fibrozisin daha düşük oranda geliştiği gösterildi. Aradaki farkın istatistiksel olarak anlamlı olduğu görüldü. Fibroblast sayısına göre yapılan evrelemede, grup-2'de grup-1'e göre daha düşük derecede epidural fibrozis geliştiği ve aradaki farkın istatistiksel olarak anlamlı olduğu tespit edildi. soNuÇ: Çalışmamızda, manuka balı'nın sıçanlarda laminektomi sonrası EF derecesini azalttığı gösterilmiştir. Cerrahi yaralarda güvenli bir şekilde klinik olarak uygulanabilen manuka balı'nnın laminektomi sonrası epidural fibrozis gelişimini önlemek amacıyla rutin olarak kullanılabileceği kanaatindeyiz.
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