Impact of Prone Surgical Positioning on the Scoliotic Spine

Driscoll, Christopher; Aubin, Carl‐Éric; Canet, Fanny; Dansereau, J.

doi:10.1097/bsd.0b013e318211ffa6

Cited by 10 publications

(10 citation statements)

References 26 publications

(20 reference statements)

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“…Using such approach, it was possible to quantify Charleston brace's biomechanical effects, such as the inversion of asymmetrical compressive loading in the major scoliotic curve, and the worsening of compressive loading in the compensatory curves [21]. The finite element modeling of daytime braces was also extensively done to assess the biomechanics of braces [17][18][19][20][21][22] and improve their design [20,23], as well as to study the effect of recumbent positioning [24]. In a recent ongoing randomized clinical trial, preliminary results of 40 patients showed that a novel design scheme combining CAD/CAM and 3D FEM simulation allowed the fabrication of more efficient and lighter braces compared to the use of CAD/CAM only [25].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Assessment of Providence Nighttime Brace for the Treatment of Adolescent Idiopathic Scoliosis

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Biomechanical Assessment of Providence Nighttime Brace for the Treatment of Adolescent Idiopathic Scoliosis

et al. 2016

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“… 74 Simulations have modelled the reduction in curvature due to prone positioning, and patient weight and surgical bed configuration. 72 …”

Section: Methodsmentioning

confidence: 99%

“…Many scoliotic models are validated by simulating the surgical intervention performed and then comparing predicted curvature to the post‐operative curvature 13 , 15 , 70 , 72 , 73 , 74 , 81 , 84 , 106 , 127 , 128 , 129 , 131 , 132 , 133 , 139 or by simulating a bending test and comparing the predicted curvature to the measured curvature from radiographic images. 69 , 85 , 96 , 134 , 135 , 136 , 137 , 140 Predicted Cobb angles within 5° of the clinically measured values are often predicted and are considered acceptable as it corresponds to the clinical accuracy.…”

Section: Methodsmentioning

confidence: 99%

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Computational modelling of the scoliotic spine: A literature review

Gould¹,

Cristofolini

Davico³

et al. 2021

Numer Methods Biomed Eng

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Scoliosis is a deformity of the spine that in severe cases requires surgical treatment. There is still disagreement among clinicians as to what the aim of such treatment is as well as the optimal surgical technique. Numerical models can aid clinical decision‐making by estimating the outcome of a given surgical intervention. This paper provided some background information on the modelling of the healthy spine and a review of the literature on scoliotic spine models, their validation, and their application. An overview of the methods and techniques used to construct scoliotic finite element and multibody models was given as well as the boundary conditions used in the simulations. The current limitations of the models were discussed as well as how such limitations are addressed in non‐scoliotic spine models. Finally, future directions for the numerical modelling of scoliosis were addressed.

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“…Among other things, it has an impact on spinal geometry, which can be exploited to reduce pathologic deformities such as scoliosis. Studies [1][2][3] have shown that Cobb angles are reduced on average between 25 and 37% due to prone positioning, anesthesia, and surgical opening. While one of the primary objectives of scoliosis instrumentation procedures is reduction of the coronal plane deformation, and more recently on the transverse plane rotation [4], current spinal operating frames such as the Jackson, Relton-Hall, Wilson or Andrews do not allow any additional 3D corrections to be made.…”

Section: Introductionmentioning

confidence: 99%

Assessment of two novel surgical positions for the reduction of scoliotic deformities: lateral leg displacement and hip torsion

2011

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Cobb angles and apical vertebral rotations (AVR) are two of the main scoliosis deformity parameters which spinal instrumentation and fusion techniques aim to reduce. Despite this importance, current surgical positioning techniques do not allow the reduction of these parameters. Two new surgical frame accessory prototypes have been developed: (1) a lateral leg displacer (LLD) allows lateral bending of a patient's legs up to 75° in either direction and (2) a pelvic torsion device (PTD) which allows transverse plane twisting of a patient's pelvis at 30° in either direction while raising the thoracic cushion, opposite to the raised side of the pelvis, by 5 cm. The objective of this study was to evaluate the ability of the LLD and PTD to reduce Cobb angles and AVR. Experimental testing was performed pre-operatively on 12 surgical scoliosis patients prone on an experimental surgical frame. Postero-anterior radiographs of their spines were taken in the neutral prone position on a surgical frame, and then again for 6 with their legs bent towards the convexity of their lowest structural curve, 4 with their pelvis raised on the convex side of their lowest structural curve and one each in opposite LLD and PTD intended use. Use of the LLD allowed for an average supplementary reduction of 16° (39%) for Cobb angle and 9° (33%) for AVR in the lowest structural curve. Use of the PTD allowed for an average supplementary reduction of 9° (19%) for Cobb angle and 17° (48%) for AVR in the lowest structural curve. Both devices were most efficient on thoraco-lumbar/lumbar curves. Opposite of intended use resulted in an increase in both Cobb angle and AVR. The LLD and PTD provide interesting novel methods to reduce Cobb angles and AVR through surgical positioning which can be used to facilitate instrumentation procedures by offering an improved intra-operative geometry of the spine.

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Impact of Prone Surgical Positioning on the Scoliotic Spine

Abstract: Prone positioning results in a reduction of all spinal segmental curves which is dependent on a number of patient and surgical frame factors.

Cited by 10 publications

References 26 publications

Biomechanical Assessment of Providence Nighttime Brace for the Treatment of Adolescent Idiopathic Scoliosis

Biomechanical Assessment of Providence Nighttime Brace for the Treatment of Adolescent Idiopathic Scoliosis

Computational modelling of the scoliotic spine: A literature review

Assessment of two novel surgical positions for the reduction of scoliotic deformities: lateral leg displacement and hip torsion

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