Minimally invasive surgery using posterior-only Pedicle screw fixation in treatment of Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

Fiore, Michele; Ruffilli, Alberto; Viroli, Giovanni; Barile, Francesca; Manzetti, Marco; Faldini, Cesare

doi:10.1016/j.jocn.2022.03.019

Cited by 4 publications

(6 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Given that minimally invasive spine corrective surgery operative time has been reported to range between 4.2 and 8.78 hours, the prolonged time the device was left inflated may have had an accumulation of pressure to result in the point of limb ischemia. 10 This may have resulted in more severe neurological and vascular insults to his leg if it had not been detected via neuromonitoring. The authors hope this case serves as a reminder of the potential benefits of neuromonitoring, especially in the recent discussion of implementing neuromonitoring as the standard of care for spinal deformity surgery.…”

Section: Discussionmentioning

confidence: 99%

Failure of Sequential Compression Device Detected by Neuromonitoring during Minimally Invasive Posterior Scoliosis Surgery

Raue

Shils

Fessler

2023

J Neuroanaesth Crit Care

View full text Add to dashboard Cite

Intraoperative neuromonitoring is recommended as standard practice for corrective scoliosis surgery. Common methods include somatosensory-evoked potentials (SSEPs) and transcranial motor-evoked potentials (TcMEPs), which have been shown to have a high diagnostic accuracy in detecting new neurological deficits postoperatively. Sequential compression devices (SCDs) are a common method for thromboprophylaxis in spine surgery and are not known to have many device-related complications. To date, there have been no reports of lower extremity ischemia secondary to SCD deflation failure detected by multimodality neuromonitoring during minimally invasive posterior spine surgery. We, therefore, present a case report of an 18-year-old male with adolescent idiopathic scoliosis who underwent minimally invasive posterior spinal fusion with instrumentation. Intraoperative decrease in SSEPs and TcMEPs were noted in the left leg shortly after incision before any instrumentation or reduction occurred. Further examination revealed that the left leg was hypoperfused compared with the right leg and that the left SCD was not properly deflating. Bilateral SCDs were removed, and perfusion and neuromonitoring returned to baseline immediately. Bilateral SCDs and the machine were replaced, and neuromonitoring remained within normal limits for the rest of the surgery. The patient had no postoperative neurologic or vascular deficits. Early detection of lower extremity ischemia by neuromonitoring resulted in the prompt identification and addressing of SCD malfunction, sparing devastating neurological and vascular injury to the patient's leg. This case reinforces the importance of neuromonitoring within spine surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Failure of Sequential Compression Device Detected by Neuromonitoring during Minimally Invasive Posterior Scoliosis Surgery

Raue

Shils

Fessler

2023

J Neuroanaesth Crit Care

View full text Add to dashboard Cite

show abstract

“…Com o avanço de técnicas cirúrgicas diversas novas abordagens têm sido propostas para condução da escoliose idiopática, como uso de hastes de crescimento controladas magneticamente 6 e cirurgias minimamente invasivas que buscam aumentar a qualidade de vida, individualizar o tratamento e reduzir riscos associados à abordagens cirúrgicas tradicionais. 8 9 10…”

Section: Introductionunclassified

“…7 Com o avanço de técnicas cirúrgicas diversas novas abordagens têm sido propostas para condução da escoliose idiopática, como uso de hastes de crescimento controladas magneticamente 6 e cirurgias minimamente invasivas que buscam aumen-tar a qualidade de vida, individualizar o tratamento e reduzir riscos associados à abordagens cirúrgicas tradicionais. [8][9][10] A videotoracoscopia, ou cirurgia torácica vídeo-assistida foi descrita inicialmente em 1993 por Mack et al 11 para realização de abordagem de agravos no segmento torácico da coluna vertebral. Segundo descrição da técnica realizada pelos autores os pacientes recebem anestesia endotraqueal com tubo de duplo lúmen para colapso do pulmão ipsilateral, são posicionados em decúbito lateral e submetido à ventilação mecânica unilateral, realizando-se uma incisão de 10mm em linha axilar média, cuja altura irá variar conforme o nível da coluna a ser acessado para realização de uma toracoscopia exploratória inicial, seguida da colocação de um segundo trocarte.…”

Section: Introductionunclassified

“…7 The advancement of surgical techniques resulted in several new approaches proposed to manage idiopathic scoliosis, such as magnetically controlled growth rods 6 and minimally invasive surgeries that seek to increase the quality of life, individualize treatment, and reduce the risks associated with traditional surgery. [8][9][10] Mack et al 11 were the first to describe video-assisted thoracoscopy, or video-assisted thoracic surgery, in 1993 to approach injuries in the thoracic spinal segments. According to these authors, the patients receive endotracheal anesthesia with a double-lumen tube for ipsilateral lung collapse.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cirurgia toracoscópica na abordagem da escoliose idiopática: Revisão sistemática de literatura

Aziz,

Blattes

2023

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

ResumoA escoliose idiopática é caracterizada por um quadro de deformidade tridimensional da coluna vertebral com rotação axial e inclinação lateral com angulação maior que 10° segundo o Método de Cobb. Sua abordagem pode se dar de maneira conservadora ou cirúrgica, a depender do grau de angulação, desenvolvimento osteomuscular e idade da criança ou adolescente acometido, ou ainda, a depender do comprometimento funcional advindo da condição. O objetivo deste estudo foi analisar o impacto da videotoracoscopia na abordagem da escoliose idiopática. Trata-se de uma revisão sistemática de literatura, construída conforme protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e registrada no PROSPERO sob número CRD42022351466. A busca por estudos foi realizada entre agosto de 2022 e setembro do mesmo ano, em bancos de dados bibliográficos incluindo MEDLINE, The Cochrane Library e Web of Science. A técnica é uma alternativa minimamente invasiva à toracotomia que apresentou grande evolução nos últimos anos. Destacam-se como principais vantagens a menor perda sanguínea durante procedimento, menor tempo de internação e melhora da estética pós-cirúrgica. Uma das desvantagens citadas pelos autores é a maior complexidade e exigência tecnológica, maior tempo cirúrgico e necessidade de seleção criteriosa dos pacientes, conforme graus de desvio vertebral. O uso de analgésicos e anti-inflamatórios não teve diferença significativa entre os procedimentos tradicionais (toracotomia) ou videotoracoscopia.

show abstract

“…In recent years, more patients have needed to undergo pedicle screw fixation due to a variety of spinal pathologies [ 1 , 2 ], and screw implantation accuracy is critical. As an auxiliary medical device, surgical robots can improve the accuracy and safety of surgery and are increasingly favored by doctors [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Clinical Trial of a New Orthopedic Surgical Robot for Positioning and Navigation

Chang

et al. 2022

JCM

View full text Add to dashboard Cite

Robot-assisted orthopedic surgery has great application prospects, and the accuracy of the robot is the key to its overall performance. The aim of this study was to develop a new orthopedic surgical robot to assist in spinal surgeries and to compare its feasibility and accuracy with the existing orthopedic robot. A new type of high-precision orthopedic surgical robot (Tuoshou) was developed. A multicenter, randomized controlled trial was carried out to compare the Tuoshuo with the TiRobot (TINAVI Medical Technologies Co., Ltd., Beijing) to evaluate the accuracy and safety of their navigation and positioning. A total of 112 patients were randomized, and 108 patients completed the study. The position deviation of the Kirschner wire placement in the Tuoshuo group was smaller than that in the TiRobot group (p = 0.014). The Tuoshuo group was better than the TiRobot group in terms of the pedicle screw insertion accuracy (p = 0.016) and entry point deviation (p < 0.001). No differences were observed in endpoint deviation (p = 0.170), axial deviation (p = 0.170), sagittal deviation (p = 0.324), and spatial deviation (p = 0.299). There was no difference in security indicators. The new orthopedic surgical robot was highly accurate and optimized for clinical practice, making it suitable for clinical application.

show abstract

Minimally invasive surgery using posterior-only Pedicle screw fixation in treatment of Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 49 publications

Failure of Sequential Compression Device Detected by Neuromonitoring during Minimally Invasive Posterior Scoliosis Surgery

Failure of Sequential Compression Device Detected by Neuromonitoring during Minimally Invasive Posterior Scoliosis Surgery

Cirurgia toracoscópica na abordagem da escoliose idiopática: Revisão sistemática de literatura

Development and Clinical Trial of a New Orthopedic Surgical Robot for Positioning and Navigation

Contact Info

Product

Resources

About