1. Electronic conductivity devices can improve outcomes. In a study published in Spine, 248 pediatric scoliosis patients underwent surgical correction with or without electronic conductivity devices. There were 1,270 pedicle screws that were placed with ECD and 1,400 pedicle screws placed without ECD. Neuromonitoring alarms concomitant with screw placement occurred during three procedures when ECD was used, compared with 10 procedures when ECD wasn’t used. Of the 13 total monitoring alarms, 69 percent were associated with implantation adjacent to the apex of the spine curve. The study authors found that ECD use can significantly reduce the incidence of clinically relevant misplaced screws.
2. New genetic markers identified for idiopathic scoliosis. A five year study at Texas Scottish Rite Hospital for Children has culminated in the identification of two new genetic markers for idiopathic scoliosis: CHL1 and DSCAM. According to director of molecular genetics at TSRHC and study lead author Carol Wise, PhD, the genes play a role in the neurologic and spinal systems. The findings won’t change scoliosis detection or treatment in the near future, but it could eventually change how the disorder is monitored, depending on data researchers are able to glean in the meantime.
“There has never been a direct connection between a neurologic case and scoliosis,” Dr. Wise says. “In the non-scoliosis research world, most people see [scoliosis] as a bone disease because that’s how we treat it. We can now say that our research suggests that the pathology of the nerves is a significant part of the disease.”
3. Girls with scoliosis weigh less. Girls with adolescent idiopathic scoliosis are more likely to weigh less and have a lower BMI than girls without the disorder, according to a study published in Spine. Researchers assessed 52 girls with AIS who had an average scoliosis curve of 27 degrees Cobb and compared them with 92 girls without spinal deformity. The AIS girls had a significantly lower average weight and BMI than the control group. The AIS girls experienced a progressive BMI decrease as they aged and there were 11 girls in this group who showed a BMI below 17.5, which is the limit for anorexia. Only three girls in the control group had a similar BMI.
4. Continuous infusion of bupivacaine can help patients postoperatively. Patients can decrease the amount of postoperative morphine they receive after posterior surgical correction for scoliosis by receiving a continuous infusion of bupivacaine. In a study of 244 adolescent patients who underwent surgical correction for idiopathic scoliosis, 129 patients received continuous bupivacaine through a catheter. There were significantly fewer patients (32.6 percent) in the bupivacaine group who required continuous basal infusion of morphine than in the control group (85.2 percent). The depth of the bupivacaine catheter did not have an impact on the postoperative opioid use. The study based on this research was published in Spine.
5. 3D CT scans help with preplanning. A study published in Spine found that three dimensional CT scan-based measurements are useful when planning and predicting the outcome of scoliosis corrective surgery. The study involved 50 adolescent idiopathic scoliosis patients who underwent corrective surgery. Researchers examined the the preoperative 3D CT scans before and after surgery. They found a significant decrease in coronal curvature, rip hump, index and sternal shift as well as some decrease in vertebral rotation.
6. Surgical intervention for neuromuscular scoliosis has high morbidity risk. The Scoliosis Research Society conducted a review of 19,360 cases of pediatric scoliosis that were entered into the M&M database over a three-year period, and found complications occurring in 10.2 percent of all cases. The complication rate was higher (17.9 percent) among patients with neuromuscular scoliosis. Only about 10 percent of the patients with congenital scoliosis and 6 percent of patients with idiopathic scoliosis experienced complications. Additionally, the rate of new neurologic deficits was higher for procedures using just the anterior screw or wire constructs compared to patients with just pedicle screw constructs. The results of the study were published in Spine.
Related Articles on Scoliosis:
Scoliosis as a Neurologic Condition: 4 Points on Two New Genes Making the Connection
Improving Scoliosis Treatments: Q&A With Dr. Vincent Arlet, Developer of Scolisoft Scoliosis Database
Adolescent Scoliosis Treatment Challenges and Innovations: Q&A With Dr. Christopher R. Good of the Virginia Spine Institute
