- Post-Procedure: Pedicle Hook Implantation
- Post-Procedure: Transverse Process Hook Implantation
- Post-Procedure: Laminar Hook Implantation
- Post-Procedure: Instrumentation Sequence in Typical Lenke IA Curve
- Post-Procedure: Thoracic Pedicle Screw Insertion Techniques
- Post-Procedure: Iliac Fixation with Iliac Screws
- Post-Procedure: Posterior Multihook and Screw Segmental Instrumentation (Crandall)
- Post-Procedure: Posterior Column Shortening Procedure for Scheuermann's Kyphosis (Ponte)
Post-Procedure: Pedicle Hook Implantation
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Pedicle Hook Implantation
Post-Procedure: Transverse Process Hook Implantation
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Transverse Process Hook Implantation
Post-Procedure: Laminar Hook Implantation
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Laminar Hook Implantation
Post-Procedure: Instrumentation Sequence in Typical Lenke IA Curve
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Instrumentation Sequence in Typical Lenke IA Curve
Post-Procedure: Thoracic Pedicle Screw Insertion Techniques
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Thoracic Pedicle Screw Insertion Techniques
Post-Procedure: Thoracic Pedicle Screw Insertion Techniques
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Thoracic Pedicle Screw Insertion Techniques
Post-Procedure: Iliac Fixation with Iliac Screws
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Iliac Fixation with Iliac Screws
Post-Procedure: Posterior Multihook and Screw Segmental Instrumentation (Crandall)
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Posterior Multihook and Screw Segmental Instrumentation (Crandall)
Post-Procedure: Posterior Column Shortening Procedure for Scheuermann's Kyphosis (Ponte)
POST-PROCEDURE CARE
- Restrict oral intake until bowel sounds are heard and monitor for an ileus.
- Administer intravenous antibiotics for 48 hours after surgery.
- Use "pulmonary toilet" and incentive spirometer to minimize atelectasis.
- Use an anesthesia pump and/or oral pain medication to control postoperative pain.
- Remove the Hemovac drain after 24 to 48 hours.
- Mobilize the patient from the bed to a chair as soon as pain allows.
- A brace is usually not necessary.
- Discharge from hospital when oral intake is tolerated, temperature normalizes, and the patient is independent.
- May shower at 2 weeks post-op but limit lifting and heavy exertion for 6 months.
- Advise against future contact sports.
COMPLICATIONS
- Neurologic injury
- Infection (less than 1%)
- Ileus
- Atelectasis
- Pneumothorax
- Dural tear
- Wrong level surgery
- Urinary complications
- Pseudarthorosis
- Loss of lumbar lordosis
- Crankshaft phenomenon
- Superior mesenteric artery syndrome
- Trunk decompensation
ANALYSIS OF RESULTS
The newer segmental fixation devices for the correction of spinal deformities from a posterior approach have a high rate of success with a low rate of complications.
OUTCOMES AND EVIDENCE
- Hamill et al: Pedicle screws improved coronal and sagittal correction and had better restoration of segmental lordosis than hook configuration.
- Barr et al: Pedicle screws provided greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves when compared with hook configurations.
- Suk et al: Hook fixation resulted in 55% correction compared to 72% with thoracic pedicle screws. Pedicle screws had a 3% malposition rate on radiographs.
- Luhmann et al: Thoracic posterior-only pedicle screw constructs provided equal correction to hook constructs with anterior release.
- Kim et al: Better curve correction without neurologic problems, improved pulmonary function, and shorter fusion length with posterior pedicle screw instrumentation compared to segmental hook instrumentation.
- Liljenqvist et al: 25% of pedicle screws penetrated the pedicle cortex or anterior vertebral body cortex on CT scan, most clinically relevant in the thoracic spine.
Procedure: Posterior Column Shortening Procedure for Scheuermann's Kyphosis (Ponte)
|
|
