Idiopathic Scoliosis: The Harms Study Group Treatment Guide PDF
Preview Idiopathic Scoliosis: The Harms Study Group Treatment Guide
E1FM.qxd 4/23/10 10:06 PM Page i Idiopathic Scoliosis The Harms Study Group Treatment Guide E1FM.qxd 4/23/10 10:06 PM Page ii E1FM.qxd 4/23/10 10:06 PM Page iii Idiopathic Scoliosis The Harms Study Group Treatment Guide Peter O. Newton, MD Randal R. Betz, MD Clinical Associate Professor Chief of Staff Department of Orthopaedic Surgery Medical Director University of California–San Diego Spinal Cord Injury Unit Division of Orthopaedic Surgery Shriners Hospital for Children Rady Children’s Hospital Philadelphia, Pennsylvania San Diego, California Michael F. O’Brien, MD Robert A. Dickson Director of Research Emeritus Professor Baylor Spine Center Orthopaedic Surgery/Consultant Spinal Surgeon Spine Surgeon Southwest Scoliosis Institute University of Leeds and Leeds General Infirmary Plano, Texas Leeds, United Kingdom Harry L. Shufflebarger, MD Jürgen Harms, MD Director Professor and Chief Department of Orthopaedic Surgery Department of Orthopaedics and Traumatology Miami Children’s Hospital Klinikum Karlsbad–Langensteinbach Miami, Florida Karlsbad, Germany Thieme New York • Stuttgart E1FM.qxd 4/23/10 10:06 PM Page iv Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Editorial Director: Michael Wachinger Executive Editor: Kay D. Conerly Managing Editor: J. Owen Zurhellen IV Editorial Assistant: Emma Lassiter International Production Director: Andreas Schabert Production Editor: Kenneth L. Chumbley, Publication Services Vice President, International Marketing and Sales: Cornelia Schulze Chief Financial Officer: James W. Mitos President: Brian D. Scanlan Illustrator: James Millerick Compositor: Thomson Digital Printer: Everbest Library of Congress Cataloging-in-Publication Data Idiopathic scoliosis : the Harms Study Group treatment guide / [edited by] Peter O. Newton ... [et al.]. p. ; cm. Includes bibliographical references. ISBN 978-1-60406-024-9 (alk. paper) 1. Scoliosis. I. Newton, Peter O. II. Harms Study Group. [DNLM: 1. Scoliosis—therapy. 2. Adolescent. 3. Braces. 4. Orthopedic Procedures—methods. 5. Spine—surgery. WE 735 I19 2010] RD771.S3I35 2010 616.7’3—dc22 2010007751 Copyright ©2011 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage. Important note:Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confirm the information contained herein with other sources. 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Printed in China 5 4 3 2 1 ISBN 978-1-60406-024-9 E1FM.qxd 4/23/10 10:06 PM Page v We dedicate this book to our respective families E1FM.qxd 4/23/10 10:06 PM Page vi E1FM.qxd 4/23/10 10:06 PM Page vii Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Chapter 1 History of the Treatment of Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Robert A. Dickson Chapter 2 Basic Principles of Scoliosis Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Robert A. Dickson Chapter 3 Pathogenesis of Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Robert A. Dickson Chapter 4 Epidemiology of Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Robert A. Dickson Chapter 5 Clinical and Radiographic Evaluation of the Scoliotic Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 Alvin H. Crawford, Alan E. Oestreich, Linda P. D’Andrea, Joshua E. Heller, and Patrick Cahill Chapter 6 The Importance of the Sagittal Plane: Spinopelvic Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Frank Schwab, Virginie Lafage, Ashish Patel, and Michael F. O’Brien Chapter 7 The Case for Bracing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Suken A. Shah Chapter 8 The Case Against Bracing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94 Robert A. Dickson Chapter 9 Classification of Adolescent Idiopathic Scoliosis for Surgical Intervention . . . . . . . . . . . . . . . . . . . . .101 David H. Clements, Joshua M. Pahys, and Patrick Cahill Chapter 10 Biomechanics and Reduction of Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108 Thomas R. Haher, Jahangir Asghar, Loren Latta, and Patrick Cahill Chapter 11 Anesthesia for Scoliosis Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Elizabeth Demers Lavelle, Mohamed Mahmoud, See Wan Tham, Mark Vadney, and Sara Lozano E1FM.qxd 4/23/10 10:06 PM Page viii viii Contents Chapter 12 Selective versus Nonselective Surgery for Adolescent Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . .136 Daniel J. Sucato Chapter 13 Selection of Fusion Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150 Daniel S. Mulconrey and Lawrence G. Lenke Chapter 14 Posterior Correction Techniques in Late-onset Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165 Suken A. Shah Chapter 15 The Use of Traction in Treating Large Scoliotic Curves in Idiopathic Scoliosis . . . . . . . . . . . . . . . . . .179 Paul D. Sponseller and Ryan Takenaga Chapter 16 The Treatment of Rigid Adolescent Idiopathic Scoliosis: Releases, Osteotomies, and Apical Vertebral Column Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 Lynn Letko, Rubens G. Jensen, and Jürgen Harms Chapter 17 Surgical Treatment of the Right Thoracic Curve Pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200 Peter O. Newton and Vidyadhar V. Upasani Chapter 18 Diagnosis, Treatment, and Outcomes of Treatment of the Double Thoracic Curve Pattern in Adolescent Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224 Shay Bess, Frances Faro, and Thomas G. Lowe Chapter 19 The Surgical Treatment of Lumbar and Thoracolumbar Curve Patterns (Lenke Type 5): Anterior versus Posterior Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233 Harry L. Shufflebarger, James T. Guille, and Burt Yaszay Chapter 20 The Surgical Treatment of Double and Triple Curves (Lenke Types 3, 4, and 6) . . . . . . . . . . . . . . . . .249 Burt Yaszay, William F. Lavelle, and Baron S. Lonner Chapter 21 Outcomes of Treatment of Adolescent Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262 Michelle C. Marks, Tracey Bastrom, William F. Lavelle, and Peter O. Newton Chapter 22 Complications in Surgery for Spinal Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .284 HoSun Hwang, Angel Macagno, Munish C. Gupta, and Michael F. O’Brien Chapter 23 Spinopelvic Fixation in Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323 Mark F. Abel, Michael F. O’Brien, and Burt Yaszay Chapter 24 Untreated Late-onset Idiopathic Scoliosis and Revision Surgery in Adults . . . . . . . . . . . . . . . . . . . . .339 Charles A. Sansur, Rod J. Oskouian Jr, Michael F. O’Brien, and Christopher I. Shaffrey Chapter 25 Osteobiological Agents for Spinal Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .352 Safdar N. Khan, William F. Lavelle, and Munish C. Gupta Chapter 26 Electrophysiological Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .372 Joshua D. Auerbach, Amer F. Samdani, and John P. Dormans Chapter 27 Correction Without Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .392 Randal R. Betz, William F. Lavelle, and Peter O. Newton Chapter 28 The Impact of Genetics Research on Adolescent Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . .408 John T. Braun, William F. Lavelle, and James W. Ogilvie Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .417 E1FM.qxd 4/23/10 10:06 PM Page ix Foreword The diagnosis and treatment of idiopathic scoliosis, as well as colleagues in Germany quickly spread throughout much more complex types of spinal deformity, has experienced of Europe and then to the United States—first, via Harry revolutionary advances since Paul Harrington of Houston in- Shufflebarger (Miami), and then to other North American troduced the concept of Harrington rod instrumentation and centers dedicated to the concepts of Harms’ treatment then instrumentation plus fusion (Moe) in about 1960. Prior methods, including Randy Betz (Philadelphia), Peter Newton to that, surgical correction of scoliosis was unpredictable and (San Diego), and Michael O’Brien (Dallas). The international difficult, depending on in situ posterior spinal fusions (Hibbs, multicenter Harms Study Group was then developed. This 1911), followed by prolonged periods of casting in large, organization, which in some ways resembles the long-term often grotesque body casts (LeMesurier et al., “fishnet” cast). patient follow-up program set up by the A-O documenta- Following Paul Harrington’s revolutionary introduction, tion center in Bern and Davos, Switzerland, was established instrumented surgical correction of scoliosis made evolution- to study the efficacy of scoliosis treatment methods. ary gains, including Luque spinal instrumentation (laminar The Harms Study Group database has become a world- wiring), the segmental attachment of spinal instrumentation class information source regarding scoliosis treatment including derotation (Cotrel and Dubousset), and the more outcomes, which has led to hundreds of publications and revolutionary concept of pedicle screw attachment to the presentations (Scoliosis Research Society and other confer- spine (Roy and Camille ) that provided an even better grasp ences). The result has been a synthesis of current knowl- for segmental control and correction. edge and thinking about the treatment of spinal deformity, As these advances were evolving, spine treatment centers both in children and adolescents, as well as adults. of excellence evolved throughout the world (United States, Idiopathic Scoliosis: The Harms Study Group Treatment France, United Kingdom, Germany, and elsewhere). The Guide, edited by Peter Newton and colleagues, with multi- German school of scoliosis surgery became internationally ple authors from the Harms Study Group, as well as other recognized in the 1970s and 1980s through the work of Klaus recognized experts from throughout the scoliosis world, Zielke in Bad Wildungen, where I gained first-hand exposure provides state-of-the-art information on the natural history, to German thinking while attending an international scoliosis etiology, and nonoperative treatment, as well as both basic instructional course in the mid-1980s. At that time, a and extremely advanced concepts for surgical correction of dynamic, energetic, and relatively junior-levelprofessor, Jür- spine deformity. gen Harms, presented his work. Despite his young age, whis- Scoliosis fellows, young surgeons, and even experienced pered conversations in the teaching auditorium and operating scoliosis surgeons, will find much that is new and important rooms concluded that Harms represented the future of Ger- in this book. Just reading Robert Dickson on the history, man spine and scoliosis surgery. This new and important text pathogenesis, epidemiology, and basic principals of scolio- represents to a great extent the accuracy of that prophecy. sis treatment justifies owning this book, while at the same Other developments in the 1970s and 1980s included time correcting the intellectual deficit of not having read major advances in the management of scoliosis and spinal or had access to the original The Management of Spinal disorders by brilliant surgeons who worked in regional Deformitiesby Leatherman and Dickson. centers, including Kenton Leatherman at the Kosair Child- This book provides a strong basis for understanding sco- ren’s Hospital in Louisville, Kentucky, and Robert Dickson, liosis as we enter the second decade of the twenty-first a prior fellow with Dr. Leatherman, who then became century and will likely remain a landmark work throughout professor and head of the orthopedic department at the the century—a period which promises unrivaled further University of Leeds in the United Kingdom. Their landmark advances in understanding and treating the still somewhat 1988 textbook, The Management of Spinal Deformities,syn- mysterious condition know as idiopathic scoliosis. thesized a global understanding of scoliosis, but was never revised to a second edition. Instead, that classic text pro- Dennis R. Wenger, MD vided the basic model for this new Harms Study Group Director, Pediatric Orthopedic Training Program book. In fact, the first four chapters are written by Dickson. Rady Children’s Hospital-San Diego The dynamic, innovative, and often complex methods Clinical Professor of Orthopedic Surgery for correcting spinal deformity developed by Harms and University of California–San Diego
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