Surgery for atypical scoliosis

Joseph Gjolaj, Paul David Sponseller

Research output: Contribution to journalArticle

Abstract

Purpose of review: Atypical scoliosis poses challenges for recognition and medical and surgical management. Recent technological advances in spine surgery provide new opportunities for application to atypical deformity. Recent findings: Marfan syndrome must be recognized for proper cardiovascular management. Spinal challenges include early deformity, poor response to bracing, increased blood loss, thin pedicles, risk of cerebrospinal fluid leak, and failure of fixation and adding-on. Neurofibromatosis presents large curves at an early age. Dystrophic apices may present thin pedicles and consequent difficulties of fixation. Anterior surgery should be considered if kyphosis and/or dystrophic curves cannot be corrected. Syringomyelia should be considered in early-onset or left-main thoracic scoliosis, or patients with subtle neurologic findings. Curves less than 45° may stabilize with neurosurgical treatment of the syrinx itself. About 10% of patients with Charcot-Marie-Tooth disorder will have scoliosis. Spinal cord monitoring may be unpredictable. Scoliosis in patients with Ehlers-Danlos syndrome should be approached primarily posteriorly. Summary: Newer principles of spinal deformity can produce significant improvements in management of atypical deformity.

Original languageEnglish (US)
Pages (from-to)222-232
Number of pages11
JournalCurrent Opinion in Orthopaedics
Volume17
Issue number3
DOIs
StatePublished - Jun 2006

Fingerprint

Scoliosis
Ehlers-Danlos Syndrome
Syringomyelia
Marfan Syndrome
Kyphosis
Neurofibromatoses
Syringes
Neurologic Manifestations
Spinal Cord
Tooth
Spine
Thorax
Therapeutics

Keywords

  • Dystrophic spine
  • Marfan
  • Neurofibromatosis
  • Scoliosis
  • Syringomyelia

ASJC Scopus subject areas

  • Surgery

Cite this

Surgery for atypical scoliosis. / Gjolaj, Joseph; Sponseller, Paul David.

In: Current Opinion in Orthopaedics, Vol. 17, No. 3, 06.2006, p. 222-232.

Research output: Contribution to journalArticle

Gjolaj, Joseph ; Sponseller, Paul David. / Surgery for atypical scoliosis. In: Current Opinion in Orthopaedics. 2006 ; Vol. 17, No. 3. pp. 222-232.
@article{04e3da48bb614525a4776ee289f79e3b,
title = "Surgery for atypical scoliosis",
abstract = "Purpose of review: Atypical scoliosis poses challenges for recognition and medical and surgical management. Recent technological advances in spine surgery provide new opportunities for application to atypical deformity. Recent findings: Marfan syndrome must be recognized for proper cardiovascular management. Spinal challenges include early deformity, poor response to bracing, increased blood loss, thin pedicles, risk of cerebrospinal fluid leak, and failure of fixation and adding-on. Neurofibromatosis presents large curves at an early age. Dystrophic apices may present thin pedicles and consequent difficulties of fixation. Anterior surgery should be considered if kyphosis and/or dystrophic curves cannot be corrected. Syringomyelia should be considered in early-onset or left-main thoracic scoliosis, or patients with subtle neurologic findings. Curves less than 45° may stabilize with neurosurgical treatment of the syrinx itself. About 10{\%} of patients with Charcot-Marie-Tooth disorder will have scoliosis. Spinal cord monitoring may be unpredictable. Scoliosis in patients with Ehlers-Danlos syndrome should be approached primarily posteriorly. Summary: Newer principles of spinal deformity can produce significant improvements in management of atypical deformity.",
keywords = "Dystrophic spine, Marfan, Neurofibromatosis, Scoliosis, Syringomyelia",
author = "Joseph Gjolaj and Sponseller, {Paul David}",
year = "2006",
month = "6",
doi = "10.1097/01.bco.0000223530.65019.7a",
language = "English (US)",
volume = "17",
pages = "222--232",
journal = "Current Orthopaedic Practice",
issn = "1940-7041",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Surgery for atypical scoliosis

AU - Gjolaj, Joseph

AU - Sponseller, Paul David

PY - 2006/6

Y1 - 2006/6

N2 - Purpose of review: Atypical scoliosis poses challenges for recognition and medical and surgical management. Recent technological advances in spine surgery provide new opportunities for application to atypical deformity. Recent findings: Marfan syndrome must be recognized for proper cardiovascular management. Spinal challenges include early deformity, poor response to bracing, increased blood loss, thin pedicles, risk of cerebrospinal fluid leak, and failure of fixation and adding-on. Neurofibromatosis presents large curves at an early age. Dystrophic apices may present thin pedicles and consequent difficulties of fixation. Anterior surgery should be considered if kyphosis and/or dystrophic curves cannot be corrected. Syringomyelia should be considered in early-onset or left-main thoracic scoliosis, or patients with subtle neurologic findings. Curves less than 45° may stabilize with neurosurgical treatment of the syrinx itself. About 10% of patients with Charcot-Marie-Tooth disorder will have scoliosis. Spinal cord monitoring may be unpredictable. Scoliosis in patients with Ehlers-Danlos syndrome should be approached primarily posteriorly. Summary: Newer principles of spinal deformity can produce significant improvements in management of atypical deformity.

AB - Purpose of review: Atypical scoliosis poses challenges for recognition and medical and surgical management. Recent technological advances in spine surgery provide new opportunities for application to atypical deformity. Recent findings: Marfan syndrome must be recognized for proper cardiovascular management. Spinal challenges include early deformity, poor response to bracing, increased blood loss, thin pedicles, risk of cerebrospinal fluid leak, and failure of fixation and adding-on. Neurofibromatosis presents large curves at an early age. Dystrophic apices may present thin pedicles and consequent difficulties of fixation. Anterior surgery should be considered if kyphosis and/or dystrophic curves cannot be corrected. Syringomyelia should be considered in early-onset or left-main thoracic scoliosis, or patients with subtle neurologic findings. Curves less than 45° may stabilize with neurosurgical treatment of the syrinx itself. About 10% of patients with Charcot-Marie-Tooth disorder will have scoliosis. Spinal cord monitoring may be unpredictable. Scoliosis in patients with Ehlers-Danlos syndrome should be approached primarily posteriorly. Summary: Newer principles of spinal deformity can produce significant improvements in management of atypical deformity.

KW - Dystrophic spine

KW - Marfan

KW - Neurofibromatosis

KW - Scoliosis

KW - Syringomyelia

UR - http://www.scopus.com/inward/record.url?scp=33646945942&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646945942&partnerID=8YFLogxK

U2 - 10.1097/01.bco.0000223530.65019.7a

DO - 10.1097/01.bco.0000223530.65019.7a

M3 - Article

AN - SCOPUS:33646945942

VL - 17

SP - 222

EP - 232

JO - Current Orthopaedic Practice

JF - Current Orthopaedic Practice

SN - 1940-7041

IS - 3

ER -