Scoliosis Surgery Normalizes Cardiac Function in Adolescent Idiopathic Scoliosis Patients.

Study Design: Single-center retrospective chart review with minimum 2-year follow up.

Objective: To determine incidence of pulmonary hypertension in adolescent idiopathic scoliosis patients and to determine the effect of scoliosis surgery on pulmonary hypertension.

Summary Of Background Data: Spinal deformity in adolescent idiopathic scoliosis can increase right atrial and ventricular pressures secondary to restrictive lung disease.

The menisci are not shock absorbers: A biomechanical and comparative perspective.

The lateral and medial menisci are fibrocartilaginous structures in the knee that play a crucial role in normal knee biomechanics. However, one commonly cited role of the menisci is that they function as "shock absorbers." Here we provide a critique of this notion, drawing upon a review of comparative anatomical and biomechanical data from humans and other tetrapods.

Is step width decoupled from pelvic motion in human evolution?

Humans are the only primate that walk bipedally with adducted hips, valgus knees, and swing-side pelvic drop. These characteristic frontal-plane aspects of bipedalism likely play a role in balance and energy minimization during walking. Understanding when and why these aspects of bipedalism evolved also requires an understanding of how each of these features are interrelated during walking.

The Screw-Aorta Dilemma: Changing Patient Position in Computed Tomography Scan Is Critical in Documenting Aortic Mobility.

Study Design: Retrospective chart review.

Objective: To determine if obtaining a prone computed tomography (CT)-scan can better delineate a questionable screw-aorta relationship.

Summary Of Background Data: Pedicle screw misplacement rate is reported between 6% and 15%.

Academic Metrics Do Not Explain the Underrepresentation of Women in Orthopaedic Training Programs.

Background: Among medical specialties, orthopaedic surgery persistently has one of the lowest representations of women in residency programs. This study examined whether differences exist in the academic metrics of the orthopaedic residency applicants and enrolled candidates by sex, which may be contributing to the persistent underrepresentation of women. Differences in enrollment rate in orthopaedic residency programs also were analyzed.

Fentanyl versus remifentanil-based TIVA for pediatric scoliosis repair: does it matter?

Introduction: Opioid-induced hyperalgesia (OIH) and acute opioid tolerance have been demonstrated extensively in patients undergoing adolescent idiopathic scoliosis (AIS) repair. Remifentanil infusion has been strongly linked to both tolerance and OIH in these patients; however, the impact of using an intraoperative fentanyl infusion has not been well studied. This study aims to determine if patients undergoing operative management of AIS have decreased opioid consumption and pain scores when an intraoperative fentanyl infusion is used as compared with a remifentanil infusion.

Current Trends in Sex, Race, and Ethnic Diversity in Orthopaedic Surgery Residency.

Background: The representation of minorities among medical students has increased over the past two decades, but diversity among orthopaedic residents lags behind. This phenomenon has occurred despite a recent focus by the American Academy of Orthopaedic Surgeons on the recruitment of minorities and women.

Objective: To analyze the impact of recent efforts on diversity in orthopaedic residents in comparison with other surgical specialties from 2006 to 2015.

Underrepresented Minority Applicants Are Competitive for Orthopaedic Surgery Residency Programs, but Enter Residency at Lower Rates.

Introduction: Orthopaedic surgery residency programs have the lowest representation of ethnic/racial minorities compared with other specialties. This study compared orthopaedic residency enrollment rates and academic metrics of applicants and matriculated residents by race/ethnicity.

Methods: Data on applicants from US medical schools for orthopaedic residency and residents were analyzed from 2005 to 2014 and compared between race/ethnic groups (White, Asian, Black, Hispanic, and Other).

Evaluation of Sex, Ethnic, and Racial Diversity Across US ACGME-Accredited Orthopedic Subspecialty Fellowship Programs.

In recent years, there has been an increasing trend toward subspecialization in orthopedic surgery via fellowships. This study sought to characterize sex, ethnic, and racial representation within each fellowship program and to examine their changes over time to identify trends and/or gaps. Demographic data were obtained from the National Graduate Medical Education Census.

Cadaveric Study of the Safety and Device Functionality of Magnetically Controlled Growing Rods After Exposure to Magnetic Resonance Imaging.

Study Design: Cadaveric study.

Objective: To establish the safety and efficacy of magnetically controlled growing rods (MCGRs) after magnetic resonance imaging (MRI) exposure.

Summary Of Background Data: MCGRs are new and promising devices for the treatment of early-onset scoliosis (EOS).

When Do Patients Return to Physical Activities and Athletics After Scoliosis Surgery?: A Validated Patient Questionnaire Based Study.

Study Design: A retrospective chart review with a survey.

Objectives: This study seeks to determine time of return to normal, physical and athletic activities, and delaying factors after all pedicle screw fixation.

Summary Of Background Data: Return to athletic activity after posterior spine fusion (PSF) in adolescent idiopathic scoliosis (AIS) is largely dependent on a surgeon's philosophy.

Pedicle Screw Safety: How Much Anterior Breach Is Safe?: A Cadaveric and CT-Based Study.

Unlabelled: MINI: The objective of this study was to determine the safety limits of anterior/anterolateral pedicle screw breaches. Through clinical and cadaveric study, it appears that less than 4 mm of breach has a significantly lower likelihood of impingement on vital structures (P < 0.001).

Can Postoperative Radiographs Accurately Identify Screw Misplacements?

Study Design: Retrospective case series.

Objective: The objective of this study was to determine the safety of postoperative radiographs to assess screw placement.

Summary Of Background Data: Previously defined criteria are frequently employed to determine pedicle screw placement on intraoperative supine radiographs.

A pilot cadaveric study of temperature and adjacent tissue changes after exposure of magnetic-controlled growing rods to MRI.

Purpose: To test for possible thermal injury and tissue damage caused by magnetic-controlled growing rods (MCGRs) during MRI scans.

Methods: Three fresh frozen cadavers were utilized. Four MRI scans were performed: baseline, after spinal hardware implantation, and twice after MCGR implantation.

MRIs Are Less Accurate Tools for the Most Critically Worrisome Pedicles Compared to CT Scans.

Study Design: Retrospective review of magnetic resonance imaging (MRI) and computed tomographic (CT) scan imaging modalities.

Objective: To determine MRI's capability of identifying pedicle morphology.

Summary Of Background Data: Understanding pedicle morphology is important for accurate placement of pedicle screws.

Triggered EMG Potentials in Determining Neuroanatomical Safe Zone for Transpsoas Lumbar Approach: Are They Reliable?

Study Design: In vivo analysis in swine model.

Objective: The purpose of this study was to determine the accuracy of triggered EMG (t-EMG) and its reliability in lateral lumbar interbody fusions surgery. We also aim to document changes in psoas muscle produced during the approach.

Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis.

Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients.

Are We Underestimating the Significance of Pedicle Screw Misplacement?

Study Design: A retrospective review of charts, x-rays (XRs) and computed tomography (CT) scans was performed.

Objective: To evaluate the accuracy of pedicle screw placement using a novel classification system to determine potentially significant screw misplacement.

Summary Of Background Data: The accuracy rate of pedicle screw (PS) placement varies from 85% to 95% in the literature.

CT-Based Anatomical Evaluation of Pre-Vertebral Structures With Respect to Vertebral Body Using a Clock-Face Analogy.

Study Design: Retrospective Chart and CT Scan Review.

Objective: To define the relationship of the pre-vertebral structures for each level to assist in easier intraoperative visualization.

Summary Of Background Data: Vascular and visceral injuries from pedicle screws are well-known.