Displaying publications 1 - 20 of 70 in total

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  1. Chan CY, Kwan MK, Saw LB
    Surg Radiol Anat, 2011 Jan;33(1):19-25.
    PMID: 20848102 DOI: 10.1007/s00276-010-0726-1
    Pedicle screw instrumentation has superior biomechanical as well as clinical outcome. Thoracic pedicles show great variation in different population groups, particularly in Asians who have been shown to have smaller pedicle dimensions. Although plain radiographs are widely performed prior to spine surgery, no studies have been done so far to investigate whether the thoracic pedicle profile on plain radiographs affect thoracic pedicle screw insertion. Therefore, this is a cadaveric study aimed to determine the relationship between plain radiographic thoracic pedicle profile in Asians and the outcome of pedicle screw insertion in the thoracic spine.
    Matched MeSH terms: Thoracic Vertebrae/radiography; Thoracic Vertebrae/surgery*
  2. Foo CH, Hii BYS, Wong CC, Ohn KM
    BMJ Case Rep, 2021 Jul 12;14(7).
    PMID: 34253529 DOI: 10.1136/bcr-2021-243788
    Postoperative pseudomeningocele usually has a benign course. We report a rare presentation of postoperative acute neurological deficit caused by compressive thoracic pseudomeningocele. This patient had posterior spinal fusion and decompression surgery for thoracic ossification of posterior longitudinal ligament and ligamentum flavum. Intraoperative incidental durotomy was covered with hydrogel dural sealant. She developed acute neurological deterioration 1 week after index surgery. Emergency decompression surgery was performed. One year after the surgery, she showed good neurological recovery.
    Matched MeSH terms: Thoracic Vertebrae/surgery
  3. Muhammad MT, Kwan MK, Chan CY, Lim BS, Goh DW
    Med J Malaysia, 2012 Dec;67(6):633-5.
    PMID: 23770965 MyJurnal
    A 15-year-old teenager with Type 1 Neurofibromatosis presented with grade 4 spondylolisthesis over T12/L1 junction resulting paraparesis (Frankel D). Radiograph showed a Cobb angle of 88 degrees. Computed tomography scan showed dysplastic vertebral bodies, pedicles and facet joints of T11, T12 and L1 vertebra with complete T12/L1 facets dislocation. Magnetic resonance imaging confirmed presence of spinal cord compression. He underwent posterior instrumentation and posterolateral fusion (T8 to L4) using hybrid instrumentation. Extensive corticotomy of the posterior elements was followed by the use of large amount of bone graft. Post operatively, his neurology improved markedly back to normal. Radiographs showed a good correction of the deformity. He was immobilized in a thoracolumbar orthosis for six months. A solid posterior fusion was achieved at six months follow up. At 36-month follow up, he remained asymptomatic. This case report illustrates a successful treatment of a grade 4 thoracolumbar spondylolisthesis secondary to neurofibromatosis with posterior spinal fusion alone.
    Matched MeSH terms: Thoracic Vertebrae*
  4. Chee CP
    Neurosurgery, 1987 Nov;21(5):749-51.
    PMID: 3696416
    The author describes a posterolateral extradural approach for total excision of small to moderate symptomatic lateral thoracic meningoceles. Its advantages over the classical laminectomy, intradural repair, and thoracotomy excision are discussed.
    Matched MeSH terms: Thoracic Vertebrae/surgery*
  5. Kwan MK, Chiu CK, Gani SMA, Wei CCY
    Spine (Phila Pa 1976), 2017 Mar;42(5):326-335.
    PMID: 27310021 DOI: 10.1097/BRS.0000000000001738
    STUDY DESIGN: Retrospective review of CT scan.

    OBJECTIVE: To investigate the accuracy and safety of pedicle screws placed in adolescent idiopathic scoliosis (AIS) patients.

    SUMMARY OF BACKGROUND DATA: The reported pedicle screws perforation rates for corrective AIS surgery vary widely from 1.2% to 65.0%. Knowledge regarding the safety of pedicle screws in scoliosis surgery is very important in preventing complications.

    METHODS: This study investigates the accuracy and safety of pedicle screws placed in 140 AIS patients. CT scans were used to assess the perforations that were classified according to Rao et al (2002): grade 0, grade 1 (<2 mm), grade 2 (2-4 mm), and grade 3 (>4 mm). Anterior perforations were classified into grade 0, grade 1 (<4 mm), grade 2 (4-6 mm), and grade 3 (>6 mm). Grade 2 and 3 (excluding lateral grade 2 and 3 perforation over thoracic vertebrae) were considered as critical perforations.

    RESULTS: A total of 2020 pedicle screws from 140 patients were analyzed. The overall total perforation rate was 20.3% (410 screws) with 8.2% (166 screws) grade 1, 2.9% (58 screws) grade 2 and 9.2% (186 screws) grade 3 perforations. Majority of the perforations was because of lateral perforation occurring over the thoracic region, as a result of application of extrapedicular screws at this region. When the lateral perforations of the thoracic region were excluded, the perforation rate was 6.4% (129 screws), grade 2, 1.4% (28 screws) and grade 3, 0.8% (16 screws). There were only two symptomatic left medial grade 2 perforations: one screw at T12 presented with postoperative iliac crest numbness and another screw at L2 presented with radicular pain that subsided with conservative treatment. There were six anterior perforations abutting the right lung, four anterior perforations abutting the aorta, two anterior perforations abutting the esophagus, and one abutting the trachea was noted.

    CONCLUSION: Pedicle screws insertion in AIS has a total perforation rate of 20.3%. After exclusion of lateral thoracic perforations, the overall perforation rate was 8.6% with a critical perforation rate of 2.2% (44/2020). The rate of symptomatic screw perforation leading to radicular symptoms was 0.1%. There was no spinal cord, aortic, esophageal, or lung injuries caused by malpositioned screws in this study.

    LEVEL OF EVIDENCE: 4.

    Matched MeSH terms: Thoracic Vertebrae/surgery*
  6. Lim HH, Choon DSK
    Med J Malaysia, 2000 Sep;55 Suppl C:29-34.
    PMID: 11200041
    Segmental spinal instrumentation with Harrington rod secured to the spine by sublaminar wires was a popular method of scoliosis correction in 1980's. It was gradually replaced by newer rod-hook systems due to concern about neurological complications. However, correction of type II and III curves by selectively fusing the thoracic curves with these new instruments has resulted in poor results in some cases. The aim of this study is to review the result of selective thoracic fusion treated by segmental spinal instrumentation. Between January 1989 to October 1994, 31 patients with King II scoliosis were treated operatively in our unit. These consisted of 29 girls and 2 boys. The mean age of these patients were 11.3 years. The study population consisted of 21 Chinese, 5 Malays and 5 Indians. In one patient, the thoracic curve was convex to the left whilst the thoracic curves in the majority were to the right. The surgery was performed by three surgeons using harrington rods and posterior fusion with autograft. Anterior releases were also required in eight patients to increase flexibility. The curve correction obtained was an improvement from a average preoperative cobb's angle of 71.5 degrees to 39.5 degrees postoperatively. After an average follow-up period of 77.9 months, the correction deteriorated by 22% in the thoracic curve and 59% in the lumbar spine without disturbance to truncal balance. Only one sublaminar wire broke. However, no implant failure or removal has to be performed as yet. This technique appears useful in our institution with minimal morbidity.
    Matched MeSH terms: Thoracic Vertebrae/surgery*
  7. Chan CYW, Naing KS, Chiu CK, Mohamad SM, Kwan MK
    J Orthop Surg (Hong Kong), 2019 6 25;27(2):2309499019857250.
    PMID: 31232161 DOI: 10.1177/2309499019857250
    PURPOSE: To analyze the incidence, pattern, and contributing factors of pelvic obliquity among Adolescent Idiopathic Scoliosis (AIS) patients who will undergo surgery.

    METHODS: In total, 311 patients underwent erect whole spine anteroposterior, lateral and lower limb axis films. Radiographic measurements included Transilium Pelvic Height Difference (TPHD; mm), Hip Abduction-Adduction angle (H/Abd-Add; °), Lower limb Length Discrepancy (LLD; mm), and Pelvic Hypoplasia (PH angle; °). The incidence and severity of pelvic obliquity were stratified to Lenke curve subtypes in 311 patients. The causes of pelvic obliquity were analyzed in 57 patients with TPHD ≥10 mm.

    RESULTS: The mean Cobb angle was 64.0 ± 17.2°. Sixty-nine patients had a TPHD of 0 mm (22.2%). The TPHD was <5 mm in 134 (43.0%) patients, 5-9 mm in 104 (33.4%) patients, 10-14 mm in 52 (16.7%) patients, 15-19 mm in 19 (6.1%) patients, and ≥20 mm in only 2 (0.6%) patients. There was a significant difference between the Lenke curve types in terms of TPHD (p = 0.002). L6 curve types had the highest TPHD of 9.0 ± 6.3 mm followed by L5 curves, which had a TPHD of 7.1 ± 4.8 mm. In all, 44.2% of L1 curves and 50.0% of L2 curves had positive TPHD compared to 66.7% of L5 curves and 74.1% of L6 curves which had negative TPHD. 33.3% and 24.6% of pelvic obliquity were attributed to PH and LLD, respectively, whereas 10.5% of cases were attributed to H/Abd-Add positioning.

    CONCLUSIONS: 76.4% of AIS cases had pelvic obliquity <10 mm; 44.2% of L1 curves and 50.0% of L2 curves had a lower right hemipelvis compared to 66.7% of L5 curves and 74.1% of L6 curves, which had a higher right hemipelvis. Among patients with pelvic obliquity ≥10 mm, 33.3% were attributed to PH, whereas 24.6% were attributed to LLD.

    Matched MeSH terms: Thoracic Vertebrae/surgery*
  8. Sardi JP, Lazaro B, Smith JS, Kelly MP, Dial B, Hills J, et al.
    J Neurosurg Spine, 2023 Feb 01;38(2):217-229.
    PMID: 36461845 DOI: 10.3171/2022.8.SPINE22423
    OBJECTIVE: Previous reports of rod fracture (RF) in adult spinal deformity are limited by heterogeneous cohorts, low follow-up rates, and relatively short follow-up durations. Since the majority of RFs present > 2 years after surgery, true occurrence and revision rates remain unclear. The objectives of this study were to better understand the risk factors for RF and assess its occurrence and revision rates following primary thoracolumbar fusions to the sacrum/pelvis for adult symptomatic lumbar scoliosis (ASLS) in a prospective series with long-term follow-up.

    METHODS: Patient records were obtained from the Adult Symptomatic Lumbar Scoliosis-1 (ASLS-1) database, an NIH-sponsored multicenter, prospective study. Inclusion criteria were as follows: patients aged 40-80 years undergoing primary surgeries for ASLS (Cobb angle ≥ 30° and Oswestry Disability Index ≥ 20 or Scoliosis Research Society-22r ≤ 4.0 in pain, function, and/or self-image) with instrumented fusion of ≥ 7 levels that included the sacrum/pelvis. Patients with and without RF were compared to assess risk factors for RF and revision surgery.

    RESULTS: Inclusion criteria were met by 160 patients (median age 62 years, IQR 55.7-67.9 years). At a median follow-up of 5.1 years (IQR 3.8-6.6 years), there were 92 RFs in 62 patients (38.8%). The median time to RF was 3.0 years (IQR 1.9-4.54 years), and 73% occurred > 2 years following surgery. Based on Kaplan-Meier analyses, estimated RF rates at 2, 4, 5, and 8 years after surgery were 11%, 24%, 35%, and 49%, respectively. Baseline radiographic, clinical, and demographic characteristics were similar between patients with and without RF. In Cox regression models, greater postoperative pelvic tilt (HR 1.895, 95% CI 1.196-3.002, p = 0.0065) and greater estimated blood loss (HR 1.02, 95% CI 1.005-1.036, p = 0.0088) were associated with increased risk of RF. Thirty-eight patients (61% of all RFs) underwent revision surgery. Bilateral RF was predictive of revision surgery (HR 3.52, 95% CI 1.8-6.9, p = 0.0002), while patients with unilateral nondisplaced RFs were less likely to require revision (HR 0.39, 95% CI 0.18-0.84, p = 0.016).

    CONCLUSIONS: This study provides what is to the authors' knowledge the highest-quality data to date on RF rates following ASLS surgery. At a median follow-up of 5.1 years, 38.8% of patients had at least one RF. Estimated RF rates at 2, 4, 5, and 8 years after surgery were 11%, 24%, 35%, and 49%, respectively. Greater estimated blood loss and postoperative pelvic tilt were significant risk factors for RF. These findings emphasize the importance of long-term follow-up to realize the true prevalence and cumulative incidence of RF.

    Matched MeSH terms: Thoracic Vertebrae/surgery
  9. Chung WH, Mihara Y, Chiu CK, Hasan MS, Chan CYW, Kwan MK
    Clin Spine Surg, 2022 Feb 01;35(1):18-23.
    PMID: 33979103 DOI: 10.1097/BSD.0000000000001186
    STUDY DESIGN: This was a retrospective study.

    SUMMARY OF BACKGROUND DATA: Prolonged operation duration in adolescent idiopathic scoliosis (AIS) surgery was associated with increased perioperative complications. However, the factors affecting operation duration in AIS surgery were unknown.

    OBJECTIVE: The aim of the study was to investigate the factors affecting operation duration in posterior spinal fusion (PSF) surgery using a dual attending surgeon strategy among Lenke 1 and 2 AIS patients.

    METHODS: In all, 260 AIS patients with Lenke 1 and 2 curves who underwent PSF were retrospectively reviewed. Preoperative and intraoperative factors affecting operation duration such as age, sex, height, weight, body mass index, Risser grade, Lenke subtypes, number of fusion level, number of screws, screw density, wound length, upper and lowest instrumented vertebrae level, preoperative Cobb angle, and flexibility of the major curve were assessed using univariate and multivariate linear regression analyses. Independent factors were determined when P-value <0.05.

    RESULTS: The mean operation duration was 122.2±28.6 minutes. Significant independent factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 subtypes (β=8.86, P=0.008), number of screws (β=7.01, P<0.001), wound length (β=1.14, P=0.009), and flexibility of the major curve (β=-0.25, P=0.005). The overall model fit was R2=0.525. Operation duration can be predicted using the formula: (8.86×Lenke subtypes)+(7.01×number of screws)+(1.14×wound length)-(0.25×flexibility)-0.54, where Lenke 2=1 and Lenke 1=0.

    CONCLUSION: The factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 curves, number of screws, wound length, and curve flexibility. The knowledge of these factors enables the spinal deformity surgeons to plan and estimate the operation duration before AIS surgery.

    Matched MeSH terms: Thoracic Vertebrae/surgery
  10. Kwan MK, Abdelhai AM, Saw LB, Chan CY
    Spine (Phila Pa 1976), 2012 Dec 15;37(26):E1676-9.
    PMID: 23044619 DOI: 10.1097/BRS.0b013e318276b48c
    Case report.
    Matched MeSH terms: Thoracic Vertebrae/pathology*; Thoracic Vertebrae/radiography
  11. Hassan E, Liau KM, Ariffin I, Halim Yusof A
    Spine (Phila Pa 1976), 2010 Jun 1;35(13):1253-6.
    PMID: 20461037 DOI: 10.1097/BRS.0b013e3181c1172b
    A cross sectional study of thoracic pedicle morphometry in the immature spine of Malaysian population using reformatted computed tomographic (CT) images.
    Matched MeSH terms: Thoracic Vertebrae/radiography*; Thoracic Vertebrae/surgery*
  12. Wong CC, Ting F, Wong B, Lee PI
    Med J Malaysia, 2005 Jul;60 Suppl C:35-40.
    PMID: 16381281
    Pedicle screw system has increasingly been used for correction of thoracic scoliosis. It offers several biomechanical advantages over hook system as it controls all three-column of the spine with enhanced stability. Of many techniques of pedicle screw placement in the thoracic spine, the funnel technique has been used in Sarawak General Hospital since 2002. This prospective study aims to assess the accuracy of the placement of thoracic pedicle screws using the funnel technique in the corrective surgery of idiopathic scoliosis. A total of 88 thoracic pedicle screws were inserted into the T4 to T12 vertebrae of 11 patients. Post-operative CT-scan was performed to evaluate the position of the pedicle screw. Seventy six (86.4%) screws were noted to be totally within the pedicle. There was no screw with medial violation of the pedicle, 8 (9.1%) screws breeching the lateral wall of the pedicle and 4 (4.5%) screws with anterior and lateral penetration of the vertebral body. No clinical sequel with the mal-positioned screws was noted. In conclusion, the funnel technique enabled simple, accurate and reliable insertion of pedicle screw even in the scoliotic thoracic spine without the need of any imaging guidance. It is however imperative for the surgeon to have a thorough knowledge of the thoracic spine anatomy, and to be familiar with the technique to insert these screws diligently.
    Matched MeSH terms: Thoracic Vertebrae/radiography; Thoracic Vertebrae/surgery*
  13. Liau KM, Yusof MI, Abdullah MS, Abdullah S, Yusof AH
    Spine (Phila Pa 1976), 2006 Jul 15;31(16):E545-50.
    PMID: 16845341
    A cross-sectional study of thoracic pedicle morphometry (T1-T12) of 180 Malaysian Malay patients obtained from computed tomographic scan.
    Matched MeSH terms: Thoracic Vertebrae/radiography*; Thoracic Vertebrae/surgery*
  14. Chan CYW, Aziz I, Chai FW, Kwan MK
    Spine (Phila Pa 1976), 2017 Feb 15;42(4):E248-E252.
    PMID: 28207671 DOI: 10.1097/BRS.0000000000001748
    STUDY DESIGN: Case report.

    OBJECTIVE: To report the successful rehabilitation and the training progress of an elite high performance martial art exponent after selective thoracic fusion for Adolescent Idiopathic Scoliosis (AIS).

    SUMMARY OF BACKGROUND DATA: Posterior spinal fusion for AIS will result in loss of spinal flexibility. The process of rehabilitation after posterior spinal fusion for AIS remains controversial and there are few reports of return to elite sports performance after posterior spinal fusion for AIS.

    METHODS: We report a case of a 25-year-old lady who was a national Wu Shu exponent. She was a Taolu (Exhibition) exponent. She underwent Selective Thoracic Fusion (T4 to T12) using alternate level pedicle screw placement augmented with autogenous local bone graft in June 2014. She commenced her training at 3-month postsurgery and the intensity of her training was increased after 6 months postsurgery. We followed her up to 2 years postsurgery and showed no instrumentation failure or lost of correction.

    RESULTS: After selective thoracic fusion, her training process consisted of mainly speed training, core strengthening, limb strengthening, and flexibility exercises. At 17 months of postoperation, she participated in 13th World Wu Shu Championship 2015 and won the silver medal.

    CONCLUSION: Return to elite high-performance martial arts sports was possible after selective thoracic fusion for AIS. The accelerated and intensive training regime did not lead to any instrumentation failure and complications.

    LEVEL OF EVIDENCE: 2.

    Matched MeSH terms: Thoracic Vertebrae/physiopathology*; Thoracic Vertebrae/surgery*
  15. Chung WH, Eu WC, Chiu CK, Chan CYW, Kwan MK
    J Orthop Surg (Hong Kong), 2019 12 27;28(1):2309499019888977.
    PMID: 31876259 DOI: 10.1177/2309499019888977
    PURPOSE: To describe the reduction technique of thoracolumbar burst fracture using percutaneous monoaxial screws and its radiological outcomes compared to polyaxial screws.

    METHODS: All surgeries were performed by minimally invasive technique with either percutaneous monoaxial or percutaneous polyaxial screws inserted at adjacent fracture levels perpendicular to both superior end plates. Fracture reduction is achieved with adequate rod contouring and distraction maneuver. Radiological parameters were measured during preoperation, postoperation, and follow-up.

    RESULTS: A total of 21 patients were included. Eleven patients were performed with monoaxial pedicle screws and 10 patients performed with polyaxial pedicle screws. Based on AO thoracolumbar classification system, 10 patients in the monoaxial group had A3 fracture type and 1 had A4. In the polyaxial group, six patients had A3 and four patients had A4. Total correction of anterior vertebral height (AVH) ratio was 0.30 ± 0.10 and 0.08 ± 0.07 in monoaxial and polyaxial groups, respectively (p < 0.001). Total correction of posterior vertebral height (PVH) ratio was 0.11 ± 0.05 and 0.02 ± 0.02 in monoaxial and polyaxial groups, respectively (p < 0.001). Monoaxial group achieved more correction of 13° (62.6%) in local kyphotic angle compared to 8.2° (48.0%) in polyaxial group. Similarly, in regional kyphotic angle, 16.5° (103.1%) in the monoaxial group and 8.1° (76.4%) in the polyaxial group were achieved.

    CONCLUSIONS: Monoaxial percutaneous pedicle screws inserted at adjacent fracture levels provided significantly better fracture reduction compared to polyaxial screws in thoracolumbar fractures.

    Matched MeSH terms: Thoracic Vertebrae/injuries*; Thoracic Vertebrae/surgery
  16. Kwan MK, Chiu CK, Lee CK, Chan CY
    Bone Joint J, 2015 Nov;97-B(11):1555-61.
    PMID: 26530660 DOI: 10.1302/0301-620X.97B11.35789
    Percutaneous placement of pedicle screws is a well-established technique, however, no studies have compared percutaneous and open placement of screws in the thoracic spine. The aim of this cadaveric study was to compare the accuracy and safety of these techniques at the thoracic spinal level. A total of 288 screws were inserted in 16 (eight cadavers, 144 screws in percutaneous and eight cadavers, 144 screws in open). Pedicle perforations and fractures were documented subsequent to wide laminectomy followed by skeletalisation of the vertebrae. The perforations were classified as grade 0: no perforation, grade 1: < 2 mm perforation, grade 2: 2 mm to 4 mm perforation and grade 3: > 4 mm perforation. In the percutaneous group, the perforation rate was 11.1% with 15 (10.4%) grade 1 and one (0.7%) grade 2 perforations. In the open group, the perforation rate was 8.3% (12 screws) and all were grade 1. This difference was not significant (p = 0.45). There were 19 (13.2%) pedicle fractures in the percutaneous group and 21 (14.6%) in the open group (p = 0.73). In summary, the safety of percutaneous fluoroscopy-guided pedicle screw placement in the thoracic spine between T4 and T12 is similar to that of the conventional open technique.
    Matched MeSH terms: Thoracic Vertebrae/injuries; Thoracic Vertebrae/radiography; Thoracic Vertebrae/surgery*
  17. Kwan MK, Loh KW, Chung WH, Chiu CK, Hasan MS, Chan CYW
    BMC Musculoskelet Disord, 2021 May 04;22(1):413.
    PMID: 33947368 DOI: 10.1186/s12891-021-04225-5
    BACKGROUND: There has been a growing interest in using all pedicle screw construct in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) surgery in recent years. However, studies focusing on perioperative outcome and complications utilizing only pedicle screw system in AIS population are lacking. This study aims to evaluate perioperative outcomes and to determine the prevalence of major and minor complications following single-staged PSF for AIS.

    METHODS: In this retrospective study of prospectively collected data, 1057 AIS patients operated between 2012 and 2019 were included. Main outcome measures were operative time, intraoperative blood loss, allogeneic blood transfusion rate, length of hospital stay after surgery, complication rate, and mean drop of haemoglobin (Hb) level. We documented the number of fusion levels, screw density, and postoperative radiographic parameters.

    RESULTS: There were 917 females and 140 males. Majority were Lenke 1 curve type (46.9%). Mean age was 15.6 ± 3.7 years, with mean BMI of 18.6 ± 3.2 kg/m2. Mean operative time was 146.8 ± 49.4 min. Average intraoperative blood loss was 952.9 ± 530.4 ml with allogeneic blood transfusion rate of 5%. Mean screw density was 1.27 ± 0.21 screws per fusion level. Average hospital stay after surgery was 3.5 ± 0.9 days. Twenty-four complications were documented: twelve superficial infections (1.14%), five transient neurological deficits (0.47%), two deep infections (0.19%), two superior mesenteric artery syndrome, and one case each (0.09%) for massive intraoperative blood loss, intraoperative seizure, and lung atelectasis.

    CONCLUSION: AIS patients treated with single-staged PSF using pedicle screw construct had a 0.95% rate of major complications and 1.32% rate of minor complications. Rate of neurologic complication was 0.47% while non-neurologic postoperative complications was 1.80% with infection being the leading complication at 1.32%.

    Matched MeSH terms: Thoracic Vertebrae
  18. Mihara Y, Chung WH, Mohamad SM, Chiu CK, Chan CYW, Kwan MK
    Eur Spine J, 2021 03;30(3):653-660.
    PMID: 33486626 DOI: 10.1007/s00586-020-06701-3
    PURPOSE: Knowledge on the factors affecting the correction rate (CR) aids in the surgical planning among severe idiopathic scoliosis (IS) patients. This study aimed to investigate the independent factors affecting CR among patients with severe IS (Cobb angle ≥ 90°) who underwent single-staged posterior spinal fusion (PSF).

    METHODS: We retrospectively reviewed 128 severe IS patients who underwent single-staged PSF. Factors including age, height, weight, body mass index, Risser sign, Lenke subtypes, preoperative major Cobb angle, side bending major Cobb angle, side bending flexibility (SBF), motion segments of the major curve, AR curve, number of levels fused, screw density, operative time and postoperative major Cobb angle were analysed using linear regression analysis.

    RESULTS: The mean age was 15.5 ± 4.5 years with mean Risser sign of 3.1 ± 1.6. The mean preoperative Cobb, SBF, postoperative Cobb and CR were 102.8 ± 12.3°, 37.5 ± 13.7%, 44.4 ± 13.5° and 57.2 ± 10.8%, respectively. From stepwise multiple linear regression analysis, SBF, Risser sign and AR curve were the independent predictive factors for CR, with R2 value of 0.345 (p 

    Matched MeSH terms: Thoracic Vertebrae
  19. Norazian, K., Saw, L.B., Chan, C.Y.W., Amin, R., Kwan, M.K.
    Malays Orthop J, 2010;4(3):22-25.
    MyJurnal
    Chondrosarcoma of the spine is rare; it presents predominantly in very young males and presentation with neurological deficit is uncommon. Treatment of this type of tumour is mainly through surgery as adjuvant therapy is ineffective. En bloc resection of tumours in the spine are difficult although it remains the recommended treatment for chondrosarcoma. We report here presentation of a female with paresis (Frankel C) whom was diagnosed with a large chondrosarcoma of the T2 vertebra extending to the right upper thoracic cavity. The patient underwent radical xcision through an anterior and posterior approach to the spine.
    Matched MeSH terms: Thoracic Vertebrae
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