File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

TitleOptimal surgical care for adolescent idiopathic scoliosis: an international consensus
Authors
Issue Date2014
PublisherSpringer Berlin Heidelberg.
Citation
European Spine Journal, 2014, v. 23 n. 12, p. 2603-2618 How to Cite?
AbstractPurpose The surgical management of adolescent idiopathic scoliosis (AIS) has seen many developments in the last two decades. Little high-level evidence is available to support these changes and guide treatment. This study aimed to identify optimal operative care for adolescents with AIS curves between 40° and 90° Cobb angle. Methods From July 2012 to April 2013, the AOSpine Knowledge Forum Deformity performed a modified Delphi survey where current expert opinion from 48 experienced deformity surgeons, representing 29 diverse countries, was gathered. Four rounds were performed: three web-based surveys and a final face-to-face meeting. Consensus was achieved with ≥70 % agreement. Data were analyzed qualitatively and quantitatively. Results Consensus of what constitutes optimal care was reached on greater than 60 aspects including: preoperative radiographs; posterior as opposed to anterior (endoscopic) surgical approaches; use of intraoperative spinal cord monitoring; use of local autologous bone (not iliac crest) for grafts; use of thoracic and lumbar pedicle screws; use of titanium anchor points; implant density of <80 % for 40°–70° curves; and aspects of postoperative care. Variability in practice patterns was found where there was no consensus. In addition, there was consensus on what does not constitute optimal care, including: routine pre- and intraoperative traction; routine anterior release; use of bone morphogenetic proteins; and routine postoperative CT scanning. Conclusions International consensus was found on many aspects of what does and does not constitute optimal operative care for adolescents with AIS. In the absence of current high-level evidence, at present, these expert opinion findings will aid health care providers worldwide define appropriate care in their regions. Areas with no consensus provide excellent insight and priorities for future research
Persistent Identifierhttp://hdl.handle.net/10722/203258

 

DC FieldValueLanguage
dc.contributor.authorde Kleuver, Men_US
dc.contributor.authorLewis, SJen_US
dc.contributor.authorGermscheid, NMen_US
dc.contributor.authorKamper, SJen_US
dc.contributor.authorAlanay, Aen_US
dc.contributor.authorBerven, SHen_US
dc.contributor.authorCheung, KMCen_US
dc.contributor.authorIto, Men_US
dc.contributor.authorLenke, LGen_US
dc.contributor.authorPolly, DWen_US
dc.contributor.authorvan Tulder, Men_US
dc.contributor.authorShaffrey, Cen_US
dc.date.accessioned2014-09-19T13:11:35Z-
dc.date.available2014-09-19T13:11:35Z-
dc.date.issued2014en_US
dc.identifier.citationEuropean Spine Journal, 2014, v. 23 n. 12, p. 2603-2618en_US
dc.identifier.urihttp://hdl.handle.net/10722/203258-
dc.description.abstractPurpose The surgical management of adolescent idiopathic scoliosis (AIS) has seen many developments in the last two decades. Little high-level evidence is available to support these changes and guide treatment. This study aimed to identify optimal operative care for adolescents with AIS curves between 40° and 90° Cobb angle. Methods From July 2012 to April 2013, the AOSpine Knowledge Forum Deformity performed a modified Delphi survey where current expert opinion from 48 experienced deformity surgeons, representing 29 diverse countries, was gathered. Four rounds were performed: three web-based surveys and a final face-to-face meeting. Consensus was achieved with ≥70 % agreement. Data were analyzed qualitatively and quantitatively. Results Consensus of what constitutes optimal care was reached on greater than 60 aspects including: preoperative radiographs; posterior as opposed to anterior (endoscopic) surgical approaches; use of intraoperative spinal cord monitoring; use of local autologous bone (not iliac crest) for grafts; use of thoracic and lumbar pedicle screws; use of titanium anchor points; implant density of <80 % for 40°–70° curves; and aspects of postoperative care. Variability in practice patterns was found where there was no consensus. In addition, there was consensus on what does not constitute optimal care, including: routine pre- and intraoperative traction; routine anterior release; use of bone morphogenetic proteins; and routine postoperative CT scanning. Conclusions International consensus was found on many aspects of what does and does not constitute optimal operative care for adolescents with AIS. In the absence of current high-level evidence, at present, these expert opinion findings will aid health care providers worldwide define appropriate care in their regions. Areas with no consensus provide excellent insight and priorities for future researchen_US
dc.languageengen_US
dc.publisherSpringer Berlin Heidelberg.en_US
dc.relation.ispartofEuropean Spine Journalen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleOptimal surgical care for adolescent idiopathic scoliosis: an international consensusen_US
dc.typeArticleen_US
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_US
dc.identifier.authorityCheung, KMC=rp00387en_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s00586-014-3356-1en_US
dc.identifier.hkuros239555en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats