Selection of fusion levels in adolescent idiopathic scoliosis (AIS) using the fulcrum bending radiograph prediction: verification based on pedicle screw strategy

E-Poster - Adolescent Idiopathic Scoliosis: no. 297Utilizing the fulcrum bending radiographic technique to assess curve flexibility to aid in the selection of fusion levels, a prospective radiographic study was performed to assess the safety and effectiveness of pedicle screw fixation with alternate level screw strategy (ALSS) for thoracic AIS. This study suggests that ALSS obtains greater deformity correction than hook and hybrid systems, and improves balance without compromising fusion levels.postprin

'Clinical Triad' findings in Klippel-feil patients

E-Poster - Congenital Deformity: no. 530It has been propagated that Klippel-Feil Syndrome (KFS) is associated with the clinical triad findings (CTF) of short neck, low posterior hairline, and limited range of motion. This study noted that CTFs are not consistently noted in KFS patients. KFS patients with extensive congenitally fused cervical segments were more likely to exhibit one of the components of CTF.postprin

The safety and efficacy of a remotely distractible, magnetic controlled growing rod (MCGR) for the treatment of scoliosis in children: a prospective case series with minimum two year follow-up

Concurrent Session 2B - Early Onset Scoliosis: paper no. 26SUMMARY: The growing rod has been the gold standard for the treatment of scoliosis in young children. However, such management requires multiple open surgeries under general anesthesia for rod distraction and is associated with numerous postoperative complications. To avoid such pitfalls, we utilized a magnetically-controlled growing rod (MCGR) implant. Our study found that the MCGR was safe and effective, allowing for distractions on a non-invasive out-patient basis at monthly intervals, eliminating the need for surgeries and their associated complications. Introduction: Traditionally, growing rods are the standard of treatment for young children with severe spinal deformities and significant residual growth potential. However, this requires repeated open distractions under general anesthesia and is associated with numerous post-operative complications. This report addresses the safety and efficacy of the MCGR implant for non-invasive out-patient distractions for scoliosis correction in young children. METHODS: This was a prospective, patient series of the MCGR procedure. From November 2009 to March 2011, five patients (n=3 female; n=2 male) were treated with the MCGR. In this study, we report the first three patients (2 females and 1 male) with minimum 2 years follow-up. All cases were non-invasively distracted using an external magnet on a monthly basis. Pre and post distraction radiographs were carried out to assess the Cobb’s angle, predicted versus achieved rod distraction length and spinal length. Clinical outcome assessment was performed with the pain score (Visual Analogue Scale) and the SRS-30 questionnaire. All procedural or rod related complications were recorded. RESULTS: The main correction of the Cobb’s angle was obtained in the initial surgery and was maintained. The mean monthly increase in T1-T12, T1-S1 and instrumented segment length was 1.6mm, 2.5mm and 1.2mm, respectively. Predicted versus actual length gain per distraction were similar. One case had a superficial wound infection and there was one event of loss of distraction. On last follow-up, no pain was noted and SRS-30 scores remained unchanged to baseline. CONCLUSION: The MCGR is a safe and effective procedure for the surgical treatment of scoliosis in children. The MCGR provides external distractions on an out-patient basis without the need for sedation or anesthesia, and that remote distraction allows more frequent lengthening of the rod that may more closely mimic physiologic growth.postprin

Next generation of growth-sparing techniques: preliminary clinical results of a magnetically controlled growing rod in 14 patients

Session 3A - Early Onset Scoliosis: Paper no. 33SUMMARY: Growth-sparing techniques are commonly used for the treatment of progressive EOS. The standard growing rod (GR) technique requires multiple surgeries for lengthening. The preliminary results of MCGR has shown the comparable outcomes to standard GR without the need for repeated surgery which can be expected to reduce the overall complication rate in GR surgery. INTRODUCTION: The growing rod (GR) technique for management of progressive Early-Onset Scoliosis (EOS) is a viable alternative but with a high complication rate attributed to frequent surgical lengthenings. The safety and efficacy of a non-invasive Magnetically Controlled Growing Rod (MCGR) has been previously reported in a porcine model. We are reporting the preliminary results of this technique in EOS. METHODS: Retrospective review of prospectively collected multi-center data. Only patients who underwent MCGR surgery and at least 3 subsequent spinal distractions were included in this preliminary review. Distractions were performed in clinic without anesthesia or analgesics. T1-T12 and T1-S1 height and the distraction distance inside the actuator were analyzed in addition to conventional clinical and radiographic data. RESULTS: Patients (N=14; 7 F and 7 M) had a mean age of 8y+10m (3y+6m to 12y+7m) and underwent a total of 14 index surgeries (SR: index single rod in 5 and DR: dual rod in 9) and 91 distractions. There were 5 idiopathic, 4 neuromuscular, 2 congenital, 2 syndromic and one NF. Mean follow-up (FU) was 10 months (5.8-18.2). Mean Cobb changed from 57° pre-op to 35° post-op and correction was maintained (35°) at latest FU. T1-T12 increased by 4 mm for SR and 10 mm for DR with mean monthly gain of 0.5 and 1.39, respectively. T1-S1 gain was 4 mm for SR and 17 mm for DR with mean monthly gain of 0.5 mm for SR and 2.35 mm for DR. The mean interval between index surgery and the first distraction was 66 days and thereafter was 43 days. Complications included one superficial infection in (SR), one prominent implant (DR) and minimal loss of initial distraction in three after index MCGR (all SR). Overall, partial loss of distraction was observed following 14 of the 91 distractions (one DR and 13 SR). This loss was regained in subsequent distractions. There was no neurologic deficit or implant failure. CONCLUSION: MCGR appears to be safe and provided adequate distraction similar to the standard GR technique without the need for repeated surgeries. DR patients had better initial curve correction and greater spinal height. No major complications were observed during the short follow-up period. The FDA has not cleared the drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an ‘off label’ use).postprin

Clamp-assisted retractor advancement for lower eyelid involutional entropion

Scientific Poster 144PURPOSE: To describe a novel approach to internal repair of lower lid entropion using the Putterman clamp. METHODS: Retrospective, consecutive case series of patients with entropion who underwent retractor advancement using the clamp. RESULTS: Seven eyes of 6 patients (average age: 80; 4 women and 2 men) were analyzed. Complete resolution was achieved in 5 of the 6 patients (83.3%). The 1 patient with recurrence had 2 previous entropion surgeries on each eye over the past 4 years; there was lid laxity, and horizontal tightening was needed. No severe adverse events occurred in the patients. CONCLUSION: Clamp-assisted lower lid retractor advancement offers a safe and effective, minimally invasive approach to involutional entropion. Further study is needed to assess its role in recurrent entropion.postprin

Calendar 2000

The annual University publication which provides general and historical information about the University of Sydney, the statutes and regulations under which it operates and the Senate resolutions relating to constitutions and courses in each faculty

Calendar 2000

The annual University publication which provides general and historical information about the University of Sydney, the statutes and regulations under which it operates and the Senate resolutions relating to constitutions and courses in each faculty

A History Of The Sleaford Navigation

No detailed study of any part of the canal and navigation system of Lincolnshire has so far been undertaken and, using primary sources almost exclusively, this work is the first complete account of the origins and the development of one of these rural navigations and the effects it had upon the local communities. The early history of south Lincolnshire's drainage is considered and its close relationship with the River Slea/Kyme Eau. The importance of these waterways to the towns of Boston and Lincoln is also discussed. With the quickening of industrial and agricultural change in England during the second half of the 18th. century the waterway systems of the country were extended and attempts were made to make navigable the River Slea/Kyme Eau in order to become a part of this network. Those attempts are here considered in detail, as is the opposition given to the various schemes by both individuals and corporate bodies. A number of surveys, reports, estimates and applications to Parliament for an Act were made and these and the Parliamentary proceedings are examined. In support of a navigation the vital role played by Sir Jospeh Banks, the President of the Royal Society, both in Parliament and in relation to Drainage and Navigation Commissioners and supportes of the scheme, is explained. The trading patterns exemplified by the Navigation during the early deccades of the 19th. century give insight into the economic climate both locally and nationally and the importance of water transport for freight to this district is fully demonstrated. Competing forms of transport are examine, in particular the railway, which was established in direct opposition to the Sleaford Navigation. Finally, the reasons for the decline and closure of the waterway are considered and the present-day efforts to re-open the river to vessels