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151 results on '"Hanstein, Regina"'

16. Percutaneous epiphysiodesis using transphyseal screws (PETS) versus tension-band plating (TBP): comparative study of outcomes for correcting limb length discrepancy.

Author

Younis, Manaf H., Hanstein, Regina, Javed, Kainaat, Fornari, Eric D., Gomez, Jaime A., Sharkey, Melinda S., and Schulz, Jacob F.

Subjects
*BONE lengthening (Orthopedics), *ORTHOPEDIC implants, *BONE screws, *RETROSPECTIVE studies, *ACQUISITION of data, *LEG length inequality, *TREATMENT effectiveness, *MEDICAL records, *EVALUATION
Abstract

Objectives: The best effective treatment strategy for limb length discrepancy (LLD) is still being debated. The goal of this study was to compare the efficacy and results of tension-band plating (TBP) and percutaneous epiphysiodesis using transphyseal screws (PETS) for LLD correction. Methods: From June 2008 to January 2019, children who had lower extremity epiphysiodesis with either TBP or PETS were reviewed retrospectively. At the conclusion of treatment, LLD, angular deformity, and complications were reviewed. The t-test or Wilcoxon rank sum test was used to compare continuous variables. Categorical variables were evaluated using Fisher's exact test or χ2 test. Results: A total of 32 epiphysiodeses with TBP (14 patients, 24 femur/tibias) or PETS (13 patients, 23 femur/tibias) were compared. TBPs were conducted while the patients were younger (11.0 vs. 13.1 years, p = 0.005). The treatment durations were similar in both groups (TBP: 23.5 months vs. PETS: 24 months, p = 0.132). PETS had significantly shorter operative time (p = 0.047), length of hospital stay (p = 0.014), and time to return to full activity (p = 0.043). LLD in the TBP group reduced from 2.64 to 1.38 cm (p = 0.005), while in the PETS group it decreased from 2.76 to 1.08 cm (p = 0.001). During treatment, the rate of LLD correction was 0.49 ± 0.9 cm/year for limbs treated with TBP and 1.0 ± 1.1 cm/year for limbs treated with PETS (p = 0.185). At the end of treatment, 8 TBP cases (47%) and 9 PETS cases (60%) had achieved LLD ≤ 2 cm (p = 0.502), and at the most recent follow-up, this had grown to 11 (65%) in the TBP group and 12 (80%) in the PETS group. There were no significant differences in the total number of complications between groups (p > 0.05). Revision surgery was required in 11 TBP and 3 PETS limbs due to persistent LLD or angular deformity (AD) (p = 0.016). Logistic regression did not reveal any significant association between TBP and the rate of complication or revision surgery. Conclusion: PETS and TBP are both effective methods for limb length equalization. PETS, on the other hand, was linked to a shorter operative time, a shorter hospital stay, a faster recovery to pre-operative function, and a lower complication rate. The rate of revision surgery due to persistent LLD or AD was higher in TBP. We advise surgeons against utilizing TBP to correct LLD. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Magnetically Controlled Growing Rods (MCGR) Versus Single Posterior Spinal Fusion (PSF) Versus Vertebral Body Tether (VBT) in Older Early Onset Scoliosis (EOS) Patients

Author

Mackey, Catherine, primary, Hanstein, Regina, additional, Lo, Yungtai, additional, Vaughan, Majella, additional, St. Hilaire, Tricia, additional, Luhmann, Scott J., additional, Vitale, Michael G., additional, Glotzbecker, Michael P., additional, Samdani, Amer, additional, Parent, Stefan, additional, and Gomez, Jaime A., additional

Published
2021
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22. The Effect of Spinopelvic Parameters on the Development of Proximal Junctional Kyphosis in Early Onset: Mean 4.5-Year Follow-up

Author

Gomez, Jaime, Kubat, Ozren, Tovar Castro, Mayra A, Hanstein, Regina, Flynn, Tara BA, Lafage, Virginie, Hurry, Jennifer, Soroceanu, Alexandra, Schwab, Frank, Skaggs, David, El-Hawary, Ron, and Pediatric Spine Study Group (PSSG)

Subjects
Pelvic tilt, Male, medicine.medical_specialty, Kyphosis, Scoliosis, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Risk Factors, Medicine, Humans, Orthopedics and Sports Medicine, Orthopedic Procedures, Postoperative Period, Risk factor, Age of Onset, Child, 030222 orthopedics, business.industry, Hazard ratio, Retrospective cohort study, General Medicine, medicine.disease, Sagittal plane, Spine, Surgery, Radiography, medicine.anatomical_structure, Child, Preschool, Pediatrics, Perinatology and Child Health, proximal junctional kyphosis, pelvic incidence, pelvic tilt, Female, Risk Adjustment, Age of onset, business, Follow-Up Studies
Abstract

Background: Proximal junctional kyphosis (PJK) is a major complication after posterior spinal surgery. It is diagnosed radiographically based on a proximal junctional angle (PJA) and clinically when proximal extension is required. We hypothesized that abnormal spinopelvic alignment will increase the risk of PJK in children with early-onset scoliosis (EOS). Methods: A retrospective study of 135 children with EOS from 2 registries, who were treated with distraction-based implants. Etiologies included 54 congenital, 10 neuromuscular, 37 syndromic, 32 idiopathic, and 2 unknown. A total of 89 rib-based and 46 spine-based surgeries were performed at a mean age of 5.3±2.83 years. On sagittal radiographs, spinopelvic parameters were measured preoperatively and at last follow-up: scoliosis angle (Cobb method, CA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope and PJA. Radiographic PJK was defined as PJA≥10 degrees and PJA≥10 degrees greater than preoperative measurement. The requirement for the proximal extension of the upper instrumented vertebrae was considered a proximal junctional failure (PJF). Analysis of risk factors for the development of PJK and PJF was performed. Results: At final follow-up (mean: 4.5±2.6 y), CA decreased (P50 degrees was a risk factor for the development of radiographic PJK (relative risk: 1.67, P=0.04). Children with high postoperative CA [hazard ratio (HR): 1.03, P=0.015], postoperative PT≥30 degrees (HR: 2.77, P=0.043), PI−LL>20 degrees (HR: 2.92, P=0.034), as well as greater preoperative to postoperative changes in PT (HR: 1.05, P=0.004), PI (HR: 1.06, P=0.0004) and PI−LL (HR: 1.03, P=0.013) were more likely to develop PJF. Children with rib-based constructs were less likely to develop radiographic PJK compared with children with spine-based distraction constructs (31% vs. 54%, respectively, P=0.038). Conclusions: In EOS patients undergoing growth-friendly surgery for EOS, preoperative TK>50 degrees was associated with increased risk for radiographic PJK. Postoperative PI−LL>20 degrees, PT≥30 degrees, and overcorrection of PT and PI−LL increased risk for PJF. Rib-based distraction construct decreased the risk for radiographic PJK in contrast with the spine-based constructs.

Published
2020

43. Spinopelvic alignment affects Health-related Quality of Life (HRQoL) for Patients with Early

Author

Gomez, Jaime A., Kubat, Ozren, Hurry, Jennifer, Soroceanu, Alexandra, Flynn, Tara, Tovar, Mayra, Hanstein, Regina, Lafage, Virginie, Schwab, Frank, Smith, John, Skaggs, David, and El-Hawary, Ron

Subjects
HRQoL, scoliosis
Abstract

Recent studies in the adult scoliosis population have shown effects of spinopelvic parameters on HRQoL outcomes. In this retrospective cohort study of 75 EOS patients treated with growth-friendly surgery, spinopelvic parameters affected HRQoL (EOSQ-24). Pre-operative PI>60° increased the risk for poor pain outcomes, pre- and post-operative LL>60° increased the risk for poor satisfaction, post-operative PI-LL mismatch of O >20° and post-operative PJK increased the risk of Fatigue.

Published
2017
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44. Single Fusion (PSF) Vs Growth Friendly (GF) Device in Older EOS Patients

Author

Gomez, Jaime, primary, Xin, Ryan, additional, Lo, Yungtai, additional, Hanstein, Regina, additional, St. Hilaire, Tricia, additional, Flynn, Tara, additional, White, Klane, additional, El-Hawary, Ron, additional, Garg, Sumeet, additional, Cahill, Patrick, additional, Vitale, Michael, additional, and Redding, Gregory, additional

Published
2018
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47. Adult Scoliosis Deformity Surgery

Author

Gomez, Jaime A., primary, Lafage, Virginie, additional, Scuibba, Daniel M., additional, Bess, Shay, additional, Mundis, Gregory M., additional, Liabaud, Barthelemy, additional, Hanstein, Regina, additional, Shaffrey, Christopher, additional, Kelly, Michael, additional, Ames, Christopher, additional, Smith, Justin S., additional, Passias, Peter G., additional, Errico, Thomas, additional, and Schwab, Frank, additional

Published
2017
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