Pediatric spine imaging post scoliosis surgery

Abstract

Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque–Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications.

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Acknowledgments

We acknowledge Dr. J. Ouellet for allowing us to use one of his figures from the article “Surgical Technique: Modern Luque Trolley, a Self-growing Rod Technique” [22].

This paper was previously presented as an educational exhibit at the IPR 7th Conjoint Meeting and Exhibition, May 15–20, 2016, in Chicago, IL.

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Correspondence to Alaa N. Alsharief.

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Dr. A.N. Alsharief and Dr. P. Schmit have no conflicts of interest to disclose. Dr. R. El-Hawary discloses research, education and consulting with DePuy Synthes Spine and Medtronic Spine.

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Alsharief, A.N., El-Hawary, R. & Schmit, P. Pediatric spine imaging post scoliosis surgery. Pediatr Radiol 48, 124–140 (2018). https://doi.org/10.1007/s00247-017-3941-7

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Keywords

  • Adolescents
  • Children
  • Computed tomography
  • Implants
  • Radiography
  • Scoliosis
  • Spine