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Pediatric spine imaging post scoliosis surgery

Pediatric Radiology volume 48, pages 124–140 (2018)Cite this article

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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Authors and Affiliations

  1. Diagnostic Imaging Department, IWK Children’s Health Center, Dalhousie University, Halifax, NS, Canada

    Alaa N. Alsharief & Pierre Schmit

  2. Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON M5G 1X8, Canada

    Alaa N. Alsharief

  3. Department of Medical Imaging, King Abdul-Aziz Medical City, King Khaled National Guard Hospital-Western Region, King Saud University, Jeddah, Saudi Arabia

    Alaa N. Alsharief

  4. Orthopedic Surgery Department, IWK Children’s Health Center, Dalhousie University, Halifax, NS, Canada

    Ron El-Hawary

Authors
  1. Alaa N. Alsharief
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  2. Ron El-Hawary
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Correspondence to Alaa N. Alsharief.

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Conflicts of interest

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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  • DOI: https://doi.org/10.1007/s00247-017-3941-7

Keywords

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