Zhu et al. New susceptibility loci for adolescent idiopathic scoliosis

Millions of children develop spine deformity due to adolescent idiopathic scoliosis (AIS). Despite the prevalence of AIS, which can be as high as 4%, we are only just beginning to understand the genetics of this complex disease. 


For More Info : http://www.nature.com/bonekey/knowledgeenvironment/2016/160120/bonekey20168/full/bonekey20168.html

Over 250 children with scoliosis awaiting treatment

New figures show there are over 250 children with scoliosis either waiting on an operation to fix a spinal curvature or waiting to see a consultant.

There are 165 children with scoliosis currently waiting for surgery, 143 at Our Lady's Children's Hospital Crumlin and 22 at Temple Street Children's University Hospital.

Figures show there are 91 children with scoliosis waiting to see a consultant and some have been waiting for up to 15 months.

In a statement, the Children's Hospital Group said it is working with the Health Service Executive to progress treatment for those waiting as quickly as possible.

One of Ireland's leading orthopedic surgeons, David Moore, has raised concerns about the length of time children and teenagers are waiting for operations.

He says the longer the wait for surgery the worse the curve gets which causes the cost of the procedure to rise.

A statement from The Rights for Children with Scoliosis Parents Action Group said that while it welcomes the news that efforts are being made to address waiting lists, it feels more needs to be done.

“There needs to be a more effective system put in place to stop children falling through the cracks,” it said.



Source : RTE , 21st Jan 2016

NuVasive To Acquire Ellipse Technologies

In a recent press release, San Diego, California-based NuVasive, Inc. 

announced that it will acquireEllipse Technologies, Inc. (“Ellipse”), a privately held medical technology company based in Aliso Viejo, California.  According to its website, NuVasive is the third largest medical device company in the global spine industry and is dedicated to innovation and development focused on minimally disruptive surgical products and procedures for the spine.  Ellipse describes itself as an innovative company dedicated to the design, development, and successful commercialization of non-invasively

adjustable, remote controlled implants for a broad spectrum of spinal and orthopedic applications.

The press release states that the acquisition builds on NuVasive’s reputation as the leading technology provider for spine procedure solutions by adding a “highly regarded, disruptive technology platform.”  Specifically, a Medical Device and Diagnostic Industry article reports that the acquisition strategically adds two of Ellipse’s main products to NuVasive’s product portfolio – MAGEC and PRECICE – products that will help boost NuVasive’s 

international footprint, since 37% of Ellipse’s 2015 revenue came from overseas.  According to Ellipse, MAGEC (shown to the right) is a non-invasively adjustable growing rod used to brace the spine during growth to minimize the progression of scoliosis, and PRECICE is an adjustable intramedullary nail used for limb lengthening of the femur and tibia.

In connection with the acquisition, Gregory T. Lucier, Chairman and CEO of NuVasive, stated:

NuVasive remains committed to adult deformity through our Integrated Global Alignment (iGA™) platform, and the acquisition of Ellipse will aggressively insert NuVasive into early onset and idiopathic scoliosis, an important and attractive part of the spinal deformity market for NuVasive where we have tremendous opportunities for accelerated growth.

Edmund J. Roschak, President and CEO of Ellipse, said:

Joining forces with NuVasive not only validates the promise of our technology, but provides us with the scale and resources necessary to realize our full potential.

The press release notes that the Boards of Directors of both companies unanimously approved the terms of the acquisition, which include a $380 million upfront cash payment as well as a potential $30 million milestone payable in 2017.  The transaction is expected to close by the end of February 2016, subject to customary closing conditions and regulatory approvals.

Source : JD Supra Buisness Advisor , 22 Jan 2016 

TRUNK MUSCLE ACTIVITY IS MODIFIED IN OSTEOPOROTIC VERTEBRAL FRACTURE AND THORACIC KYPHOSIS WITH POTENTIAL CONSEQUENCES FOR VERTEBRAL HEALTH.

Authors: Greig AM, Briggs AM, Bennell KL, Hodges PW

Abstract


This study explored inter-relationships between vertebral fracture, thoracic kyphosis and trunk muscle control in elderly people with osteoporosis. Osteoporotic vertebral fractures are associated with increased risk of further vertebral fractures; but underlying mechanisms remain unclear. Several factors may explain this association, including changes in postural alignment (thoracic kyphosis) and altered trunk muscle contraction patterns. Both factors may increase risk of further fracture because of increased vertebral loading and impaired balance, which may increase falls risk. This study compared postural adjustments in 24 individuals with osteoporosis with and without vertebral fracture and with varying degrees of thoracic kyphosis.

Trunk muscle electromyographic activity (EMG) associated with voluntary arm movements was recorded and compared between individuals with and without vertebral fracture, and between those with low and high thoracic kyphosis. Overall, elderly participants in the study demonstrated co-contraction of the trunk flexor and extensor muscles during forwards arm movements, but those with vertebral fractures demonstrated a more pronounced co-contraction than those without fracture. Individuals with high thoracic kyphosis demonstrated more pronounced alternating flexor and extensor EMG bursts than those with less kyphosis. Co-contraction of trunk flexor and extensor muscles in older individuals contrasts the alternating bursts of antagonist muscle activity in previous studies of young individuals. This may have several consequences, including altered balance efficacy and the potential for increased compressive loads through the spine. Both of these outcomes may have consequences in a population with fragile vertebrae who are susceptible to fracture.


Source : London Spine , 23rd Dec 2015 

Two-level cement augmentation may decrease the rate of acute proximal junctional fractures

Researchers evaluated potential methods to prevent acute proximal junction fractures in patients with adult spinal deformity and found use of two-level cement augmentation was linked with a significant reduction in the incidence of proximal junction fractures and revision procedures.

Researchers retrospectively studied data on 51 patients with adult spinal deformity after thoracolumbar fusion from the pelvis to thoracolumbar junction with at least 6 months of follow-up. Health-related quality of life outcomes (HRQoL), demographics and radiograph parameters of deformity were compared for patients who underwent the following procedures: no cement; two-level cement augmentation at upper instrumented vertebra (UIV) and vertebra one level proximal to UIV (UIV+1); and cement at another location (other).

A total of 19 patients underwent two-level cement augmentation at UIV, 23 patients had no cement and nine patients underwent cement at another location.

Researchers noted two-level procedures without cement had a 19% revision rate for proximal junctional fractures (PJF) compared with a 0% revision rate for two-level procedures with cement. When adjusted for UIV, the risk of proximal junction fracture revision surgery increased by 13.1-times for the “other” category of patients. In addition, two-level cement procedures increased HRQoLs in all patients, while only back and leg pain significantly improved in non-two-level cement procedures, researchers wrote. – by Robert Linnehan

Disclosure: The researchers reported receiving funds from the National Center for Advancing Translational Sciences, NIH, through UCSF-CTSI



Source : Healio , 22nd Dec 2015 

Spine Surgeons Say New Device, ApiFix®, Makes Kids’ Scoliosis Surgery Minimally Invasive

ApiFix® Ltd. announced today that the company is helping the parents of children from Australia, Canada and the United States who have Adolescent Idiopathic Scoliosis (AIS) to identify spine surgeons in Europe and Israel who have adopted the ApiFix® system to treat AIS. ApiFix is approved for sale in Europe and Israel.

(Click here for video.)

“There is an acute need for an alternative to today’s standard for scoliosis correction in children and adolescents, which is the most aggressive and invasive procedure in spine surgery,” said Uri Arnin, CEO. “Therefore we are grateful to be able to introduce the parents of children with AIS to spine surgeons who have adopted ApiFix and are treating patients in countries where ApiFix is now approved for use.”

“The scoliosis curve correction at up to three years follow-up is substantial for the children who have been treated with the less-invasive ApiFix procedure. We are extremely proud to be able to offer this innovation to children and adolescents from 10 to 17 years of age,” said Prof. Dr. Yizhar Floman.

A clinical study of The ApiFix® System led by Prof. Dr. Floman, past President of the Israel Spine Society, was published this year in the peer-reviewed medical journal Scoliosis, which concluded that “there are many drawbacks to the current gold standard of AIS surgery, which are almost nonexistent with the use of ApiFix.”

Now, there’s the ApiFix system,” approved for sale in Europe and designed to be a new standard for correcting scoliosis in children and adolescents.

ApiFix® is a commercial-stage company that has developed the CE-markedApiFix®System — a non-fusion minimally invasive treatment alternative for Adolescent Idiopathic Scoliosis (AIS). Scoliosis surgery is the most invasive procedure in spine. The average procedure fuses 10 vertebrae together using 20 screws, resulting in significant and permanent loss of spine mobility.

(For detailed clinical data, contact ApiFix CEO Uri Arnin: uri@apifix.com.)

View source version on Business Wire 

http://www.businesswire.com/news/home/20151217005980/en/

Source : Pharmi Web , 21st Dec 2015

How The Portland Hospital Changed the Life of a Teenage Scoliosis Patient

Leah Potton’s mum feared the worst when she noticed that her daughter’s right hip was sticking out. After a series of tests scoliosis was diagnosed, and Leah’s orthopaedic surgeon recommended spinal fusion surgery to correct the curvature of her spine.




Leah's Story - Portland Hospital

After waiting a year for life-changing surgery, Leah’s curvature was getting worse, and it was clear that the need for surgery was growing increasingly urgent. The Portland Hospital stepped in and took over Leah’s treatment, and her life has already been transformed.

This is Leah’s story.

Dawn Quinn is Leah’s mum, and she remembers the moment she noticed a potential problem with her daughter’s spine.

“As soon as I realised her right shoulder blade was looking distorted, and she seemed to be getting a rib hump as well, I began to worry.

“I developed a slight curvature of the spine when I was a teenager, which is still causing me back pain now.”

For 18 months, Leah visited the family’s GP in Surrey in an attempt to address the problem, and she was eventually referred to St Thomas’ Hospital in London for further investigation.

When Leah’s scoliosis was finally diagnosed, her surgeon recommended that she undergo spinal fusion surgery as quickly as possible. But after spending a year on the waiting list for treatment, Leah’s curvature remained untreated - and continued to worsen.

It wasn’t until Dawn’s husband started a new job with private medical insurance that the option of private healthcare arose. Leah’s parents booked a consultation with Mr Tom Ember - a consultant orthopaedic and spinal surgeon at The Portland Hospital.

Mr Ember has an excellent reputation within the field of scoliosis surgery, and he performs an average of five spinal fusions surgeries every week at The Portland Hospital, Great Ormond Street and Guy’s and St Thomas Hospitals. He immediately concluded that Leah needed surgery as soon as possible.

Mr Ember explained why Leah’s need for surgery was so pressing.

“Patients with a spinal curve measuring more than 50 degrees are likely to see an increase of another one or two degrees a year.”

“By the time I saw Leah, her curve already measured 60 degrees. Left to progress further, it would have become more and more deforming – driving her left shoulder down, leading to severe thoracic back pain and affecting her lung function.”

Leah’s posterior spinal fusion surgery was booked in almost straight away, and took place just seven weeks later.

This complex, delicate procedure involves peeling back muscles to fully expose the spine. The painstaking process of twisting each vertebra back into its correct position then begun. Mr Ember had to use a series of metal screws and attach them to two rods in order to straighten Leah’s spine. Everything was then fused together with a bone graft.

Mr Ember was delighted with the results of Leah’s procedure, and he explained that surgery in such a well-equipped hospital significantly reduces the chance of serious complications.

“Fifteen is the perfect age for this operation, as the majority of growing has already been done,” he explains.

“Complications are rare, and reduced even further in units like The Portland Hospital, where there are state-of-the-art operating facilities, spinal cord monitoring and intensive care.

“Within just three hours we were able to achieve a lovely correction for Leah, which has virtually eliminated her curve. She should go on to lead an entirely normal life with no further complications.”

Leah now faces a tough road to recovery, and although the results of surgery were not perfect, Dawn is surprised at how quickly both the shoulder protrusion and rib hump have disappeared.

Leah spent a total of five nights in The Portland Hospital before returning home, and she spent four weeks rebuilding her strength and mobility before returning to school.

The speed of Leah’s treatment and recovery, as well as the positive effect surgery has had, are testament to the facilities and the medical team at The Portland Hospital. Thanks to Mr Ember’s procedure, this teenager can look forward to a curve-free future - doing the things most teenagers take for granted.



Source : Hull Daily Mail , 17th Dec 2015