Dr. Mike Selby, Anterior Scoliosis Correction (ASC) Non-Fusion Surgery, by Dr. Derek Lee скачать в хорошем качестве

Dr. Mike Selby, Anterior Scoliosis Correction (ASC) Non-Fusion Surgery, by Dr. Derek Lee

This interview is for educational purposes and covers information provided by Dr. Mike Selby regarding his opinions on Anterior Scoliosis Correction (ASC) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below. Chapters 00:00 Introduction 0:20 Training in pediatric and adult spine scoliosis surgery. 2:49 First exposure to Vertebral Body Tethering (VBT). 3:27 Anterior spinal surgery training in Australia is a natural transition to VBT/ASC. 4:30 Anterior Scoliosis Correction (ASC) training with Dr. Betz & Dr. Antonacci. 5:34 Preferred approach to anterior scoliosis surgery for VBT/ASC. Thoracoscopic versus mini-open approach. 7:31 Why does a mini-open anterior approach allow for greater spine de-rotation? 8:13 Long term complications from lung deflation with VBT/ASC. 10:07 Type of instrumentation used for VBT/ASC. 10:43 What was the motivation to learn VBT/ASC? Early lumbar fusion complications. 13:15 Case Study 1: 17 year old female, AIS, ligamentous laxity, lumbar fusion. Follow up at 2 years, complications at 5 years post fusion. 16:43 Complications following lumbar fusion surgical treatment of AIS. 17:48 Case Study 2: 30 year old female, 15 years post lumbar fusion. Thoracic implants removed, severe low back pain. 18:21 Back pain and outcomes of pregnancy after spinal fusion for AIS. Fusion to L3 and especially L4 levels can lead to back pain. 18:54 Lumbar fusion cases have led to considering ASC to preserve motion. 19:04 Case Study 3: Peripheral Neuromodulation for severe chronic low back pain. 20:30 Good Long term outcomes of anterior fusion surgery for thoracolumbar/lumbar AIS. Fusions typically ended at L2 and L3 vertebrae. 21:56 Case Study 4: 16 year old male, thoracolumbar scoliosis. Marfan's Syndrome (hypermobility). 23:13 Solid fusion in Marfan's patients may lead to PJK/DJK complications. Proximal Junctional Kyphosis (PJK), Distal Junctional Kyphosis (DJK). 23:54 Minimally Invasive Technique for Vertebral Body Tethering (VBT). 25:16 Complications with transpsoas approach for lumbar screws. 27:33 What vertebral levels can be accessed via lumbar anterior approach? 28:47 Video of minimally invasive surgical technique. 30:46 What's the lowest lumbar vertebrae that can be tethered? 31:35 Tether tensioning and disc alignment with VBT/ASC. 32:09 Tether technology. 33:27 Perspective on mature spine tethering (ASC). Double tethers. 34:03 Perspective on lumbar disc release for ASC. 35:02 ASC and thoracic disc release. 35:29 Perspective on thoracic vs lumbar disc release. 35:52 Thoracic disc autofusion and osteophyte formation is common in adults. 36:38 Definition of disc release for ASC. 38:25 ASC and nucleus of the disc. 39:03 Perspective on kyphosis with ASC. 40:28 Case Study 5: double lumbar tethers for a primary thoracic curve, AIS. 41:55 Does disc degeneration disqualify a patient from ASC? 42:19 ASC may be an option for an older patient where disc degeneration is at the base of the spine. 42:25 With scoliosis, discs degenerate faster at curve apex and at base of the spine, specifically at L4-5 and L5-S1 discs due to shear forces. 43:56 ASC parameters for immature & mature spines. 44:43 Spine flexibility parameters for tethering. Traction under general anesthetic x-ray. 45:44 Age limit for ASC patients? 46:07 Number of ASC surgeries performed. 47:00 Do VBT & ASC have potentially the best treatment outcomes for scoliotic lumbar spines? 47:18 Thoracic VBT/ASC versus thoracic fusion. 48:31 Would more surgeons use ASC for mature spines if a tether was longer lasting? Does a tether need to last forever? 55:38 VBT/ASC and kyphosis. 54:50 Kyphoscoliosis. drdereklee.com