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Editorial Board
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - November 30, 2016 Category: Orthopaedics Source Type: research

Table of Contents
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - November 30, 2016 Category: Orthopaedics Source Type: research

Contributors
(Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - November 30, 2016 Category: Orthopaedics Source Type: research

The Shilla Growth Guidance Technique
In order to correct spinal deformity and harness the natural growth of a child ′s spine, the Shilla growth guidance system has been developed. With over ten years′ experience with this system, the author (developer) describes the best method for insertion of the Shilla device. Radiographic images aid in the placement of apical screws which fixate to the rod, and with mobil ity gained from spinal osteotomies, the apex is corrected to neutral in all planes and fused. Growing screws placed through the muscle with the aid of C-arm imagery are attached to the rod in such a way as to permit the continued control of spinal gr...
Source: Operative Techniques in Orthopaedics - September 19, 2016 Category: Orthopaedics Authors: Richard E. McCarthy Source Type: research

Anterior Scoliosis Correction in Immature Patients with Idiopathic Scoliosis
The current standard of care for skeletally immature patients with progressive scoliosis measuring>25 ° is a thoracolumbosacral orthosis. Recent evidence has established the efficacy of bracing in halting curve progression in patients with curves measuring 20°-40°. However, issues surrounding psychosocial impact, compliance, and the efficacy of bracing in larger curves remain. In patients with si gnificant growth remaining, anterior growth modulation surgery has been established as a unique and promising alternative. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Robert J. Ames, Amer F. Samdani, Randal R. Betz Source Type: research

Magnetically Controlled Growing Rod
Magnetically controlled growing rods (MCGR) that have Food and Drug Administration clearance since 2014 for the treatment of progressive early onset scoliosis in immature patients at risk for thoracic insufficiency syndrome are designed to reduce the number of planned open surgical procedures for lengthening and minimize the complications of more conventional techniques such as traditional growing rods (TGR). MCGR is a safe and effective distraction-based growing rod technique with similar results in curve correction and growth achievement as TGR. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Behrooz A. Akbarnia, Pooria Hosseini Source Type: research

Hemivertebra Excision —Posterior-Only Approach With 3-Rod Technique
Posterior-only hemivertebra (HV) excision (PHVE) is an effective treatment for isolated hemivertebrae that cause significant local deformity. Multiple balanced hemivertebrae or global structural deformity is probably not appropriate for PHVE. PHVE works well in cervicothoracic, thoracolumbar, lumbar, and lumbosacral locations, with varying degrees of technical difficulty, while midthoracic PHVE seems less effective. Associated segmental kyphotic deformity is most easily treated, whereas segmental lordosis can be problematic with a posterior-only approach. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: John B. Emans, Michael Glotzbecker, Daniel Hedequist Source Type: research

Myelokyphectomy in Spina Bifida: The Modified Fackler or Sagittal Shilla Technique
Severe focal kyphosis occurs in approximately 5 –10% of infants with myelomeningocele with the apex of the curve centered around the second lumbar vertebra. The kyphosis is fixed in nature and is usually associated with a compensatory thoracic lordosis proximally. Indications for surgery include an impaired sitting balance, recurrent skin ulcer ations, respiratory depression, and pain. The modified Fackler or sagittal Shilla technique is used to solve these problems in a child of 9 years of age or younger. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Adam Margalit, Paul D. Sponseller Source Type: research

Rib-Based Anchors for Growing Rods in the Treatment of Early-Onset Scoliosis
The treatment of early-onset scoliosis (EOS) has evolved substantially over the years. Traditional growing-rod constructs rely on spine-based fixation for proximal and distal anchor sites. Hybrid growing-rod constructs pair rib-based proximal anchors with spinal or pelvic anchors distally. Both traditional and hybrid growing-rod constructs can control spinal deformity in young patients with early-onset scoliosis while preserving spinal and thoracic growth. Proximal rib fixation has many theoretical and practical advantages over spine-based proximal anchors. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Daniel J. Miller, Michael G. Vitale Source Type: research

Rib-to-Pelvis Distraction Techniques in the Growing Spine in Children With Myelomeningocele
This article describes the technique of using rib-to-pelvis distraction to manage spine deformity in these children while preserving growth of the spine. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: John T. Smith Source Type: research

Introduction
In just 15 years, there has been an amazing evolution in both in the philosophy towards the approach of young children with scoliosis as well as with regard to available technologies. Those of us taking care of patients with early onset scoliosis have had the good fortune to practice in an exciting era of change offering possibilities for much better outcomes for these patients. Supporting this rapidly changing field, we are also fortunate to have two well-functioning study groups which have facilitated a tremendous amount of research in the field. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Michael G. Vitale Source Type: research

Casting for Infantile Idiopathic Scoliosis
Over the past decade, casting for scoliosis has become increasingly popular, likely because surgical methods still fall short of a perfect solution. Casting is a useful technique for treating progressive early onset scoliosis because the treatment often results in either a cure for younger children with smaller curves or a delay in the need for surgery in others. Proper technique focuses on the rotational component of the curve and avoids pushing the convex ribs further into the chest. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: James O. Sanders Source Type: research

Myelokyphectomy in Spina Bifida: The Modified Fackler/Sagittal Shilla Technique
Severe focal kyphosis occurs in about 10% of infants with myelomeningocele with the apex of the curve centered around the second lumbar vertebra. The kyphosis is fixed in nature and is usually associated with a compensatory thoracic lordosis proximally. Indications for surgery include an impaired sitting balance, recurrent skin ulcerations, respiratory depression, and pain. The Modified Fackler/Sagittal Shilla technique is used to solve these problems in a child nine years of age or younger. It combines aspects of both the Shilla technique described by McCarthy and the originally described Fackler technique for myelokyphos...
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Adam Margalit, Paul D. Sponseller Source Type: research

Rib –to–Pelvis Distraction Techniques in the Growing Spine in Children with Myelomeningocele
Children born with myelomeningocele frequently develop spinal deformity at an early age. Management of these deformities while preserving growth is challenging and associated with a significant incidence of complications related to poor bone quality, multiple co-morbidities ′, and poor skin. This paper describes the technique of using rib-to-pelvis distraction to manage spine deformity in these children while preserving growth of the spine. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: John T. Smith Source Type: research

Magnetically Controlled Growing Rod (MCGR)
Magnetically controlled growing rods (MCGR) which have FDA clearance since 2014 for the treatment of progressive EOS in immature patients at risk for thoracic insufficiency syndrome are designed to reduce the number of planned open surgical procedures for lengthening and minimize the complications of more conventional techniques like Traditional Growing Rods (TGR). MCGR is a safe and effective distraction-based growing rod technique with similar results in curve correction and growth achievement as to TGR. (Source: Operative Techniques in Orthopaedics)
Source: Operative Techniques in Orthopaedics - September 14, 2016 Category: Orthopaedics Authors: Behrooz A. Akbarnia, Pooria Hosseini Source Type: research