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Steven Mardjetko

Publications and source records attributed to Steven Mardjetko.

4 recordsLinked to original sources
PubMed2006

Electromagnetic topographical technique of curve evaluation for adolescent idiopathic scoliosis.

STUDY DESIGN: Diagnostic testing. OBJECTIVE: The goal of this study is to measure the accuracy and reliability of the Orthoscan (Orthoscan Technologies, Inc.) and to determine whether it can be substituted for radiographs in the surveillance of adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: AIS is usually followed using scoliosis radiographs, which offer the most reliable way to quantify the curve, but carry the risk of exposure to ionizing radiation. The Orthoscan is a nonradiographic topographic method for measuring spinal curves. MATERIALS AND METHODS: There were 5 phases of this study that measured: the accuracy and reliability of the machine when used with a plastic model; the variability with a real patient; the intraobserver variability; the correlation between the measurements of the machine and that of the radiograph; and the correlation between the change in radiograph measurement over time and the change in Orthoscan measurement over time. RESULTS: In measurement of a static plastic model, the machine measured curves with a standard deviation of +/-1 degrees in trunk rotation and +/-2 degrees in curve measurement. Error increased with a real patient. Thirty-six comparisons in the thoracic spine, and 19 comparisons in the lumbar spine, were made between measurements using the Orthoscan and radiographs. Mean curves in the 2 groups were not significantly different and had poor-to-moderate correlation. Longitudinal evaluation included 47 curves in 28 patients. The Orthoscan predicted the radiograph change within an acceptable range 55.3% of the time. CONCLUSIONS: The Orthoscan does not accurately predict the scoliosis curve magnitude or the overall change in curve over time. While analysis in groups of patients using this technique reveals group means that begin to look acceptable, if the variability is too great, then this technology is not yet ready to replace the radiograph in the evaluation of a scoliosis curve.

Adolescent↗
PubMed2003

Selective anterior fusion and instrumentation for the treatment of neuromuscular scoliosis.

STUDY DESIGN: A retrospective cohort study was conducted. OBJECTIVE: To evaluate the results of anterior spinal fusion with anterior instrumentation alone in selected patients with neuromuscular scoliosis. SUMMARY OF BACKGROUND DATA: Traditionally posterior spinal fusion with instrumentation has been done, usually to the pelvis, to achieve correction of neuromuscular scoliosis. However, certain selected patients might benefit from shorter fusion segment to preserve some motion and yet still achieve good correction of the curve. This may serve to improve or preserve various functional abilities that might be adversely affected by a long fusion. METHOD: Patients who had anterior spinal fusion (ASF) with anterior instrumentation (AI) alone were selected from an entire group of patients with neuromuscular spinal deformity who had surgery at Shriners Hospital for Children-Chicago since January of 1988. The charts and radiographs of these patients were examined and various radiographic parameters were measured pre- and after surgery and at final follow-up. Additionally, functional level of the patients included, ambulatory status was obtained from the medical records. RESULTS: In these 21 patients excellent results were obtained with regard to primary and secondary curve correction as well as the pelvic obliquity without significant deterioration at final follow-up. Ambulatory status was not changed after surgery. This cohort of patients had various neuromuscular diseases. However, the majority of them had myelomeningocele. Few complications occurred which resulted in the reoperation of several patients who had progression of the curve around the instrumented segment which itself remained unchanged when the complication was recognized. One infection occurred requiring irrigation and debridement. CONCLUSIONS: In selected patients with neuromuscular scoliosis, even that associated with pelvic obliquity, excellent correction and maintenance correction can be obtained fusing a relatively short segment of the spine with ASF and AI rather than a long construct posteriorly to the pelvis. Maintenance of the correction of the primary curve as well as the pelvic obliquity was maintained over the period of follow-up. This approach for selected patients should be offered as a way of limiting the extend of the surgery, preserving motion segments and maintaining orenhancing functions such as activities of daily living.

Adolescent↗