Dr Damian Muñoz

Dr Damian Muñoz
Curso mínima invasiva south beach

lunes, 5 de mayo de 2014

Discusión entre pares / 12th old male. Treatment option pliz Spine surgeons

12th old male. Treatment option pliz Spine surgeons
 — con Avisek Majumder y Godspeed M. Khawlhring.

  • Javed Shaikh Conservative i believe
    Molded brace....
    We will c spine surgeon suggesion 
  • Damandeep Singh Type 1c curve. Cannot measures cobbs angle on screen or see riser grade. Looks more than 45 degrees. Correction is the answer.
  • Vedant Vaksha Agree with Damandeep Singh - T4-L4 PSF with DVR at apex likely.
  • Saif Rehman Need details, idiopathic or neuromuscular, looks idiopathic, Cobb angle, lateral and ap full length views, will be decided on those the levels, needs posterior instrumentation and fusion
  • Ara Antaranyan Risser sign? ... conservative treatement is optional with brace or casting , for surgry you need additional views lat , side bending , traction films ...
  • Rune Hedlund Looks idiopathic, but being a boy I strongly recommend MRI to rulle out other patology. Cabb is at least 50 degrees, so under all circumstances surgical correction is mandatory. Conservative treatment Will fail badly With severe curve progression. Levels for posterior fusion för me would be T5 - L3. Bending x rays or traction x Ray of value in this decision, but i dont think L4 is necessary for Lower level, and L2 is unnecessary short.
  • Jwalant Mehta Good for short segment anterior.
  • Chandrasekar Prasad X ray Pelvis with both hip ?
  • Swetabh Verma As per history and x ray, looks type 5 lenke with lumbar modifier 1c, curve ranging from D4-L4, apex being at D12 and cobbs well over 50 degrees.would like to see how much growth is left. But stil would go all posterior by fixing above levels with a few ponte osteotomy near apex..
  • Swetabh Verma L3 being the neutral vertebra, instrumentation can stop at this level also.but i wil take L4 also
  • Shashidhar Bk Agree with the above discussion [ Apex at D11- d12 disc].....
  • Chandrasekar Prasad X ray pelvis with hip to assess maturity ?
  • Sudhir Pavithra Its lenkes type 5 and modifier c.. will require side blending films.. lateral view to know abt kyphosis.. surgery is t treatment of choice.. posterior instrumented fusion from d4 to l4.. with multiple ponte' s..
  • Jwalant Mehta Type 5 is always lumbar modifier c. Check the classification paper. Flexibility assessment and maturity assessment important. What does the patient want? Is that important to the discussion. Any of you seen anterior corrections?
  • Shashidhar Bk risk of progression, patient expectations, magnitude of curve 3 most crucial factors to decide for surgery ...once that is decided type of curve and modifiers helps in levels of fusion ....anterior or posterior is mostly surgeons preference[ influenced mostly by mentor of the surgeon] ...
  • Jwalant Mehta traction X-ray and t10 - l1.....3 discs will get it straight. Worth learning irrespective of where you trained. Anyone that wants to come here to see let me know. Larger more rigid curves from the back. Anterior release and apical ponte if over 80 or 90 deg. Staged with halo femoral if over 100 deg....... For this case 3 - 4 disc anterior.
  • Freddy F Galvis Gomez need tac for planing but acoord spiene group of venezuela need short fusion after rx bending lateral of curves for definition of fixed corp involved.i belive taht level of fusion need is T-1o To L2 plus Lea Plaza instrumentation or T.R.S.H. posterior fusion.

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