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00:00:00 – 01:00:07
The video features discussions by Dr. Antonacci and other speakers on the advancements in anterior scoliosis correction (ASC) compared to traditional treatments like vertebral body tethering (VBT) and metal rods. Key points include the benefits of ASC in achieving higher correction rates, lower revision rates, three-dimensional spine balance, and improved disc health. The importance of MRI assessment, double screw chord technique, and multiple cords for strength in corrections are highlighted. The video showcases successful outcomes of ASC in various age groups, emphasizing the preservation of spine integrity and mobility. Additionally, the speakers caution against a hybrid approach and stress the significance of proper thoracic spine treatment for spinal balance.
00:00:00
In this segment of the video, Dr. Antonacci, a leading Orthopedic spine surgeon, discusses the advancements in anterior scoliosis correction (ASC) over the past few years. He emphasizes the evolution from the initial concept of vertebral body tethering (VBT) to the more refined ASC technique, which involves multi-screw constructs and double cord techniques. Dr. Antonacci highlights the benefits of ASC over VBT, such as improved thoracic kyphosis and successful outcomes with higher correction rates (80%) and lower revision rates (2-4%). He contrasts this with VBT, which has lower correction rates (37-55%) and higher revision rates (up to 30%). The transition towards ASC is shown through data trends, indicating a paradigm shift away from traditional metal rods and VBT towards ASC. Dr. Antonacci also mentions the importance of clarifying the nuances of ASC implementation and the necessity for continued research and development in the field.
00:10:00
In this segment of the video, the speaker discusses different categories of scoliosis treatment, including metal rods, VBT, and ASC. They explain how treatment options vary depending on the patient’s age and growth potential. The speaker highlights the limitations of VBT in certain cases, such as the lack of derotation, and compares the success rates and revision rates of ASC and VBT. They emphasize the importance of restoring balance to the spine three-dimensionally and correcting kyphosis using ASC. The speaker also discusses the benefits of the release technique in ASC, which aims to maintain function of the discs and prevent degenerative changes. The data presented shows significant clinical success rates with ASC, especially in cases of severe curves.
00:20:00
In this segment of the video, the speaker discusses the importance of assessing disk quality after surgery using MRI data. They present cases where a 13-year-old and a 46-year-old patient underwent surgery, resulting in significant corrections and improved disk health shown on post-surgery MRIs. The surgical technique described, Anterior Scoliosis Correction (ASC), aims to achieve balance in the spine and prevent degeneration. Results from various cases, including a 10-year-old patient, demonstrate positive outcomes and improved disk health post-ASC surgery. The speaker also contrasts ASC with traditional metal rod fusion surgeries, highlighting the benefits of ASC in maintaining motion and avoiding extensive muscle disruption. The segment emphasizes the effectiveness of ASC in correcting spinal curves and preserving spinal health in patients of different age groups.
00:30:00
In this segment of the video, the speaker discusses cases of scoliosis correction using a double screw chord technique, emphasizing the importance of maintaining the integrity of segmental arteries to prevent paralysis. They compare the outcomes of surgeries with metal rods versus the anterior Scoliosis Correction (ASC) technique, highlighting the benefits of ASC, such as quicker recovery and fewer complications. The video also touches on the transition to ASC for treating scoliosis and the advancements made in the field, showcasing results of various surgeries to illustrate the effectiveness of ASC in correcting scoliotic curves.
00:40:00
In this part of the video, the speaker discusses various cases of spinal curve corrections using anterior scoliosis correction (ASC) surgery. They address different degrees of curvature, corrections achieved, and potential risks of chord breakage. The speaker explains the process of releasing every single level to achieve correction and mentions the use of spacers in certain cases. The benefits of revisions after primary surgery are highlighted, with emphasis on similar or faster recovery. The impact on lung function post-revision is briefly discussed, indicating minimal damage to the lungs. Additionally, the speaker mentions the use of triple and quadruple chords in recent years for improved stability in spinal surgeries.
00:50:00
In this segment of the video, the speaker discusses their philosophy of releasing and detethering rather than using a tether, emphasizing the use of multiple cords for strength in the correction process. They explain nuances like using multiple screw lines for strength and controlling transition zones carefully. The speaker also addresses maintaining flexibility with multiple cords and notes that the initial repositioning and healing usually occur within a few months after the procedure. They differentiate their technique by focusing on maintaining spine integrity and mobility as much as possible. The discussion includes considerations for mature adults in their 30s, 40s, and 50s and the impact of facet joint degeneration on the feasibility of the procedure. The speaker also mentions their experience with early onset scoliosis cases and the importance of releasing to accommodate growth in younger patients. Finally, they caution against a hybrid approach, emphasizing the need for proper treatment of the thoracic spine in achieving spinal balance.
01:00:00
In this segment of the video, the speaker concludes the discussion, thanks the audience, and says goodbye.