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Pediatric posterior spinal fusion

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https://www.readbyqxmd.com/read/28321954/anaphylactic-reaction-to-tranexamic-acid-in-an-adolescent-undergoing-posterior-spinal-fusion
#1
Jennifer Chiem, Iskra Ivanova, Andrew Parker, Walter Krengel, Nathalia Jimenez
Tranexamic acid is an anti-fibrinolytic agent frequently used in pediatric surgery. Common side effects include nausea, flushing, and headache, but in rare instances, it may produce anaphylaxis; with only one previously reported case in a 72-year-old man. We report a case of a delayed anaphylactic reaction in a pediatric patient undergoing posterior spine fusion; and discuss the intraoperative management of the acute event, immunologic confirmation, and subsequent anesthetic approach.
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28263228/pain-is-the-greatest-preoperative-concern-for-patients-and-parents-prior-to-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#2
Priscella Chan, David Skaggs, Austin Sanders, Gabriela A Villamor, Paul D Choi, Vernon Tolo, Lindsay M Andras
STUDY DESIGN: Prospective cross-sectional study OBJECTIVE.: To evaluate patients' and parents' concerns so they can be addressed with appropriate preoperative counseling. SUMMARY OF BACKGROUND DATA: Despite much research on outcomes for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS), little is available about preoperative fears or concerns. METHODS: AIS patients undergoing PSF, their parents, and surgeons, were prospectively enrolled and asked to complete a survey on their fears and concerns about surgery at their preoperative appointment...
March 3, 2017: Spine
https://www.readbyqxmd.com/read/28213667/point-of-care-testing-for-coagulation-function-coaguchek-%C3%A2-xs-system-versus-standard-laboratory-testing-in-pediatric-patients-with-normal-and-abnormal-coagulation-function
#3
Hiromi Kako, Vidya T Raman, Dmitry Tumin, Julie Rice, Joseph D Tobias
PURPOSE: Intraoperative abnormalities of coagulation function may occur for various reasons. In most scenarios, treatment is directed by laboratory parameters. Unfortunately, standard laboratory testing may take 1-2 h. The purpose of the current study was to evaluate a point-of-care testing device (CoaguChek(®) XS System) in pediatric patients. METHODS: Patients ranging in age from 2 to 18 years, undergoing posterior spinal fusion (PSF) or cardiac surgery using cardiopulmonary bypass (CPB) were eligible for inclusion...
February 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28192267/posterior-only-vertebral-column-resection-for-the-treatment-of-severe-spinal-deformities-in-pediatric-patients-a-retrospective-case-series
#4
Malte Schroeder, Lennart Viezens, Philip Kunkel, Karsten Ridderbusch, Tim Nicolas Hissnauer, Oliver Dirk Jungesblut, Michael Hoffmann, Johannes Maria Rueger, Ralf Stuecker
OBJECTIVE: The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiological outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities. METHODS: A case series of eleven pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28060179/uniplanar-versus-fixed-pedicle-screws-in-the-correction-of-thoracic-kyphosis-in-the-treatment-of-adolescent-idiopathic-scoliosis-ais
#5
Siddharth A Badve, Ryan C Goodwin, David Gurd, Thomas Kuivila, Swamy Kurra, William F Lavelle
BACKGROUND: The aim of surgical treatment of scoliosis is to obtain fusion of the spinal column, balanced in the coronal and sagittal planes. Great success has been attained with coronal correction; however, the sagittal profile has received less attention, resulting in little correction of sagittal plane alignment. The purpose of this study was to compare uniplanar and fixed pedicle screws in the correction of the thoracic sagittal alignment in the treatment of adolescent idiopathic scoliosis (AIS)...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#6
Joshua M Pahys, James T Guille
BACKGROUND: Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27927517/management-of-spinal-implants-in-acute-pediatric-surgical-site-infections-a-multicenter-study
#7
Michael P Glotzbecker, Jaime A Gomez, Patricia E Miller, Michael J Troy, David L Skaggs, Michael G Vitale, John M Flynn, Kody K Barrett, Gregory I Pace, Brittany N Atuahene, Daniel J Hedequist
STUDY DESIGN: A retrospective review of patients who underwent posterior spinal fusion (PSF) and returned within 90 days with an acute infection. OBJECTIVES: The study motive is to identify and understand the risk factors associated with failure of retaining spinal implants and failure to treat acute infection. BACKGROUND: The natural history of early surgical site infection (SSI) (less than 3 months) after PSF is not known and removing the implants early after PSF risks pseudarthrosis and deformity progression...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927507/sacral-alar-iliac-fixation-in-pediatric-deformity-radiographic-outcomes-and-complications
#8
Amit Jain, Khaled M Kebaish, Paul D Sponseller
STUDY DESIGN: Retrospective case series. OBJECTIVES: To assess the radiographic outcomes and complications of sacral-alar-iliac (SAI) fixation in children. SUMMARY OF BACKGROUND DATA: Pelvic fixation in children undergoing spinal deformity surgery can be challenging because of complex anatomy, compound biomechanical forces at the lumbosacral junction, and poor bone quality. METHODS: Radiographic and clinical records of 80 consecutive patients aged 18 years or younger who underwent posterior spinal fusion surgery with SAI fixation by one pediatric orthopedic surgeon and who had a minimum 2 years of follow-up (mean follow-up: 3...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927504/does-the-type-of-metal-instrumentation-affect-the-risk-of-surgical-site-infection-in-pediatric-scoliosis-surgery
#9
Margaret L Wright, David L Skaggs, Hiroko Matsumoto, Regina P Woon, Ashley Trocle, John M Flynn, Michael G Vitale
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the association of implant metal composition with the risk of surgical site infection (SSI) following pediatric spine surgery. SUMMARY OF BACKGROUND DATA: SSI is a well-described complication following pediatric spine surgery. Many risk factors have been identified in the literature, but controversy remains regarding metal composition as a risk factor. METHODS: This was a retrospective study of patients who underwent posterior spinal instrumentation procedures between January 1, 2006, and December 31, 2008, at three large children's hospitals for any etiology of scoliosis and had at least 1 year of postoperative follow-up...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27791706/patient-reported-outcomes-of-occipitocervical-and-atlantoaxial-fusions-in-children
#10
Aditya Vedantam, Daniel Hansen, Valentina Briceño, Alison Brayton, Andrew Jea
OBJECTIVE There is limited literature on patient-reported outcomes (PROs) and health-related quality of life (HRQOL) outcomes in pediatric patients undergoing surgery for craniovertebral junction pathology. The aim of the present study was to assess surgical and quality of life outcomes in children who had undergone occipitocervical or atlantoaxial fusion. METHODS The authors retrospectively reviewed the demographics, procedural data, and outcomes of 77 consecutive pediatric patients who underwent posterior occipitocervical or atlantoaxial fusion between 2008 and 2015 at Texas Children's Hospital...
January 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27749348/perioperative-surgical-home-in-pediatric-settings-preliminary-results
#11
Karen Thomson, Sophie R Pestieau, Janish J Patel, Heather Gordish-Dressman, Ariana Mirzada, Zeev N Kain, Matthew E Oetgen
BACKGROUND: The Perioperative Surgical Home (PSH) is a patient-centered, team-based approach that aims to improve the value of perioperative care. We implemented a PSH for patients with adolescent idiopathic scoliosis who were undergoing posterior spinal fusion at Children's National Health System. We hypothesized that this PSH would improve patient surgical outcomes and reduce hospital length of stay (LOS). METHODS: A multidisciplinary group created evidence-based protocols for the preoperative, operative, postoperative, and postdischarge care of this patient population...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27713677/intraoperative-anaphylactic-reaction-is-it-the-floseal
#12
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27603190/intraoperative-hypothermia-is-common-but-not-associated-with-blood-loss-or-transfusion-in-pediatric-posterior-spinal-fusion
#13
Mathew D Schur, Gideon W Blumstein, Derek A Seehausen, Patrick A Ross, Lindsay M Andras, David L Skaggs
BACKGROUND: Intraoperative hypothermia may be associated with increased blood loss due to the effects of temperature on clotting but this has not been evaluated in the setting of pediatric posterior spinal fusion (PSF). The purpose of this study was to determine if a correlation exists between intraoperative hypothermia and estimated blood loss (EBL) or transfusion requirements in pediatric patients undergoing PSF. METHODS: A retrospective review of consecutive patients undergoing PSF for scoliosis at a single institution between 6/2004 and 3/2012 was performed...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27589598/factors-associated-with-spinal-fusion-after-posterior-fossa-decompression-in-pediatric-patients-with-chiari-i-malformation-and-scoliosis
#14
Charles E Mackel, Patrick J Cahill, Marie Roguski, Amer F Samdani, Patrick A Sugrue, Noriaki Kawakami, Peter F Sturm, Joshua M Pahys, Randal R Betz, Ron El-Hawary, Steven W Hwang
OBJECTIVE The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve. METHODS The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression...
December 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27584679/the-association-between-adjuvant-pain-medication-use-and-outcomes-following-pediatric-spinal-fusion
#15
Rebecca E Rosenberg, Stacey Trzcinski, Mindy Cohen, Mark Erickson, Thomas Errico, Lisa McLeod
STUDY DESIGN: Comparative effectiveness database study. OBJECTIVE: To describe variation in use of adjuvant therapies for managing postoperative pain in in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic (AIS) and determine association between use of these therapies and patient outcomes. SUMMARY OF BACKGROUND DATA: Variation in postoperative pain management for children undergoing PSF for AIS likely impacts outcomes...
August 31, 2016: Spine
https://www.readbyqxmd.com/read/27398889/prolonged-perioperative-low-dose-ketamine-does-not-improve-short-and-long-term-outcomes-after-pediatric-idiopathic-scoliosis-surgery
#16
Marina Perelló, David Artés, Cristina Pascuets, Elisabeth Esteban, Ana M Ey Batlle
STUDY DESIGN: A randomized, double-blind, placebo-controlled study, with a six-month follow-up period. OBJECTIVES: The aim of this study was to test the hypothesis that a 72-hour dose of subanesthetic ketamine in this surgical procedure reduces postoperative morphine use and to assess whether there are fewer adverse effects, if postoperative recovery is faster, if there is less peri-incisional hyperalgesia, or if there is lower incidence of persistent postsurgical pain...
March 2017: Spine
https://www.readbyqxmd.com/read/27326974/proximal-junctional-kyphosis-following-posterior-hemivertebra-resection-and-short-fusion-in-children-younger-than-10-years
#17
Yingsong Wang, Noriaki Kawakami, Taichi Tsuji, Tetsuya Ohara, Yoshitaka Suzuki, Toshiki Saito, Ayato Nohara, Ryoji Tauchi, Kazuki Kawakami
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate whether PJK or obvious proximal junctional angle (PJA) changes in the sagittal plane develops following short fusion in children younger than 10 years of age with congenital scoliosis, and to investigate the possible risk factors. SUMMARY OF BACKGROUND DATA: Proximal junctional kyphosis (PJK) following long spinal fusion in adolescents and adults is a serious postoperative complication...
June 20, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27203810/spinal-fusion-for-pediatric-neuromuscular-scoliosis-national-trends-complications-and-in-hospital-outcomes
#18
Kavelin Rumalla, Chester K Yarbrough, Andrew J Pugely, Linda Koester, Ian G Dorward
OBJECTIVE The objective of this study was to determine if the recent changes in technology, surgical techniques, and surgical literature have influenced practice trends in spinal fusion surgery for pediatric neuromuscular scoliosis (NMS). In this study the authors analyzed recent trends in the surgical management of NMS and investigated the effect of various patient and surgical factors on in-hospital complications, outcomes, and costs, using the Nationwide Inpatient Sample (NIS) database. METHODS The NIS was queried from 2002 to 2011 using International Classification of Diseases, Ninth Edition, Clinical Modification codes to identify pediatric cases (age < 18 years) of spinal fusion for NMS...
October 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27186138/clevidipine-resistance-in-a-patient-taking-aripiprazole-and-methylphenidate
#19
M Alysse Jacklen, Jason A Campagna, Joseph D Tobias
Various factors may be responsible for blood pressure alterations during perioperative care. When these physiologic alterations require treatment, several therapeutic options are available. Clevidipine is an ultrashort-acting, intravenous L-type calcium channel antagonist of the dihydropyridine class. Anecdotal experience has demonstrated its efficacy in various clinical scenarios in the pediatric population. We report apparent resistance to the vasodilatory effects of clevidipine in a 13-year-old girl who presented for anesthetic care during posterior spinal fusion for neuromuscular scoliosis whose chronic medication regimen included aripiprazole and methylphenidate for the treatment of depression and attention-deficit/hyperactivity disorder...
2014: Journal of Experimental Pharmacology
https://www.readbyqxmd.com/read/27172284/metallosis-presenting-as-a-progressive-neurologic-deficit-four-years-after-a-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis-a-case-report
#20
Seth H Richman, Andrew J Razzano, Melanie A Morscher, Patrick M Riley
STUDY DESIGN: A case report. OBJECTIVE: The aim of this study was to report a case of progressive pain and paraparesis secondary to metallosis four years after a pediatric posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: Metallosis as a late complication of pediatric spinal surgery is rarely reported. Myelographic computed tomography (CT) can be helpful in establishing the diagnosis. The use of serum chromium levels as a means of definitive diagnosis has been suggested, but has only been reported retrospectively...
January 1, 2017: Spine
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