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Pediatric posterior spinal fusion

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https://www.readbyqxmd.com/read/28937466/compressive-myelopathy-in-congenital-kyphosis-of-the-upper-thoracic-spine-a-retrospective-study-of-6-cases
#1
Zhengfeng Zhang, Honggang Wang, Wenjie Zheng
STUDY DESIGN: A retrospective study. OBJECTIVE: The goal of this retrospective study was to describe the uncommon presentation of neurological deficits in patients with congenital kyphosis of the upper thoracic spine (T1-T4). SUMMARY OF BACKGROUND DATA: Congenital kyphosis is an uncommon deformity but can potentially lead to spinal cord compression and paraplegia, particularly in type I (failure of formation) deformities. Few reports have described compressive myelopathy associated with congenital kyphosis of the upper thoracic spine...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28885083/risk-factors-for-progressive-neuromuscular-scoliosis-requiring-posterior-spinal-fusion-after-selective-dorsal-rhizotomy
#2
Vijay M Ravindra, Michael T Christensen, Kaine Onwuzulike, John T Smith, Kyle Halvorson, Douglas L Brockmeyer, Marion L Walker, Robert J Bollo
OBJECTIVE Selective dorsal rhizotomy (SDR) via limited laminectomy is an effective treatment of lower-extremity spasticity in the pediatric population. Children with spasticity are also at risk for neuromuscular scoliosis; however, specific risk factors for progressive spinal deformity requiring posterior spinal fusion (PSF) after SDR are unknown. The authors' goal was to identify potential risk factors. METHODS The authors performed a retrospective cohort study of patients who underwent SDR via limited laminectomy between 2003 and 2014 and who had at least 1 year of follow-up...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#3
Mark C Lee, Casey Jarvis, Matthew J Solomito, Jeffrey Thomson
Background Context Many pelvic fixation options exist for posterior spinal fusion of pediatric neuromuscular scoliosis, including standard iliac screws (SIS) or a more recently introduced S2-Alar (S2A) technique. However, little data exists comparing the clinical and radiographic outcomes of these techniques. Purpose Identify differences in clinical and radiographic outcomes for pediatric neuromuscular scoliosis patients treated with standard iliac screw (SIS) or S2-Alar (S2-A) pelvic fixation. Study Design/Setting Retrospective cohort study at a pediatric orthopaedic clinic...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28870307/perioperative-pain-management-in-pediatric-spine-surgery
#4
REVIEW
Benjamin W Sheffer, Derek M Kelly, Leslie N Rhodes, Jeffrey R Sawyer
Pain management after spinal deformity correction surgery for scoliosis in the pediatric population can be difficult. Deformity correction with posterior spinal fusion causes significant tissue trauma. Historically, pain control has been achieved with intravenous opiates. Opiates provide excellent analgesic effect; however, they have serious consequences when used alone. In adult total joint arthroplasty, multimodal pain control has become an increasingly common method to achieve pain control without these sequelae...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28837459/the-crankshaft-phenomenon
#5
Robert F Murphy, James F Mooney
The crankshaft phenomenon, a progressive rotational and angular spinal deformity that can occur after posterior spinal surgery, has been reported in pediatric patients with idiopathic, congenital, and neuromuscular scoliosis. In the skeletally immature patient, the crankshaft phenomenon is thought to occur secondary to continued growth of the anterior elements of the spine after solid posterior spinal fusion. The condition has also been reported in the setting of newer, so-called growth-friendly posterior distraction-based spinal instrumentation...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28520681/delayed-dural-leak-following-posterior-spinal-fusion-for-idiopathic-scoliosis-using-all-posterior-pedicle-screw-technique
#6
Lorena V Floccari, A Noelle Larson, Anthony A Stans, Jeremy Fogelson, Iikka Helenius
BACKGROUND: In pediatric patients, pedicle screws are malpositioned 5% to 15% of the time. Complications associated with malpositioned screws are infrequently reported in the literature. We present a series of adolescent idiopathic scoliosis (AIS) patients who presented in a delayed manner with positional headache and chronic dural leak adjacent to the pedicle screw tract. METHODS: Scoliosis databases at 2 centers were reviewed, and cases of delayed positional headaches following posterior spinal fusion for AIS were identified...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28466094/periosteal-turndown-flap-for-posterior-occipitocervical-fusion-a-technique-review
#7
Siamak Yasmeh, Adrienne Quinn, Liam Harris, Austin E Sanders, Ted Sousa, David L Skaggs, Lindsay M Andras
PURPOSE: Recently, several authors have proposed techniques for improving the fusion rate in pediatric posterior occipitocervical fusion including a variety of implants and the use of bone morphogenetic protein. A technique by Koop et al. using a periosteal flap for occipitocervical arthrodesis was described in 1984. METHODS: A straight incision is made about the posterior neck to expose the occipitocervical region from the inion superiorly to the lowest cervical vertebrae to be fused inferiorly...
May 2, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28448398/intrathecal-morphine-versus-extended-release-epidural-morphine-for-postoperative-pain-control-in-pediatric-patients-undergoing-posterior-spinal-fusion
#8
RANDOMIZED CONTROLLED TRIAL
Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin
BACKGROUND: Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine. METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28441684/development-of-consensus-based-best-practice-guidelines-for-postoperative-care-following-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#9
Nicholas D Fletcher, Michael P Glotzbecker, Michelle Marks, Peter O Newton
STUDY DESIGN: Delphi process with multiple iterative rounds using a nominal group technique. OBJECTIVE: The aim of this study was to use expert opinion to achieve consensus on various aspects of postoperative care following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Significant variability exists in postoperative care following PSF for AIS, despite a relatively healthy patient population and continuously improving operative techniques...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28437340/proximal-junctional-kyphosis-following-posterior-hemivertebra-resection-and-short-fusion-in-children-younger-than-10-years
#10
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 proximal junctional kyphosis (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: PJK following long spinal fusion in adolescents and adults is a serious postoperative complication...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28321954/anaphylactic-reaction-to-tranexamic-acid-in-an-adolescent-undergoing-posterior-spinal-fusion
#11
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.
July 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
#12
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
#13
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...
June 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
#14
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 radiologic outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities. METHODS: A case series of 11 pediatric patients with severe spinal deformity who were treated by PVCR between 2009 and 2013 were retrospectively analyzed...
May 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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