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Pediatric spine

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https://www.readbyqxmd.com/read/28735126/multilevel-spinal-segmental-fixation-for-kyphotic-cervical-spinal-deformity-in-pediatric-age-group-report-of-management-in-2-cases
#1
Atul Goel, Amol Kaswa, Abhidha Shah, Arjun Dhar
OBJECTIVE: We discuss the role of instability of multiple segments of spine that includes atlantoaxial joint in pathogenesis of cervical kyphotic deformity. MATERIAL AND METHODS: Two male patients (5 and 17 year old) had severe cervical kyphosis and presented with symptoms related to myelopathy. The patients underwent multi-segmental spinal distraction and fixation that included atlantoaxial joint. No bone decompression was done. RESULTS: At a follow-up of more than 30 months, both patients had significant neurological recovery...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28713667/absent-congenital-cervical-pedicle-nearly-misdiagnosed-as-a-facet-dislocation-a-case-report
#2
Scott Safir, Jonathan Rasouli, Jeremy Steinberger, Branko Skovrlj, Amish Doshi, Konstantinos Margetis, Saadi Ghatan
BACKGROUND: Cervical spinal injury encompasses up to 1.5% of all pediatric injuries. Children, and more specifically infants, are a difficult subset of patients to obtain neurological exam in the setting of trauma, thus necessitating the use of cervical X-rays, CT scans, and MRI imaging. CASE DESCRIPTION: A healthy, 15-month-old boy had an unwitnessed fall down a flight of stairs and received a CT scan of the head and cervical spine in the emergency department due to cephalohematoma and mechanism of injury...
September 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/28710045/management-of-pediatric-atlantoaxial-rotatory-subluxation-with-a-simple-hand-made-cervical-traction-device-doing-more-with-less
#3
Mohammad Sadegh Masoudi, Nima Derakhshan, Fariborz Ghaffarpasand, Tayebeh Sadeghpoor
Atlanto-axial (C1- C2) joint is accountable for up to two third of total axial craniocervical rotation. Its major role in pivotal rotation of cervical spine makes it more vulnerable to a certain type of injury known as atlanto-axial rotatory subluxation (AARS). Management of AARS is based on the Fielding classification which includes closed reduction and immobilization and cervical fusion in unstable cases. There are several cervical traction devices including the Gardner-Wells tongs and halter traction device...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#4
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28690908/primary-occipital-ewing-s-sarcoma-with-subsequent-spinal-seeding
#5
Ali Alqahtani, Roaa Amer, Eman Bakhsh
Ewing's sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing's sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28689877/a-10-year-follow-up-of-bone-mineral-density-in-hiv-infected-youths-receiving-tenofovir-disoproxil-fumarate
#6
Vania Giacomet, Katia Maruca, Alessandro Ambrosi, Gian Vincenzo Zuccotti, Stefano Mora
BACKGROUND: The use of tenofovir disoproxil fumarate (TDF) has simplified the antiretroviral regimen for HIV-infected patients and improved their compliance with treatment, but it has been associated with decreased bone mineral density (BMD) in adult patients, and data in pediatric patients are debated. The aim of the current study was to assess the long-term effect of TDF on BMD in young patients. METHODS: BMD was measured at the lumbar spine and in the whole skeleton in 26 HIV-infected youths (13 female and 13 male, aged 5 to 17 years at baseline)...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28685857/biomechanical-simulations-of-costo-vertebral-and-anterior-vertebral-body-tethers-for-the-fusionless-treatment-of-pediatric-scoliosis
#7
Carl-Éric Aubin, Julien Clin, Jeremy Rawlinson
Compression-based fusionless tethers are an alternative to conventional surgical treatments of pediatric scoliosis. Anterior approaches place an anterior (ANT) tether on the anterolateral convexity of the deformed spine to modify growth. Posterior, or costo-vertebral (CV), approaches have not been assessed for biomechanical and corrective effectiveness. The objective was to biomechanically assess CV and ANT tethers using six patient-specific, finite element models of adolescent scoliotic patients (11.9 ± 0...
July 7, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28678026/transoral-closed-reduction-of-fixed-atlanto-axial-rotatory-subluxation-aars-in-childhood-and-adolescence
#8
Dezsoe Jeszenszky, Tamas Fekete, Frank Kleinstück, Daniel Haschtmann, Markus Loibl
Atlanto-axial rotatory-subluxation (AARS) is the most common pediatric cervical spine injury. Patients usually present with contralateral rotation and inclination of the upper cervical spine after minor trauma, or associated with an infection of the upper respiratory tract. According to the authors, initial management of patients with acute and chronic AARS type I-II should comprise closed reduction and immobilization with a cervical collar or a Halo-Body-Jacket. Surgical options of open reduction or C1/2 fusion should be restricted to irreducible or recurrent subluxations...
July 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28678011/-coordinated-care-unit-for-patients-with-neural-tube-anomalies-and-their-families
#9
Liliana Raquel Menna, Carlos Miguélez Lago
Bifid Spine is a multisystem malformation incurable and transmissible with a lot of important sequelae, some of them with treatment and some other avoidable. They affect and limit not only health but social-work life too. The main objective must be prevention. The primary prevention, meaning not occurrence, could be done by recognizing the possible etiologic factors that affect the population. This is a responsibility of health policies based in scientific evidences and expert's opinions. Secondary prevention would be to make efforts to decrease the consequences and improve newborns with bifid spine lif's quality and life expectancy...
July 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28676226/late-toxicity-and-outcomes-following-radiation-therapy-for-chest-wall-sarcomas-in-pediatric-patients
#10
John T Lucas, Israel Fernandez-Pineda, Christopher L Tinkle, Michael W Bishop, Sue C Kaste, Rajiv Heda, Andrew M Davidoff, Matthew J Krasin
PURPOSE: To investigate the contribution of radiation therapy to acute and late toxicity in pediatric chest wall sarcoma patients and evaluate dosimetric correlates of higher incidence toxicities such as scoliosis and pneumonitis. METHODS AND MATERIALS: The data from 23 consecutively treated pediatric patients with chest wall sarcomas of various histologies (desmoid, Ewing, rhabdomyosarcoma, nonrhabdomyosarcoma-soft tissue sarcomas) were reviewed to evaluate the relationship between end-organ radiation dose, clinical factors, and the risk of subsequent late effects (scoliosis, pneumonitis)...
April 26, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28665821/spine-and-thoracic-height-measurements-have-excellent-interrater-and-intrarater-reliability-in-patients-with-early-onset-scoliosis
#11
Nicole Michael, Patrick Carry, Mark Erickson, Nikki Bloch, Steven Gibbons, Courtney O'Donnell, Sumeet Garg
STUDY DESIGN: Reproducibility of measurements OBJECTIVE.: This study investigates the reliability and standard error of measurement of spine and thoracic height radiographic measurements in patients with early onset scoliosis (EOS). SUMMARY OF BACKGROUND DATA: Spine and thoracic height radiographic measurements are often used as a surrogate for pulmonary development in patients with EOS. There is limited literature validating the reliability of spine and thoracic height measurements in the EOS population...
June 29, 2017: Spine
https://www.readbyqxmd.com/read/28665242/changes-in-use-of-cervical-spine-magnetic-resonance-imaging-for-pediatric-patients-with-nonaccidental-trauma
#12
Ahyuda Oh, Michael Sawvel, David Heaner, Amina Bhatia, Andrew Reisner, R Shane Tubbs, Joshua J Chern
OBJECTIVE Past studies have suggested correlations between abusive head trauma and concurrent cervical spine (c-spine) injury. Accordingly, c-spine MRI (cMRI) has been increasingly used in radiographic assessments. This study aimed to determine trends in cMRI use and treatment, and outcomes related to c-spine injury in children with nonaccidental trauma (NAT). METHODS A total of 503 patients with NAT who were treated between 2009 and 2014 at a single pediatric health care system were identified from a prospectively maintained database...
June 30, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28657811/description-of-the-case-mix-experienced-by-chiropractic-students-during-a-clinical-internship
#13
Aaron A Puhl, Christine J Reinhart, H Stephen Injeyan, Anthony Tibbles
OBJECTIVE: The primary objective of this study was to describe the case mix experienced by chiropractic students during their clinical internship at the Canadian Memorial Chiropractic College. Secondary objectives were to characterize teaching clinic patient populations, assess the similarity to previously published data for practicing chiropractors, and describe the treatment plans being recommended by interns. METHODS: A prospective, observational study was conducted using a convenience sample of 24 chiropractic interns...
June 28, 2017: Journal of Chiropractic Education
https://www.readbyqxmd.com/read/28656384/x-ray-vs-ct-in-identifying-significant-c-spine-injuries-in-the-pediatric-population
#14
Andrew T Hale, Abraham Alvarado, Amita K Bey, Sumit Pruthi, Gregory A Mencio, Christopher M Bonfield, Jeffrey E Martus, Robert P Naftel
PURPOSE: Evaluation of cervical spine injury (CSI) in children requires rapid, yet accurate assessment of damage. Given concerns of radiation exposure, expert consensus advises that computed tomography (CT) should be used sparingly. However, CT can provide superior image resolution and detection of pathology. Herein, we evaluate if X-ray offers equal diagnostic accuracy compared to CT imaging in identifying CSI in children. METHODS: We conducted a retrospective study between October 2000 and March 2012 of pediatric patients evaluated for cervical spine injury at a level 1 trauma center...
June 27, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28654505/avulsion-of-the-anterior-inferior-iliac-spine-rehabilitation-in-a-rural-private-practice
#15
Damon Burn
An unusual case is presented of an 11-year-old girl presenting for treatment to a semirural private physical therapy practice, not specializing in pediatric care, following an avulsion fracture of the anterior inferior iliac spine. The patient presented initially non-weight-bearing, with little hip movement due to pain. Following treatment, the patient returned to preinjury status including return to full participation in netball. A review of the literature regarding healing and rehabilitation is described...
July 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28650886/elevated-fdg-activity-in-the-nonpneumatized-sphenoid-bone-in-an-infant
#16
Yin Jie Chen, Nelleke Tolboom, Lisa J States, Hongming Zhuang
A 7-month-old boy with malignant rhabdoid tumor of the right lateral neck, status post resection and chemotherapy, underwent FDG PET/CT for restaging. The images showed diffuse increased activity in the spleen and in the bone marrow of the appendicular bones and the spine, which is related to hematopoietin administered after chemotherapy. The images also revealed intense activity in the region of sphenoid bone, which is not a common region to have elevated FDG activity. The subsequent MRI scan showed that this activity was due to not-yet-converted red marrow in the sphenoid bone in this pediatric patient...
June 24, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#17
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#18
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640707/response-assessment-in-neuro-oncology-clinical-trials
#19
Patrick Y Wen, Susan M Chang, Martin J Van den Bent, Michael A Vogelbaum, David R Macdonald, Eudocia Q Lee
Development of novel therapies for CNS tumors requires reliable assessment of response and progression. This requirement has been particularly challenging in neuro-oncology for which contrast enhancement serves as an imperfect surrogate for tumor volume and is influenced by agents that affect vascular permeability, such as antiangiogenic therapies. In addition, most tumors have a nonenhancing component that can be difficult to accurately quantify. To improve the response assessment in neuro-oncology and to standardize the criteria that are used for different CNS tumors, the Response Assessment in Neuro-Oncology (RANO) working group was established...
July 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28632204/successful-pharmacotherapy-for-the-treatment-of-severe-feeding-aversion-with-mechanistic-insights-from-cross-species-neuronal-remodeling
#20
W G Sharp, A G Allen, K H Stubbs, K K Criado, R Sanders, C E McCracken, R G Parsons, L Scahill, S L Gourley
Pediatric feeding disorders affect up to 5% of children, causing severe food intake problems that can result in serious medical and developmental outcomes. Behavioral intervention (BI) is effective in extinguishing feeding aversions, and also expert-dependent, time/labor-intensive and not well understood at a neurobiological level. Here we first conducted a double-blind, placebo-controlled trial comparing BI with BI plus d-cycloserine (DCS). DCS is a partial N-methyl-d-aspartate (NMDA) receptor agonist shown to augment extinction therapies in multiple anxiety disorders...
June 20, 2017: Translational Psychiatry
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