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Pediatric spine

Martha Nowosielski, Patrick Y Wen
The identification of more effective therapies for brain tumors has been limited in part by the lack of reliable criteria for determining response and progression. Since its introduction in 1990, the MacDonald criteria have been used in neuro-oncology clinical trials to determine response, but they fail to address issues such as pseudoprogression, pseudoresponse, and nonenhancing tumor progression that have arisen with more recent therapies. The Response Assessment in Neuro-Oncology (RANO) working group, a multidisciplinary international group consisting of neuro-oncologists, medical oncologists, neuroradiologists, neurosurgeons, radiation oncologists, and neuropsychologists, was formed to improve response assessment and clinical trial endpoints in neuro-oncology...
February 2018: Seminars in Neurology
Swaminathan Ganesh, Gandham E Jonathan, Bimal Patel, Krishna Prabhu
No abstract text is available yet for this article.
March 2018: Neurology India
Kyriakos Paraskeva, Dimitrios Giakoumettis, Ioannis Nikas, George Georgoulis, George Sfakianos, Marios S Themistocleous
INTRODUCTION: Neck pain and torticollis are common symptoms in the pediatric population that rarely requires further investigation. However, in case symptoms persist, then a more meticulously approach should be considered. Underlying conditions such as infections, neck injury, autoimmune disorders or even cervical spine cancer should be excluded from diagnosis. Cervical spine cancer is a rare neurosurgical entity in the pediatric population and even rarer is atlantoaxial Ewing's sarcoma...
March 3, 2018: Neurologia i Neurochirurgia Polska
Carolyn J Baglole, Feng Liang, Hussein Traboulsi, Angela Rico de Souza, Christian Giordano, Josephine T Tauer, Frank Rauch, Basil J Petrof
BACKGROUND: Osteogenesis imperfecta (OI) is most often caused by mutations in type I collagen genes. Respiratory complications have been largely attributed to spine and ribcage deformities. We hypothesized that direct involvement of the pulmonary parenchyma and/or diaphragm by the disease may occur. METHODS: In Col1a1Jrt/+ mice, a model of severe dominant OI, mean linear intercept length (Lm) was used to assess distal airspace size. Cross-sectional area (CSA) and myosin heavy chain (MyHC) phenotype of diaphragm muscle fibers, as well as contractile properties, were determined...
March 14, 2018: Pediatric Research
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Joel B Huleatt, Carl W Nissen, Matthew D Milewski
The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...
April 2018: Clinics in Sports Medicine
Alexander J Adams, Nakul S Talathi, Jigar S Gandhi, Neeraj M Patel, Theodore J Ganley
Fractures of the tibial spine are estimated to occur in 3 per 100,000 children annually, but account for 2 to 5% of pediatric knee injuries with effusion. Although these fractures were historically associated with bicycle accidents, the surge of organized youth sports in recent decades has brought renewed attention to this injury. While minimally displaced fractures can be treated nonoperatively, several techniques have been described for fixation of displaced or comminuted fractures. Sequelae of this injury can include arthrofibrosis, knee instability, and nonunion...
March 7, 2018: Journal of Knee Surgery
Xiangsheng Tang, Liang Dong, Mingsheng Tan, Ping Yi, Feng Yang, Qingying Hao
OBJECTIVE: The goal of this study was to evaluate the impact of C1-C2 pedicle screw fixation on the occipitoatlantal angle and subaxial cervical spine for a pediatric population, and the clinical efficacy and adjacent-segment degeneration after C1-C2 pedicle screw fixation with a minimum of 2 years of follow-up. METHODS: Twenty-two pediatric patients with atlantoaxial dislocation who were enrolled in this study underwent atlantoaxial pedicle screw fixation. The correlation between C0-C1, C2-C7, and C1-C2 pre- and postoperative sagittal angles was assessed using plain radiographs, and adjacent-segment degeneration (ASD) and JOA scores (Japanese Orthopaedic Association scores) were evaluated after atlantoaxial pedicle screw fixation...
March 8, 2018: Pediatric Neurosurgery
Pooya Hosseinzadeh, Craig Louer, Jeffrey Sawyer, John Flynn, Stephen Albanese
BACKGROUND: The field of pediatric orthopaedic surgery is evolving with a reported increase in the number of pediatric orthopaedic fellows being trained as well as an increase in the number of fellows completing additional fellowship training in another subspecialty. The purpose of this study was to examine the historic trends of trainees seeking multiple fellowships within pediatric orthopaedics over an 11-year period using the database of the American Board of Orthopaedic Surgery (ABOS)...
March 5, 2018: Journal of Pediatric Orthopedics
Taylor E Purvis, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, C Rory Goodwin, Mari L Groves, Michael C Ain, Daniel M Sciubba
OBJECTIVE: To compare in-hospital complication rates in pediatric patients with atlantoaxial and subaxial injuries undergoing either external fixation or surgical fusion. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2002-2011 Nationwide Inpatient Sample (NIS) for patients under the age of 18 with a diagnosis of cervical spine fracture without spinal cord injury or cervical spine subluxation. Patients who underwent external immobilization or internal fixation were included for analysis...
February 5, 2018: Clinical Neurology and Neurosurgery
Muhammad Younus Khan Durrani, Amir Humza Sohail, Inamullah Khan, Pervaiz Hashmi
Various shoulder bone deformities have been identified in the pediatric age group, with the most common being undescended scapula. Sprengel's deformity is dysplasia and malposition of the scapula, especially in the supraspinatus portion, mainly due to abnormal descent in the embryonic period. The clavicle is shorter and has a different contour. In some patients cervical spine deformities are also noted. This is a case of 3 years old girl presented to the clinic with difficulty in abducting right shoulder and sleeping with an internal rotation of the right arm...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Matthew E Oetgen
Evidence-based medicine (EBM) is a process of decision-making aimed at making the best clinical decisions as they relate to patients' health. The current use of EBM in pediatric spine surgery is varied, based mainly on the availability of high-quality data. The use of EBM is limited in idiopathic scoliosis, whereas EBM has been used to investigate the treatment of pediatric spondylolysis. Studies on early onset scoliosis are of low quality, making EBM difficult in this condition. Future focus and commitment to study quality in pediatric spinal surgery will likely increase the role of EBM in these conditions...
April 2018: Orthopedic Clinics of North America
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
Elham Z Movassagh, Adam D G Baxter-Jones, Saija Kontulainen, Susan Whiting, Michael Szafron, Hassan Vatanparast
BACKGROUND: The amount of bone accrued during adolescence is an important determinant of later osteoporosis risk. Little is known about the influence of dietary patterns (DPs) on the bone during adolescence and their potential long-term implications into adulthood. We examined the role of adolescent DPs on adolescent and young adult bone and change in DPs from adolescence to young adulthood. METHODS: We recruited participants from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2011)...
February 28, 2018: Nutrition Journal
Angela R Shih, Gregory M Cote, Ivan Chebib, Edwin Choy, Thomas DeLaney, Vikram Deshpande, Francis J Hornicek, Ruoyu Miao, Joseph H Schwab, G Petur Nielsen, Yen-Lin Chen
Chordoma is a rare malignant tumor of bone with high morbidity and mortality. Recently, aggressive pediatric poorly differentiated chordoma with SMARCB1 loss has been described. This study summarizes the clinicopathologic features of poorly differentiated chordoma with SMARCB1 loss in the largest series to date. A search of records between 1990-2017 at MGH identified 19 patients with poorly differentiated chordoma. Immunohistochemical stains were evaluated. Kaplan-Meier survival statistics and log-rank (Mantel Cox) tests compared survival with other subtypes...
February 26, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Jonathan A Mitchell, Alessandra Chesi, Shana E McCormack, Diana L Cousminer, Heidi J Kalkwarf, Joan M Lappe, Vicente Gilsanz, Sharon E Oberfield, John A Shepherd, Andrea Kelly, Struan F A Grant, Babette S Zemel
PURPOSE: To determine if replacing time spent in high and low impact physical activity (PA) predicts changes in pediatric bone mineral density (BMD) and content (BMC). METHODS: We analyzed data from the longitudinal Bone Mineral Density in Childhood Study (N=2,337 with up to 7 visits). The participants were aged 5-19 years at baseline, 51.2% were female and 80.6% were non-Black. Spine, total hip, and femoral neck areal BMD (aBMD) and total body less head (TBLH) BMC Z-scores were calculated...
February 20, 2018: Medicine and Science in Sports and Exercise
Christopher Elia, Omid R Hariri, Jason Duong, Fanglong Dong, Raed Sweiss, Dan Miulli
INTRODUCTION: Laminectomy utilizing a high-speed drill with an unprotected cutting drill bit can be rapid and effective, but it has been associated with known complications. Another technique utilizes a pediatric craniotome drill with the footplate attachment. Currently, there are no studies comparing clinical outcomes between these two stated decompressive techniques. METHODS: A retrospective review was conducted at a single institution. Two cohorts of patients were considered based on the technical method of laminectomy for decompression...
February 17, 2018: World Neurosurgery
Andrew T Pennock, James D Bomar, John D Manning
BACKGROUND: In managing many pediatric knee conditions, an accurate bone age assessment may be critical for diagnostic, prognostic, and treatment purposes. The aim of this study was to create an atlas of magnetic resonance imaging (MRI) studies of the knee spanning the pediatric and adolescent years that would enable accurate skeletal age to be assessed, potentially forgoing the need for a left-hand radiograph. METHODS: We performed a retrospective assessment of 11 to 31 MRIs from male and female patients of each age from 2 to 19 years...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Victor S Alvarez, Svein Kleiven
Finite element (FE) models are a powerful tool that can be used to understand injury mechanisms and develop better safety systems. This study aims to extend the understanding of pediatric spine biomechanics, where there is a paucity of studies available. A newly developed and continuously scalable FE model was validated and scaled to 1.5-, 3-, 6-, 10-, 14- and 18-year-old using a non-linear scaling technique, accounting for local topological changes. The oldest and youngest ages were also scaled using homogeneous geometric scaling...
February 8, 2018: Journal of Biomechanics
Joseph Piatt, Nicholas Imperato
OBJECTIVE There has been no successful study of trends in population-based incidences of pediatric spinal injury in the United States. The goal of the current study was to develop robust data to correct this deficiency in contemporary trauma epidemiology. METHODS Discharges coded for spinal injury were extracted from the Kids' Inpatient Database for 1997, 2000, 2003, 2006, 2009, and 2012 for patients younger than 18 years. Childhood was defined as ages 0 through 14 years and adolescence as ages 15, 16, and 17 years...
February 16, 2018: Journal of Neurosurgery. Pediatrics
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