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Pediatric spine

Andrea Angelini, Andreas F Mavrogenis, Eugenio Rimondi, Giuseppe Rossi, Pietro Ruggieri
This review summarizes current concepts in the diagnosis and management of the patients with eosinophilic granuloma. Given the benign biology, the clinical course, and the pediatric group of patients that this condition more commonly affects, a treatment approach that carries a lower risk of complications while ensuring a successful cure is desirable. Variable treatment options have been reported with satisfactory results and a recurrence rate of less than 20 %. In this setting, symptomatic lesions that are accessible in the spine or the extremities may be treated with intralesional methylprednisolone injection after tissue biopsy for histological diagnosis...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
J Do Cao, A Wiedemann, T Quinaux, S F Battaglia-Hsu, L Mainard, R Froissart, C Bonnemains, S Ragot, B Leheup, P Journeau, F Feillet
: Patients under 5 years were not evaluated in the phase-3 study for enzyme replacement therapy (ERT) in MPS IV A. Here we describe the evolution of a severe Morquio A pediatric patient who was diagnosed at 19 months old and treated by ERT at 21 months old for the next 30 months. Applying the standard ERT protocol on this very young patient appeared to reduce his urinary excretion of glycosaminoglycans (GAGs); the improvements in both the 6 minute-walk test (6MWT) and the stair climb test, however, were no different than those reported in the nature history study...
December 2016: Molecular Genetics and Metabolism Reports
Tommy Y Kim, Kristin Ratnayake
Minor cervical spine injury is a common cause of pediatric emergency department visits. We present a case of a 10-year-old boy with transient paresthesia after minor cervical trauma found to have a rare cervical spine abnormality requiring surgical fusion. We present and discuss the management options for os odontoideum.
October 8, 2016: Pediatric Emergency Care
Soo Young Jin, Seong Beom Oh, Young Oh Kim
OBJECTIVE: This study aimed to compare the optimal chest compression depth for infants and children with that of adults when the simulated compression depth was delivered according to the current guidelines. METHODS: A total of 467 consecutive chest computed tomography scans (93 infants, 110 children, and 264 adults) were reviewed. The anteroposterior diameter and compressible diameter (CD) for infants and children were measured at the inter-nipple level and at the mid-lower half of the spine for adults...
March 2016: Clin Exp Emerg Med
Lynn Babcock, Cody S Olsen, David M Jaffe, Julie C Leonard
OBJECTIVE: The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities. METHODS: This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury from sports or recreational activities (n = 179)...
September 30, 2016: Pediatric Emergency Care
Ki Jin Jung, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Byung Chae Cho, Myoung Ki Chung, Seung Jun Moon, Jaeyoung Kim, Moon Seok Park
The present study aimed to evaluate bone mineral density (BMD) in children and adolescents with cerebral palsy (CP) and to critically analyze the effects of a variety of factors, particularly the Gross Motor Function Classification System (GMFCS) level, the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire, and the Pediatric Outcomes Data Collection Instrument (PODCI), on BMD. Fifty patients with CP who underwent dual-energy X-ray absorptiometry were included. Collected data included the extent of involvement, muscle tone, demographic data, factors determined through chart review, and laboratory results...
October 11, 2016: Journal of Clinical Densitometry
Anna Marie Nathan, Hui Yan Loo, Jessie Anne de Bruyne, Kah Peng Eg, Sze Ying Kee, Surendran Thavagnanam, Marilyn Bouniu, Jiat Earn Wong, Chin Seng Gan, Lucy Chai See Lum
INTRODUCTION: Home ventilation (HV) for children is growing rapidly worldwide. The aim was to describe (1) the sociodemographic characteristics of children on HV and (2) the indications for, means and outcome of initiating HV in children from a developing country. METHODOLOGY: This retrospective study included patients sent home on noninvasive or invasive ventilation, over 13 years, by the pediatric respiratory unit in a single center. Children who declined treatment were excluded...
October 6, 2016: Pediatric Pulmonology
Kenneth Chin, Joshua M Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
February 15, 2016: Instructional Course Lectures
Suryapratap Singh
Baastrup's disease is an uncommon entity in the elderly spine and it is very rare in the pediatric age group. There are only few case reports in the literature containing Baastrup's disease in pediatric spine. Baastrup's disease is also known as kissing spine because the posterior spinous processes touch or "kiss" one another, characterized by enlarged posterior spinous projections with normal neuroforamina and normal spinal disk height. There are various pathological and etiological hypotheses behind Baastrup's disease...
October 2016: Asian Journal of Neurosurgery
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Robert W Molinari, Christine Kerr, Danielle Kerr
BACKGROUND: There is a paucity of literature describing the use of bone graft substitutes to achieve fusion in the pediatric spine. Outcomes and complications involving the off-label use of bone morphogenetic protein 2 (BMP-2) in the pediatric spine are not clearly defined. The purpose of this study is to review the existing literature with respect to reported outcomes and complications involving the use of low-dose BMP-2 in pediatric patients. METHODS: A Medline and PubMed literature search was conducted using the words bone morphogenetic protein, BMP, rh-BMP-2, bone graft substitutes, and pediatric spine...
March 2016: J Spine Surg
Silky Jain, Sandeep Jain, Gauri Kapoor, Anju Virmani, Ram Bajpai
BACKGROUND: Acute lymphoblastic leukemia (ALL) and its treatment are often implicated in adversely affecting bone health. Conflicting reports in the literature and a paucity of studies from the developing world prompted us to study bone mineral density (BMD) in childhood ALL survivors. METHODS: BMD lumbar spine (LS) and whole body (WB) were evaluated, using dual energy x-ray absorptiometry in 65 pediatric ALL survivors who had been off-therapy for at least 2 years...
September 26, 2016: Pediatric Blood & Cancer
Bartosz Polis, Jacek Krawczyk, Lech Polis, Emilia Nowosławska
PURPOSE: The aim of the article is to present the new extrapedicular percutaneous technique for posttraumatic vertebral column fracture. METHODS: A 15-year-old boy needed a surgical Th8 posttraumatic vertebral body (VB) compressive fracture reduction due to insufficient conservative treatment and consistent severe clinical symptoms. After 6 months of external Jevett long-roll brace stabilization, progressive sagittal balance disturbance of thoracic kyphosis was measured and persistent clinical symptoms were observed...
September 26, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
David Dornbos, Jocelyn Morin, Joshua R Watson, Jonathan Pindrik
Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease...
September 23, 2016: Journal of Neurosurgery. Pediatrics
Julio J Jauregui, Dean C Perfetti, Frank S Cautela, David B Frumberg, Qais Naziri, Carl B Paulino
BACKGROUND: Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. METHODS: A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries...
September 22, 2016: Journal of Pediatric Orthopedics
Omar Adib, Emeline Berthier, Didier Loisel, Christophe Aubé
Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult...
September 20, 2016: Skeletal Radiology
Rachel B Webman, Jennifer L Fritzeen, JaeWon Yang, Grace F Ye, Paul C Mullan, Faisal G Qureshi, Sarah H Parker, Aleksandra Sarcevic, Ivan Marsic, Randall S Burd
BACKGROUND: Errors directly causing serious harm are rare during pediatric trauma resuscitation, limiting the use of adverse outcome analysis for performance improvement in this setting. Errors not causing harm because of mitigation or chance may have similar causation and are more frequent than those causing adverse outcomes. Analyzing these error types is an alternative to adverse outcome analysis. The purpose of this study was to identify errors of any type during pediatric trauma resuscitation and evaluate team responses to their occurrence...
October 2016: Journal of Trauma and Acute Care Surgery
Robert F Murphy, James F Mooney
Complications following spine fusion for adolescent idiopathic scoliosis can be characterized as either intra-operative or post-operative. The most serious and feared complication is neurologic injury, both in the intra- and post-operative period. Other intra-operative complications include dural tears and ophthalmologic or peripheral nerve deficits, which may be related to positioning. Among the most common post-operative complications are surgical site infection, venous thromboembolism, gastrointestinal complications, and implant-related complications...
September 17, 2016: Current Reviews in Musculoskeletal Medicine
Manila Antonelli, Alessandro Raso, Samantha Mascelli, Marco Gessi, Paolo Nozza, Antonella Coli, Marina P Gardiman, Antonietta Arcella, Maura Massimino, Francesca R Buttarelli, Felice Giangaspero
Chordomas arise in the skull base and spine and usually occur in adults and are rare in the pediatric population. Cases of chordoma in pediatric age are often poorly differentiated, showing cytologic atypia, increased cellularity, and mitosis, and their aggressive behavior is associated with a high incidence of metastatic spread and a short patient survival. Recent studies have described loss of SMARCB1/INI1 protein in poorly differentiated chordomas associated not with point mutations but with SMARCB1/INI1 gene deletions instead...
September 15, 2016: American Journal of Surgical Pathology
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