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Pediatric spine

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https://www.readbyqxmd.com/read/28091700/computed-tomography-localization-of-the-appendix-in-the-pediatric-population-relative-to-the-lumbar-spine
#1
John Davis, Albert T Roh, Matthew B Petterson, Tammy R Kopelman, Samantha L Matz, Daniel G Gridley, Mary J Connell
BACKGROUND: Computed tomography (CT) is commonly used to evaluate suspected acute appendicitis. Although very effective, CT uses ionizing radiation, exposing patients to an increased risk of cancer. OBJECTIVE: This study assessed the potential for decreasing the field of view of the CT (and therefore the dose to the patient) in the evaluation of suspected acute appendicitis in children. MATERIALS AND METHODS: This study was a retrospective review of prospectively collected data from 212 consecutive patients who underwent CT for suspected acute appendicitis...
January 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28089483/patterns-of-failure-after-radiotherapy-for-pediatric-patients-with-intracranial-ependymoma
#2
Fatima Tensaouti, Anne Ducassou, Léonor Chaltiel, Stéphanie Bolle, Xavier Muracciole, Bernard Coche-Dequeant, Claire Alapetite, Valérie Bernier, Line Claude, Stéphane Supiot, Aymeri Huchet, Christine Kerr, Elisabeth le Prisé, Anne Laprie
PURPOSE: To investigate the patterns of failure after radiotherapy for pediatric intracranial ependymoma and their correlation with dose parameters. METHODS: Between 2000 and 2013, 206 patients were treated in France. MRI scans at relapse were registered to the original planning CTs for topographic analysis of failure patterns. To compare relapse patients (RP) with non relapse patients (NRP), several dose parameters were derived from dose volume histograms. RESULTS: Over a median follow-up of 53...
January 12, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28079740/venous-thromboembolism-among-pediatric-orthopedic-trauma-patients-a-database-analysis
#3
Daniel Guzman, Samir Sabharwal, Caixia Zhao, Sanjeev Sabharwal
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients (<21 years old) with fractures of the upper limb, lower limb, spine, pelvis, and multiple locations and calculated the overall prevalence of venous thromboembolism (VTE) and associated potential risk factors. 387 (0.68%) of 57 183 patients with one or more fractures were diagnosed with VTE. Children sustaining fractures of the axial skeleton and those with multiple fractures had a higher prevalence of VTE than those with isolated extremity fractures...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28070685/porcine-spine-finite-element-model-a-complementary-tool-to-experimental-scoliosis-fusionless-instrumentation
#4
Bahe Hachem, Carl-Eric Aubin, Stefan Parent
PURPOSE: Developing fusionless devices to treat pediatric scoliosis necessitates lengthy and expensive animal trials. The objective was to develop and validate a porcine spine numerical model as an alternative platform to assess fusionless devices. METHODS: A parametric finite element model (FEM) of an osseoligamentous porcine spine and rib cage, including the epiphyseal growth plates, was developed. A follower-type load replicated physiological and gravitational loads...
January 9, 2017: European Spine Journal
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/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#6
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28044467/magnetically-controlled-growing-rods-for-scoliosis-surgery
#7
Umesh Metkar, Swamy Kurra, David Quinzi, Stephen Albanese, William F Lavelle
Early onset scoliosis can be both a disfiguring as well as a life threatening condition. When more conservative treatments fail, pediatric spinal surgeons are forced to consider operative interventions. Traditionally, these interventions have involved the insertion of a variety of implants into the patient with a limited number of anchor points controlling the spine. In the past, these pediatric patients have had multiple surgeries for elective lengthening of these devices to facilitate their growth while attempting to control the scoliosis...
January 3, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28029391/off-hour-surgery-among-orthopedic-subspecialties-at-an-urban-quaternary-care-level-1-trauma-center
#8
Amanda Lans, Stein J Janssen, David Ring
PURPOSE: We sought to determine and quantify which subspecialties of orthopedic surgeons are operating off hours in an urban, quaternary-care, level 1 trauma center. MATERIALS AND METHODS: We used our clinical registry to identify 43,211 orthopedic surgeries performed between January 2008 and December 2011. Our outcome measures were the number and proportion of off-hour surgeries performed as well as the number and proportion of off-hours per subspecialty. The denominators were the total number of surgeries and the total number of surgical hours worked per subspecialty...
October 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#9
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#10
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/28005690/low-bone-mineral-density-in-vertically-hiv-infected-children-and-adolescents-risk-factors-and-the-role-of-t-cell-activation-and-senescence
#11
Beatriz Jiménez, Talía Sainz, Laura Díaz, María José Mellado, María Luisa Navarro, Pablo Rojo, María Isabel González-Tomé, Luis Prieto, Jorge Martínez, María Isabel de José, José Tomás Ramos, María Ángeles Muñoz-Fernandez
BACKGROUND: Our aim was to determine the prevalence and risk factors associated with low bone mineral density (BMD) in vertically HIV-infected patients; and to investigate whether low BMD is related to immune activation and senescence induced by HIV infection. METHODS: A cross-sectional study was performed in 98 vertically HIV-infected patients. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine. Height adjustment of BMD Z-score was performed using height-for-age Z-score...
December 21, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27998635/predictors-of-intrathoracic-injury-after-blunt-torso-trauma-in-children-presenting-to-an-emergency-department-as-trauma-activations
#12
Caitlin McNamara, Irina Mironova, Erik Lehman, Robert P Olympia
BACKGROUND: Thoracic injuries are a major cause of death associated with blunt trauma in children. Screening for injury with chest x-ray study, compared with chest computed tomography (CT) scan, has been controversial, weighing the benefits of specificity with the detriment of radiation exposure. OBJECTIVE: To identify predictors of thoracic injury in children presenting as trauma activations to a Level I trauma center after blunt torso trauma, and to compare these predictors with those previously reported in the literature...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#13
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSI) after blunt trauma in children are rare but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging respectively during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk-assessment tool is needed to inform EMS and ED provider decision-making...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27959586/utility-of-repeat-core-needle-biopsy-of-musculoskeletal-lesions-with-initially-nondiagnostic-findings
#14
Jim S Wu, Colm J McMahon, Santiago Lozano-Calderon, Justin W Kung
OBJECTIVE: The purpose of the present study is to assess the utility of repeat image-guided core needle biopsy (CNB) of musculoskeletal lesions in the setting of initially nondiagnostic CNB findings. MATERIALS AND METHODS: A retrospective review was conducted of 1302 consecutive CNBs performed on bone or soft-tissue lesions at a single institution. Pediatric cases and spine lesions were not included. All cases for which a repeat biopsy of the same lesion was performed because biopsy results were nondiagnostic were included in the study...
December 13, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27942474/ultrasonographic-clues-for-diagnosis-of-spina-bifida-occulta-in-children
#15
Emin Cakmakci, Hasibe Gokce Cinar, Cigdem Uner, Berna Ucan, Ayse Secil Eksioglu, Melek Pala, Yasemin Tasci Yildiz, Selma Cakmakci, Hulya Seker Yikmaz
BACKGROUND: The aim of the current study was to find out if spinal ultrasonography might have a predictive potential for detection of spina bifida occulta (SBO) in pediatric nocturnal enuresis patients. METHODS: A total of 108 children (58 females, 50 males) with a mean age of 8 (range, 6-15) years diagnosed for nocturnal enuresis in our tertiary care center were included in this cross-sectional analysis. Half of the cases (n=54, 50%) were found to have SBO, while the other half did not have SBO...
October 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#16
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27927552/multicenter-comparison-of-3d-spinal-measurements-using-surface-topography-with-those-from-conventional-radiography
#17
Patrick Knott, Peter Sturm, Baron Lonner, Patrick Cahill, Marcel Betsch, Richard McCarthy, Michael Kelly, Lawrence Lenke, Randal Betz
INTRODUCTION: In pediatric spinal deformity the gold standard for curve surveillance remains standing full-column radiographs, but repeated exposure to ionizing radiation motivates us to look for nonradiographic solutions. This study tests a modern system of surface topography (ST) to determine whether it is reliable and reproducible. METHODS: Patients from 6 pediatric spinal deformity clinics were recruited for enrollment. Inclusion criteria were age 8-18; diagnosis of scoliosis measuring ≥10 and <50 degrees or increased kyphosis of ≥45 degrees...
March 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927516/preoperative-mrsa-screening-in-pediatric-spine-surgery-a-helpful-tool-or-a-waste-of-time-and-money
#18
Scott J Luhmann, June C Smith
OBJECTIVES: To review the use of preoperative screening for Staphylococcus aureus for all pediatric spine procedures that was instituted at our facility in a multimodal approach to decrease the frequency of postoperative wound infections. SUMMARY OF BACKGROUND DATA: Four years ago at our facility, a multimodal approach to decrease the frequency of postoperative infections after pediatric spine surgery was instituted. METHODS: A single-center, single-surgeon pediatric spine surgery database was queried to identify all patients who had preoperative S...
July 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/27924366/utility-of-plain-radiographs-and-mri-in-cervical-spine-clearance-in-symptomatic-non-obtunded-pediatric-patients-without-high-impact-trauma
#20
Justin M Moore, Jonathan Hall, Michael Ditchfield, Christopher Xenos, Andrew Danks
PURPOSE: The optimal imaging modality for evaluating cervical spine trauma and optimizing management in the pediatric population is controversial. In pediatric populations, there are no well-established guidelines for cervical spine trauma evaluation and treatment. Currently, there is virtually no literature regarding imaging and management of symptomatic pediatric patients who present with cervical spine trauma without high-impact mechanism. This study aims to establish an optimal imaging strategy for this subgroup of trauma patients...
December 6, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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