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Pediatric spine infection

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
Stephen J Warner, Tyler J Uppstrom, Andy O Miller, Sean T O'Brien, Christine M Salvatore, Roger F Widmann, Stephanie L Perlman
STUDY DESIGN: Single-institution, retrospective case series. OBJECTIVE: To determine whether the microbiology of deep surgical site infections (SSI) after spinal fusion surgery for deformity has changed over the last decade at our institution. SUMMARY OF BACKGROUND DATA: Surgical site infection after pediatric spinal deformity surgery results in significantly increased patient morbidity and healthcare costs. While risk factors are multifactorial, prophylactic and treatment antibiotic coverage is based in part on historical epidemiologic data, which may evolve over time...
June 14, 2016: Spine
David A Porter, Michael P Glotzbecker, M Timothy Hresko, Daniel J Hedequist
OF BACKGROUND DATA: This is the first reported series looking specifically at factors associated with deep surgical site infections (SSI) following pediatric cervical spine surgery. OBJECTIVE: To identify risk factors present in pediatric patients who are at risk for SSI following cervical spine surgery. DESIGN: Level of evidence: level IV-retrospective case series. INTRODUCTION: To date there are no studies regarding SSI in pediatric cervical spine surgery and thus no benchmark data or risk factors have been identified...
June 8, 2016: Journal of Pediatric Orthopedics
Curt Vandenberg, Cameron Niswander, Patrick Carry, Nikki Bloch, Zhaoxing Pan, Mark Erickson, Sumeet Garg
BACKGROUND: A multidisciplinary task force, designated Target Zero, has developed protocols for prevention of surgical site infection (SSI) for spine surgery at our institution. The purpose of this study was to evaluate how compliance with an antibiotic bundle impacts infection incidences in pediatric spine surgery. METHODS: After institutional review board approval, a consecutive series of 511 patients (517 procedures) who underwent primary spine procedures from 2008 to 2012 were retrospectively reviewed to identify patients who developed SSI...
June 8, 2016: Journal of Pediatric Orthopedics
Antonio Pizzol, Matteo Bramuzzo, Roberto Pillon, Andrea Taddio, Egidio Barbi
Acquired torticollis is a common clinical finding in children evaluated in the pediatric emergency department. It may be the presentation symptom of different illnesses, such as trauma, muscle contraction, infections, or malignancies, and an accurate differential diagnosis is required to correctly identify the cause and choose the right treatment. Spondylodiscitis is a low-grade bacterial infection that involves intervertebral disks and the adjacent vertebral bodies. Spondylodiscitis of the cervical spine is unusual and may be a rare cause of torticollis...
February 10, 2016: Pediatric Emergency Care
Brandon A Sherrod, James M Johnston, Brandon G Rocque
OBJECTIVE Hospital readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and risk factors for patient readmission after pediatric neurosurgical procedures. METHODS The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database was queried for pediatric patients treated by a neurosurgeon between 2012 and 2013. Procedures were categorized by current procedural terminology (CPT) code...
September 2016: Journal of Neurosurgery. Pediatrics
Alka Sudhir Karnik, Alpana Karnik, Alpana Joshi
Ultrasound (US) is a simple, non-invasive imaging modality which allows high-resolution imaging of the musculoskeletal (MSK) system. Its increasing popularity in pediatrics is due to the fact that it does not involve radiation, has an ability to visualize non-ossified cartilaginous and vascular structures, allows dynamic imaging and quick contralateral comparison. US is the primary imaging modality in some pediatric MSK conditions like infant hip in developmental dysplasia (DDH), hip joint effusion, epiphyseal trauma and evaluation of the neonatal spine...
June 2016: Indian Journal of Pediatrics
Tavitiya Sudjaritruk, Torsak Bunupuradah, Linda Aurpibul, Pope Kosalaraksa, Nia Kurniati, Wasana Prasitsuebsai, Jiratchaya Sophonphan, Jintanat Ananworanich, Thanyawee Puthanakit
OBJECTIVES: The impact of hypovitaminosis D and secondary hyperparathyroidism on bone mineral density (BMD) in the setting of pediatric HIV infection remains unclear. This study aimed to determine the prevalence of hypovitaminosis D and hyperparathyroidism and their effects on bone turnover and BMD among HIV-infected adolescents in Southeast Asia. DESIGN: A multicenter, cross-sectional study evaluating bone health and vitamin D metabolism in HIV-infected adolescents in Thailand and Indonesia...
April 24, 2016: AIDS
Rishiram Poudel, Venkatesan Sampath Kumar, Ashok Kumar, Shah Alam Khan
BACKGROUND: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO). MATERIALS AND METHODS: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i) Basic Sciences (ii) trauma (upper limb and lower limb) (iii) infections (iv) pediatric orthopedics (v) arthroplasty (vi) arthroscopy (vii) spine surgery (viii) musculoskeletal oncology (ix) hand and microvascular surgery (x) adult reconstruction (including the Ilizarov technique) (xi) general orthopedics and miscellaneous (xii) letter to editor (xiii) book review...
November 2015: Indian Journal of Orthopaedics
Lorena V Floccari, Todd A Milbrandt
Surgical site infection (SSI) after spinal deformity surgery is a complication in the pediatric population resulting in high morbidity and cost. Despite modern surgical techniques and preventative strategies, the incidence remains substantial, especially in the neuromuscular population. This review focuses on recent advancements in identification of risk factors, prevention, diagnosis, and treatment strategies for acute and delayed pediatric spine infections. It reviews recent literature, including the best practice guidelines for infection prevention in high-risk patients...
April 2016: Orthopedic Clinics of North America
Shannon Tew, Brad M Taicher
Mastocytosis includes a spectrum of diseases characterized by abnormal mast cell infiltration in various organs, which can lead to mast cell mediator release and immediate hypersensitivity. We review anesthetic challenges presented by a 6-year-old girl with a history of mast cell mediator release because of the urticaria pigmentosa variant of cutaneous mastocytosis, factor VII deficiency, increasing episodes of urinary tract infections, and pyelonephritis. She underwent spine magnetic resonance imaging, subsequent lumbar laminectomy for fatty filum release, and a cystourethroscopy...
November 15, 2015: A & A Case Reports
Sven Karstensen, Tanvir Bari, Martin Gehrchen, John Street, Benny Dahl
BACKGROUND CONTEXT: Most literature on complications in spine surgery has been retrospective or based on national databases with few variables. The Spine AdVerse Events Severity (SAVES) system has been found reliable and valid in two Canadian centers, providing precise information regarding all adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population...
February 2016: Spine Journal: Official Journal of the North American Spine Society
T Odent, B Ilharreborde, L Miladi, N Khouri, P Violas, J Ouellet, V Cunin, J Kieffer, K Kharrat, F Accadbled
BACKGROUND: Surgical treatment of early-onset scoliosis has greatly developed in recent years. Early-onset scoliosis covers a variety of etiologies (idiopathic, neurologic, dystrophic, malformative, etc.) with onset before the age of 5 years. Progression and severity threaten respiratory development and may result in respiratory failure in adulthood. Many surgical techniques have been developed in recent years, aiming to protect spinal and thoracic development. MATERIAL AND METHODS: Present techniques are based on one of two main principles...
October 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Stephen P Miranda, Kristopher T Kimmell, Howard J Silberstein
BACKGROUND: Chiari I malformation (CM-I) is defined by cerebellar tonsillar herniation through the foramen magnum. Patients typically present with chronic complaints, including headache, dizziness, and numbness, although there are few reports in the literature of pediatric patients presenting acutely with neurological deficit caused by CM-I. We report a child who presented acutely with hemiparesis and magnetic resonance imaging findings consistent with CM-I and spinal cord edema. CASE DESCRIPTION: A 3-year old boy with normal development presented with difficulty walking and increased drooling...
January 2016: World Neurosurgery
Sümeyye Çoruh Kaplan, Murat Şakir Ekşi
OBJECTIVE: Cervical spine encompasses a bridge role between the head and the lower parts of the spine and therefore has unique properties. Our aim in this study was to evaluate the cervical sagittal alignment parameters in pediatric and adult non-surgical patients and to find any differences in respect of age, sex and admission type. METHODS: All patients who were admitted to emergency and neurosurgery clinics of Diyarbakir Bismil State Hospital due to cervical spine problems (trauma, radiculopathy, paraspinal pain) in 2014 were enrolled retrospectively into the study...
June 2015: Korean Journal of Spine
Alkinoos Athanasiou, Ioannis Magras, Panagiotis Sarlis, Evangelos Spyridopoulos, Konstantinos Polyzoidis
PURPOSE: We report a rare case of anterolateral meningioma of the foramen magnum (FMM) and high cervical spine presenting both intradural and extradural growth in a 7.5-year-old boy. We also performed a review of the relevant peer-reviewed literature. METHODS: The patient presented with progressive tetraparesis and gait instability. Neuroimaging revealed an anterolateral tumor of the foramen magnum, C1 and C2 cervical spine level. The patient was treated in two stages: During the first operation, the extradural part was resected while the intradural part was removed in a second operation...
December 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Justin A Iorio, Andre M Jakoi, Craig D Steiner, Patrick J Cahill, Amer Samdani, Randal R Betz, Anuj Singla
INTRODUCTION: Surgical correction of spinal deformity in myelomeningocele is associated with high rates of pseudarthrosis and implant failure. The anterior fusion is traditionally a wide exposure from the thorax to the sacrum. We report minimally invasive lateral interbody fusion (MILIF) to address the issue of fusion between vertebrae with marginal posterior elements while minimizing the morbidity of an open approach. MATERIALS AND METHODS: We performed a single-center, retrospective review of patients with myelomeningocele and severe scoliosis who underwent posterior spinal fusion (PSF) and staged MILIF for anterior fusion of the thoracolumbar/lumbar spine...
May 2015: Surgical Technology International
Andrea Rossi
Inflammatory and infectious disorders of the spine in children are less common than in adults, and are usually categorized according to location into (1) those predominantly affecting the spinal cord; (2) those predominantly affecting the nerve roots and meninges; and (3) those predominantly affecting the vertebrae, discs, and epidural space. Disorders primitively involving the spinal cord may be grouped into 2 basic categories: (1) inflammatory (represented by acute transverse myelopathy) and (2) infectious (ie, bacterial, viral, fungal, or parasitic)...
May 2015: Neuroimaging Clinics of North America
Jill M Cholette, Anthony P Pietropaoli, Kelly F Henrichs, George M Alfieris, Karen S Powers, Richard Phipps, Sherry L Spinelli, Michael Swartz, Francisco Gensini, L Eugene Daugherty, Emily Nazarian, Jeffrey S Rubenstein, Dawn Sweeney, Michael Eaton, Neil Blumberg
OBJECTIVES: Infants and children undergoing open heart surgery routinely require multiple RBC transfusions. Children receiving greater numbers of RBC transfusions have increased postoperative complications and mortality. Longer RBC storage age is also associated with increased morbidity and mortality in critically ill children. Whether the association of increased transfusions and worse outcomes can be ameliorated by use of fresh RBCs in pediatric cardiac surgery for congenital heart disease is unknown...
March 2015: Pediatric Critical Care Medicine
Gideon W Blumstein, Lindsay M Andras, Derek A Seehausen, Liam Harris, Patrick A Ross, David L Skaggs
OBJECTIVE: To determine the frequency and clinical significance of postoperative fever in pediatric patients undergoing posterior spinal fusion (PSF). STUDY DESIGN: A retrospective chart review was performed for consecutive patients undergoing PSF at a single institution between June 2005 and April 2011, with a minimum of 2-year follow up. Exclusion criteria were previous spine surgery, a combined anterior-posterior approach, and delayed wound closure at the time of surgery...
March 2015: Journal of Pediatrics
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