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Cerebral palsy surgery

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https://www.readbyqxmd.com/read/28317070/lumbar-translaminar-fenestration-for-insertion-of-intrathecal-baclofen-catheter-a-novel-technique
#1
Manraj K S Heran, Hisham Al-Shikarchy, Carolyn Chowne
Intrathecal baclofen has long been known to be an efficacious treatment of spasticity in children with cerebral palsy. Test bolus administration is often necessary to ensure patients will benefit from this treatment. The introduction of a intrathecal catheter for test bolus administration can prove challenging in a subset of this population, particularly those who have received surgery with postoperative spinal fusion masses. We outline a novel technique of inserting a spinal catheter for test bolus administration in a patient with a postoperative fusion mass whereby a fenestration is created through the lamina using an osteotomy needle...
March 20, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28291217/-early-postoperative-results-of-surgical-treatment-of-patients-with-anterior-clinoidal-meningiomas
#2
S V Chernov, D A Rzaev, A V Kalinovsky, A B Dmitriev, A R Kasymov, A V Zotov, E V Gormolysova, E K Uzhakova
Resection of anterior clinoidal meningiomas is a challenging task due to their localization, frequent involvement of the major cerebral arteries and cranial nerves, a high risk of postoperative neurological deficits, and low radicalness of surgery. AIM: To evaluate the radicalness of microsurgical removal and a neurological deficit in the early postoperative period in patients with anterior clinoidal meningiomas. MATERIAL AND METHODS: A total of 35 patients with anterior clinoidal meningiomas underwent surgery at the Department of Neurooncology of the Novosibirsk Federal Neurosurgical Center in the period from 2013 to July 2016...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#3
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28278135/the-influence-of-the-unaffected-hip-on-gait-kinematics-in-patients-with-hemiplegic-cerebral-palsy
#4
Mikhail Tretiakov, Khanh P Do, Michael Aiona
BACKGROUND: Hemiplegic cerebral palsy (HCP) patients have transverse-plane gait deviations that may include the "uninvolved" side. The aim of this study is to quantify the static rotational profile, the dynamic position during gait and determine whether any correlations between the involved and uninvolved side exist. METHODS: A total of 171 subjects that met the inclusion criteria of HCP and no prior history of bony surgery were reviewed. Clinical and gait measurements were analyzed and compared between subjects and a population of typically developing (TD) children...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28262923/outcomes-after-scoliosis-surgery-for-children-with-cerebral-palsy-a-systematic-review
#5
REVIEW
Rachel Toovey, Adrienne Harvey, Michael Johnson, Louise Baker, Katrina Williams
AIM: This study aims (1) to evaluate and synthesize the evidence for the postoperative outcomes after scoliosis surgery for children with cerebral palsy (CP), and (2) to identify preoperative risk factors for adverse outcomes after surgery. METHOD: Medline, EMBASE, CINAHL, and PubMed were searched for relevant literature. Included studies were assessed for risk of bias using the Cochrane Effective Practice and Organisation of Care tool. Quality of evidence for overall function, quality of life (QoL), gross motor function, caregiver outcomes, deformity correction, and postoperative complications were assessed using GRADE (Grades of Recommendation, Assessment, Development and Evaluation)...
March 6, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28242571/predictors-for-anterior-pelvic-tilt-following-surgical-correction-of-flexed-knee-gait-including-patellar-tendon-shortening-in-children-with-cerebral-palsy
#6
Harald Böhm, Matthias Hösl, Leonhard Döderlein
INTRODUCTION: Patellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis. RESEARCH QUESTION: Which CP patients are at risk for excessive anterior pelvic tilt following correction of flexed knee gait including patellar tendon shortening? METHODS: 32 patients with CP between 8 and 18 years GMFCS I&II were included...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28219164/-a-combination-use-of-endoscope-and-microscope-in-cerebral-pontine-angle-surgery
#7
Z Y Wang, H Jia, J Yang, H Y Tan, H Wu
Objective: To evaluate the application of combination use of microscope and endoscope in cerebral pontine angle (CPA) surgery. Methods: A total of 72 patients undergone lateral skull base surgeries via endoscope under microscopic control from January 2006 to January 2015 was reviewed respectively. The patients including 35 males and 37 females were composed of 22 cases of vestibular swannnomas, 45 cases of cranial neuropathy and 5 cases of CPA chelesteatoma. Twenty cases of vestibular swannnomas, 15 cases of cranial neuropathy and 2 cases of CPA chelesteatoma undergone the surgery via retrosigmoid approach, while other cases undergone the surgery via retrolabyrinthine approach...
February 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28197774/popliteal-block-for-lower-limb-surgery-in-children-with-cerebral-palsy-effect-on-sevoflurane-consumption-and-postoperative-pain-a-randomized-double-blinded-controlled-trial
#8
Derya Ozkan, Emel Gonen, Taylan Akkaya, Mesut Bakir
PURPOSE: The aim of this study was to evaluate the effects of a preoperative popliteal block on sevoflurane consumption, postoperative pain, and analgesic consumption in children with cerebral palsy (CP) following lower limb surgery. METHODS: Fifty-four patients undergoing lower limb surgery were randomized to receive either a popliteal block + general anaesthesia (group P, n = 27) or general anaesthesia without a popliteal block (group C, n = 27). After anesthesia induction with 50% N2O, O2, and 8% sevoflurane, a popliteal block was given to group P patients with ultrasound guidance as a single dose of 0...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28177174/a-case-controlled-comparison-of-postoperative-analgesic-dosing-between-girls-with-rett-syndrome-and-girls-with-and-without-developmental-disability-undergoing-spinal-fusion-surgery
#9
Chantel C Barney, Alyssa M Merbler, Kelsey Quest, Breanne J Byiers, George L Wilcox, Scott Schwantes, Samuel A Roiko, Timothy Feyma, Arthur Beisang, Frank J Symons
BACKGROUND: Rett syndrome is associated with severe motor and communicative impairment making optimal postoperative pain management a challenge. There are case reports documenting reduced postoperative analgesic requirement in Rett syndrome. AIM: The goal of this preliminary investigation was to compare postoperative analgesic management among a sample of girls with Rett syndrome compared to girls with and without developmental disability undergoing spinal fusion surgery...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28166806/the-we-study-does-botulinum-toxin-a-make-walking-easier-in-children-with-cerebral-palsy-study-protocol-for-a-randomized-controlled-trial
#10
Siri Merete Brændvik, Karin Roeleveld, Guro Lillemoen Andersen, Anne Elisabeth Ross Raftemo, Kjersti Ramstad, Jasmina Majkic-Tajsic, Torarin Lamvik, Bendik Lund, Turid Follestad, Torstein Vik
BACKGROUND: Intramuscular injections of botulinum toxin A (BoNT-A) have been a cornerstone in the treatment of spasticity for the last 20 years. In Norway, the treatment is now offered to two out of three children with spastic cerebral palsy (CP). However, despite its common use, the evidence for its functional effects is limited and inconclusive. The objective of this study is to determine whether BoNT-A makes walking easier in children with CP. We hypothesize that injections with BoNT-A in the calf muscles will reduce energy cost during walking, improve walking capacity, increase habitual physical activity, reduce pain and improve self-perceived performance and satisfaction...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28151778/undercorrection-of-planovalgus-deformity-after-calcaneal-lengthening-in-patients-with-cerebral-palsy
#11
Byung Chae Cho, In Hyeok Lee, Chin Youb Chung, Ki Hyuk Sung, Kyoung Min Lee, Soon-Sun Kwon, Seung Jun Moon, Jaeyoung Kim, Hyunwoo Lim, Moon Seok Park
Calcaneal lengthening (CL) is one of the treatment options for planovalgus deformity in patients with cerebral palsy (CP). However, its indication still needs to be clarified according to the functional status of CP. The aim of this study was to investigate the radiographic outcome after CL in patients with CP and to evaluate the risk factors causing undercorrection of planovalgus deformities. We included consecutive patients with CP who underwent CL for planovalgus deformity, were followed for more than 2 years, and had preoperative and postoperative weight-bearing anteroposterior (AP) and lateral foot radiographs...
February 1, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28111312/dual-channel-endoscopic-indocyanine-green-fluorescence-angiography-for-clipping-of-cerebral-aneurysms
#12
Won-Sang Cho, Jeong Eun Kim, Hyun-Seung Kang, Eun Jin Ha, Minwoong Jung, Choonghee Lee, Il Hyung Shin, Uk Kang
OBJECTIVE: Neuroendoscopy is useful for assessing the status of perforators, parent arteries, and aneurysms beyond the straight line of microscopic view during aneurysm clipping. We aimed to evaluate the clinical usefulness of our endoscopic indocyanine green angiography (eICGA) system, which can simultaneously display both visible light and ICG fluorescent images. METHODS: A total of 16 unruptured aneurysms in 10 patients were surgically clipped via the keyhole approach...
January 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28097247/the-management-of-scoliosis-in-children-with-cerebral-palsy-a-review
#13
REVIEW
Thomas Cloake, Adrian Gardner
Children who suffer with cerebral palsy (CP) have a significant chance of developing scoliosis during their early years and adolescence. The behavior of this scoliosis is closely associated with the severity of the CP disability and unlike idiopathic scoliosis, it continues to progress beyond skeletal maturity. Conservative measures may slow the progression of the curve, however, surgery remains the only definitive management option. Advances in surgical technique over the last 50 years have provided methods to effectively treat the deformity while also reducing complication rates...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28081026/the-effect-of-nebulized-glycopyrrolate-on-posterior-drooling-in-patients-with-brain-injury-two-cases-of-different-brain-lesions
#14
Zee-Ihn Lee, Kwang Jae Yu, Dae Hee Lee, Seong Kyung Hong, Seung Beom Woo, Jong Min Kim, Donghwi Park
Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28074440/distal-femoral-extension-and-shortening-osteotomy-as-a-part-of-multilevel-surgery-in-children-with-cerebral-palsy
#15
Matthias C M Klotz, Klemens Hirsch, Daniel Heitzmann, Michael W Maier, Sebastien Hagmann, Thomas Dreher
BACKGROUND: There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of fl exed knee gait, but investigations analyzing outcome and infl uence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) infl uences outcome...
December 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28073083/the-edinburgh-visual-gait-score-the-minimal-clinically-important-difference
#16
L W Robinson, N D Clement, J Herman, M S Gaston
OBJECTIVE: The primary aim was to define the minimal clinically important difference (MCID) of the Edinburgh Visual Gait Score (EVGS) using correlations with the Gross Motor Function Classification System (GMFCS) and the Functional Assessment Questionnaire (FAQ). The secondary aim was to confirm the numerical value of the MCID in the Gait Profile Score (GPS). METHOD: The EVGS and GPS scores for 151 patients with diplegic cerebral palsy (GMFCS Levels I-III) were retrospectively identified from a database held at the study centre...
January 3, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28051880/the-effect-of-additional-virtual-reality-training-on-balance-in-children-with-cerebral-palsy-after-lower-limb-surgery-a-feasibility-study
#17
Pieter Meyns, Liene Pans, Kaat Plasmans, Lieve Heyrman, Kaat Desloovere, Guy Molenaers
OBJECTIVE: Impaired balance is disabling for children with cerebral palsy (CPc), especially for CPc who recently underwent lower limb surgery. Positive results of using virtual reality (VR) in balance rehabilitation have been published in several outpatient populations. We investigated the feasibility of applying additional VR training focused on sitting balance in CP inpatients of a rehabilitation center after lower limb surgery. Additionally, we investigated the rate of enjoyment of VR training compared with conventional physiotherapy...
February 2017: Games for Health
https://www.readbyqxmd.com/read/28028970/diagnostic-and-therapeutic-difficulties-in-carotid-body-paragangliomas-based-on-clinical-experience-and-a-review-of-the-literature
#18
Karolina Dorobisz, Tadeusz Dorobisz, Hanna Temporale, Tomasz Zatoński, Marzena Kubacka, Mariusz Chabowski, Andrzej Dorobisz, Tomasz Kręcicki, Dariusz Janczak
BACKGROUND: Paragangliomas are rare neuroendocrine tumors, representing 0.03% of all tumors. Half of them develop in the head and neck, and among these 50% are sporadic cervical tumors. OBJECTIVES: The aim of the study was to carry out an epidemiological and clinical analysis of paraganglioma patients diagnosed and treated at the authors' clinics between 1985 and 2014. MATERIAL AND METHODS: The medical data of 47 patients were analyzed. All the patients were qualified for surgery...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28027144/orthopaedic-surgery-in-dystonic-cerebral-palsy
#19
Francesco C Blumetti, Jenny Chia Ning Wu, Federica Barzi, Matthias W Axt, Mary-Clare Waugh, Paulo Selber
BACKGROUND: Outcomes after orthopaedic interventions in patients with dystonic cerebral palsy (DCP) are historically regarded as unpredictable. This study aims to evaluate the overall outcome of orthopaedic surgery in children with DCP. METHOD: Children with DCP who underwent lower limb orthopaedic surgery with a minimum follow-up of 12 months were included. Data collected included age at time of surgery, surgical procedures performed, Gross Motor Function Classification System (GMFCS) level, and Barry Albright Dystonia Scale (BADS) score...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28017556/bilateral-globus-pallidus-internus-deep-brain-stimulation-for-dyskinetic-cerebral-palsy-supports-success-of-cochlear-implantation-in-a-5-year-old-ex-24%C3%A2-week-preterm-twin-with-absent-cerebellar-hemispheres
#20
Jean-Pierre Lin, Margaret Kaminska, Sarah Perides, Hortensia Gimeno, Lesley Baker, Daniel E Lumsden, Anzell Britz, Sandra Driver, Alec Fitzgerald-O'Connor, Richard Selway
BACKGROUND: Early onset dystonia (dyskinesia) and deafness in childhood pose significant challenges for children and carers and are the cause of multiple disability. It is particularly tragic when the child cannot make use of early cochlear implantation (CI) technology to relieve deafness and improve language and communication, because severe cervical and truncal dystonia brushes off the magnetic amplifier behind the ears. Bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) neuromodulation can reduce dyskinesia, thus supporting CI neuromodulation success...
January 2017: European Journal of Paediatric Neurology: EJPN
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