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Spine surgery scoliosis

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https://www.readbyqxmd.com/read/29049087/raising-mean-arterial-pressure-alone-restores-20-of-intraoperative-neuromonitoring-losses
#1
Joshua Yang, David L Skaggs, Priscella Chan, Suken A Shah, Michael G Vitale, Geraldine Neiss, Nicholas Feinberg, Lindsay M Andras
STUDY DESIGN: Multicenter prospective. OBJECTIVE: To assess the effect of intraoperative interventions in restoring intraoperative neuromonitoring (IONM) signals in pediatric spine surgery. SUMMARY OF BACKGROUND DATA: No prior studies have prospectively examined the rate of return of IONM signals by increasing blood pressure (BP) alone. METHODS: Patients undergoing posterior spinal deformity surgery were enrolled at their preoperative appointment...
October 18, 2017: Spine
https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#2
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033574/surgical-site-infections-following-instrumented-stabilization-of-the-spine
#3
Ulrike Dapunt, Caroline Bürkle, Frank Günther, Wojciech Pepke, Stefan Hemmer, Michael Akbar
BACKGROUND: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs) of the hip and knee, current treatment options (eg, antibiotic prophylaxis) of implant-associated infections have mostly been adapted according to these results. OBJECTIVE: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29029213/recovery-kinetics-of-radiographic-and-implant-related-revision-patients-following-adult-spinal-deformity-surgery
#4
Peter G Passias, Cyrus M Jalai, Virginie Lafage, Gregory W Poorman, Shaleen Vira, Samantha R Horn, Justin K Scheer, D Kojo Hamilton, Breton G Line, Shay Bess, Frank J Schwab, Christopher P Ames, Douglas C Burton, Robert A Hart, Eric O Klineberg
BACKGROUND: Prior studies have observed similar health-related quality of life (HRQL) in revisions and nonrevision (NR) patients following adult spinal deformity (ASD) correction. However, a novel comparison approach may allow better comparisons in spine outcomes groups. OBJECTIVE: To determine if ASD revisions for radiographic and implant-related complications undergo a different recovery than NR patients. METHODS: Inclusion: ASD patients with complete HRQL (Oswestry Disability Index, Short-Form-36 version 2 (SF-36), Scoliosis Research Society [SRS]-22) at baseline, 6 wk, 1 yr, 2 yr...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29021683/aarskog-scott-syndrome-an-unusual-cause-of-scoliosis
#5
Kerim Sariyilmaz, Okan Ozkunt, Murat Korkmaz, Fatih Dikici, Unsal Domanic
A 16-year-old boy who had been diagnosed previously as Aarskog-Scott syndrome (AAS), referred to our clinic with shoulder asymmetry for 1 year. Results of spine examination showed a 52° right thoracic curve at T3-T11. Surgery was planned, and T1-L1 posterior instrumentation and fusion were performed. After surgery, satisfactory correction was achieved, and during 10 years follow-up, the patient had no complaints. AAS is a X-linked genetic disorder with facial, genital, and skeletal manifestations. Scoliosis is not reported as a typical finding of AAS, and there is no reported case in the English literature...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29016427/comparison-of-intended-lengthening-of-magnetically-controlled-growing-rods-ultrasound-versus-x-ray
#6
Mutlu Cobanoglu, Suken A Shah, Peter Gabos, Kenneth Rogers, Petya Yorgova, Geraldine Neiss, Leslie Grissom, William G Mackenzie
BACKGROUND: In the treatment of early onset scoliosis (EOS), there has been a trend to use magnetically controlled growing rods (MCGR) in order to reduce the number of surgeries. To confirm the amount of lengthening, spine radiographs were required. Recently, ultrasound (US) has been added to monitor lengthening of MCGR to avoid radiation exposure. Our aim was to determine whether US is as accurate as plain radiography (x-ray) in determining the amount of length achieved at individual MCGR lengthening episodes...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28985584/strategies-to-prevent-ischemic-optic-neuropathy-following-major-spine-surgery-a-narrative-review
#7
REVIEW
Wilson Fandino
Postoperative vision loss following a major spine operation is a rare but life-changing event. Most of reports have been linked to ischemic optic neuropathy, and patients undergoing surgery for scoliosis correction or posterior lumbar fusion seem to be at the highest risk. Despite that some key risk factors have been identified, much of the pathophysiology still remain unknown. In fact, whereas only a minority of patients at high risk will present this complication, others with similar risk factors undergoing different procedures may not develop it at all...
October 3, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28984540/evolution-of-the-postoperative-sagittal-spinal-profile-in-early-onset-scoliosis-is-there-a-difference-between-rib-based-and-spine-based-growth-friendly-instrumentation
#8
Zhonghui Chen, Song Li, Yong Qiu, Zezhang Zhu, Xi Chen, Liang Xu, Xu Sun
OBJECTIVE Although the vertical expandable prosthetic titanium rib (VEPTR) and growing rod instrumentation (GRI) encourage spinal growth via regular lengthening, they can create different results because of their different fixation patterns and mechanisms in correcting scoliosis. Previous studies have focused comparisons on coronal plane deformity with minimal attention to the sagittal profile. In this retrospective study, the authors aimed to compare the evolution of the sagittal spinal profile in early-onset scoliosis (EOS) treated with VEPTR versus GRI...
October 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28965448/neuromuscular-scoliosis-complication-rates-from-2004-to-2015-a-report-from-the-scoliosis-research-society-morbidity-and-mortality-database
#9
Daniel Cognetti, Heather M Keeny, Amer F Samdani, Joshua M Pahys, Darrell S Hanson, Kathy Blanke, Steven W Hwang
OBJECTIVE Postoperative complications are one of the most significant concerns in surgeries of the spine, especially in higher-risk cases such as neuromuscular scoliosis. Neuromuscular scoliosis is a classification of multiple diseases affecting the neuromotor system or musculature of patients leading to severe degrees of spinal deformation, disability, and comorbidity, all likely contributing to higher rates of postoperative complications. The objective of this study was to evaluate deformity correction of patients with neuromuscular scoliosis over a 12-year period (2004-2015) by looking at changes in postsurgical complications and management...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965447/evaluation-and-management-of-adolescent-idiopathic-scoliosis-a-review
#10
Ajit Jada, Charles E Mackel, Steven W Hwang, Amer F Samdani, James H Stephen, James T Bennett, Ali A Baaj
Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options. Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965446/insertion-of-magnetically-controlled-growing-rods-in-a-patient-with-a-diaphragmatic-pacemaker-case-report
#11
Andrew C Vivas, Steven W Hwang, Joshua M Pahys
Phrenic stimulators offer an alternative to standard mechanical ventilation as well as the potential for ventilator independence in select patients with chronic respiratory failure. Young patients (< 10 years old) with high cervical spinal cord injuries often develop paralytic scoliosis due to loss of muscle tone caudal to their spinal cord lesion. Growing rod systems allow for stabilization of spinal deformity while permitting continued growth of the spine and thoracic cavity. Magnetically controlled growing rods (MCGRs) offer the advantage of noninvasive expansion, as opposed to the operative expansion required in traditional growing rod systems...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965445/temporary-occipital-fixation-in-young-children-with-severe-cervical-thoracic-spinal-deformity
#12
Brian J Kelley, Anas A Minkara, Peter D Angevine, Michael G Vitale, Lawrence G Lenke, Richard C E Anderson
OBJECTIVE The long-term effects of instrumentation and fusion of the occipital-cervical-thoracic spine on spinal growth in young children are poorly understood. To mitigate the effects of this surgery on the growing pediatric spine, the authors report a novel technique used in 4 children with severe cervical-thoracic instability. These patients underwent instrumentation from the occiput to the upper thoracic region for stabilization, but without bone graft at the craniovertebral junction (CVJ). Subsequent surgery was then performed to remove the occipital instrumentation, thereby allowing further growth and increased motion across the CVJ...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#13
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28958698/predictors-of-chronic-neuropathic-pain-after-scoliosis-surgery-in-children
#14
Florence Julien-Marsollier, Raphaelle David, Julie Hilly, Christopher Brasher, Daphné Michelet, Souhayl Dahmani
BACKGROUND: Numerous publications describe chronic pain following surgery in both adults and children. However, data in the paediatric population are still sparse and both prevalence of chronic pain after surgery and risk factors of this complication still undetermined. METHODS: We prospectively evaluated the prevalence of chronic pain and its neuropathic pain component at 1 year following correction of idiopathic scoliosis in children less than 18 years of age...
September 22, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28943907/total-en-bloc-spondylectomy-of-the-eleventh-thoracic-vertebra-following-denosumab-therapy-for-the-treatment-of-a-giant-cell-tumor
#15
Gen Inoue, Takayuki Imura, Masayuki Miyagi, Wataru Saito, Ryo Tazawa, Toshiyuki Nakazawa, Masashi Takaso
Although denosumab has been reported to induce effective clinical results with respect to tumor shrinkage in a short-term follow-up clinical study, total spondylectomy is recognized as the treatment of choice for eradicating giant cell tumors (GCTs) of the spine. The present study reports the case involving a GCT in the 11th thoracic vertebra complicated by idiopathic scoliosis and treated using total en bloc spondylectomy (TES) with preoperative denosumab therapy. A 35-year-old woman received preoperative denosumab therapy for 8 months, followed by surgery using a computed tomography (CT)-based navigation system that optimized accuracy by recognizing the area of the detached parietal pleura, the irregular border of the collapsed vertebra, and the adjacent vertebra...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926385/graduation-protocol-after-growing-rod-treatment-removal-of-implants-without-new-instrumentation-is-not-a-realistic-approach
#16
Ismail Aykut Kocyigit, Z Deniz Olgun, H Gokhan Demirkiran, Mehmet Ayvaz, Muharrem Yazici
BACKGROUND: The growing rod remains an effective option in the treatment of early-onset scoliosis, and has previously been likened to an internal brace. While details of growing-rod treatment have been largely agreed on, the appropriate end point remains a matter of controversy. A decision was made in 2004, at the beginning of growing-rod treatment at our institution, to remove longitudinal instrumentation when the period of lengthening concluded and, similar to discontinuing a brace, leave the spine free...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28918465/congenital-lumbar-kyphosis-with-skin-ulceration-and-osteomyelitis-in-a-myelomeningocele-child-a-case-report
#17
Benoit Vibert, Marco Turati, Pierre-Yves Rabattu, Marco Bigoni, Ahmad Eid, Aurélien Courvoisier
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28887681/pediatric-spine-imaging-post-scoliosis-surgery
#18
Alaa N Alsharief, Ron El-Hawary, Pierre Schmit
Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible...
September 8, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28887065/pulmonary-function-and-thoracic-deformities-in-adolescent-idiopathic-scoliosis-27-years-or-longer-after-spinal-fusion-with-harrington-instrument
#19
Tsutomu Akazawa, Shingo Kuroya, Masahiro Iinuma, Kota Asano, Yoshiaki Torii, Tasuku Umehara, Toshiaki Kotani, Tsuyoshi Sakuma, Shohei Minami, Sumihisa Orita, Kazuhide Inage, Kazuki Fujimoto, Yasuhiro Shiga, Gen Inoue, Masayuki Miyagi, Wataru Saito, Seiji Ohtori, Hisateru Niki
BACKGROUND: The aim of this study was to conduct an investigation into spinal fusion with Harrington instrument (HI) in patients with adolescent idiopathic scoliosis (AIS) and to survey pulmonary function and thoracic deformity outcomes many years after surgery. METHODS: Subjects comprised 194 patients diagnosed with AIS and treated with spinal fusion using HI between 1968 and 1987. Patients who gave their informed consent were subjected to a complete standing spine X-ray, chest CT, and pulmonary function tests...
September 5, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28885330/fractional-curve-progression-with-maintenance-of-fusion-mass-in-congenital-scoliosis-an-18-year-follow-up-of-a-case-report
#20
Dong-Gune Chang, Jae Hyuk Yang, Se-Il Suk, Seung-Woo Suh, Jin-Hyok Kim, Seung-Joo Lee, Ki-Ho Na, Jung-Hee Lee
RATIONALE: The management of congenital scoliosis concentrates on early diagnosis and proper surgical treatment before the development of severe deformities. Decision making regarding the appropriate fusion levels, proper surgical treatment, and reduction amount of kyphoscoliosis is very important but difficult in the treatment of congenital scoliosis, especially in young children. PATIENT CONCERNS: We report an 11-year follow-up of revision surgery for fractional curve progression after combined anterior and posterior fusion without hemivertebra resection using pedicle screw fixation (PSF) in congenital kyphoscoliosis at age 4 years (a total 18-year follow-up)...
September 2017: Medicine (Baltimore)
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