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Pediatric spinal deformity

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https://www.readbyqxmd.com/read/29112006/modified-lumbosacral-angle-and-modified-pelvic-incidence-as-new-parameters-for-management-of-pediatric-high-grade-spondylolisthesis
#1
Zhenjiang Ma, Changqing Zhao, Kai Zhang, Lin Du, Jianping Tian, Xiaojiang Sun, Jie Zhao
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: We aimed to introduce new parameters that can better describe the pelvic morphology and lumbosacral segmental deformity in children with high-grade spondylolisthesis of the L5 vertebra: modified pelvic incidence (mPI) and modified lumbosacral angle (mLSA). Also, we aimed to establish the mLSA as a convenient, reliable measurement method and criteria to evaluate the reduction of L5 vertebral slippage. SUMMARY OF BACKGROUND DATA: Numerous parameters and methods exist to evaluate segmental deformity and reduction of L5 vertebral slippage, but no definitive standard for accurately and conveniently describing lumbosacral kyphosis and degree of reduction exists...
November 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29093792/managing-the-pediatric-spine-growth-assessment
#2
REVIEW
Jason Pui Yin Cheung, Keith Dip-Kei Luk
Management of pediatric spinal deformities requires an accurate prediction of growth spurts to allow for timely initiation of treatment and prevention of curve progression. Determining remaining growth potential is also important for avoiding prolonged unnecessary treatment, e.g. bracing for patients nearing skeletal maturity. Many clinical and radiological growth parameters have been developed to aid clinicians in growth prediction. Of these, several commonly used measures such as height and arm span growth trends, timing of menarche, and the Risser sign are mostly retrospective and lack strong predictive utility...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29053056/intradural-spine-surgery-may-not-carry-an-increased-risk-of-shunt-revision-compared-with-extradural-spine-surgery-in-pediatric-patients-with-myelomeningocele
#3
Elizabeth N Kuhn, Betsy Hopson, Michael J Conklin, Jeffrey P Blount
OBJECTIVE Patients with myelomeningocele are often affected by scoliosis and tethered cord syndrome, and frequently require spine surgery. Intradural spine surgeries may carry an inherently higher risk of inducing shunt malfunction due to entry into the subarachnoid space. In this study, the authors sought to compare rates of shunt malfunction after intradural and extradural spine surgeries among pediatric patients with myelomeningocele. METHODS The authors reviewed records of the National Spina Bifida Program Registry for Children's Hospital of Alabama...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29050714/when-does-intraoperative-blood-loss-occur-during-pediatric-scoliosis-correction
#4
Sean Wahlquist, Montri Wongworawat, Scott Nelson
BACKGROUND: The purpose of our study was to assess the relationship between amount of blood loss and surgical stage in pediatric patients undergoing posterior spinal fusion for deformity correction to determine: (1) when the highest rate of blood loss occurred; (2) what percentage of total blood loss occurred during deformity correction and closure; and (3) how to predict remaining blood loss during a procedure. Blood loss following exposure and placement of the final pedicle screw is often underestimated, which may result in lack of sufficient blood product availability...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29049087/raising-mean-arterial-pressure-alone-restores-20-of-intraoperative-neuromonitoring-losses
#5
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/29016431/incidence-of-congenital-spinal-abnormalities-among-pediatric-patients-and-their-association-with-scoliosis-and-systemic-anomalies
#6
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Bassel G Diebo, Shaleen Vira, Samantha R Horn, Joseph F Baker, Kartik Shenoy, Saqib Hasan, John Buza, Wesley Bronson, Justin C Paul, Ian Kaye, Norah A Foster, Ryan T Cassilly, Jonathan H Oren, Ronald Moskovich, Breton Line, Cheongeun Oh, Shay Bess, Virginie LaFage, Thomas J Errico
BACKGROUND: Congenital abnormalities when present, according to VACTERL theory, occur nonrandomly with other congenital anomalies. This study estimates the prevalence of congenital spinal anomalies, and their concurrence with other systemic anomalies. METHODS: A retrospective cohort analysis on Health care Cost and Utilization Project's Kids Inpatient Database (KID), years 2000, 2003, 2006, 2009 was performed. ICD-9 coding identified congenital anomalies of the spine and other body systems...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28965455/single-stage-deformity-correction-in-children-with-neurogenic-kyphoscoliosis-nuances-and-a-proposal-for-risk-stratification
#7
Suhas Udayakumaran, Sajesh K Menon, Chiazor U Onyia, Naveen Tahasildar
OBJECTIVE Neurogenic kyphoscoliosis in pediatric patients has varied causes and diverse management options. The most common management strategy is to stage the orthopedic and neurosurgical aspects of the correction at an interval of 3-6 months from each other. The aim of this study was to report the authors' experience with correction of deformity in children with associated neurological abnormalities requiring intervention as a single-stage surgical treatment. METHODS Of 591 pediatric patients with scoliosis treated at the Amrita Institute of Medical Sciences and Research Centre between January 2001 and January 2011, the authors identified all patients with neurogenic kyphoscoliosis who underwent deformity correction and a neurosurgical procedure in the same surgical session when they were younger than 15 years...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965452/introduction-pediatric-spinal-deformity
#8
Ali A Baaj, Douglas Brockmeyer, Andrew Jea, Amer F Samdani
No abstract text is available yet for this article.
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965451/instrumented-fusion-for-spinal-deformity-after-laminectomy-or-laminoplasty-for-resection-of-intramedullary-spinal-cord-tumors-in-pediatric-patients
#9
David S Hersh, Rajiv R Iyer, Tomas Garzon-Muvdi, Ann Liu, George I Jallo, Mari L Groves
OBJECTIVE Spinal deformity has become a well-recognized complication of intramedullary spinal cord tumor (IMSCT) resection. In particular, laminectomy can result in biomechanical instability caused by loss of the posterior tension band. Therefore, laminoplasty has been proposed as an alternative to laminectomy. Here, the authors describe the largest current series of pediatric patients who have undergone laminoplasty for IMSCT resection and investigate the need for surgical fusion after both laminectomy and laminoplasty...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28965445/temporary-occipital-fixation-in-young-children-with-severe-cervical-thoracic-spinal-deformity
#10
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/28965444/intraoperative-neuromonitoring-alerts-in-a-pediatric-deformity-center
#11
Maria Zuccaro, James Zuccaro, Amer F Samdani, Joshua M Pahys, Steven W Hwang
OBJECTIVE Intraoperative neuromonitoring (IONM) involves the use of somatosensory evoked potentials (SSEPs) and transcranial electric motor evoked potentials (TceMEPs). In this retrospective study the authors examined the sensitivity and specificity of both SSEPs and TceMEPs during pediatric spinal deformity surgeries. METHODS The authors performed a retrospective quantitative analysis of data obtained in 806 patients (197 males and 609 females) treated from December 2011 until October 2015. All patients were diagnosed with scoliosis that was classified as one of the following: adolescent idiopathic scoliosis (AIS) (38%), congenital scoliosis (22%), or syndromic scoliosis (40%)...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28954008/community-care-administration-of-spinal-deformities-in-the-brazilian-public-health-system
#12
Mario Bressan-Neto, Carlos Fernando Pereira da Silva Herrero, Lilian Maria Pacola, AltacĂ­lio Aparecido Nunes, Helton Luiz Aparecido Defino
OBJECTIVE: Underfunding of the surgical treatment of complex spinal deformities has been an important reason for the steadily growing waiting lists in publicly funded healthcare systems. The aim of this study is to characterize the management of the treatment of spinal deformities in the public healthcare system. METHODS: A cross-sectional study of 60 patients with complex pediatric spinal deformities waiting for treatment in December 2013 was performed. The evaluated parameters were place of origin, waiting time until first assessment at a specialized spine care center, waiting time for the surgical treatment, and need for implants not reimbursed by the healthcare system...
August 2017: Clinics
https://www.readbyqxmd.com/read/28937466/compressive-myelopathy-in-congenital-kyphosis-of-the-upper-thoracic-spine-a-retrospective-study-of-6-cases
#13
Zhengfeng Zhang, Honggang Wang, Wenjie Zheng
STUDY DESIGN: A retrospective study. OBJECTIVE: The goal of this retrospective study was to describe the uncommon presentation of neurological deficits in patients with congenital kyphosis of the upper thoracic spine (T1-T4). SUMMARY OF BACKGROUND DATA: Congenital kyphosis is an uncommon deformity but can potentially lead to spinal cord compression and paraplegia, particularly in type I (failure of formation) deformities. Few reports have described compressive myelopathy associated with congenital kyphosis of the upper thoracic spine...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28887681/pediatric-spine-imaging-post-scoliosis-surgery
#14
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/28885083/risk-factors-for-progressive-neuromuscular-scoliosis-requiring-posterior-spinal-fusion-after-selective-dorsal-rhizotomy
#15
Vijay M Ravindra, Michael T Christensen, Kaine Onwuzulike, John T Smith, Kyle Halvorson, Douglas L Brockmeyer, Marion L Walker, Robert J Bollo
OBJECTIVE Selective dorsal rhizotomy (SDR) via limited laminectomy is an effective treatment of lower-extremity spasticity in the pediatric population. Children with spasticity are also at risk for neuromuscular scoliosis; however, specific risk factors for progressive spinal deformity requiring posterior spinal fusion (PSF) after SDR are unknown. The authors' goal was to identify potential risk factors. METHODS The authors performed a retrospective cohort study of patients who underwent SDR via limited laminectomy between 2003 and 2014 and who had at least 1 year of follow-up...
November 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#16
Mark C Lee, Casey Jarvis, Matthew J Solomito, Jeffrey Thomson
Background Context Many pelvic fixation options exist for posterior spinal fusion of pediatric neuromuscular scoliosis, including standard iliac screws (SIS) or a more recently introduced S2-Alar (S2A) technique. However, little data exists comparing the clinical and radiographic outcomes of these techniques. Purpose Identify differences in clinical and radiographic outcomes for pediatric neuromuscular scoliosis patients treated with standard iliac screw (SIS) or S2-Alar (S2-A) pelvic fixation. Study Design/Setting Retrospective cohort study at a pediatric orthopaedic clinic...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28870307/perioperative-pain-management-in-pediatric-spine-surgery
#17
REVIEW
Benjamin W Sheffer, Derek M Kelly, Leslie N Rhodes, Jeffrey R Sawyer
Pain management after spinal deformity correction surgery for scoliosis in the pediatric population can be difficult. Deformity correction with posterior spinal fusion causes significant tissue trauma. Historically, pain control has been achieved with intravenous opiates. Opiates provide excellent analgesic effect; however, they have serious consequences when used alone. In adult total joint arthroplasty, multimodal pain control has become an increasingly common method to achieve pain control without these sequelae...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28837459/the-crankshaft-phenomenon
#18
Robert F Murphy, James F Mooney
The crankshaft phenomenon, a progressive rotational and angular spinal deformity that can occur after posterior spinal surgery, has been reported in pediatric patients with idiopathic, congenital, and neuromuscular scoliosis. In the skeletally immature patient, the crankshaft phenomenon is thought to occur secondary to continued growth of the anterior elements of the spine after solid posterior spinal fusion. The condition has also been reported in the setting of newer, so-called growth-friendly posterior distraction-based spinal instrumentation...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28819600/extensively-drug-resistant-tuberculosis-of-the-lumbar-spine-in-a-six-year-old-child-a-case-report
#19
Siddharth Sanjay Shah, Aakanksha Arvind Goregaonkar, Arvind Balkrishna Goregaonkar
INTRODUCTION: The emergence of extensively drug-resistant tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide today. The treatment is further compounded with unique management difficulties faced in pediatric patients. Treatment of XDR-TB requires prolonged chemotherapy with second-line drugs which offer lesser potency and increased risk of drug-related side effects. We present a case of spinal XDR-TB in a child, managed with extended second-line antitubercular chemotherapy (ATT)...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28777282/intrawound-vancomycin-powder-associated-with-reduced-surgical-site-infection-in-rib-based-distraction-surgery
#20
Justin M Haller, John A Heflin, David A Hulet, Qian Ding, Angela P Presson, John T Smith
BACKGROUND: Despite clinical reports of improved pulmonary function and reduced spinal deformity with rib-based distraction surgery in early-onset scoliosis (EOS) patients, infection remains a common complication, reported as high as 32% in some studies. The purpose of this study was to evaluate intrawound vancomycin powder in pediatric patients managed with rib-based distraction for EOS. METHODS: This was a single institution retrospective cohort study of EOS patients treated with rib-based distraction...
August 2, 2017: Journal of Pediatric Orthopedics
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