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Pediatric spinal deformity

Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Max S Riley, Lawrence G Lenke, Todd M Chapman, Brenda A Sides, Kathy M Blanke, Michael P Kelly
BACKGROUND: Short-term studies have shown improved outcomes and alignment after posterior vertebral column resection for severe spinal deformity. Our goal was to report long-term changes in radiographic and health-related quality-of-life measures in a consecutive series of pediatric and adult patients undergoing posterior vertebral column resection with a minimum follow-up of 5 years. METHODS: We reviewed all patients undergoing posterior vertebral column resection by a single surgeon prior to January 1, 2010, at a single institution...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Victor S Alvarez, Svein Kleiven
Finite element (FE) models are a powerful tool that can be used to understand injury mechanisms and develop better safety systems. This study aims to extend the understanding of pediatric spine biomechanics, where there is a paucity of studies available. A newly developed and continuously scalable FE model was validated and scaled to 1.5-, 3-, 6-, 10-, 14- and 18-year-old using a non-linear scaling technique, accounting for local topological changes. The oldest and youngest ages were also scaled using homogeneous geometric scaling...
February 8, 2018: Journal of Biomechanics
Andrew J Kobets, Daniel Komlos, John K Houten
BACKGROUND: Ehler-Danlos syndome (EDS) refers to a group of heritable connective tissue disorders; rare manifestations of which are cervical kyphosis and clinical myelopathy. Surgical treatment is described for the deformity in the thoracolumbar spine in adolescents but not for infantile cervical spine. Internal fixation for deformity correction in the infantile cervical spine is challenging due to the diminutive size of the bony anatomy and the lack of spinal instrumentation specifically designed for young children...
February 15, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
J-C Bernard, E Berthonnaud, J Deceuninck, L Journoud-Rozand, G Notin, E Chaleat-Valayer
Background: Scoliosis is a 3D deformity that can be reconstructed through 2D antero-posterior and lateral radiographs, which provide an upper view of the deformed spine as well as regional planes matching all vertebrae of elective plane for each curve. The objective of this study is to explore whether all idiopathic scoliosis classified Lenke 1A have the same 3D representation made with regional planes. Methods: All patients treated for idiopathic thoracic scoliosis during the growth period and classified Lenke 1A were included in this study conducted in the pediatric spinal orthopedic department of Centre des Massues...
2018: Scoliosis and Spinal Disorders
Marco Virgolin, Irma W E M van Dij, Jan Wiersma, Cécile M Ronckers, Cees Witteveen, Arjan Bel, Tanja Alderliesten, Peter A N Bosman
PURPOSE: The aim of this study is to establish the first step towards a novel and highly individualized 3D dose distribution reconstruction method, based on CT scans and organ delineations of recently treated patients. Specifically, the feasibility of automatically selecting the CT scan of a recently treated childhood cancer patient who is similar to a given historically treated child who suffered from Wilms' tumor is assessed. METHODS: A cohort of 37 recently treated children between 2 and 6 years old is considered...
February 12, 2018: Medical Physics
B Lin, Z D Chen, T Y Cai, S S Wu, Z M Guo
Objective: To investigate the clinical curative effect of C(1)-C(2) pedicle screw fixation for pediatric atlantoaxial dislocation after a long-term follow-up. Methods: From March 2005 to April 2011, a total of 12 male and 9 female patients were included, with age from 3 to 9 years old (mean, 6.1 years old). Among them, 14 cases (67%) had typeⅠinstability atlantoaxial dislocation, 7 cases (33%) had type Ⅱ reducible atlantoaxial dislocation. All 21 pediatric patients with atlantoaxial dislocation underwent posterior pedicle screw fixations...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Nathan E How, John T Street, Marcel F Dvorak, Charles G Fisher, Brian K Kwon, Scott Paquette, Justin S Smith, Christopher I Shaffrey, Tamir Ailon
We conducted a systematic review with meta-analysis and qualitative synthesis. This study aims to characterize pseudarthrosis after long-segment fusion in spinal deformity by identifying incidence rates by etiology, risk factors for its development, and common features. Pseudarthrosis can be a painful and debilitating complication of spinal fusion that may require reoperation. It is poorly characterized in the setting of spinal deformity. The MEDLINE, EMBASE, and Cochrane databases were searched for clinical research including spinal deformity patients treated with long-segment fusions reporting pseudarthrosis as a complication...
February 6, 2018: Neurosurgical Review
Aditi Singh, Poonam Dalal, Jasbir Singh, Pooja Tripathi
Spinal muscular atrophy (SMAs) is a group of rare autosomal recessive diseases in which there is degeneration of alpha motor neurons in the spinal cord leading to progressive distal motor weakness. Here we report a case of type 0 SMA in a female neonate born at the Department of Pediatrics, PGIMS, Rohtak (Haryana) India, associated with generalized osteopenia and bony deformity in form of unilateral club foot. It may be emphasized that diagnosis of SMA should be kept in mind as a differential in cases of unexplained severe generalized hypotonia and severe respiratory compromise immediately after birth...
2018: Iranian Journal of Child Neurology
Kazuta Yamashita, Kosaku Higashino, Toshinori Sakai, Yoichiro Takata, Akihiro Nagamachi, Koichi Sairyo
CASE: A spinal deformity with wedging of L5 and rounding of the surface of the sacral dome is very common in pediatric patients with spondylolisthesis at the L5 vertebral level, and it has been well documented that severe spondylolisthesis is a good indication for spinal arthrodesis. We report the natural correction and adaptation of a severely deformed sacral dome with slippage (40.8%) in a pediatric patient with nonoperative treatment. CONCLUSION: Vertebral deformity in children can be reversible...
April 2017: JBJS Case Connector
Christian Fisahn, Fernando Alonso, Ghazwan A Hasan, R Shane Tubbs, Joseph R Dettori, Thomas A Schildhauer, Tarush Rustagi
Study Design: Systematic review. Objectives: (1) What are the surgical indications? Have they changed over time since the year 2000? (2) What is the current surgical approaches of choice? Have they changed over time since the year 2000? Do they vary by geographical region? (3) What are the most common outcome measures following surgery? Methods: Electronic databases and reference lists of key articles were searched from database inception from January 1, 2000 to December 31, 2016 to identify studies specifically evaluating surgical indications, current surgical approaches, and outcome measures for spinal tuberculosis...
December 2017: Global Spine Journal
Ewa Misterska, Jakub Głowacki, Adam Okręt, Maria Laurentowska, Maciej Głowacki
We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990...
2017: PloS One
Diane Dudas Sheehan, John Grayhack
Evaluation of pediatric spinal deformity requires knowledge of special orthopaedic testing and radiographic interpretation. The determination of recommendations for treatment of spinal abnormalities in children can be challenging and at times complex, as treatment options are dependent upon a variety of factors. The etiology of scoliosis or kyphosis, presence or absence of vertebral anomalies, symptoms, magnitude of the curve, physiologic/skeletal age, and evidence of and risk of progression all require consideration and play a role in the shared decision-making process...
December 1, 2017: Pediatric Annals
Zhi-Da Chen, Jin Wu, Cheng-Wu Lu, Wen-Rong Zeng, Zhuan-Zhi Huang, Bin Lin
BACKGROUND: There are few studies reporting the use of atlantoaxial pedicle screws and the long-term effects of C1-C2 posterior fusion in children. Our study is to investigate the initial results of C1-C2 pedicle screw fixation for pediatric atlantoaxial dislocation (AAD) and assessed spontaneous change of postoperative radiography after a long-term follow-up period. METHODS: Posterior pedicle screw fixations were performed in 21 pediatric patients with AAD. All the patients underwent implant removal 1 year after their initial surgery and had regular follow-up with an average duration of 76...
December 8, 2017: Journal of Pediatric Orthopedics
Amit Jain, Brian T Sullivan, Hamid Hassanzadeh, Nigel N Hsu, Paul D Sponseller
STUDY DESIGN: Retrospective. OBJECTIVE: To investigate the indications, radiographic outcomes, and complications in children with spinal deformities treated with posterolateral diskectomy with posterior fusion (PLDF), and to compare them against those of patients treated with anteroposterior spinal fusion (APSF). SUMMARY OF BACKGROUND DATA: A novel technique for treating large, rigid spinal deformities in children has been proposed, consisting of PLDF at the apex of the deformity using an all-posterior approach...
December 8, 2017: Spine
Guru Dutta Satyarthee, M Sangani, Sumit Sinha, Deepak Agrawal
Pediatric thoracolumbar spine fractures are considered rare injuries with paucity of publication across the globe. Further, spine injuries in children are comparatively rarer, and pediatric spine differs from adults, both biomechanically and anatomically; so, adult spine management strategy cannot be applied to pediatric cases, and exact guidelines for management of pediatric spinal injury is lacking. The current study is undertaken to study epidemiology, surgical management, and outcome of pediatric dorsolumbar unstable spine injury...
July 2017: Journal of Pediatric Neurosciences
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
February 2018: Journal of Pediatric Orthopedics
Eugen Boltshauser
No abstract text is available yet for this article.
November 29, 2017: Neuropediatrics
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
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
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