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Pediatric spinal fusion

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https://www.readbyqxmd.com/read/28937466/compressive-myelopathy-in-congenital-kyphosis-of-the-upper-thoracic-spine-a-retrospective-study-of-6-cases
#1
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
#2
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/28887279/sacral-alar-iliac-fixation-in-children-with-neuromuscular-scoliosis-minimum-5-year-follow-up
#3
Amit Jain, Brian T Sullivan, Anne Kuwabara, Khaled Kebaish, Paul D Sponseller
OBJECTIVE: The aim of our study was to investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. METHODS: We reviewed clinical and radiographic records of patients ≤18 years old treated by 1 pediatric orthopaedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients, with a minimum 5-year radiographic follow-up (6.0 ± 1.2 years), were studied. Mean patient age was 13 ± 2...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28885083/risk-factors-for-progressive-neuromuscular-scoliosis-requiring-posterior-spinal-fusion-after-selective-dorsal-rhizotomy
#4
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...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28882350/preoperative-norepinephrine-levels-in-cerebrospinal-fluid-and-plasma-correlate-with-pain-intensity-after-pediatric-spine-surgery
#5
Catherine E Ferland, Alexandre J Parent, Neil Saran, Pablo M Ingelmo, Anaïs Lacasse, Serge Marchand, Philippe Sarret, Jean A Ouellet
PURPOSE: Catecholamines were found to be involved in descending pain modulation and associated with perioperative pain. The purpose of the present study was to investigate the relationship between preoperative concentrations of catecholamines and postoperative pain intensity of pediatric patients. METHODS: Fifty adolescents with idiopathic scoliosis scheduled for elective spinal fusion surgery were enrolled in this prospective cohort study. Preoperative plasma and cerebrospinal fluid (CSF) samples were collected and analyzed by mass spectrometry...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#6
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
#7
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
#8
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/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#9
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28643037/pediatric-spondylolysis-spinal-stenosis-and-disc-herniation-national-trends-in-decompression-and-discectomy-surgery-evaluated-through-the-kids-inpatient-database
#10
Tridu R Huynh, Carlito Lagman, Fadi Sweiss, Faris Shweikeh, Miriam Nuño, Doniel Drazin
PURPOSE: The purpose of this study is to describe national trends in spinal decompression without fusion and discectomy procedures in the US pediatric inpatient population. METHODS: The Kids' Inpatient Database (KID) was queried for pediatric patients with primary diagnoses of spinal spondylolysis/stenosis or disc herniation and having undergone spinal decompression without fusion or discectomy over more than a decade (2000 to 2012). The primary (indirect) outcomes of interest were in-hospital complication rates, length of stay (LOS), total costs, and discharge dispositions...
June 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28609322/thoracic-spine-growth-revisited-how-accurate-is-the-dimeglio-data
#11
Ozgur Dede, Kadir Büyükdoğan, Halil Gökhan Demirkıran, Erhan Akpınar, Muharrem Yazici
STUDY DESIGN: Cross-sectional descriptive study. OBJECTIVE: To describe the normal rate pattern of thoracic spine growth in children without any spinal deformity. SUMMARY OF BACKGROUND DATA: The knowledge of thoracic spine growth and height is important for growing spine treatment and the decision of final fusion. Currently, pediatric spinal deformity is approached as early onset and late onset with an understanding of the fast growth during the first 5 years of life...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28602642/precision-and-accuracy-of-consumer-grade-motion-tracking-system-for-pedicle-screw-placement-in-pediatric-spinal-fusion-surgery
#12
Andrew Chan, Janelle Aguillon, Doug Hill, Edmond Lou
Adolescent idiopathic scoliosis (AIS) is a 3-dimensional spinal deformity involving lateral curvature and axial rotation. Surgical intervention involves insertion of pedicle screws into the spine, requiring accuracies of 1mm and 5° in translation and rotation to prevent neural and vascular complications. While commercial CT-navigation is available, the significant cost, bulk and radiation dose hinders their use in AIS surgery. The objective of this study was to evaluate a commercial-grade Optitrack Prime 13W motion capture cameras to determine if they can achieve adequate accuracy for screw insertion guidance in AIS...
June 9, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28598902/child-and-parent-pain-catastrophizing-and-pain-from-presurgery-to-6-weeks-postsurgery-examination-of-cross-sectional-and-longitudinal-actor-partner-effects
#13
Kathryn A Birnie, Jill Chorney, Ron El-Hawary
Child and parent pain catastrophizing are reported preoperative risk factors for children's acute and persistent postsurgical pain. This study examined dyadic relations between child and parent pain catastrophizing and child and parent ratings of child pain prior to (M = 4.01 days; "baseline") and following surgery (M = 6.5 weeks; "acute follow-up"), as well changes in pain catastrophizing during this time in 167 youth (86% female; Mage = 14.55 years) undergoing spinal fusion surgery and 1 parent (89% mothers)...
June 8, 2017: Pain
https://www.readbyqxmd.com/read/28548996/distal-junctional-failure-following-pediatric-spinal-fusion
#14
Lorena V Floccari, Alvin W Su, Amy L McIntosh, Karl Rathjen, William J Shaughnessy, A Noelle Larson
BACKGROUND: Adjacent segment pathology is a known complication after spinal fusion, but little has been reported on junctional failure. A series of adolescent patients presented with acute distal junctional failure (DJF). We sought to determine any common features of these patients to develop a prevention strategy. METHODS: A retrospective review was conducted of pediatric patients who developed DJF after instrumented spinal fusion performed at 2 institutions from 1999 to 2013...
August 4, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28546128/predictive-factors-of-intraoperative-cell-salvage-during-pediatric-scoliosis-surgery-cell-saver-during-scoliosis-surgery-in-children
#15
Daphné Michelet, Florence Julien-Marsollier, Julie Hilly, Thierno Diallo, Christophe Vidal, Souhayl Dahmani
INTRODUCTION: blood saving strategy during spinal surgery in children often includes recombinant erythropoietin (rEPO) and antifibrinolytic therapapy (AFT). The aim of this study was to investigate the efficacy of intraoperative blood salvage in decreasing homologous blood transfusion. MATERIAL AND METHODS: using the prospective data from patients operated during a one year period for scoliosis correction, we calculate the predictable hematocrit at day postoperative 1 without the use of blood salvage and compare it to the target hematocrit transfusion according to patient's status...
May 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28520681/delayed-dural-leak-following-posterior-spinal-fusion-for-idiopathic-scoliosis-using-all-posterior-pedicle-screw-technique
#16
Lorena V Floccari, A Noelle Larson, Anthony A Stans, Jeremy Fogelson, Iikka Helenius
BACKGROUND: In pediatric patients, pedicle screws are malpositioned 5% to 15% of the time. Complications associated with malpositioned screws are infrequently reported in the literature. We present a series of adolescent idiopathic scoliosis (AIS) patients who presented in a delayed manner with positional headache and chronic dural leak adjacent to the pedicle screw tract. METHODS: Scoliosis databases at 2 centers were reviewed, and cases of delayed positional headaches following posterior spinal fusion for AIS were identified...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28488618/pediatric-thoracolumbar-spinal-injuries-the-etiology-and-clinical-spectrum-of-an-uncommon-entity-in-childhood
#17
R A Babu, Arivazhagan Arimappamagan, Nupur Pruthi, Dhananjaya I Bhat, H R Arvinda, B Indira Devi, Sampath Somanna
BACKGROUND: Pediatric thoracolumbar (TL) spinal injuries are uncommon entities with an incidence of 5-34% of all pediatric spinal injuries. There is a scarcity of studies done on the pediatric population in the developing countries like India. This study aims to review our experience with TL spine injuries in children over a 12-year period. MATERIALS AND METHODS: We retrospectively reviewed the epidemiology, risk factors, mechanisms, patterns of injury and management of pediatric TL injuries in our population...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28466094/periosteal-turndown-flap-for-posterior-occipitocervical-fusion-a-technique-review
#18
Siamak Yasmeh, Adrienne Quinn, Liam Harris, Austin E Sanders, Ted Sousa, David L Skaggs, Lindsay M Andras
PURPOSE: Recently, several authors have proposed techniques for improving the fusion rate in pediatric posterior occipitocervical fusion including a variety of implants and the use of bone morphogenetic protein. A technique by Koop et al. using a periosteal flap for occipitocervical arthrodesis was described in 1984. METHODS: A straight incision is made about the posterior neck to expose the occipitocervical region from the inion superiorly to the lowest cervical vertebrae to be fused inferiorly...
May 2, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28460705/massive-transfusion-protocol-simulation-an-innovative-approach-to-team-training
#19
REVIEW
Allison Langston, Dayna Downing, Jennifer Packard, Marion Kopulos, Shelley Burcie, Kay Martin, Brennan Lewis
At a 72-bed pediatric facility, a multidisciplinary team approach was used to prepare for the expansion of services for patients requiring spinal fusion. This preparation included emergency response requiring massive transfusion, necessitating the need for a Massive Transfusion Protocol (MTP) process to be in place. Such instances are low volume/high risk, creating difficulty for staff to gain and maintain proficiency with the equipment and processes related to the MTP in a secure environment. The purpose of this article is to highlight the preparation and education put into place before receiving the first pediatric patient for spinal fusion...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28448398/intrathecal-morphine-versus-extended-release-epidural-morphine-for-postoperative-pain-control-in-pediatric-patients-undergoing-posterior-spinal-fusion
#20
RANDOMIZED CONTROLLED TRIAL
Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin
BACKGROUND: Posterior spinal fusion for scoliosis is one of the most painful elective pediatric surgeries. Good postoperative pain control allows early ambulation and return of ability to tolerate oral intake. Options for analgesia in this patient population are suboptimal. We hypothesized that extended-release epidural morphine (EREM) would provide better pain control and less adverse effects compared to intrathecal (IT) morphine. METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively...
June 2017: Anesthesia and Analgesia
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