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Pediatric spinal fusion

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https://www.readbyqxmd.com/read/27861447/diagnostic-accuracy-of-neuromonitoring-for-identification-of-new-neurologic-deficits-in-pediatric-spinal-fusion-surgery
#1
Victor M Neira, Kamyar Ghaffari, Srinivas Bulusu, Paul J Moroz, James G Jarvis, Nicholas Barrowman, William Splinter
BACKGROUND: Intraoperative neuromonitoring (IONM) modalities, transcranial motor-evoked potentials (TcMEPs), and somatosensory-evoked potentials (SSEPs) are accepted methods to identify impending spinal cord injury during spinal fusion surgery. Debate exists over sensitivity and specificity of these modalities. Our purpose was to measure the incidence of new neurologic deficits (NNDs) and estimate sensitivity and specificity of IONM modalities. METHODS: Institutional Ethics Board approval was obtained to review charts of patients younger than 22 years undergoing scoliosis surgery from 2007 to 2014 retrospectively...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27857788/ultrasonography-and-magnetic-resonance-imaging-evaluation-of-pediatric-spinal-anomalies
#2
Dhaval Durlabhbhai Dhingani, Deb Kumar Boruah, Hemonta Kumar Dutta, Rudra Kanta Gogoi
CONTEXT: Spinal dysraphisms are congenital abnormalities of the spine due to imperfect fusion of midline mesenchymal, bony and neural structures. Imaging plays a vital role in their evaluation as significant portion of patients may present with concurrent anomalies that need to be corrected simultaneously to avoid repeat surgeries. AIMS: The aims of the study were to evaluate Spinal dysraphisms using USG and MRI and to correlate imaging findings with operative findings in patients undergoing surgery...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27836772/return-to-play-in-athletes-with-spinal-cord-concussion-a-systematic-literature-review
#3
REVIEW
Narihito Nagoshi, Lindsay Tetreault, Hiroaki Nakashima, Aria Nouri, Michael G Fehlings
STUDY DESIGN: Systematic review OBJECTIVE: To evaluate whether spinal cord concussion (SCC) patients can safely return to play sports and if there are factors that can predict SCC recurrence or development of a spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: Although SCC is a reversible neurologic disturbance of spinal cord function, its management and the implications for return to play controversial. METHODS: We conducted a systematic search of the literature using keywords Cervical Spine AND Sports AND Injuries in six databases...
November 8, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27792108/efficacy-of-intraoperative-neurophysiologic-monitoring-for-pediatric-cervical-spine-surgery
#4
Daniel G Tobert, Michael P Glotzbecker, M Timothy Hresko, Lawrence I Karlin, Mark R Proctor, John B Emans, Patricia E Miller, Daniel J Hedequist
STUDY DESIGN: Clinical case series OBJECTIVE.: To investigate the efficacy of intraoperative neuromonitoring in pediatric cervical spine surgery SUMMARY OF BACKGROUND DATA.: Intraoperative neuromonitoring (IONM) consisting of somatosensory evoked potentials (SSEP) and transcranial motor evoked potentials (tcMEP) has been shown to effectively prevent permaneny neurologic injury in deformity surgery. The role of IONM during pediatric cervical spine surgery is not well documented. Advances in cervical spine instrumentation have expanded the surgical options in pediatric populations...
October 25, 2016: Spine
https://www.readbyqxmd.com/read/27791706/patient-reported-outcomes-of-occipitocervical-and-atlantoaxial-fusions-in-children
#5
Aditya Vedantam, Daniel Hansen, Valentina Briceño, Alison Brayton, Andrew Jea
OBJECTIVE There is limited literature on patient-reported outcomes (PROs) and health-related quality of life (HRQOL) outcomes in pediatric patients undergoing surgery for craniovertebral junction pathology. The aim of the present study was to assess surgical and quality of life outcomes in children who had undergone occipitocervical or atlantoaxial fusion. METHODS The authors retrospectively reviewed the demographics, procedural data, and outcomes of 77 consecutive pediatric patients who underwent posterior occipitocervical or atlantoaxial fusion between 2008 and 2015 at Texas Children's Hospital...
October 28, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27757429/surgeon-driven-neurophysiologic-monitoring-in-a-spinal-surgery-population
#6
Michael Pickell, Stephen M Mann, Rajesh Chakravertty, Daniel P Borschneck
BACKGROUND: This is a prospective observational study examining the use of a surgeon-driven intraoperative neurophysiologic monitoring system. Intraoperative neurophysiologic monitoring is becoming the standard of care for spinal surgeries with potential post-operative neurologic deficits. This standard applies to both adult and pediatric spinal surgery, but a shortage of appropriately trained and certified technologists and physiologists can compromise monitoring capabilities in some centers...
September 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27753786/primary-versus-revision-spinal-fusion-in-children-an-analysis-of-74-525-cases-from-the-nationwide-inpatient-sample
#7
Rafael De la Garza Ramos, C Rory Goodwin, Taylor Purvis, Isaac O Karikari, Amer F Samdani, Daniel M Sciubba
STUDY DESIGN: Retrospective cohort study of a nationwide database. OBJECTIVE: To compare in-hospital outcomes for pediatric patients who underwent primary versus revision spinal fusion. SUMMARY OF BACKGROUND DATA: There is limited data on outcomes after primary versus revision spinal fusion in children. METHODS: Data from the Nationwide Inpatient Sample from 2002 to 2011 was analyzed. Pediatric patients (age <18) who underwent ≥ 3 level spinal fusion were identified...
October 6, 2016: Spine
https://www.readbyqxmd.com/read/27749348/perioperative-surgical-home-in-pediatric-settings-preliminary-results
#8
Karen Thomson, Sophie R Pestieau, Janish J Patel, Heather Gordish-Dressman, Ariana Mirzada, Zeev N Kain, Matthew E Oetgen
BACKGROUND: The Perioperative Surgical Home (PSH) is a patient-centered, team-based approach that aims to improve the value of perioperative care. We implemented a PSH for patients with adolescent idiopathic scoliosis who were undergoing posterior spinal fusion at Children's National Health System. We hypothesized that this PSH would improve patient surgical outcomes and reduce hospital length of stay (LOS). METHODS: A multidisciplinary group created evidence-based protocols for the preoperative, operative, postoperative, and postdischarge care of this patient population...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27713677/intraoperative-anaphylactic-reaction-is-it-the-floseal
#9
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27677014/2005-2015-ten-years-clinical-experience-in-treating-dmd-patients-by-corticosteroids-in-lyon
#10
Stéphanie Fontaine Carbonnel, Pascal Rippert, Isabelle Poirot, Dominique Gachet, Capucine de Lattre, Carole Vuillerot
OBJECTIVE: Since 2005, in France, corticosteroid therapy is now widely used in Duchenne muscular dystrophy (DMD). This treatment has changed our practice of pediatric rehabilitation teams. We describe here our 10-year clinical experience in treating DMD patients by CS according to international guidelines i.e. prednisone 0.75mg/kg/day started from the plateau of motor function. MATERIALS/PATIENTS AND METHODS: We conducted a prospective study. Information was given on the expected effects and side effects...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27603194/complication-rates-after-bone-morphogenetic-protein-bmp-use-in-orthopaedic-surgery-in-children-a-concise-multicenter-retrospective-cohort-study
#11
Sumeet Garg, James J McCarthy, Ryan Goodwin, Joel Kolmodin, Wudbhav N Sankar, Corinna Franklin, Douglas Armstrong, David Fryzel, Susan Hassenbein, Cara Meder
BACKGROUND: The use of bone morphogenetic protein (BMP) has been associated with a number of complications in adult patients. However, this association is less established in children. The aim of this study was to evaluate the safety of BMP use in children by determining the complication rates after BMP use at multiple institutions. METHODS: In a retrospective study (2000 to 2013), the medical records of all patients who received BMP at any of the 5 institutions were reviewed...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27603190/intraoperative-hypothermia-is-common-but-not-associated-with-blood-loss-or-transfusion-in-pediatric-posterior-spinal-fusion
#12
Mathew D Schur, Gideon W Blumstein, Derek A Seehausen, Patrick A Ross, Lindsay M Andras, David L Skaggs
BACKGROUND: Intraoperative hypothermia may be associated with increased blood loss due to the effects of temperature on clotting but this has not been evaluated in the setting of pediatric posterior spinal fusion (PSF). The purpose of this study was to determine if a correlation exists between intraoperative hypothermia and estimated blood loss (EBL) or transfusion requirements in pediatric patients undergoing PSF. METHODS: A retrospective review of consecutive patients undergoing PSF for scoliosis at a single institution between 6/2004 and 3/2012 was performed...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27603096/temporary-percutaneous-pedicle-screw-stabilization-without-fusion-of-adolescent-thoracolumbar-spine-fractures
#13
Shari Cui, Gennadiy A Busel, Aki S Puryear
BACKGROUND: Pediatric spine trauma often results from high-energy mechanisms. Despite differences in healing potential, comorbidities, and length of remaining life, treatment is frequently based on adult criteria; ligamentous injuries are fused and bony injuries are treated accordingly. In this study, we present short-term results of a select group of adolescent patients treated using percutaneous pedicle screw instrumentation without fusion. METHODS: An IRB-approved retrospective review was performed at a level 1 pediatric trauma center for thoracolumbar spine fractures treated by percutaneous pedicle screw instrumentation...
October 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27589598/factors-associated-with-spinal-fusion-after-posterior-fossa-decompression-in-pediatric-patients-with-chiari-i-malformation-and-scoliosis
#14
Charles E Mackel, Patrick J Cahill, Marie Roguski, Amer F Samdani, Patrick A Sugrue, Noriaki Kawakami, Peter F Sturm, Joshua M Pahys, Randal R Betz, Ron El-Hawary, Steven W Hwang
OBJECTIVE The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve. METHODS The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression...
December 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27584679/the-association-between-adjuvant-pain-medication-use-and-outcomes-following-pediatric-spinal-fusion
#15
Rebecca E Rosenberg, Stacey Trzcinski, Mindy Cohen, Mark Erickson, Thomas Errico, Lisa McLeod
STUDY DESIGN: Comparative effectiveness database study. OBJECTIVE: To describe variation in use of adjuvant therapies for managing postoperative pain in in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic (AIS) and determine association between use of these therapies and patient outcomes. SUMMARY OF BACKGROUND DATA: Variation in postoperative pain management for children undergoing PSF for AIS likely impacts outcomes...
August 31, 2016: Spine
https://www.readbyqxmd.com/read/27499651/new-developments-in-the-treatment-of-early-onset-spinal-deformity-role-of-the-shilla-growth-guidance-system
#16
REVIEW
Sean M Morell, Richard E McCarthy
Early-onset scoliosis is a complex condition with multiple facets. The goal of treating any spinal deformity is to improve the condition of the patient with the least intervention necessary. A system that allows for continuation of natural spinal growth while correcting the deformity should be the goal of treating this complex condition. The SHILLA growth guidance system allows for continued growth of the pediatric spine while correcting and guiding the apex and guiding the future growth of the curvature. The system involves selective fusion across the apex of the curvature, and minimally invasive instrumentation is then used above and below the apex to allow for continued growth of the spine...
2016: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/27471214/improvement-in-patient-transfer-process-from-the-operating-room-to-the-picu-using-a-lean-and-six-sigma-based-quality-improvement-project
#17
Stephen J Gleich, Michael E Nemergut, Anthony A Stans, Dawit T Haile, Scott A Feigal, Angela L Heinrich, Christopher L Bosley, Sandeep Tripathi
BACKGROUND AND OBJECTIVES: Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU...
August 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27453221/how-does-patient-radiation-exposure-compare-with-low-dose-o-arm-versus-fluoroscopy-for-pedicle-screw-placement-in-idiopathic-scoliosis
#18
Alvin W Su, Amy L McIntosh, Beth A Schueler, Todd A Milbrandt, Jennifer A Winkler, Anthony A Stans, A Noelle Larson
BACKGROUND: Intraoperative C-arm fluoroscopy and low-dose O-arm are both reasonable means to assist in screw placement for idiopathic scoliosis surgery. Both using pediatric low-dose O-arm settings and minimizing the number of radiographs during C-arm fluoroscopy guidance decrease patient radiation exposure and its deleterious biological effect that may be associated with cancer risk. We hypothesized that the radiation dose for C-arm-guided fluoroscopy is no less than low-dose O-arm scanning for placement of pedicle screws...
August 1, 2015: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27443575/one-size-care-does-not-fit-all-patients-undergoing-a-spinal-fusion
#19
Taralyn McMullan
PURPOSE: Spinal fusion (SF) surgery is a complex procedure that affects children with and without underlying disabilities. The purpose of this article was to describe the necessary steps when preparing a child, specifically with cerebral palsy (CP), and family for a SF, while also emphasizing the postoperative care during discharge planning. DESIGN: Literature review on pediatric patients undergoing spinal fusion and those who have cerebral palsy. METHOD: Literature was searched using the CINAHL database, from 2009 to 2016...
July 22, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
https://www.readbyqxmd.com/read/27438402/lumbar-spinous-process-fixation-and-fusion-a-systematic-review-and-critical-analysis-of-an-emerging-spinal-technology
#20
Alejandro J Lopez, Justin K Scheer, Nader S Dahdaleh, Alpesh A Patel, Zachary A Smith
STUDY DESIGN: A systematic review. OBJECTIVE: The available literature on interspinous rigid fixation/fusion devices (IFD) was systematically reviewed to explore the devices' efficacy and complication profile. SUMMARY OF BACKGROUND DATA: The clinical application of new spinal technologies may proceed without well-established evidence, as is the case with IFDs. IFDs are plate-like devices that are attached to the lateral aspects of 2 adjacent spinous processes to promote rigidity at that segment...
July 19, 2016: Clinical Spine Surgery
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