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pediatric scoliosis

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https://www.readbyqxmd.com/read/29351095/the-effect-of-ketorolac-on-thoracolumbar-posterolateral-fusion-a-systematic-review-and-meta-analysis
#1
Jesse Li, Remi M Ajiboye, Michael H Orden, Akshay Sharma, Austin Drysch, Sina Pourtaheri
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The purpose of this study was to evaluate the effect of postoperative ketorolac administration (ie, dosage and duration of use) on pseudarthrosis following thoracolumbar posterolateral spinal fusions. SUMMARY OF BACKGROUND DATA: Ketorolac is a nonsteroidal anti-inflammatory drug often administered for pain control after spine surgery. The main concern with ketorolac is the risk of pseudarthrosis following fusion...
January 18, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29287815/preventing-distal-junctional-kyphosis-by-applying-the-stable-sagittal-vertebra-concept-to-selective-thoracic-fusion-in-adolescent-idiopathic-scoliosis
#2
Joshua Yang, Lindsay M Andras, Alexander M Broom, Nicholas R Gonsalves, Kody K Barrett, Andrew G Georgiadis, John M Flynn, Vernon T Tolo, David L Skaggs
STUDY DESIGN: Multicenter retrospective review. OBJECTIVE: To assess the effectiveness of using the stable sagittal vertebra (SSV) for selecting the lowest instrumented vertebrae (LIV) to prevent distal junctional kyphosis (DJK) in selective thoracic fusions. SUMMARY OF BACKGROUND DATA: Cho et al. reported that including the SSV in a fusion decreased the rate of DJK in thoracic hyperkyphosis. METHODS: A retrospective review was performed of patients from two pediatric hospitals with adolescent idiopathic scoliosis who underwent selective posterior thoracic fusion with the LIV at L2 or above from 2000 to 2012...
January 2018: Spine Deformity
https://www.readbyqxmd.com/read/29285106/pediatric-chiari-malformation-type-i-long-term-outcomes-following-small-bone-window-posterior-fossa-decompression-with-autologous-fascia-duraplasty
#3
Hai Liu, Chenlong Yang, Jun Yang, Yulun Xu
Chiari malformation type I (CM-I) is a common hindbrain disorder that is associated with deformity and elongation of the cerebellar tonsils. Although CM-I occurs in both pediatric and adult patients, its prevalence, clinical features and management in the pediatric population are not well defined. The current study evaluated a consecutive case series of 92 children (38 females and 54 males) who were diagnosed with congenital CM-I. All patients underwent small-bone-window posterior fossa decompression with autologous-fascia duraplasty...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29248202/clonidine-administration-during-intraoperative-monitoring-for-pediatric-scoliosis-surgery-effects-on-central-and-peripheral-motor-responses
#4
Pedro Calderón, Paul Deltenre, Ida Stany, Jean-Paul Kaleeta Maalu, Magali Stevens, Jean Lamoureux, Michel Bellemans, Sylvie Dujardin, Philippe Van der Linden, Bernard Dachy
OBJECTIVE: To study the effect of clonidine administrated as a co-analgesic during scoliosis surgery, on the neuromonitoring of spinal motor pathways. METHODS: Using standardized intraoperative monitoring, we compared the time course of peripherally and transcranially electrically evoked motor potentials (TcEMEPs) before and after injection of a single bolus of clonidine in children under total intravenous anesthesia (TIVA). MEP data were obtained from 9 patients and somatosensory evoked potentials (SSEPs) were obtained from 2 patients...
December 13, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29236600/benefit-of-intraoperative-neurophysiological-monitoring-in-a-pediatric-patient-with-spinal-dysmorphism-split-cord-malformation-and-scoliosis
#5
Faisal R Jahangiri, Samir Al Sayegh, Moutasem Azzubi, Abdulrahman M Alrajhi, Monerah M Annaim, Shmoukh A Al Sharif, Tanweer Aziz, Sami Al Eissa
Intraoperative neurophysiological monitoring (IONM) consists of a group of neurodiagnostic techniques that assess the nervous system's functional integrity during surgical operations. A retrospective analysis of a pediatric female patient was conducted who underwent 12 operations for the correction of scoliosis, tethered cord, and split spinal cord wherein IONM played an important role. From age 3 to 6, she underwent six procedures including a release of the tethered cord, resection of the filum terminale, removal of a T11-T12 bony spur, release of L3 adhesions, repair of subcutaneous meningocele, and correction of scoliosis with a vertical expandable prosthetic titanium rod (VEPTR) technique without the use of IONM...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/29228056/back-and-neck-pain-and-function-in-females-with-adolescent-idiopathic-scoliosis-a-follow-up-at-least-23-years-after-conservative-treatment-with-a-milwaukee-brace
#6
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
https://www.readbyqxmd.com/read/29227524/pediatric-scoliosis-and-kyphosis-an-overview-of-diagnosis-management-and-surgical-treatment
#7
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
https://www.readbyqxmd.com/read/29225911/understanding-muscle-immune-interactions-in-adolescent-idiopathic-scoliosis-a-feasibility-study
#8
Srikesh Rudrapatna, Devin Peterson, Paul Missiuna, Ishan Aditya, Brian Drew, Nicola Sahar, Lehana Thabane, M Constantine Samaan
Background: Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis in children, and its cause remains unknown. The Immune-metabolic CONnections to Scoliosis (ICONS) Study was designed to elucidate the potential mechanisms by which immune system-paraspinal muscle crosstalk contributes to the development of AIS. In this report, we document the evaluation of ICONS Study feasibility. Methods: This study was conducted at a tertiary pediatric academic center in Hamilton, Ontario, Canada...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29212713/a-degradation-fragment-of-type-x-collagen-is-a-real-time-marker-for-bone-growth-velocity
#9
Ryan F Coghlan, Jon A Oberdorf, Susan Sienko, Michael D Aiona, Bruce A Boston, Kara J Connelly, Chelsea Bahney, Jeremie LaRouche, Sarah M Almubarak, Daniel T Coleman, Irute Girkontaite, Klaus von der Mark, Gregory P Lunstrum, William A Horton
Despite its importance as a key parameter of child health and development, growth velocity is difficult to determine in real time because skeletal growth is slow and clinical tools to accurately detect very small increments of growth do not exist. We report discovery of a marker for skeletal growth in infants and children. The intact trimeric noncollagenous 1 (NC1) domain of type X collagen, the marker we designated as CXM for Collagen X Marker, is a degradation by-product of endochondral ossification that is released into the circulation in proportion to overall growth plate activity...
December 6, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29189528/incidence-and-diagnostic-evaluation-of-postoperative-fever-in-pediatric-patients-with-neuromuscular-disorders
#10
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...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29182113/fusion-segment-of-high-grade-lumbar-spondylolisthesis-2-year-follow-up
#11
X Li, L Xu, Q Kong
The clinical efficacy of reduction and fusion surgery and the suitable range of fusion-segment were evaluated in 12 pediatric patients treated for high-grade spondylolisthesis. Pre/post-operative clinical and radiological assessments were analyzed. A transient L5 nerve root paralysis was observed in one patient with L5 spondylolisthesis. No degenerative spondylolisthesis or adjacent segmental instability occurred above the fusion segments. In conclusion, we suggest that, in case of spondylolisthesis without severe structural scoliosis deformity or only associated with lumbosacral deformity, the posterior ligament complex should be protected in case of adjacent segmental instability and spondylolisthesis...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#12
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#13
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29120963/high-dose-versus-low-dose-tranexamic-acid-to-reduce-transfusion-requirements-in-pediatric-scoliosis-surgery
#14
Daniel J Johnson, Christine C Johnson, Susan M Goobie, Nina Nami, Joshua A Wetzler, Paul D Sponseller, Steven M Frank
BACKGROUND: Our objective was to quantify blood loss and transfusion requirements for high-dose and low-dose tranexamic acid (TXA) dosing regimens in pediatric patients undergoing spinal fusion for correction of idiopathic scoliosis. Previous investigators have established the efficacy of TXA in pediatric scoliosis surgery; however, the dosing regimens vary widely and the optimal dose has not been established. METHODS: We retrospectively analyzed electronic medical records for 116 patients who underwent spinal fusion surgery for idiopathic scoliosis by a single surgeon and were treated with TXA...
December 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29112006/modified-lumbosacral-angle-and-modified-pelvic-incidence-as-new-parameters-for-management-of-pediatric-high-grade-spondylolisthesis
#15
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/29064871/best-practice-guidelines-for-surgical-site-infection-prevention-with-surgical-treatment-of-early-onset-scoliosis
#16
Michael P Glotzbecker, Tricia A St Hilaire, Jeff B Pawelek, George H Thompson, Michael G Vitale
BACKGROUND: Postoperative surgical site infection (SSI) is unfortunately a commonly encountered complication in the surgical treatment of children with Early Onset Scoliosis (EOS). There is documented variation in the treatment of this patient population. Previous work building consensus for the approach to high risk patients (eg, neuromuscular etiology) has been promising. The goal of the current study is to apply similar principles to develop consensus-based guidelines for the treatment of patients with EOS...
October 23, 2017: Journal of Pediatric Orthopedics
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
#17
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
#18
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/29050711/prevalence-of-vitamin-d-deficiency-in-pediatric-patients-with-scoliosis-preparing-for-spinal-surgery
#19
Theresa Mayes, Jennifer M Anadio, Peter F Sturm
BACKGROUND: Establishing prevalence of vitamin D deficiency in elective scoliosis surgery may impact clinical outcomes. The objectives of this study were to document vitamin D status of patients with scoliosis preparing for surgical intervention in order to establish frequency of deficiency and determine characteristics influencing levels. METHODS: Records were queried for patients with scoliosis diagnosis who underwent posterior spinal fusion or initial growing rod placement and had serum vitamin 25 hydroxyvitamin D (D25) recorded in the preoperative period...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29049087/raising-mean-arterial-pressure-alone-restores-20-of-intraoperative-neuromonitoring-losses
#20
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
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