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pediatric spine surgery

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https://www.readbyqxmd.com/read/28321954/anaphylactic-reaction-to-tranexamic-acid-in-an-adolescent-undergoing-posterior-spinal-fusion
#1
Jennifer Chiem, Iskra Ivanova, Andrew Parker, Walter Krengel, Nathalia Jimenez
Tranexamic acid is an anti-fibrinolytic agent frequently used in pediatric surgery. Common side effects include nausea, flushing, and headache, but in rare instances, it may produce anaphylaxis; with only one previously reported case in a 72-year-old man. We report a case of a delayed anaphylactic reaction in a pediatric patient undergoing posterior spine fusion; and discuss the intraoperative management of the acute event, immunologic confirmation, and subsequent anesthetic approach.
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28319509/a-high-preoperative-pain-and-symptom-profile-predicts-worse-pain-outcomes-for-children-after-spine-fusion-surgery
#2
Terri Voepel-Lewis, Michelle S Caird, Alan R Tait, Shobha Malviya, Frances A Farley, Ying Li, Matthew D Abbott, Tara van Veen, Afton L Hassett, Daniel J Clauw
BACKGROUND: Preoperative pain predicts persistent pain after spine fusion, yet little is understood about the nature of that pain, related symptoms, and how these symptoms relate to postoperative pain outcomes. This prospective study examined children's baseline pain and symptom profiles and the association between a high symptom profile and postoperative outcomes. METHODS: Seventy children (aged 10-17 years) scheduled for correction of idiopathic scoliosis completed pain and symptom surveys during their preoperative visit (ie, pain intensity [0-10 numeric rating scores], a pediatric version of the 2011 fibromyalgia survey criteria [including pain locations and symptom severity scale], neuropathic pain symptoms [painDETECT], and Patient-Reported Outcome Measurement System measures of fatigue, depression, function, pain interference, and pain catastrophizing)...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28301365/preserving-the-legitimacy-of-board-certification
#3
Michael S Hanemann, Holly C Wall, John A Dean
OBJECTIVES: The aims of this discussion were to inform the medical community about the American Board of Cosmetic Surgery's ongoing attempts in Louisiana to achieve equivalency to American Board of Medical Specialties (ABMS) member boards so that its diplomates may use the term "board certified" in advertising and to ensure public safety by upholding the standards for medical board certification. BACKGROUND: In 2011, Louisiana passed a truth in medical advertising law, which was intended to protect the public by prohibiting the use of the term "board certified" by improperly credentialed physicians...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#4
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28263228/pain-is-the-greatest-preoperative-concern-for-patients-and-parents-prior-to-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#5
Priscella Chan, David Skaggs, Austin Sanders, Gabriela A Villamor, Paul D Choi, Vernon Tolo, Lindsay M Andras
STUDY DESIGN: Prospective cross-sectional study OBJECTIVE.: To evaluate patients' and parents' concerns so they can be addressed with appropriate preoperative counseling. SUMMARY OF BACKGROUND DATA: Despite much research on outcomes for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS), little is available about preoperative fears or concerns. METHODS: AIS patients undergoing PSF, their parents, and surgeons, were prospectively enrolled and asked to complete a survey on their fears and concerns about surgery at their preoperative appointment...
March 3, 2017: Spine
https://www.readbyqxmd.com/read/28247113/management-of-eosinophilic-granuloma-in-pediatric-patients-surgical-intervention-and-surgery-combined-with-postoperative-radiotherapy-and-or-chemotherapy
#6
Zhenhai Zhou, Hongqi Zhang, Chaofeng Guo, Honggui Yu, Longjie Wang, Qiang Guo
BACKGROUND: Eosinophilic granuloma (EG) of spine in pediatric patients presents kinds of clinical manifestation and a difficult management scenario. The choice of treatment, issues of surgical intervention versus conservative treatment, combination therapy or single treatment, all these factors, including neurological deficits, spinal stability, long-term complications, and continued skeletal growth, must be considered. METHODS: From 2008 to the 2015, 31 pediatric patients of spinal EG were retrospectively reviewed...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#7
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28217238/fetus-in-fetu-case-report-and-brief-review-of-literature-on-embryologic-origin-clinical-presentation-imaging-and-differential-diagnosis
#8
Suhas Aithal Sitharama, Bibekanand Jindal, Mrudula Kumari Vuriti, Bikash Kumar Naredi, Sriram Krishnamurthy, Deepak Barathi Subramania
BACKGROUND: Fetus in fetu (FIF) is a rare entity in which a malformed diamniotic monochorionic parasitic fetal twin develops inside a normal co-twin's body, most commonly in the abdominal cavity. FIF is differentiated from the teratoma by the presence of vertebral column often with an appropriate arrangement of other organs or limbs around it. CASE REPORT: A two-and-a-half-year-old girl presented with a painless abdominal swelling in the right hypochondrium. On imaging, a heterogenous soft tissue mass with internal calcific densities was noted in the retroperitoneum...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28186477/bilateral-sagittal-split-mandibular-osteotomies-for-enhanced-exposure-of-the-anterior-cervical-spine-in-children-technical-note
#9
Michael Karsy, Neal Moores, Faizi Siddiqi, Douglas L Brockmeyer, Robert J Bollo
The bilateral sagittal split mandibular osteotomy (BSSMO), a common maxillofacial technique for expanding the oropharynx during treatment of micrognathia, is a rarely employed but useful adjunct to improve surgical access to the ventral cervical spine in children. Specifically, it provides enhanced exposure of the craniocervical junction in the context of midface hypoplasia, and of the subaxial cervical spine in children with severe kyphosis. The authors describe their technique for BSSMO and evaluate long-term outcomes in patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28186474/morbidity-associated-with-30-day-surgical-site-infection-following-nonshunt-pediatric-neurosurgery
#10
Brandon A Sherrod, Brandon G Rocque
OBJECTIVE Morbidity associated with surgical site infection (SSI) following nonshunt pediatric neurosurgical procedures is poorly understood. The purpose of this study was to analyze acute morbidity and mortality associated with SSI after nonshunt pediatric neurosurgery using a nationwide cohort. METHODS The authors reviewed data from the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2014 database, including all neurosurgical procedures performed on pediatric patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28185981/analysis-of-the-s2-alar-iliac-screw-as-compared-with-the-traditional-iliac-screw-does-it-increase-stability-with-sacroiliac-fixation-of-the-spine
#11
Daniel G Hoernschemeyer, Troy D Pashuck, Ferris M Pfeiffer
BACKGROUND CONTEXT: Arthrodesis of the lumbosacral junction continues to be a challenge in pediatric and adult spinal deformity surgery. PURPOSE: To evaluate the biomechanical rigidity of two types of lumbosacral fixation. Our hypothesis was that the use of S2 alar-iliac (S2AI) fixation will result in statistically similar biomechanical fixation as compared with use of an iliac screw with a 95% confidence interval. STUDY SETTING: Controlled biomechanical laboratory METHODS: Ten human cadaveric lumbosacral specimens were separated into two test groups: (1) S2AI (n=5) and (2) iliac screw (n=5)...
February 6, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28184249/atlantoaxial-rotatory-fixation-as-a-rare-complication-from-head-positioning-in-otologic-surgery-report-of-two-cases-in-young-children
#12
Hiroshi Sakaida, Koji Akeda, Akihiro Sudo, Kazuhiko Takeuchi
BACKGROUND: Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#13
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28044467/magnetically-controlled-growing-rods-for-scoliosis-surgery
#14
REVIEW
Umesh Metkar, Swamy Kurra, David Quinzi, Stephen Albanese, William F Lavelle
Early onset scoliosis can be both a disfiguring as well as a life threatening condition. When more conservative treatments fail, pediatric spinal surgeons are forced to consider operative interventions. Traditionally, these interventions have involved the insertion of a variety of implants into the patient with a limited number of anchor points controlling the spine. In the past, these pediatric patients have had multiple surgeries for elective lengthening of these devices to facilitate their growth while attempting to control the scoliosis...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28029391/off-hour-surgery-among-orthopedic-subspecialties-at-an-urban-quaternary-care-level-1-trauma-center
#15
Amanda Lans, Stein J Janssen, David Ring
PURPOSE: We sought to determine and quantify which subspecialties of orthopedic surgeons are operating off hours in an urban, quaternary-care, level 1 trauma center. MATERIALS AND METHODS: We used our clinical registry to identify 43,211 orthopedic surgeries performed between January 2008 and December 2011. Our outcome measures were the number and proportion of off-hour surgeries performed as well as the number and proportion of off-hours per subspecialty. The denominators were the total number of surgeries and the total number of surgical hours worked per subspecialty...
October 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#16
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#17
Joshua M Pahys, James T Guille
BACKGROUND: Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#18
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27927516/preoperative-mrsa-screening-in-pediatric-spine-surgery-a-helpful-tool-or-a-waste-of-time-and-money
#19
Scott J Luhmann, June C Smith
OBJECTIVES: To review the use of preoperative screening for Staphylococcus aureus for all pediatric spine procedures that was instituted at our facility in a multimodal approach to decrease the frequency of postoperative wound infections. SUMMARY OF BACKGROUND DATA: Four years ago at our facility, a multimodal approach to decrease the frequency of postoperative infections after pediatric spine surgery was instituted. METHODS: A single-center, single-surgeon pediatric spine surgery database was queried to identify all patients who had preoperative S...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927504/does-the-type-of-metal-instrumentation-affect-the-risk-of-surgical-site-infection-in-pediatric-scoliosis-surgery
#20
Margaret L Wright, David L Skaggs, Hiroko Matsumoto, Regina P Woon, Ashley Trocle, John M Flynn, Michael G Vitale
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the association of implant metal composition with the risk of surgical site infection (SSI) following pediatric spine surgery. SUMMARY OF BACKGROUND DATA: SSI is a well-described complication following pediatric spine surgery. Many risk factors have been identified in the literature, but controversy remains regarding metal composition as a risk factor. METHODS: This was a retrospective study of patients who underwent posterior spinal instrumentation procedures between January 1, 2006, and December 31, 2008, at three large children's hospitals for any etiology of scoliosis and had at least 1 year of postoperative follow-up...
May 2016: Spine Deformity
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