Unexpected higher blood loss associated with higher dose ε-aminocaproic acid in pediatric scoliosis surgery
The purpose of this study was to determine if a higher dosing of ε-aminocaproic acid (EACA) is associated with less perioperative blood loss than a lower dose. A total of 74 patients having scoliosis surgery were analyzed. Of the 74 patients, 36 patients received EACA (10 mg/kg/h) and 38 patients received EACA (33 mg/kg/h). After controlling for key variables, an infusion of 33 mg/kg/h of EACA was associated with an increase in intraoperative blood loss of 8.1 ml/kg compared with an infusion of 10 mg/kg/h of EACA. A 33 mg/kg/h intraoperative infusion is associated with higher intraoperative blood loss than an infusion at 10 mg/kg/h.
A new analysis compares the cost-effectiveness of surgical and nonsurgical treatment options for adult symptomatic lumbar scoliosis. How do they measure up?Spine
AbstractPurposeThe study is aimed to investigate the expression ofPAX3 in bilateral paravertebral muscles in adolescent idiopathic scoliosis (AIS) and controls, and to further clarify its association with the paravertebral muscle volume and curve severity.MethodsTen AIS patients and 10 age-matched controls with lumbar disc herniation were included. Bilateral biopsies of paravertebral muscles were obtained at the apical vertebral level for patients and at L5 level for controls. The concave and convex expression ofPAX3 was compared between the two groups. The AIS patients were evaluated with magnetic resonance imaging scan o...
Conditions: Adult Spinal Deformity; Scoliosis; Kyphosis; Sagittal Imbalance Intervention: Procedure: Index or spine revision surgery for complex adult spinal deformity Sponsors: International Spine Study Group Foundation; Medtronic; Globus Medical Inc; SI-BONE, Inc. Recruiting
Conclusions: This is the first study that follows AIS patients treated with spine stapling to skeletal maturity. Staples likely changed natural history in some of our patients. Initial percentage of correction on first standing postoperative PA x-rays was the only predictor of success. Stapling was safe without any long-term complications. Level of Evidence: Level III—retrospective study.
Conclusions: Three-dimensional reconstruction of the rib cage using biplanar stereoradiography is a reliable method to estimate preoperative thoracic parameters in patients with AIS. Level of Evidence: Level IV—diagnostic study.
Conclusions: Our goals for NF-1 scoliosis are to obtain deformity correction, to achieve stable instrumentation by using longer fusion levels and to attain a solid fusion mass that can tolerate continual erosion during the long-term follow-up. We achieve this by using a circumferential approach for EOS associated with NF-1. Level of Evidence: Level IV—case series.
Conclusions: We developed consensus-based BPG for the use and implementation of HGT for pediatric spinal deformity. This can serve as a measure to help drive future research as well as give new surgeons a place to begin their practice of HGT. Level of Evidence: Level V—expert opinion.
Conclusions: In a large group of children treated for idiopathic EOS, we found a high prevalence of commonly associated conditions—hip dysplasia, torticollis, plagiocephaly, metatarsus adductus, and clubfoot. In 6.2% of our sample, a diagnosis of hip dysplasia was not made in a timely manner despite routine radiographic spine follow-up. With increasing subspecialization within pediatric orthopaedics, surgeons need to maintain vigilance in assessing the entire child. Level of Evidence: Level IV.
Authors: Ximena S Abstract Tetralogy of Fallot is the most common congenital heart malformation that produces cyanosis. It consists of four different defects of the heart: ventricular septal defect, pulmonary artery stenosis (blockage of blood flow from the right ventricle to the lungs), right ventricle hypertrophy and dextroposition of aorta. Echocardiography is essential in establishing the diagnosis of patients with cardiac malformation. Patients with Fallot tetralogy present a higher frequency of major non-cardiac congenital disorders. The association with congenital scoliosis influences vital and functional ov...
Conclusions. The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised.