Occipital Neuromodulation: A Surgical Technique with Reduced Complications.

Background: Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication.

Objectives: The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgical technique employing 2-point anchoring of stimulator leads designed to provide a tension-relief loop and the use of ultrasound for lead placement would decrease the complication rate.

Managing Chronic Pain in Children and Adolescents: A Clinical Review.

Chronic pain in children and adolescents can be difficult for a single provider to manage in a busy clinical setting. Part of this difficulty is that pediatric chronic pain not only impacts the child but also the families of these children. In this review article, we discuss etiology and pathophysiology of chronic pain, along with variables that impact the severity of chronic pain and functional loss.

Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography.

Objectives: The purpose of this study was to investigate the feasibility and reliability of passive muscle stiffness measurements in children by shear wave ultrasound elastography.

Methods: We conducted a prospective cross-sectional study quantifying the passive stiffness of bilateral lateral gastrocnemius muscles during passive stretching in 20 typically developing children (age range, 2.0-12.

Physical activity in children and adolescents.

After obesity rates in youth reached alarming rates, public health officials recognized the need for specific physical activity guidelines for children and adolescents. Numerous health care groups and sports and fitness organizations collaborated on the development of the Physical Activity Guidelines for Americans in 2008, which have been widely endorsed and include recommendations for the pediatric population. Children and adolescents should participate in moderate-to-vigorous physical activity 1 or more hours per day and muscle and bone-strengthening activities 3 or more times per week.

Sonographically guided obturator internus injections: techniques and validation.

Objectives: The primary purpose of this investigation was to describe and validate sonographically guided techniques for injecting the obturator internus (OI) muscle or bursa using a cadaveric model.

Methods: A single experienced operator completed 10 sonographically guided OI injections in 5 unembalmed cadaveric pelvis specimens (4 female and 1 male, ages 71-89 years with body mass indices of 15.5-24.

Postoperative gait velocity and mean knee flexion in stance of ambulatory children with spastic diplegia four years or more after multilevel surgery.

Factors associated with longer-term outcomes of multilevel orthopaedic surgery in ambulatory children with cerebral palsy using a multivariate approach were evaluated using a retrospective pretest-posttest design. The population included 20 ambulatory children with spastic diplegia who had undergone multilevel orthopaedic surgery with a minimum of 4-year interval between a preoperative and a postoperative gait assessment. Multiple regression analysis was used to identify factors associated with postoperative velocity and mean knee flexion in stance.