Sports after single-suture synostosis surgery: a survey of Synostosis Research Group members.

Objective: Patients with a history of surgery for single-suture craniosynostosis (SSC) as an infant often wish to participate in sports later in childhood. However, there are no established guidelines from neurosurgeons and craniofacial surgeons to guide parents in which sports their child should or should not participate. Therefore, this study aimed to evaluate the attitudes and practice patterns of experienced neurosurgeons and craniofacial surgeons regarding the counseling of caregivers of these patients about sports participation.

Craniosynostosis surgery practice patterns in the United States: what are we doing and how are we doing it?

Objective: The surgical management of craniosynostosis varies without consensus on technique or standard outcomes reporting. The authors of this study aimed to investigate current surgical management of craniosynostosis in the United States.

Methods: Two hundred seventy-five surgeons actively treating craniosynostosis in the United States were surveyed.

Comprehensive craniometry for sagittal synostosis.

Objective: Sagittal synostosis is the most common type of craniosynostosis, resulting in deformity with distinctive morphological characteristics. These include occipital narrowing, parietal narrowing, anteriorly shifted vertex with parietal depression, and exaggerated frontal bossing. The traditional cephalic index affords limited reliability in quantifying initial severity and correction.

Craniosynostosis: Current Evaluation and Management.

Craniosynostosis is characterized by the premature fusion of one or more cranial sutures, which can lead to abnormal skull shape and restricted skull growth. Although most cases are present in isolation, some are associated with genetic syndromes, such as Pfeiffer, Muenke, Couzon, Apert, and others, which increases the complexity of care. Today, a spectrum of surgical options to treat craniosynostosis are available and range from traditional open cranial vault remodeling to newer and less invasive suturectomy-based techniques.

Evaluating the prevalence of psychiatric comorbidities associated with pediatric scoliosis utilizing ResearchMatch.

Purpose: The goal of this study is to characterize the self-reported prevalence of psychiatric comorbidities among patients with adolescent scoliosis.

Methods: Eligible patients across the US were surveyed using ResearchMatch, a validated online platform. The survey collected patient demographics, type of scoliosis, scoliosis treatment received, and the mental health diagnoses and interventions.

Do Iliac Screws Placed Close to the Sciatic Notch Have Greater Pullout Strength?

Background And Objectives: Optimal iliac screw position in relation to the sciatic notch remains unknown. In 12 cadavers undergoing S2 alar-iliac (S2AI) screw placement, we tested the pullout strength of screws placed in proximity to the sciatic notch (≤5 mm) vs farther away from the sciatic notch (>5 mm).

Methods: A biomechanical, cadaver-based study was performed on 12 cadavers undergoing bilateral S2AI screw insertion.

Retrospective Case Series of Spinal Cord Neurapraxia in Male Adolescent Athletes: Can These Athletes Return-to-Play?

Background And Objectives: While spinal cord neurapraxia (SCN) is a documented pathology in athletes, guidance for neurosurgeons evaluating these patients is sparse. Therefore, in a cohort of adolescent athletes with SCN, we sought to (1) review their presentation and management and (2) describe outcomes and return-to-play (RTP).

Methods: A single-center, retrospective case series was conducted to examine adolescent athletes diagnosed with SCN from 2017 to 2022.

Sport-related concussion in 8- to 12-year-olds: an understudied population.

Objective: Most studies regarding sport-related concussion (SRC) focus on high school and collegiate athletes; however, little has been published on children younger than 12 years of age. In a cohort of children aged 8-12 years with SRC, the authors sought to describe demographics, initial presentation, and recovery in this understudied population.

Methods: A retrospective cohort study of children aged 8-12 years who sustained an SRC between November 2017 and April 2022 and were treated at a regional sports concussion center was conducted.

Neurosurgical management of cervicomedullary compression, spinal stenosis, and hydrocephalus in pediatric achondroplasia: a systematic review.

Objective: Pediatric achondroplasia is often associated with conditions requiring neurosurgical intervention, including CSF diversion and multilevel spinal decompression. However, there is a lack of clinical guidelines and reliable estimates of the benefits and risks of these interventions. This study aimed to summarize the literature on the neurosurgical management of pediatric achondroplasia patients in order to aid in determining optimal treatment and standardization of care.

Measuring coagulopathy in pediatric craniofacial surgery.

The goal of this study was to describe hematologic and coagulation laboratory parameters and identify if these laboratory studies could predict blood loss in a cohort of pediatric patients undergoing complex cranial vault reconstruction (CCVR) for repair of craniosynostosis. We reviewed records from 95 pediatric CCVR patients between 2015 and 2019. Primary outcome measures were hematologic and coagulation laboratory parameters.

Frontal sinus hypoplasia in unoperated older patients with craniosynostosis: a pilot study.

Purpose: The purpose of this study is to determine whether patients with unoperated craniosynostosis have different frontal sinus pneumatization than unaffected controls.

Methods: Retrospective review was performed between 2009 and 2020 of previously unoperated patients with craniosynostosis older than 5 years old at first presentation to our institution. Total frontal sinus volume (FSV) was calculated using 3D volume rendering tool in Sectra IDS7 PACS system.

Surgical treatment of craniovertebral junction instability in children with Down syndrome: a systematic review.

Objective: Down syndrome (DS) affects 1 in 700 live births and approximately one-third of patients develop craniovertebral junction (CVJ) instability, diagnosed by clinical examination and radiological measures such as the atlantodens interval (ADI) and space available for the cord (SAC). Patients with symptomatic CVJ instability are at increased risk for spinal cord injury. There are no guidelines for surgical management of CVJ instability in DS, the existing literature is sparse, and there is a lack of consistent pediatric data.

Predicting early versus late recovery from sport-related concussion using decision tree analysis.

Objective: Accurately predicting early (≤ 14 days) versus typical (15-27 days) or delayed (≥ 28 days) recovery from sport-related concussion (SRC) may allow for improved resource utilization and precision in planning and carrying out rehabilitation. In this study, the authors sought to develop an algorithm that enables accurate differentiation of recovery periods and duration after SRC. The authors hypothesized that data regarding initial symptom burden as quantified by a Post-Concussion Symptom Scale (PCSS) score, time to presentation, and number of prior concussions would be the most useful for analyzing predictive factors for concussion recovery duration.

Building consensus for the medical management of children with moderate and severe acute spinal cord injury: a modified Delphi study.

Objective: The focus of this modified Delphi study was to investigate and build consensus regarding the medical management of children with moderate and severe acute spinal cord injury (SCI) during their initial inpatient hospitalization. This impetus for the study was based on the AANS/CNS guidelines for pediatric SCI published in 2013, which indicated that there was no consensus provided in the literature describing the medical management of pediatric patients with SCIs.

Methods: An international, multidisciplinary group of 19 physicians, including pediatric neurosurgeons, orthopedic surgeons, and intensivists, were asked to participate.

Investigation of Factors Contributing to Racial Differences in Sport-Related Concussion Outcomes.

Objective: Following sport-related concussion (SRC), early studies have demonstrated racial differences in time to clinical recovery; however, these differences have not been fully explained. We sought to further explore these associations by considering possible mediating/moderating factors.

Methods: Data from patients aged 12-18 years diagnosed with SRC from November 2017 to October 2020 were analyzed.

The Efficacy of Blended Learning in a Pediatric Spine Deformity Management Program in Sub-Saharan Africa.

Introduction: Our study assessed the efficacy of blended learning, which combines in-person learning and e-learning, in a pediatric scoliosis training program through an international collaborative effort.

Methods: The course comprised two parts: the online portion, where participants reviewed educational materials for 3 weeks and met with faculty once/week for discussion, and the in-person session, where participants reviewed cases in a team-based approach and came to a consensus on treatment strategy, followed by discussion with an international expert. All participants completed a needs assessment (NA) and clinical quiz at three points: before the course, after the online session, and after the in-person session, which covered various topics in pediatric spine deformity.

Local conceptions of the role of folate in neural tube defects in Zambia.

Objective: In sub-Saharan Africa, neural tube defects (NTDs) are the second most common birth defect, occurring eight times more frequently than in the US. The objective of this study was to assess baseline Zambian caregiver understanding of folate and NTDs and the effectiveness of an NTD prevention educational program.

Methods: This prospective survey-based study included Zambian caregivers of children born with NTDs who completed pre- and post-educational program surveys between January 2020 and January 2021.

A multi-institutional survey on calvarial vault remodeling techniques for sagittal synostosis and outcomes analysis for patients treated at 12 months and older.

Objective: Surgical treatment of sagittal craniosynostosis is challenging in older patients. This study aimed to assess the effect of increasing age on open surgical technique selection and patient outcomes using the multi-institutional Synostosis Research Group (SynRG) collaboration.

Methods: Surgeons in SynRG were surveyed for key influences on their preferred open calvarial vault remodeling techniques at various patient ages: < 6, 6-12, and > 12 months.