Can Intra-Operative Cell Salvage Reduce the Rate of Allogeneic Transfusion in Pediatric Spinal Deformity Surgery?

Study Design: Retrospective cohort study.

Objectives: The objective of this study was to characterize the association between cell-salvage and allogeneic transfusion rate in pediatric patients undergoing posterior arthrodesis for scoliosis.

Methods: NSQIP Pediatric database years 2016-2022 was used.

Timing of surgery for children and adolescents sustaining complete traumatic spinal cord injury.

Objective: Spinal cord injury (SCI) trials have historically underrepresented pediatric patients. There are limited pediatric data examining the influence of surgical timing on complications and mortality for children and adolescents who have sustained complete traumatic SCI.

Methods: The following multicenter cohort study used Trauma Quality Improvement Program data from 2010 to 2020.

The diagnostic accuracy of community spine radiology for adolescent idiopathic scoliosis brace candidates.

Purpose: The study aims to establish the diagnostic accuracy of community spine x-rays for brace candidates.

Methods: A review of adolescent idiopathic scoliosis patients seen for initial visit at a tertiary care pediatric hospital was conducted (n = 170). The index test was the pre-referral community spine x-ray interpreted by a community radiologist.

The global impact of the COVID-19 pandemic on pediatric spinal care: A multi-centric study.

Background: The COVID-19 pandemic has affected healthcare worldwide since December 2019. We aimed to identify the effect of the COVID-19 pandemic on outpatient clinic and surgical volumes and peri-operative complications for pediatric spinal deformities patients.

Methods: In this multi-center retrospective study, outpatient visits (in-person and virtual care) and pediatric spine surgeries volumes in four high-volume pediatric spine centers were compared between March and December 2019 and the same period in 2020.

Magnetically Controlled Growing Rods Graduation: Lessons From a Single-center Series of 48 Patients.

Background: Magnetically controlled growing rod (MCGR) treatment for early-onset scoliosis (EOS) has become a widely utilized method of deformity control, but long-term follow-up reports are sparse. We evaluated the outcomes of a large group of consecutive pediatric patients diagnosed with EOS who were treated by MCGR to the endpoint of definitive spinal fusion in a single center. We hypothesized that lessons learned from treating a large volume of MCGR patients would lower the complication rate in comparison to what was previously reported by other studies.

A comparison of three- and two-rod constructs in the correction of severe pediatric scoliosis.

Purpose: Managing severe scoliosis is challenging and risky with a significant complication rate regardless of treatment strategy. In this retrospective comparative study, we report our results using a three-rod compared to two-rod construct in the surgical treatment of severe spine deformities to investigate which technique is safer, and which provides superior radiological outcomes.

Methods: Forty-six consecutive patients undergoing posterior spine fusion for scoliosis between 2006 and 2017 were identified in our institutional records.

Management of perinatal cervical spine injury using custom-fabricated external orthoses: design considerations, narrative literature review, and experience from the Hospital for Sick Children. Illustrative cases.

Background: Cervical spine injuries in neonates are rare and no guidelines are available to inform management. The most common etiology of neonatal cervical injury is birth-related trauma. Management strategies that are routine in older children and adults are not feasible due to the unique anatomy of neonates.

Surgical management of high-grade paediatric spondylolisthesis: meta-analysis and systematic review.

Purpose: There is currently no consensus on the management of high-grade spondylolisthesis (HGS) in paediatric populations. The objective of this analysis is to compare the outcomes of reduction followed by fusion (RFF) or in situ fusion (ISF) in paediatric patients.

Methods: Using major databases, a systematic literature search was performed.

Increased proximal vertebral rotation is associated with shoulder imbalance after posterior spinal fusion for severe adolescent idiopathic scoliosis.

Purpose: Residual shoulder imbalance is associated with suboptimal outcomes following the surgical correction of adolescent idiopathic scoliosis (AIS) including poor patient satisfaction. In this retrospective study, we evaluate the radiographic parameters and the relationship between the global and local indices of spinal alignment with shoulder balance pre- and postoperatively utilizing EOS imaging and 3D reconstruction.

Methods: A retrospective radiographic analysis was performed on patients with AIS, treated with posterior spinal fusion.

Cementless posterior spinal fusion for the treatment of OI patients with severe spine deformity-a case series.

Purpose: The purpose of this study is to present the outcomes all patients with osteogenesis imperfecta (OI) who underwent cementless posterior spinal fusion for the treatment of severe spine deformity in our institution.

Methods: All patients with OI who underwent surgical correction of their spine deformity in our institution between 2003 and 2020 were enrolled. The collected data included demographics, operative and follow-up findings, medical history, bisphosphonate therapy, HGT protocol, pre- and post-HGT and postoperative scoliosis and kyphosis curve measurements, hospitalization length, complications, and revision surgeries.

Prioritizing Elective Surgical Cases During a Pandemic or Global Crisis: The Elective-Pediatric Orthopedic Surgical Timing (E-POST) Score.

Background: As the first wave of the COVID-19 pandemic stabilized and resources became more readily available, elective surgery was reinitiated and hospitals realized that there was little guidance on how to prioritize elective cases.

Methods: A prioritization tool was formulated based on clinically relevant elements and previous literature. Nine pediatric orthopaedic surgeons from North American institutions evaluated 25 clinical scenarios on 2 occasions separated in time.

The impact of COVID-19 on idiopathic scoliosis referrals: cause for concern.

Study Design: Retrospective comparative review.

Objective: The aim of this study was to determine the short-term impact of the COVID-19 pandemic on the demographic and clinical profile of new idiopathic scoliosis (IS) patients, with a particular focus on treatment and late referral. The COVID-19 pandemic has limited health-care services and public access and, as a result, the diagnosis and management of non-COVID-19 health conditions have been compromised.

Magnetically Controlled Growing Rods Graduation: Deformity Control with High Complication Rate.

Study Design: A multicenter retrospective review of consecutive series of patients.

Objective: Long-term experience with using the magnetically controlled growing rods (MCGR) to treat patients with deformity in the growing spine to the conclusion of treatment with posterior spine fusion.

Summary Of Background Data: MCGR treatment for growing spine gained popularity with paucity of long-term follow up data.

Comparison of interventions and outcomes of enhanced recovery after surgery: a systematic review and meta-analysis of 2456 adolescent idiopathic scoliosis cases.

Purpose: The objective of this meta-analysis and systematic review is to compare the methodology and evaluate the efficacy of Enhanced recovery after Spine Surgery (ERAS) for adolescent idiopathic scoliosis (AIS) and to compare the outcomes with traditional discharge (TD) pathways.

Methods: Using major databases, a systematic search was performed. Studies comparing the implementation of ERAS or ERAS-like and TD pathways in patients with AIS were identified.

Implant-Related Complications Using Uniaxial Implants In Pediatric Spinal Deformity Surgery.

Introduction:  The successful surgical treatment of paediatric spinal deformity relies on robust anchors to achieve correction. Uniaxial pedicle screws are designed with articulation between the screw head and screw shaft, thus reducing the risk of anchor failure whilst permitting corrective manoeuvres. The purpose of this study was to describe the incidence, nature, and chronology of implant-related complications in pediatric spinal deformity treated with uniaxial pedicle screws.

The Use of Halo Gravity Traction in Severe, Stiff Scoliosis.

Purpose: The correction of severe, stiff scoliosis in children is challenging. One method used to reduce the risk is preoperative halo gravity traction (HGT). In this study, the authors sought to define the efficiency and safety of HGT and characterize the chronology of the correction seen.

The use of three rods in correcting severe scoliosis.

Purpose: The three-rod technique, utilising a short apical concavity rod is an option to achieve controlled correction in severe scoliosis. We describe this technique, the complications encountered, and the long-term outcomes.

Method: All paediatric patients who had at least 2 years follow-up after undergoing corrective surgery for scoliosis ≥ 100° using 3 parallel rods were included.

Congenital Kyphosis: Progressive Correction With an Instrumented Posterior Epiphysiodesis: A Preliminary Report.

Purpose: Congenital kyphosis is a rare condition. In this case series we sought to identify the outcomes and complications of posterior instrumented fusion and the resultant epiphysiodesis effect in uniplanar congenital kyphosis in pediatric patients.

Method: Pediatric patients were included if treated for a uniplanar congenital kyphotic deformity treated with posterior instrumented spinal fusion between October 2006 and August 2017, with a minimum of 2 years of follow-up.

Spinal Casting for the Treatment of Severe Early Onset Scoliosis: Utilization of a Nonsurgical Health Care Provider for Cast Application.

Background: Spinal casting with the aim of delaying surgical intervention is a widely accepted but resource intensive conservative management strategy used by spine surgeons to treat severe early onset scoliosis. Opting to use a nonsurgical health care provider for cast application may be an effective use of human resources if the quality of care is not compromised. This study aimed to evaluate the outcomes of spinal cast treatment utilizing a nonsurgical health care provider for cast application.