Erector Spinae Plane Block with Liposomal Bupivacaine for Adolescent Idiopathic Scoliosis Surgery: No Patient Controlled Analgesia Needed.

Study Design: Retrospective Controlled Cohort.

Objective: To evaluate the effect of intraoperative liposomal bupivacaine (LB) via Erector Spinae Plane Block (ESPB) on postoperative adolescent idiopathic scoliosis (AIS) patients with and without patient-controlled analgesia (PCA).

Summary Of Background Data: Pain control after posterior spinal fusion (PSF) for AIS includes opioids and other modalities.

Use of a Standardized Perioperative Care Path for Adolescent Idiopathic Scoliosis Leads to Decreased Complications and Readmissions.

Study Design: Retrospective review of patients ages 10-18 who underwent posterior fusion for adolescent idiopathic scoliosis (AIS) at a single institution from 2014 to 2019.

Objective: The aim was to evaluate a standardized Care Path to determine its effects on perioperative outcomes in patients undergoing spinal fusion for AIS.

Summary Of Background Data: AIS is the most common pediatric spinal deformity and thousands of posterior fusions are performed annually.

Fractures Around the Knee in Children.

Knee injuries are common in children, but epiphyseal and physeal injuries involving the distal femur and proximal tibia are relatively rare. This can make diagnosis and evaluation of pediatric knee injuries challenging. Pediatric knee physeal injuries can also be complicated by vascular injuries with potentially devastating consequences, and thus, a heightened suspicion for these injuries is indicated.

Distal Femoral Physeal Fractures.

Physeal fractures of the distal femoral are rare injuries accounting for less than 2% of all physeal injuries, and tend to have a worse prognosis than similar injuries in other locations. This article reviews the evaluation (including imaging), classification, and treatment of these injuries, and discusses their most important complications and their management, including vascular injury and growth arrest.

Intraoperative Three-Dimensional Navigation for Talocalcaneal Coalition Resection.

Talocalcaneal tarsal coalitions are a common source of foot pain, stiffness, and deformity. These coalitions are treated symptomatically with rest and periods of immobilization. When those measures fail, surgical resection is attempted.

Noninvasive Hemoglobin Monitoring: A Rapid, Reliable, and Cost-Effective Method Following Total Joint Replacement.

Background: Noninvasive hemoglobin (nHgb) monitoring was initially introduced in the intensive care setting as a means of rapidly assessing Hgb values without performing a blood draw. We conducted a prospective analysis to compare reliability, cost, and patient preference between nHgb monitoring and invasive Hgb (iHgb) monitoring performed via a traditional blood draw.

Methods: We enrolled 100 consecutive patients undergoing primary or revision total hip or total knee arthroplasty.

Femoral head asymmetry and coxa magna: anatomic study.

Background: Coxa magna, the asymmetrical circumferential enlargement of the femoral head, is an important sequela of pediatric disorders such as Legg-Calvé-Perthes disease. Definitions vary because of lack of controls and a scarcity of research on the distribution of the femoral head asymmetry. This study aims at defining the normal distribution of asymmetry between the left and the right femoral head and neck in the population and how demographics affect these properties.

Disk degeneration in lumbar spine precedes osteoarthritic changes in hip.

It is not clear whether spinal degeneration leads to hip arthritis, or hip arthritis leads to spinal degeneration. We conducted a study to determine which degenerative process precedes the other. We examined 340 cadaveric human specimens from the Hamann-Todd Osteological Collection (Cleveland, Ohio).

Does chronic warfarin cause increased blood loss and transfusion during lumbar spinal surgery?

Background Context: The use of oral anticoagulation therapy such as warfarin is projected to increase significantly as the population ages and the prevalence of cardiovascular disease increases. Current recommendations state that warfarin be discontinued before surgery and the international normalized ratio (INR) normalized.

Purpose: To determine if stopping warfarin 7 days before surgery and correcting INR had any effect on intraoperative blood loss or the requirements for blood product transfusion.

Are the left and right proximal femurs symmetric?

Background: The contralateral femur frequently is used for preoperative templating for THA or hemiarthroplasty when the proximal femur is deformed by degenerative changes or fracture. Although femoral symmetry is assumed in these situations, it is unclear to what degree the contralateral femur is symmetrical.

Questions/purpose: We therefore defined the degree of asymmetry between left and right proximal femurs and determined whether it was affected by demographics and proximal femoral anatomy.

Establishment of parameters for congenital stenosis of the cervical spine: an anatomic descriptive analysis of 1,066 cadaveric specimens.

Purpose: Congenital cervical stenosis (CCS) occurs when the bony anatomy of the cervical canal is smaller than expected in the general population predisposing an individual to symptomatic neural compression. No studies have defined CCS based on the normal population. The diagnosis is currently made based on clinical impression from radiographic studies.

Is congenital bony stenosis of the cervical spine associated with lumbar spine stenosis? An anatomical study of 1072 human cadaveric specimens.

Object: Congenital cervical and lumbar stenosis occurs when the bony anatomy of the spinal canal is smaller than expected, predisposing an individual to symptomatic neural compression. While tandem stenosis is known to occur in 5%-25% of individuals, it is not known whether this relationship is due to an increased risk of degenerative disease in these individuals or whether this finding is due to the tandem presence of a congenitally small cervical and lumbar canal. The purpose of the present study was to determine if the presence of congenital cervical stenosis is associated with congenital lumbar stenosis.