Expansion Thoracoplasty for Thoracic Insufficiency Syndrome Associated with Jarcho-Levin Syndrome.

Introduction: Although surgical treatment of spondylothoracic dysplasia (STD) is controversial, we have found that an expansion thoracoplasty using a Vertical Expandable Prosthetic Titanium Rib (VEPTR; DePuy Synthes) results in favorable outcomes, including 100% survivability (at an average follow-up of 6.2 years), increased thoracic spinal length, and decreased requirements for ventilation support.

Step 1 Preoperative Preparation: Make anteroposterior and lateral radiographs of the spine.

Respiratory effects, hemodynamic changes and cement leakage during multilevel cement balloon kyphoplasty.

Purpose: The purpose of this study is to evaluate the effects of multilevel balloon kyphoplasty (BK) on blood pressure, blood gases and cement leakage.

Methods: This is a prospective study of 63 patients: 31 were treated for osteoporotic vertebral compressive fractures (OVCF) and 32 for osteolytic tumors (OT). Twenty-six patients were treated at 1 level, 15 at 2, 2 at 3, 6 at 4, 3 at 5, 4 at 6, 5 at 7 and 2 at 8.

Can VEPTR(®) control progression of early-onset kyphoscoliosis? A cohort study of VEPTR(®) patients with severe kyphoscoliosis.

Background: Kyphoscoliosis is considered a relative contraindication to treatment with the Vertical Expandable Prosthetic Titanium Rib (VEPTR(®); Synthes Inc, Paoli, PA). Nevertheless, patients do present with early-onset kyphoscoliosis and thoracic insufficiency syndrome, and no suitable alternative treatments are currently available. However, it is unclear whether VEPTR(®) is reasonable for treating patients with kyphoscoliosis.

The effect of mid-thoracic VEPTR opening wedge thoracostomy on cervical tilt associated with congenital thoracic scoliosis in patients with thoracic insufficiency syndrome.

Study Design: Prospective clinical trial of vertical expandable prosthetic titanium rib (VEPTR) surgery in patients with congenital thoracic scoliosis with thoracic insufficiency syndrome and cervical tilt.

Objective: Report efficacy and safety of VEPTR mid-thoracic opening wedge thoracostomy in treatment of cervical tilt and head/truncal decompensation in children with thoracic insufficiency syndrome associated with thoracic congenital scoliosis.

Summary Of Background Data: Cervical tilt in children is a rare problem, usually associated with congenital cervical or cervical-thoracic scoliosis, and in progressive deformity, surgical fusion or hemi-vertebrectomy risks neurologic injury, loss of motion of the cervical spine, and unknown effect on pulmonary function.

Pseudarthrosis after lumbar spine fusion: nonoperative salvage with pulsed electromagnetic fields.

We studied 100 patients in whom symptomatic pseudarthrosis had been established at more than 9 months after lumbar spine fusion. All patients were treated with a pulsed electromagnetic field device worn consistently 2 hours a day for at least 90 days. Solid fusion was achieved in 67% of patients.

Small bowel motility and transit after aortic surgery.

Objective: The inability to tolerate feedings after aortic surgery prolongs hospitalization. The aim of this study was to define jejunal manometric and small bowel transit characteristics associated with the ileus that follows transperitoneal aortic surgery.

Methods: Five male patients who underwent transperitoneal infrarenal aortobifemoral bypass had intraoperative placement of a jejunal multilumen catheter.