Balloon Kyphoplasty for Managing Intractable Pain in Pediatric Pathologic Vertebral Fractures.

Background: Vertebral compression fractures are a common result of osteoporosis and osteopenia secondary to steroid use and chemotherapy treatment. Balloon kyphoplasty is a treatment option with good to excellent results well described in adults. Although a few recent studies have been published regarding the use of kyphoplasty in children, no formal indication exists for the pediatric population.

Recurrence of rib prominence following surgery for adolescent idiopathic scoliosis with pedicle screws and direct vertebral body derotation.

Purpose: Pedicle screw constructs combined with direct vertebral body derotation (DVBD) provide a powerful corrective force of the rib prominence associated with adolescent idiopathic scoliosis (AIS). We wished to evaluate the incidence and correlative factors associated with recurrence of rib prominence (RRP) developing postoperatively despite adequate initial correction.

Methods: 103 patients with AIS underwent pedicle screw fixation with DVBD without thoracoplasty and had postoperative scoliometer readings at 6, 12, and 24 months.

Is there a role for the 5-degree rule in adolescent idiopathic scoliosis?

Background: Nonstructural curves are defined in the Lenke classification system for adolescent idiopathic scoliosis as bending out to <25 degrees. A caveat in the original paper states, however, that if the difference in Cobb magnitude between the major and minor curves is <5 degrees, then the minor curve should be considered structural, regardless of its Cobb magnitude. It is unclear whether following this rule affects patient outcomes.

Is there a "July effect" in surgery for adolescent idiopathic scoliosis?

Background: Prior studies in various medical and surgical specialties have suggested that the changeover of medical trainees in the United States at the end of the academic year, or so-called "July effect," negatively impacts the quality of patient care, including increasing morbidity and decreasing efficiency. We analyzed whether the outcomes of surgery for adolescent idiopathic scoliosis involving physicians-in-training as first assistants were affected by the time of year the surgery was performed.

Methods: We performed a multicenter retrospective study with use of a prospectively collected database to examine outcomes following instrumented posterior spinal fusion in patients with adolescent idiopathic scoliosis.

The efficacy of rib-based distraction with VEPTR in the treatment of early-onset scoliosis in patients with arthrogryposis.

Background: Although arthrogryposis multiplex congenital (AMC) is a rare condition, rapidly progressive scoliosis is common in children with AMC. Only a limited number of studies characterize the nature of these curves, and even fewer describe surgical outcomes. To determine efficacy or rib-based distraction in these patients, we reviewed the outcomes of the use of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) device in what we believe is the first study to report this.

The posterior pedicle screw construct: 5-year results for thoracolumbar and lumbar curves.

Object: Several studies of the outcomes of patients with adolescent idiopathic scoliosis (AIS) with thoracolumbar and lumbar curves after treatment with posterior pedicle screws have been reported, but most of these studies reported only 2-year follow-up. The authors analyzed the radiographic and clinical outcomes of patients with thoracolumbar and lumbar curves treated with posterior pedicle screws after 5 years of follow-up.

Methods: A multicenter database was retrospectively queried to identify patients with AIS who underwent spinal fusion for Lenke 3C, 5C, and 6C curves.

Adolescent scoliosis classification and treatment.

Adolescent idiopathic scoliosis (AIS) affects up to 3% of the population. It can be stratified by curve type according to the Lenke classification. This classification system incorporates curve magnitude, flexibility, the lumbar modifier, and the sagittal plane.

Variations in the iliolumbar vein during the anterior approach for spinal procedures.

Study Design: Retrospective study from data from a single access surgeon at 2 hospitals.

Objective: To increase the surgeon's awareness of iliolumbar vein (ILV) variants during the anterior approach to the lumbar spine.

Summary Of Background Data: Although there are many advantages to using the anterior approach, serious risks are involved, namely, vascular injury.

Risk of recurrence of non-metastatic breast cancer in women under 40 years: a population-registry cancer study in a European country.

Unlabelled: Breast cancer in young patients is relatively uncommon. There is no consensus about the impact of young age on prognosis. The aim of this study was to analyze the effect of young age over the risk of recurrence of breast cancer using a population-registry cancer database in Spain.

[A method for individualising the risk of a negative lymph node classification error in cancer of the colon].

Introduction: In cancer of the colon, the number of lymph nodes that should be analysed before a patient is classified as free of lymph node involvement has been widely discussed. A mathematical model is proposed which is based on the Bayes Theorem for calculating the probability of error (PE) similar to that normally used to evaluate a diagnostic test, but adapted to a quantitative variable, the lymph node count.

Methods: The clinical histories of 480 patients routinely operated on in attempt to cure cancer of the colon were reviewed.

Demographic factors affect Scoliosis Research Society-22 performance in healthy adolescents: a comparative baseline for adolescents with idiopathic scoliosis.

Study Design: Prospective analysis.

Objective: The purpose of this study was to: (1) evaluate the influence of variable demographic factors on the Scoliosis Research Society (SRS)-22 performance and (2) evaluate SRS-22 performance in normal adolescents without scoliosis to establish a comparative baseline for adolescent idiopathic scoliosis.

Summary Of Background Data: The SRS-22 instrument has been used widely to evaluate patients with scoliosis but no study has characterized how variable patient demographics in normal, unaffected individuals may influence SRS-22 scores.

Percutaneous drainage treatment of traumatic pancreatic rupture with pancreatic transection.

Management of traumatic pancreatic pseudocyst associated with pancreatic duct laceration is controversial. Surgical therapy has been clasically considered the treatment of choice for those pseudocysts. However, several authors have published good results with percutaneous drainage.

Debating the mathematical model to validate the sentinel lymph biopsy techniques in breast cancer patients. The danger of bias and its practical implications.

Background: Sentinel node biopsy (SNB) is an effective alternative to axillary lymph node dissection (ALD) for axillary staging. SNB (test) needs a validation period in which ALD (the gold standard) is always performed. Sensitivity, specificity and predictive values (PV) are used to define the accuracy of the procedure.

Treatment of morbid obesity and hiatal paraesophageal hernia by laparoscopic Roux-en-Y gastric bypass.

Obesity has been proven to be a significant independent risk factor for hiatal hernia. In morbidly obese patients, the usual techniques to improve gastroesophageal reflux after hiatal hernia repair could have poorer outcomes than in the general population. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to be an effective procedure in controlling symptoms and complications of gastroesophageal reflux in these patients.