Allogeneic blood transfusion and AIS surgery: how the NSQIP database can improve patient safety.

Purpose: Describe the experience of one institution in modifying allogeneic blood transfusion protocols for AIS surgery in response to the results of ACS-NSQIP-PEDS comparative data in a retrospective cohort study.

Methods: NSQIP data demonstrated that AIS patients at our hospital had a significantly greater risk of ALBT compared to similar institutions (OR 4.1).

Comparison of S2-Alar and traditional iliac screw pelvic fixation for pediatric neuromuscular deformity.

Background Context: Many pelvic fixation options exist for posterior spinal fusion of pediatric neuromuscular scoliosis, including standard iliac screws (SISs) or a more recently introduced S2-Alar (S2A) technique. However, little data exist comparing the clinical and radiographic outcomes of these techniques.

Purpose: This study aimed to dentify differences in clinical and radiographic outcomes for pediatric neuromuscular scoliosis patients treated with SIS or S2A pelvic fixation.

Utility of early postoperative radiographs after posterior spinal fusion for adolescent idiopathic scoliosis.

Study Design: Retrospective.

Objective: Evaluate the ability of serial full-length spine radiographs to detect clinically significant implant-related (IR) and non-implant-related (NIR) radiographical abnormalities in the first 6 months after routine posterior spinal fusion for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Patients with AIS are exposed to repeated doses of ionizing radiation during the course of their treatment with potential consequences for their long-term health.

Loss in spinal motion from inclusion of a single midlumbar level in posterior spinal fusion for adolescent idiopathic scoliosis.

Study Design: Prospective study.

Objective: Evaluate the impact of the distal fusion level on overall spine motion in patients with adolescent idiopathic scoliosis.

Summary Of Background Data: In the surgical treatment of adolescent idiopathic scoliosis, the impact of incorporating a single additional distal lumbar fusion level on residual spinal motion is unclear.

Mini-C-arm fluoroscopy for emergency-department reduction of pediatric forearm fractures.

Background: Reduction of pediatric forearm fractures with the patient under sedation in the emergency department is a common practice throughout the United States. We hypothesized that the use of a mini-c-arm fluoroscopy device as an alternative to routine radiographs for evaluation of fracture reduction would (1) allow a more anatomic fracture reduction, (2) decrease the number of repeat reductions or subsequent procedures, (3) reduce overall radiation exposure to the patient, and (4) decrease the orthopaedic consultation time in the emergency department.

Methods: A retrospective cohort analysis of 279 displaced forearm and wrist fractures treated with closed reduction and casting with the patient under sedation in the emergency department of a level-I pediatric trauma center was performed, and the data were compared with historical controls.

Orthopedic management of spina bifida.

The management of orthopedic problems in spina bifida has seen a dramatic change over the past 10 years. The negative effects of spasticity, poor balance, and the tethered cord syndrome on ambulatory function are better appreciated. There is less emphasis on the hip radiograph and more emphasis on the function of the knee and the prevention of knee pain.

Low body mass index: a risk factor for superior mesenteric artery syndrome in adolescents undergoing spinal fusion for scoliosis.

Study Design: Five cases of superior mesenteric artery (SMA) syndrome occurred at our institution over a 4-year period in adolescents undergoing spinal fusion surgery for scoliosis. All patients had in common a very slender body habitus. The measurement of body mass index (BMI) was low in all patients and an age-matched control group of patients undergoing similar surgery without this complication was assessed with this Index to determine its utility as a screening tool for this postoperative condition.

Clinical and radiographic predictors of scoliosis in patients with myelomeningocele.

Background: The prevalence of scoliosis in patients with myelomeningocele has been reported to be as high as 80% to 90% in some studies. However, those studies included patients with both congenital and developmental curves. The variation in the patient population as well as the definition of scoliosis in those studies made it difficult to predict the true prevalence of scoliosis in these patients.

Hardware complications in scoliosis surgery.

Background: Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide.