Publications by authors named "Kira Skaggs"
Background: Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury.
Purpose: To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury.
Study Design: Cross-sectional study; Level of evidence, 3.
Background: Patients are faced with several treatment decisions after an ulnar collateral ligament (UCL) injury: nonoperative versus operative treatment, repair versus reconstruction, and immediate versus delayed surgery.
Purpose/hypothesis: The aim of this study was to investigate the factors important to patients when deciding which treatment to pursue after a UCL injury. We hypothesized that (1) length of time away from sports and seasonal timing would be important to patients and (2) treatment decision-making would be heavily influenced by how many and which seasons of their baseball career would be missed.
Case: We present 3 cases in which spinal rods extending beyond the intended level of fusion caused injury to adjacent structures, which we term "adjacent segment impingement." All cases presented as back pain with no neurological symptoms, with a minimum 6 years of follow-up from the initial procedure. Treatment consisted of extending the fusion to include the affected adjacent segment.
View Article and Find Full Text PDFBackground: The study sought to evaluate the utility of a single supine radiograph in determining curve flexibility in early-onset scoliosis (EOS) patients.
Methods: EOS patients with upright (standing/seated), supine, and side-bending radiographs who underwent spinal deformity surgery were identified. Coronal parameters included: proximal thoracic (PT) curve, main thoracic (MT) curve, and thoracolumbar/lumbar (TL/L) curve.
Background: Radiographic assessment of bone age is critically important to decision-making on the type and timing of operative interventions in pediatric orthopaedics. The current widely accepted method for determining bone age is time and resource-intensive. This study sought to assess the reliability and accuracy of 2 abbreviated methods, the Shorthand Bone Age (SBA) and the SickKids/Columbia (SKC) methods, to the widely accepted Greulich and Pyle (GP) method.
View Article and Find Full Text PDFPurpose: The purpose of this study was to describe contraindications to the magnetically controlled growing rod (MCGR) in patients with early onset scoliosis (EOS) by establishing consensus amongst expert surgeons who treat these patients frequently.
Methods: Nine pediatric spine surgeons from an international EOS study group participated in semi-structured interviews via email to identify factors that influence decision making in the use of MCGR. A 39-question survey was then developed to specify these factors as contraindications for MCGR-these included patient age and size, etiology, medical comorbidities, coronal and sagittal curve profiles, and skin and soft tissue characteristics.
Introduction: Due to a combination of poor respiratory muscle control and mechanical lung compression secondary to spine and chest wall deformities, patients with neuromuscular (NM) early-onset scoliosis (EOS) are at a high risk for pulmonary complications including pneumonia. The purpose of this study is to examine the effect of surgical intervention on the prevalence and risk of postoperative pneumonia in patients with NM EOS.
Methods: In this retrospective cohort study, pediatric (18 y old and below) patients with NM EOS undergoing index fusion or growth-friendly instrumentation from 2000 to 2018 were identified.
Case: We present 2 cases of life-threatening intraoperative anaphylaxis to the bovine flowable gelatin matrix during pediatric spinal deformity surgery for kyphoscoliosis. Both patients had no known bovine or gelatin allergies. Anaphylaxis occurred shortly after pressurized injection into the first cannulated pedicle tract and was successfully treated with epinephrine, diphenhydramine, and methylprednisolone infusion.
View Article and Find Full Text PDFObjective: To identify the prevalence of male and female athlete triad risk factors in ultramarathon runners and explore associations between sex hormones and bone mineral density (BMD).
Design: Multiyear cross-sectional study.
Setting: One hundred-mile ultramarathon.
Objective: Institutions investigating value and quality emphasize utilization of two attending surgeons with different areas of technical expertise to treat complex surgical cases and to minimize complications. Here, the authors chronicle the 12-year experience of using a two-attending surgeon, two-specialty model to perform hemivertebra resection in the pediatric population.
Methods: Retrospective cohort data from 2008 to 2019 were obtained from the NewYork-Presbyterian Morgan Stanley Children's Hospital operative database.
Study Design: Retrospective.
Objective: The aim of this study is to evaluate if standing in a Schroth trained position influences the radiographic assessment of Cobb angle and other radiographic parameters compared to a normal standing position. Schroth method has been associated with improved Cobb angle.
Background: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively.
Methods: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center.
Study Design: Single-center retrospective review of spinal deformity patients undergoing removal of infected posterior spinal fusion implants over a 10-year period.
Objective: To evaluate the intraoperative blood loss and perioperative complications of implant removal in posterior spinal fusions.
Summary Of Background Data: To our knowledge, no studies examine blood loss or complications associated with removal of infected spinal implants in spinal deformity.
Objective: Our aim was to report the first case of a posterior tether used for growth modulation in the treatment of spinal deformity.
Methods: A 9-year-old boy with progressive kyphoscoliosis failed multiple attempts of brace treatment; the deformity progressed to kyphosis of 73° and scoliosis of 41° on standing radiographs. We placed a posterior tether using hydroxyapatite-coated pedicle screws with a flexible polymer cord under modest compression unilaterally from T3 to T11 with no subperiosteal dissection and no attempt at fusion.
Study Design: Case Series and Review of the Literature.
Objective: To report on cases of spinal cord injury from loss of fixation of upper thoracic pedicle screws.
Summary Of Background Data: Despite generally low rates of intraoperative neurological injury from pedicle screws, there is 1 reported case of T2 pedicle screw pullout causing spinal cord injury.
Objective: To assess availability of timely orthopedic fracture care to children.
Study Design: Fifty randomly selected orthopedic practices were contacted twice with an identical scenario to request an appointment for a fictitious child with an arm fracture, once with the staff told that the child had private insurance and once with Medicaid. Access to appointments on the basis of insurance was compared with rates 10 years earlier.