Imaging modalities for low back pain in children: a review of spondyloysis and undiagnosed mechanical back pain.

Purpose: Mechanical low back pain is common in the pediatric population; recent studies have shown that undiagnosed mechanical low back pain (UMLBP) is the most common cause of low back pain presenting in adolescents, accounting for up to 78% of cases. Spondylolysis/spondylolisthesis is the most common cause with diagnosed pathology observed in this age group. The goals of this study are to: determine the natural history of low back pain, evaluate the value of radiographic studies in establishing a diagnosis of spondylolysis, and determine the cost and radiation effective doses (EDs) associated with those studies with the associated risks radiation exposure.

Perioperative antibiotic use for spinal surgery procedures in US children's hospitals.

Study Design: Retrospective cohort study using the Pediatric Health Information System database.

Objective: To describe longitudinal patterns of prophylactic antibiotic use and determinants of antibiotic choice for spinal fusion surgical procedures performed at US children's hospitals.

Summary Of Background Data: Surgical site infections (SSIs) account for a significant proportion of post-spinal surgery complications, particularly among children with complex conditions such as neuromuscular disease.

Tibial eminence fractures in children: earlier posttreatment mobilization results in improved outcomes.

Background: Arthrofibrosis and decreased range of motion (ROM) are well-described sequelae of tibial eminence fractures. We sought to evaluate the effects of timing of ROM rehabilitation and postsurgical immobilization on clinical outcomes in children with fractures of the tibial eminence.

Methods: We retrospectively reviewed the records of all children diagnosed with closed tibial eminence fractures between 2000 and 2010.

The prevalence of defensive orthopaedic imaging: a prospective practice audit in Pennsylvania.

Background: Defensive medicine has been identified as an area of wasteful health-care spending. Estimates of its prevalence and its contribution to the cost of defensive practices have varied widely. To date, there has been no prospective evaluation of the use of defensive medicine for musculoskeletal conditions.

Computed tomography-guided navigation of thoracic pedicle screws for adolescent idiopathic scoliosis results in more accurate placement and less screw removal.

Study Design: Retrospective study of computed tomography-guided navigation (CTGN) of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis (AIS).

Objective: To compare the accuracy and safety of thoracic pedicle screw placement and frequency of intraoperative removal using CTGN versus conventional freehand technique in AIS.

Summary Of Background Data: Even in experienced hands, more than 10% of the thoracic pedicle screws are misplaced.