Rigid Thoracolumbar Orthosis Does Not Improve Outcomes of Acute Adolescent Spondylolysis as Compared with Placebo. Bony Union Predicts Improved Health-Related Quality of Life Outcomes at 2-year Follow-Up.

Study Design: A prospective, comparative study on clinical, radiographic, and health-related quality of life (HRQoL) outcomes in adolescents with acute spondylolysis treated with a rigid thoracolumbar orthosis (Boston brace) or with a placebo (elastic lumbar support) with a 2-year follow-up time.

Objective: To compare outcomes of acute adolescent spondylolysis treated with a rigid thoracolumbar orthosis or a placebo with a 2-year follow-up time.

Summary Of Background Data: The benefits of the use of rigid orthosis for treatment of spondylolysis and achieving bony union of spondylolysis remains unclear.

Elastic Lumbar Support Versus Rigid Thoracolumbar Orthosis for Acute Pediatric Spondylolysis: A Prospective Controlled Study.

Study Design: A prospective study on clinical, radiographic, and health-related quality of life (HRQoL) outcomes in children with acute spondylolysis treated with a rigid thoracolumbar orthosis or with an elastic lumbar support.

Objective: To compare outcomes of pediatric spondylosysis treated with a hard brace or an elastic lumbar support.

Summary Of Background Data: The benefits of the use of a rigid orthosis in treatment of spondylolysis are not clear.

Pregabalin and Persistent Postoperative Pain Following Posterior Spinal Fusion in Children and Adolescents: A Randomized Clinical Trial.

Background: Surgical correction of spinal deformity requires major surgical intervention with extensive manipulation of the spine and neural elements. Persistent postoperative pain affects patient quality of life and can also cause financial burden for patient families and for society. We aimed to investigate the effect of perioperative pregabalin on the incidence of persistent pain following instrumented spinal fusion.

Health-Related Quality of Life Outcomes of Instrumented Circumferential Spinal Fusion for Pediatric Spondylolisthesis: A Comparison With Age and Sex Matched Healthy Controls.

Study Design: A prospective study on the clinical, radiographic, and the health-related quality of life (HRQOL) outcomes in adolescents with spondylolisthesis undergoing instrumented circumferential spinal fusion compared with age and sex matched controls.

Objective: To determine the outcomes of pediatric spondylolisthesis patients minimum 2 years after surgery and to compare their HRQOL with age and sex matched controls.

Summary Of Background Data: There is limited evidence of the HRQOL of adolescent spondylolisthesis patients after surgery and no studies comparing it with healthy controls.

Radiographic Outcomes of Immobilization using Boston Brace for Pediatric Spondylolysis.

Background And Aims: Spondylolysis is a common cause of lower back pain during youth. The aim of this study is to report the bony union rate and risk factors for non-union of the lumbar spondylolysis of pediatric patients treated with a rigid thoracolumbosacral orthosis (Boston brace).

Materials And Methods: A retrospective review of 68 children (mean age = 13.

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion: A Double-Blinded, Placebo-Controlled, Randomized Clinical Trial.

Background: Pregabalin as part of a multimodal pain-management regimen has been shown to reduce opioid consumption after spinal surgery in adults but it is unclear whether this is also true in adolescents. Pregabalin has been found to have neuroprotective effects and therefore could have a positive impact on pain after spinal deformity surgery. We conducted a randomized, double-blinded, placebo-controlled clinical trial of adolescent patients undergoing spinal fusion to evaluate the short-term effects of pregabalin on postoperative pain and opioid consumption.

Back Pain and Quality of Life After Surgical Treatment for Adolescent Idiopathic Scoliosis at 5-Year Follow-up: Comparison with Healthy Controls and Patients with Untreated Idiopathic Scoliosis.

Background: Posterior spinal fusion with pedicle screws is the gold-standard treatment for adolescent idiopathic scoliosis (AIS); however, it is unclear whether this procedure results in improved long-term back pain and health-related quality of life compared with patients not surgically treated for AIS. The aim of the present study was to evaluate back pain and quality of life in surgically managed patients with a minimum follow-up of 5 years compared with patients with untreated AIS and a healthy control group.

Methods: Fifty-five consecutive adolescent patients who underwent posterior pedicle screw instrumentation for AIS by a single orthopaedic surgeon were prospectively enrolled.

Comparison of Circular and Sagittal Reinforced Rod Options on Sagittal Balance Restoration in Adolescents Undergoing Pedicle Screw Instrumentation for Idiopathic Scoliosis.

Objective: Pedicle screw instrumentation is widely used for spinal deformity correction and fusion in adolescents for idiopathic scoliosis. The goal is to achieve and sustain good alignment in all 3 planes. We compared 2 different cobalt-chromium (CoCr) rod designs with different stiffnesses with regard to the restoration of coronal and sagittal balance in adolescents operated on for idiopathic scoliosis.

Posterior Spinal Fusion Extended to Stable Vertebra Provides Similar Outcome in Juvenile Idiopathic Scoliosis Patients Compared with Adolescents with Fusion to the Touched Vertebra.

Background And Aims:: To compare outcomes between posterior spinal fusion of juvenile idiopathic scoliosis and adolescent idiopathic scoliosis patients with a minimum of 2-year follow-up. The juvenile idiopathic scoliosis patients were fused to the stable vertebra and adolescent idiopathic scoliosis to the touched vertebra. We hypothesized that extending the spinal fusion to the stable vertebra in juvenile patients would provide similar outcomes compared with fusion to the touched vertebra in adolescents.

Postoperative urinary retention or difficulties to empty the bladder in young patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis.

Background: Postoperative urinary retention has been reported to affect up to 27% of adults undergoing degenerative lumbar spine surgery and approximately one-third of children undergoing lower-extremity orthopedic surgery. No data exist on the incidence and risk factors of postoperative urinary tract retention/difficulties to empty the bladder in young patients undergoing instrumented posterior spinal fusion. We aimed to characterize incidence, risk factors and treatment of postoperative urinary retention (POUR) and difficulties to empty the bladder in young patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis.

Preoperative pregabalin has no effect on intraoperative neurophysiological monitoring in adolescents undergoing posterior spinal fusion for spinal deformities: a double-blind, randomized, placebo-controlled clinical trial.

Purpose: This study was designed to evaluate the effect of preoperative pregabalin on intraoperative neurophysiological monitoring in adolescents undergoing surgery for spinal deformities.

Methods: Thirty-one adolescents undergoing posterior spinal fusion were randomized to receive preoperatively either pregabalin 2 mg/kg twice daily or placebo. The ability to make reliable intraoperative neurophysiological measurements, transcranial motor (MEPs) and sensory evoked potentials (SSEP) was evaluated.

Treatment of Aneurysmal Bone Cysts with Bioactive Glass in Children.

Background And Aims: Aneurysmal bone cysts represent about 1% of primary bone tumors. The standard treatment is curettage, followed by local adjuvant treatments and bone grafting. The problem is the high recurrence rate.

Gelatine matrix with human thrombin decreases blood loss in adolescents undergoing posterior spinal fusion for idiopathic scoliosis: a multicentre, randomised clinical trial.

Aims: In a multicentre, randomised study of adolescents undergoing posterior spinal fusion for idiopathic scoliosis, we investigated the effect of adding gelatine matrix with human thrombin to the standard surgical methods of controlling blood loss.

Patients And Methods: Patients in the intervention group (n = 30) were randomised to receive a minimum of two and a maximum of four units of gelatine matrix with thrombin in addition to conventional surgical methods of achieving haemostasis. Only conventional surgical methods were used in the control group (n = 30).

[Treatment of severe scoliosis].

Untreated severe scoliosis results in a serious malposition of the back, restrictive lung disease and increases mortality compared with the normal population. Idiopathic scoliosis rarely reaches a severe degree. In the treatment of severe scoliosis, preoperative head traction of several weeks' duration has proven a safe and effective method of correcting the malposition, and will also make scoliosis surgery technically easier.

[Treatment of posterior cruciate ligament injury in skeletally immature patients].

Posterior cruciate ligament tear is a rare injury in the pediatric and adolescent population. Primary diagnosis of posterior cruciate ligament injury is based on careful attention to specific physical examination, but MRI is the mainstay for assessing the extent of ligamentous and possible associated injuries. In general, most of the posterior cruciate ligament tears in children and adolescents can be treated non-operatively with good functional outcome.

Pitfalls of femoral titanium elastic nailing.

Background And Aims: Despite several potential complications of elastic intramedullary nailing, it is currently the treatment of choice for femoral diaphyseal fractures in school-aged children. This study aimed to critically evaluate the complications of titanium elastic nailing in pediatric femoral shaft fractures.

Material And Methods: This study evaluated patients with a diaphyseal femoral fracture treated with titanium elastic nailing (TEN) in Tampere University Hospital in Finland.

Stable incidence of surgical treatment and hospitalisation for humeral shaft fractures among 0- to 16-year-old patients in Finland from 1987 to 2010.

Background: Studies among children experiencing fractures report an increasing trend toward operative management. In the present study, we examined whether the same trend has occurred for humeral shaft fractures in accordance with increasing interest toward intramedullary nailing and other operative treatments. The number, incidence and treatment of all hospitalised 0- to 16-year-old patients with humeral shaft fractures in Finland was assessed over a recent 24-year period.

Normal behavior of plasma procalcitonin in adolescents undergoing surgery for scoliosis.

Background And Aims: Surgical site infections are relatively common after spinal deformity surgery. Early detection of deep wound infections is important, since it may allow retention of spinal instrumentation. However, serum C-reactive protein and erythrocyte sedimentation rate may remain elevated for almost 6 weeks, making differential diagnosis of systemic inflammatory response and acute deep bacterial wound infection difficult.

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010.

Background: Studies of pediatric and adolescent fractures in general report a significant increase in the incidence of upper-extremity fractures as well as in their surgical treatment. The aim of this study was to determine the trends of the incidence and treatment of distal humeral fractures in hospitalized 0- to 18-year-old patients in Finland.

Method: The study included the entire pediatric and adolescent (<19 years) population in Finland during the 24-year period from 1 January 1987 to 31 December 2010.

Lisfranc injury in adolescents.

Background: There are only few studies of Lisfranc injuries in children and adolescents. The aim of this study was to evaluate the mid-term results of the operatively treated injuries.

Methods: Seven Lisfranc injuries of adolescents were treated operatively in the Tampere University Hospital between 2004 and 2009.

Hybrid versus total pedicle screw instrumentation in patients undergoing surgery for neuromuscular scoliosis: a comparative study with matched cohorts.

We compared the clinical, radiological and quality-of-life outcomes between hybrid and total pedicle screw instrumentation in patients undergoing surgery for neuromuscular scoliosis. A matched comparison using prospectively collected data was undertaken. A total of 66 patients underwent posterior or anteroposterior correction and fusion with hybrid (n = 33, mean age at surgery 15.

A critical analysis of postoperative complications of antebrachium TEN-nailing in 35 children.

Background: Unstable antebrachium diaphyseal fractures in children are nowadays increasingly treated operatively by elastic intramedullary nailing.

Aim: Aim of the study was to critically assess both radiological and functional outcome of antebrachium fractures treated by titanium elastic nail (TEN) in a pediatric cohort.

Material And Methods: This retrospective study investigated 75 consecutive children, who were treated for antebrachium shaft fractures at Tampere University Hospital during the time period from January 2001 to December 2005.

The incidence and outcomes of vertebral column resection in paediatric patients: a population-based, multicentre, follow-up study.

We report the results of vertebral column resection (VCR) for paediatric patients with spinal deformity. A total of 49 VCRs in paediatric patients from four university hospitals between 2005 and 2009 with a minimum two-year follow-up were retrospectively identified. After excluding single hemivertebral resections (n = 25) and VCRs performed for patients with myelomeningocele (n = 6), as well as spondylectomies performed for tumour (n = 4), there were 14 patients who had undergone full VCR at a mean age of 12.

Non-absorbable interrupted versus absorbable continuous skin closure in pediatric appendectomies.

Background And Aims: appendectomy wounds are still commonly closed with non-absorbable sutures. Stitch removal has financial costs and causes anxiety in children. Our aim was to compare interrupted non-absorbable (NA) and continuous intradermal absorbable (A) sutures in appendectomy wounds to evaluate whether absorbable suturing increases the risk of complications.

EEG sources of noise in intraoperative somatosensory evoked potential monitoring during propofol anesthesia.

Objective: It was hypothesized that somato- sensory evoked potentials can be achieved faster by selective averaging during periods of low spontaneous electroen- cephalographic (EEG) activity. We analyzed the components of EEG that decrease the signal-to-noise ratio of somatosensory evoked potential (SEP) recordings during propofol anesthesia.

Methods: Patient EEGs were recorded with a high sampling frequency during deep anesthesia, when EEGs were in burst suppression.