Simple bone cysts: better with age?

Purpose: The purpose of this study was to evaluate whether simple bone cysts (SBC) resolve with age.

Methods: Twenty four subjects with SBC who participated in a prior randomized clinical trial but had not healed at trial conclusion were evaluated for cyst healing. The following clinical and radiographic data were evaluated: age, sex, pain (Visual Analogue Scale), functional health (Short Form 36), subsequent fracture, involved bone, cyst area (cm), distance from physis (cm), endosteal thickening (yes/no), scalloping (no new scalloping/new scalloping), opacity/radiolucency (as is), loculation (yes/no), trabeculation (yes/no), tubulation (yes/no), transition zone (sharp/wide), geographic borders (geographic nonpermeative/nongeographic permeative), radiodense rim (>50%/no rim), and growth plate status (open/closed).

Outcomes of bracing in juvenile idiopathic scoliosis until skeletal maturity or surgery.

Study Design: Retrospective comparative study.

Objective: To evaluate the outcome of bracing in patients with juvenile idiopathic scoliosis (JIS) at either skeletal maturity or time of scoliosis surgery.

Summary Of Background Data: JIS is generally thought to have poor outcomes with high rates of surgical fusion.

Recent developments in treatment for simple bone cysts.

Purpose Of Review: The purpose of this paper is to review treatment strategies for simple bone cysts (SBCs).

Recent Findings: Recent studies have focused on disrupting the wall of the cyst in combination with injectable bone substitutes. Bone substitutes are minimally invasive, provide an osteoconductive scaffold, and are relatively easy to use.

Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

Background: Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery.

Treatment for unicameral bone cysts in long bones: an evidence based review.

The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies.

Sharing clinical trial results with adolescent idiopathic scoliosis patients.

Background: Results from clinical trials are generally not shared with participants unless they are thought to affect their future medical care. Few institutional review boards require that participants receive results of the research. Research in this area has largely focused on life-threatening medical conditions, and little is known about sharing clinical trial results in other populations.

Towards an understanding of the information and support needs of surgical adolescent idiopathic scoliosis patients: a qualitative analysis.

Background: Informed decision making for adolescents and families considering surgery for scoliosis requires essential information, including expected outcomes with or without treatment and the associated risks and benefits of treatment. Ideally families should also receive support in response to their individual concerns. The aim of this study was to identify health-specific needs for online information and support for patients with adolescent idiopathic scoliosis who have had or anticipate having spinal surgery.

What do patients and parents know about surgery for adolescent idiopathic scoliosis?: a knowledge questionnaire.

Study Design: Questionnaire.

Objective: The purpose of this study was to develop a reliable and valid questionnaire to assess patient and parent knowledge concerning risks, benefits, and complications of surgery for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Families of adolescents with moderate to severe AIS are required to make an important decision on whether to proceed with surgery.

A randomized clinical trial comparing intralesional bone marrow and steroid injections for simple bone cysts.

Background: Simple bone cysts are common benign lesions in growing children that predispose them to fracture and are sometimes painful. The purpose of this trial was to compare rates of healing of simple bone cysts treated with intralesional injections of bone marrow with rates of healing of those treated with methylprednisolone acetate.

Methods: Of ninety patients randomly allocated to treatment with either a bone-marrow or a methylprednisolone acetate injection, seventy-seven were followed for two years.

Are surgeons' preferences for instrumentation related to patient outcomes? A randomized clinical trial of two implants for idiopathic scoliosis.

Background: Although many techniques for the surgical treatment of scoliosis have been described, we are not aware of any randomized trials that have compared implant systems. The relationship between surgeons' preferences for implants and patient outcomes is unknown. The purpose of the present study was to compare quality of life and curve correction associated with use of the Moss Miami system and the Universal Spine System for spinal fusion in patients with adolescent idiopathic scoliosis.

Improvement in quality of life following surgery for adolescent idiopathic scoliosis.

Study Design: We used the Climent Quality of Life for Spinal Deformities Scale prospectively in a nonrandomized prospective comparative cohort of operative versus observational management of adolescent idiopathic scoliosis.

Objective: To compare the change in disease-specific quality of life associated with operating on adolescents with idiopathic scoliosis, to the change in disease-specific quality of life among observed scoliosis patients with a similar 2-year follow-up period.

Summary Of Background Data: The immediate effect of scoliosis surgery on quality of life from a patient perspective has not been properly documented but should play a role in the patient's decision to operate.

Surgical decision making in adolescent idiopathic scoliosis.

Study Design: Cross-sectional survey.

Objective: The objective of this paper was to assess the reliability of surgeons' decision-making in adolescent idiopathic scoliosis (AIS) based on patient photographs and clinical and radiographic data.

Summary Of Background Data: Orthopedic spine surgeons rated severity of deformity as the most important surgical consideration in AIS.

Surgeon reliability in rating physical deformity in adolescent idiopathic scoliosis.

Study Design: Cross sectional survey.

Objectives: To compare pediatric spine surgeons' relative rankings of the importance of surgical considerations, and their reliability of ratings of the physical deformity of patients with adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Adolescents' appearance is a factor in surgical decision-making.

Rush University guidelines and protocols for the management of hyperglycemia in hospitalized patients: elimination of the sliding scale and improvement of glycemic control throughout the hospital.

The management of inpatient hyperglycemia has received much recent attention because of an expanding literature supporting the benefits of quality improvement and the creation of guidelines in this area. The authors began a process in 2002 to create modern protocols for glycemic control with intravenous insulin in their intensive care units and with subcutaneous basal-prandial insulin in all of their non-intensive care units. In this report, they describe both the process employed and the current protocols they are using.

Parents' and patients' perceptions of postoperative appearance in adolescent idiopathic scoliosis.

Study Design: A cross-sectional evaluation of patients after surgery for adolescent idiopathic scoliosis (AIS).

Objectives: To determine the agreement between patients' and parents' perceptions of the patient's postoperative appearance and to compare those perceptions with physical and radiographic measures of deformity.

Summary Of Background Data: Improving cosmesis is an important aim of surgery.

Construction and validation of the scoliosis quality of life index in adolescent idiopathic scoliosis.

Study Design: A prospective cross-sectional design was used to evaluate the Scoliosis Quality of Life Index (SQLI). SQLI is a 22-item self-reporting health-related quality-of-life questionnaire for idiopathic scoliosis patients.

Objective: The goal of this study was to evaluate the psychometric qualities of SQLI.