Vertebral Body Tethering in Skeletally Immature Patients: Results of a Prospective U.S. FDA Investigational Device Exemption Study.

Background: The purpose of this study was to report on 2-year results of vertebral body tethering (VBT), performed under a Food and Drug Administration protocol, to obtain insight into outcomes and complications.

Methods: Forty prospectively enrolled patients with adolescent idiopathic scoliosis (AIS) who had a Sanders score of ≤4 or a Risser score of ≤2 underwent VBT for curves between 40° and 70°. Surgical, radiographic, and patient-reported outcomes were reviewed at a minimum 2-year follow-up.

Applying sequence analysis to uncover 'real-world' clinical pathways from routinely collected data: a systematic review.

Objectives: This systematic review aims to elucidate the methodological practices and reporting standards associated with sequence analysis (SA) for the identification of clinical pathways in real-world scenarios, using routinely collected data.

Study Design And Setting: We conducted a methodological systematic review, searching five medical and health databases: MEDLINE, PsycINFO, CINAHL, EMBASE and Web of Science. The search encompassed articles from the inception of these databases up to February 28, 2023.

Correction: Simultaneous Bilateral Proximal Femur Implant Failure: A Case Report.

[This corrects the article DOI: 10.7759/cureus.32543.

Simultaneous Bilateral Proximal Femur Implant Failure: A Case Report.

A seven-year-old boy with Moebius syndrome and bilateral hip dysplasia underwent left-sided adductor lengthening, bilateral proximal femur varus derotational osteotomies, and internal fixation with proximal femur blade plates, and left-sided Dega pelvic osteotomy. Postoperatively, he was immobilized in a Petrie cast. A month later, the child presented with bilateral proximal femur blade plate implant failure.

Open Reduction and Internal Fixation of a Pediatric Apophyseal Calcaneus Fracture Using Cannulated Screws: A Case Report.

We report a case of a 12-year-old boy who sustained a displaced calcaneal apophysis fracture, which was analogous to a bony avulsion of the insertion of the Achilles tendon, secondary to an awkward landing while jumping at a trampoline park. Treatment with open reduction and internal fixation with cannulated screws provided a novel approach to fixation for this type of fracture in the pediatric population.

Nurses' Perceptions, Involvement, Confidence and Perceived Barriers Towards Antimicrobial Stewardship Program in Pakistan: Findings from a Multi-Center, Cross-Sectional Study.

Purpose: Antimicrobial resistance (AMR) is leading to greater therapeutic cost, length of hospital stays, adverse events, morbidity and mortality. Hospital-based antimicrobial stewardship programs (ASPs) engaging physicians, pharmacists, microbiologists and nurses are considered as effective way to ensure appropriate use of antimicrobial agents. The aims of our study were to assess nurses' perception, involvement, confidence and barriers towards hospital-based ASPs, and use the findings to provide future guidance.

Measurable Lumbar Motion Remains 1 Year After Vertebral Body Tethering.

Introduction: Vertebral body tethering (VBT) is growing in popularity for skeletally immature patients with scoliosis because of presumed preservation of spinal motion. Although results have shown preserved thoracic motion, there is minimal data to support motion over the lumbar instrumented segments after VBT. The purpose of this study was to analyze the range of motion of the thoracolumbar and lumbar spine after lumbar VBT.

Noninvasive Hemoglobin Monitoring for Postoperative Pediatric Orthopaedic Patients: A Preliminary Study.

Background: Hemoglobin (Hgb) levels are frequently checked through venipuncture [invasive hemoglobin (iHgb)] in pediatric orthopaedic patients after high blood loss procedures. This needlestick may causes further anxiety and fear in hospitalized children. Noninvasive hemoglobin (nHgb) monitoring has been effectively utilized in the adult intensive care and postoperative total joint arthroplasty setting.

Vertebral body tethering compared to posterior spinal fusion for skeletally immature adolescent idiopathic scoliosis patients: preliminary results from a matched case-control study.

Purpose: Direct comparisons between vertebral body tethering (VBT) and posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) are limited. We aimed to evaluate 2-year results of VBT and PSF to report comparative outcomes.

Methods: 26 prospectively enrolled VBT patients were matched 1:1 by age, gender, Risser sign and major curve magnitude with PSF patients.

Intervertebral Disk Health Following Vertebral Body Tethering for Adolescent Idiopathic Scoliosis: A Preliminary Study.

Background: Interest in vertebral body tethering (VBT) as an alternative to posterior spinal fusion for adolescent idiopathic scoliosis (AIS) continues to grow. The purpose of this study was to prospectively assess intervertebral disk health on magnetic resonance imaging (MRI) at 1 year following VBT in AIS patients.

Methods: AIS patients were enrolled in a prospective surgeon-sponsored Food and Drug Administration (FDA) Investigational Device Exemption (IDE) Study and underwent MRI at 1-year following VBT.

Are Serum Ion Levels Elevated in Pediatric Patients With Metal Implants?

Background: Previous studies report elevated serum titanium (Ti) levels in children with spinal implants. To provide additional data on this topic, we sought to assess serum ion levels at multiple timepoints in pediatric patients with growing spine devices, spinal fusion instrumentation, and extremity implants placed for fracture treatment. We hypothesized that serum Ti, cobalt (Co), and chromium (Cr) levels would be elevated in pediatric patients with growing spine devices compared with patients with extremity implants.

Measurable Thoracic Motion Remains at 1 Year Following Anterior Vertebral Body Tethering, with Sagittal Motion Greater Than Coronal Motion.

Background: Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering.

Thoracic paravertebral nerve catheter reduces postoperative opioid use for vertebral body tethering patients.

Purpose: Vertebral body tethering is increasingly being performed, yet postoperative pain management has not yet been optimized. We sought to determine whether the addition of a thoracic paravertebral block in addition to a standard multimodal postoperative pain management program could provide greater pain relief, reduced analgesic requirement, and reduced length of stay.

Methods: Patients who underwent VBT at a single tertiary referral center were retrospectively reviewed.

Defining the learning curve in CT-guided navigated thoracoscopic vertebral body tethering.

Unlabelled: Estimated blood loss (EBL), anesthesia time, operative time, and length of stay decreased over 67 navigated vertebral body tethering (VBT) surgeries performed in a 5-year period, indicating a steep learning curve.

Design: Retrospective review of prospectively collected data.

Hypothesis: There would be a significant improvement in the performance of VBT procedures over time at a single tertiary center in terms of perioperative and postoperative outcomes.

Does preoperative and intraoperative imaging for anterior vertebral body tethering predict postoperative correction?

Purpose: Anterior vertebral body tethering (AVBT) is an emerging approach for idiopathic scoliosis. However, overcorrection and under-correction are common causes of revision surgery, and intraoperative tensioning of the cord is one key component to achieve appropriate curve correction. We sought to determine whether preoperative flexibility radiographs or intraoperative radiographs would predict correction at first erect imaging for scoliosis patients undergoing anterior vertebral body tethering (AVBT).

Characteristics and reoperation rates of paediatric tarsal coalitions: a population-based study.

Purpose: Tarsal coalitions are congenital fusions of two or more tarsal bones and can lead to foot pain and stiffness. Few studies examine the long-term reoperation rates following paediatric tarsal coalition surgery.

Methods: A population-based database, linking medical records at all medical centres to capture the entire medical history of the full population of a Midwest county, was used to identify tarsal coalitions in children between 1966 and 2018.

Unusual case of upper gastrointestinal haemorrhage secondary to a ruptured gastroduodenal artery pseudoaneurysm: case presentation and literature review.

Pseudoaneurysm rupture of the gastroduodenal artery (GDA) is life-threatening and can present as an acute upper gastrointestinal haemorrhage. Here, we present a case of upper gastrointestinal haemorrhage arising from a ruptured GDA pseudoaneurysm. A 56-year-old woman presented acutely with haematemesis.

Is the axial spinal cord classification predictive of intraoperative neurologic alert for pediatric scoliosis patients? An independent retrospective validation study.

Purpose: We sought to determine whether the axial spinal cord classification by Sielatycki et al. would be associated with increased intraoperative neuromonitoring (IONM) alerts for pediatric scoliosis patients undergoing posterior spinal fusion (PSF) surgery.

Methods: Children less than age 19 with scoliosis undergoing PSF were retrospectively reviewed.

Incidence of Symptomatic Pediatric Tarsal Coalition in Olmsted County: A Population-Based Study.

Background: Tarsal coalitions are an important reason for foot pain in children. Early estimates placed the prevalence at up to 2%, while more recent data suggest that it is as high as 11% to 13%. To our knowledge, there have been no population-based studies to determine the true incidence of symptomatic tarsal coalitions in a pediatric population.

Rare cause of right iliac fossa pain in a UK patient.

A 62-year-old Asian man presented with a 3-month history of right iliac fossa pain which had progressively worsened over the last 3 weeks. All blood parameters were found to be unremarkable except for mildly elevated erythrocyte sedimentation rate. CT imaging demonstrated thickening of the ascending colon and caecum.

Acute cor pulmonale from saddle pulmonary embolism in a patient with previous COVID-19: should we prolong prophylactic anticoagulation?

Severe coronavirus disease 2019 (COVID-19) is known to be associated with a heightened risk of thromboembolism. However, the risk associated with mild and moderate illness from COVID-19 is unknown, and there is no current recommendation for prophylaxis against thromboembolism in patients after hospital treatment, unless there are established thrombophilic risk factors. We report the case of a 52-year-old woman who presented with massive saddle pulmonary embolism 1 week after initial hospital discharge, which was treated successfully with thrombolysis.

Natural History of Slipped Capital Femoral Epiphysis.

Background: Slipped capital femoral epiphysis (SCFE) occurs at a rate of 1 in 10,000 to 20,000 children.

Methods: A PubMed search was undertaken to evaluate recent SCFE literature. A convenience sample of articles were selected and summarized.