Study Design: Analysis of a prospective series of 300 consecutive cases undergoing intraoperative monitoring in pediatric orthopedic spinal surgery, of which 10% were children younger than 4 years.
Objective: Determine feasibility and performance of intraoperative monitoring in children younger than 4 years. Analyze distinct physiopathologic mechanisms of relevant alerts.
Summary Of Background Data: There are few studies in the literature concerning the intraoperative monitoring of children younger than 4 years. During childhood, the development of sensori-motor pathways is dominated by two coexisting phenomena, which have opposite effects: maturation decreasing latencies and height increasing them.
Methods: We used intraoperative somatosensory-evoked potentials and neurogenic mixed evoked potentials with a flexible bipolar epidural electrode. Uniform total intravenous anesthesia was used.
Results: Values of sensitivity and specificity of the monitoring showed slight differences between patients younger than 4 years versus older patients. There was no false-negative outcome. Various tendencies were highlighted. There were more true positive alerts for secondary etiologies than for idiopathic ones, for revision spinal surgeries than for index ones, and for boys than for girls. There were no more true positive alerts for children younger than 4 years than for older patients whereas the proportion of hemivertebrae was obviously greater for the younger group. Relevant monitoring alerts were more frequent in case of kyphoscoliosis. This is highlighted in case reports.
Conclusion: In some cases of kyphoscoliosis, during a posterior-based vertebral column resection, monitoring changes were corrected by positioning a rod that allowed correction of the position of the spine in the sagittal plane. Intraoperative spinal cord monitoring can be performed in children younger than 4 years and allows real-time assessment of spinal functional integrity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BRS.0b013e3181f806d9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hospital admission of older patients with mild traumatic brain injury and traumatic intracranial hemorrhage: is it always necessary?
Eur J Trauma Emerg Surg
January 2025
Department of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK, The Hague, The Netherlands.
Background And Importance: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.
View Article and Find Full Text PDFInsomnia Prevalence and Correlates in Cancer Patients Undergoing Treatment.
Psychooncology
January 2025
Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.
Background: Insomnia is the most common sleep disturbance among cancer patients undergoing active treatment. If untreated, it is associated with significant physical and psychological health consequences. Prior efforts to determine insomnia prevalence and correlates have primarily assessed patients in clinical trials, in limited disease groups, and excluding important patient subgroups.
View Article and Find Full Text PDFTrends (2017-2022) in adolescent metabolic and bariatric surgery.
Surg Obes Relat Dis
December 2024
UMass Memorial Medical Center, Worcester, Massachusetts.
Article Synopsis
- Metabolic and Bariatric Surgery (MBS) for adolescents has been made more accessible due to recent policy changes, but challenges remain, particularly for diverse populations.
- A study from 2017-2022 revealed that about 15%-20% of MBS cases in the U.S. involved adolescents, predominantly females and white patients with an average age of 16.1 years.
- Despite a decline in cases during COVID-19, the volume rebounded, with an increase in sleeve gastrectomy and robotic-assisted surgeries, while overall complication rates remained low at 2.9%.
Mitochondrial HMG-CoA synthase deficiency.
Mol Genet Metab
January 2025
Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. Electronic address:
Mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2) deficiency is a rare, potentially life-threatening autosomal recessive disorder resulting from mutations in the HMGCS2 gene, leading to impaired ketogenesis. We systematically reviewed the clinical presentations, biochemical and genetic abnormalities in 93 reported cases and 2 new patients diagnosed based on biochemical findings. Reported onset ages ranged from 3 months to 6 years, mostly before the age of 3.
View Article and Find Full Text PDFDepression and dementia: interrogating the causality of the relationship.
J Neurol Neurosurg Psychiatry
January 2025
Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Background: Depression is often cited as a major modifiable risk factor for dementia, though the relative contributions of a true causal relationship, reverse causality and confounding factors remain unclear. This study applied a subset of the Bradford Hill criteria for causation to depression and dementia including strength of effect, specificity, temporality, biological gradient and coherence.
Methods: A total of 491 557 participants in UK Biobank aged between 40 and 69 at enrolment and followed up for a mean duration of 12.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!