Preserving Ambulatory Potential in Pediatric Patients With Cerebral Palsy Who Undergo Spinal Fusion Using Unit Rod Instrumentation

Spine ◽  
2003 ◽  
Vol 28 (5) ◽  
pp. 480-483 ◽  
Author(s):  
Athanasios I. Tsirikos ◽  
Wei-Ning Chang ◽  
Suken A. Shah ◽  
K. W. Dabney ◽  
Freeman Miller
Keyword(s):  
Cerebral Palsy ◽  
Spinal Fusion ◽  
Pediatric Patients

scholarly journals Spinal Deformity Surgery in Pediatric Patients With Cerebral Palsy: A National-Level Analysis of Inpatient and Postdischarge Outcomes

2020 ◽  
pp. 219256822096007
Author(s):  
Nathan J. Lee ◽  
Michael Fields ◽  
Venkat Boddapati ◽  
Justin Mathew ◽  
Daniel Hong ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Respiratory Failure ◽  
Length Of Stay ◽  
Acute Respiratory Failure ◽  
Spinal Fusion ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
National Level ◽  
Spinal Deformity Surgery ◽  
Tract Infections

Study Design: Retrospective cohort. Objective: To provide a national-level assessment of the short-term outcomes after spinal deformity surgery in pediatric patients with cerebral palsy. Methods: A national, prospectively collected database was queried to identify pediatric (≤18 years) patients with cerebral palsy, who underwent spinal fusion surgery from 2012 to 2017. Separate multivariate analyses were performed for the primary outcomes of interest including extended length of stay (>75th percentile, >8 days), and readmissions within 90 days after the index admission. Results: A total of 2856 patients were reviewed. The mean age ± standard deviation was 12.8 ± 2.9 years, and 49.4% of patients were female. The majority of patients underwent a posterior spinal fusion (97.0%) involving ≥8 levels (79.9%) at a teaching hospital (96.6%). Top medical complications (24.5%) included acute respiratory failure requiring mechanical ventilation (11.4%), paralytic ileus (8.2%), and urinary tract infections (4.6%). Top surgical complications (40.7%) included blood transfusion (35.6%), wound complication (4.9%), and mechanical complication (2.7%). The hospital cost for patients with a length of hospital stay >8 days ($113 669) was nearly double than that of those with a shorter length of stay ($68 411). The 90-day readmission rate was 17.6% (mean days to readmission: 30.2). The most common reason for readmission included wound dehiscence (21.1%), surgical site infection (19.1%), other infection (18.9%), dehydration (16.9%), feeding issues (14.5%), and acute respiratory failure (13.1%). Notable independent predictors for 90-day readmissions included preexisting pulmonary disease (odds ratio [OR] 1.5), obesity (OR 3.4), cachexia (OR 27), nonteaching hospital (OR 3.5), inpatient return to operating room (OR 1.9), and length of stay >8 days (OR 1.5). Conclusions: Efforts focused on optimizing the perioperative pulmonary, hematological, and nutritional status as well as reducing wound complications appear to be the most important for improving clinical outcomes.

Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

2003 ◽  
Vol 45 (10) ◽  
Author(s):  
Athanasios I Tsirikos ◽  
Wei-Ning Chang ◽  
Kirk W Dabney ◽  
Freeman Miller ◽  
Joseph Glutting
Keyword(s):  
Cerebral Palsy ◽  
Life Expectancy ◽  
Spinal Fusion ◽  
Pediatric Patients ◽  
Neuromuscular Scoliosis

scholarly journals Clinical and Electroencephalographic Profile Of Children

2015 ◽  
Vol 11 (2) ◽  
pp. 110-116
Author(s):  
N Limbu ◽  
BH Paudel ◽  
D Thakur
Keyword(s):  
Cerebral Palsy ◽  
Febrile Seizure ◽  
Pediatric Patients ◽  
Birth Asphyxia ◽  
Seizure Disorder ◽  
Chi Square ◽  
Demographic Profiles ◽  
Epileptiform Discharges ◽  
Chi Square Test ◽  
The Relationship

Background Reports on pediatric electroencephalogram of Nepalese patients are rare. Objective We aimed to study the relationship between provisional clinical and electrophysiological diagnoses of pediatric patients with documentation of demographic profiles, and type and frequency of the disorders/diseases. Methods Electroencephalographic reports of 634 children from 2006 to 2009 were analyzed at neurophysiology laboratory, department of Basic and Clinical Physiology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal, retrospectively. Chi-Square test was applied after detail descriptive statistics. Results Male and female were 72.2 % (n=458/634) and 27.76 % (n=176/634) respectively. Most frequent EEG abnormality was seizure disorder (n=370, 59.39%), then febrile seizure (n= 94, 15.08%) and birth asphyxia with hypoxic-induced encephalopathy (n=68, 10.91%). Electroencephalogram showed significant epileptiform discharges in seizure disorder (p=0.001, OR= 2.26, 95 % CI= 1.61 to 3.18) and in cerebral palsy (p=0.049, OR=6.88, 95 % CI=0.89 to 145.95), specifically in 6 to 12 (p=0.001, OR=2.94, 95 % CI=1.43 to 6.06) and one to five (p=0.019) years, respectively. Electroencephalogram detected significantly less epileptiform discharges (p=0.001, OR=0.25, 95 % CI= 0.15 to 0.42) in febrile seizure specifically in 1 to 5 years (p=0.003, OR=0.16, 95 % CI= 0.04 to 0.63). Conclusion Predominant Electroencephalographic abnormality was seizure disorder, followed by febrile seizure and birth asphyxia with hypoxic-induced encephalopathy respectively. Electroencephalographic abnormality was highly associated with seizure disorder and cerebral palsy but was not associated with febrile seizure. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12484 Kathmandu University Medical Journal Vol.11(2) 2013: 110-116

scholarly journals Heart Rate Variability in Children and Adolescents with Cerebral Palsy—A Systematic Literature Review

2020 ◽  
Vol 9 (4) ◽  
pp. 1141 ◽  
Author(s):  
Jakub S. Gąsior ◽  
Antonio Roberto Zamunér ◽  
Luiz Eduardo Virgilio Silva ◽  
Craig A. Williams ◽  
Rafał Baranowski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cerebral Palsy ◽  
English Language ◽  
Pediatric Patients ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Cardiac Autonomic Dysfunction ◽  
Guidelines And Recommendations ◽  
Methodological Guidelines

Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic review was performed in PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases searched for English language publications from 1996 to 2019 using Medical Subject Headings (MeSH) terms “heart rate variability” and “cerebral palsy” in conjunction with additional inclusion criteria: studies limited to humans in the age range of 0–18 years and empirical investigations. Out of 47 studies, 12 were included in the review. Pediatric patients with CP presented a significantly higher resting heart rate and reduced HRV, different autonomic responses to movement stimuli compared to children with normal development, but also reduced HRV parameters in the children dependent on adult assistance for mobility compared to those generally independent. None of the included studies contained the necessary details concerning RR intervals acquisition and HRV measurements as recommended by the guidelines. Authors of HRV studies should follow the methodological guidelines and recommendations on HRV measurement, because such an approach may allow a direct comparison of their results.

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