scholarly journals Orthostatic hypotension following posterior spinal fusion surgeries for spinal deformity correction in adolescents: prevalence and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ying Yang ◽  
Yaping Chen ◽  
Bingdu Tong ◽  
Xue Tian ◽  
Chunjie Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Orthostatic Hypotension ◽  
Hospital Stay ◽  
Spinal Fusion ◽  
Spinal Deformity ◽  
Case Series ◽  
Deformity Correction ◽  
Length Of Hospital Stay ◽  
Posterior Spinal Fusion ◽  
Lower Limbs

Abstract Study design Retrospective case series. Objectives This study aimed to determine the prevalence and risk factors for orthostatic hypotension (OH) in adolescents undergoing posterior spinal fusion for spinal deformity correction. Methods The data of 282 consecutive adolescents who underwent posterior spinal fusion for spinal deformity correction in our center over 12 months were retrieved. Patient characteristics, including whether laminectomy or osteotomy was performed during the surgery, the occurrence of postoperative nausea and vomiting (PONV), perioperative hemoglobin albumin changes, perioperative blood transfusion, length of bed rest, willingness to ambulate, length of postoperative exercises of the lower limbs, and length of hospital stay, were collected and compared statistically between patients who did and did not develop postoperative OH. Results Of 282 patients, 197 (69.86%) developed OH postoperatively, and all cases completely resolved 5 days after the first out-of-bed exercises. Significant differences in the incidence of PONV, the willingness to ambulate and the length of postoperative exercises of the lower limbs were observed. The mean length of hospital stay of the patients with OH was longer than that of the patients without OH. Conclusion Our study suggests that temporary OH is a common manifestation following posterior spinal fusion for spinal deformity correction in adolescents. Postoperative OH may increase the length of hospital stay in these patients. Patients with PONV, who are not willing to ambulate and who perform postoperative lower limb exercises for a shorter time are more likely to have OH.

scholarly journals Orthostatic Hypotension Following Posterior Spinal Fusion Surgeries for Spinal Deformity Correction in Adolescents: Prevalence and Risk Factors

2021 ◽  
Author(s):  
Ying Yang ◽  
Yaping Chen ◽  
Bingdu Tong ◽  
Xue Tian ◽  
Chunjie Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Orthostatic Hypotension ◽  
Hospital Stay ◽  
Spinal Fusion ◽  
Spinal Deformity ◽  
Case Series ◽  
Deformity Correction ◽  
Length Of Hospital Stay ◽  
Posterior Spinal Fusion ◽  
Lower Limbs

Abstract Study Design: Retrospective case series.Objectives: This study aimed to determine the prevalence and risk factors for orthostatic hypotension (OH) in adolescents undergoing posterior spinal fusion for spinal deformity correction.Methods: The data of 312 consecutive adolescents who underwent posterior spinal fusion for spinal deformity correction in our center over 12 months were retrieved. Patient characteristics, including whether laminectomy or osteotomy was performed during the surgery, the occurrence of postoperative nausea and vomiting (PONV), perioperative hemoglobin albumin changes, perioperative blood transfusion, length of bed rest, willingness to ambulate, length of postoperative exercises of the lower limbs, and length of hospital stay, were collected and compared statistically between patients who did and did not develop postoperative OH.Results: Of 312 patients, 225 (72.1%) developed OH postoperatively, and all cases completely resolved 5 days after the first out-of-bed exercises. Significant differences in BMI, the incidence of PONV, the willingness to ambulate and the length of postoperative exercises of the lower limbs were observed. The mean length of hospital stay of the patients with OH was longer than that of the patients without OH.Conclusion: Our study suggests that temporary OH is a common manifestation following posterior spinal fusion for spinal deformity correction in adolescents. Postoperative OH may increase the length of hospital stay in these patients. Patients with PONV, who are not willing to ambulate and who perform postoperative lower limb exercises for a shorter time are more likely to have OH.

166 Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction

Neurosurgery ◽  
2016 ◽  
Vol 63 ◽  
pp. 166-167 ◽  
Author(s):  
Justin K. Scheer ◽  
Tamir T. Ailon ◽  
Justin S. Smith ◽  
Robert Hart ◽  
Douglas C. Burton ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Predictive Modeling ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Length Of Hospital Stay

Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days

2018 ◽  
Vol 115 ◽  
pp. e422-e427 ◽  
Author(s):  
Michael M. Safaee ◽  
Justin K. Scheer ◽  
Tamir Ailon ◽  
Justin S. Smith ◽  
Robert A. Hart ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Predictive Modeling ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Length Of Hospital Stay

scholarly journals Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy

2017 ◽  
Vol 20 (5) ◽  
pp. 456-463 ◽  
Author(s):  
Vijay M. Ravindra ◽  
Michael T. Christensen ◽  
Kaine Onwuzulike ◽  
John T. Smith ◽  
Kyle Halvorson ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Cobb Angle ◽  
Spinal Fusion ◽  
Spinal Deformity ◽  
Posterior Spinal Fusion ◽  
Neuromuscular Scoliosis ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy

OBJECTIVESelective dorsal rhizotomy (SDR) via limited laminectomy is an effective treatment of lower-extremity spasticity in the pediatric population. Children with spasticity are also at risk for neuromuscular scoliosis; however, specific risk factors for progressive spinal deformity requiring posterior spinal fusion (PSF) after SDR are unknown. The authors’ goal was to identify potential risk factors.METHODSThe authors performed a retrospective cohort study of patients who underwent SDR via limited laminectomy between 2003 and 2014 and who had at least 1 year of follow-up. They analyzed demographic, clinical, and radiographic variables to elucidate risk factors for progressive neuromuscular scoliosis. The primary outcome was need for PSF.RESULTSOne hundred thirty-four patients underwent SDR and had at least 12 months of follow-up (mean 65 months); 48 patients (36%) had detailed pre- and postoperative radiographic data available. The mean age at surgery was 10 years (SD 5.1 years). Eighty-four patients (63%) were ambulatory before SDR, 109 (82%) underwent a single-level laminectomy, and a mean of 53% of the dorsal rootlets from L-1 to S-1 were sectioned. Fifteen patients (11.2%) subsequently required PSF for progressive deformity. Nonambulatory status (p < 0.001) and a preoperative Cobb angle > 30° (p = 0.003) were significantly associated with PSF on univariate analysis, but no statistically significant correlation was found with any clinical or radiographic variable and PSF after SDR on multivariate regression analysis.CONCLUSIONSPatients with preoperative nonambulatory status and Cobb angle > 30° may be at risk for progressive spinal deformity requiring PSF after SDR. These are well-known risk factors for progressive deformity in children with spasticity in general. Although our analysis suggests SDR via limited laminectomy may not significantly accelerate the development of neuromuscular scoliosis, further case-control studies are critical to elucidate the impact of SDR on spinal deformity.

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

Incidence of Pleural Fluid and Its Associated Risk Factors After Posterior Spinal Fusion in Patients With Adolescent Idiopathic Scoliosis

Spine ◽  
2017 ◽  
Vol 42 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Pleural Fluid ◽  
Posterior Spinal Fusion ◽  
Associated Risk Factors

First-Ray Radiographic Changes After Flexible Adult Acquired Flatfoot Deformity Correction

2021 ◽  
pp. 107110072110345
Author(s):  
Chien-Shun Wang ◽  
Yun-Hsuan Tzeng ◽  
Tzu-Cheng Yang ◽  
Chun-Cheng Lin ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hallux Valgus ◽  
Reconstructive Surgery ◽  
Case Series ◽  
Deformity Correction ◽  
Level Of Evidence ◽  
Factors Affecting ◽  
Radiographic Parameters ◽  
Case Series Study ◽  
Adult Acquired Flatfoot Deformity

Background: Adult acquired flatfoot deformity (AAFD) and hallux valgus (HV) are common foot and ankle deformities. Few studies have reported the changes in radiographic parameters of HV after reconstructive surgery for AAFD. This study aimed to evaluate the changes in radiographic parameters of HV and analyze the risk factors for increased HV after correction of AAFD. Methods: Adult patients with flexible AAFD who underwent similar bony procedures including medializing calcaneal osteotomy and Cotton osteotomy were included. Radiographic parameters were measured on weightbearing radiographs preoperatively, postoperatively, and at the final follow-up. Patients were divided into hallux valgus angle (HVA) increased and HVA nonincreased groups; logistic regression analysis was performed to identify risk factors affecting increased HV. Results: Forty-six feet of 43 patients were included. After AAFD reconstructive surgery, the tibial sesamoid position improved by 1 grade, but the HVA increased 4 degrees in average. Further, 21 of 46 feet (46%) showed an HVA increase ≥5 degrees immediately after AAFD correction surgery. Preoperative talonavicular coverage angle <21.6 degrees was a risk factor associated with HV increase immediately after the surgery. Conclusion: In this case series, using plain radiographs to measure standard parameters of foot alignment, we found the association between AAFD correction and HV deformity measures somewhat paradoxical. Correction of overpronation of the hindfoot and midfoot appears to improve the first metatarsal rotational deformity but may also increase HVA. A lower preoperative talonavicular coverage angle was associated with an increase of the HVA after surgery. Level of Evidence: Level IV, case series study.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

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