scholarly journals Spinal Deformities after Childhood Tumors

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3555
Author(s):  
Anna K. Hell ◽  
Ingrid Kühnle ◽  
Heiko M. Lorenz ◽  
Lena Braunschweig ◽  
Katja A. Lüders ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Cns Tumors ◽  
Spinal Tumors ◽  
Spinal Deformities ◽  
Surgical Biopsy ◽  
Surgical Interventions ◽  
Childhood Tumors ◽  
Number Of Children ◽  
Spinal Implants ◽  
Spinal Fusions

Childhood tumors of the central nervous system (CNS) and other entities affecting the spine are rare. Treatment options vary from surgical biopsy to partial, subtotal, and total resection, to radiation, to chemotherapy. The aim of this study is to investigate spinal deformity and subsequent surgical interventions in this patient cohort. A retrospective review at our institution identified children with CNS tumors, spinal tumors, and juxta-spinal tumors, as well as spinal deformities. Tumor entity, treatment, mobilization, and radiographic images were analyzed relative to the spinal deformity, using curve angles in two planes. Conservative or surgical interventions such as orthotic braces, growth-friendly spinal implants, and spinal fusions were evaluated and analyzed with respect to treatment results. Tumor entities in the 76 patients of this study included CNS tumors (n = 41), neurofibromatosis with spinal or paraspinal tumors (n = 14), bone tumors (n = 12), embryonal tumors (n = 7), and others (n = 2). The initial treatment consisted of surgical biopsy (n = 5), partial, subtotal, or total surgical resection (n = 59), or none (n = 12), followed by chemotherapy, radiotherapy, or both (n = 40). Out of 65 evaluated patients, 25 revealed a moderate or severe scoliotic deformity of 71° (range 21–116°), pathological thoracic kyphosis of 66° (range 50–130°), and lordosis of 61° (range 41–97°). Surgical treatment was performed on 21 patients with implantation of growth-friendly spinal implants (n = 9) as well as twelve dorsal spinal fusions (two with prior halo distraction). Surgical interventions significantly improved spinal deformities without additional neurological impairment. With the increasing number of children surviving rare tumors, attention should be focused on long-term problems such as spinal deformities and consequent disabilities. A significant number of children with CNS tumors, spinal tumors or juxta-spinal tumors required surgical intervention. Early information about spinal deformities and a close follow-up are mandatory for this patient group.

Trampoliny – czy są bezpieczne? Skoki na batucie jako przyczyna urazów narządu ruchu w materiale dziecięcego oddziału urazowo-ortopedycznego

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Piotr Zając
Keyword(s):  
Distal Tibia ◽  
Severe Injuries ◽  
Locomotor System ◽  
Surgical Interventions ◽  
Number Of Children ◽  
Risk Of Injury ◽  
Limb Injuries ◽  
Supracondylar Humerus Fractures ◽  
Forearm Bones ◽  
Humerus Fractures

Introduction. Skilful marketing and accessible prices are main causes of popularity of garden trampolines. Increasingly often the improper and unwise use of them leads to severe injuries of the locomotor system. Aim. An analysis of the above-mentioned injuries in children using materials of the Orthopaedics and Trauma Unit. Material and methods. Using the hospital IT system emergency admittances were analysed for the years 2016-2017. A selected group of patients was evaluated in terms of epidemiology and treatment methods. Results. Treatment was provided to 41 patients (21 boys, 20 girls), aged 2 to 16 years (mean age: 7.3 years). 85.4% of the admitted patients used the trampoline together with other children, 70.7% children bounced on the trampoline unsupervised by adults. Upper limb injuries represented 82.9% (34 children) of all cases, the majority of injuries involved the elbow joint and the forearm. Supracondylar humerus fractures and fractures of the shaft of both forearm bones were most frequently diagnosed. Lower limb injuries represented 17.1% (7 children) of all cases, related to the knee joint and ankle area, the most frequently diagnosed injuries were distal tibia and fibula fractures. Twenty eight (68.3%) children required surgical treatment, and 13 (31.7%) patients received conservative treatment. Conclusions. There are a growing number of children with locomotor system injuries related to playing on a trampoline and requiring hospitalisation and surgical interventions. Own experience and quoted references allow formulating principles reducing the risk of injury, including prohibiting the youngest children to play, reduction of the simultaneous use of a trampoline by more than one child, and a requirement of a constant supervision.

scholarly journals Halo-gravity traction in the treatment of complex spinal deformities in children with respiratory dysfunctions

2021 ◽  
pp. 10-14
Author(s):  
A.F. Levytskyi ◽  
◽  
V.O. Rogozinskyi ◽  
M.M. Dolianytskyi ◽  
L.V. Duda ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
World Literature ◽  
Three Dimensional ◽  
Pulmonary Insufficiency ◽  
Spinal Deformities ◽  
Scoliotic Deformity ◽  
Life Prognosis ◽  
Ventilation Failure ◽  
Safe Technique ◽  
Grade 3

HGT is a safe technique as the world literature describes complications in the form of loosening of the pins or superficial infections of the skin around the pins, which are not significant and do not pose a threat to the patient’s life. Purpose – to improve the results of the ventilation function of the lungs in patients with complex spinal deformities through the preliminary use of halo gravity traction and to introduce an effective and safe method for the treatment of complex spinal deformities in children with respiratory dysfunctions. Materials and methods. 64 children with complex spinal deformities (>100°) were treated in the orthopedic and traumatology department of the Okhmatdet NSPU using halo gravity traction during the period from 2003 until 2018. Of these, 38 are boys and 26 are girls. The average age of the patients was 11.6 years. The average Risser score was 3.8 (P>0.01). Results. According to the data of spirography performed, 46% of patients had moderate ventilation disorders and 54% – severe ventilation disorders (FVC<60% – grade 3 and 4 of ventilation failure). Mixed type disorders were recorded in 83% of patients, and restrictive type disorders in 17% (8/48) of children. After HGT, there was an improvement in pulmonary function indicators: an increase in FVC from 63.19% to 71.77% and FEV1 from 54.71% to 65.46%, Tiffeneau-Pinelli index – from 74.59% to 85.33%. Compared with the initial level of indicators, the improvement in FVC was 13.6% after HGT and 14.6% in dynamics during the year, and FEV1 – 19.6% and 21.6%, respectively. The results obtained indicate a significant improvement in the ventilation function of the lungs, especially due to the degree of FEV1 increase, which correlates with the degree of improvement in performance, mortality and life prognosis. Conclusions. The use of HGT makes it possible to improve the results of the final correction of spinal deformity, which in turn significantly improves the ventilation function of the lungs, which in turn helps to reduce the risks of mortality due to pulmonary insufficiency in adulthood. The choice of the appropriate methods of surgical correction for complex deformity of the spine is a prerequisite for successful treatment and the achievement of three-dimensional correction of the spine to maximally approximate its parameters to the physiological norm. The indication for halo gravity traction is a rigid scoliotic deformity of the spine with a deformity angle (>100°). This study was conducted in accordance with the principles of the Helsinki Declaration. The research protocol was approved by the Local Ethics Committee of the institutions mentioned in the work. Informed parental agreement was obtained for the research. No conflict of interests was declared by the authors. Key words: spinal deformity, respiratory dysfunctions, halo-gravity traction.

scholarly journals BIPLANAR IMAGING WITH TRIDIMENSIONAL CAPABILITIES: APPLICABILITY OF THIS NEW EXAMINATION TO SPINAL DEFORMITIES

2020 ◽  
Vol 19 (1) ◽  
pp. 67-70
Author(s):  
RAPHAEL DE REZENDE PRATALI ◽  
MURILO TAVARES DAHER ◽  
ROBERT MEVES
Keyword(s):  
Spinal Deformity ◽  
Imaging System ◽  
Adult Spinal Deformity ◽  
Three Dimensional ◽  
Entire Body ◽  
Spinal Deformities ◽  
Compensatory Mechanisms ◽  
Level Of Evidence ◽  
The Individual ◽  
Bone Structures

ABSTRACT This study presents details about the applicability of the new image acquisition system, called the biplanar imaging system, with three-dimensional capabilities (EOS®) to the treatment of spinal deformities. This system allows radiographic acquisition of the entire body, with a great reduction in the dose of radiation absorbed by the patient and three-dimensional (3D) stereoradiographic image reconstruction of bone structures, including the spine. In the case of adolescent idiopathic scoliosis, the analysis of the spinal deformity with 3D reconstruction allows better understanding of the deformity and surgical planning. In the case of adult spinal deformity, full-body analysis allows an evaluation of the spinopelvic deformity, including loss of sagittal alignment, in addition to an evaluation of compensatory mechanisms recruited by the individual in an attempt to maintain the sagittal balance. Level of evidence III; Descriptive Review.

scholarly journals Broken rods in spinal deformity surgery: an analysis of clinical experience and a literature review

2020 ◽  
Vol 7 (4) ◽  
pp. 15-26
Author(s):  
Mikhail V. Mikhaylovskiy ◽  
Alexander S. Vasujra ◽  
Vitaliy L. Lukinov
Keyword(s):  
Literature Review ◽  
Spinal Deformity ◽  
Congenital Scoliosis ◽  
Study Groups ◽  
Lower Percentage ◽  
Reference List ◽  
Spinal Deformities ◽  
Significant Difference ◽  
Spinal Deformity Surgery ◽  
Rod Fracture

Backgrоund. Rod fractures are one of the specific complications of spinal deformity surgery. The number of publications on this topic is small, and the conclusions are often contradictory. Aim. The aim of this study is to analyze the current situation concerning the problem of fractures of the rods in spinal deformities of various etiologies in terms of frequency and risk factors for this complication. Materials and methods. The study included 3,833 patients who underwent operations between 1996 and 2018. The inclusion criteria of being over 10 years of age with no history of spinal surgery were applied. Results. Fractures of metal implant rods were detected in 85 patients out of a total of 3,833 (2.2%). There was a significant difference between the groups of idiopathic and congenital scoliosis patients. A rod fracture in 62 of the 85 patients was the reason for reintervention to restore integrity with a connector or a full replacement. An increase in BMI by one raised the chance of a fracture by 1.07 times (p = 0.019). Increasing the age by one year increased the possibility of a fracture by 1.03 times (p = 0.039). A statistically significant association of the ventral stage of surgical treatment (discectomy and interbody fusion with autologous bone) where no fracture was detected (p = 0.403) was revealed. Being over 15 years old a statistically significant predictor was in the group under 20 years of age (p = 0.048). For BMI, there was no statistically significant threshold for fracture probability in the group under 20 years of age. It was confirmed that a hybrid fixation system produced a significantly lower percentage of complications than a hook system. A systematic literature review of sources on this topic included international databases (Scopus, Medline, and Google Scholar) as well as investigating the publications contained in the reference list. Conclusions. Rod fractures during surgery for spinal deformities of various etiologies are one of the typical complications. Fracture frequency in large study groups is small. The risk of developing this complication rises with both increasing BMI and patient age, although there is no statistically significant threshold for BMI relative to the chances of fracture in the group up to 20 years of age. Modern reticular systems of attachment of the endocorrector to the vertebral structures can dramatically reduce the risk of rod fracture during the postoperative period.

scholarly journals Endoscopic removal of metal foreign bodies by magnet: case report

2020 ◽  
Vol 10 (4) ◽  
pp. 467-472
Author(s):  
Vladimir I. Petlakh ◽  
Vladimir A. Borovitsky ◽  
Alexander K. Konovalov ◽  
Natalya N. Strogova
Keyword(s):  
Case Report ◽  
Conservative Therapy ◽  
Foreign Bodies ◽  
Intestinal Wall ◽  
The Body ◽  
Surgical Interventions ◽  
Number Of Children ◽  
The Past ◽  
A Chain ◽  
The Right

The number of children swallowing magnetic foreign bodies has been a significantly high for the past decades, increasingly needing endoscopic or surgical interventions. Case report. In our observation, a 12-year-old girl swallowed magnetic balls from childrens designer 10 days prior to hospital admission. Foreign bodies (5 balls) were found during X-ray examination in the projection of the cecum. Conservative therapy carried out for 4 days had no success, thus colonoscopy was performed to remove foreign bodies. Foreign bodies were fixed to the intestinal wall, and attempts to separate them were unsuccessful. When a medical magnet was placed outside the body in the right iliac region, a chain of magnetic balls detached from the intestinal wall and made it possible to be captured in a trap loop and be removed. The girl avoided a laparotomy with an opening of the colon. Conclusion. External use of a medical magnet is effective for navigation and assistance during colonoscopic extraction when magnetic foreign bodies are found in the colon.

CONGENITAL THORACOLUMBAR SPINE DEFORMITIES

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A78-A85 ◽  
Author(s):  
Hamidreza Aliabadi ◽  
Gerald Grant
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Congenital Anomalies ◽  
Thoracolumbar Spine ◽  
Deformity Correction ◽  
Spinal Deformities ◽  
Spine Deformities ◽  
Frequent Reason

ABSTRACT CONGENITAL THORACOLUMBAR SPINAL deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. Here we review a variety of congenital anomalies and address the maldevelopments associated with each, as well as the appropriate evaluation of such patients including nonoperative and operative approaches. Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.

VERTEBRAL COLUMN RESECTION FOR RIGID SPINAL DEFORMITY

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A177-A182 ◽  
Author(s):  
Justin S. Smith ◽  
Vincent Y. Wang ◽  
Christopher P. Ames
Keyword(s):  
Spinal Deformity ◽  
Vertebral Column ◽  
Surgical Techniques ◽  
Deformity Correction ◽  
Postoperative Management ◽  
Three Dimensions ◽  
Spinal Deformities ◽  
Vertebral Column Resection ◽  
Case Examples ◽  
Significant Correction

ABSTRACT OBJECTIVE Vertebral column resection (VCR) is a surgical technique that may be applied for correction of moderate to severe spinal deformities, including those with large rigid curves, fixed trunk translation, or asymmetry between the length of the convex and concave column of the deformity. This article reviews the VCR technique as it relates to correction of rigid spinal deformity, including case examples to illustrate its application. METHODS The literature was reviewed in reference to the use of VCR for correction of rigid spinal deformity. RESULTS VCR involves complete resection of one or more vertebral segments using either combined anterior and posterior approaches or a posterior-only approach and enables significant deformity correction in all three dimensions. Herein, we provide description of the indications, preoperative planning, surgical techniques, complication avoidance, postoperative management, and case examples for VCR. CONCLUSION VCR enables significant correction of rigid spinal deformities in cases in which less aggressive approaches are not adequate.

scholarly journals Assessment of factors responsible for early menopause in Interior Sindh, Pakistan

2020 ◽  
Vol 24 (3) ◽  
pp. 198-203
Author(s):  
Latafat Ali Chughtai ◽  
Aliza Sahito ◽  
Jawaid Ahmed Zai ◽  
Zaibunisa Mughal ◽  
Jamshed Warsi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Anorexia Nervosa ◽  
Brain Tumor ◽  
Cross Sectional Study ◽  
Premature Menopause ◽  
Early Menopause ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Number Of Children ◽  
Sheehan Syndrome

Objective: To evaluate the factors leading to the early onset of menopause (<40 years) in the women in the interior of Sindh. Materials and Methods: A cross-sectional study was conducted on 218 individuals among them 109 were postmenopausal women (with premature menopause)  and 109 were normal menstruating females during the period of six months from November 2014 to April  2015, data was obtained from Interior Sindh, Larkana, Hyderabad, and Benazirabad.  Factors considered were age, number of children, history of the obstetric process (ovarian and uterine), diseases, and premature menopause history in first-cousin marriages. The questionnaire data and blood samples were collected for hormonal assays such as LH,  prolactin, and FSH. The hormone levels were analyzed by ELISA method, SPSS version 17 was used for data analysis. Results:  Out of 109 subjects the percentage of early menopause due to: anorexia nervosa was 17%, brain tumor 7%, ovarian cancer 6%, hormonal disorders 23%, hysterectomy 15%, oophorectomy 5%, Pituitary gland dysfunction 4%, Sheehan Syndrome 24%, Polycystic Ovarian Syndrome (PCOS) 8%. Conclusion: Early menopause was found related to pathological and psychological factors including brain tumor, ovarian cancer, family history, Anorexia nervosa, and certain surgical interventions.

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