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  1. AU="Anderson, Richard C E"
  2. AU="Garcia, Paula"
  3. AU="Soumya Nayak"

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  1. Artikel ; Online: Neonatal Halter Traction for Severe Cervical Spine Deformity: A Technical Case Report With 2-Year Follow-up.

    Menger, Richard P / Beauchamp, Eduardo C / Alexiades, Nikita / Szpilka, Ryan T / Anderson, Richard C E

    Operative neurosurgery (Hagerstown, Md.)

    2023  Band 24, Heft 6, Seite(n) e454–e457

    Abstract: Background and importance: Although rare, severe congenital cervical spine deformity can present with limited treatment options and potentially catastrophic outcomes. The use of halter traction for cervical deformity correction in children has been well ...

    Abstract Background and importance: Although rare, severe congenital cervical spine deformity can present with limited treatment options and potentially catastrophic outcomes. The use of halter traction for cervical deformity correction in children has been well described, but it has not been previously reported in the management of neonates.
    Clinical presentation: A baby girl born at full-term gestation presented with generalized hypotonia, bilateral club feet, and significant right upper extremity weakness. Imaging demonstrated a severe congenital swan-neck deformity with spinal cord compression. Halter traction was initiated in the neonatal intensive care unit with subsequent neurological and radiographic improvement. After 7 days, traction was discontinued and she was placed in a custom-fitted cervico-thoracic orthosis. At 2 years of follow-up, she remains neurologically stable with maintained cervical alignment.
    Conclusion: Halter traction followed by external bracing is technically possible in the neonatal period. For children with severe cervical congenital deformity, this technique can reduce spinal cord compression, provide significant deformity correction, and delay the need for definitive operative spinal stabilization.
    Mesh-Begriff(e) Female ; Child ; Infant, Newborn ; Humans ; Traction/methods ; Spinal Cord Compression ; Follow-Up Studies ; Braces ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery
    Sprache Englisch
    Erscheinungsdatum 2023-02-23
    Erscheinungsland United States
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1227/ons.0000000000000651
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Pediatric Spine Trauma: A Brief Review.

    Alexiades, Nikita G / Parisi, Frank / Anderson, Richard C E

    Neurosurgery

    2020  Band 87, Heft 1, Seite(n) E1–E9

    Abstract: Pediatric spinal trauma is a broad topic with nuances specific to each anatomic region of the spinal column. The purpose of this report is to provide a brief review highlighting the most important and common clinical issues regarding the diagnosis and ... ...

    Abstract Pediatric spinal trauma is a broad topic with nuances specific to each anatomic region of the spinal column. The purpose of this report is to provide a brief review highlighting the most important and common clinical issues regarding the diagnosis and management of pediatric spine trauma. Detailed descriptions of imaging findings along with specific operative and nonoperative management of each fracture and dislocation type are beyond the scope of this review.
    Mesh-Begriff(e) Child ; Female ; Humans ; Male ; Spinal Cord Injuries ; Spinal Injuries
    Sprache Englisch
    Erscheinungsdatum 2020-07-11
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1093/neuros/nyaa119
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  3. Artikel ; Online: Association between structural rib autograft and the rate of arthrodesis in children undergoing occiput-C2 instrumentation and fusion.

    Eremiev, Alexander / Kurland, David B / Cheung, Alexander T M / Cook, Danielle / Dastagirzada, Yosef / Harter, David H / Rodriguez-Olaverri, Juan / Brockmeyer, Douglas / Pahys, Joshua M / Hedequist, Daniel / Oetgen, Matthew / Samdani, Amer F / Anderson, Richard C E

    Journal of neurosurgery. Pediatrics

    2024  , Seite(n) 1–8

    Abstract: Objective: The purpose of this study was to identify factors associated with fusion success among pediatric patients undergoing occiput-C2 rigid instrumentation and fusion.: Methods: The Pediatric Spine Study Group registry was queried to identify ... ...

    Abstract Objective: The purpose of this study was to identify factors associated with fusion success among pediatric patients undergoing occiput-C2 rigid instrumentation and fusion.
    Methods: The Pediatric Spine Study Group registry was queried to identify patients ≤ 21 years of age who underwent occiput-C2 posterior spinal rigid instrumentation and fusion and had a 2-year minimum clinical and radiographic (postoperative lateral cervical radiograph or CT scan) follow-up. Fusion failure was defined clinically if a patient underwent hardware revision surgery > 30 days after the index procedure or radiographically by the presence of hardware failure or screw haloing on the most recent follow-up imaging study. Univariate comparisons and multivariable logistic regression analyses were subsequently performed.
    Results: Seventy-six patients met inclusion criteria. The median age at surgery was 9 years (range 1.5-17.2 years), and 51% of the cohort was male. Overall, 75% of patients had syndromic (n = 41) or congenital (n = 15) etiologies, with the most frequent diagnoses of Down syndrome (28%), Chiari malformation (13%), and Klippel-Feil syndrome (12%). Data were available to determine if there was a fusion failure in 97% (74/76) of patients. Overall, 38% (28/74) of patients had fusion failure (95% CI 27%-50%). Univariate analysis demonstrated that use of a rigid cervical collar postoperatively (p = 0.04) and structural rib autograft (p = 0.02) were associated with successful fusion. Multivariable logistic regression analysis determined that patients who had rib autograft used in surgery had a 73% decrease in the odds of fusion failure (OR 0.27, 95% CI 0.09-0.82; p = 0.02). Age, etiology including Down syndrome, instrumentation type, unilateral instrumentation, use of recombinant human bone morphogenetic protein, and other variables did not influence the risk for fusion failure.
    Conclusions: In this multicenter, multidisciplinary, international registry of children undergoing occiput-C2 instrumentation and fusion, fusion failure was seen in 38% of patients, a higher rate than previously reported in the literature. The authors' data suggest that postoperative immobilization in a rigid cervical collar may be beneficial, and the use of structural rib autograft should be considered, as rib autograft was associated with a 75% higher chance of successful fusion.
    Sprache Englisch
    Erscheinungsdatum 2024-03-22
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2403985-8
    ISSN 1933-0715 ; 1933-0707
    ISSN (online) 1933-0715
    ISSN 1933-0707
    DOI 10.3171/2024.1.PEDS23419
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  4. Artikel ; Online: Modern Surgical Management of Early Onset and Adolescent Idiopathic Scoliosis.

    Beauchamp, Eduardo C / Anderson, Richard C E / Vitale, Michael G

    Neurosurgery

    2018  Band 84, Heft 2, Seite(n) 291–304

    Abstract: The early principles of spinal fusion in the adolescent population focused on preventing progression while simultaneously correcting the spinal deformity. These principles have remained relatively unchanged since their introduction more than a century ... ...

    Abstract The early principles of spinal fusion in the adolescent population focused on preventing progression while simultaneously correcting the spinal deformity. These principles have remained relatively unchanged since their introduction more than a century ago, but recent improvements in imaging, instrumentation, and corrective techniques have provided new insight on the diagnosis, management, and postoperative care of this condition. Treatment options for the management of patients with early onset scoliosis have also evolved dramatically over the last 2 decades. Further knowledge on the physiology of lung development and the detrimental effects of early fusion in the early onset scoliosis population has led to the development of growth friendly implants and other surgical techniques that allow correction of the deformity while maintaining spine, lung, and chest wall development. The following is an overview of current techniques on the management of adolescent idiopathic and early onset scoliosis to help provide guidance on the available surgical alternatives to address these conditions.
    Mesh-Begriff(e) Adolescent ; Child ; Disease Management ; Female ; Humans ; Kyphosis/diagnostic imaging ; Kyphosis/surgery ; Male ; Prostheses and Implants ; Retrospective Studies ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Spinal Fusion/methods ; Treatment Outcome ; Young Adult
    Sprache Englisch
    Erscheinungsdatum 2018-07-26
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1093/neuros/nyy267
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  5. Artikel ; Online: Younger age at spinal cord detethering is potentially associated with a reduced risk of curve progression in children with early onset scoliosis.

    Iyer, Rajiv R / Fano, Adam N / Matsumoto, Hiroko / Sinha, Rishi / Roye, Benjamin D / Vitale, Michael G / Anderson, Richard C E

    Spine deformity

    2022  Band 11, Heft 3, Seite(n) 739–745

    Abstract: Purpose: In children with early onset scoliosis (EOS) who have tethered spinal cord (TSC), spinal cord detethering is commonly performed prior to spinal deformity correction (SDC). The purpose of this study was to investigate whether age or curve ... ...

    Abstract Purpose: In children with early onset scoliosis (EOS) who have tethered spinal cord (TSC), spinal cord detethering is commonly performed prior to spinal deformity correction (SDC). The purpose of this study was to investigate whether age or curve magnitude at the time of detethering is associated with curve progression at a follow-up of at least 2 years. It was hypothesized that patients who undergo detethering at a younger age, or those with a smaller curve magnitude, would experience a reduced rate of curve progression when compared with those who are older or with larger curves.
    Methods: Patients with EOS who underwent detethering at least 2 years prior to SDC were identified in a multicenter international registry. Radiographs were assessed just prior to the detethering procedure (pre-detether) and at the most recent visit prior to SDC (most recent post-detether). The rate of curve progression > 10° was examined. Owing to unequal follow-up in individual patients, Cox regression was used to investigate associations between primary variables (age and magnitude of major coronal curve) and rate of curve progression.
    Results: 37 patients met inclusion criteria and 18 (mean age: 3.7 ± 2.9 years, 66.7% female, mean follow-up: 3.4 ± 1.3 years) had radiographic data available for analysis. Pre-detether and most recent post-detether major coronal curves were 44.8° ± 18.5° and 47.6° ± 23.9°, respectively. 5 (27.8%) patients had curve progression > 10° at a follow-up of 3.2 ± 1.2 years. Patients with progression > 10° were older at the time of detethering when compared with those without (5.6 ± 2.8 vs. 3 ± 2.7 years, p = 0.084). Regression analysis demonstrated that as age at detethering increased by 1 year, the rate of curve progression > 10° increased by 28.6% [95% confidence interval (CI) 0.899; 1.839, p = 0.169]. There was no evidence of an association between pre-detethering curve magnitude and rate of curve progression > 10° [HR: 1.027, 95% CI 0.977; 1.079, p = 0.297].
    Conclusion: In a small multicenter cohort of EOS patients with TSC, younger age, but not curve size, at the time of detethering was associated with a lower rate of scoliosis progression. Although these results indicate a potential role for early spinal cord detethering in the EOS population, they require further prospective investigation with a larger number of patients.
    Level of evidence: Level II.
    Mesh-Begriff(e) Humans ; Child ; Female ; Infant ; Child, Preschool ; Male ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Scoliosis/complications ; Treatment Outcome ; Retrospective Studies ; Neural Tube Defects/complications ; Spinal Cord
    Sprache Englisch
    Erscheinungsdatum 2022-12-14
    Erscheinungsland England
    Dokumenttyp Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-022-00612-7
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  6. Artikel ; Online: High Prevalence of Gram-Negative Rod and Multi-Organism Surgical Site Infections after Pediatric Complex Tethered Spinal Cord Surgery: Preliminary Report from a Single-Center Study.

    Alexiades, Nikita G / Shao, Belinda / Saiman, Lisa / Feldstein, Neil / Anderson, Richard C E

    Pediatric neurosurgery

    2020  Band 55, Heft 2, Seite(n) 92–100

    Abstract: Background: Surgical site infections (SSIs) are one of the most common complications following pediatric complex tethered spinal cord release. This patient population is similar in some ways to the neuromuscular scoliosis population, in which higher- ... ...

    Abstract Background: Surgical site infections (SSIs) are one of the most common complications following pediatric complex tethered spinal cord release. This patient population is similar in some ways to the neuromuscular scoliosis population, in which higher-than-expected rates of gram-negative SSIs have been identified.
    Methods: We conducted a single-center retrospective chart review of all patients who underwent complex tethered spinal cord release over a 10-year period between 2007 and 2017.
    Results: A total of 69 patients were identified, with 10 documented SSIs (14%). 50% of the SSIs were polymicrobial or included at least 1 gram-negative organism. Among the organisms isolated, 3 were fully or -partially resistant to cefazolin, the most common antibiotic prophylaxis in this population.
    Conclusion: Among children undergoing complex tethered spinal cord release, gram-negative and polymicrobial infections are a significant cause of SSIs. Although further multicenter data are needed, these findings suggest that standard antibiotic prophylaxis with cefazolin may not be sufficient.
    Mesh-Begriff(e) Child ; Child, Preschool ; Female ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/epidemiology ; Humans ; Infant ; Male ; Neural Tube Defects/diagnosis ; Neural Tube Defects/epidemiology ; Neural Tube Defects/surgery ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/trends ; Pilot Projects ; Prevalence ; Retrospective Studies ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2020-07-16
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 1091757-3
    ISSN 1423-0305 ; 1016-2291
    ISSN (online) 1423-0305
    ISSN 1016-2291
    DOI 10.1159/000508753
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  7. Artikel ; Online: Classification and Management of Pediatric Craniocervical Injuries.

    Goldstein, Hannah E / Anderson, Richard C E

    Neurosurgery clinics of North America

    2017  Band 28, Heft 1, Seite(n) 73–90

    Abstract: This article addresses the key features, clinical presentation, patterns of injury, indicated workup, and radiographic findings associated with craniocervical injuries in the pediatric population. It discusses nonsurgical and surgical management of ... ...

    Abstract This article addresses the key features, clinical presentation, patterns of injury, indicated workup, and radiographic findings associated with craniocervical injuries in the pediatric population. It discusses nonsurgical and surgical management of pediatric cervical spine trauma, addressing when each is indicated, and the various techniques available to the pediatric neurosurgeon.
    Mesh-Begriff(e) Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Child ; Humans ; Tomography, X-Ray Computed ; Trauma, Nervous System/classification ; Trauma, Nervous System/diagnostic imaging ; Trauma, Nervous System/surgery
    Sprache Englisch
    Erscheinungsdatum 2017-01
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1196855-2
    ISSN 1558-1349 ; 1042-3680
    ISSN (online) 1558-1349
    ISSN 1042-3680
    DOI 10.1016/j.nec.2016.08.001
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  8. Artikel ; Online: Resection of congenital hemivertebra in pediatric scoliosis: the experience of a two-specialty surgical team.

    Bixby, Elise C / Skaggs, Kira / Marciano, Gerard F / Simhon, Matthew E / Menger, Richard P / Anderson, Richard C E / Vitale, Michael G

    Journal of neurosurgery. Pediatrics

    2021  Band 28, Heft 3, Seite(n) 250–259

    Abstract: Objective: Institutions investigating value and quality emphasize utilization of two attending surgeons with different areas of technical expertise to treat complex surgical cases and to minimize complications. Here, the authors chronicle the 12-year ... ...

    Abstract Objective: Institutions investigating value and quality emphasize utilization of two attending surgeons with different areas of technical expertise to treat complex surgical cases and to minimize complications. Here, the authors chronicle the 12-year experience of using a two-attending surgeon, two-specialty model to perform hemivertebra resection in the pediatric population.
    Methods: Retrospective cohort data from 2008 to 2019 were obtained from the NewYork-Presbyterian Morgan Stanley Children's Hospital operative database. This database included all consecutive pediatric patients < 21 years old who underwent hemivertebra resection performed with the two-attending surgeon (neurosurgeon and orthopedic surgeon) model. Demographic information was extracted. Intraoperative complications, including durotomy and direct neurological injury, were queried from the clinical records. Intraoperative neuromonitoring data were evaluated. Postoperative complications were queried, and length of follow-up was determined from the clinical records.
    Results: From 2008 to 2019, 22 patients with a median (range) age of 9.1 (2.0-19.3) years underwent hemivertebra resection with the two-attending surgeon, two-specialty model. The median (range) number of levels fused was 2 (0-16). The mean (range) operative time was 5 hours and 14 minutes (2 hours and 59 minutes to 8 hours and 30 minutes), and the median (range) estimated blood loss was 325 (80-2700) ml. Navigation was used in 14% (n = 3) of patients. Neither Gardner-Wells tongs nor halo traction was used in any operation. Neuromonitoring signals significantly decreased or were lost in 14% (n = 3) of patients. At a mean ± SD (range) follow-up of 4.6 ± 3.4 (1.0-11.6) years, 31% (n = 7) of patients had a postoperative complication, including 2 instances of proximal junctional kyphosis, 2 instances of distal junctional kyphosis, 2 wound complications, 1 instance of pseudoarthrosis with hardware failure, and 1 instance of screw pullout. The return to the operating room (OR) rate was 27% (n = 6), which included patients with the abovementioned wound complications, distal junctional kyphosis, pseudoarthrosis, and screw pullout, as well as a patient who required spinal fusion after loss of motor evoked potentials during index surgery.
    Conclusions: Twenty-two patients underwent hemivertebra resection with a two-attending surgeon, two-specialty model over a 12-year period at a specialized children's hospital, with a 14% rate of change in neuromonitoring, 32% rate of nonneurological complications, and a 27% rate of unplanned return to the OR.
    Sprache Englisch
    Erscheinungsdatum 2021-07-02
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2403985-8
    ISSN 1933-0715 ; 1933-0707
    ISSN (online) 1933-0715
    ISSN 1933-0707
    DOI 10.3171/2020.12.PEDS20783
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  9. Artikel ; Online: The Era of Neuroendoscopy: Just How Far Can We Go?

    Goldstein, Hannah E / Anderson, Richard C E

    World neurosurgery

    2016  Band 87, Seite(n) 656–658

    Mesh-Begriff(e) Biopsy/methods ; Biopsy/mortality ; Cerebral Ventricle Neoplasms/pathology ; Cerebral Ventricles/pathology ; Female ; Humans ; Male ; Neuroendoscopy/methods ; Neuroendoscopy/mortality
    Sprache Englisch
    Erscheinungsdatum 2016-03
    Erscheinungsland United States
    Dokumenttyp Comment ; Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2015.10.046
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  10. Artikel ; Online: Assessment of craniocervical motion in Down syndrome: a pilot study of two measurement techniques.

    Martin, Jonathan E / Rocque, Brandon G / Jea, Andrew / Anderson, Richard C E / Pahys, Joshua / Brockmeyer, Douglas

    Journal of neurosurgery. Pediatrics

    2019  Band 25, Heft 1, Seite(n) 1–7

    Abstract: Objective: Hypermobility of the craniocervical junction (CCJ) in patients with Down syndrome (DS) is common. Whereas atlantoaxial (C1-2) hypermobility is well characterized, occipitoatlantal (Oc-C1) laxity is recognized but poorly defined. A clear ... ...

    Abstract Objective: Hypermobility of the craniocervical junction (CCJ) in patients with Down syndrome (DS) is common. Whereas atlantoaxial (C1-2) hypermobility is well characterized, occipitoatlantal (Oc-C1) laxity is recognized but poorly defined. A clear understanding of the risks associated with DS-related hypermobility is lacking. Research efforts to address the topic of axial cervical spine instability in the patient with DS require a reliable and reproducible means of assessing CCJ mobility. The authors conducted a pilot study comparing two methods of quantifying motion of the CCJ on dynamic (flexion/extension) plain radiographs: the delta-condyle-axial interval (ΔCAI) and the delta-basion-axial interval (ΔBAI) methods.
    Methods: Dynamic radiographs from a cohort of 10 patients with DS were evaluated according to prescribed standards. Independent movement of Oc-C1, C1-2, and Oc-C2 was calculated. Interrater and intrarater reliability for CCJ mobility was then calculated for both techniques.
    Results: Measurement using the ΔCAI technique had excellent fidelity with intraclass correlation coefficients (ICCs) of 0.77, 0.71, and 0.80 for Oc-C1, C1-2, and Oc-C2, respectively. The ΔBAI technique had lower fidelity, yielding respective ICCs of 0.61, 0.65, and 0.50.
    Conclusions: This pilot study suggests that ΔCAI is a superior measurement technique compared to ΔBAI and may provide reliable assessment of the mobility of the CCJ on dynamic radiographs in the pediatric patient with DS. The use of reliable and reproducible measurement techniques strengthens the validity of research derived from pooled database efforts.
    Sprache Englisch
    Erscheinungsdatum 2019-10-04
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2403985-8
    ISSN 1933-0715 ; 1933-0707
    ISSN (online) 1933-0715
    ISSN 1933-0707
    DOI 10.3171/2019.7.PEDS191
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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