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  1. Artikel ; Online: A Comparative Analysis of Revision Surgery Before or After 2 Years After Graduation From Growth-friendly Surgery for Early Onset Scoliosis.

    Prior, Anjali / Hardesty, Christina K / Emans, John B / Thompson, George H / Sponseller, Paul D / Smith, John T / Skaggs, David L / Vaughan, Majella / Barfield, William R / Murphy, Robert F

    Journal of pediatric orthopedics

    2023  Band 43, Heft 8, Seite(n) 481–485

    Abstract: Introduction: After discontinuation of growth-friendly (GF) surgery for early onset scoliosis, patients are termed graduates: they undergo a spinal fusion, are observed after final lengthening with GF implant maintenance, or are observed after GF ... ...

    Abstract Introduction: After discontinuation of growth-friendly (GF) surgery for early onset scoliosis, patients are termed graduates: they undergo a spinal fusion, are observed after final lengthening with GF implant maintenance, or are observed after GF implant removal. The purpose of this study was to compare the rates of and reasons for revision surgery in two cohorts of GF graduates: before or after 2 years of follow-up from graduation.
    Methods: A pediatric spine registry was queried for patients who underwent GF spine surgery with a minimum of 2 years of follow-ups after graduation by clinical and/or radiographic evidence. Scoliosis etiology, graduation strategy, number of, and reasons for revision surgery were queried.
    Results: There were 834 patients with a minimum of 2-year follow-up after graduation who were analyzed. There were 241 (29%) congenital, 271 (33%) neuromuscular, 168 (20%) syndromic, and 154 (18%) idiopathic. 803 (96%) had traditional growing rod/vertical expandable titanium rib as their GF construct and 31 (4%) had magnetically controlled growing rod. Five hundred ninety-six patients (71%) underwent spinal fusion at graduation, 208 (25%) had GF implants retained, and 30 (4%) had GF implants removed.In the entire cohort, there were 108/834 (13%) patients who underwent revision surgery. Of the revisions, 71/108 (66%) occurred as acute revisions (ARs) between 0 and 2 years from graduation (mean 0.6 y), and the most common AR indication was infection (26/71, 37%). The remaining 37/108 (34%) patients underwent delayed revision (DR) surgery >2 years (mean 3.8 y) from graduation, and the most common DR indication was implant issues (17/37, 46%).Graduation strategy affected revision rates. Of the 596 patients with spinal fusion as a graduation strategy, 98/596 (16%) underwent revision, compared with only 8/208 (4%) patients who had their GF implants retained, and 2/30 (7%) that had their GF implants removed ( P ≤ 0.001).A significantly higher percentage of the ARs had a spinal fusion as the graduation strategy (68/71, 96%) compared with 30/37 DRs, (81%, P = 0.015). In addition, the 71 patients who underwent AR undergo more revision surgeries (mean: 2, range: 1 to 7) than 37 patients who underwent DR (mean: 1, range: 1 to 2) ( P = 0.001).
    Conclusion: In this largest reported series of GF graduates to date, the overall risk of revision was 13%. Patients who undergo a revision at any time, as well as ARs in particular, are more likely to have a spinal fusion as their graduation strategy. Patients who underwent AR, on average, undergo more revision surgeries than patients who underwent DR.
    Level of evidence: Level III, comparative.
    Mesh-Begriff(e) Child ; Humans ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Scoliosis/etiology ; Reoperation ; Retrospective Studies ; Spine/surgery ; Prostheses and Implants ; Spinal Fusion/adverse effects ; Treatment Outcome
    Sprache Englisch
    Erscheinungsdatum 2023-07-03
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002467
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 1681: Hefte anzeigen Standort:
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  2. Artikel ; Online: Extracorporeal photopheresis for the treatment of chronic graft versus host disease.

    Kansu, Emin / Ward, David / Sanchez, Amber P / Cunard, Robyn / Hayran, Mutlu / Huseyin, Beril / Vaughan, Majella / Ku, Grace / Curtin, Peter / Mulroney, Carolyn / Costello, Caitlin / Castro, Januario E / Wieduwilt, Matthew / Corringham, Sue / Ihasz-Davis, Anita / Nelson, Connie / Ball, Edward D

    Hematology (Amsterdam, Netherlands)

    2022  Band 27, Heft 1, Seite(n) 785–794

    Abstract: Objectives: Chronic graft versus host disease (chronic GVHD) still remains the leading cause of late morbidity and mortality for allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. In this retrospective study, 53 consecutive allo-HSCT ... ...

    Abstract Objectives: Chronic graft versus host disease (chronic GVHD) still remains the leading cause of late morbidity and mortality for allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. In this retrospective study, 53 consecutive allo-HSCT patients with chronic GVHD refractory to corticosteroids were treated with extracorporeal photopheresis (ECP).
    Methods: This study was performed as a retrospective single-center study. Medical records of a total of 59 patients treated with ECP for chronic GVHD were reviewed.
    Results: Best organ responses to ECP were observed in skin, mouth mucosa, eyes and liver. Overall response rate (ORR) to ECP was 81.2% (CR 17% and PR 64.2%). Overall survival (OS) was 84.9% and 36.7%, at 1 and 3 years, respectively. Female sex appears to have an advantage on ORR. Patients achieving ORR were able to maintain their responses with a prolonged continuation of treatments for +6 and +12 months indicating the benefits of longer ECP treatment.
    Discussion: We found that patients with chronic GVHD who were treated with ECP for 12 months or longer had a higher response rate. Our findings in line with the data reported previously suggest that patients responding to ECP should continue longer therapy schedules to achieve a better and sustained response. In our cohort, long-term ECP therapy was safe and well-tolerated with no significant adverse effects. Best responses were observed in the patients with skin, eye, liver and oral involvement. The ECP procedure offers the advantage relative to the problems with typical immunosuppressive agents. The female sex appeared to have an advantage based on the cumulative probability of the OR after ECP for chronic GVHD.
    Mesh-Begriff(e) Chronic Disease ; Female ; Graft vs Host Disease/etiology ; Graft vs Host Disease/therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Photopheresis/adverse effects ; Photopheresis/methods ; Retrospective Studies ; Transplantation, Homologous/adverse effects
    Sprache Englisch
    Erscheinungsdatum 2022-07-08
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1341428-8
    ISSN 1607-8454 ; 1024-5332 ; 1024-5340
    ISSN (online) 1607-8454
    ISSN 1024-5332 ; 1024-5340
    DOI 10.1080/16078454.2022.2095884
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 4538: Hefte anzeigen Standort:
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  3. Artikel ; Online: Magnetically Controlled Growing Rods (MCGR) Versus Single Posterior Spinal Fusion (PSF) Versus Vertebral Body Tether (VBT) in Older Early Onset Scoliosis (EOS) Patients: How Do Early Outcomes Compare?

    Mackey, Catherine / Hanstein, Regina / Lo, Yungtai / Vaughan, Majella / St Hilaire, Tricia / Luhmann, Scott J / Vitale, Michael G / Glotzbecker, Michael P / Samdani, Amer / Parent, Stefan / Gomez, Jaime A

    Spine

    2021  Band 47, Heft 4, Seite(n) 295–302

    Abstract: Study design: Retrospective review of prospective data from multicenter registry.: Objective: Compare outcomes of posterior spinal fusion (PSF) versus magnetically controlled growing rods (MCGR) versus vertebral body tethers (VBT) in 8- to 11-year- ... ...

    Abstract Study design: Retrospective review of prospective data from multicenter registry.
    Objective: Compare outcomes of posterior spinal fusion (PSF) versus magnetically controlled growing rods (MCGR) versus vertebral body tethers (VBT) in 8- to 11-year-old idiopathic early onset scoliosis (EOS) patients.
    Summary of background data: In EOS, it is unclear at what age the benefit of growth-sparing strategies outweighs increased risks of surgical complications, compared with PSF.
    Methods: One hundred thirty idiopathic EOS patients, 81% female, aged 8-11 at index surgery (mean 10.5 yrs), underwent PSF, MCGR, or VBT. Scoliosis curve, kyphosis, thoracic and spinal height, complications, and Quality of Life (QoL) were assessed preoperatively and at most recent follow-up (prior to final fusion for VBT/MCGR).
    Results: Of 130 patients, 28.5% received VBT, 39.2% MCGR, and 32.3% PSF. The VBT cohort included more females (P < 0.0005), was older (P < 0.0005), more skeletally mature (P < 0.0005), and had smaller major curves (P < 0.0005). At follow-up, scoliosis curve corrected 41.1 ± 22.4% in VBT, 52.2 ± 19.9% in PSF, and 27.4 ± 23.9% in MCGR (P < 0.0005), however, not all VBT/MCGR patients finished treatment. Fifteen complications occurred in 10 VBTs, 6 requiring unplanned surgeries; 45 complications occurred in 31 MCGRs, 11 requiring unplanned surgeries, and 9 complications occurred in 6 PSFs, 3 requiring unplanned revisions. Cox proportional hazards regression adjusted for age, gender, and preoperative scoliosis curve revealed that MCGR (hazard ratio [HR] = 21.0, 95% C.I. 4.8-92.5; P < 0.001) and VBT (HR = 7.1, 95% C.I. 1.4-36.4; P = 0.019) patients were at increased hazard of requiring revision, but only MCGR patients (HR = 5.6, 95% C.I. 1.1-28.4; P = 0.038) were at an increased hazard for unplanned revisions compared with PSF. Thoracic and spinal height increased in all groups. QoL improved in VBT and PSF patients, but not in MCGR patients.
    Conclusion: In older idiopathic EOS patients, MCGR, PSF, and VBT controlled curves effectively and increased spinal height. However, VBT and PSF have a lower hazard for an unplanned revision and improved QoL.Level of Evidence: 3.
    Mesh-Begriff(e) Aged ; Child ; Female ; Humans ; Male ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Scoliosis/surgery ; Spinal Fusion/adverse effects ; Treatment Outcome ; Vertebral Body
    Sprache Englisch
    Erscheinungsdatum 2021-09-28
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Multicenter Study
    ZDB-ID 752024-4
    ISSN 1528-1159 ; 0362-2436
    ISSN (online) 1528-1159
    ISSN 0362-2436
    DOI 10.1097/BRS.0000000000004245
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 1305: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Artikel ; Online: No Difference in the Rates of Unplanned Return to the Operating Room Between Magnetically Controlled Growing Rods and Traditional Growth Friendly Surgery for Children With Cerebral Palsy.

    Sun, Margaret Man-Ger / Buckler, Nicholas J / Al Nouri, Mason / Howard, Jason J / Vaughan, Majella / St Hilaire, Tricia / Sponseller, Paul D / Smith, John T / Thompson, George H / El-Hawary, Ron

    Journal of pediatric orthopedics

    2021  Band 42, Heft 2, Seite(n) 100–108

    Abstract: Background: Early-onset scoliosis (EOS) is common in children with cerebral palsy (CP). The effectiveness of magnetically controlled growing rods (MCGR) and the risk for unplanned return to the operating room (UPROR) remain to be studied in this patient ...

    Abstract Background: Early-onset scoliosis (EOS) is common in children with cerebral palsy (CP). The effectiveness of magnetically controlled growing rods (MCGR) and the risk for unplanned return to the operating room (UPROR) remain to be studied in this patient population. The primary outcome of this study was to examine the frequency of UPROR between MCGRs as compared with traditional growth friendly (TGF) surgeries for children with EOS secondary to CP.
    Methods: Patients with EOS secondary to CP were prospectively identified from an international database, with data retrospectively analyzed. Scoliosis, kyphosis, T1-S1, and T1-T12 height were measured preoperation, immediate postoperation, and at minimum 2-year follow-up. The risk and etiology of UPRORs were compared between MCGR and TGF.
    Results: Of the 120 patients that met inclusion criteria, 86 received TGF (age 7.5±0. 1.8 y; mean follow-up 7.0±2.9 y) and 34 received MCGR (age 7.1±2.2 y, mean follow-up 2.8±0.0.5 y). Compared with TGF, MCGR resulted in significant improvements in maintenance of scoliosis (P=0.007). At final follow-up, UPRORs were 8 of 34 patients (24%) for MCGR and 37 of 86 patients (43%) for TGF (P=0.05). To minimize the influence of follow-up period, UPRORs within the first 2 years postoperation were evaluated: MCGR (7 of 34 patients, 21%) versus TGF (20 of 86 patients, 23%; P=0.75). Within the first 2 years, etiology of UPROR as a percentage of all patients per group were deep infection (13% TGF, 6% MCGR), implant failure/migration (12% TGF, 9% MCGR), dehiscence (4% TGF, 3% MCGR), and superficial infection (4% TGF, 3% MCGR). The most common etiology of UPROR for TGF was deep infection and for MCGR was implant failure/migration.
    Conclusion: For patients with EOS secondary to CP, there was no difference in the risk of UPROR within the first 2 years postoperatively whether treated with TGF surgery or with MCGRs (23% TGF, 21% MCGR).
    Level of evidence: Level III-retrospective cohort, therapeutic study.
    Mesh-Begriff(e) Cerebral Palsy ; Child ; Child, Preschool ; Humans ; Kyphosis ; Operating Rooms ; Retrospective Studies ; Scoliosis/surgery
    Sprache Englisch
    Erscheinungsdatum 2021-10-07
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000001892
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 1681: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Über subito bestellen

    Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.

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