Journal of pediatric orthopedics
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Randomized Controlled Trial
Does preoperative orientation and education alleviate anxiety in posterior spinal fusion patients? A prospective, randomized study.
A prospective, randomized study examined the effect of interventional preoperative education and orientation for scoliosis surgery (PEOSS) on anxiety levels of patients undergoing posterior spinal fusion (PSF). Secondary outcomes analyzed were caregiver anxiety, length of stay, morphine equivalent usage, and patient/caregiver satisfaction. ⋯ Level I study.
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To report on early failures of pelvic fixation in posterior spinal fusions for neuromuscular scoliosis. ⋯ Level IV.
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Chronic pain is associated with increased anxiety, depression, and maladaptive behaviors, especially in adolescents. We hypothesized that adolescents with chronic hip pain selected for hip preservation surgery (HPS) would demonstrate increased anxiety and depression compared with same-age peers. We designed a study to assess the psychological state of adolescents before HPS. ⋯ Preoperative evaluation identified patients who reported at-risk or clinically significant symptoms of anxiety and/or depression, with up to one third of patients reporting maladaptive behavior that may significantly influence their postoperative outcomes. Preoperative psychological evaluation, with appropriate intervention and follow-up, if needed, should be considered before surgery selection as mental health conditions may be undiagnosed and will likely influence functional outcomes.
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Joint pain and raised inflammatory markers are features of both acute rheumatic fever (ARF) and septic arthritis, often posing a diagnostic challenge to clinicians. Important differences in the presenting serological inflammatory marker profile may assist patient diagnosis, however, as clinical experience suggests that ARF is associated with a higher erythrocyte sedimentation rate (ESR), whereas other serological markers may be similarly elevated in these 2 conditions. ⋯ ARF and septic arthritis are important diagnoses to consider in children presenting with acute joint pain in New Zealand. A significant proportion of patients with ARF initially present with acute monoarthritis. Serological inflammatory markers and WCC on presentation differ significantly between children with ARF and septic arthritis.
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The incidence of late infection published in the literature varies from 1% to 12% with varying definition of late infection (range, 3 mo to 1 y). Current evidence suggests implant removal and antibiotic therapy is necessary to clear these infections. A high incidence of late (>1 y) deep infection after instrumented spinal fusion was identified at our institution. We sought to evaluate the efficacy of our management of these patients. ⋯ retrospective comparative study.