European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Case Reports
Balloon kyphoplasty and percutaneous fixation of lumbar fractures in pediatric patients.
Type A fractures of the spine requiring operative stabilization are rare injuries in the pediatric population. Current reports have demonstrated the safety of the combination of balloon kyphoplasty and minimal invasive management of thoraco-lumbar fractures in adults. There is no information about the efficacy of this approach in managing pediatric vertebral fractures. ⋯ This study is the first one to present an excellent outcome of children with type A fractures treated with a combination of balloon kyphoplasty and percutaneous stabilization.
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The occurrence of spinal epidural haematoma of 'spontaneous' origin in adults is a well-documented entity, though it is rare in children. In the literature to date, there are few cases of this kind of spontaneous haematoma proven to be due to an underlying vascular abnormality. ⋯ These are the first two such cases described with clinico-pathological correlation.
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Lumbar spondylolysis, a stress fracture of the pars interarticularis in the lumbar spine, is often precipitated by trauma, but there may be a congenital predisposition to this condition. There have been few studies on spondylolysis in young children, despite their suitability for studies on congenital defects. The aim of this study was to identify the clinical features of lumbar spondylolysis in elementary school age children in order to elucidate its pathogenesis. ⋯ Lumbar spondylolysis in elementary school age children was commonly a terminal-stage bone defect at L5, which was not necessarily related to history of athletic activity and was sometimes asymptomatic. It was often associated with SBO, indicating a possible congenital predisposition. These findings may provide further insight into the pathogenesis of lumbar spondylolysis.
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Previous studies have demonstrated vertebral coplanar alignment (VCA) as an effective surgical option for adolescent idiopathic scoliosis (AIS). The purpose of this study is to analyze the outcome of VCA for the surgical correction of adult idiopathic scoliosis (AdIS). ⋯ VCA can be effectively used for the correction of the coronal and rotational deformity, with better sagittal profile restoration in adult thoracic idiopathic scoliosis with sagittal malalignment.
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Observational Study
Bacterial colonization of VEPTR implants under repeated expansions in children with severe early onset spinal deformities.
Historically, severe spinal and thoracic deformities in children were treated with early long spinal fusions. This prevented further growth of the spine and thorax and often led to small stiff thoraces. Therefore, growth-retaining implants, like vertical expandable titanium ribs (VEPTR), were developed to stimulate thoracic and spinal growth. To accommodate growth, these implants have to be expanded every 6 months. Infection rates of up to 2 % per procedure are reported. Exchange of implant parts allows analyzing the development of implant-related infections and subclinical colonizations. ⋯ The rate of implant colonization is 4.5 times higher than the rate of manifest infections in VEPTR patients. Colonization may lead to a manifest infection over time. The knowledge of persistent implant colonization may change the treatment algorithm in patients with growth-retaining implants.