1
|
Xiao A, Feng Y, Yu S, Xu C, Chen J, Wang T, Xiao W. General anesthesia in children and long-term neurodevelopmental deficits: A systematic review. Front Mol Neurosci 2022; 15:972025. [PMID: 36238262 PMCID: PMC9551616 DOI: 10.3389/fnmol.2022.972025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMillions of children experienced surgery procedures requiring general anesthesia (GA). Any potential neurodevelopmental risks of pediatric anesthesia can be a serious public health issue. Various animal studies have provided evidence that commonly used GA induced a variety of morphofunctional alterations in the developing brain of juvenile animals.MethodsWe conducted a systematic review to provide a brief overview of preclinical studies and summarize the existing clinical studies. Comprehensive literature searches of PubMed, EMBASE, CINAHL, OVID Medline, Web of Science, and the Cochrane Library were conducted using the relevant search terms “general anesthesia,” “neurocognitive outcome,” and “children.” We included studies investigating children who were exposed to single or multiple GA before 18, with long-term neurodevelopment outcomes evaluated after the exposure(s).ResultsSeventy-two clinical studies originating from 18 different countries published from 2000 to 2022 are included in this review, most of which are retrospective studies (n = 58). Two-thirds of studies (n = 48) provide evidence of negative neurocognitive effects after GA exposure in children. Neurodevelopmental outcomes are categorized into six domains: academics/achievement, cognition, development/behavior, diagnosis, brain studies, and others. Most studies focusing on children <7 years detected adverse neurocognitive effects following GA exposure, but not all studies consistently supported the prevailing view that younger children were at greater risk than senior ones. More times and longer duration of exposures to GA, and major surgeries may indicate a higher risk of negative outcomes.ConclusionBased on current studies, it is necessary to endeavor to limit the duration and numbers of anesthesia and the dose of anesthetic agents. For future studies, we require cohort studies with rich sources of data and appropriate outcome measures, and carefully designed and adequately powered clinical trials testing plausible interventions in relevant patient populations.
Collapse
Affiliation(s)
- Aoyi Xiao
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Feng
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Yu
- Department of Anesthesiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Chunli Xu
- Department of Anesthesiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jianghai Chen
- Department of Hand Surgery, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Wang
- Department of Anesthesiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- Tingting Wang
| | - Weimin Xiao
- Department of Anesthesiology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Weimin Xiao
| |
Collapse
|
2
|
Liu W, Xu R, Jia J, Shen Y, Li W, Bo L. Research Progress on Risk Factors of Preoperative Anxiety in Children: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169828. [PMID: 36011459 PMCID: PMC9407918 DOI: 10.3390/ijerph19169828] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/23/2022] [Accepted: 08/08/2022] [Indexed: 06/01/2023]
Abstract
Preoperative anxiety has adverse effects on children and negative impacts on postoperative rehabilitation. Anesthesiologists can accurately identify children with preoperative anxiety, and individualized intervention can effectively improve their psychological state and clinical prognosis. However, a comprehensive summary of the current available evidence has yet to be conducted. Searches were conducted in Medline databases from inception to March 2022. Primary studies that reported preoperative anxiety in children and its attendant effects on postoperative recovery and prognosis were screened and included. Among the 309 publications identified, 12 related studies (n = 3540 patients) met the eligibility criteria. The incidence of preoperative anxiety in children in the included studies ranged from 41.7% to 75.44%. While 16 influencing factors were identified, only 5 factors had a significant impact on preoperative anxiety in children: younger age (n = 8), parental anxiety (n = 7), negative previous hospitalizations (n = 3), less sociableness (n = 2), and surgical setting (n = 1). The current scoping review identified risk factors for preoperative anxiety in children. Healthcare workers should identify and manage preoperatively anxious children. There are still some factors that are controversial, and large-scale clinical studies are needed.
Collapse
Affiliation(s)
- Weiwei Liu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Rui Xu
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Ji’e Jia
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Yilei Shen
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Wenxian Li
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
| | - Lulong Bo
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| |
Collapse
|
3
|
Seidel CP, Gilday SE, Jain VV, Sturm PF. How much does depth matter? Magnetically controlled growing rod distraction directly influenced by rod tissue depth. Spine Deform 2022; 10:177-182. [PMID: 34570308 DOI: 10.1007/s43390-021-00399-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Magnetically controlled growing rod (MCGR) for the treatment of early-onset scoliosis (EOS) is a relatively innovative technique. MCGR benefits over traditional growing rods are known but limitations and complications are being revealed. The purpose of this study was to examine the importance of tissue depth on rod lengthening. METHODS A single-institution retrospective review of 72 MCGR patients was performed. Ultrasound measured rod distraction. Differences in programmed and actual distraction, and complications were recorded. Tissue depths and achieved length were averaged and used to construct a regression to account for variability. RESULTS Percentage of std and offset orientation rod lengthening relative to the programmed distraction was inversely proportional to rod depth (std R = 0.50, p = 0.002) (offset R = 0.60, p < 0.001). Expected std rod lengthening achieved decreased by 1.46%/mm depth. Expected offset rod lengthening achieved decreased by 1.68%/mm depth. 28 pts (38.9%) sustained complications. Age, sex, BMI, standard tissue depth, and/or offset tissue depth had no predictive ability with respect to complications sustained (overall model R = 0.31, p = 0.36). CONCLUSION In a series of EOS surgical patients treated with MCGRs, the relationship between percentage of programmed lengthening achieved as well as total lengthening was inversely proportional to tissue depth of the rod. There was a trend towards increasing frequency of complications recorded with decreasing tissue depth though this was not significant. These data can help with surgical planning during MCGR placement.
Collapse
Affiliation(s)
| | - Sarah E Gilday
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Viral V Jain
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Peter F Sturm
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
| |
Collapse
|
4
|
Sozbilen MC, Evren Sahin K. Long-term efficacy and safety of repeated botulinum toxin a applications based on function and anesthesia type in children with cerebral palsy. J Orthop 2021; 29:22-27. [PMID: 35027815 PMCID: PMC8731691 DOI: 10.1016/j.jor.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE This study evaluates the motor development of patients undergoing three or more repeated Botulinum toxin A (BoNT-A) applications in a tertiary pediatric hospital as well as the safety of three different types of anesthesia. METHODS Seventy-five children who underwent BoNT-A applications at least three consecutive times at six-month intervals and a total of 320 procedures were examined. Gross Motor Function Classification System (GMFCS) was employed in motor development evaluation. The three anesthesia methods (sedation analgesia, anesthesia with larengeal mask [LMA] and inhalation mask) were compared in terms of sedation, procedure, recovery, and total operation room time. RESULTS Following the procedures, significant motor development was observed in 60 (80%) patients. In sedation analgesia group during the first three procedures, the recovery time was seen to be significantly shorter, while there was no difference between the anesthesia methods of any procedures following the fourth. Regardless of the type of anesthesia, the recovery times of those having undergone six or more procedures were longer than those with less than six procedures. CONCLUSIONS As repeated BoNT-A application provides motor step progress, it can be applied safely and effectively under anesthesia. Sedation analgesia provides an easier recovery compared to LMA and mask only within the first three applications. However, recovery time increases with four or more repeated applications, specifically increasing as the number of applications increases. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Murat Celal Sozbilen
- Department of Orthopaedic Surgery, School of Medicine Hospital, Ege University, Bornova, Izmir, Turkey,Corresponding author.
| | - Kubra Evren Sahin
- Department of Anesthesiology and Reanimation, Dr Behcet Uz Child Diseases and Surgery Research and Training Hospital, Konak, Izmir, Turkey
| |
Collapse
|
5
|
Chang WC, Hsu KH, Feng CK. Pulmonary function and health-related quality of life in patients with early onset scoliosis after repeated traditional growing rod procedures. J Child Orthop 2021; 15:451-457. [PMID: 34858531 PMCID: PMC8582615 DOI: 10.1302/1863-2548.15.210021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate pulmonary function and health-related quality of life after traditional growing rod (TGR) procedures. METHODS Between January 2006 and December 2017, a retrospective observational study of 17 early onset scoliosis (EOS) patients with a mean follow-up of 6.2 years (2.3 to 10.4) was conducted. The forced expiratory volume in one second (FEV1), expiratory forced vital capacity (FVC) and 24-Item Early Onset Scoliosis Questionnaire (EOSQ-24) score before the index surgery and at last follow-up were investigated. RESULTS The mean percentage of predicted FEV1 improved from 50% (20% to 86%) to 53% (15% to 80%; p = 0.08); and the mean percentage of predicted FVC improved from 51% (24% to 81%) to 55% (25% to 89%; p = 0.06). The mean EOSQ-24 score was 78.2 (58 to 90) preoperatively and 77.2 (55 to 88) at last follow-up, there was no statistical difference (p = 0.70). The subdomain scores of pulmonary function (p < 0.01) and daily living (p < 0.01) significantly improved, whereas the subdomain scores of pain (p < 0.01), emotion (p < 0.01) and satisfaction (p = 0.02) significantly declined at last follow-up. CONCLUSION The TGR procedure was associated with stable pulmonary function and decline in EOSQ-24 pain, emotion and satisfaction scores. LEVEL OF EVIDENCE Level III, retrospective cohort study.
Collapse
Affiliation(s)
- Wen-Chieh Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuei-Hsiang Hsu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Kuang Feng
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Correspondence should be sent to: Chi-Kuang Feng, MD, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taiwan. E-mail:
| |
Collapse
|
6
|
Evaluation of Neurotoxicity of Multiple Anesthesia in Children Using Visual Evoked Potentials. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2019; 53:284-289. [PMID: 32377097 PMCID: PMC7192278 DOI: 10.14744/semb.2018.59454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/30/2018] [Indexed: 12/19/2022]
Abstract
Objectives: Anesthetic applications may cause increased neuronal damage in infants and children. Commonly cognitive or learning disability tests were used to investigate the neurological progress in children. Visual Evoked Potential is a gross electrical signal generated by the occipital regions of the cerebral cortex in response to visual stimulation and an objective assessment of brain function. In this study, to acquire more objective results, Visual Evoked Potential responses of children who had multiple exposures to anesthesia during the treatment of corrosive esophagitis were compared to children who have never received anesthesia before. Methods: In this prospective, single-blinded, randomized, controlled study, 25 children, who were admitted to our pediatric surgery clinic because of corrosive esophagitis and who received general anesthesia more than 15 times composed Group-P; 25 children, who admitted to our well-child-clinic and who had never received anesthesia before consisted Group-C. The flash and pattern VEP responses of both groups were measured at the electrophysiology laboratory without any anesthetic drug application. The VEP responses of children in Group-P were recorded at least three days after the last exposure to anesthesia. Results: Latencies and amplitudes of the N2 and P2 components of the pattern and flash VEP responses were statistically significantly different between the two groups (p=0.000). Conclusion: This study shows that in children who had repeated anesthetic applications VEP parameters are significantly altered. We believe that VEP responses may be a reliable objective criterion for the evaluation of anesthesia neurotoxicity.
Collapse
|
7
|
Propofol Induces Postoperative Depression and Inhibits Microglial Function in Mice. Mediators Inflamm 2019; 2019:7651383. [PMID: 31281228 PMCID: PMC6590526 DOI: 10.1155/2019/7651383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022] Open
Abstract
Many patients experience excellent physical recoveries after surgery; however, there are some of them who from suffer mood fluctuation, even depression. Postoperative depression may be resulted from cognitive dysfunction, pain, and a compromised immune system during the surgery. But there is a higher possibility that general anaesthesia may be responsible for the development of depression. Here, we employed one of the most used anaesthetics, propofol, in a mouse model to investigate whether this intravenous anaesthetic compound could cause depressive-like behavioural performance in mice. We found a single dose of propofol caused significant abnormal behavioural performance in tail suspension, forced swimming, and open field tests. We also examined the brain section of these mice and revealed that there was significant reduced expression of the CD11b protein, which demonstrated an inhibition of propofol on microglial function. We investigated the effect of propofol on synaptic protein, SYP, and found there was no notable influence on the protein expression. These above results suggested that propofol treatment might promote the depressive-like behaviours in mice via influencing the microglial cell function. Furthermore, we found the level of the IL-6 cytokine was significantly increased in the brain tissue, which might subsequently cause the activation of the transcriptional factor, STAT3. Our finding may provide a new perspective of further understanding the mechanism of anaesthetic drugs and deciphering the underlying mechanism of postoperative depression.
Collapse
|
8
|
Bakri MH, Ismail EA, Ali MS, Elsedfy GO, Sayed TA, Ibrahim A. Behavioral and emotional effects of repeated general anesthesia in young children. Saudi J Anaesth 2015; 9:161-6. [PMID: 25829904 PMCID: PMC4374221 DOI: 10.4103/1658-354x.152843] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Preclinical and clinical data suggest the possibility of neurotoxicity following exposure of young children to general anesthetics with subsequent behavioral disturbances. The aim of the study was to determine the overall effect of repeated general anesthesia on behavior and emotions of young children aged 1½-5 years old, compared to healthy children. MATERIALS AND METHODS Thirty-five children underwent repeated anesthesia and surgery were matched with the same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist (CBCL) 1½-5 years and Diagnostic and Statistical Manual of Mental Disorders (DSM) oriented scale. Behavior data were collected through a semi-structured questionnaire. RESULTS The CBCL score revealed that children with repeated anesthesia were at risk to become anxious or depressed (relative risk [RR]; 95% confidence interval [CI] = 11 [1.5-80.7]), to have sleep (RR; 95% CI = 4.5 [1.1-19.4]), and attention problems (RR; 95% CI = 8 [1.1-60.6]). There was no difference in the risk between the two groups regarding emotionally reactive, somatic complaints, withdrawn problems, aggressive behavior, internalizing or externalizing problems. On DSM scale, children with repeated anesthesia were at risk to develop anxiety problems (RR; 95% CI = 3.7 [1.1-12.0]), and attention deficit/hyperactivity problems (RR; 95% CI = 3 [1.1-8.4]). There was no difference in the risk between the two groups regarding affective, pervasive developmental and oppositional defiant problems. CONCLUSION Young children who undergone repeated surgical procedures under general anesthesia were at risk for subsequent behavioral and emotional disturbances. Proper perioperative pain management, social support, and avoidance of unpleasant surgical experiences could minimize these untoward consequences.
Collapse
Affiliation(s)
- Mohamed H Bakri
- Department of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eman A Ismail
- Department of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mohamed S Ali
- Department of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ghada O Elsedfy
- Department of Pediatric, Faculty of Medicine, Children's Hospital, Assiut University, Assiut, Egypt
| | - Taher A Sayed
- Department of Psychiatry, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Ibrahim
- Department of Community Medicine, Faculty of Medicine, University of Western Kordofan, Sudan
| |
Collapse
|
9
|
Oofuvong M, Geater AF, Chongsuvivatwong V, Chanchayanon T, Worachotekamjorn J, Sriyanaluk B, Saefung B, Nuanjun K. Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study. SPRINGERPLUS 2014; 3:164. [PMID: 25674447 PMCID: PMC4320222 DOI: 10.1186/2193-1801-3-164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 03/21/2014] [Indexed: 11/10/2022]
Abstract
Purpose To determine whether perioperative desaturation (PD) in preschool children undergoing non-cardiac surgery is associated with subsequent impairment of intelligence or subsequent change in age-specific weight and height percentile. Method A historical-concurrent follow-up study was conducted in children aged ≤ 60 months who underwent general anesthesia (GA) for non-cardiac surgery between January 2008 and December 2011 at Songklanagarind Hospital. Children who developed PD (PD group) and children who did not develop perioperative respiratory events (no-PRE group) were matched on sex, age, year of having index GA, type of surgery and choice of anesthesia. The children’s age-specific weight and height percentile and intelligence quotient (IQ) scores by Standford Binet-LM or Wechsler Intelligence Scale for Children, 3rd edition 12–60 months after GA were compared using Student’s t- test and Wilcoxon’s rank sum test. Multivariate linear regression models for standardized IQ and multivariate mixed effects linear regression models for the change of age-specific weight and height percentile from the time of index GA to the time of IQ test were performed to identify independent predictors. The coefficients and 95% confidence intervals (CI) were displayed and considered significant if the F test p-values were < 0.05. Results Of 103 subjects in each group (PD vs no-PRE), there were no statistically significant differences in IQ (94.7 vs 98.3, p = 0.13), standardized IQ (−0.1 vs 0.1, p = 0.14) or age-specific weight percentile (38th vs 63th, p = 0.06). However, age-specific height percentile in the PD group at the time of IQ test was significantly lower (38th vs 50th, p = 0.02). In the multivariate analysis, PD was not a significant predictor for standardized IQ (coefficient: −0.06, 95% CI: −0.3, 0.19, p = 0.57), change in age-specific weight percentile (coefficient: 4.66, 95% CI: −2.63, 11.95, p = 0.21) or change in age-specific height percentile (coefficient: −1.65, 95% CI: −9.74, 6.44, p = 0.69) from the time of index GA to the time of IQ test after adjusting for family and anesthesia characteristics. Conclusion Our study could not demonstrate any serious effect of PD on subsequent intelligence or on the change in age-specific weight and height percentile of children after non-cardiac surgery. Electronic supplementary material The online version of this article (doi:10.1186/2193-1801-3-164) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Maliwan Oofuvong
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | - Alan Frederick Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | | | - Thavat Chanchayanon
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | - Juthamas Worachotekamjorn
- Division of Child Development, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | - Bussarin Sriyanaluk
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | - Boonthida Saefung
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| | - Kanjana Nuanjun
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90112 Thailand
| |
Collapse
|
10
|
Akbarnia BA, Campbell RM, Dimeglio A, Flynn JM, Redding GJ, Sponseller PD, Vitale MG, Yazici M. Fusionless procedures for the management of early-onset spine deformities in 2011: what do we know? J Child Orthop 2011; 5:159-72. [PMID: 22654977 PMCID: PMC3100462 DOI: 10.1007/s11832-011-0342-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 04/11/2011] [Indexed: 02/03/2023] Open
Abstract
While attempts to understand them better and treat them more effectively, early-onset deformities have gained great pace in the past few years. Large patient series with long follow-ups that would provide high levels of evidence are still almost non-existent. That there is no safe treatment algorithm defined and agreed upon for this patient population continues to pose a challenge for pediatric spine surgeons. In this review, authors who are well known for their research and experience in the treatment of early-onset scoliosis (EOS) have come together in order to answer those questions which are most frequently asked by other surgeons. The most basic eight questions in this field have been answered succinctly by these authors and a current overview is provided.
Collapse
Affiliation(s)
| | - Robert M. Campbell
- />Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Alain Dimeglio
- />Service de Chirurgie Orthopedique Pediatrique, CHU Lapeyronie, Montpellier, Cedex 5, France
| | - Jack M. Flynn
- />Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Gregory J. Redding
- />Pulmonary Division, Seattle Children’s Hospital, University of Washington, Seattle, WA USA
| | | | | | - Muharrem Yazici
- />Department of Orthopaedics, Faculty of Medicine, Hacettepe University, 06100 Sıhhıye, Ankara, Turkey
| |
Collapse
|