Ernesto Bersusky - Academia.edu (original) (raw)
Papers by Ernesto Bersusky
Orthopaedic Proceedings, Nov 1, 2002
Malignant hyperthermia (MH) is a pharmacogenetic disorder, potentially lethal, due to the exposur... more Malignant hyperthermia (MH) is a pharmacogenetic disorder, potentially lethal, due to the exposure to anesthetic drugs that triggers, a high increase of corporal temperature, progressive muscular stiffness, severe rabdomiolisis and death due to cardiac dysfunction. Many research works relate Malignant Hyperthermia to muscular illnesses or to the King Syndrome. Through this study we present the incidence of MH in patients with congenital vertebrae malformations. (CVM) The objective is to establish the incidence of the MH in patients who were operated on CVM and to alert about this association. 1029 patients with CVM were treated between 1972 and 2000. 390 with congenital vertebrae malformation were operated on. 3 patients (0.76%) (1 girl and 2 boys) developed MH while they underwent surgical treatment for the CVM. 1 patient presented an isolated congenital vertebrae malformation. 1 patient presented King Syndrome and the other presented Robert Syndrome. Only 1 elevated amount of preoperative CPK was found (the are no reports on the others). No muscular biopsy was done to test sensitivity. Two of them were biopsied for a post episode study. At the surgical moment, any patients reported personal or familiar antecedents of MH. No deaths were reported, although it is considered as a potentially lethal disorder. We found no reports in the literature in this subject. Most of the bibliographic data belonged to anesthesiologists or geneticists. Our approach as spine surgeons leaded us to the detailed analysis of this studies and the 0.76% (3 out of 390) incidence suggested us to have an alert attitude when facing patients with surgical MVC and take the necessary precautions.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de... more El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la ortopedia y traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definimos su uso e incluimos bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Aug 31, 2022
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Global Spine Journal, May 1, 2015
This study aims to describe surgical technique of locally wound autologous bone conservation when... more This study aims to describe surgical technique of locally wound autologous bone conservation when primary surgery becomes mandatory to be staged, described as well the evolution and technique complications.
Global Spine Journal, May 1, 2015
This study aims to assess the evolution of neurological complications because of kyphosis or scol... more This study aims to assess the evolution of neurological complications because of kyphosis or scoliosis surgery in children. Conclusion Early detection of a neurological complication, its etiological diagnosis, and surgical resolution improve neurological outcome of the patient, avoiding or reducing its severity sequel. spine deformities neurological complication surgery
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Feb 19, 2016
Introducción: es práctica frecuente en nuestro centro realizar controles clínicos y radiológicos ... more Introducción: es práctica frecuente en nuestro centro realizar controles clínicos y radiológicos durante el primer año POP de EIA, habitualmente en el POP inmediato, 3, 6, 9 y 12 meses. Es conocido el impacto negativo de estas radiaciones sobre el cuerpo humano y no hay guías claras sobre cuál sería el esquema óptimo de seguimiento radiológico.Materiales y métodos: se realizó un estudio retrospectivo de 55 pacientes operados por vía post. Con tornillos pediculares sin síntomas de rediculopatía ni pérdida de corrección clínica, analizándose los hallazgos radiológicos durante el primer año POP. Se evaluaron las intercurrencias que presentó este grupo y su impacto en la conducta terapéutica.Resultado: edad media: 15,1; media del Risser: 3,7 (0-5); porcentaje de pedículos instrumentados en la curva: 81,7 %; media de corrección de la curva principal: 74%; la media de espinogramas POP de la población fue de 3,7 +/- 0.93 (cada espinograma consta de un frente y un perfil). Ningún Pte. Del grupo tuvo modificación de la conducta terapéutica en base a los hallazgos radiológicos.Conclusión: en los pacientes con diagnóstico de EIA operados con tornillos pediculares que no presenten síntomas de radiculopatía, dolores persistentes y/o pérdida clínica de corrección se podrían reducir los controles radiológicos a 3 durante el primer año POP.Palabras clave: escoliosis idiopatica del adolescente; control radiografico
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Jan 22, 2015
Spine deformity, Mar 23, 2020
Study design Retrospective study. Objective To describe pathogens found in SSI during pediatric-i... more Study design Retrospective study. Objective To describe pathogens found in SSI during pediatric-instrumented spine surgery, and to assess the relationship between pathogens and the etiology of the spinal deformity. Summary and background data Surgical site infection (SSI) after pediatric spine fusion is a well-known complication with incidence rates between 0.5 and 42%, associated with the patient underlying disorder. Pathogens involved in SSI seem to be related to patient characteristics, such as the etiology of the spinal deformity. GNB (gram-negative bacilli) are more frequent in neuropathic, muscular, and syndromic conditions. High-risk pediatric patients with a spine deformity undergoing instrumented surgery might benefit from receiving perioperative intravenous prophylaxis for GNB. Methods We conducted a retrospective study at our tertiary-care pediatric hospital from January 2010 to January 2017. We reviewed records of all episodes of SSI that occurred in the first 12 months postoperatively. All patients who underwent instrumented spine surgery were included in this study. Results We assessed 1410 pediatric-instrumented spine surgeries; we identified 68 patients with deep SSIs, overall rate of 4.8%. Mean age at instrumented spine surgery was 12 years and 9 months. Time elapsed between instrumented surgery and debridement surgery was 28.8 days. Cultures were positive in 48 and negative in 20. Of the 48 positive culture results, 41 (72%) were GNB, 12 (21%) gram-positive cocci (GPC), three (5%) gram-positive anaerobic cocci (GPAC), and one (2%) coagulase-negative staphylococci (CoNS). Of the 68 patients with primary SSIs, 46 were considered to have a high risk of infection, which reported GNB in 81%, GPC in 15%, GPAC in 2%, and CoNS in 2%. Conclusion Cefazolin prophylaxis covers GPC and CoNS, but GNB with unreliable effectiveness. Gram-negative pathogens are increasingly reported in SSIs in high-risk patients. Adding prophylaxis for GNB in high-risk patients should be taken into account when considering spine surgery. Level of evidence IV.
Spine deformity, Sep 1, 2017
Study Design: Retrospective study. Objective: To assess results of posterior instrumented fusion ... more Study Design: Retrospective study. Objective: To assess results of posterior instrumented fusion using pedicle screws in 12 children with osteogenesis imperfecta (OI) with spinal deformity at a single institution from 2001 to 2012. Summary of Background Data: This is the first case series of OI patients who underwent nonecement augmented screw-rod instrumented fusion published in the literature. Methods: Of a total of 54 children with spinal deformity associated with OI, 12 (22.2%) were submitted to posterior spinal fusion with pedicle screws (80% density) because of severe spinal deformity. Here we reported the results in seven females and five males. Results: Five thoracic (41.7%), five double (thoracic and lumbar 41.7%), and two lumbar (16.7%) curves were considered. The mean number of fused levels was 11.8 (range: 5 to 16). Mean age at surgery was 13 years 8 months. Mean follow-up was 7 years 11 months (range: 3 years 7 months to 16 years 1 month). The mean preoperative scoliosis angle was 75.6 , whereas the postoperative angle was 31.4 (58.5% correction rate). The mean preoperative kyphosis angle was 57.4 and the postoperative angle was 42.3. We observed one superficial infection, one dural tear, and three cases of proximal junctional kyphosis; two patients required one revision surgery each (2 years and 4 months postoperatively on average). Conclusions: To our knowledge, this is the first case series published in the literature regarding OI with instrumented fusion with nonecement augmented pedicle screws exclusively in children with spinal deformity. We found that posterior spinal fusion with the screwrod system in OI deformity in children is feasible and reliable, and has acceptable clinical and imaging results in the long-term follow-up.
Spine deformity, Sep 1, 2017
Study Design: Retrospective. Level IV Evidence. Objective: To assess the utility of intraoperativ... more Study Design: Retrospective. Level IV Evidence. Objective: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. Summary and Background Data: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA. Methods: This is a retrospective study of seven consecutive patients (3 girls and 4 boys, mean age: 9 years 4 months) with imaging and clinical signs compatible with spinal OO who underwent CT-guided RFA, under general anesthesia, and IONM in a single center between 2011 and 2015. Before the RFA procedure, a CT-guided percutaneous biopsy of the nidus was performed in the same setting. RFA was divided into four cycles of increasing time and temperature and performed under IONM in every patient. Results: Two patients had lesions located in the thoracic spine and five patients had lumbar involvement. The RFA technical and clinical success was 85.7%. Six patients presented with reversible neurophysiological changes either during biopsy needle positioning or RFA cycles. In the remaining case, as IONM changes did not improve after several minutes of neuroprotective hypertension, the procedure was interrupted. Neither neurologic nor vascular complications were observed after RFA treatment. In only one biopsy sample, OO was confirmed by histopathologic studies. Conclusion: CT-guided RFA is an accepted minimally invasive technique for the treatment of spinal OO in children. IONM may be a helpful tool that requires minimal additional time and provides feedback on the state of the spinal cord and nerves at risk during the procedure. We promote the use of IONM during these procedures to detect and possibly prevent impending neurologic damage.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de... more El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la ortopedia y traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definimos su uso e incluimos bibliografía original y actualizada.Nivel de Evidencia: V
Spine Deformity, 2020
Study design A retrospective, comparative study. Objective To compare the results, complications,... more Study design A retrospective, comparative study. Objective To compare the results, complications, and costs of preoperative halo-gravity traction in in-and outpatient settings. Background data Surgical management of severe spinal deformities remains complex and controversial. Preoperative halogravity traction results in a decreased need for aggressive surgical techniques, lower incidence of intraoperative neurologic complications, and improvement of nutritional parameters and preoperative cardiopulmonary function. Methods Twenty-nine patients younger than 18 years with kyphoscoliosis undergoing preoperative halo-gravity traction were divided into two groups: inpatients (n: 15) and outpatients (n: 14, home care or care at the Foundation). Traction time (weeks), traction weight (kg), radiographic curve correction, complications, and costs were compared. For statistical analysis, t test and odds ratio were calculated with a significance of p < 0.05. Results Mean traction time was 6 weeks for in-and 4 weeks for outpatients (p = 0.038). Initial traction weight was 6 kg in both groups, while final traction weight was 13 kg for in-and 15 kg for outpatients (p = 0.50). At the end of the traction period, coronal correction was 24° in in-and 28° in outpatients (p = 0.5), while sagittal correction was 27° and 29°, respectively (p = 0.80). Pin loosening was observed in 2 patients in each group, of whom 1 outpatient developed pin-site infection. In each group, one patient developed transient neurologic complications (odds ratio 1.091). Mean treatment cost per patient was 2.8-fold higher in inpatients. Conclusions Considering complications and costs, our results show that preoperative halo-gravity traction in an outpatient setting is an option to be taken into account. Level of evidence Grade III.
Orthopaedic Proceedings, Nov 1, 2002
Malignant hyperthermia (MH) is a pharmacogenetic disorder, potentially lethal, due to the exposur... more Malignant hyperthermia (MH) is a pharmacogenetic disorder, potentially lethal, due to the exposure to anesthetic drugs that triggers, a high increase of corporal temperature, progressive muscular stiffness, severe rabdomiolisis and death due to cardiac dysfunction. Many research works relate Malignant Hyperthermia to muscular illnesses or to the King Syndrome. Through this study we present the incidence of MH in patients with congenital vertebrae malformations. (CVM) The objective is to establish the incidence of the MH in patients who were operated on CVM and to alert about this association. 1029 patients with CVM were treated between 1972 and 2000. 390 with congenital vertebrae malformation were operated on. 3 patients (0.76%) (1 girl and 2 boys) developed MH while they underwent surgical treatment for the CVM. 1 patient presented an isolated congenital vertebrae malformation. 1 patient presented King Syndrome and the other presented Robert Syndrome. Only 1 elevated amount of preoperative CPK was found (the are no reports on the others). No muscular biopsy was done to test sensitivity. Two of them were biopsied for a post episode study. At the surgical moment, any patients reported personal or familiar antecedents of MH. No deaths were reported, although it is considered as a potentially lethal disorder. We found no reports in the literature in this subject. Most of the bibliographic data belonged to anesthesiologists or geneticists. Our approach as spine surgeons leaded us to the detailed analysis of this studies and the 0.76% (3 out of 390) incidence suggested us to have an alert attitude when facing patients with surgical MVC and take the necessary precautions.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de... more El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la ortopedia y traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definimos su uso e incluimos bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Aug 31, 2022
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Global Spine Journal, May 1, 2015
This study aims to describe surgical technique of locally wound autologous bone conservation when... more This study aims to describe surgical technique of locally wound autologous bone conservation when primary surgery becomes mandatory to be staged, described as well the evolution and technique complications.
Global Spine Journal, May 1, 2015
This study aims to assess the evolution of neurological complications because of kyphosis or scol... more This study aims to assess the evolution of neurological complications because of kyphosis or scoliosis surgery in children. Conclusion Early detection of a neurological complication, its etiological diagnosis, and surgical resolution improve neurological outcome of the patient, avoiding or reducing its severity sequel. spine deformities neurological complication surgery
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Feb 19, 2016
Introducción: es práctica frecuente en nuestro centro realizar controles clínicos y radiológicos ... more Introducción: es práctica frecuente en nuestro centro realizar controles clínicos y radiológicos durante el primer año POP de EIA, habitualmente en el POP inmediato, 3, 6, 9 y 12 meses. Es conocido el impacto negativo de estas radiaciones sobre el cuerpo humano y no hay guías claras sobre cuál sería el esquema óptimo de seguimiento radiológico.Materiales y métodos: se realizó un estudio retrospectivo de 55 pacientes operados por vía post. Con tornillos pediculares sin síntomas de rediculopatía ni pérdida de corrección clínica, analizándose los hallazgos radiológicos durante el primer año POP. Se evaluaron las intercurrencias que presentó este grupo y su impacto en la conducta terapéutica.Resultado: edad media: 15,1; media del Risser: 3,7 (0-5); porcentaje de pedículos instrumentados en la curva: 81,7 %; media de corrección de la curva principal: 74%; la media de espinogramas POP de la población fue de 3,7 +/- 0.93 (cada espinograma consta de un frente y un perfil). Ningún Pte. Del grupo tuvo modificación de la conducta terapéutica en base a los hallazgos radiológicos.Conclusión: en los pacientes con diagnóstico de EIA operados con tornillos pediculares que no presenten síntomas de radiculopatía, dolores persistentes y/o pérdida clínica de corrección se podrían reducir los controles radiológicos a 3 durante el primer año POP.Palabras clave: escoliosis idiopatica del adolescente; control radiografico
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Jan 22, 2015
Spine deformity, Mar 23, 2020
Study design Retrospective study. Objective To describe pathogens found in SSI during pediatric-i... more Study design Retrospective study. Objective To describe pathogens found in SSI during pediatric-instrumented spine surgery, and to assess the relationship between pathogens and the etiology of the spinal deformity. Summary and background data Surgical site infection (SSI) after pediatric spine fusion is a well-known complication with incidence rates between 0.5 and 42%, associated with the patient underlying disorder. Pathogens involved in SSI seem to be related to patient characteristics, such as the etiology of the spinal deformity. GNB (gram-negative bacilli) are more frequent in neuropathic, muscular, and syndromic conditions. High-risk pediatric patients with a spine deformity undergoing instrumented surgery might benefit from receiving perioperative intravenous prophylaxis for GNB. Methods We conducted a retrospective study at our tertiary-care pediatric hospital from January 2010 to January 2017. We reviewed records of all episodes of SSI that occurred in the first 12 months postoperatively. All patients who underwent instrumented spine surgery were included in this study. Results We assessed 1410 pediatric-instrumented spine surgeries; we identified 68 patients with deep SSIs, overall rate of 4.8%. Mean age at instrumented spine surgery was 12 years and 9 months. Time elapsed between instrumented surgery and debridement surgery was 28.8 days. Cultures were positive in 48 and negative in 20. Of the 48 positive culture results, 41 (72%) were GNB, 12 (21%) gram-positive cocci (GPC), three (5%) gram-positive anaerobic cocci (GPAC), and one (2%) coagulase-negative staphylococci (CoNS). Of the 68 patients with primary SSIs, 46 were considered to have a high risk of infection, which reported GNB in 81%, GPC in 15%, GPAC in 2%, and CoNS in 2%. Conclusion Cefazolin prophylaxis covers GPC and CoNS, but GNB with unreliable effectiveness. Gram-negative pathogens are increasingly reported in SSIs in high-risk patients. Adding prophylaxis for GNB in high-risk patients should be taken into account when considering spine surgery. Level of evidence IV.
Spine deformity, Sep 1, 2017
Study Design: Retrospective study. Objective: To assess results of posterior instrumented fusion ... more Study Design: Retrospective study. Objective: To assess results of posterior instrumented fusion using pedicle screws in 12 children with osteogenesis imperfecta (OI) with spinal deformity at a single institution from 2001 to 2012. Summary of Background Data: This is the first case series of OI patients who underwent nonecement augmented screw-rod instrumented fusion published in the literature. Methods: Of a total of 54 children with spinal deformity associated with OI, 12 (22.2%) were submitted to posterior spinal fusion with pedicle screws (80% density) because of severe spinal deformity. Here we reported the results in seven females and five males. Results: Five thoracic (41.7%), five double (thoracic and lumbar 41.7%), and two lumbar (16.7%) curves were considered. The mean number of fused levels was 11.8 (range: 5 to 16). Mean age at surgery was 13 years 8 months. Mean follow-up was 7 years 11 months (range: 3 years 7 months to 16 years 1 month). The mean preoperative scoliosis angle was 75.6 , whereas the postoperative angle was 31.4 (58.5% correction rate). The mean preoperative kyphosis angle was 57.4 and the postoperative angle was 42.3. We observed one superficial infection, one dural tear, and three cases of proximal junctional kyphosis; two patients required one revision surgery each (2 years and 4 months postoperatively on average). Conclusions: To our knowledge, this is the first case series published in the literature regarding OI with instrumented fusion with nonecement augmented pedicle screws exclusively in children with spinal deformity. We found that posterior spinal fusion with the screwrod system in OI deformity in children is feasible and reliable, and has acceptable clinical and imaging results in the long-term follow-up.
Spine deformity, Sep 1, 2017
Study Design: Retrospective. Level IV Evidence. Objective: To assess the utility of intraoperativ... more Study Design: Retrospective. Level IV Evidence. Objective: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. Summary and Background Data: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA. Methods: This is a retrospective study of seven consecutive patients (3 girls and 4 boys, mean age: 9 years 4 months) with imaging and clinical signs compatible with spinal OO who underwent CT-guided RFA, under general anesthesia, and IONM in a single center between 2011 and 2015. Before the RFA procedure, a CT-guided percutaneous biopsy of the nidus was performed in the same setting. RFA was divided into four cycles of increasing time and temperature and performed under IONM in every patient. Results: Two patients had lesions located in the thoracic spine and five patients had lumbar involvement. The RFA technical and clinical success was 85.7%. Six patients presented with reversible neurophysiological changes either during biopsy needle positioning or RFA cycles. In the remaining case, as IONM changes did not improve after several minutes of neuroprotective hypertension, the procedure was interrupted. Neither neurologic nor vascular complications were observed after RFA treatment. In only one biopsy sample, OO was confirmed by histopathologic studies. Conclusion: CT-guided RFA is an accepted minimally invasive technique for the treatment of spinal OO in children. IONM may be a helpful tool that requires minimal additional time and provides feedback on the state of the spinal cord and nerves at risk during the procedure. We promote the use of IONM during these procedures to detect and possibly prevent impending neurologic damage.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corrien... more El Comité Editorial quiere brindar a sus lectores una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la Ortopedia y Traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definiendo su uso e incluyendo bibliografía original y actualizada.
Revista de la Asociación Argentina de Ortopedia y Traumatología
El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de... more El Comité Editorial quiere brindar a los lectores de la RAAOT una actualización de las escalas de uso corriente. El empleo de tablas y escalas es una práctica muy extendida en la ortopedia y traumatología. La medición y la cuantificación de los aspectos clínicos, funcionales y radiográficos se convirtieron en una herramienta imprescindible para la toma de decisiones en diferentes aspectos de la actividad asistencial. Llevamos a cabo una revisión de las escalas más utilizadas, definimos su uso e incluimos bibliografía original y actualizada.Nivel de Evidencia: V
Spine Deformity, 2020
Study design A retrospective, comparative study. Objective To compare the results, complications,... more Study design A retrospective, comparative study. Objective To compare the results, complications, and costs of preoperative halo-gravity traction in in-and outpatient settings. Background data Surgical management of severe spinal deformities remains complex and controversial. Preoperative halogravity traction results in a decreased need for aggressive surgical techniques, lower incidence of intraoperative neurologic complications, and improvement of nutritional parameters and preoperative cardiopulmonary function. Methods Twenty-nine patients younger than 18 years with kyphoscoliosis undergoing preoperative halo-gravity traction were divided into two groups: inpatients (n: 15) and outpatients (n: 14, home care or care at the Foundation). Traction time (weeks), traction weight (kg), radiographic curve correction, complications, and costs were compared. For statistical analysis, t test and odds ratio were calculated with a significance of p < 0.05. Results Mean traction time was 6 weeks for in-and 4 weeks for outpatients (p = 0.038). Initial traction weight was 6 kg in both groups, while final traction weight was 13 kg for in-and 15 kg for outpatients (p = 0.50). At the end of the traction period, coronal correction was 24° in in-and 28° in outpatients (p = 0.5), while sagittal correction was 27° and 29°, respectively (p = 0.80). Pin loosening was observed in 2 patients in each group, of whom 1 outpatient developed pin-site infection. In each group, one patient developed transient neurologic complications (odds ratio 1.091). Mean treatment cost per patient was 2.8-fold higher in inpatients. Conclusions Considering complications and costs, our results show that preoperative halo-gravity traction in an outpatient setting is an option to be taken into account. Level of evidence Grade III.