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  • 1
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    Online Resource
    Influence of Paraspinal Growth-Friendly Spinal Implants in Children with Spinal Muscular Atrophy on Parasol Deformity, Rib-Vertebral Angles, Thoracic, and Lung Volumes
    S. Karger AG ; 2023
    In:  Pediatric Neurosurgery Vol. 58, No. 4 ( 2023), p. 185-196
    Details
    In: Pediatric Neurosurgery, S. Karger AG, Vol. 58, No. 4 ( 2023), p. 185-196
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Children with spinal muscular atrophy (SMA) and progressive neuromuscular scoliosis often require early growth-friendly spinal implant (GFSI) treatment for deformity correction with implant fixation either through pedicle screws or bilateral to the spine using ribto pelvis fixation. It has been proposed that the latter fixation may change the collapsing parasol deformity via changes in the rib-vertebral angle (RVA) with a positive effect on thoracic and lung volume. The purpose of this study was to analyze the effect of paraspinal GFSI with bilateral rib-to-pelvis fixation on the parasol deformity, RVA, thoracic, and lung volumes. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 SMA children with ( 〈 i 〉 n 〈 /i 〉 = 19) and without ( 〈 i 〉 n 〈 /i 〉 = 18) GFSI treatment were included. Last follow-up was before definite spinal fusion at puberty. Scoliosis and kyphosis angles, parasol deformity, and index, as well as convex and concave RVA, were measured on radiographs, whereas computed tomography images were used to reconstruct thoracic and lung volumes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In all SMA children ( 〈 i 〉 n 〈 /i 〉 = 37; with or without GFSI), convex RVA was smaller than concave values at all times. GFSI did not crucially influence the RVA over the 4.6-year follow-up period. Comparing age- and disease-matched adolescents with and without prior GFSI, no effect of GFSI treatment could be detected on either RVA, thoracic, or lung volumes. Parasol deformity progressed over time despite GFSI. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Despite different expectations, implantation of GFSI with bilateral rib-to-pelvis fixation did not positively influence parasol deformity, RVA and/or thoracic, and lung volumes in SMA children with spinal deformity directly and over time.
    Type of Medium: Online Resource
    ISSN: 1016-2291 , 1423-0305
    URL: Article
    DOI: 10.1159/000531549
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483546-0
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  • 2
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    Foot Typology, Dynamic and Static Weight Distribution, and Radiographic Changes After Subtalar Arthroereisis in Juvenile Symptomatic Flexible Flat Feet
    Elsevier BV ; 2022
    In:  The Journal of Foot and Ankle Surgery Vol. 61, No. 2 ( 2022-03), p. 272-278
    Details
    In: The Journal of Foot and Ankle Surgery, Elsevier BV, Vol. 61, No. 2 ( 2022-03), p. 272-278
    Type of Medium: Online Resource
    ISSN: 1067-2516
    URL: Article
    DOI: 10.1053/j.jfas.2021.07.021
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2102633-6
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  • 3
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    Smaller Intervertebral Disc Volume and More Disc Degeneration after Spinal Distraction in Scoliotic Children
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 10 ( 2021-05-14), p. 2124-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 10 ( 2021-05-14), p. 2124-
    Abstract: In recent decades, magnetically controlled growing rods (MCGR) were established to treat progressive early-onset scoliosis. The aim of this investigation was to assess the effect of long-term MCGR with continuous distraction on intervertebral discs in scoliotic children. Magnetic resonance imaging (MRI) of 33 children with spinal muscular atrophy was analyzed by grading intervertebral disc degeneration (IDD) and measuring intervertebral disc volume. Cohort I (n = 17) were children who had continuous spinal distraction with MCGRs for 5.1 years and MRI before (av. age 8.1) and after (av. age 13.4) MCGR treatment. Cohort II (n = 16, av. age 13.7) were patients without prior surgical treatment. Lumbar intervertebral disc volume of cohort I did not change during 5.1 years of MCGR treatment, whereas disc volumes were significantly larger in age- and disease-matched children without prior treatment (cohort II). Cohort I showed more IDD after MCGR treatment in comparison to early MRI studies of the same patients and children without surgical treatment. MRI data showed a volume reduction and disc degeneration of lower thoracic and lumbar intervertebral discs in scoliotic children after continuous spinal distraction with MCGRs. These effects were confirmed in the same subjects before and after treatment as well as in surgically untreated controls.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10102124
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 4
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    Reduced Volumetric Bone Mineral Density of the Spine in Adolescent Rett Girls with Scoliosis
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 12 ( 2022-12-04), p. 1902-
    Details
    In: Children, MDPI AG, Vol. 9, No. 12 ( 2022-12-04), p. 1902-
    Abstract: In advanced Rett syndrome (RTT), limited or complete loss of ambulation, nutritional problems and scoliosis are unfavorable factors for bone mineral density (BMD). Still, there are few data available in this research area. Spinal quantitative computed tomography (QCT) allows an exact measurement of the volumetric BMD (vBMD) in this patient group. Two examiners measured vBMD of thoracic and lumbar vertebrae on asynchronous calibrated CTs that were acquired prior to surgical scoliosis correction (n = 21, age 13.6 ± 2.5 years). The values were compared to age- and sex-matched healthy controls to additionally derive Z-scores (n = 22, age 13.8 ± 2.0 years). The results showed the most significant reduction of vBMD values in non-ambulatory RTT patients, with p 〈 0.001 and average BMD-Z-score −1.5 ± 0.2. In the subgroup comparison, non-ambulatory patients with valproate treatment had significant lower values (p 〈 0.001) than ambulatory patients without valproate therapy, with an average BMD-Z-score of −2.3 ± 0.2. Comparison of the Z-scores to critical BMD thresholds of 120 and 80 mg/cm3 showed normal Z-scores in case of the ambulatory RTT subgroup, as opposed to BMD-Z-scores of the non-ambulatory RTT subgroups, which were partially below osteopenia-equivalent values. Furthermore, valproate treatment seems to have a direct effect on vBMD in RTT patients and when combined with loss of ambulation, BMD-Z-scores are reduced to osteoporosis-equivalent levels or even further.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9121902
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 5
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    Online Resource
    A Preclinical Pilot Study on the Effects of Thermal Ablation on Lamb Growth Plates
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 6 ( 2022-06-12), p. 878-
    Details
    In: Children, MDPI AG, Vol. 9, No. 6 ( 2022-06-12), p. 878-
    Abstract: (1) Background: Thermal ablation has been demonstrated to affect the bone growth of osteoid osteoma in adolescents. Growth modulation due to thermal heat in children is conceivable, but has not yet been established. We used lamb extremities as a preclinical model to examine the effect of thermal ablation on growth plates in order to evaluate its potential for axial or longitudinal growth modulation in pediatric patients. (2) Methods: Thermal ablation was performed by electrocautery on eight different growth plates of the legs and distal radii of a stillborn lamb. After treatment, target hits and the physical extent of the growth plate lesions were monitored using micro-computed tomography (micro-CT) and histology. (3) Results: Lesions and their physical extent could be quantified in 75% of the treated extremities. The histological analysis revealed that the disruption of tissue was confined to a small area and the applied heat did not cause the entire growth plate to be disrupted or obviously damaged. (4) Conclusions: Thermal ablation by electrocautery is minimally invasive and can be used for targeted disruption of small areas in growth plates in the animal model. The results suggest that thermal ablation can be developed into a suitable method to influence epiphyseal growth in children.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9060878
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 6
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    Osmotic pump with potential for bone lengthening distracts continuously in vitro and in vivo
    Public Library of Science (PLoS) ; 2023
    In:  PLOS ONE Vol. 18, No. 9 ( 2023-9-14), p. e0291335-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 9 ( 2023-9-14), p. e0291335-
    Abstract: In pediatric orthopedics, long bone lengthening procedures are routinely performed using manual, motorized or magnetically controlled implants. This study aims to prove expansion of a newly designed osmotic pump prior to long bone lengthening in living organisms and to rule out any complications related to in vivo conditions, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump, as well as to compare in vivo and in vitro expansion data. Methods Osmotic pumps, which were designed to distract a plate osteosynthesis, were inserted in the dorsal paraspinal musculature of four piglets. To compare the performance of the pumps in in vivo and in vitro conditions, another set of pumps was submerged in physiologic saline solution at different temperatures. The lengthening progress was measured radiographically and sonographically in the study animals. Results Both, in vitro and in vivo tested osmotic pumps started distraction after an intended rest phase of four days and distracted evenly over the following twelve days. No complications, clogging or damages occurred. However, we observed a temperature dependency of the distraction rate ranging from 0.98 mm/day at 39°C to 1.10 mm/day at 42°C. With a second setup, we confirmed that the distraction rate differed by 72% within a measured temperature interval of 14° C. Conclusions The data presented here confirm that the novel osmotic pump showed comparable lengthening characteristics in vivo and in vitro . No complications, such as congestion of the semipermeable membrane, local infection, or lack of water to drive the osmotic pump were observed. Thus, osmotic pumps may have great potential in future applications such as long bone lengthening procedures, where continuous distraction probably provides a better bone quality than intermittent lengthening procedures. The fact that one pump failed to elongate in each condition, highlights the importance of technical improvement, but also demonstrates that this was not due to different circumstances within the in vivo or in vitro condition.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1371/journal.pone.0291335
    DOI: 10.1371/journal.pone.0291335.g001
    DOI: 10.1371/journal.pone.0291335.g002
    DOI: 10.1371/journal.pone.0291335.g003
    DOI: 10.1371/journal.pone.0291335.g004
    DOI: 10.1371/journal.pone.0291335.g005
    DOI: 10.1371/journal.pone.0291335.t001
    DOI: 10.1371/journal.pone.0291335.t002
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2023
    detail.hit.zdb_id: 2267670-3
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  • 7
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    Online Resource
    Cross (X) union technique for treatment of congenital pseudarthrosis of the tibia (CPT)
    Springer Science and Business Media LLC ; 2021
    In:  Der Unfallchirurg Vol. 124, No. 9 ( 2021-09), p. 768-773
    Details
    In: Der Unfallchirurg, Springer Science and Business Media LLC, Vol. 124, No. 9 ( 2021-09), p. 768-773
    Type of Medium: Online Resource
    ISSN: 0177-5537 , 1433-044X
    URL: Article
    DOI: 10.1007/s00113-021-01057-9
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3120926-9
    detail.hit.zdb_id: 1461952-0
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  • 8
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    Vertebral body changes after continuous spinal distraction in scoliotic children
    Springer Science and Business Media LLC ; 2021
    In:  European Spine Journal Vol. 30, No. 7 ( 2021-07), p. 1928-1934
    Details
    In: European Spine Journal, Springer Science and Business Media LLC, Vol. 30, No. 7 ( 2021-07), p. 1928-1934
    Abstract: Growth-friendly spinal implants (GFSI) were established for scoliotic children as an interim solution until definite spinal fusion could be performed during puberty. While deformity control was clearly proven, the effects on vertebral shape and morphology are still unclear. Our prospective study assesses the effect of GFSI with continuous distraction on vertebral body shape and volume in SMA children in comparison with previously untreated age-matched SMA patients. Methods Cohort I ( n  = 19, age 13.2 years) were SMA patients without prior surgical scoliosis treatment. Cohort II ( n  = 24, age 12.4 years) were children, who had continuous spinal distraction with GFSI for 4.5 years. Radiographic measurements and computed tomography (CT) 3D volume rendering were performed before definite spinal fusion. For cohort II, additional radiographs were analyzed before the first surgical implantation of GFSI, after surgery and every year thereafter. Results Our analysis revealed decreased depth and volume in scoliotic patients with prior GFSI compared to scoliotic patients without prior implants. This difference was significant for the lower thoracic and entire lumbar spine. Vertebral body height and pedicle size were unchanged between the two cohorts. Conclusion CT data showed volume reduction in the vertebral body in scoliotic children after GFSI treatment. This effect was more severe in the lumbar and lower thoracic area. While vertebral height was identical in both groups, vertebral depth was reduced in the GFSI-treated group. Reduced vertebral depth and altered vertebral morphology should be considered before instrumenting the spine in previously treated scoliotic SMA children. Level of evidence III Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
    Type of Medium: Online Resource
    ISSN: 0940-6719 , 1432-0932
    URL: Article
    DOI: 10.1007/s00586-021-06775-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1472721-3
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  • 9
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    Aktuelle Therapiekonzepte und Ergebnisse für Kinder mit Spinaler Muskelatrophie und Wirbelsäulendeformität
    Georg Thieme Verlag KG ; 2020
    In:  Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin Vol. 59, No. 03 ( 2020-06), p. 174-179
    Details
    In: Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, Georg Thieme Verlag KG, Vol. 59, No. 03 ( 2020-06), p. 174-179
    Abstract: Hintergrund Kinder mit Spinaler Muskelatrophie (SMA) Typ I und II entwickeln fast immer eine progrediente Wirbelsäulendeformität, welche nach Einführung der intrathekalen Injektionstherapie mit Nusinersen durch die damit verbundenen Schwierigkeiten bei der Punktion in den letzten Monaten in den Fokus gerückt sind. Ziel der Arbeit Die vorliegende Untersuchung untersucht die Ergebnisse einer neuartigen operativen Therapie zur Wirbelsäulenkorrektur bei SMA Kindern im Vergleich zu unbehandelten SMA Jugendlichen. Methoden In einer prospektiven Studie wurden 30 SMA Kinder (Gruppe I) mit von extern auszufahrenden magnetischen Implantaten versorgt, welche parallel zur Wirbelsäule implantiert wurden. Im Wachstumsverlauf wurden die Implantate ambulant alle drei Monate distrahiert. Diesem Kollektiv wurden 15 SMA Jugendliche (Gruppe II) mit unbehandelten Deformitäten gegenübergestellt. Ergebnisse Gruppe I war bei Implantation durchschnittlich 7,6 Jahre alt u nd wurde 41 Monate nachuntersucht. Der Skoliosekrümmungswinkel konnte von 62 auf 25° (59%; p 〈 0,001) und der Beckenschiefstand von 15 auf 4° (73%; p 〈 0,001) reduziert werden. Im Gegensatz dazu hatte Gruppe II (Alter 13,7 Jahre) eine Skoliose von 101° und einen Beckenschiefstand von 22°. In Gruppe I konnten die erzielten Korrekturen im Untersuchungszeitraum gehalten werden. Schlussfolgerung Bei SMA Kindern konnte durch die vorgestellte Operationstechnik eine signifikante Skoliosereduktion und Verbesserung des Beckenschiefstandes erreichen und im Verlauf gehalten werden im Vergleich zu unbehandelten Jugendlichen. Gerade auch in Hinblick auf die intrathekale Injektionstherapie mit Nusinersen zur SMA Behandlung ist die Notwendigkeit einer Wirbelsäule ohne starke Deformierung gegeben.
    Type of Medium: Online Resource
    ISSN: 0940-6689 , 1439-085X
    URL: Article
    DOI: 10.1055/a-0965-7485
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    detail.hit.zdb_id: 2072467-6
    SSG: 31
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  • 10
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    Validation of the German version of the 24-item Early-Onset Scoliosis Questionnaire
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2019
    In:  Journal of Neurosurgery: Pediatrics Vol. 23, No. 6 ( 2019-06), p. 688-693
    Details
    In: Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 23, No. 6 ( 2019-06), p. 688-693
    Abstract: During childhood, early-onset scoliosis (EOS) may show severe progressive deformity, which consequently leads to aggressive treatment strategies, such as serial casting, long-term bracing, or surgical interventions. The latter usually includes repeated surgeries for implant lengthening every 6 months in order to allow sufficient growth of the thorax and spine. In 2011, the 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) was introduced to measure health-related quality of life for this patient group and their families. Since then, cross-culturally adapted versions of the EOSQ-24 have been published in Spanish, Turkish, traditional Chinese, and Norwegian. The purpose of the study was to transculturally adapt the original English version of the EOSQ-24 into the German language and evaluate the reliability of the German version. METHODS After adaptation and forward/backward translation, the German version of the EOSQ-24 was given to the parents or caregivers of 67 EOS patients (33 male, 34 female) Data quality was evaluated by mean, standard deviation, percentage of data missing, and extent of ceiling and floor effects. Reliability was estimated by internal consistency using Cronbach α and item-total correlations. RESULTS In the study group (n = 67), 12 children were either observed (n = 7) or treated with a brace (n = 5). The other 55 patients were treated surgically with growth-friendly implants. The item response to the German EOSQ-24 was high with a minimum of missing data (1.7%). All items showed very good to excellent internal consistencies (0.879–0.903). Floor effects for the 24 items were between 0% and 31% and ceiling effects between 9% and 78%. The calculated Cronbach α for the 24-item scale was 0.9003, indicating excellent reliability. CONCLUSIONS The German adaptation of the EOSQ-24 shows excellent reliability and therefore is a valid tool to measure objective health-related quality of life in children with EOS.
    Type of Medium: Online Resource
    ISSN: 1933-0707 , 1933-0715
    URL: Article
    DOI: 10.3171/2019.1.PEDS18704
    RVK:
    XA 55270.2
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2019
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