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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_X | Pages 109 - 109
1 Apr 2012
Bertram W Katsimihas M Harding I Nelson I Hutchinson J
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Post traumatic stress disorder (PTSD) is well recognised in children having repeated medical/surgical procedures. It has been suggested that it is common in young children undergoing growing rod treatment with ongoing lengthening and the inevitable accompanying complications. We present an index case history, review the literature in order to infer a correlation for the incidence of PTSD and discuss diagnosis and management. We present an index case history of PTSD in a young child undergoing growing rod treatment for scoliosis. The literature was reviewed for PTSD in paediatric surgery and pathologies requiring multiple treatments. Spinal surgery is compared with paediatric cancer, burns, organ failure/transplant, cardiopulmonary disease, inflammatory bowel disease, cystic fibrosis and limb lengthening. No published studies examine PTSD in children undergoing multiple spinal surgeries. One paper reports that children undergoing growing rod treatments show “behavioural alterations” and changes in psychosocial behaviour, including anxiety on entering the operating room and broken rod worries. A recent spine meeting presentation referred to this. Psychosocial problems occur in up to 30% of children with chronic or life-threatening illnesses which involve ongoing treatments. Factors such as age, parental anxiety and previous adverse medical experiences influence anxiety, depression and PTSD. Based on our index case and methodological correlation with similar pathologies, we fell that PTSD is a genuine concern in children who have repeated spinal operations. This paper is part of an ongoing study, but we believe that the spinal community should be aware of this diagnosis and its management. Ethics approval: Audit Interest Statement: None


The Bone & Joint Journal
Vol. 103-B, Issue 5 | Pages 976 - 983
3 May 2021
Demura S Kato S Shinmura K Yokogawa N Shimizu T Handa M Annen R Kobayashi M Yamada Y Murakami H Kawahara N Tomita K Tsuchiya H

Aims

To evaluate the perioperative complications associated with total en bloc spondylectomy (TES) in patients with spinal tumours, based on the extent and level of tumour resection.

Methods

In total, 307 patients who underwent TES in a single centre were reviewed retrospectively. There were 164 male and 143 female patients with a mean age at the time of surgery of 52.9 years (SD 13.3). A total of 225 patients were operated on for spinal metastases, 34 for a malignant primary tumour, 41 for an aggressive benign tumour, and seven with a primary of unknown origin. The main lesion was located in the thoracic spine in 213, and in the lumbar spine in 94 patients. There were 97 patients who underwent TES for more than two consecutive vertebrae.


The Bone & Joint Journal
Vol. 98-B, Issue 2 | Pages 229 - 237
1 Feb 2016
Roberts SB Dryden R Tsirikos AI

Aims

Clinical and radiological data were reviewed for all patients with mucopolysaccharidoses (MPS) with thoracolumbar kyphosis managed non-operatively or operatively in our institution.

Methods

In all 16 patients were included (eight female: eight male; 50% male), of whom nine had Hurler, five Morquio and two Hunter syndrome. Six patients were treated non-operatively (mean age at presentation of 6.3 years; 0.4 to 12.9); mean kyphotic progression +1.5o/year; mean follow-up of 3.1 years (1 to 5.1) and ten patients operatively (mean age at presentation of 4.7 years; 0.9 to 14.4); mean kyphotic progression 10.8o/year; mean follow-up of 8.2 years; 4.8 to 11.8) by circumferential arthrodesis with posterior instrumentation in patients with flexible deformities (n = 6).