A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”?

Gouzoulis, Michael J.; Joo, Peter Y.; Jeong, Seongho; Jabbouri, Sahir S.; Moran, Jay; Zhu, Justin R.; Grauer, Jonathan N.

doi:10.1007/s43390-024-00858-3

Cited by 2 publications

(1 citation statement)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While minor curves can be treated conservatively, curves that exceed 50–60 degrees are frequently treated by instrumented spinal fusion surgery. While these surgeries are invasive, they offer a durable correction and generally acceptable long-term outcomes [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Dosing Cefazolin for Surgical Site Infection Prophylaxis in Adolescent Idiopathic Scoliosis Surgery: Intermittent Bolus or Continuous Infusion?—A Pilot Study

Yu,

Dooley,

Woods

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Cefazolin may minimize the risk of surgical site infection (SSI) following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Cefazolin dosing recommendations vary and there is limited evidence for achieved tissue concentrations. Methods: We performed a randomized, controlled, prospective pharmacokinetic pilot study of 12 patients given cefazolin by either intermittent bolus (30 mg/kg every 3 h) or continuous infusion (30 mg/kg bolus followed by 10/mg/kg per hour) during PSF for AIS. Results: Patients were well matched for demographic and perioperative variables. While total drug exposure, measured as area-under-the-curve (AUC), was similar in plasma for bolus and infusion dosing, infusion dosing achieved greater cefazolin exposure in subcutaneous and muscle tissue. Using the pharmacodynamic metric of time spent above minimal inhibitory concentration (MIC), both bolus and infusion dosing performed well. However, when targeting a bactericidal concentration of 32 µg/mL, patients in the bolus group spent a median of 1/5 and 1/3 of the typical 6 h operative time below target in subcutaneous and muscle tissue, respectively. Conclusions: We conclude that intraoperative determination of cefazolin tissue concentrations is feasible and both bolus and infusion dosing of cefazolin achieve concentrations in excess of typical MICs. Infusion dosing appears to more consistently achieve bactericidal concentrations in subcutaneous and muscle tissues.

show abstract

Section: Introductionmentioning

confidence: 99%

Dosing Cefazolin for Surgical Site Infection Prophylaxis in Adolescent Idiopathic Scoliosis Surgery: Intermittent Bolus or Continuous Infusion?—A Pilot Study

Yu,

Dooley,

Woods

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

Emergency Department Use Within 90 Days After Single-Level Posterior Cervical Foraminotomy

Jayaram,

Oghenesume,

Day

et al. 2024

Orthopedics

View full text Add to dashboard Cite

Background This study sought to characterize the incidence of, timing of, predictive factors for, and reasons for emergency department (ED) visits within 90 days of single-level posterior cervical foraminotomy (PCF). These visits, after PCF, have received limited attention. Materials and Methods The 2010–2022 M161 PearlDiver database was queried for elective single-level PCFs, excluding multilevel procedures, midline laminectomies, fusions, or other posterior/anterior procedures, as well as indications of trauma, infection, or neoplasm. Patient age, sex, Elixhauser Comorbidity Index (ECI), insurance, and region were extracted. Weekly ED use after PCF was calculated. Multivariate analyses were used to identify predictive factors for ED use, and primary ED diagnoses were categorized. Results Of 10,588 PCF patients, 9.09% (n=962) visited the ED within 90 days after surgery, mostly in the first 4 weeks. Multivariate analysis identified that predictors included younger age (odds ratio [OR], 1.02 per decade decrease), female sex (OR, 1.19), higher ECI (OR, 1.28 for ECI 1–2; OR, 1.41 for ECI 3–4; OR, 1.51 for ECI ≥5), Midwest (OR, 1.16) or Northeast (OR, 1.19) region, and Medicare (OR, 1.09) or Medicaid (OR, 1.57) coverage. In the first 4 weeks, 69.9% of ED visits were related to the surgical site; this decreased to 27.1% thereafter. Conclusion Almost one-tenth of PCF patients visited the ED within 90 days after surgery. Specific patient characteristics were associated with ED visits, with surgical site-related diagnoses predominating in the acute postoperative period. Tailoring health care interventions based on timing of, risk factors for, and causes of ED visits may enhance outcomes and reduce costs. [ Orthopedics . 202x;4x(x):xx–xx.]

show abstract

A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”?

Cited by 2 publications

References 29 publications

Dosing Cefazolin for Surgical Site Infection Prophylaxis in Adolescent Idiopathic Scoliosis Surgery: Intermittent Bolus or Continuous Infusion?—A Pilot Study

Dosing Cefazolin for Surgical Site Infection Prophylaxis in Adolescent Idiopathic Scoliosis Surgery: Intermittent Bolus or Continuous Infusion?—A Pilot Study

Emergency Department Use Within 90 Days After Single-Level Posterior Cervical Foraminotomy

Contact Info

Product

Resources

About