Most of the severe DDI alerts could be automatically handled, if for example laboratory values could be taken into account. The DDI database should ideally be supplemented by information enabling more sophisticated computerised support in order to deliver more reasonable results from DDI checks.”
“Study Design. Retrospective study.
Objective. To compare arthrodesis techniques for pediatric cervical kyphosis.
Summary of Background Data. Cervical kyphosis is rare in the pediatric population. The most common etiologies are acquired instabilities or an underlying syndrome. The largest pediatric case series in the literature describes the treatment of nine patients.
Methods.
A retrospective review was performed of pediatric patients treated for cervical kyphosis with posterior spinal fusion (PSF), anterior spinal fusion (ASF) with strut graft, or anteroposterior fusion MLN0128 datasheet with strut graft (A/PSF). Patients were divided into groups on the basis of the etiology of the kyphosis. Group 1 was composed of patients with acquired instability, either traumatic or postlaminectomy. selleckchem Group 2 was composed of
patients with syndromic deformity.
Results. Twenty-four patients were identified: 9 in group 1 and 15 in group 2. Arthrodesis techniques performed in group 1 were 2 PSF, 2 ASF, and 5 A/PSF and in group 2 were 11 PSF, 0 ASF, and 4 A/PSF. Primary union was achieved in all group PP2 mouse 1 patients with no major complications. Pseudarthrosis and other major complications were frequent in group 2. Among syndromic patients (group 2) treated with primary PSF (11 patients), the mean immediate postoperative kyphosis was 32 degrees in seven patients who achieved primary union and 77 degrees in four patients with pseudarthrosis who required reoperation (P = 0.022); two of these four patients with pseudarthrosis developed late myelopathy with an episode of transient quadriparesis. Primary union was achieved in three of four syndromic patients with A/PSF; pseudarthrosis occurred in the patient with Gorham’s disease.
Conclusion. Arthrodesis was effective without major complications
in nonsyndromic kyphosis. Complications were frequent in syndromic kyphosis. There was a significant association of greater residual kyphosis with pseudarthrosis in syndromic patients treated with PSF alone. Circumferential arthrodesis with strut grafting may decrease pseudarthrosis risk in syndromic patients with severe, rigid kyphosis. PSF alone may be sufficient in syndromic patients with flexible kyphosis when adequate postoperative correction is achieved.”
“We describe a technique for the removal of soft cataracts that can be easily taught with good reproducibility. Following hydrodissection, nucleus removal starts by sculpting a central bowl down to the posterior capsule. The surrounding nuclear rim is then broken into a C-shaped mass that can be rotated and emulsified simultaneously.