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 78,556 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the present study was to introduce a new magnetic resonance imaging (MRI) procedure showing the whole spine in a coronal and sagittal plane, and to study the assessment of sagittal Cobb angle measurements using this technique. Prospectively we studied 32 patients (average age 14.8 years) with idiopathic scoliosis (mean thoracic Cobb angle 33 degrees on radiograph) and 18 patients (average age 14.5 years) without scoliosis. The MRI investigation was carried out in a standard supine position. The cervical and upper thoracic spine and the lower thoracic and lumbar spine were measured on a 1.5-T Gyroscan ACS-NT Powertrak 6000 system. An algorithm was developed to combine the results of the cranial and caudal scans into a coronal and a sagittal image of the whole spine (MR total spine imaging). Measurement of the sagittal Cobb angle conducted ten times by four independent investigators revealed an intraobserver variance of 1.6 degrees and an interobserver variance of 1.8 degrees. In the group with scoliosis the mean sagittal Cobb angle from T4 to T12 was 12 degrees (range -3 degrees to 24 degrees) and in the group without scoliosis 22 degrees (range 16 degrees to 30 degrees), which was a significant difference. MR total spine imaging makes it possible to image scoliosis in the sagittal plane. On these MR projections, idiopathic thoracic scoliosis was identified by a reduced sagittal Cobb angle. MR total spine imaging would allow monitoring of scoliosis in the sagittal plane, which can reveal relevant clinical data without radiation exposure.
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PMID:A new MRI technique for imaging scoliosis in the sagittal plane. 1134 31

This was a retrospective study of data prospectively collected from 2012 to 2016 from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. The objective was to evaluate the effect of pediatric fellowship training on 30-day perioperative morbidity and mortality following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Several pathways exist in North America by which physicians acquire the clinical and technical skills to manage AIS surgically. Previous work has noted that surgeons with pediatric fellowship training tend to perform the bulk of pediatric spine surgeries. However, no study has been performed that examines if pediatric fellowship training (PFT) has an impact on early postoperative outcomes. A total of 14,194 AIS surgical patients were identified from the ACS NSQIP database. A cohort receiving isolated PSF was abstracted from this group and separated into 3 groups according to surgeon training: (1) ped+ (with PFT, n=4455); (2) ped-(without PFT, n=325); and (3) ped+match (patients selected from ped+ matched to ped- for age, sex, and fusion levels, n=325). The groups were compared for 30-day perioperative morbidity and mortality. No significant differences were noted for the 3 groups in terms of wound infections, length of hospital stay, readmissions, and unplanned returns to the operating room. Ped+match and ped- groups had no difference in neurologic injury rates. However, the ped+ and ped+match groups had significantly lower rates of blood transfusion and average volume of blood lost compared with the ped- group. Surgeons with pediatric fellowship training have a significantly lower average blood loss volume and blood transfusion rate in PSF for AIS than surgeons without such training. Understanding that different training pathways for surgeons may directly impact operative outcomes invites further examination of surgical education in North America to improve training consistency. [Orthopedics. 2020;43(5):e454-e459.].
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PMID:Impact of Pediatric Subspecialty Training on Perioperative Complications in Adolescent Idiopathic Scoliosis Surgery. 3274 24