Impact of Pregnancy on Loss of Deformity Correction After Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis

OBJECTIVE: A retrospective multicenter comparative study was carried out to evaluate whether pregnancy leads to the loss of deformity correction (LOC) in female patients surgically treated for idiopathic scoliosis. METHODS: A total of 128 female patients who underwent segmental spinal instrumentation and fusion for adolescent idiopathic scoliosis (AIS) between 1999 and 2014 were reviewed. Of these patients, 62 became pregnant (surgery-pregnancy group [SPG]), whereas 66 did not (surgery-nonpregnancy [SNP] group). Radiographic parameters were analyzed before surgery, after surgery, before pregnancy, up to 1 year after delivery, and at final follow-up (FFU). Health-related quality of life was analyzed using the Scoliosis Research Society outcome questionnaire (SRS-22r). RESULTS: The mean age at the time of surgery was 16 years in both groups. The mean preoperative major curves were 65 degrees (standard deviation [SD], 12 degrees) versus 67 degrees (SD, 11 degrees), 18 degrees (SD, 9 degrees) versus 17 degrees (SD, 9 degrees) immediately after surgery, and 20 degrees (SD, 8 degrees) versus 20 degrees (SD, 8 degrees) at FFU in the SPG and SNP groups, respectively (P > 0.10 for all comparisons). The mean loss of correction was 3.5 degrees (SD, 3 degrees) in the SPG and 4.5 (SD, 3 degrees) for SNP groups, respectively (P = 0.379). The mean preoperative thoracic kyphosis (T5-T12) was 26.5 degrees (SD, 11.9 degrees) for SPG and 24.7 degrees (SD, 14.5 degrees) for SNP, after surgery 19.2 degrees (SD, 9.5 degrees) for SPG, 18.8 (SD, 8.9 degrees) for SNP and at FFU, 20.3 degrees (SD, 9 degrees) for SPG and 21.3 degrees (SD, 8.5 degrees) for SNP. CONCLUSIONS: Women who have undergone pedicle screw instrumentation and fusion who have had >= 1 pregnancies do not have curve progression or deterioration in the longer-term outcomes compared with patients who have not become pregnant.Peer reviewe

Towards an understanding of the information and support needs of surgical adolescent idiopathic scoliosis patients: a qualitative analysis

<p>Abstract</p> <p>Background</p> <p>Informed decision making for adolescents and families considering surgery for scoliosis requires essential information, including expected outcomes with or without treatment and the associated risks and benefits of treatment. Ideally families should also receive support in response to their individual concerns. The aim of this study was to identify health-specific needs for online information and support for patients with adolescent idiopathic scoliosis who have had or anticipate having spinal surgery.</p> <p>Methods</p> <p>Focus group methodology was chosen as the primary method of data collection to encourage shared understandings, as well as permit expression of specific, individual views. Participants were considered eligible to participate if they had either experienced or were anticipating surgery for adolescent idiopathic scoliosis within 12 months, were between the ages of 10 and 18 years of age, and were English-speaking.</p> <p>Results</p> <p>Two focus groups consisting of 8 adolescents (1 male, 7 female) and subsequent individual interviews with 3 adolescents (1 male, 2 female) yielded a range of participant concerns, in order of prominence: (1) recovery at home; (2) recovery in hospital; (3) post-surgical appearance; (4) emotional impact of surgery and coping; (5) intrusion of surgery and recovery of daily activities; (6) impact of surgery on school, peer relationships and other social interactions; (7) decision-making about surgery; (8) being in the operating room and; (9) future worries.</p> <p>Conclusion</p> <p>In conclusion, adolescents welcomed the possibility of an accessible, youth-focused website with comprehensive and accurate information that would include the opportunity for health professional-moderated, online peer support.</p

Program design features that can improve participation in health education interventions

<p>Abstract</p> <p>Background</p> <p>Although there have been reported benefits of health education interventions across various health issues, the key to program effectiveness is participation and retention. Unfortunately, not everyone is willing to participate in health interventions upon invitation. In fact, health education interventions are vulnerable to low participation rates. The objective of this study was to identify design features that may increase participation in health education interventions and evaluation surveys, and to maximize recruitment and retention efforts in a general ambulatory population.</p> <p>Methods</p> <p>A cross-sectional questionnaire was administered to 175 individuals in waiting rooms of two hospitals diagnostic centres in Toronto, Canada. Subjects were asked about their willingness to participate, in principle, and the extent of their participation (frequency and duration) in health education interventions under various settings and in intervention evaluation surveys using various survey methods.</p> <p>Results</p> <p>The majority of respondents preferred to participate in one 30–60 minutes education intervention session a year, in hospital either with a group or one-on-one with an educator. Also, the majority of respondents preferred to spend 20–30 minutes each time, completing one to two evaluation surveys per year in hospital or by mail.</p> <p>Conclusion</p> <p>When designing interventions and their evaluation surveys, it is important to consider the preferences for setting, length of participation and survey method of your target population, in order to maximize recruitment and retention efforts. Study respondents preferred short and convenient health education interventions and surveys. Therefore, brevity, convenience and choice appear to be important when designing education interventions and evaluation surveys from the perspective of our target population.</p

Control of Bending-Bending Coupled Vibrations of a rRotating Thin-Walled Composite Beam

The paper presents a study of a possible application of structure embedded piezoelectric actuators to enhance the performance of a rotating composite beam exhibiting the coupled flexural-flexural vibrations. The discussed transversal and lateral bending modal coupling results from the directional properties of the beam’s laminate and ply stacking distribution. The mathematical model of the beam is based on an assumption of cross-sectional non-deformability and it incorporates a number of non-classical effects. The final 1-D governing equations of an active composite beam include both orthotropic properties of the laminate and transversely isotropic properties of piezoelectric layers. The system’s control capabilities resulting from embedded Macro Fiber Composite piezoelectric actuators are represented by the boundary bending moment. To enhance the dynamic properties of the composite specimen under consideration a combination of linear proportional control strategies has been used. Comparison studies have been performed, including the impact on modal coupling magnitude and cross-over frequency shift

Diagnostic problems in tumour of Th10 vertebra in a 10-year-old girl - case study

Introduction. Despite a wide range of imaging modalities available today, clinically silent osteolytic changes in the skeletal system occurring in children are still a diagnostic challenge. Case report. The study presents the case of 10-year-old girl with a tumour in a thoracic vertebra. The patient was admitted to the Paediatric Orthopedics Clinic in the Paediatric Clinical Hospital in Lublin suffering from severe pain in the thoracic and lumbar spine. The pain had started suddenly. Physical examination showed lumbar spine pain and a forced scoliotic position. To reduce the symptoms, spinal traction, analgetics and myorelaxing drugs were used. X-ray and CT of the spine showed congenital unfused S1-S3 vertebrae. An MRI was scheduled for further diagnosis. After treatment, the symptoms disappeared and the the patient was discharged after 6 days. MRI showed an oval, well-demarcated lesion in the vertebra body and left side of the arch of the Th10 vertebra. The patient was admitted to the Clinic one again. CT scan of the thoracic spine showed an osteolytic lesion in Th10 vertebra. In the spine X-ray irregular vertebral body contour in Th10 vertebra, was seen. There were no signs of neoplastic infiltration. Scintigraphy showed increased radioisotope uptake in spinal processes of Th10 and Th11 vertebrae, which confirmed the MRI results. A transpendicular trepanobiopsy of the Th10 vertebrae was performed to provide material for histopathological examination. Then, a transpedicular stabilization of Th9-Th11 vertebrae and posterior sponylodesis with spinal autografts was performed. Histopathological examination showed no malignant cells but did not help to establish a diagnosis. Conclusion. In spite of using all the available diagnostic methods it was impossible to determine the type of lesion in the patient’s spine. Genetic tumour marker test can be considered

Modelling and Simulation of 3 Blade Helicopter's Rotor Model

Results of model tests of a rotating composite beam with integrated piezoelectric active element are presented in the paper. A proposed electromechanical system is a simplified model of the structure of a modern helicopter rotor blade. Numerical analysis of the considered system is developed by means of the finite element method. In addition, the laboratory setup has been built in order to perform real experimental studies. Selected static and dynamic characteristics of the object are determined by a series of numerical simulations. The results are compared with the outcomes of tests performed on the experimental setup. A very good agreement between numerical simulation and experiment results is observed