Nutritional improvement following growing rod surgery in children with early onset scoliosis

Purpose We aimed to evaluate the nutritional status of children with early onset scoliosis (EOS) and to determine if treatment with growing rod instrumentation improves weight percentile. Methods: Data was retrospectively collected on 88 EOS patients treated with growing rods at six institutions. Mean age at surgery was 5.8 years, and mean Cobb angle was 75°. All patients were followed for at least 2 years (mean 4 years). Weights were converted to normative percentiles based on the patients’ age and gender. Results: Preoperatively, 47 % (41/88) of patients were 0.05). Children with neuromuscular and syndromic diagnoses do not appear to improve their mean nutritional status after surgery when compared to patients with idiopathic or congenital/structural scoliosis (p = 0.006). Conclusion: Following growing rod treatment, there was significant improvement in nutritional status in approximately 50 % of patients, similar to that reported with VEPTR. Neuromuscular and syndromic patients did not experience nutritional improvement post-operatively. These findings support the theory that growing rods improve the clinical status of EOS patients, as nutritional improvement is one outcome of improved clinical status. The relationship between age at initial surgery and nutritional improvement is intriguing

Climate of Minnesota: Part XVI Incoming and Reflected Solar Radiation at St. Paul

73 pagesSolar radiation is the driving force for weather systems that constantly form , dissipate, and reform as they circle the globe. The same can be said for the relationship of the hydrologic cycle to solar radiation. A portion of the solar beam is collected in green matter as an integral element in photosynthesis, and, in a different form, solar energy has been stored in the coal , oil , and gas reserves of the earth. In effect, solar radiation is the essential element for all natural processes taking place on the earth. Today, the direct capture of solar radiation for heat and energy is part of a technology developing to replace or supplement the more standard energy sources of coal, oil, and gas. The objective of this study is to provide solar radiation information that is both broader and more detailed than provided in the preceding publications dealing with solar radiation in Minnesota (Baker, 1971; Baker and Klink, 1975; and Baker, 1977)

Staying out of trouble in pediatric orthopaedics/ David L. Skaggs, John M. (Jack) Flynn, Mininder S. Kocher, Kenneth J. Noonan, Michael G. Vitale ; consulting gurus, Lindsay Andras ... [and 37 others]

Includes bibliographical references and index"Filled with pearls and wisdom from experts in the field, Staying Out of Trouble in Pediatric Orthopaedics, 2nd Edition, is a concise, easy-to-read guide to managing difficult orthopaedic problems in children. This high-yield, highly illustrated reference provides practical advice on how to deal with commonly seen issues as well as those that are less common but that pose grave threats to the patient. Focusing on preventing problems and avoiding serious complications and prepared by editors, authors, and gurus with more than 1000 years of combined experience in pediatric orthopaedics, this title is an invaluable resource for pediatric orthopaedic surgery fellows and all orthopaedists who care for children"--1 online resource (xix, 541 pages

New technique and case report: Robot-assisted intralaminar screw fixation of spondylolysis in an adolescent

Introduction: Management of spondylolysis in adolescents is generally successful with conservative management. Uncommonly, surgical fixation is necessary for refractory cases. Direct repair with intralaminar screws is one commonly utilized technique. Recently, less invasive spinal procedures are becoming viable with the enabling of technologies, including robotics. Case description: A 14-year-old baseball player and surfer presented with low back pain, diagnosed by MRI as bony edema and stress fractures of the posterior spinal elements. After 18 months, the pain was unresponsive to rest, physical therapy, and bracing. There was no radicular pain or neurologic symptoms. Computed tomography (CT) revealed bilateral, chronic nonhealing pars defects at L5. He underwent outpatient, robot-assisted percutaneous intralaminar fixation with hydroxyapatite-coated screws through a 2 cm skin incision. Outcome: On postoperative day 1, the patient reported relief of his preoperative pain and he was ambulating without difficulty. At 2 weeks follow-up, the patient was completely pain free and surfing. At 2 months follow-up, low-dose CT demonstrated partial incorporation of the hydroxyapatite-coated screws, and the patient returned to sports. At 6 months follow-up, the patient had no pain and was swinging his baseball bat with full force. Low-dose CT revealed complete healing of the defects with full incorporation of the hydroxyapatite-coated screws. Conclusions: A novel minimally invasive robotic percutaneous approach for direct spondylolysis repair using hydroxyapatite-coated screws is a potential surgical treatment option for non-healing pars defects in adolescent patients

Risk-Based Decision Support for Dredging the Lower Mississippi River

The paper reviews progress of a U.S. Army Corps of Engineers project to develop a prototype risk-based decision support system (DSS) for operational scheduling of dredging on the Lower Mississippi River. The DSS incorporates uncertainty in dredging costs, navigation control depths, and navigation costs avoided in an integrated manner to explore the risks and costs associated with potential operational dredging decisions. The DSS is intended to provided economic and risk-based operational guidance and justification in the scheduling, operation, and movement of maintenance dredges. Several lessons are inferred for risk analysis modeling of maintenance dredging activities, and risk analysis in general