16 results on '"Thomas G. Luerssen"'
Search Results
2. In Memoriam: John Edward Kalsbeck, MD (1928–2017)
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Thomas G. Luerssen, Andrew Jea, and Daniel H. Fulkerson
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business.industry ,Medicine ,Surgery ,Neurology (clinical) ,Theology ,business - Published
- 2017
3. Routine Use of Recombinant Human Bone Morphogenetic Protein-2 in Posterior Fusions of the Pediatric Spine: Safety Profile and Efficacy in the Early Postoperative Period
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Robert C. Dauser, Daniel K. Fahim, Andrew Jea, William E. Whitehead, Thomas G. Luerssen, and Daniel J. Curry
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Male ,Hyperostosis ,medicine.medical_specialty ,Adolescent ,Bone Morphogenetic Protein 2 ,Bone morphogenetic protein ,Young Adult ,Lumbar ,Restenosis ,Transforming Growth Factor beta ,Humans ,Medicine ,Spinal canal ,Child ,Rachis ,Retrospective Studies ,business.industry ,Infant ,medicine.disease ,Combined Modality Therapy ,Recombinant Proteins ,Spine ,Surgery ,Radiography ,Spinal Fusion ,Treatment Outcome ,medicine.anatomical_structure ,El Niño ,Child, Preschool ,Bone Morphogenetic Proteins ,Intercellular Signaling Peptides and Proteins ,Female ,Neurology (clinical) ,business ,Complication - Abstract
BACKGROUND: Previous studies using recombinant human bone morphogenetic protein-2 (rhBMP-2) in the adult lumbar spine have shown consistently good results, There have been no pediatric case series. OBJECTIVE: To determine the safety and efficacy of rhBMP-2 use in posterior instrumented fusions of the pediatric population. METHODS: A retrospective review of 19 consecutive pediatric patients who underwent posterior occiptocervical, cervical, thoracic, lumbar, or lumbosacral spine fusion from October 1, 2007, to June 30, 2008, at Texas Children's Hospital was performed. The average age was approximately 12 years old (range, 9 months to 20 years). The minimum follow-up was 17 months (average of 19 months, range: 17-25 months), with computed tomography (CT) evaluation and grading of fusion by an independent radiologist at 3 months after surgery. RESULTS: The average CT grade was 3, indicating bilateral bridging bone. No pseudoarthroses or loss of correction was identified clinically or radiographically at 3 months and latest follow-up. There was one complication of bony overgrowth and restenosis of the spinal canal necessitating reoperation, and two superficial wound infections. There were no deep wound infections. CONCLUSION: Early outcomes using rhBMP-2 in the pediatric population show that it is a safe and efficacious adjunct to posterior spine fusions of the occipitocervical, cervical, thoracic, lumbar, and lumbosacral spine. It dependably results in the development of stable bridging bone at 3 months after surgery with good maintenance of correction and stability in long-term follow-up. Lessons learned from the case of unexpected bony overgrowth are discussed.
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- 2010
4. USE OF AXIAL AND SUBAXIAL TRANSLAMINAR SCREW FIXATION IN THE MANAGEMENT OF UPPER CERVICAL SPINAL INSTABILITY IN A SERIES OF 7 CHILDREN
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James M. Drake, Daniel J. Curry, William E. Whitehead, Keyne K. Johnson, Roukoz B. Chamoun, Thomas G. Luerssen, Andrew Jea, and Katherine Relyea
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Joint Instability ,Male ,medicine.medical_specialty ,Adolescent ,Vertebral artery ,Bone Screws ,Nonunion ,Os Odontoideum ,Iliac crest ,Fixation (surgical) ,medicine.artery ,Image Processing, Computer-Assisted ,medicine ,Humans ,Child ,Rachis ,business.industry ,Infant ,X-Ray Microtomography ,Perioperative ,medicine.disease ,Surgery ,Spinal Fusion ,Treatment Outcome ,medicine.anatomical_structure ,Atlanto-Axial Joint ,Spinal Cord ,Child, Preschool ,Cervical Vertebrae ,Female ,Cervical collar ,Neurology (clinical) ,business - Abstract
Objective The management of upper cervical spinal instability in children continues to represent a technical challenge. Traditionally, a number of wiring techniques followed by halo orthosis have been applied; however, they have been associated with a high rate of nonunion and poor tolerance for the halo. Alternatively, C1-C2 transarticular screws and C2 pars/pedicle screws allow more rigid fixation, but they are technically demanding and associated with vertebral artery injuries. Recently, C2 translaminar screws have been added to the armamentarium of the pediatric spine surgeon as a technically simple and biomechanically efficient method of fixation. However, subaxial translaminar screws have not been described in the pediatric population. We describe our experience with axial and subaxial translaminar screws in 7 pediatric patients. Methods Seven pediatric patients with the diagnosis of upper cervical spinal instability required surgical fixation (age, 19 months-14 years; sex, 4 boys and 3 girls; follow-up, 4-21 months; etiology, trauma [3 patients], os odontoideum/os terminale [2 patients], hypoplastic dens [2 patients]). All patients underwent axial and/or subaxial translaminar screw insertion. Iliac crest bone graft was used for fusion in 4 patients; bone morphogenic protein and cancellous morselized allograft was used for fusion in 3 patients. A rigid cervical collar was applied for 12 weeks postoperatively in all cases. No intraoperative image guidance was used for insertion of the translaminar screws. Results All patients had a postoperative computed tomographic scan. Two patients underwent placement of bilateral crossing C2 translaminar screws. Two patients had subaxial translaminar screw placement at C3 and the upper thoracic spine, respectively. Hybrid constructs (a C2 translaminar screw combined with a C2 pars screw) were incorporated in 3 patients. No patients were found to have a breach of the ventral laminar cortex. All patients achieved solid fusion. One patient had a perioperative complication: prolonged dysphagia probably related to C1 lateral mass screw insertion rather than C2 translaminar screw placement. Conclusion To our knowledge, this report represents the only series of pediatric patients treated with axial and subaxial translaminar screws. This series shows that axial and subaxial translaminar screw fixation is a viable option for upper cervical spinal fusion in children. The technique is safe and results in adequate fixation with high fusion rates and minimal complications.
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- 2009
5. Comparative Effectiveness of Surgical Treatments for Pediatric Hydrocephalus
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Thomas G. Luerssen, Dominic A. Harris, Sandi Lam, and I-Wen Pan
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Ventriculostomy ,Male ,medicine.medical_specialty ,Georgia ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Child ,Propensity Score ,Survival analysis ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Endoscopic third ventriculostomy ,Infant ,medicine.disease ,Cerebrospinal Fluid Shunts ,Surgery ,Hydrocephalus ,Treatment Outcome ,030220 oncology & carcinogenesis ,Relative risk ,Child, Preschool ,Propensity score matching ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Shunt (electrical) - Abstract
BACKGROUND Pediatric hydrocephalus represents a high health care burden in the United States (US). Surgery is the mainstay of treatment. OBJECTIVE To perform a comparative effectiveness analysis for endoscopic third ventriculostomy (ETV) and cerebrospinal fluid shunt placement in pediatric hydrocephalus patients in the US using a large administrative claims database through the application of propensity scores matching. METHODS The MarketScan® database (Truven Health Analytics, Atlanta, Georgia) 2003 to 2011 was used. Patients 19 yr or younger at first occurrence of ETV or shunt during the study period were included. The study outcome, surgery failure, was defined as further surgical treatment for hydrocephalus subsequent to initial ETV or shunt procedure. Age, etiology of hydrocephalus, and history of shunt were used to create matched samples for the ETV and shunt cohorts. Kaplan-Meier survival curves, stratified log-rank test, and Cox proportional-hazard models were used to analyze samples. RESULTS There were 3231 eligible cases (478 ETV; 2753 shunt). Propensity scores matching produced 455 balanced pairs. For matched samples, 326 of 455 (72%) pairs were concordant, while 129 pairs were discordant in surgery outcomes within 3 mo. Among discordant pairs, ETV patients were more likely to experience surgery failure compared to patients receiving shunt (relative risk = 1.4, P value = .011). Furthermore, patients' age < 1 yr had lower ETV success rates than those with shunt (P value = .009). No similar pattern was found in patients' age ≥ 1 yr. CONCLUSION There was no significant effect on time to failure between patients undergoing ETV and shunt, except in infants' age
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- 2015
6. Hybrid spinal constructs using sublaminar polyester bands in posterior instrumented fusions in children: a series of 5 cases
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Thomas G. Luerssen, Ashwin Viswanathan, Keyne K. Johnson, Daniel J. Curry, Andrew Jea, and William E. Whitehead
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Male ,medicine.medical_specialty ,Demographics ,Adolescent ,Polyesters ,medicine ,Humans ,Kyphosis ,Rachis ,Retrospective Studies ,Neuromuscular scoliosis ,business.industry ,Spina bifida ,Instrumented fusion ,Infant ,Prostheses and Implants ,Sacrum ,medicine.disease ,Kyphotic deformity ,Spinal surgery ,Surgery ,Spinal Fusion ,Scoliosis ,Child, Preschool ,Female ,Neurology (clinical) ,business - Abstract
OBJECTIVE: The authors report the novel use of sublaminar polyester bands in posterior instrumented spinal fusions of the thoracic and lumbar spine and sacrum in 5 children. This is the first reported use of polyester bands in spinal surgery in the United States. METHODS: The authors retrospectively reviewed the demographics and procedural data for children who underwent posterior instrumented fusion using sublaminar polyester bands. RESULTS: Five children, ranging in age from 9 months to 18 years, underwent posterior instrumented fusion for posttrauma kyphotic deformity (1 patient), congenital scoliosis from hemivertebra anomaly (3 patients), and neuromuscular scoliosis associated with spina bifida (1 patient).There were 1 instance of lamina fracture with application and tensioning of the polyester band and 1 instance of transient worsening of proprioception with sublaminar passage of the polyester band. CONCLUSION: Pedicle screws, laminar/pedicle/transverse process hooks, and sublaminar metal wires have been incorporated into posterior spinal constructs and widely reported and used in the thoracic and lumbar spine and sacrum with varying success. This report demonstrates the successful results of hybrid posterior spinal constructs that include sublaminar polyester bands that promise the technical ease of passing sublaminar instrumen - tation with the immediate biomechanical rigidity of pedicte screws and hooks.
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- 2010
7. 195 The Effect of Weekend and After-Hours Surgery on Morbidity and Mortality Rates in Pediatric Neurosurgery
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Sandi Lam, David D. Gonda, Andrew Jea, Virendra R. Desai, and Thomas G. Luerssen
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medicine.medical_specialty ,Ruptured abdominal aortic aneurysm ,Weekend effect ,Adult patients ,business.industry ,Pediatric neurosurgery ,Mortality rate ,education ,medicine.disease ,Pulmonary embolism ,Surgery ,Pediatric surgery ,Medicine ,Neurology (clinical) ,Pediatric Surgical Procedures ,business ,human activities - Abstract
INTRODUCTION:Several studies have indicated that 30-day morbidity and mortality risk is higher among pediatric and adult patients who are admitted on the weekends. This “weekend effect” has been observed among patients admitted with and for a variety of diagnoses and procedures, respectively, includ
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- 2015
8. 105 Incidence and Predictors of Complications After Bypass Surgery for Pediatric Patients With Moyamoya Disease
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Sandi Lam, Thomas G. Luerssen, Dominic A. Harris, I-Wen Pan, and Yimo Lin
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Down syndrome ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Vascular bypass ,medicine.disease ,Surgery ,Sepsis ,Postoperative stroke ,Bypass surgery ,medicine ,Neurology (clinical) ,Drepanocytes ,Moyamoya disease ,business - Published
- 2015
9. Computed Tomography Morphometric Analysis for Translaminar Screw Fixation in the Upper Thoracic Spine of the Pediatric Population
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William E. Whitehead, Jacob Cherian, Daniel H. Fulkerson, Akash J. Patel, Benjamin D. Fox, Andrew Jea, Daniel J. Curry, and Thomas G. Luerssen
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Upper thoracic spine ,medicine.medical_specialty ,medicine.diagnostic_test ,Morphometric analysis ,business.industry ,Medicine ,Surgery ,Computed tomography ,Neurology (clinical) ,Radiology ,business ,Screw fixation ,Pediatric population - Published
- 2010
10. Use of Axial and Subaxial Translaminar Screws in the Management of Upper Cervical Spinal Instability in Children
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Thomas G. Luerssen, William E. Whitehead, Keyne K. Johnson, James M. Drake, Daniel J. Curry, Roukoz B. Chamoun, and Andrew Jea
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medicine.medical_specialty ,business.industry ,medicine ,Spinal instability ,Surgery ,Neurology (clinical) ,business - Published
- 2008
11. 821 Hypothermia on Admission in Patients with Severe Brain Injury
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Sung C. Choi, Emmy R. Miller, Donald W. Marion, Guy L. Clifton, J. Paul Muizelaar, Kenneth R. Smith, Harvey S. Levin, Thomas G. Luerssen, and Stephen R. McCauley
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business.industry ,Anesthesia ,medicine ,In patient ,Surgery ,Neurology (clinical) ,Hypothermia ,medicine.symptom ,business - Published
- 2001
12. Academic Recovery after Head Injury
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Dennis E. Bowman and Thomas G. Luerssen
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medicine.medical_specialty ,business.industry ,Head injury ,medicine ,Physical therapy ,Surgery ,Neurology (clinical) ,medicine.disease ,business - Published
- 1993
13. Severe Head Injury in Children
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Harvey S. Levin, E. Francois Aldrich, Christy Saydjari, Howard M. Eisenberg, Mary A. Foulkes, Monique Bellefleur, Thomas G. Luerssen, John A. Jane, Anthony Marmarou, Lawrence F. Marshall, and Harold F. Young
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Surgery ,Neurology (clinical) - Published
- 1992
14. Postsurgical Arachnoid Cyst: Report of Two Cases
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Thomas G. Luerssen and John E. Kalsbeck
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Adult ,Male ,Neurological signs ,medicine.medical_specialty ,Adenoma ,medicine.medical_treatment ,Postoperative Complications ,Arachnoid cyst ,X ray computed ,medicine ,Humans ,Pituitary Neoplasms ,Child ,Craniotomy ,Adenoma, Chromophobe ,Cysts ,business.industry ,Reye Syndrome ,Space-occupying lesion ,medicine.disease ,Cerebrospinal Fluid Shunts ,Surgery ,Shunting ,Female ,Neurology (clinical) ,Arachnoid ,Tomography, X-Ray Computed ,business ,Complication - Abstract
We present two cases that demonstrate the occurrence of symptomatic arachnoid cysts after craniotomy. Both patients presented 1 year postoperatively with generalized seizures as the only symptom. Focal or localizing neurological signs were not present. Both patients responded well to shunting procedures.
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- 1983
15. Spontaneous saphenous neuralgia
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Robert L. Campbell, Robert M. Worth, Thomas G. Luerssen, and Ray J. Defalque
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Saphenous nerve block ,Cicatrix ,Postoperative Complications ,medicine ,Humans ,Neurolysis ,business.industry ,Muscles ,Nerve Compression Syndromes ,Neurectomy ,Leg pain ,Middle Aged ,medicine.disease ,Lower limb pain ,Surgery ,Saphenous nerve ,Thigh ,Neuralgia ,Female ,Neurology (clinical) ,Differential diagnosis ,business ,Femoral Nerve - Abstract
Six patients representing seven cases of spontaneous (nontraumatic) saphenous neuralgia secondary to entrapment of the nerve in the subsartorial canal are presented. All patients complained of medial knee and leg pain. Clinical findings included tenderness over the subsartorial canal and sensory changes in the cutaneous distribution of one or both terminal branches of the saphenous nerve. The diagnosis was confirmed by saphenous nerve block in all cases. All patients were treated operatively, which resulted in symptomatic improvement. All six patients initially underwent external neurolysis; however, three patients required saphenous neurectomy for recurrent symptoms. Saphenous neuralgia should be considered in the differential diagnosis of medial lower extremity pain.
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- 1983
16. Determinants of head injury mortality: importance of the low risk patient
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Lawrence F. Marshall, Melville R. Klauber, Howard M. Eisenberg, Ralph F. Frankowski, Thomas G. Luerssen, and Kamran Tabaddor
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Hospital unit ,Chest injury ,Risk Factors ,Epidemiology ,medicine ,Craniocerebral Trauma ,Humans ,In patient ,Risk factor ,Child ,Aged ,business.industry ,Public health ,Head injury ,Age Factors ,Infant, Newborn ,Infant ,Middle Aged ,medicine.disease ,Surgery ,Blood pressure ,Brain Injuries ,Child, Preschool ,Emergency medicine ,Female ,Neurology (clinical) ,business - Abstract
Data were obtained prospectively for 7,912 head-injured patients admitted from 1980 to 1981 to 41 hospitals in 3 U.S. metropolitan areas. Highly significant independent predictors of mortality were motor score, number of reactive eyes, systolic blood pressure, abdominal injury, chest injury, age, and hospital unit (hospital or group of hospitals). The difference between the number of deaths observed and the number expected, by hospital unit, ranged from 43% below expectation to 52% above expectation. The 2 hospital units with the lowest mortality had only 1 death, where 9.4 would be expected, in patients whose risk of death was estimated to be less than 10%. In the single hospital with clearly excess mortality, however, the standardized mortality ratios were 208, 135, and 144% for the risk groups whose probabilities of death were 0 to 50, 50 to 80, and 80 to 100%, respectively. The lack of deaths in those hospitals with the best mortality experience and the excess mortality in the hospital with the worst mortality experience appear to be explained largely by differences in patients who, by clinical criteria, seem to be at low risk for death, and not by severely injured patients.
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- 1989
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