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185 results on '"Raitio, Arimatias"'

22. Maternal risk factors for congenital vertebral formation and mixed defects: A population-based case–control study.

Author

Heiskanen, Susanna, Helenius, Ilkka, Syvänen, Johanna, Kemppainen, Teemu, Löyttyniemi, Eliisa, Ahonen, Matti, Gissler, Mika, and Raitio, Arimatias

Subjects
HUMAN abnormalities, RECURRENT miscarriage, DRUGS, CASE-control method, CONGENITAL disorders, BODY mass index
Abstract

Background: The etiology and risk factors of congenital vertebral anomalies are mainly unclear in isolated cases. Also, there are no reports on the risk factors for different subgroups of vertebral anomalies. Therefore, we assessed and identified potential maternal risk factors for these anomalies and hypothesized that diabetes, other chronic diseases, smoking, obesity, and medication in early pregnancy would increase the risk of congenital vertebral anomalies. Methods: All cases with congenital vertebral anomalies were identified in the Finnish Register of Congenital Malformations from 1997 to 2016 for this nationwide register-based case–control study. Five matched controls without vertebral malformations were randomly selected. Analyzed maternal risk factors included maternal age, body mass index, parity, smoking, history of miscarriages, chronic diseases, and prescription drug purchases in early pregnancy. Results: The register search identified 256 cases with congenital vertebral malformations. After excluding 66 syndromic cases, 190 non-syndromic malformations (74 formation defects, 4 segmentation defects, and 112 mixed anomalies) were included in the study. Maternal smoking was a significant risk factor for formation defects (adjusted odds ratio 2.33, 95% confidence interval 1.21–4.47). Also, pregestational diabetes (adjusted odds ratio 8.53, 95% confidence interval 2.33–31.20) and rheumatoid arthritis (adjusted odds ratio 13.19, 95% confidence interval 1.31–132.95) were associated with mixed vertebral anomalies. Conclusion: Maternal pregestational diabetes and rheumatoid arthritis were associated with an increased risk of mixed vertebral anomalies. Maternal smoking increases the risk of formation defects and represents an avoidable risk factor for congenital scoliosis. Level of evidence: III [ABSTRACT FROM AUTHOR]

Published
2024
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28. Surgical and Health-related Quality of life Outcomes in Children With Congenital Scoliosis During 5-year Follow-up. Comparison to Age and Sex-matched Healthy Controls

Author

Haapala, Hermanni, Heiskanen, Susanna, Syvanen, Johanna, Raitio, Arimatias, Helenius, Linda, Ahonen, Matti, Diarbakerli, Elias, Gerdhem, Paul, Helenius, Ilkka, Haapala, Hermanni, Heiskanen, Susanna, Syvanen, Johanna, Raitio, Arimatias, Helenius, Linda, Ahonen, Matti, Diarbakerli, Elias, Gerdhem, Paul, and Helenius, Ilkka

Abstract

Background:Congenital spinal anomalies represent a heterogeneous group of spinal deformities, of which only progressive or severe curves warrant surgical management. Only a limited number of studies have investigated the impact of surgery on the health-related quality of life and very limited data exists comparing these outcomes to healthy controls. Methods:A single surgeon series of 67 consecutive children with congenital scoliosis (mean age at surgery 8.0 y, range: 1.0 to 18.3 y, 28 girls) undergoing hemivertebrectomy (n = 34), instrumented spinal fusion (n = 20), or vertical expandable prosthetic titanium rib procedure (n = 13) with a mean follow-up of 5.8 years (range: 2 to 13 y). The comparison was made to age and sex-matched healthy controls. Outcome measures included the Scoliosis Research Society questionnaire both pre and postoperatively, radiographic outcomes, and complications. Results:The average major curve correction was significantly better in the hemivertebrectomy (60%) and instrumented spinal fusion (51%) than in the vertical expandable prosthetic titanium rib group (24%), respectively (P < 0.001). Complications were noted in 8 of 67 (12%) children, but all patients recovered fully during follow-up. Pain, self-image, and function domains improved numerically from preoperative to final follow-up, but the pain score was the only one with a statistically significant change (P = 0.033). The Scoliosis Research Society pain, self-image, and function domain scores remained at a significantly lower level at the final follow-up than in the healthy controls (P <= 0.05), while activity scores improved to a similar level. Conclusions:Surgery for congenital scoliosis improved angular spinal deformities with a reasonable risk of complications. Health-related quality of life outcomes improved from preoperative to final follow-up, but especially pain and function domains remained at a significantly lower level than in the age and sex-matched healthy controls.

Published
2023
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34. Vertebral Body Tethering : Indications, Surgical Technique, and a Systematic Review of Published Results

Author

Raitio, Arimatias, Syvänen, Johanna, Helenius, Ilkka, Department of Surgery, I kirurgian klinikka (Töölö), and HUS Musculoskeletal and Plastic Surgery

Subjects
surgery, ADOLESCENT IDIOPATHIC SCOLIOSIS, MINIMUM, SPINAL-FUSION, 3126 Surgery, anesthesiology, intensive care, radiology, growth-friendly techniques, GROWTH-MODULATION, vertebral body tethering
Abstract

Vertebral body tethering (VBT) represents a new surgical technique to correct idiopathic scoliosis using an anterior approach, spinal instrumentation with vertebral body screws, and a cable compressing the convexity of the curve. According to the Hueter-Volkmann principle, compression reduces and distraction increases growth on the growth plates. VBT was designed to modulate spinal growth of vertebral bodies and hence, the term 'growth modulation' has also been used. This review describes the indications and surgical technique of VBT. Further, a systematic review of published studies was conducted to critically evaluate the results and complications of this technique. In a total of 23 included studies on 843 patients, the preoperative main thoracic curve corrected from 49 to 23 degrees in a minimum 2 year follow-up. The complication rate of VBT was 18%. The results showed that 15% of VBT patients required reoperations for pulmonary or tether-related issues (10%) and less than 5% required conversion to spinal fusion. While the reported median-term results of VBT appear promising, long-term results of this technique are currently lacking.

Published
2022

38. Health-related quality of life after segmental pedicle screw instrumentation: a matched comparison of patients with neuromuscular and adolescent idiopathic scoliosis.

Author

SOINI, Venla, SYVÄNEN, Johanna, HELENIUS, Linda, RAITIO, Arimatias, and HELENIUS, Ilkka

Subjects
ACADEMIC medical centers, CONFIDENCE intervals, NEUROMUSCULAR diseases, SPINAL fusion, BONE screws, RETROSPECTIVE studies, CASE-control method, ACQUISITION of data, TREATMENT effectiveness, COMPARATIVE studies, QUALITY of life, MEDICAL records, QUESTIONNAIRES, DESCRIPTIVE statistics, ADOLESCENT idiopathic scoliosis, LONGITUDINAL method, EVALUATION
Abstract

Background and purpose -- Progressive neuromuscular scoliosis (NMS) often requires a long instrumented spinal fusion to improve health-related quality of life (HRQoL) and sitting balance. Segmental pedicle screw instrumentation improves HRQoL in patients with adolescent idiopathic scoliosis (AIS), but data on NMS is limited. We aimed to assess the impact of spinal fusion on HRQoL in NMS patients. Patients and methods -- We conducted a retrospective case-control study with prospective data collection of NMS patients undergoing posterior spinal fusion at a tertiary level hospital in 2009-2021. 2 controls with AIS matched for sex and age were selected for each NMS patient. The Scoliosis Research Society-24 (SRS-24) questionnaire was utilized for pre- and postoperative HRQoL assessment. Follow-up time was a minimum of 2 years. Results -- 60 NMS and 120 AIS patients were included in the analysis, and the mean age (SD) at operation was 14.6 (2.7) in NMS and 15.7 (2.5) in AIS groups. Total SRS score and all domains showed a significant improvement in NMS patients (p < 0.05). Total SRS score improved more (p < 0.001), while pain score improved less (p = 0.04) in NMS (change [95% CI], 0.31 [0.05-0.58] and 0.55 [0.27-0.81]) compared with AIS (0.01 [-0.10 to 0.12] and 0.88 [0.74-1.03]). Postoperative self-image was significantly better in NMS than in AIS at 2-year follow up (p = 0.01). Pelvic instrumentation reduced improvements in the SRS domains. Conclusion -- HRQoL in NMS patients improved significantly after spinal fusion, and these benefits are comparable to those of AIS patients. [ABSTRACT FROM AUTHOR]

Published
2023
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39. The association of perinatal and clinical factors with outcomes in infants with gastroschisis-a retrospective multicenter study in Finland : A retrospective multicenter study in Finland

Author

Tauriainen, Asta, Sankilampi, Ulla, Raitio, Arimatias, Tauriainen, Tuomas, Helenius, Ilkka, Vanamo, Kari, Hyvärinen, Anna, I kirurgian klinikka (Töölö), University of Helsinki, and Helsinki University Hospital Area

Subjects
Gastroschisis, Central line sepsis, 3123 Gynaecology and paediatrics, Outcomes, 3126 Surgery, anesthesiology, intensive care, radiology, Liver herniation
Abstract

The aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and/or short bowel syndrome or hospital stay > 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome. Conclusion: The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line-associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting. What is known: center dot Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing. center dot Complex gastroschisis has been reported to increase risk of mortality and complications. What is new: center dot Central line sepsis was found to be independently associated with mortality in gastroschisis patients. center dot Liver herniation was also significantly associated with mortality.

Published
2021

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