Search

Compared with 12 months earlier, 206 patients (32.7%) said they found their current health to be "much better", 209 patients (33.1%) felt "somewhat better", 123 patients (19.5%) felt "about the same", 75 patients (11.9%) felt "somewhat worse", and 18 patients (2.9%) felt "much worse." Predictors of poor postoperative patient satisfaction in patients unde... Background A significant number of patients who undergo spine surgery have pre-existing compensation claims. The feasibility of a multidisciplinary transitional pain service in pa... Background Patients who undergo spine surgery have high rates of perioperative opioid consumption compared with patients undergoing other types of surgery, and unfortunately many opioid-naive patients going into spine surgery remain on opioids long term. Spine surgery in patients with morbid obesity: tips and tricks Background Patients with obesity are becoming more prevalent in our society, and spine surgery in patients with morbid obesity presents a challenge in several aspects. Background Cobb angle measurement is a standard method for quantification of scoliosis in patients with adolescent idiopathic scoliosis (AIS). [Extracted from the article]

BACKGROUND: Elevated ambient PCO2 in the International Space Station (ISS) has been cited as a potential contributor to the vision impairment intracranial pressure syndrome (VHP), a significant health risk for astronauts during long-duration space missions. The elevation in ambient PCO2 is rather modest and normal respiratory compensation could minimize the impact on arterial PCO2. METHODS: In nine male astronauts, breaths measured prior to a rebreathing maneuver were examined to assess inspired and end-tidal PCO2 during upright seated preflight and in-flight conditions. RESULTS: Inspired PCO2 increased from preflight baseline (0.6 ± 0.1 mmHg) to in flight (3.8 ± 0.4 mmHg). End-tidal PCO2 also increased from preflight baseline (36.0 ± 3.2 mmHg) to in flight (42.1 ± 3.7 mmHg). The difference between end-tidal PCO2 comparing in flight to preflight (6.1 ±1.6 mmHg) was greater than the difference between inspired PCO2 comparing preflight to in flight (3.3 ± 0.5 mmHg). DISCUSSION: The greater increase in end-tidal vs. inspired PCO2 might reflect alveolar hypoventilation due to differences in ventilatory control with spaceflight. These data suggest that further studies should focus on arterial PCO2 and acid-base balance to determine if CO2 dilates cerebral and retinal vessels and might contribute to the incidence of VHP in astronauts. [ABSTRACT FROM AUTHOR]

Background: Children with neuromuscular scoliosis undergoing scoliosis surgery face substantial rates of complications. To mitigate surgical risks such as blood loss in pediatric patients with neuromuscular scoliosis, this study focuses on enabling instrumentation planning for their abnormal vertebral and pelvic anatomy and osteopenia. This study assessed the feasibility of an "ultralow-dose" CT (ULD CT) protocol without sedation in pediatric patients with neuromuscular scoliosis who often have comorbid movement disorders. Our prospective quality improvement study aims: (1) to determine if ULD CT without sedation is feasible in this patient group; (2) to quantify the radiation dose from ULD CT and compare it with preoperative spine radiographs (XR); and (3) to assess if ULD CT allows accurate anatomical assessment and intraoperative navigation given the prevalence of movement disorders., Methods: Children with neuromuscular scoliosis underwent spine XR and ULD CT scans. Chart reviews assessed disease etiology and comorbidities. Radiation dose was quantified through Monte-Carlo simulations giving dose indices and effective dose, with statistical analysis done using a paired student's t-test (α=0.05). CT image quality was assessed for its use in preoperative planning and intraoperative navigation., Results: Fourteen patients (5 males, 9 females, average age 14±3 y) participated. One patient needed sedation due to autism spectrum disorder and global developmental delay. The radiation dose for spine XR was 0.5±0.2 mSv, and ULD CT was 0.6±0.1 mSv. There was no statistically significant difference in radiation doses between methods. All ULD CT scans had adequate quality for preoperative assessment of pedicle diameter and orientation, obstacles impeding pedicle entry, S2 Alar-Iliac screw orientation, and intraoperative navigation., Conclusions: ULD CT without sedation is feasible for children with neuromuscular scoliosis. Radiation doses were comparable to standard radiographs. ULD CT provided accurate anatomical assessments and supported intraoperative navigation, proving beneficial despite movement disorders in these patients., Level of Evidence: Level 2-Development of diagnostic criteria on basis of consecutive patients (with universally applied reference widely accepted standard)., Competing Interests: M.C. is a consultant for OrthoPediatrics Inc. and 7D Surgical Inc. (SeaSpine). The other authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Elevated ambient Pco 2 in the International Space Station (ISS) has been cited as a potential contributor to the vision impairment intracranial pressure syndrome (VIIP), a significant health risk for astronauts during long-duration space missions. The elevation in ambient Pco 2 is rather modest and normal respiratory compensation could minimize the impact on arterial Pco 2 ., Methods: In nine male astronauts, breaths measured prior to a rebreathing maneuver were examined to assess inspired and end-tidal Pco 2 during upright seated preflight and in-flight conditions., Results: Inspired Pco 2 increased from preflight baseline (0.6 ± 0.1 mmHg) to in flight (3.8 ± 0.4 mmHg). End-tidal Pco 2 also increased from preflight baseline (36.0 ± 3.2 mmHg) to in flight (42.1 ± 3.7 mmHg). The difference between end-tidal Pco 2 comparing in flight to preflight (6.1 ± 1.6 mmHg) was greater than the difference between inspired Pco 2 comparing preflight to in flight (3.3 ± 0.5 mmHg)., Discussion: The greater increase in end-tidal vs. inspired Pco 2 might reflect alveolar hypoventilation due to differences in ventilatory control with spaceflight. These data suggest that further studies should focus on arterial Pco 2 and acid-base balance to determine if CO 2 dilates cerebral and retinal vessels and might contribute to the incidence of VIIP in astronauts. Hughson RL, Yee NJ, Greaves DK. Elevated end-tidal Pco 2 during long-duration spaceflight. Aerosp Med Hum Perform. 2016; 87(10):894-897.