EFFICACY AND COST CONSIDERATIONS OF INTRAOPERATIVE AUTOLOGOUS TRANSFUSION IN SPINAL FUSION FOR IDIOPATHIC SCOLIOSIS WITH PREDEPOSITED BLOOD.
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Idiopathic scoliosis
Autologous blood
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A program of autologous blood transfusion in 101 patients who underwent spinal surgery was analyzed. Autologous transfusion was achieved by intraoperative blood salvage using a cell saver adn with predeposited blood. The techniques of predeposition of blood included. freezing the blood and using a storage solution. Forty-eight patients had scoliosis and received mainly cryopreserved autologous blood and 53 patients had other spinal diseases. Furgery was performed using only autologous blood transfusion in more than 90% of all patients cases. The program was well tolerated by the patiens and easily managed by the blood canter staff. There were no severe complications associated with this program. The use of instrumentation and extensive spinal fusion were found to be factors associated with inceased intraoparative blood loss. This finding suggests that instrumentation surgery and extensive spinal fusin are indications for autologous blood transfusion. Cryopreserved autologous blood transfusion in an affective method for storing a sufficient volume of blood for scoliosis surgery without affecting the patients' preoperative hemodynamic status.
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Objective In order to correct the rib prominence scoliosis inchildren .Methods From 1997 to 1999, 49 children with congenital scoliosis(27), idiopathic scoliosis(15), neurofibromatosis with scoliosis(6) and Marfan's syndrome with scoliosis(1) were treated. Rib resection was performed during the posterior spinal fusion on scoliosis, the spinal orthosis was applied postoperatively. Results No pneumothorax was happened postoperatively . All cases got satisfactory cosmetic appearance except 3 had residual rib prominence. Conclusions Multiple short segment costectomy is a safe and effective technique for the rib deformity in children with scoliosis. The resected ribs could provide the bone grafting for spinal fusion.
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Idiopathic scoliosis is commonly found in adolescents of 10 to 17 years of age, patients are required to undergo various types of treatment based on different angles in scoliosis. With the summarized literature and expert opinions, this article describes the treatment and nursing care for various degrees of scoliosis.
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Nachemson suggested that there are more girls than boys with progressive adolescent idiopathic because of a different timing between skeletal maturation and postural maturation in the sexes during adolescence. We termed Nachemson's concept the neuro-osseous timing of maturation (NOTOM) hypothesis and used it to propose a possible medical treatment for idiopathic scoliosis by delaying puberty through the pituitary using gonadorelin analogues as in idiopathic precocious puberty. The prevalence of scoliosis is reported to be increased in rhythmic gymnasts (RGs) in Bulgaria and in ballet dancers (BDs) in the USA. Both groups exhibit delayed puberty, which, at first sight, nullifies the NOTOM hypothesis for idiopathic scoliosis. While constitutional and environmental factors may determine these scolioses, the different curve types in RGs and BDs suggest that the exercise pattern over many years determines which type of scoliosis develops, although not the curve severity. We support the view that scoliotic RGs should be included in a group of sports-associated scoliosis separate from idiopathic scoliosis. Hence the delayed puberty of RGs and BDs with scoliosis does not nullify the NOTOM hypothesis as their scolioses are not idiopathic. There is a need to focus research on such subjects who have defined constitutional and environmental factors related to their scolioses.
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