Clostridium difficile Colitis in Patients Undergoing Surgery for Adolescent Idiopathic Scoliosis.

PURPOSE OF THE STUDY To identify risk factors associated with developing Clostridium difficile infection (CDI) in adolescent idiopathic scoliosis patients after surgery and to describe the clinical presentation of CDI in these patients. Clostridium difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on CDI rates and its consequences on patient undergoing surgery for adolescent idiopathic scoliosis. MATERIAL AND METHODS A retrospective database review of patients who underwent elective idiopathic scoliosis surgery between January 2019 to June 2021 was conducted. The population was divided into patients who developed Clostridium difficile colitis and those who did not. RESULTS A total of 128 patients were included in the study. We did not find notable risk factors for the development of CDI. In 2 patients diagnosis of CDI, was made. Length of hospital stays, and readmissions were significantly higher in patients with CDI. CONCLUSIONS CDI is a rare post-surgical complication in patients who undergo surgery for idiopathic scoliosis. Currently, we cannot identify predisposing factors for the development of CDI in adolescent idiopathic scoliosis patients. A high index of suspicion is necessary for timely diagnosis and treatment in patients presenting with abdominal symptoms around post-operative day 5 after surgical treatment for idiopathic scoliosis. Key words: Clostridium difficile infection, adolescent idiopathic scoliosis, abdominal pain, diarrhea.

Isolated unilateral facet dislocation of the lumbosacral junction.

Traumatic unilateral facet dislocation of the lumbosacral junction without fracture or with non-displaced fractures of adjacent vertebrae is extremely rare. We describe a case of a young male who sustained a unilateral facet dislocation of the lumbosacral junction in a motor vehicle accident. The unusual features of this case include an unremarkable physical and neurological examination on presentation and absence of other substantial vertebral or extra-vertebral injuries.

Pediatric Scoliosis Surgery - the association between preoperative risk factors and postoperative complications with emphasis on cerebral palsy children.

Scoliosis repair surgery is a common procedure. Our study's first goal was to compare pre- and postoperative parameters between the cerebral palsy (CP) and idiopathic scoliosis (IS) children. The second goal was to establish possible associations between preoperative parameters that could predict the outcome of spinal surgery and the incidence of early postoperative complications. A retrospective record review of all children who underwent scoliosis operative surgery between 1998 and 2007 was conducted. Of the 141 children included, 21 were CP and 120 were IS. The CP children attended surgery with significantly lower weight and pulmonary reserves and had larger curves and fusions compared to the IS children. CP children had a significantly higher rate of major complications, especially pulmonary and neurological, and a higher rate of delayed extubations. In addition, young age at surgery and posterior spinal fusion correlated with a more favorable immediate postoperative prognosis among the IS population. CP children attended surgery in worse physical condition and in turn had a poorer immediate and short-term postoperative prognosis than IS children. Young age at surgery and posterior fusions revealed protective characteristics among the IS population.

Good results of circumferential spine fusion in smokers, using autograft and allograft.

We have examined the rates of anterior interbody fusion of lumbar spine segments following fusion with a fresh frozen femoral head allograft in 25 heavy smoking patients. They were all stabilized both anteriorly and posteriorly. The indications for surgery were: degenerative disc disease, degenerative spondylolisthesis and nonunion following previous posterolateral fusion of lumbar spine segments. Only patients who had fusion of one or two lumbar segments were included. They all were stabilized posteriorly with pedicle screws and autogenic iliac bone graft. The fusion was assessed at least one year after surgery according to plan X-rays as "Solid", "Questionable" or "Failure". One patient was found at follow up not fused, in another one the fusion was "questionable" and all the other 23 patients had an anterior solid fusion. Clinically, 84% of the patients had the same or improved work status as before surgery and 68% acknowledged that they were satisfied with the surgical results. No major complications were recorded and the average length of hospitalization was 10.3 days.