Abstract:
BACKGROUND/AIMS:The perception of a surgical complication may differ between surgeons and patients. In pediatric spine surgery, the perception of the parent or primary caregiver may also differ. In order to better define these relationships, we performed a pilot study surveying a convenience sample of pediatric spinal surgeons, patients and their parent or primary caregiver. We hope to use this initial pilot study as a starting point for future research into this incompletely defined, yet increasingly relevant topic. METHODS:A survey of case vignettes describing a potential perioperative complication was administered to 14 pediatric spine surgeons at the Texas Children's Hospital Pediatric NeuroSpine Clinic from June 1 to July 31, 2009. The same survey, with modified language, was presented to a group of 13 pediatric patients (age range: 12-18 years). In addition, the surveys were separately presented to 34 primary caregivers of pediatric patients evaluated in a spine surgery clinic. The 61 respondents were asked to evaluate the cases and determine if there was a minor, a major or no complication present. Fisher's exact test was employed to evaluate associations of respondent groups and complication severity. RESULTS:There were no statistically significant differences in the proportion of patients and caregivers rating the presence of complications. In 8 of 13 cases, a majority of surgeons and a majority of patients/caregivers felt a complication was present (all p > 0.06). A greater proportion of surgeons than patients/caregivers felt a complication was present in 2 cases of transient neurological deficit/paraparesis (6 weeks to 6 months; p < 0.04) and 1 case of cosmetically significant pressure sores to the face (p = 0.0002). A greater proportion of patients/caregivers identified a complication in a loss of range of motion after occipitocervical fusion (p < 0.0001) and a loss of motor evoked potentials without a neurological deficit. Amongst those who identified a complication, a greater proportion of surgeons considered the following as a 'major' complication: malpositioned spinal instrumentation with a return to the operating room (p = 0.02); transient new neurological deficit (p < 0.01), and deep wound infection with return to the operating room (p < 0.01). In no scenario did a greater proportion of patients/caregivers consider the complication 'major' compared to surgeons. CONCLUSIONS:In this pilot study, there appear to be differences in how postoperative complications are perceived by surgeons when compared to patients/caregivers. The importance of reconciling such differing opinions through open discussions between surgeons, patients and their families is integral to ensure congruent expectations of planned surgical interventions.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Fulkerson DH,Vachhrajani S,Brayton A,Kulkarni AV,Jea Adoi
10.1159/000319364subject
Has Abstractpub_date
2010-01-01 00:00:00pages
213-20issue
3eissn
1016-2291issn
1423-0305pii
000319364journal_volume
46pub_type
杂志文章abstract::Most cerebrospinal fluid (CSF) shunts employed in the treatment of hydrocephalus include in their designs a pump mechanism that has been used in office practice as an indicator of whether the shunt is functioning properly; however, the pumping characteristics of shunts have been shown to correlate poorly with clinical...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121100
更新日期:1996-08-01 00:00:00
abstract:INTRODUCTION:The majority of the present distraction osteogenesis techniques involve local site expansion that only produces localized decompression and affords limited decompression and cosmetic results. We designed a new surgical procedure, total calvarial transsutural distraction osteogenesis (TSuDO). METHODS:We pe...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000381860
更新日期:2015-01-01 00:00:00
abstract::We here describe the case of a boy with an atypical teratoid-rhabdoid tumor (ATRT) of the 4th ventricle at 1 year of age and a local tumor recurrence at 19 months of age. Due to brainstem infiltration, only incomplete tumor resection was possible each time. High-dose chemotherapy, stem cell transplantation and irradia...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000092366
更新日期:2006-01-01 00:00:00
abstract::Today, hemispherectomy is a well-established procedure for the treatment of some sorts of catastrophic epilepsies. This, however, has not always been the case. The technique was developed to deal with brain tumors; however, the initial results were not remarkable. Moreover, when its morbidity became evident, it was al...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000085870
更新日期:2005-05-01 00:00:00
abstract:AIM:To study the outcome and recurrence in supratentorial anaplastic ependymoma. METHODS:Sixteen cases of supratentorial anaplastic ependymoma were reviewed. The average age of presentation was 8.2 years ranging from 1 to 16 years of age. The mean duration between the onset of first symptoms to time of presentation wa...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000106384
更新日期:2007-01-01 00:00:00
abstract::Cyanotic breath-holding spell is a benign and self-limiting disease of young children but occasionally associated with sudden, unexpected death. The authors report a rare case in a 2-year-old girl with a severe form that started after radical resection of a cervicomedullary ganglioglioma. She was admitted to our hospi...
journal_title:Pediatric neurosurgery
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doi:10.1159/000085163
更新日期:2005-03-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000110661
更新日期:2008-01-01 00:00:00
abstract::A case of an intracerebral juvenile xanthogranuloma (JXG) producing complex-partial seizures in a 13-year-old boy is presented. Although the child had no history of JXGs or a systemic histiocytic proliferative disorder, the histopathological and immunocytochemical studies of this lesion were identical to that of a cut...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000121212
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000084862
更新日期:2005-01-01 00:00:00
abstract::Cavernous malformations (CMs) of the central nervous system are benign, angiographically occult vascular lesions and are diagnosed by magnetic resonance imaging techniques. Giant CMs do not differ from smaller-sized CMs in their clinical, surgical or histopathological presentation but may be radiologically different. ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000447407
更新日期:2017-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000072471
更新日期:2003-10-01 00:00:00
abstract::Ewing sarcoma (ES) is an aggressive, primary bone malignancy with occasional soft tissue extension. Purely extra-osseous ES is rare. A primary intraspinal, intradural ES without bone involvement is exceedingly rare. ES may be differentiated from other primitive neuroectodermal tumors by molecular analysis. The authors...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000488767
更新日期:2018-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000083742
更新日期:2004-11-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000056052
更新日期:2002-04-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000113118
更新日期:2008-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000071321
更新日期:2003-07-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000257525
更新日期:2009-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120569
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000202621
更新日期:2009-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000339355
更新日期:2011-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000028764
更新日期:1999-02-01 00:00:00
abstract::Tumors located in the region of the foramen of Monro often present with signs and symptoms of obstructive hydrocephalus. Various types of lesions occur in this location. We describe a case of a dysembryoplastic neuroepithelial tumor of the septum pellucidum presenting with obstructive hydrocephalus and its successful ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000090464
更新日期:2006-01-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028662
更新日期:1998-05-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028872
更新日期:1999-11-01 00:00:00
abstract::Although unilateral epidural hematomas are well known, bilateral presentation, especially at the confluens sinuum, is uncommon, and its diagnosis may be delayed, thus causing morbidity. We report a case of acute posttraumatic cortical blindness due to epidural hematoma at the confluens sinuum caused by venous sinus te...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000068813
更新日期:2003-03-01 00:00:00
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journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000340068
更新日期:2012-01-01 00:00:00