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Background: The COVID-19 pandemic has affected healthcare worldwide since December 2019. We aimed to identify the effect of the COVID-19 pandemic on outpatient clinic and surgical volumes and peri-operative complications for pediatric spinal deformities patients. Methods: In this multi-center retrospective study, outpatient visits (in-person and virtual care) and pediatric spine surgeries volumes in four high-volume pediatric spine centers were compared between March and December 2019 and the same period in 2020. Peri-operative complications were collected and compared in the same periods. Descriptive statistics were calculated, and comparative analyses were performed. Results: During the 2020 study period, the outpatient visit (in-person and virtual care) volume decreased during local lockdown periods by 71% for new patients (p < 0.001) and 53% for returning patients (p = 0.03). Overall, for 2020, there was a 20% reduction in new patients (p = 0.001) and 21% decrease in returning patients (p < 0.001). During the pandemic, there was also 20% less overall surgical volume of adolescent idiopathic scoliosis (AIS) patients undergoing primary posterior spinal fusion, with a 70% reduction during lockdown times (p < 0.001). Complication rate and profile were similar between periods. Conclusion: There was a significant decrease in outpatient pediatric spine outpatient visits, particularly new patients, which may increase the proportion of pediatric patients with spinal deformities that present late, meeting surgical indication. This, in combination with the reduction in surgical volume of AIS over the first year of the pandemic, could result in an extended waitlist for surgeries during years to come. Complication rate was similar for both periods, suggesting it is safe to continue elective pediatric spine surgery even in a time of a pandemic. Level of evidence: level IV. [ABSTRACT FROM AUTHOR]

The total sample included 43 487 patients undergoing ACDF, 6800 patients undergoing laminoplasty, 2075 patients undergoing CDA and 32 871 patients undergoing posterior laminectomy and fusion. Patient's expectations of surgery for degenerative spondylolisthesis: analysis b... Background Patients with lumbar degenerative spondylolisthesis have higher expectations of pain relief and functional well-being than patients with lumbar stenosis. At 1 year after surgery, mildly frail patients were 1.50 times (p = 0.002), moderately frail patients were 1.72 times (p < 0.001) and severely frail patients were 1.71 times (p < 0.001) more likely to achieve MCID. Results A total of 493 patients were included in this study, with 272 patients (55.2%) receiving their surgery less than 60 days after providing consent for surgery and 221 patients (44.8%) 60 days or more after providing consent for surgery. Results A total of 253 patients were included: 40 patients died within the first 3 months after surgery and 213 patients survived more than 3 months. [Extracted from the article]

Characterization of the esophageal microbiota in EoE subjects relative to non-EoE controls was performed by comparison of steroid-naïve subjects with active or inactive EoE to non-EoE controls. We aimed to characterize the bacterial and fungal communities in the esophageal mucosa of children with EoE and non-EoE controls and examine the effects of TSS on the microbiota in children with EoE. Eosinophilic esophagitis (EoE) is a chronic inflammatory disease characterized by an eosinophil-predominant inflammation of the esophageal mucosa.1 We have previously characterized bacterial communities of the human esophagus in healthy children and adults.2 Our data and work from others suggest that the normal esophageal bacterial microbiota is dominated by I Firmicutes i species.2-4 Active inflammation in EoE is associated with bacterial dysbiosis, specifically with an increase in members of the I Proteobacteria i .2,3 However, while some have described the role of bacteria in atopic gastrointestinal diseases,5 little is known about the role of fungi in allergic esophageal inflammation or the role of topical swallowed steroids (TSS) in disease-associated dysbiosis. [Extracted from the article]