Scott Adzik
81 statements · 3 topics · summaries given as host listed separately
Featured statements
The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms.
clinical ·
Fetal Surgery
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
clinical ·
Fetal Surgery
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
clinical ·
Myelomeningocele
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
clinical ·
Myelomeningocele
At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case.
clinical ·
Spina Bifida
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
clinical ·
Spina Bifida
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Scott's statements about Fetal Surgery 43 statements
Open the Fetal Surgery collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Quotation
New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them.
Open
Statement
Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day.
Open
Statement
Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day.
Open
Statement
With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation.
Open
Statement
With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation.
Open
Statement
About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year.
Open
Statement
About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year.
Open
Statement
The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation.
Open
Statement
The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation.
Open
Statement
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
Open
Statement
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
Open
Statement
In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence.
Open
Statement
Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal.
Open
Statement
Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal.
Open
Statement
In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair.
Open
Statement
In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair.
Open
Statement
Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level.
Open
Statement
Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level.
Open
Statement
The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery.
Open
Statement
The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery.
Open
Statement
In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group.
Open
Statement
In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group.
Open
Statement
At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group.
Open
Statement
At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group.
Open
Statement
At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case.
Open
Statement
At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case.
Open
Statement
Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks.
Open
Statement
Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks.
Open
Statement
Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair.
Open
Statement
Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair.
Open
Statement
A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally.
Open
Statement
Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery.
Open
Statement
Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery.
Open
Statement
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
Open
Statement
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
Open
Statement
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
Open
Statement
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
Open
Statement
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
Open
Statement
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
Open
Statement
The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms.
Open
Statement
Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups.
Open
Scott's statements about Myelomeningocele 19 statements
Open the Myelomeningocele collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Statement
Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day.
Open
Statement
With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation.
Open
Statement
About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year.
Open
Statement
The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation.
Open
Statement
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
Open
Statement
Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal.
Open
Statement
In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair.
Open
Statement
Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level.
Open
Statement
The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery.
Open
Statement
In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group.
Open
Statement
At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group.
Open
Statement
At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case.
Open
Statement
Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks.
Open
Statement
Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair.
Open
Statement
Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery.
Open
Statement
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
Open
Statement
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
Open
Statement
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
Open
Scott's statements about Spina Bifida 19 statements
Open the Spina Bifida collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Statement
Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day.
Open
Statement
With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation.
Open
Statement
About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year.
Open
Statement
The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation.
Open
Statement
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
Open
Statement
Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal.
Open
Statement
In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair.
Open
Statement
Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level.
Open
Statement
The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery.
Open
Statement
In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group.
Open
Statement
At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group.
Open
Statement
At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case.
Open
Statement
Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks.
Open
Statement
Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair.
Open
Statement
Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery.
Open
Statement
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
Open
Statement
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
Open
Statement
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
Open
Summaries Scott gave as host · 15 summaries
Recaps of other experts' statements, not Scott's own clinical position.
Summaries Scott gave as host · Fetal Surgery 5 summaries
Open the Fetal Surgery collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Host summary
Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them.
Open
Host summary
Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence.
Open
Host summary
Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally.
Open
Host summary
Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms.
Open
Host summary
Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups.
Open
Summaries Scott gave as host · Myelomeningocele 5 summaries
Open the Myelomeningocele collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Host summary
Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them.
Open
Host summary
Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence.
Open
Host summary
Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally.
Open
Host summary
Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms.
Open
Host summary
Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups.
Open
Summaries Scott gave as host · Spina Bifida 5 summaries
Open the Spina Bifida collection →
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
Host summary
Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them.
Open
Host summary
Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence.
Open
Host summary
Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally.
Open
Host summary
Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms.
Open
Host summary
Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups.
Open