Ana C. Belzarena

By Roselle C. Okubo, Claudio Silveri and Ana C. Belzarena

Spina bifida is a common nervous system malformation and it encompasses a wide array of presentations with diverse orthopedic challenges. Manifestations of this disease can include dislocates hips, joint contractures, spine deformity such as scoliosis or kyphosis, clubfeet and limb rotational deformities. Additionally, many of these patients are non-ambulatory and prone to osteoporosis induced pathological fractures. The care of spina bifida patients is a challenging one, requiring many health care professionals from different areas to be working in conjunction. Nowadays, spina bifida patients live longer due to advances in health care and improving the quality of life of these patients is paramount.

Part of the book: Spina Bifida and Craniosynostosis

By Ana C. Belzarena

Lung cancer patients frequently present with to bone metastases. Such lesions are responsible for increased morbidity, low quality of life, and increased costs to patients and the health care system. Pain is the most common symptom; however, these lesions also present as skeletal related events (SRE) which include pathological fractures, hypercalcemia, spinal cord and nerve compressions and cause the need for surgery and/or radiotherapy. Even though bone metastases are associated with poor prognosis, current treatment multimodalities continue to improve survival. Awareness and effective treatment of these lesions is paramount to maintain a good quality of life and function in lung cancer patients.

Part of the book: Lung Cancer

By Gottardo Bianchi, Leticia Gaiero, Nicolas Casales, Claudio Silveri and Ana C. Belzarena

Osteogenic sarcoma is the most common primary bone cancer frequently affecting children and teenagers. Despite many years of research, little have the survival rates changed in the last fifty years. Early diagnosis, a complete systemic treatment program with a good tumor response and adequate margins continue to be the main determinants of patients’ prognosis in this disease. Neoadjuvant chemotherapy followed by surgery and subsequent adjuvant systemic treatment remain the standard of care. Numerous reconstruction options available provide these patients better function and improved quality of life.

Part of the book: Recent Advances in Bone Tumours and Osteoarthritis

By Stephanie D. Zarate and Ana C. Belzarena

The proximal humerus is a common location for bone tumors. Those can affect patients of different ages and can be of benign or malignant nature. For bone sarcomas is the 3rd most common location and is a frequent site of spread in non-axial metastatic disease. In pediatric patients is frequent to encounter benign bone tumors in this location but also osteosarcomas and Ewing’s sarcomas. Careful assessment of the patients by a surgeon with the appropriate training is paramount. Shoulder reconstruction for patients with bone tumors encompasses a diverse group of patients, diagnoses and surgical options. While most patients with primary bone tumors may be of a younger age and more involved in sport activities, those with metastatic disease oftentimes are associated with an older age, worse preoperative function and worse prognosis due to the primary disease. The surgeon must weigh in all factors that need to be taken into consideration in the treatment decision-making plan. Currently, with new advances in oncology treatments patients may benefit from longer survivals times than in the past, thus restoring the patient’s function and quality of life is essential.

Part of the book: Shoulder Surgery for RC Pathology, Arthropathy and Tumors