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Preop MRI Screening for Adolescent Idiopathic Scoliosis May Not Be Necessary

By MedImaging International staff writers
Posted on 02 May 2011

Most patients with scoliosis developing after the age of 10 do not need routine magnetic resonance imaging (MRI) scanning before spine-straightening surgery, suggests new research.

The study's findings were published in the April 14, 2011, issue of the journal Spine. In young scoliosis patients without symptoms of neurologic abnormalities, preoperative MRI scanning adds costs while detecting few abnormalities and adding little data for surgical planning, according to research led by Dr. Mohammad Diab, from the University of California San Francisco (UCSF; USA).

The researchers analyzed data on 2,206 patients with adolescent idiopathic scoliosis, gathered from a larger study of scoliosis surgery in children. Adolescent idiopathic scoliosis is the most common type of scoliosis, generally developing after age ten. These children have no identifiable cause of their spinal curvature. The patients were 1,812 girls and 394 boys; average age at scoliosis surgery was 14 years, 3 months.

Forty-two percent of the patients underwent MRI scanning before surgery. Preoperative MRI is at times recommended to look for accompanying conditions that may affect the surgical plan--especially neurologic disorders causing damage to the spinal cord itself. None of the children in the study had any indications of neurologic problems before surgery.

The MRI scans detected other abnormalities in about 10% of children screened, or approximately 4% overall. The most common abnormalities were congenital malformations (syringes and Chiari malformations) with the potential to cause spinal cord damage. Patients with these neurologic abnormalities need neurosurgery, in addition to straightening of the spinal curve.

Two factors--more severe curvature of the middle spine and juvenile scoliosis (developing before age ten)--were correlated with a higher rate of MRI abnormalities. These factors might be helpful in identifying which children should undergo preoperative MRI scanning. There were no differences in complication rates between patients with normal versus abnormal MRI scans.

The study provides spinal surgeons with new guidance on using MRI for preoperative evaluation of patients with adolescent idiopathic scoliosis. The results suggest that MRI is currently over-requested--it is performed in a relatively high number of patients, most of whom have no abnormality. In this situation, performing MRI not only adds unnecessary costs, but may potentially lead to increased risks.

Although the study may invite debate among surgeons, Dr. Diab and coauthors believe that most patients with adolescent idiopathic scoliosis--as long as they have no symptoms indicating neurologic abnormalities-do not need MRI scanning before surgery. They concluded, "Our data question the routine use of MRI as a screening tool for adolescent idiopathic scoliosis."

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63 (549.0779876709): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (72.956085205078): select jos_twitters.link from jos_twitters where cat=10

65 (42.915344238281): select jos_facebook.link from jos_facebook where cat=10

66 (45.061111450195): select jos_google_plus.link from jos_google_plus where cat=10

67 (41.007995605469): select jos_linkedin.link from jos_linkedin where cat=10

68 (61.988830566406): SELECT fid FROM jos_deeppockets WHERE id=294734795 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294734795 AND published='1' LIMIT 1

69 (70.095062255859): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (437.02125549316): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (434.87548828125): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (58.889389038086): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 4148.9601135254): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (117.06352233887): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (103.95050048828): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (48.160552978516): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (51.975250244141): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (64.13459777832): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (105.14259338379): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

105 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

106 (!!!!! 3067.0166015625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (783.92028808594): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

109 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

110 (75.101852416992): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (702.1427154541): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (814.91470336914): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 2515.7928466797): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

115 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

116 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

117 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

118 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

119 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

120 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

121 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

122 (592.94700622559): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 60097.932815552): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (700.95062255859): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734795 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734795 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 23264.169692993): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (73.19450378418): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (326.87187194824): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (54.121017456055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (!!!!! 4999.1607666016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (!!!!! 8033.0371856689): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (!!!!! 7525.9208679199): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (!!!!! 3494.0242767334): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (!!!!! 1695.8713531494): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (215.76881408691): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (497.10273742676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (380.03921508789): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (254.86946105957): SELECT name FROM jos_deeppockets WHERE id=212

138 (44.107437133789): SELECT name FROM jos_deeppockets WHERE id=212

139 (716.9246673584): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (732.8987121582): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (333.07075500488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

142 (!!!!! 1489.8777008057): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

143 (!!!!! 8862.9722595215): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 1751.184463501): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (87.976455688477): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294734795 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (430.10711669922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

149 (42.200088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

150 (!!!!! 4984.8556518555): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (340.93856811523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

152 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

153 (!!!!! 3173.828125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294734795 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294734795 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (70.095062255859): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (32.901763916016): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (32.901763916016): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

158 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294734795 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294734795 AND published='1' LIMIT 1

159 (35.04753112793): select jos_twitters.link from jos_twitters where cat=10

160 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

161 (28.848648071289): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

163 (311.85150146484): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1127.0046234131): insert into jos_banners_delta values (14615,'2025-06-27 07:23:34','216.73.216.249','view'),(14202,'2025-06-27 07:23:34','216.73.216.249','view'),(14203,'2025-06-27 07:23:34','216.73.216.249','view')

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