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Query: UMLS:C0700208 (scoliosis)
 8,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The tethered cord syndrome is a clinical entity manifested by progressive motor and sensory changes in the legs, incontinence, back of leg pain, and scoliosis. In order to elucidate the pathophysiology involved in the tethered cord, the reduction/oxidation ratio (redox) was used in vivo of cytochrome alpha,alpha 3 to signal oxidative metabolic functioning in human examples of tethered cord and in animal models. Studies in experimental models indicate marked metabolic and electrophysiological susceptibility to hypoxic stress to lumbosacral cord under traction with greater weights (3, 4 or 5 gm). Similar effects were demonstrated in redox behavior of human tethered cord during surgical procedures. The authors conclude that symptoms and signs of tethered cord are concomitant with lumbosacral neuronal dysfunction which could be due to impairment of mitochondrial oxidative metabolism under constant or intermittent cord stretching. It is assumed that prolonged or accentuated neuronal dysfunction may lead to structural damage to the neuronal perikarya and later of the axons. Untethering procedures in human tethered cord improve oxidative metabolism, and probably facilitate the repair mechanism of injured neurons.
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PMID:Pathophysiology of "tethered cord syndrome". 625 1

Disturbances of bladder function in 11 children with congenital non-cystic spinal anomalies are described. The spinal anomalies were divided into 2 groups, segmental and dysraphic. The segmental group comprised 6 children with sacral agenesis : their bladder disturbance was characterised by incontinence without bladder distension. The dysraphic group contained 5 children who had lesions such as intra thecal lipomata or severe kypho-scoliosis : they had incontinence due to retention with overflow. Manometric studies of the bladder and urethra were helpful in differentiating the types of functional disturbance. In some children incontinence improved spontaneously, others were helped by pharmacological agents or by intermittent catheterisation.
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PMID:Bladder function in congenital non-cystic spinal abnormalities. 675 59

Patients with cerebral palsy are prompted to seek urological evaluation when urinary tract infection, socially unacceptable incontinence or hematuria occurs. We attempted to determine the prevalence of urinary tract structural changes by prospectively screening on sonography the kidneys and bladder of 90 patients 1 to 25 years old (mean age 8 years) who had cerebral palsy with or without urological symptoms. Uncooperative patients or those who would require sedation were excluded. Of the patients 66 were incontinent and used diapers, 18 were completely dry and 6 had nocturnal enuresis with daytime dryness. Sonographic abnormalities were detected in 7 patients, including renal size discrepancy in 2 (1 with severe scoliosis and 1 with a history of renal artery thrombosis), mild to moderate hydronephrosis with thickened bladders suggestive of neurogenic bladder dysfunction in 3 and a nonvisualized kidney in 2. However, repeat sonography confirmed 2 normal kidneys in the latter patients. Thus, urinary tract abnormalities were detected unexpectedly in 2% of patients studied. This relatively low proportion suggests that routine urinary tract screening in cerebral palsy patients may not be warranted.
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PMID:Is urinary tract screening necessary for patients with cerebral palsy? 793 10

Massive bilateral vesicoureteral reflux (VUR) in a 7-year-old girl with spinal scoliosis was successfully treated by endoscopic correction. She was admitted due to a febrile urinary tract infection and urinary incontinence. A cystometrogram demonstrated normal detrusor function during storage. The endoscopic subureteric injection of polytetrafluoroethylene (Teflon) was performed, resulting in the disappearance of the VUR. A postoperative cystometrogram demonstrated overactive detrusor function during storage, necessitating anticholinergic medication. She has been free of febrile urinary tract infections and incontinence for 2 years postoperatively, although self-catheterization is necessary. In a case of neurogenic vesical dysfunction with massive reflux, endoscopic subureteric injection is not only a therapeutic tool, but also a useful diagnostic option for detecting occult detrusor overactivity during storage prior to open surgery.
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PMID:Urodynamic changes after endoscopic correction of vesicoureteral reflux. 953 12

Myelomeningocele is a common birth defect that is associated with significant lifelong morbidity. Despite improvements in technology and overall patient care, little progress has been made in the postnatal surgical management of the child with spina bifida. Postnatal surgery is aimed at covering the exposed spinal cord and preventing infection. Numerous interventions for ventricular shunts, tethered cord, scoliosis, incontinence, urologic complications, and extremity anomalies are frequently required. Although myelomeningocele is a nonlethal fetal anomaly, the limitations with current postnatal treatment strategies has led to extensive investigation of prenatal treatment options. This article outlines the rationale for fetal intervention and discusses the preliminary experience with human fetal myelomeningocele surgery.
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PMID:Fetal surgery for myelomeningocele. 1063 May 42

The aim of this study was to examine the prevalence of secondary impairments in young adults with spina bifida and to relate the prevalence to the type of spina bifida and the level of lesion. This cross-sectional study is part of the ASPINE (Adolescents with Spina Bifida in the Netherlands) study. Data were collected on medical history, hydrocephalus (shunt: yes/no), neurological level of lesion (International Standards for Neurological and Functional Classification of Spinal Cord Injury), visual acuity (Landolt rings), spasticity (Modified Ashworth Scale), contractures (range of motion), scoliosis (deviation from perpendicular), ambulation (Hoffer criteria), pressure sores and blood pressure (physical examination), epilepsy, pain, incontinence and sexuality (questionnaire), and cognitive functioning (Raven Standard Progressive Matrices). In total, 179 patients with spina bifida participated (41% male, age range 16 to 25 years, mean 20 years 9 months, SD 2 years 11 months). These were 37 patients with spina bifida occulta, 119 patients with spina bifida aperta and hydrocephalus (AHC+) and 23 patients with spina bifida aperta without hydrocephalus (AHC-). Of our patient group, 73 had a high-level lesion (L2 and above), 68 a mid-level lesion (L3 to L5), and 38 a low-level lesion (S1 and below). Both subdivisions were strongly related with patients with higher lesions more often having hydrocephalus. Most secondary impairments were found for patients with AHC+, and patients with AHC- were mostly comparable to patients with spina bifida occulta. According to level of lesion, most medical problems were found in the high-level lesion group. However, all subgroups suffered from health problems.
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PMID:Secondary impairments in young adults with spina bifida. 1517 35

Congenital scoliosis from laterally located hemivertebrae at the lumbosacral junction has been described previously. However, dorsally located midline hemivertebrae at this location have not been reported. The authors describe the presentation, treatment, and outcomes of 2 patients (1 male and 1 female) with this rare malformation. All clinical and radiographic records were reviewed. Outcomes were recorded using survey instruments (Oswestry Disability Index and the 36-Item Short Form Health Survey). Radiographic assessment of bony fusion was performed using CT scanning 1 year after surgery. Both patients presented with back and leg pain, urinary hesitancy/incontinence, difficulty sitting and lying down, waddling gait, and restriction of movement. Imaging showed a wedge-shaped dorsal deformity that stretched the nerve roots and compressed the canal. Both patients underwent resection of the hemivertebra with posterolateral instrumented fusion from L-2 to the pelvis. The female patient had a low-lying conus and underwent sectioning of the filum terminale. Both patients showed improvement in the ability to sit and lie flat and in bowel and bladder function after surgery. The authors describe their experience with 2 patients with similar, rare congenital bony deformities at the lumbosacral junction. To their knowledge, similar cases have not been previously reported.
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PMID:Dorsal midline hemivertebra at the lumbosacral junction: report of 2 cases. 2534 9