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

The use of embryonated chicken eggs as a model for assessing the teratogenic potential of animal viruses was investigated with 12 members of the Bunyaviridae family. Infection of 4-day-old embryonated chicken eggs via the yolk sac with 10 of the viruses resulted in deaths or congenital deformities that were similar to those observed in Akabane virus infections of fetal ruminants and included arthrogryposis, scoliosis, mandible defects, and retarded development. Statistical analysis showed that the viruses fell into three main groupings, namely, those that caused both death and deformities (Akabane, Aino, Tinaroo, and Belmont viruses), those that mainly caused death (Peaton, Thimiri, and Facey's Paddock viruses), and those that required very high doses to cause either death or deformities (Douglas and CSIR0296 viruses). In addition, two viruses (Kowanyama and Mapputta viruses) caused neither death nor deformities. A difference in the pathogenic potential between two Akabane isolates (B8935 and CSIR016) in the embryonated chicken egg model was found to correlate with differences previously observed in experimentally infected sheep; Akabane CSIR016 was the more pathogenic. It is concluded that the embryonated chicken egg model should also be of value in assessing the teratogenic potential of other Bunyaviridae and attenuated vaccine viruses, although it does not assess the ability of the virus to cross the placenta.
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PMID:Teratogenicity of Australian Simbu serogroup and some other Bunyaviridae viruses: the embryonated chicken egg as a model. 669 Apr 12

Neuropathic arthritis is a destructive arthropathy frequently associated with loss of proprioception. A third of patients, however, may have no demonstrable neurological deficit. Patients with diabetes, syphilis, syringomyelia and other neuropathies are particularly prone to developing this joint disease. The diagnosis of Charcot's joints should be considered in anyone who develops what appears to be a severe osteoarthritis or a transverse fracture of the tibia or fibula after minor trauma. Scoliosis with particularly destructive changes on radiography should prompt a search for syringomyelia or syphilis. The most common radiographic abnormalities are those of distension in 3D (Dislocation, Destruction and Degeneration). An atrophic form with resorption of the proximal humerus, most frequently described in syringomyelia, has been observed in diabetes. Loss of the distal end of the clavicle has not been described before in the neuropathies. These changes coupled with speckled calcification or shards of bone in the periarticular soft tissue confirm the diagnosis. Infection and CPPD crystal disease can be difficult to exclude. The joint fluid may be inflammatory and infection may be a complication. Treatment includes anti-inflammatories and splinting. Indications for surgery are limited.
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PMID:The neuropathic joint. 807 Jan 70

Delayed presentation of infection is a rare complication of anterior instrumentation and fusion for scoliosis. Three cases that followed the Dwyer procedure are reported. Pain was absent in these patients, but mild constitutional symptoms were present. An elevated erythrocyte sedimentation rate (ESR) is an important indicator of this complication. Two patients developed groin abscesses and sinuses as the hallmark of deep infection. Infection resolved after removal of instrumentation and local debridement.
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PMID:Late presentation of infection as a complication of Dwyer anterior spinal instrumentation. 834 78

Complications occur frequently after surgical treatment of scoliosis. In order to prevent from them effectively, 101 cases with failure and postoperative complications were analysed. They included rod fracture in 22 cases (15 Harrington rods, 4 Zielke rods, and 3 Luque rods); recurrence of curve severity in 12 cases; broken or loossened luque wires in 15 cases; loss of thoracic kyphosis (flat back) in 6 cases; progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases; and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra. Infection occurred in 8 cases (incision infection 7 cases; deep wound infection in 1 case); and pneumothorax in 1 cases. They were induced by biomechanical factors in 23 cases (22.77%), incorrect selections of indications in 29 cases (28.71%), oprational mistakes in 37 cases (36.63%), internal fixation factors in 15 cases (14.85%). The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.
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PMID:[Failure and complication following surgical treatment of scoliosis: analysis of 101 cases]. 959 69

One hundred twenty-four cases of lumbosacral fusion receiving transpedicular screw fixation were divided into two groups and reviewed retrospectively. The conditions treated include spondylolisthesis, scoliosis, tumor, trauma, and degenerative disc disease. There were 83 males and 41 females in this consecutive series averaging a 45.2-month follow-up. The primary or first-time arthrodesis rate was 91.9%. A learning curve effect as it relates to operative time but not pedicular screw placement was shown. Instrumentation-related and general medical and surgical complications were low. Infection rates were also low; superficial 2.4%, deep 1.6%. Nonunion or delayed union was salvaged in 10 cases, improving the overall fusion rate to 97.6%. The results of this study support the use of lumbosacral transpedicular screw fixation in select spinal conditions.
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PMID:Lumbosacral instrumented fusion: analysis of 124 consecutive cases. 1007 43

Since current bone procurement and processing standards have been adopted, published studies have consistently shown that the risk of disease transmission from allograft is small. The purpose of this study was to evaluate allograft use and opinions regarding allograft safety during spinal deformity surgery. A postal survey was sent to 151 pediatric orthopaedists chosen from a cross-referenced listing of active members of both the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America. The survey consisted of six questions covering allograft use during idiopathic and neuromuscular scoliosis cases, concerns about disease transmission, preoperative counseling, concerns about providers, and evaluation of clinical results. The response rate was 80%. Allograft bone use was reported by 96% of those responding for neuromuscular cases and by 62% for idiopathic cases. Infection (68%) and pseudoarthrosis (26%) were the most common topics mentioned among the 41% who addressed potential risks. Variation was found in surgeons' perceptions regarding the safety and efficacy of allograft for scoliosis surgery.
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PMID:Perceptions of allograft safety and efficacy among spinal deformity surgeons. 1167 52

Complications occur frequently after surgical treatment of scoliosis. In order to prevent from them effectively, 101 cases with failure and postoperative complications were analysed. They included rod fracture in 22 cases (15 Harrington rods, 4 Zielke rods, and 3 Luque rods); recurrence of curve severity in 12 cases; broken or loossened luque wires in 15 cases; loss of thoracic kyphosis (flat back) in 6 cases; progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases; and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra. Infection occurred in 8 cases (incision infection 7 cases, deep wound infection in 1 case); and pneumothorax in 1 case. They were induced by biomechanical factors in 23 cases (22.8%), incorrect selections of indications in 29 cases (28.7%), operational mistakes in 37 cases (36.6%), internal fixation factors in 15 cases (14.9%). The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.
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PMID:Failure and complication following surgical treatment of scoliosis--an analysis of 101 cases. 1290 20

Alpha-mannosidosis is an inherited lysosomal storage disorder characterized by immune deficiency, facial and skeletal abnormalities, hearing impairment, and intellectual disability. It occurs in approximately 1 of 500,000 live births. The children are often born apparently normal, and their condition worsens progressively. Some children are born with ankle equinus or develop hydrocephalus in the first year of life. Main features are immune deficiency (manifested by recurrent infections, especially in the first decade of life), skeletal abnormalities (mild-to-moderate dysostosis multiplex, scoliosis and deformation of the sternum), hearing impairment (moderate-to-severe sensorineural hearing loss), gradual impairment of mental functions and speech, and often, periods of psychosis. Associated motor function disturbances include muscular weakness, joint abnormalities and ataxia. The facial trait include large head with prominent forehead, rounded eyebrows, flattened nasal bridge, macroglossia, widely spaced teeth, and prognathism. Slight strabismus is common. The clinical variability is significant, representing a continuum in severity. The disorder is caused by lysosomal alpha-mannosidase deficiency. Alpha-mannosidosis is inherited in an autosomal recessive fashion and is caused by mutations in the MAN2B1 gene located on chromosome 19 (19 p13.2-q12). Diagnosis is made by measuring acid alpha-mannosidase activity in leukocytes or other nucleated cells and can be confirmed by genetic testing. Elevated urinary secretion of mannose-rich oligosaccharides is suggestive, but not diagnostic. Differential diagnoses are mainly the other lysosomal storage diseases like the mucopolysaccharidoses. Genetic counseling should be given to explain the nature of the disease and to detect carriers. Antenatal diagnosis is possible, based on both biochemical and genetic methods. The management should be pro-active, preventing complications and treating manifestations. Infections must be treated frequently. Otolaryngological treatment of fluid in the middle ear is often required and use of hearing aids is invariably required. Early educational intervention for development of social skills is needed and physiotherapy is important to improve bodily function. Orthopedic surgery may be necessary. The long-term prognosis is poor. There is an insidiously slow progression of neuromuscular and skeletal deterioration over several decades, making most patients wheel-chair dependent. No patients manage to be completely socially independent. Many patients are over 50 years of age.
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PMID:Alpha-mannosidosis. 1865 71

Myelomeningocele (MMC) a complex congenital spinal anomaly, results from neural tube defect during first 4 weeks of gestation. Medical records of 135 children who underwent excision and repair of MMC from January 2003 to December 2006 were analyzed, retrospectively. Data on associated illnesses, anesthetic management, perioperative complications, and outcome were recorded. The patient population consisted of older infants with unrepaired MMC. The average age of presentation was 1 year and 8 months. The commonest site of presentation was lumbar (39.3%). Leaking MMC was present in 19.3% of cases, most had associated electrolyte imbalance. Hydrocephalus was the commonest association (67.4%) followed by Chiari-II malformation (58.4%). Renal abnormality was present in 9% of cases and 24.4% of children had scoliosis. Two infants (1.5%) presented with inspiratory stridor. Intraoperative cardiac and respiratory problems were observed in 15.6% and 11.1%, of cases, respectively. Two children (1.5%) suffered cardiac arrest; both had associated Chiari-II malformation and hydrocephalus. Postoperative ventilation was required in 8.9% of children, primarily due to inadequate reversal from neuromuscular blockade. Infection, cerebrospinal fluid leak, and pseudomeningocele were common surgical complications. Improvement of motor, sensory, and sphincteric function was observed in 30.5%, 22.9%, and 14.1%, respectively. To conclude, surgical repair of MMC may at times pose life-threatening complications mostly because of associated anomalies. Children with associated Chiari malformation and/or hydrocephalus need special attention during perioperative period.
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PMID:Anesthetic concerns and perioperative complications in repair of myelomeningocele: a retrospective review of 135 cases. 1977 65

A better understanding of the consequences of spine surgery complications is warranted to optimize patient-reported outcomes and contain the rising health care costs associated with the management of adult spinal deformity (ASD). We systematically searched PubMed and Scopus databases using keywords "adult spinal deformity surgery," "complications," and "cost" for published studies on costs of complications associated with spinal surgery, with a particular emphasis on ASD and scoliosis. In the 17 articles reviewed, we identified 355,354 patients with 11,148 reported complications. Infection was the most commonly reported complication, with an average treatment cost ranging from $15,817 to $38,701. Hospital costs for patients with deep venous thrombosis, pulmonary thromboembolism, and surgical site infection were 2.3 to 3.1 times greater than for patients without those complications. An effort to collect and characterize data on cost of complications is encouraged, which may help health care providers to identify potential resources to limit complications and overall costs.
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PMID:Impact of spine surgery complications on costs associated with management of adult spinal deformity. 2727 31


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