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

The roentgenographic changes in the axial skeleton after irradiation for Wilms' tumor were studied in eighty-one patients. In addition to the initial alterations found in the individual vertebrae within the field of irradiation, spinal deformity subsequently developed in fifty-nine patients (pure scoliosis in thirty-eight, kyphoscoliosis in nineteen, and pure kyphosis in two). Unitl the adolescent growth spurt these deformities tended to remain slight, but some progression did occur. In seven patients the scoliosis became severe enough to require spine fusion. A Milwaukee brace used in three patients failed to correct the curve. The trapezoidal shape of the vertebrae and scarring of the soft tissues within the concavity made correction difficult. Recognizable roentgenographic alterations failed to develop in twenty-two patients who, in general, were older and had received less irradiation. There appeared to be a correlation between the amount of irradiation and the severity of the spinal deformity (p is less than 0.05) and between the age of irradiation and the amount of deformity (p is less than 0.02).
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PMID:Skeletal alterations following irradiation for Wilms' tumor: with particular reference to scoliosis and kyphosis. 17 64

Eighty-one patients with Wilms tumor treated by irradiation and chemotherapy were studied. Despite the fact that multiple portals for irradiation were used, each crossing the midline, the amount of irradiation delivered to different parts of the vertebral body varied and it was this variation in delivered dose which produced axial skeletal deformities in 70% of the patients. Of the 57 patients with these deformities 32 had scoliosis, 22 kyphoscoliosis and 3 patients pure kyphosis; 12 patients had a kyphotic deformity of over 25 degrees, 7 patients requiring surgical correction. A high incidence of pseudarthrosis following posterior fusion has led to the preference of a 2-stage procedure, anterior interbody fusion followed by a posterior fusion with Harrington rods after 2 weeks of correction in halo femoral traction.
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PMID:Irradiation induced kyphosis. 20 26

Wilms' tumour is one of the most common neoplasms of infancy and childhood. Current treatment regimens result in a cure rate of about 80% for localized tumours but may also cause musculoskeletal deformities. Assessment of 21 patients previously treated for Wilms' tumour showed that all had flank atrophy on the treated side. Radiologic abnormalities included asymmetry of vertebral bodies, vertebral end-plate irregularities, scoliosis, kyphosis, platyspondyly and hypoplasia of the ilium. Although the vertebral changes following radiotherapy for Wilms' tumour are present from an early age and the potential is great for an increase in spinal deformity with growth, few spinal curves progress past 20 degree. Since one cannot predict which curves will progress, all such patients need careful orthopedic follow-up until skeletal maturity is achieved.
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PMID:Musculoskeletal deformities following treatment of Wilms' tumour. 21 Sep 20

The skeletal effects of megavoltage irradiation (60Co) in 25 long term survivors of Wilms' tumor are described. In general, the changes seen with megavoltage irradiation are as frequent but not as severe as those previously reported after orthovoltage irradiation. Vertebral body changes generally occur within 5 years after irradiation. Scoliosis and/or kyphosis do not usually develop until after five years postirradiation. Kyphotic curves tend to progress after the adolescent growth spurt while scoliotic curves do not. Other bony and nonosseous changes are detailed.
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PMID:Skeletal effects of megavoltage irradiation in survivors of Wilms' tumor. 22 22

The shape of scoliotic spines as measured from frontal radiographs (see Part I of this paper) is analysed with respect to interrelations between lateral deviation, lateral tilt and axial rotation of the vertebrae. These parameters are represented by sinusoidal functions of the longitudinal coordinate. The interrelations can, therefore, be expressed in terms of amplitude and phase relations. Two additional functions--'spinal tilt' and (local) curvature--are calculated from the first and second derivatives of lateral deviation. The method has been applied to three patient groups with different aetiology: 113 patients with idiopathic scoliosis (478 radiographs, partially follow-up examinations), 23 patients with scoliosis secondary to Wilms' tumour irradiation and 18 patients with scoliosis secondary to poliomyelitis. The amplitude and phase relations of all functions reveal a characteristic pattern which is apparently independent of the specific aetiology. The results show that the available biomechanic explanations of coupling of vertebral motions are questionable.
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PMID:Evaluation of frontal radiographs of scoliotic spines--Part II. Relations between lateral deviation, lateral tilt and axial rotation of vertebrae. 133 85

The National Wilms' Tumor Study (NWTS) was initiated in 1969. One of its objectives was to modulate treatments according to risk factors to minimize the number and severity of treatment-related short-term and long-term iatrogenic complications. The NWTS has therefore incorporated a Long Term Follow-up Study (LTFS) within its framework to monitor late effects. The LTFS is confined to relapse-free survivors alive 5 years or longer after initial surgery, and data are collected using specifically designed forms. A total of 787 patients registered on NWTS-1 or NWTS-2 (1969 to 1979) were eligible, of whom 680 (86%) were available for analysis regarding musculoskeletal, cardiovascular, and neuropsychologic status, and the presence of benign and malignant tumors. Patients with early-stage disease who were treated with radiation had scoliosis reported, along with other musculoskeletal abnormalities (32 versus 2), nearly seven times as often as did the members of the cohort population who did not undergo radiation (35 of 57 versus 5 of 53, respectively). The difference in cardiovascular problems recorded in survivors who did and did not receive Adriamycin (Adria Laboratories, Columbus, OH) (2.4 versus 1.1 per 100-person years at risk) had borderline statistical significance (P = 0.06). No excess in neuropsychologic events was reported for those given the neurotoxin vincristine. When considering patients with disease of all stages, all 5 second malignant tumors occurred in the 623 patients who underwent radiation (RT patients); benign tumors were also more frequent in RT patients than in those patients who did not undergo radiation (41 of 486 or 8% versus 4 of 194 or 2%). Continuing study of this unique body of patients is needed, especially for those given Adriamycin, because of the known long interval needed for latent cardiomyopathy to become clinically manifest in some patients.
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PMID:Late effects of treatment for Wilms' tumor. A report from the National Wilms' Tumor Study Group. 184 40

In order to investigate the number, types, severity and the various treatments of spinal deformity among children under 10 years old, a retrospective survey of registered patients in the scoliosis clinic at the National Taiwan University Hospital was performed. Between August 1982 and December 1988, there were 41 children who had scoliosis with a Cobb angle larger than 10 degrees and the onset was before 10 years of age. This number accounted for 3.8% of all scoliotic patients during the same time period. Of these children, 19 had idiopathic scoliosis (46.3%), 7 with infantile and 12 with juvenile; the other 19 were due to congenital, and the remaining 3 were postradiation, a resection of Wilms' tumor in 2 and neuroblastoma in 1. In the congenital group, hemivertebra (13 patients) outnumbered other causes. Twenty three patients (56%) underwent surgical correction, the rest were either under regular observation (9 patients), bracing (7 patients) or electrical stimulation (2 patients). The average preoperative Cobb angle in the operated groups was much larger, being 67.6 degrees in the infantile; 52.4 degrees in the juvenile; 57 degrees in the congenital; and 62 degrees in the postradiation. For those without an operation, the angles were smaller than 30 degrees. The indications for surgery were that the curvature was in progression, which could not be controlled by conservative means, or that in some congenital cases, the curve had the potential tendency to exacerbate. From the present study, the percentage of scoliosis under 10 years of age was far less than the adolescent group in our clinic.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spinal deformities among children under 10 years old: a clinical analysis of 41 cases. 198 37

One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy.
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PMID:Skeletal sequelae of radiation therapy for malignant childhood tumors. 213 23

To study the effect of abdominal irradiation on spinal growth in childhood we have measured final height, sitting height, and leg length in 30 male survivors of a Wilms' tumor. Twenty-one patients received whole abdominal irradiation by either megavoltage therapy (MV: n = 11) or orthovoltage therapy (OV: n = 10); the remainder received flank irradiation. To examine the effect of the adolescent growth spurt on the irradiated spine we have followed prospectively seven patients who received whole abdominal irradiation and nine patients who received flank irradiation through puberty. Compared to a normal population there is a modest reduction in median final standing height SDS (H.SDS: -1.15) accompanied by a marked reduction in median final sitting height SDS (S.HT SDS: -2.41) with no apparent effect on median subischial leg length SDS (SILL.SDS: 0.04). This reduction in spinal growth is reflected by a strongly positive disproportion score (DPS; [SILL SDS-S.HT SDS] + 2.81). The incidence of scoliosis after abdominal irradiation has been low (10%). During puberty there is a significant fall in median sitting height SDS after both whole abdominal (median fall: -0.9, P = 0.02) and flank irradiation (median fall: -1.85, P = 0.01), and this is reflected in a significant increase in disproportion (DPS: whole abdominal; median rise +1.4, P = 0.02: flank, median rise +1.34, P = 0.01). After MV irradiation there is a significant correlation between the degree of disproportion and the age at treatment (P less than 0.0005). The younger the patient is at treatment the more severe is the restriction on spinal growth and the shorter and more disproportionate they become as an adult. The estimated eventual loss in potential height from abdominal irradiation at the age of one is 10 cm and at five years is 7 cm.
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PMID:Effect of abdominal irradiation on growth in boys treated for a Wilms' tumor. 217 54

In 1936 scoliosis was produced in growing animals by exposing one side of one or more vertebrae to radium action. The purpose of this treatment was to recurve existing curvatures of the spine on the same principle. No attempt has been made so far to correct congenital scoliosis of infants by this method. Hundreds of infants treated by X-ray for Wilms' tumor developed incidental spinal curvatures. In none of these cases was there any recorded mention of damage to the spinal cord or any other organ. Since the epiphyseal plate is much more sensitive to radiation than is the Wilms' tumor and radium radiation can be more easily controlled than X-radiation, it is suggested that scoliosis of genetic or other etiology might be successfully treated by radium or possibly other gamma rays. The choice of the rays and the dosage must be left to the experts.
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PMID:Can juvenile scoliosis be corrected by circumscribed radium-irradiation of the spine? 301 62


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