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

With a rate of 0.5-1/1,000 of the total number of births in West Germany, spina bifida is next to cerebral paresis one of the most frequent congenital defects. Altogether, fifty places in special schools are needed per one million of inhabitants for spina bifida children. The loss of physical unctions is comparable to that in the case of paraplegia. The variety of medical and psychological problems makes the cooperation of highly different branches of study indispensible in a rehabilitation team (neurosurgeon, neuropediatrician, urologist, orthopaedist, pediatrician, educator, social worker, physical therapist). Each team member must be informed about the complete rehabilitation plan. These children's shortage of environmental experience is mainly due to their backwardness as regards motoric development, which cannot be recovered by means of individual physical therapy alone. On the other hand, additional, specifically selected and organised physical education makes possible the necessary mobility and social experiences. By giving the children exercises suitable for their ages it is hoped to achieve a late maturation and stabilization of the personality. In choosing the exercises it is first of all necessary to go back to the so-called fundamental activities like climbing, hanging by one's hands, sliding, pushing oneself up off the ground, swinging or throwing and catching, before going on to wheel-chair sports. Wheel-chair sport promises a varied selection for group exercises (games) and for everyday use. Using the wheel-chair as sports equipment, it is possible for persons with other types of locomotive handicaps to be integrated into the group. For physical education in special schools the pupils whould be arranged into groups according to their ability in order to keep the groups as homogenous and the children's chances as equal as possible. The most important teaching criteria are in this case: the creation of a happy atmosphere, a high degree of clarity, the fulfilment of individual inclinations, the encouragement of independence, the development of community life and the fulfilment of everyday tasks. In swimming, the spina bifida child differs from the normal child in his greater initial fear and in the existence of contractions, a scoliosis, hyperlordosis or -kyphosis due to the resultant instability of the water. Because of this, specifically oriented swim- and work-aids must be used. The didactic procedure is then the same as in the case of normal children. After the child's familiarity with and safety in the water is assured, one can proceed to individual swimming techniques and in a few cases to sport swimming. Bacteriological examination of the water did not yield any results which could cause objection on the grounds of hygiene.
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PMID:[Physical education for spina bifida children in special schools for the physically handicapped (primary school)]. 15 44

Sixty patients with congenital deformities of the spine were operated upon in the past fifteen years using a two-stage procedure. In the fifty patients with scoliosis half of the deformities were due to hemivertebrae and half to unilateral bars. The average correction of the deformity was 47 per cent. Early neurological signs observed in two patients with a diastematomyelia resolved. Of the ten patients with kyphosis nine had neurological signs of impending paraplegia and one was completely paraplegic before operation; all improved markedly. Posterior spinal fusion alone in the rapidly progressing congenital deformity may not prevent further progression, particularly in those cases iwth unilateral bars. Anterior resection of the vertebral body with later posterior fusion with Harrington instrumentation is safe and effective.
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PMID:Two-stage corrective surgery for congenital deformities of the spine. 47 55

Four basic types of orthoses are now being used at the Twin Cities Scoliosis Center for the treatment of spinal curvatures. The Milwaukee Brace, either custom-made or using a prefabricated pelvic section is the orthosis of choice for thoracic scoliosis and kyphosis in the ambulatory child. For lumbar and thoracolumbar curves, the one-piece "TLSO" has proven the most effective design. For the collapsing spine of myelomeningocele, childhood paraplegia, and spinal muscular atrophy, the 2-piece bivalved polypropylene body jacket is excellent. For the severely involved cerebral palsy or Duchenne Dystrophy patient, the Chair Insert type Sitting Support Orthodosis is preferable.
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PMID:Modern orthotics for spinal deformities. 59 43

The incidence of spontaneous avian spondylopathy was maintained between 58 and 66% in the progeny of one flock (Flock A) and less than 40% in the progeny of another (Flock B), by proper selection and breeding for 4 generations. Spondylolisthesis, the major type of spondylopathy present, was observed at the first and sixth vertebral levels. Spondylolisthesis was progressive in nature and consisted of a ventrodorsal rotation of the 1st and/or 6th thoracic vertebrae leading to spinal cord injury and paraplegia or partial crippling in some birds. There was occasionally extensive muscle degeneration and connective tissue proliferation around the distorted vertebrae and the spinous ligaments bridging the defect were stretched and appeared heavier than normal. Spondylopathy was also observed in 20-day chick embryos. Spondylolisthesis was observed in 33% of the embryos examined from Flock A-G2 and the other conditions present consisted of scoliosis and abnormal lordosis and kyphosis. Using a grading scale of +1 (mild) to +3 (severe), all cases of embryonic spondylopathy were graded as +1. The back defects present in Flock B-G2 embryos were entirely due to abnormal kyphosis.
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PMID:Spontaneous spondylolisthesis in embryonic and adult chick. 60 43

The prognosis of the scoliosis is determined by early and exact treatment, which depends on the degree of curvature, age, localization and expected of deviation. Scoliosis up to 30 degrees is treated by physical therapy. Between 30-50 degrees an active treatment with the Milwaukee-brace is recommended. Over 50 degrees surgery is required, because further progression is to be expected. The Harrington procedure should now be used in all centers of scoliosis. Paraplegia is seen in 0,5%. Minor complications and better correction can be expected by surgery carried out in special centers.
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PMID:[Prognosis of idiopathic scoliosis]. 70 May 84

Kyphosis has become an increasingly important problem to the surgeon interested in the management of significant spinal deformity. As scoliosis has become better understood, the more difficult problems have become apparent and one of the most difficult of these is kyphosis. Kyphosis is the deformity which can produce paraplegia if it progresses to a significant degree and remains untreated. Contrary to scoliosis, in which bracing and posterior fusion alone are usually quite sufficient, kyphosis sometimes responds to bracing and other times it does not. If surgical treatment is necessary it quite often requires an anterior fusion. The purpose of this presentation is to give an overall review of the various etiologies of kyphosis and the current status of management of these various problems.
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PMID:Kyphosis in childhood and adolescence. 74 Dec 35

Of 400 patients with the diagnosis of neurofibromatosis on their hospital records, 141 actually had the disease. The presence of at least two of the following features was considered diagnostic: positive family history; positive biopsy; a minimum of six cafe-au-lait spots, each with a diameter of at least 1.5 centimeters; and multiple subcutaneous neurofibromas. Scoliosis was present in thirty-seven patients (26 per cent), most commonly associated with cafe-au-lait spots (thirty-five patients). In many of the patients with scoliosis there were associated medical and surgical problems. Although no standard pattern of spinal deformity could be identified, a sharp single right thoracic curve involving more than five vertebrae was the most common. For the whole group the initial measurement of the scoliosis averaged 42 degrees. Double curves were more sever, buth kyphosis was uncommon and no cases of paraplegia were recorded. In patients with progressive scoliosis, the best results were obtained with early Harrington instrumentation and posterior spine fusion. Progression of the scoliosis was observed both before treatment and postoperatively. The amount of progression was not necessarily related to the severity of other manifestations of neurofibromatosis, and was not significantly dependent on the length of the curve.
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PMID:Neurofibromatous scoliosis. Natural history and results of treatment in thirty-seven cases. 81 47

27 operations on the vertebral bodies of the thoracic spine are reported. Indications for operation included markedly progressive infantile and juvenile scoliosis, correction of severe kyphoses in congenital malformation, fractures, Scheuermann's disease and post-laminectomy as well as tuberculous spondylitis and tumors. The two uppermost thoracic vertebrae can be reached by the method of Southwick and Robinson, the two lowest vertebrae from an extraperitoreal-subdiaphragm approach. Thoracotomy was chosen for the remaining thoracic vertebrae. If the staff and material are available, operations on the thoracic vertebrae can be regarded as relatively safe and, in many cases, are the only possibility for obtaining a satisfactory or good result. In spite of this, strict indications must be observed. Severe complications (death, paraplegia etc.) did not occur in any of the patients.
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PMID:[Surgical interventions on the vertebral bodies of the thoracic spine (author's transl)]. 84 93

1. 166 children with paraplegia occurring before the age of 15 are presented, of whom 116 are available for the study. 2. Scoliosis of more than 15 degrees developed in approximately one-half of the children. 3. Children with thoracic paralysis appear to be particularly endangered. 4. The primary spinal column injury as a result of an accident plays only a minor role in the development of scoliosis. 5. The asymmetric neurological level of paralysis is seen as a significant cause of scoliosis. 6. As prophylaxis, a spinal support as well as standing and walking exercises, including balance exercises, are recommended. 7. As possible therapy in cases with proven asymmetric neurological paralysis, rhizotomy of several thoracic spinal nerves may be discussed in order to achieve a balanced paralysis.
Paraplegia 1977 May
PMID:Scoliotic growth in children with acquired paraplegia [proceedings]. 89 58

At the present time our preventive methods do not fully prevent the occurrence of scoliosis subsequent to juvenile paraplegia. The methods of management must be: (a) preventive; (b) early non-operative correction, such as braces; and by (c) operative correction. The operative correction must be both an anterior and posterior procedure to give good spinal alignment. Further follow-up over many years will be necessary to watch these cases, but the initial results are satisfactory re correction. Function has been improved in both (a) respiration and (b) mobility, but at the 'expense' of reduction in some areas of recreation.
Paraplegia 1977 May
PMID:Correction of scoliosis due to paraplegia sustained in paediatric age-group [proceedings]. 89 60


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