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

We have prospectively studied 45 patients undergoing scoliosis surgery (48 procedures) for evidence of postoperative acute radiculopathy. Posterior spinal fusion was performed in 42 patients (Cotrel Dubousset 28, Harrington rod with wires 9, Hartshill rectangles 5); anterior spinal fusion in 5 (Webb Morley) and an anterior release procedure in 5. Fourteen patients (29%) had sensory and/or motor signs of radiculopathy post-operatively, with moderate to severe symptoms in 10 and mild symptoms in 4. The radiculopathies were considered traumatic in 7 patients, in whom radiculopathy correlated with placement of a hook or passage of a sublaminal wire. In the remaining 7 patients, traction was considered the likely mechanism of injury; in these there was a significant association with the degree of postoperative correction of the scoliosis where it was substantially beyond the preoperatively demonstrated flexible range (p = 0.008). A system of intraoperative electromyographic monitoring for possible prevention of this complication is described. Radiculopathy is a common complication of scoliosis surgery.
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PMID:A prospective study of acute radiculopathy after scoliosis surgery. 182 25

We studied 300 patients, 61% women, with mean age 49.7 years and mean duration of dystonia 7.8 years, to determine the demographic and clinical characteristics of cervical dystonia (CD) and its relationships to other movement disorders. Torticollis was present in 82%, laterocollis in 42%, retrocollis in 29%, and anterocollis in 25%; however, the majority (66%) had a combination of these abnormal postures. Scoliosis was present in 39%, local pain reported by 68%, and 32% had evidence of secondary cervical radiculopathy. In addition to CD, 16% of patients had oral dystonia, 12% mandibular dystonia, 10% hand/arm dystonia, and 10% had blepharospasm. Tremor was noted in 71% of patients; head-neck tremor was present in 60%, and tremor in other body regions was present in 32%. A family history of a movement disorder was present in 44% of the CD patients. Tardive dystonia was the cause in 6%; 11% had posttraumatic dystonia. Anticholinergic drugs provided moderate improvement in 33% of patients, but local intramuscular botulinum toxin injections relieved CD, local pain, or both in over 90% of all treated patients.
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PMID:Cervical dystonia: clinical findings and associated movement disorders. 206 38

Fourteen patients with degenerative spondylolisthesis and three patients with degenerative scoliosis, all of whom experienced low-back pain, lumbar radiculopathy, and/or intermittent claudication were treated with posterolateral fusion and correction of deformities using a new instrumentation system. This new spinal fixation system combines the advantages of a rod for scoliotic deformities and a plate for sagittal plane disorders. The combination rod-plates can apply multiple forces to facilitate correction of complex deformities as well as enable indirect neurologic decompression. The system allows segmental rigid fixation via transpedicular screws that is limited only to the abnormal vertebral levels to preserve the maximum number of uninvolved lumbar motion segments. The physiologic lumbar lordotic curvature is also preserved. The minimum follow-up period was 1 year. Satisfactory results were obtained in 15 patients (88%). No intraoperative complications occurred. Screw fatigue occurred in two patients at 1-year follow-up examination with no sequelae. The scoliotic and spondylolisthetic deformities were reduced significantly in all patients. This method appears to assist in reducing pathologic motion and deformities that contribute to low-back pain. Compression on neural structures is relieved by thorough decompression and distraction; spinal canal anatomy is also restored.
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PMID:Degenerative spondylolisthesis and degenerative scoliosis treated with a combination segmental rod-plate and transpedicular screw instrumentation system: a preliminary report. 298 Feb 52

The combined investigations of positive contrast myelography and computed tomographic (CT) myelography were performed on 53 consecutive children. Thirty-eight (72%) of these investigations were performed as a routine pre-operative procedure to identify occult spinal dysraphism in patients with childhood scoliosis; the remainder were because of the "orthopaedic syndrome", cervical radiculopathy, back pain and patients with clinical findings to suggest spinal dysraphism. In the 20 patients (38%) with idiopathic scoliosis, there was no case of spinal dysraphism and CT myelography provided no additional information to the myelogram. In the seven patients with spinal dysraphism the plain radiographic abnormalities identified were lumbar vertebral abnormalities (five), thoracic vertebral abnormalities (one), and sacral agenesis (one). Diastematomyelia was found in four patients, a low tethered cord and lipoma in two patients and a large lipoma in one patient. In all of these cases the myelogram indicated the intraspinal abnormalities; however, CT myelography provided more precise anatomical detail. We conclude that CT myelography is not indicated in the initial preoperative assessment of idiopathic scoliosis but should be reserved for patients with congenital or complicated scoliosis where the association with dysraphism is well recognised.
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PMID:Computed tomographic myelography in the investigation of childhood scoliosis and spinal dysraphism. 331 2

The erector spinae muscles of 20 normal humans were evaluated at C7, T3, T11, and L5 vertebral body levels bilaterally. At each level, the mean potential duration of the motor unit action potential was calculated. This control group was compared with a group of patients with C7 and L5 radiculopathy and with a group of patients with thoracic scoliosis. The mean potential durations of the radiculopathy group at the C7 and L5 levels were prolonged as were those values at the convex thoracic levels in the scoliotic group. Muscle biopsy of the erector spinae in the scoliotic group revealed grouped atrophy and changes consistent with a neuropathic process. A radiculopathic process was associated with idiopathic thoracic scoliosis and involved the convex side. It was maximal near the apex of the curve.
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PMID:Neuropathy in thoracic scoliosis. 743 84

Epidemiologic studies document the overuse of surgical procedures in the United States compared with rates in 11 developed countries. Delay in return to work remains an expensive component in the cost of low back pain for workers' compensation claims. Injury to spinal nerve roots may occur secondary to compression with intraradicular edema or from inflammatory phenomena related to phlogistic properties of the nucleus pulposus, independent of nerve compression. Magnetic resonance imaging findings of intervertebral disk bulging and protrusion occur frequently in asymptomatic individuals. Reviews of adult scoliosis, postpartum back pain, diabetic radiculopathy, insufficiency fractures of the sacrum, diskitis, and facet syndrome have appeared in the literature over the past year. Patient education and minimal limitation of activity are associated with the greatest level of patient satisfaction. Long-term follow-up studies of surgical decompression for intervertebral disk herniation and spinal stenosis have resulted in good outcomes in appropriately selected patients.
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PMID:Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain. 776 95

An unusual case of multiple aneurysms of the extracranial vertebral artery associated with neurofibromatosis is presented. A 48-year-old woman, complaining of weakness and numbness of the left upper extremity, was admitted to our hospital on July 27, 1987. She had undergone the removal of a left internal thoracic artery aneurysm due to hemothorax on June 12, 1987. On the next day, the symptoms of the left upper extremity appeared. On admission, general physical examination showed multiple cafe-au-lait spots on her body and cervicothoracic scoliosis. Neurological examination revealed left C5, 6 radiculopathy. Cervical CT scans showed enhanced masses at the transverse foramina. Left subclavian angiography demonstrated multiple extracranial vertebral artery aneurysms from the origin of the vertebral artery to the C4 level. This case was treated by proximal and distal ligation of the aneurysms. Postoperative right and left angiograms revealed no aneurysms filled with contrast materials. The weakness and numbness of the left upper extremity disappeared gradually after the operation.
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PMID:[A case of multiple extracranial vertebral artery aneurysms associated with neurofibromatosis]. 807 95

Spinal instability may be a cause of juxtafacet cyst formation and the pain and disability that occur after surgical excision of the cyst. To determine the role of instability, a retrospective review of charts identified 60 facet cysts in 56 patients treated over a 6-year period. Three patients developed an asynchronous cyst at the same level but on the opposite side of the previously resected cyst and one patient had a recurrent cyst in the same location. Forty-one cysts were present in patients with radiculopathy and 16 in patients with neurogenic claudication. Two patients presented with myelopathy and one had cauda equina syndrome. Thirty-six of the 60 cysts were located at L4-5, the most mobile segment. Fifteen patients had spondylolisthesis, of whom two experienced worsening spondylolisthesis postoperatively. Seven patients had scoliosis and 20 had systemic arthritis. Fifty-five cysts were resected via mesial facetectomy. Six of the patients undergoing this procedure had transverse process fusions at initial surgery for preoperative instability. Two others required fusion for post-operative instability and increased spondylolisthesis. Follow-up review was available in 95% of patients with an average duration of 12 months. Forty patients had excellent relief of symptoms, 12 had occasional back pain, and one patient did poorly. Flexion/extension views of the spine are recommended both pre- and postoperatively to identify the need for fusion in patients with juxtafacet cysts.
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PMID:A series of 60 juxtafacet cysts: clinical presentation, the role of spinal instability, and treatment. 1797 84

The Medical Outcomes Study Short Form-36 was used preoperatively and 2 years postoperatively to compare patients' self reported assessment of health and function between 151 patients who had primary total hip replacement and 49 patients who had total hip revision, 149 patients who had primary total knee replacements, 41 patients who had lumbar laminectomy, and 43 patients who had scoliosis surgery. Primary total hip arthroplasty and lumbar laminectomy posted equivalent followup scores. Primary total hip arthroplasty showed significant improvements in physical function and health perception when compared with revision total hip arthroplasty; all other health parameters were similar. Primary total hip arthroplasty showed significantly better followup scores and greater improvement in scores in four of nine categories of the SF-36 when compared with primary total knee arthroplasty (despite identical scores preoperatively). Despite a higher level of assessed health preoperatively, patients who had scoliosis surgery compared least favorably with patients who had primary total hip arthroplasty at 2 years followup. In terms of patient self assessment of health and function, primary total hip arthroplasty and lumbar laminectomy for radiculopathy gave the best results.
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PMID:Relationship of total hip arthroplasty outcomes to other orthopaedic procedures. 937 61

Lumbar spinal stenosis refers to a diversity of conditions that decrease the total area of the spinal canal, lateral recesses, or neural foramina. Lumbar stenosis is a common disorder that may be present in isolation, with or without associated disk bulge or herniation, or can be associated with degenerative spondylolisthesis or scoliosis. Symptomatic lumbar spinal stenosis is characterized by neurogenic claudication and/or lumbar or sacral radiculopathy. Sixty percent to 85% of properly selected patients have a satisfactory symptomatic improvement with surgical treatment.
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PMID:Lumbar spinal stenosis. 1252 61


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