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

Anterior Zielke instrumentation of adolescent idiopathic scoliosis curvatures can provide excellent correction of thoracolumbar and lumbar curvatures, with substantial correction of rotational deformity. This correction allows fewer number of vertebrae to be fused, thereby leaving more normal lumbar motion segments distal to the fusion and decreasing the likelihood of lumbar spondylosis in later life. Anterior spinal surgery introduces a new set of intraoperative challenges that may be unfamiliar to the traditional posterior spine deformity surgeon. A slightly less cosmetically acceptable thoracotomy incision scar and the fact that a postoperative orthosis is required are disadvantages that are outweighed by the fewer number of motion segments that need to be involved in the fusion mass, as well as the superior correction.
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PMID:Anterior spine fusion with Zielke instrumentation for idiopathic scoliosis in adolescents. 335 86

Pelvic obliquity can be caused by leg length inequality, contractures about the hips, as part of a structural scoliosis, or as a combination of two or more of these causes. Careful physical and radiologic evaluations are necessary to establish the correct diagnosis. Treatment is then directed toward the specific cause, ie, leg length balancing, release of hip contractures, or scoliosis correction. Structural scolioses with pelvic obliquity may be either congenital or paralytic. If a traction roentgenogram reveals the curve to be flexible enough that the pelvis can be fully leveled, then a posterior fusion only is necessary. If the pelvis will not level with traction, then anterior convex wedge excisions (discectomies for the paralytic, hemivertebra excision for the congenital) are necessary for achieving adequate correction. Posterior instrumentation and fusion must follow the anterior procedure. Various forms of internal correction and fixation devices are now available, and there is no single best procedure. Anterior internal fixation devices are being used less and less, while posterior segmental fixation with Luque rods are wires is being used more and more.
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PMID:Pelvic obliquity. Its causes and its treatment. 371 23

Interspinous process segmental instrumentation (ISSI) was used in 34 patients with scoliosis due to severe cerebral palsy. Average age was 17 years, and average curve was 82 degrees. Anterior fusion was performed in 21 patients before ISSI. Mean correction was 50.5%, and progression averaged 5 degrees at the 22-month follow-up. Posterior fusion alone gave good results in smaller curves. A brace was needed only for severe movement disorders. Gross functional level improved in fewer than one-third of patients. Minor gains were made by 74%. ISSI is effective in severe cerebral palsy. It may be used alone in the smaller (less than 80 degrees), more supple curves.
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PMID:Interspinous process segmental spinal instrumentation for scoliosis in cerebral palsy. 376 Jan 65

The indications and techniques for internal fixation of the lumbar spine in degenerative conditions have changed drastically since internal fixation was first applied to the spine almost 100 years ago. Anterior instrumentation and fusion may be used for repair of pseudarthrosis after posterolateral fusion; symptomatic lumbar scoliosis associated with degenerative disc disease; late pain secondary to posttraumatic kyphosis; postlaminectomy instability; and lumbar pain secondary to thoracolumbar kyphosis. Posterior instrumentation and fusion has been performed with Luque instrumentation over 3-4 levels in cases of multilevel instability. Combined anterior and posterior instrumentation and fusion are required for lumbosacral fusion in lumbar scoliosis with degenerative disease, and surgical correction of postsurgical lumbar kyphosis (flat-back syndrome). The techniques are demanding but with attention to detail can be performed with acceptably low-complication rates.
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PMID:Techniques of internal fixation for degenerative conditions of the lumbar spine. 395 84

The effect of partial chest wall resection on subsequent production of spinal deformity was studied in six pediatric patients. The following observations are made: Scoliosis secondary to chest wall resection in the pediatric age group is progressive. The degree of curvature is related to the number of ribs resected. Anterior resection of ribs does not produce significant scoliosis, whereas resection of the posterior aspect of the ribs promptly produces scoliosis. Scoliosis associated with marked pleural thickening secondary to recurrent tumor, irradiation scarring, and underlying pulmonary metastases is always convex toward the normal side. Scoliosis associated with empyema and chest wall osteomyelitis is likewise convex toward the normal side and may respond to removal of this thether in the growing child.
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PMID:Progressive scoliosis following chest wall resection in children. 407 Dec 70

Pain is the major cause for surgical intervention in adults with scoliosis and it accounts for 65% of cases. With improved techniques of surgery, including anterior approaches, and better diagnostic methods, including the use of diskography, the satisfactory results of surgical correction have improved from 65-75% to 85-90% of the reported cases. Anterior instrumentation has resulted in decreased pseudarthrosis rates and reduction of lumbar lordosis deformities.
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PMID:Recent advances in the treatment of painful adult scoliosis. 644 51

Two autopsy cases of congenital muscular dystrophy of Fukuyama type (F-CMD) were described. The first case was diagnosed clinically and pathologically as its typical case. Neither his family history nor the history of his prenatal period were contributory. He had suffered from muscle weakness and atrophy since his birth. Serum CPK was markedly elevated. EMG and muscle biopsy proved dystrophic changes of the skeletal muscles. In addition, he manifested mental retardation and attacks of convulsion. EEG failed to elicit remarkable changes, but PEG represented ventricular dilatation. He died of respiratory insufficiency at age 12. His postmortem examination showed variegated anomalies in the nervous system. Extensive micropolygyria was present in the cerebrum and cerebellum accompanied by adhesions between the bilateral cerebral hemispheres. Assymmetry of the longitudinal fibers was pointed out in the pontine base. Anterior horn cells were atrophic and moderately depopulated. On the other hand, the second patient was an atypical F-CMD case in symptoms, signs and pathology. His grand-mothers on both father's and mother's sides wee first cousins. His three siblings showed no similar disorders. His mother developed slight gestational toxicosis in the sixth and seventh months of pregnancy. His muscle weakness, contracture of the bilateral hip-joints and clubfoot had been observed since his birth. Physical and neurological examinations at age 6 showed deformity of the skull, myopathic face, macroglossia, high-arched palate, pigeon chest, scoliosis of the thoracic spine. In addition, generalized muscular atrophy, hypotonia and areflexia were recognized. Pseudohypertrophy of the muscles was absent. Sensation was intact to all modalities. Serum CPK and LDH were moderately increased.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[2 autopsy cases of congenital muscular dystrophy of Fukuyama type--a typical and an atypical cases]. 652 23

Anterior release and fusion, combined with tong gravity traction and second stage L-rod instrumentation, establishes correctability and accomplishes circumferential arthrodesis of the spine in neuromuscular scoliosis. From March 1979 through April 1982, nine patients with neuromuscular scoliosis, with an average age of 16.4 years, underwent this two-stage surgical procedure. The parameters investigated included correction of scoliotic deformity, correction of pelvic decompensation, and spinal arthrodesis. The preoperative scoliotic curvature measured 81 degrees and the postoperative curve measured 29.3 degrees, an average correction of 63.8%. Pelvic obliquity was significant in five of nine patients, averaging 36.2 degrees preoperatively. Postoperatively the pelvic obliquity averaged 11.8 degrees, an average correction of 67.4%. One of two pelvic fixation rods rotated out of the pelvis of one patient; roentgenographically he appears to have fused without loss of correction. A second patient has a poor fusion mass by roentgenographic criteria, although she has lost no correction and has had no pain. This technique offers results comparable to other series reporting arthrodesis for neuromuscular scoliosis. It has the advantages of requiring no anterior instrumentation and no postoperative immobilization.
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PMID:Staged correction of neuromuscular scoliosis. 665 51

Curve patterns and surgical treatment in 118 consecutive patients with post-poliomyelitic paralytic scoliosis are reviewed. The typical curve pattern was double structural curves, usually including the lumbar spine. Modifying the incision and altering the sequence of instrumentation facilitated both the exposure and instrumentation of the fourth and fifth lumbar bodies. Anterior fusion and Dwyer's instrumentation yield most of the correction of pelvic obliquity and significant correction of both the upper and lower curves. Two weeks of halofemoral traction did not achieve significant curve correction. It is suggested that staged anterior and posterior procedures result in structural correction of pelvic obliquity and paralytic scoliosis in severe deformities equal to the degree of correction obtained using posterior fusion and instrumentation alone in less severe cases.
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PMID:Post-poliomyelitis paralytic scoliosis. A review of curve patterns and results of surgical treatments in 118 consecutive patients. 733 80

Scoliosis is the most common orthopaedic problem encountered in Rett syndrome. It is characterized by a long C-shaped thoracolumbar curve of neurologic origin. The occurrence of scoliosis in Rett syndrome is age-dependent, with a reported incidence of 36% to 100%. The onset of scoliosis is usually before age 8 years, and rapid curve progression is usually detected early in the second decade. In Rett syndrome, sagittal deformity with excessive kyphosis can progress and necessitates close observation. Orthotic treatment does not alter the natural history of scoliosis or kyphosis. Indications for surgery are curve progression exceeding a 40 degree or 45 degree Cobb angle or curves that cause pain or loss of function. Anterior discectomy, interbody fusion, and posterior fusion with instrumentation can achieve improved correction in young adolescents with significant curves. Surgical intervention should include fusing the scoliotic and the excessively kyphotic segments.
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PMID:Scoliosis in Rett syndrome. 788 24


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