Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0700208 (scoliosis)
 8,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postural deformities are frequent and disabling complications of Parkinson's disease (PD) and atypical parkinsonism. These deformities include camptocormia, antecollis, Pisa syndrome, and scoliosis. Recognition of specific postural syndromes might have differential diagnostic value in patients presenting with parkinsonism. The evidence to date suggests that postural deformities have a multifactorial pathophysiology. Contributing factors include muscular rigidity; axial dystonia; weakness caused by myopathy; body scheme defects due to centrally impaired proprioception; and structural changes in the spine. The relative contribution of these different factors varies between patients and across specific syndromes. Improved understanding of the mechanisms underlying postural deformities in PD might ultimately lead us to more effective management strategies for these disabling and drug-refractory complications.
 ...
PMID:Postural deformities in Parkinson's disease. 2151 90

Spinal deformities are frequent and disabling complications of movement disorders such as Parkinson disease and multiple system atrophy. The most distinct spinal deformities include camptocormia, antecollis, Pisa syndrome, and scoliosis. Spinal surgery has become lower risk and more efficacious for complex spinal deformities, and thus more appealing to patients, particularly those for whom conservative treatment is inappropriate or ineffective. Recent innovations and advances in spinal surgery have revolutionized the management of spinal deformities in elderly patients. However, spinal deformity surgeries in patients with Parkinson disease remain challenging. High rates of mechanical complications can necessitate revision surgery. The success of spinal surgery in patients with Parkinson disease depends on an interdisciplinary approach, including both surgeons and movement disorder specialists, to select appropriate surgical patients and manage postoperative movement in order to decrease mechanical failures. Achieving appropriate correction of sagittal alignment with strong biomechanical instrumentation and bone fusion is the key determinant of satisfactory results.
...
PMID:Impact of Movement Disorders on Management of Spinal Deformity in the Elderly. 2637 55

A wide range of neuromuscular diseases, including Parkinson disease, cerebral palsy, multiple sclerosis, and myopathy, are associated with spinal deformities. The most common postural deformities include anterocollis, Pisa syndrome (pleurothotonus), scoliosis, and camptocormia. Nonsurgical management of spinal deformity in patients with neuromuscular disease centers on maximizing the medical management of the underlying neurodegenerative pathology before surgical intervention is contemplated. Surgical management can include decompression alone, or decompression and fusion with short or long fusion constructs. Patients with neuromuscular disease are susceptible to postoperative medical complications, such as delirium, epidural hematomas, pulmonary emboli, and cardiac events. Compared with outcomes in the typical patient with spinal deformity, postoperative outcomes in patients with neuromuscular disease have higher rates of surgical complications, such as instrumentation failure, proximal junctional kyphosis, loss of correction, and the need for revision surgery, regardless of the magnitude of surgical treatment.
...
PMID:Management of Spinal Deformity in Adult Patients With Neuromuscular Disease. 2747

Patients with Parkinson's disease (PD) commonly develop severe spinal deformity, including scoliosis, antecollis, camptocormia, and Pisa syndrome. The etiology of PD-associated spinal deformity is not completely understood and in most cases is likely due to multiple interrelated factors, including central dystonia and focal myopathy. Once spinal deformity has occurred, surgery is often the only modality that can correct the condition, although control of the movement disorder through medication and deep brain stimulation may slow progression. Advances in spinal instrumentation and deformity correction techniques have improved the outcomes of PD spinal deformity patients, though complications and revision surgery rates remain high. Surgical intervention is reserved for individuals who are physiologically healthy and whose condition is refractory to nonoperative management and follows similar treatment principles as other causes of neuromuscular scoliosis/kyphosis. Spinal deformity patients with PD are optimally treated by spinal deformity surgeons who are familiar with the unique needs of PD patients, with vigilant preoperative and postoperative treatment of their movement disorder and bone density.
 ...
PMID:Etiology and Management of Spinal Deformity in Patients With Parkinson's Disease. 3028 78

Hand and foot deformities, known as "striatal deformities", and other musculoskeletal abnormalities such as dropped head, bent spine, camptocormia, scoliosis and Pisa syndrome, are poorly understood and often misdiagnosed features of Parkinson's disease and other parkinsonian syndromes. These deformities share some similarities with known rheumatologic conditions and can be wrongly diagnosed as rheumatoid arthritis, osteoarthritis, psoriatic arthritis, Dupuytren's contracture, trigger finger, or other rheumatologic or orthopedic conditions. Neurologists, rheumatologists, and other physicians must be familiar with these deformities to prevent misdiagnosis and unnecessary diagnostic tests, and to recommend appropriate treatment options.
 ...
PMID:Hand, foot, and spine deformities in parkinsonian disorders. 3080 10

Postural abnormalities in Parkinson's disease (PD) are considered the rule more than the exception and are disabling complications of the disease. These deformities include camptocormia, antecollis, Pisa syndrome, and scoliosis. Evidence to date suggests that postural deformities have a multifactorial pathophysiology, including muscular rigidity, axial dystonia, weakness due to myopathy, body scheme defects due to centrally impaired proprioception, and structural changes in the spine. Antecollis in parkinsonian disorders refers to a forward flexion of the head and neck. It is usually mild in severity and may be considered part of the stooped posture in patients with PD. Some authors that suggest the term antecollis should only be used in patients with at least a minimum of 45 degrees of thoracolumbar flexion. Neither camptocormia nor Pisa syndrome can be evaluated without taking into account the presence or absence of scoliosis. In this regard, the rotating component of the spine and its behavior in the supine position give important clues for a correct diagnosis. In some cases, X-rays in the standing and supine positions are necessary. The presence of marked camptocormia requires a minimum of flexion in the sagittal plane originating in the thoracolumbar spine greater than 45 degrees, with an almost complete resolution in the supine position. Pisa syndrome requires a minimum of 10 degrees of lateral flexion and is almost completely alleviated by passive mobilization or supine positioning. A certain degree of scoliosis is expected in most parkinsonian patients; therefore, both camptocormia and Pisa syndrome do not generally present as pure syndromes.
 ...
PMID:How Do I Examine Postural Disorders in Parkinson's Disease? 3083 58