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

A new instrumentation system, the H-frame system, has been developed for dorsal fusion in scoliosis, spinal fractures and degenerative low back problems. The basis is a prelinked slotted H-frame with two rods of 6-mm diameter with 5-cm threaded ends. There are 4 different lengths, solid in the middle and threaded at the ends. Connection with hooks and/or pedical screws is easy and stable. A slotted system using special conical nuts to grasp these hooks or screws tightly prevents loosening. For low back fusion in degenerative disease the slightly lordotic H-frame is connected to 4 screws. If needed, a sublaminar Luque wire may be added in between. Correction in lordosis with distraction or compression is possible. The fixation is very rigid in all directions with a minimum of implant material. For thoracolumbar fresh fractures 2 pedical screws are placed above and 2 screws below the fracture area, and an H-frame is inserted with one end fixed below and one end above the opposite side of the other rod. Because of the rotary section in the H-frame, the apparatus may be repositioned simply by pushing the frame with the two other screws under control of the H-frame cross-link connection. Distraction and correction of kyphosis is achieved with this simple movement at the same time. The total stable fixation needs no after-treatment. The method may also be used for scoliosis with a combination of hooks, screws and wires. Experience is still very limited. The apparatus has been used in the lumbar spine in more than 10 cases with over 6 months follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Current methods of dorsal spine fusion with pedical screws and presentation of a new method for treatment of fractures and low back instability. 192 40

This study was undertaken to determine if demographic, historical and/or clinical information would be helpful in predicting the presence of abnormal motion depicted on a stress radiograph (flexion, extension and lateral bending views). A total of 72 patients were divided into "normals" and "abnormals" based on the presence of abnormal sequential intersegmental vertebral motion as demonstrated on the stress radiographs. Demographically and historically, the "normal" and "abnormal" groups were essentially the same. Clinical data also failed to show any statistically significant differences between the two groups. Other radiographic findings (scoliosis, degenerative disease, and foraminal encroachment) did not show any significant differences. The value of demographic, historical and/or clinical information as input into the formulation of a protocol for stress radiography is questioned. Suggestions for further research are given.
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PMID:Stress X-rays and the low back pain patient. 214 59

The mountain gorillas of the central Virungas have been the subject of field study for the last 30 years; however, our understanding of morbidity and mortality in these apes is limited. This paper describes pathological conditions of the skeleton and dentition of these animals and evaluates lesions in relation to behavioral and environmental data. The skeletal remains of 31 mountain gorillas from the Karisoke Research Center were examined for enamel wear, carious lesions, abscesses, periodontal disease, antemortem tooth loss, trauma, inflammation, arthritis, neoplasia, and developmental anomalies. Two infants, three juveniles, 13 adult males, and 13 adult females form the sample. Enamel wear in the permanent posterior dentition is moderate. Six periapical abscesses were seen; three are associated with antemortem tooth breakage. No carious lesions were observed. Pronounced calculus buildup and alveolar resorption are the most notable pathological conditions of the dentition and affect all adult animals. The primary affliction of the skeleton is arthritis, which affects 14 animals. Vertebral degenerative disease predominates, but there is also temporomandibular joint involvement. Fractures occur at seven locations in the postcranium. In addition, there are five cranial injuries, including a fractured sagittal crest, and a penetrating wound to the vault, which is believed to result from a bite. Also thought to result from a bite is a case of cranial osteomyelitis. The only other inflammatory responses are two cases of idiopathic periostitis and one idiopathic lytic lesion. Button osteomas affect two animals and are the only neoplastic conditions observed. Two animals are afflicted by developmental abnormalities: one animal by idiopathic vertebral fusion and the other by spinal scoliosis.
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PMID:Skeletal and dental pathology of free-ranging mountain gorillas. 232 80

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

Bone prosthesis of apatite- and wollastonite-containing glass-ceramic (AW-GC), a new synthesized material, is known to be excellent in bonding directly with adjacent living bone tissue, in having strong mechanical strength and no toxic effects, in experimental studies. In spinal surgery, massive and strong bone grafts are required for reconstruction of the spinal column affected by a tumor, trauma, or a degenerative disease. However, utilization of bone allograft is not yet socially accepted in Japan and also there are other barriers against the supply of allograft bone. In the present study, AW-GC bone prosthesis was used for reconstructive surgery for various spinal diseases and follow-up studies were performed for an average of 14.9 months (range: 2-36 mo). The clinical results were satisfactory. Thirty patients (males: 17 and females: 13) with an age range of 40-75 years (mean: 55.3 years) were reviewed in this study. Preoperative diagnoses for which an AW-GC prosthesis was required were as follows; vertebral prosthesis: 15 with metastatic tumor of the spine, 3 with burst fracture of the thoraco-lumbar spine; vertebral spacer: 6 with degenerative spondylolisthesis, 2 with isthmic spondylolisthesis, 2 with lumbar intervertebral disc herniation, and one with spinal canal stenosis. Patient's satisfaction, roentgenographic evaluation, laboratory data on blood and urine, and toxic effects were examined in these patients. As a result, the patient's satisfaction for the AW-GC bone prosthesis was high, and the initial fixation and long term stability were excellent. For kyphotic deformity and scoliosis, postoperative correction could be maintained in two patients where correction was attempted, and the usefulness of AW-GC prosthesis as a spinal prosthesis was confirmed. Good bone formation around the prosthesis was observed with time. The clear zone (radiolucent line between ceramic and bone) tended to decrease or disappear. There were no systemic or local toxic side-effects considered to be due to the AW-GC bone prosthesis, or no abnormalities in the laboratory data. These findings suggested that the AW-GC bone prosthesis is a new biomaterial with excellent properties which can be successfully substituted for bone graft in reconstructive spinal surgery.
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PMID:[Clinical application of AW glass ceramic prosthesis in spinal surgery]. 807 76

Spinal fixation devices are used in the thoracic and lumbosacral spine to stabilize the spine, reduce deformities and fractures, and replace abnormal vertebrae. A bone fusion is usually attempted along with placement of the instrumentation because in most cases the hardware would eventually fail if it were used alone. The thoracolumbar spine is inherently unstable, and early operative intervention improves mobilization and rehabilitation. In some cases of lumbar spinal pain, surgical intervention is necessary for the treatment of conditions such as herniated disks, spondylolysis with spondylolisthesis, and degenerative disease with scoliosis. Surgical procedures consist of posterior (posterior elements) and anterior (vertebral body) fixation. Radiologists face continual changes in both surgical technique and instrumentation and should be knowledgeable about the devices available and the biomechanical principles that direct their use. They need to work with their surgical colleagues to become familiar with the techniques used at their institutions.
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PMID:Spinal fixation. Part 2. Fixation techniques and hardware for the thoracic and lumbosacral spine. 831 61

Spinal fixation devices provide stability and restore anatomic alignment in the treatment of fractures, degenerative disease, infection, and tumors and correct congenital deformities such as those seen in scoliosis. The devices provide immediate stability but are not strong enough to withstand prolonged stress and eventually fail, in most cases, if bone fusion does not occur. Bone graft material is often used to promote fusion and to replace bone after resection. Internal fixation is used to maintain position and alignment and to prevent motion as the spine fuses. Plates and rods are attached to the vertebral body or posterior elements with wire, screws, and hooks. Screws and wire can also be used alone as a means of fixation. Surgical techniques and instrumentation have advanced in recent years, and radiologists are exposed to a myriad of devices. They need to be able to identify the various plates, screws, wiring techniques, and grafts used most commonly and to understand their function in the cervical spine for fusions and treatment of fractures and degenerative disease.
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PMID:Spinal fixation. Part 1. Principles, basic hardware, and fixation techniques for the cervical spine. 846 Feb 24

The cases of three patients with a history of paralytic poliomyelitis in childhood who developed the flat back syndrome before or after spinal fusion for degenerative disease as adults were reviewed. The flat back syndrome, a combination of an inability to stand erect because of forward flexion of the trunk and pain in the low back and/or legs, typically occurs in the setting of decreased lumbar lordosis as a result of distraction instrumentation of the spine for scoliosis, vertebral fracture, or degenerative disease. Focus was placed on determining the factors responsible for the development and/or persistence of the flat back syndrome in these patients despite maintenance of, or partial operative restoration of, lumbar lordosis. Considering the essential role that the trunk extensor musculature plays in maintaining upright posture, it may be that a new onset of weakness (postpolio syndrome) in this musculature represents a major contributing factor to the flat back syndrome in these patients. Spine surgeons considering operative procedures in patients with a remote history of paralytic poliomyelitis should be aware of the possible increased risk of the flat back syndrome in this population of patients.
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PMID:An association between the flat back and postpolio syndromes: a report of three cases. 934 14

In recent years there has been spectacular progress in the approach to various disorders of the spinal column. Owing to improved methods of osteosynthesis there is no longer so much need for long periods of postoperative bed rest. Of all the scolioses, idiopathic scoliosis is most common. The vast majority of these cases are not clinically significant. What is seen in the remaining cases if left untreated is a progression in the curvature during growth. Progressive idiopathic scoliosis can be effectively treated using conservative methods. Screening at school is an important part of this process. If the curvature proves progressive and skeletal growth is not complete a brace can be prescribed. Use of this strategy and form of treatment can avoid progression of the curvature and development of serious deformities. This conservative therapy has markedly reduced the need for corrective surgery. Scheuermann's disease is characterized by a fixed dorsal thoracic kyphosis. Progressive Scheuermann's kyphosis can be effectively treated using a brace. The majority of fractures of the vertebral bodies can be treated conservatively. However, serious fractures normally require surgical intervention. In the industrialised Western world, low back pain is a major health problem and the foremost cause of disability and unfitness for work. Low back pain caused by degenerative disease of the spinal column should be treated using a multidisciplinary approach. The development of advanced operative techniques and osteosynthesis methods has made it possible to treat metastases of the spine surgically. The effects of this treatment on the quality of life are encouraging.
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PMID:[One hundred years of orthopedics in the Netherlands. IV. Spinal abnormalities]. 962 1

A review was carried out on 59 patients (10 males and 49 females) who had anterior interbody fusion performed with femoral ring allograft packed with autograft bone chips with a minimum follow up of 2 years. The average age at the time of surgery was 49.1 year old (26 to 75). The total number of levels grafted was 141. The diagnosis consisted of multiple degenerative disease in 6, degenerative change below the long segment of fusion for scoliosis in 9, osteoporosis with collapsed fracture in 3, pseudarthrosis after posterior laminectomy and fusion in 35, congenital scoliosis in 3, scoliosis in 2 and paralytic scoliosis due to multiple sclerosis in one. The distribution of levels fused was T12-L1 in 6, L1-2 in 12, L2-3 in 17, L3-4 in 22, L4-5 in 35 and L5-S1 in 39. The remaining 10 levels were in the lower thoracic areas (T7-T12). The operations were performed as anterior fusion alone in 13 patients, one-stage anterior and posterior fusion in 26 patients and two-stage surgery in 20 patients. Anterior instrumentation was used in all 141 levels. At average follow-up (33.7 months) there was no significant change in allograft angles (average = 1.6 degrees ). Fusion of the allograft was classified by Bridwell's grading system. At 24 months of the follow up, 97 % of the allografts were in grade I (fully incorporated) and 3% were in grade II (partially incorporated). Compared to 12 months follow-up only 76.2% of the grafts were in grade I, 28 % were in grade II and 0.8% were in grade III. Two patients had deep posterior infections which required further surgery (without resorption of the allograft anteriorly). One patient had a screw migration anteriorly which required removal. Three patients had persistence of radiolucent line at one of the vertebral end plates - graft interfaces but no subsidence of the graft or pain. In conclusion, the femoral ring allograft appeared to benefit the anterior interbody fusion in complex spinal surgery.
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PMID:Role of femoral ring allograft in anterior interbody fusion of the spine. 1211 23


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