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

The literature documents progression of spondylolisthesis, most commonly during the adolescent growth spurt. Twenty-eight patients with Grades I and II spondylolisthesis were treated with antilordotic braces. Presenting signs and symptoms included back pain (61%), tight hamstrings (53%), increased lordosis (25%), and mild scoliosis (21%). Three patients presented with spondylolysis and progressed to a slip prior to initiation of brace treatment. Mean duration of brace treatment was 25 months. In the brace, lateral roentgenograms demonstrated a significant reduction of lumbar lordosis and sacral inclination. At the conclusion of brace treatment all patients were pain-free and none had demonstrated a significant increase in slip percent.
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PMID:Brace treatment for symptomatic spondylolisthesis. 318 May 70

A series of 190 patients with lumbar spondylolisthesis treated operatively during the years 1948-80 at the mean age of 15.2 years (8-19 years) and reexamined 4-36 years (mean 11.2 years) later are presented. In 92 of them (48%) scoliosis (more than 5 degrees) in association with olisthesis was seen. The slipping affected the fifth segment in 90 and fourth segment in two patients. The female predominance was characteristic in the scoliotic group. Dysplastic changes of the posterior arc were more often seen in the group of patients with scoliosis than in the nonscoliotic group, and they also presented a more severe grade of slipping and lumbosacral kyphosis. The curve was usually mild and was situated in the lumbar area. Patients with a higher degree of lumbosacral kyphosis and more severe slipping also had a statistically higher degree of lumbar scoliosis. Operative treatment of spondylolisthesis consisted of posterior or posterolateral fusion in situ, but two patients were treated using ventral fusion and three severe cases with removal of loose posterior element. Lumbar scoliosis classified as sciatic type disappeared in 25 out of 39 patients after lumbosacral fusion, suggesting the "sciatic muscle spasm" as an etiologic factor. The torsional type of curve resulting from asymmetrical slipping of the vertebra was also corrected in 19 out of 28 cases after fusion. At follow-up patients with remaining lumbar scoliosis represented more low-back pain than those without any curve. In our opinion lumbosacral fusion is indicated before lumbar curve changes to structural scoliosis in symptomatic patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Scoliosis associated with lumbar spondylolisthesis. A clinical survey of 190 young patients. 318 12

We reviewed 77 unfused and 91 fused patients with idiopathic scoliosis who first attended between 1949 and 1965. Both groups were re-examined at least 10 years after reaching skeletal maturity, with attention to progression of the Cobb angle, increased in vertebral rotation, back pain and psychosocial problems. We found that spinal fusion protects the scoliotic spine from further deterioration during adult life except for those with severe curves and marked rotation. Fusion also significantly reduced the incidence of severe pain and allowed patients to carry out heavy physical work, but did not confer complete immunity from backache. Surgery improved the appearance, but patients were not always completely satisfied with the cosmetic result.
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PMID:Long-term follow-up of fused and unfused idiopathic scoliosis. 319 66

Lumboperitoneal (LP) shunts performed for communicating hydrocephalus have been reported to lead to neurologic deficits in the lower limbs and spinal deformities as a result of arachnoiditis. A chart review of 375 children who underwent LP shunts between 1960 and 1981 at The Hospital For Sick Children in Toronto was undertaken. Of the 375 charts reviewed, evidence of shunt-induced neurologic deficits was seen in 63 patients. Thirty-four patients had back pain with or without sciatica, 45 patients had hamstring tightness, and 40 patients had foot deformities. Forty-nine patients had lumbar hyperlordosis, lordoscoliosis, and scoliosis. These deformities are postulated to be the result of arachnoiditis involving the conus medullaris and lower lumbar roots.
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PMID:Orthopaedic complications of lumboperitoneal shunts. 319 96

Lateral subluxation of one vertebral body upon another (rotatory olisthesis) has been associated with increased incidence of back pain in scoliosis. This study was undertaken to identify the presence of and characterize rotatory olisthesis and its association with the following parameters: age, sex, curve type, curve magnitude, level of occurrence, region within curves, primary vs. secondary curves, severity of slip, and association with pain. Charts of 636 patients were reviewed for the presence or absence of pain. Curve measurements and the occurrence of rotatory olisthesis were noted. Rotatory olisthesis was statistically unrelated to the occurrence of pain associated with idiopathic scoliosis. It was significantly associated with increasing age and curve magnitude. Lumbar curves with rotatory olisthesis were more likely to be associated with radicular pain.
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PMID:Rotatory olisthesis in idiopathic scoliosis. 321 72

36 former competitive artistic women gymnasts and 10 general women gymnasts were examined after at least three years following their withdrawal from sports, for any pathological changes in their vertebral column. Anamnesis revealed that 64% of the artistic gymnasts complained of back pain during competitive sports, and even after having given it up there were still 61% complaining. X-ray film showed degenerative changes of the vertebral bodies and the intervertebral joints in 51.4%. Incidence of spondylolysis was 31.4% and hence two and a half times above that among the normal population. In 22 cases where x-ray films were available from the time they had been active, we found an increase rate of 36.4% in respect of spondylolysis, a worsening of scoliosis by 22.7% and an increase in degenerative changes at the minor vertebral joints by 31.8%.
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PMID:[Spinal changes in artistic gymnasts]. 324 61

Symptomatic loss of lumbar lordosis is a disabling complication of scoliosis surgery. This so-called "flat-back syndrome" is characterized by an inability to stand erect and by upper back pain. Distraction instrumentation extending into the lower lumbar spine or sacrum is the most frequently identified etiologic factor responsible for loss of lordosis. The more distal the level of instrumentation, the severer the loss of lumbar lordosis. Other factors that may aggravate the loss of lordosis include thoracolumbar kyphosis, fixed thoracic kyphosis, hip flexion contractures, and pseudoarthrosis. Because of the wide range of values for kyphosis and lordosis in normal individuals, there is no absolute value that can be considered "normal." It is the overall sagittal plane balance that is most important. The most useful radiographic measurement to evaluate this sagittal plane balance is the full-length standing lateral radiograph with the knees extended. On this view, the C7-S1 measurement should fall within 2 cm of the anterior aspect of the sacrum. Surgical treatment for symptomatic loss of lumbar lordosis consists of closing wedge osteotomies through the fusion mass. This should generally be preceded by an anterior release and interbody fusion. Correction should be obtained at the site of the deformity with particular attention paid to the thoracolumbar junction. The surgery is difficult and the risk of complication is high. The most important aspect of this postural disorder is prevention. Avoid distraction instrumentation that extends into the lumbar spine if possible. When distraction instrumentation is used, the techniques described will help preserve lumbar lordosis. When performing a fusion to the sacrum, distraction instrumentation should not be used.
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PMID:Loss of lumbar lordosis. A complication of spinal fusion for scoliosis. 328 6

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 authors present the case of a 23-year-old white woman gymnast with a nine-month history of severe low back pain, spasm and radiation of pain into the buttocks. When back pain had first begun, she was diagnosed elsewhere as having spondylolisthesis, grade unknown. She was started on conservative therapy which included bracing, flexion exercise, and anti-inflammatory and analgesic medication. There were periods of improvement followed by periods of relapse until two months prior to being seen by the authors, when back pain and spasm became constant. Physical examination and x-rays now revealed a Grade 4 spondylolisthesis with a spastic scoliosis from T-3 to T-6 (left) of 18 degrees and T-11 to L-2 (right) of 25 degrees. Surgery was decided on and the authors describe the surgical procedure, a combined anterior-posterior two-stage approach of anterior vertebrectomy with anterior fusion, followed by posterior stabilization and fusion. The patient has experienced complete pain relief, a return of good strength and good posture and an overall improvement in function. The authors recommend the two-stage procedure for high grade spondylolisthesis.
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PMID:Grade 4 spondylolisthesis. Two-stage therapeutic approach of anterior vertebrectomy and anterior-posterior fusion. 345 75

Twenty-seven patients with CF and joint complaints were reviewed. Twelve patients had arthritis, 11 had HPO, and four had symptoms of mechanical neck and back pain. We have confirmed the association of CF with an episodic form of arthritis. For the first time, we have reported that a subgroup of these patients later develop persistent synovitis with progressive asymmetric, erosive disease. The etiology of CF arthritis is unclear, but may relate to chronic infection and immune complex mechanisms. CF arthritis can be contrasted with CF induced HPO, which is associated with worse lung disease, a male predominance, and an older mean age of onset of symptoms. Mechanical neck and back pain may relate to an associated scoliosis or kyphosis in CF.
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PMID:The musculoskeletal manifestations of cystic fibrosis. 351 62


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