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

The hypothesis that a causal relationship exists between unequal leg length and disorders in the back or lower extremities has been hard to prove. However, at the present time there is scientific documentation of an association between a difference in length of more than 1 cm and low back pain. Thus, in children with one leg one centimetre or more longer than the other, and in adults with symptoms, the discrepancy should be adjusted, especially if a lumbar scoliosis in the standing position has been documented radiographically. A difference in length of less than 2 cm should be treated by raising the shoe. An established or estimated difference of more than this is usually corrected by surgery, either by epiphysiodesis or by shortening or lengthening osteotomy. In adults with a moderate difference in leg length, a raised shoe test is recommended in order to evaluate the effect of a correction in practice before osteotomy is performed.
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PMID:[Anisomelia. Clinical consequences and treatment]. 919 42

Physiological striae are common in adolescence, occurring in the lumbar and gluteal regions, the upper thighs, breast, lower abdomen, and back. The lesions may be mistaken for nonaccidental injury, that is, physical abuse. We present four cases of adolescents with lesions thought to be due to physical abuse. Three of these cases were revealed during a school screening program for scoliosis; of the 2600 adolescents screened, aged 12 to 16 years, 168 were found to have striae. One case was found by a family physician when a young boy presented with low back pain. Since striae may be mistakenly ascribed to physical abuse, it is important for family physicians, nurses, and pediatricians to be familiar with this benign condition.
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PMID:Striae in adolescents mistaken for physical abuse. 922 18

The tethered spinal cord syndrome is more often encountered in children, but does also occur in adults. Its clinical spectrum comprises low back pain, neurological deficits such as distal motor weakness and trophic and sensory disturbances in the legs, urological symptoms and such musculoskeletal signs as scoliosis or foot deformities. In addition, cutaneous lesions or subcutaneous lipomas in the lumbosacral region may be indirect signs of an intraspinal pathology. This consists in a tight, thickened and sometimes shortened filum terminale, an intraspinal lipoma, intradural scar formation or other lesions that lead to conus fixation. The common mechanism of injury of these types of pathologies is an impairment of longitudinal movement of the spinal cord, especially the conus medullaris, which subsequently leads to chronic local ischemia. Diagnosis is most readily achieved by magnetic resonance imaging. Treatment is aimed at the restoration of cord mobility by means of microsurgical release of the conus, the cauda equina and the filum terminale with the aid of cauda equina neuromonitoring. Further progression can be effectively halted; in fact almost half of the patient actually improve. Therefore, every patients presenting with the clinical diagnosis of tethered cord syndrome should be offered specialized surgical treatment.
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PMID:[Tethered spinal cord syndrome in adults]. 927 57

The clinical presentation of tethered spinal cord and the results of tethered cord release were examined in a group of 30 low motor level (L3 and below) children with a history of myelomeningocele without concomitant CNS complications. Changes in orthopedic and/or neurologic status formed the basis of consideration for tethered cord release. Clinically, these patients presented with a new onset or recently progressing scoliosis, spasticity with or without contractures, decrease in motor function and low back pain at the site of closure. One or more of these findings was present in all cases and led to the suspicion of tethered spinal cord. The diagnosis of tethered cord was confirmed in all cases by MRI or CT myeolography. In order to isolate tethering as the etiology for the patients' clinical deterioration, patients with concomitant CNS complications, e.g. shunt dysfunction or hydromyelia were excluded from the study. Twenty-nine such patients, of an initial 59, who would have otherwise been considered, were excluded on the basis of this criteria of concomitant CNS complications. The results of release 1 year after the procedure were as follows: regarding scoliosis, in 75% of cases the curve either remained stable or decreased by more than 10 degrees, with 25% experiencing curve progression of > 10 degrees. The most recent follow-up in this group revealed that 11.8% experienced a decrease in curvature of >10 degrees; 47.1% remained stable, and 41.2% ultimately progressed 10 degrees. In the group with spasticity, 43.8% improved; 56.3% remained stable, and none worsened. Most (78.6%) of the children who had experienced a decline in motor function improved postoperatively, and all those with back pain experienced complete resolution. In conclusion, tethered cord release in symptomatic low lumbar and sacral level children with myelomeningocele appears to be of benefit, especially with respect to stabilization of scoliosis in selected patients, back pain at the site of closure, and prior decline in motor function. Results in the cases with spasticity were more equivocal.
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PMID:Tethered cord syndrome in low motor level children with myelomeningocele. 934 49

The course and outcome of 142 pregnancies in 146 patients operated between 1970 and 1975 by the Harrington method for idiopathic scoliosis were studied to determine the effects of scoliosis on pregnancy and childbirth and the effects of pregnancy on the remaining fused and unfused scoliotic curvatures. Occurrence of and sick leave due to low back pain during pregnancy was determined. The patients, all originally treated at the Orthopaedic Hospital of the Invalid Foundation (Orton) in Helsinki, Finland, were invited to a clinical and radiological re-examination on average 19 years following surgery. The results show that pregnancy does not significantly increase fused scoliotic curvatures nor the remaining unfused curvatures. A somewhat higher proportion of children (23%) were delivered by cesarean section than in the general population (15%; P < 0.01), but this result should only be taken as suggestive. Rates of complications of pregnancy and in labor did not differ from those in the background population. The offspring were healthy. Low back pain during pregnancy occurred in about 40% of our patients, but was severe enough to cause sick leave only in 11% of the pregnancies.
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PMID:Pregnancy and delivery in patients operated by the Harrington method for idiopathic scoliosis. 939 99

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

Twenty three patients with lumbar spondylolisthesis (6 Grade I, 14 Grade II and 3 Grade III) with low back pain, and radicular pain in 14, were treated surgically when they failed to respond to conservative treatment. Their average age was 33.2 years. Bilateral posterolateral spinal fusions with autologous iliac bone chips, supplemented by a sacrospinalis muscle-pedicle bone graft on the left side, were undertaken after laminectomy and foraminotomy in all except in two adolescents, where laminectomy and foraminotomy were avoided. The period of follow-up varied from 26 to 126 months (average 65.3 months). The results in 11 (48%) patients were excellent, 9 (39%) were good, 2 (9%) fair and one (4%) poor. There was a higher incidence (87%) of good quality of osseous fusion on the left side, where the sacrospinalis muscle-pedicle bone graft was used, compared to the right, where 70% of fusions were satisfactory. Function improved in 91% of the patients. Neither scoliosis nor weakness of the extensor muscles of the back developed due to reanchorage of the sacrospinalis muscle to the lumbosacral spines.
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PMID:Sacrospinalis muscle-pedicle bone graft in posterolateral fusion for spondylolisthesis. 979 10

If nonoperative management fails to relieve a clearly identifiable and surgically treatable cause of lumbar pain, then surgery may be beneficial. Certain "red flags" indicate the need for urgent or emergent surgical intervention. Low back pain is associated with several degenerative conditions in the lumbar spine, including degenerative disc disease, spinal stenosis, spondylolisthesis, degenerative scoliosis, facet joint syndrome, and disc herniation.
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PMID:The surgical treatment of low back pain. 989 29

Beta-thalassaemias have a wide variety of musculoskeletal system manifestations. In this cross-sectional study, we aimed to investigate the frequency and features of musculoskeletal system problems in children with beta-thalassaemia. A total of 20 beta thalassaemic patients with an average age of 13.8 years were enrolled in the study. In all patients studied, detailed history regarding musculoskeletal involvement was taken and locomotor examinations were performed. All patients underwent radiographic examination with standing anteroposterior and lateral X-rays of the spine. Two physicians blinded for the diagnosis used Cobb technique for determining the degree of scoliosis. In 12 of 20 patients (60%) locomotor system involvement was found. Most frequent complaints were arthralgia and low back pain in 30% and 25% of patients respectively. Scoliosis was detected radiologically in 40% of patients with a lateral curve of at least 5 degrees Cobb.
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PMID:Beta thalassaemia: a report of 20 children. 1008 48

A 65-year-old woman presented with vertebral fractures of the lumbar spine and a history of pathological fractures following minor trauma, which had occurred before the onset of menopause. Her past medical history was significant for intermittent low back pain since childhood, which was attributed to thoracolumbar scoliosis. A diagnosis of unclassifiable osteoporosis was made until invasive diagnostic procedures suggested a mild form of type I osteogenesis imperfecta (OI). In unclear or atypical perimenopausal osteoporosis and diagnosis of OI should be considered.
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PMID:Type I osteogenesis imperfecta: diagnostic difficulties. 1008 50


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