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

Proteoglycans of 18 lumbar discs obtained at surgery for lumbar disc lesion were studied biochemically and immunologically (using monoclonal antibody that recognizes core protein of annulus fibrosus proteoglycans) and compared with the results of similar studies on discs obtained at autopsy and Zielke's operation for scoliosis. Disc proteoglycans showed a decrease in extraction and hexuronic acid/protein weight ratio with age in both surgical and post-mortem specimens. Although the molecular weight of proteoglycan monomer seemed to show a slight decrease, that of chondroitin sulfate chain showed no change with age in surgical discs. The proportion of proteoglycan aggregate showed a decrease with age until 40 years old, it went up thereafter because of the loss of proteoglycan monomers. This biochemical degeneration paralleled discogramic degeneration and monoclonal antibody that recognized core protein showed a strong affinity with severely degenerated discs. Besides aging, lumbar instability seemed to exert a profound influence on the progression of degeneration.
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PMID:Biochemical and immunological study of lumbar disc degeneration. 383 21

Spinal instability is a loosely used term resulting from a variety of traumatic, developmental, neoplastic, hereditary, and degenerative insults to the axial skeleton. As defined by White and Panjabi, lumbar instability would imply the loss of the spine's ability, under physiological loads, to maintain its patterns of displacement so as to avoid neurologic deficits, incapacitating deformity, and intractable pain. Although from a strict engineering standpoint, the concept of load and deformation is valid, it is not at all known what type of movement or what magnitude of movement is responsible for low back pain. In light of these considerations, the author would define instability as either acute or chronic. Acute mechanical instability would result from those conditions such as fracture, tumor infiltration, infection, postlaminectomy, and certain congenital defects where a small change in loading or deformation could lead to permanent vertebral displacement with fixed deformity and/or neurologic damage. Chronic instability would result from those low back disorders that lead to progressive deformity over a period of years, often producing back pain from degenerative osteoarthritis, and central as well as foraminal stenosis. These disorders would include lumbar scoliosis, kyphosis, and spondylolisthesis, either isthmic or degenerative type. In those situations associated with more chronic instability, the relationship of low back pain is not always discernable even with provocative discography or magnetic resonance imaging. The surgical treatment of low back pain associated with these spinal instabilities depends on the etiology of the conditions defined. Acute traumatic injuries are best managed by posterior segmental instrumentation. At the level of the upper lumbar spine, a combined approach may be desirable to support anterior column deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical treatment of low back pain in spine instability. 807 79

A total of 258 consecutive decompressive lumbar laminectomies performed on 244 individuals presenting with spinal stenosis were analyzed retrospectively. Spinal fusion was avoided in all but two patients. Outcome in terms of pain relief and return to normal activity was evaluated in two stages, one derived from patient charts and having a relatively short-term follow-up time (mean 8.4 months) and a second derived from patient responses to a questionnaire (which also scored for satisfaction with the results of surgery), which had a longer follow-up time (mean 4.7 years). More than 20 clinical and operative parameters were analyzed. Overall, a high degree of success (93% pain relief, 95% return to normal activity) was achieved in the short term, which was supported by the longer-term follow-up data (64% pain relief, 56% activity return, 75% satisfaction). The following factors were not significantly correlated with outcome: patient age; sex; worker's compensation or no-fault insurance status; employed versus not employed; a history of back surgery prior to the laminectomy studied; existence of degenerative spondylolisthesis or scoliosis; complete versus incomplete myelographic block; or the level of the lumbar spine undergoing surgery. The major conclusions arising from these data are: 1) for all age groups through at least the eighth decade of life, decompressive lumbar laminectomy is a relatively safe operation having a high medium-to-long-term success rate; 2) lumbar instability following laminectomy is rare, even in individuals presenting prior to surgery with degenerative instability conditions; and 3) lumbar fusion in addition to the decompressive laminectomy procedure is rarely required for degenerative spinal stenosis.
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PMID:Decompressive lumbar laminectomy for spinal stenosis. 846 98

Segmental spinal instrumentation has been applied to three groups other than scoliosis. It has been used: 1) to treat fractures of the thoracic and lumbar spine; 2) to control instability secondary to malignant destruction; 3) as a closed loop to help stabilize lumbar instability secondary to degenerative disease. A case history ot each was presented. Complications in this series of 63 patients Included three Instances of broken wires, one broken rod, one partial loss of reduction due to wire migration and one deep infection two years postoperative. There was no absolute need for postsurgical immobilization.
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PMID:Application of segmental spinal instrumentation. 2482 88