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

Spinal deformities are frequent in Marfan's disease. 37 patients were examined at the average age of 11 years. 32 showed a spinal deformity. The treatment of the spinal deformity was a brace in 15 cases, surgery in 16 cases (including 5 cases after brace-failure). 7 cases were just followed-up without treatment. Bracing was efficient only for mild curves, this treatment was satisfying 4 times out of 11 with adequate follow-up. The surgical treatment in 16 cases was a posterior fusion twice associated with anterior fusion. We used the same technique as for idiopathic scoliosis with Harrington instrumentation 5 times, Harrington with sublaminar wires 4 times and Cotrel-Dubousset instrumentation 7 times. The correction of scoliosis was achieved in 48.2 per cent. The use of segmental instrumentation compared with the use of the Harrington instrumentation can explain the small number of non unions and the improvement of the lateral spinal balance. We did not note any cardiovascular complication during or early after the operation. Aortic lesions were responsible of one death in the long term, three patients went through a surgical replacement of aortic valves or the aorta.
Rev Chir Orthop Reparatrice Appar Mot 1992
PMID:[Spinal deformities in Marfan disease]. 130 81

In order to evaluate the difficulties of treatment of associated scoliosis and congenital heart disease (C.H.D.), 44 patients who have been treated between 1970 and 1988 were reviewed. The scoliosis was idiopathic in 30 cases, congenital in 11, neurologic in 3. There were 27 females and 17 males. Twenty one patients had a cyanotic C.H.D. (twelve tetralogies of Fallot). No relation was found between the side of the cardiac approach and the side of the thoracic curves. Three cases of right aortic arch with two left thoracic scolioses were noted. Associated anomalies were encountered in 60 p. 100 of cases. The analysis of old chest X-rays, revealed that the scoliosis was already present an average of 5 years before the first orthopaedic consultation. Eight patients had an orthopaedic treatment; in ten cases surgery was decided but not performed. Twenty six patients were operated. (22 posterior and six anterior procedures). The average angulation was 55 degrees pre-operatively, 30 degrees post-operatively and 40 degrees at a 40 months follow-up. In five cases a pseudarthrosis led to re-intervention. One patient died during a posterior procedure, an other post-operatively. Two patients had a severe complication (one heart arrest; one gaz-embolism) but recovered. The surgical prognosis can be evaluated on an original scale including different cardiac parameters, and the importance of the planned surgical procedure. Under a limited mark, no serious complications occurred. In conclusion, a closed collaboration between pediatricians and the orthopaedic team, should lead to more precocious screening of scoliosis in cardiologic children and before the orthopaedic procedure, to a more precise risk factors evaluation.
Rev Chir Orthop Reparatrice Appar Mot 1991
PMID:[Scoliosis and congenital heart diseases in children. Apropos of 44 cases]. 183 22

This study shows the results obtained in 51 patients, children and adolescents by monitoring somatosensory evoked potentials during spinal surgery: Cotrel-Dubousset instrumentation, surgical anterior correction by plating, spondylolisthesis and hemivertebra surgery. The recordings were made in preoperative, peroperative and postoperative periods; the electro-physiological and anaesthetic conditions allowed us to obtain reliable recordings. Analysis of the peroperative somatosensory evoked potentials showed significant differences in latencies, but also in amplitudes and morphology during distraction in scoliosis or spondylolisthesis. These impairments gradually improved and recovered their normal values at the end of the operation. The impairments were, with equal correction, 4 times more important in Cotrel-Dubousset instrumentation than in surgical anterior correction by plating. In 3 cases, the modifications observed during instrumentation led the surgeon to change his operative behavior avoiding certainly a postoperative neurological disorder. The correlation between the neurological troubles and the impairments of the potentials allowed us to define alarm criteria, and if they persist the wake-test becomes necessary.
Rev Chir Orthop Reparatrice Appar Mot 1991
PMID:[Contribution of somatosensory evoked potentials in the surveillance of the spinal cord during spinal surgery]. 183 87

The authors report their experience at the Rizzoli Institute in treating osteoid osteomas localized to the spine (40 cases). This clinical study confirms that osteoid osteomas are tumors of adolescence, which are often diagnosed late due to their spinal localization. The role of additional investigations, dominated by bone scan and computed tomography is discussed. Their use should decrease the diagnosis delay. Mean follow-up in this series was 4 years, and confirmed that surgical excision had a favorable outcome. The outcome of associated scoliosis was also studied (8 cases). After tumor excision, there were 6 complete or partial corrections. Two cases remained unchanged. Curvature worsening after excision was not encountered.
Rev Chir Orthop Reparatrice Appar Mot 1991
PMID:[Osteoid osteoma of the spine. The experience of the Rizzoli Institute]. 183 61

Eighteen cases presenting Klippel-Feil syndrome were reviewed. Clinical and radiological criteria were analyzed: short neck, severe restriction of motion, and low posterior hairline which make up the classical clinical triad. Radiological abnormalities of the cervical spine included: a reduction in the number of cervical vertebrae, fused vertebral blocks (16 cases), cervical spine-bifida occulta, spinal dysraphism (12 cases). Other cervical vertebral disorders have been added which complete the original description: cervico-thoracic abnormalities (12 cases), craniocervical junction abnormalities (7 cases) and also thoraco lumbar abnormalities (5 cases). Although this syndrome is essentially descriptive, orthopaedic complications may occur: scoliosis (9 cases) of which only two had an increasing deformity and required posterior spine stabilisation; cervico-occipital instabilities (2 cases) which although rare, should be sought out with care because they can have serious consequences; Sprengel's deformities (7 cases) which did not warrant operative intervention. The Klippel-Feil syndrome, Wilderwanck syndrome, and Goldenhar syndrome are all close descriptive entities, and have limited surgical consequences.
Rev Chir Orthop Reparatrice Appar Mot 1990
PMID:[The so-called Klippel-Feil syndrome and its orthopedic incidences]. 214 Apr 57

The authors have reviewed 70 cases of idiopathic scoliosis operated on following the Cotrel-Dubousset technique between 1984 and 1987. The patients aged 15.2 years in average, presented with a double major curve still in progress at the thoracic or thoraco-lumbar level. The mean pre operative angle was 49 degrees, reducible to 34 degrees on bending. The goals of the method have been reached: in the three dimensional space the correction was selective with an angular gain of 65 per cent in the frontal plane, 34 per cent in the antero posterior plane and 56 per cent in the horizontal plane the technique allowed the suppression of any post operative immobilization, an early weight bearing with resume of social activities.
Rev Chir Orthop Reparatrice Appar Mot 1990
PMID:[Cotrel-Dubousset instrumentation in idiopathic scoliosis. Angular results in 70 cases]. 214 15

The authors have reviewed the charts of 82 patients who presented the association of a scoliosis and a spondylolisthesis. They insist upon the necessity to treat each abnormality for itself. 26 patients have been simply followed in the clinic, they required no treatment because of the modicity of the scoliosis and the spondylolisthesis. 23 patients were treated with orthosis because of the scoliosis progression. In this group the spondylolisthesis was not a major concern and remained stable. 15 patients had to be operated on because their scoliosis was threatening. The existence of a spondylolisthesis must not be a deterrent to the arthrodesis, and the orthotic treatment must not be carried on if inadequate. The risks to observe, below the spine fusion a progression of the slippage are extremely low (no case in our series). Although we tried to obtain a fusion of the lysis with an isthmic arthrodesis in two cases, we do not think that it represents a prerequisite to a spine fusion above the level of the lysis. 13 patients had a lumbosacral fusion for a great slippage spondylolisthesis. In this group the scoliosis had no relationship with the spondylolisthesis in four patients. But, in nine patients the scoliosis appeared to be directly related to the spondylolisthesis. The "Arthrodesis-reduction" of the spondylolisthesis enabled us to correct, at least partially, the scoliosis. At last 3 patients had a great slippage spondylolisthesis, and a threatening scoliosis. For these rare cases we propose the lumbosacral fusion with reduction of the spondylolisthesis and then, a few months later, an arthrodesis of the scoliosis as we have carried out twice successfully.
Rev Chir Orthop Reparatrice Appar Mot 1990
PMID:[Scoliosis, spondylolysis and lumbosacral spondylolisthesis. A study of their association apropos of 82 cases in children and adolescents]. 214 16

The forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) of 40 adolescents with idiopathic scoliosis were studied before and after surgery. The values obtained are expressed as percentages of the predicted normal. Twenty-one patients underwent surgical correction of the curve with Harrington rods followed by cast and brace immobilisation for one and a half years (Group A). In the other 19 patients the Harrington rod was contoured in the sagittal plane and supplemented with segmented sublaminar wires to allow rapid post-operative mobilisation free of any orthosis (Group B). A negative correlation was found pre-operatively between the magnitude of the curve and the FEV1 and FVC. The post-operative pulmonary function showed no statistically significant improvement. Contouring the Harrington rod to improve kyphosis in Group B did not affect the outcome.
Rev Chir Orthop Reparatrice Appar Mot 1989
PMID:[Respiratory function in idiopathic scoliosis in adolescents treated by Harrington instrumentation with or without sublaminar segmental wiring]. 261 39

The use of sublaminar segmental wires to enhance the stability of Harrington instrumentation was assessed in a review of our experience in the treatment of scoliosis over the last 6 years. Thirty patients were treated by spinal fusion, Harrington instrumentation and a prolonged postoperative period of immobilisation, initially in a plaster cast and then in a brace (Group 1). A further 29 patients have been treated by augmenting the Harrington instrumentation with sublaminar segmental wires (Group 2). Post-operatively, this group was left free of any brace or cast and early mobilisation was allowed. We observed no neurological complication in either group. The blood loss and the duration of the operation were greater in Group 2, but the period of hospitalisation and time to return to school has been markedly reduced. There has been no significant difference in the degree of correction of the scoliosis between the groups, but the improvement in kyphosis was greater with the use of sublaminar wires. There were no pseudoarthroses in either group during a minimum follow up of 18 months.
Rev Chir Orthop Reparatrice Appar Mot 1989
PMID:[Surgical treatment of scoliosis using Harrington instrumentation and arthrodesis. A comparison of 2 series with and without sublaminar segmental wiring]. 263 41

A study was made of 30 patients presenting with lumbar and thoracolumbar scoliosis; 15 patients had been treated with a 3-valve orthosis and 15 with a Boston brace. The mean age at the commencement of treatment was 14 years for the 3-valve orthosis and 14 years 4 months for the Boston brace. The total duration of treatment was 11.1 months for the 3-valve orthosis and 11.8 months for the Boston brace. The patients with the 3-valve orthoses presented with an initial mean curve of 30 degrees and with the Boston braces a curve of 24 degrees. The mean follow-up after removal of the brace was 17 months for the 3-valve orthosis and 12 months for the Boston braces. The efficacy of the two orthoses was studied in the frontal and horizontal planes, taking into account the overall rotation of the curve and the segmental rotation of each vertebra in the curve. The Boston brace and the 3-valve orthosis were identical in the correction of the curve. The overall derotation was better with the 3-valve orthosis. Segmentally, the 3-valve orthosis was more effective at the apex of the curve whilst the Boston brace was more effective at the extremities of the curve. The ilio-lumbar angle and the trunk instability were corrected better by the Boston brace. The specific indication for the 3-valve orthosis seems, therefore, to be scolioses in which there is a predominance of rotation at the apex of the curve. The Boston brace has its main indication in cases where rotation is considerably close to or at the ends of the curve.
Rev Chir Orthop Reparatrice Appar Mot 1988
PMID:[Treatment of lumbar and dorso-lumbar scoliosis using the Boston orthosis and the 3-valve orthosis. Comparative study of the results in the frontal and horizontal planes]. 307 Jun 53


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