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

One hundred patients with severe cerebral palsy (total body involvement) and dislocated hips were examined to determine their level of pain, sitting ability, pelvic obliquity, scoliosis, nursing care difficulties and complications of decubitus ulcers and fractures. 50 of the patients had undergone surgical procedures to treat the hip; 50 had received no treatment. No significant differences were found in the frequency of pain or other complications between the two groups. Nursing care difficulties and the ability to sit did not depend on the status of the hip. Pelvic obliquity and scoliosis were related to the severity of neurological damage rather than to hip stability. These findings suggest that surgical treatment of already dislocated hips of patients with severe cerebral palsy is not helpful.
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PMID:Treated and untreated unstable hips in severe cerebral palsy. 210 51

Hip conditions in 49 patients affected with spinal muscular atrophy were studied: 35 of these were affected with the intermediate form of the disease (patients were able to sit but not walk), and 14 with the mild form (patients were able to walk). The Perkins method was used to measure the migration percentage of the femoral head. Thirty-one percent of the patients affected by the intermediate form of the disease had normal hips, 38% had unilateral or bilateral subluxation, 11% had hip dislocation. In the mild form of the disease, 50% of the patients had normal hips, 28% had unilateral or bilateral subluxation, and 22% had a hip dislocation. In the intermediate form of the disease there was a linear correlation between migration percentage and age, and between migration percentage and scoliosis. In the patients affected with the mild form of the disease who were able to walk, and in the patients affected with the intermediate form and fitted with orthoses who were able to stand, or to walk, there was no hip dislocation. Hence, walking with or without orthoses seems to be an important factor in preventing hip dislocation.
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PMID:Hip dislocation in spinal muscular atrophy. 227 22

Seven children with spinal muscular atrophy aged between 20 months and four years, none of whom had ever walked, were fitted with knee-ankle-foot orthoses. All the children could sit unsupported and therefore were at point 9 on the Vignos functional scale. Two children achieved autonomous walking, three assisted walking and the remaining two could stand without aid. During the follow-up period there was no progression of weakness and neither scoliosis nor contractures developed.
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PMID:Promotion of ambulation of patients with spinal muscular atrophy by early fitting of knee-ankle-foot orthoses. 358 92

Nine boys with Duchenne muscular dystrophy, chairbound but without scoliosis, were fitted with a recently developed brace of metal and moulded medium-density polyethylene, the modified Calot brace. Each was also fitted with a wrap-around, moulded leather jacket. Each brace held the relaxed lumbar spine in an angle of lordosis similar to that achieved by a brief active effort to sit erect without a brace. Over-all, they proved equally acceptable to patients and carers. The modified Calot brace caused substantially less restriction of pulmonary function and so may be preferable to the moulded leather jacket.
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PMID:A new spinal brace for use in Duchenne muscular dystrophy. 651 63

Seventy-three involved cerebral palsied patients were reinvestigated 10 or more years after hip and/or knee surgery. The average age was 6.3 years at operation and 18.1 years at retest. The results were evaluated as to motor progress and hip position. While preoperatively none of the patients was independently ambulatory, this was true in 18 cases after surgery. Usually free gait however was insecure (household walking). All patients that had been unable to sit independently before surgery remained strictly wheelchair bound. The results of hip realignment differed according to degree of handicap: In 51 patients with preoperative motor age of 8 months or more 43 hip deformities had been present, that could be improved in 29 items and remained unimproved 14 times, while five new deformities developed. This meant 19 deformed hips in this group of patients. In 22 patients, whose motor age at surgery had been below 8 months, improvement of 30 deformed hips had been possible 25 times, but there were 13 newly developed changes and 5 unimproved, so that 18 hips still were found deformed. There was a marked tendency for a-symmetry after surgery: while the relation of unilateral to bilateral deformities was 21:26 before operation, this changed to 27:5 postoperatively. 15 patients developed scoliosis of more than 25 degree, 11 of them in the group with major handicap (n = 22). Our study stresses the ill prognosis of surgery in mostly handicapped cerebral palsied children.
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PMID:Late results of hip and knee surgery in severely handicapped cerebral palsy patients. 715 92

Special seating enables children with even the most severe forms of cerebral palsy to sit comfortably. A straight spine and mobile hips are desirable. Prevention of hip dislocation by operation, or release of a hip extension contracture, is required for 40% of the younger children. Surgical correction of scoliosis is required for 20% of the older ones. Seating problems may be classified by (a) ability--hands free, hand dependent or propped--(b) the pattern of deformity--symmetrically slouched or windswept--and (c) severity of deformity--none, amenable to surgery, or beyond surgery. Each of these categories requires a different therapeutic approach.
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PMID:Seating for children with cerebral palsy. 733 7

A 21 year old Japanese male of normal intelligence with severe athetosis, scoliosis with pelvic obliquity, and a positive Galant's reflex was seen with complaint of difficulty in maintaining a sitting posture. After release of the soft tissues around the hip and axilla, followed by physiotherapy, he underwent ipsilateral transfer of the tensor fasciae latae to the rib cage. Six years after the final operation there has been remarkable improvement of his scoliosis and pelvic obliquity but also diminution of Galant's reflex. In addition his daily activities have been improved by the muscle transferred. He can sit for more than one hour.
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PMID:A case of severe scoliosis associated with cerebral palsy showing remarkable improvement following soft tissue release around the hip and axilla and transfer of m. tensor fasciae latae to the ribs. 742 80

Patients with both severe mental retardation and severe physical disability, so-called "jushouji", often have scoliosis as one of the complications. The correlation between radiological findings of paraspinal muscles and progression of scoliosis was investigated by computed tomography (CT) in 15 patients. We took the CT of paraspinal muscles at the apical vertebral level in each patient, and measured the size of cross-sectional area and the CT value of paraspinal muscles of the both concave and convex side. There was no significant difference of the size of cross-sectional area of the muscles between the convex and concave side. The average CT value of the muscles was normal on the convex side, but abnormally lower on the concave side. Scattered low density areas were recognized in the fascicles of both sides like moth eaten appearance, which was speculated as fatty tissue. The CT value of remaining muscles was within normal range. The CT value on the concave side became lower as the degree of scoliosis progressed. The group who could not keep sitting position independently showed lower CT value on the concave side and had more severe scoliotic curves than the group who could sit independently or with slight support. From the above results, it may be concluded that the paraspinal muscles of the concave side become secondarily atrophic due to disuse, and may not be responsible for the progression of the scoliosis.
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PMID:[Scoliosis in the patients with both severe mental retardation and severe physical disability--computed tomography of paraspinal muscles]. 778 Dec 28

Thirty-one patients with cerebral palsy and neuromuscular scoliosis underwent instrumentation with a unit rod fixed with sublaminar wires and posterior spine fusion. The mean curve measured 79 degrees preoperatively, 19 degrees immediately postoperatively, and 18 degrees at final follow-up of 2.8 years, excluding two patients who died and four who were lost to follow-up after < 12 months. The preoperative pelvic obliquity was 25 degrees, which was initially corrected to 3 degrees and remained unchanged at 4 degrees at final follow-up. Twenty-four patients underwent a one-stage posterior fusion, and seven patients underwent both anterior and posterior fusions. Complications included one acute deep-wound infection and one late deep-wound infection seeded from the urinary tract. No pseud-arthroses or hardware failures have occurred to date. Seven children with open triadiate cartilages had a posterior spinal fusion only and were followed up to skeletal maturity with a 3 degrees loss of correction of the scoliosis and a 0 degree loss of correction of pelvic obliquity. Questionnaires filled out by primary caretakers demonstrated that the objective of improving the child's ability to sit more comfortably was accomplished for the majority (65%) of patients. Spinal fusion was recommended for other children by 86% of interviewed caretakers.
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PMID:Surgical correction of spinal deformity using a unit rod in children with cerebral palsy. 890 44

The therapy of neuromuscular scolioses has to be tailored to the needs to the individual patient; there are no universally valid schemes of treatment. Detailed knowledge of neuromuscular diseases and their course is essential. For this reason, an interdisciplinary team is desirable; only in this way can all medical and surgical aspects of the underlying disease--which interfere with the therapy of the scoliosis--be treated successfully. The continual improvement in medical treatment of neuromuscular disease in recent decades has led to a significant increase in life expectancy. In addition, the severe consequences of failure to treat spinal deformities have become clear. Neglect or inadequate treatment of neuromuscular scolioses can have dramatic consequences, including inability to sit and serious impairment of cardiorespiratory status. The goal of treatment is therefore to prevent the spinal deformities leading to a dangerous worsening of respiratory status. Moreover, the therapy should improve function, which in most cases means restoring a stable sitting position. From the mechanical viewpoint this means restoration of spinal balance with a vertical spinal axis at right angles to a horizontal pelvis.
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PMID:[Neuromuscular scoliosis. Follow-up of treatment and therapeutic principles]. 1092 32


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