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

We present a case of intramedullary spinal gangliocytoma in a 7-year-old girl who presented with scoliosis and progressive weakness of both legs. The tumour involved the whole spinal cord and medulla oblongata and was composed of inner cystic and outer solid components. On MRI, the solid portion of the lesion showed strong enhancement at the thoracolumbar level and mild enhancement at the cervical and medullary levels. Histological examination of the surgical specimen showed neoplastic ganglion cells arranged irregularly in benign normocellular glial background, which made a diagnosis of gangliocytoma.
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PMID:Gangliocytoma of the spinal cord: a case report. 1137 31

We report the case of a 39-year-old woman with adolescent idiopathic scoliosis presenting with myelopathy secondary to a spinal epidural hemangioma. MRI showed an epidural soft tissue mass within the spinal canal between T5 and T9 with severe spinal cord compression. Symptoms had a temporal relationship to her pregnancy. Surgical removal of the epidural hemangioma rapidly relieved her symptoms and neurologic deficits. Follow-up examination 2 years later demonstrated normal motor and sensory function, without any neurologic sequelae or progression of deformity.
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PMID:Spinal epidural hemangioma related to pregnancy. 1140 22

Spinal congenital dermal sinus is a rare entity, which supposedly results from the failure of neuroectoderm to separate from the cutaneous ectoderm during the process of neurulation. The present study was undertaken to know the clinical profile of these patients, to study associated anomalies and to assess the results of surgical intervention. We had 23 patients with male : female ratio of 9:16. Only 2 patients were below 2 years of age and most cases (16) were between 2-16 years (mean age =10.2 years). Lumbar region (17 cases) was most frequently involved, followed by lumbosacral and thoracic region in 3 patients each. Only three patients were asymptomatic at the time of presentation. Most of the cases presented with evidence of neural compression or tethered cord syndrome. Only one case presented with spinal abscess. The motor, sensory and autonomic deficits were seen in 20, 11 and 12 patients respectively. Scoliosis and CTEV (congenital talipus equino varus) were the common associated anomalies. MRI revealed associated dysraphic state of spinal cord in 21(>90%) cases. All patients underwent surgical exploration and repair of dysraphic state and excision of the sinus. None of the asymptomatic patients deteriorated. Overall 8 patients improved, 14 got their neurological status stabilized, including 3 asymptomatic cases. Only one patient deteriorated. Postoperative wound infection was seen in 2 cases. As age advances, the chance of developing neurological deficit increases. Associated dysraphic state should be looked for and treated simultaneously, using microsurgical technique, whenever possible. It is better to treat all these cases with aggressive surgical intervention before the neurological deficits appear.
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PMID:Spinal congenital dermal sinus: an experience of 23 cases over 7 years. 1159 40

The field of orthotics has gained scientific attention over the last few years. Its objective is to correct, adjust, or modify the operation of human limbs, joints, or muscles. Thoracolumbosacral orthosis (TLSO) braces are used by scoliosis and postoperative patients who need back correction and/or support. The anatomic dimensions for TLSO braces have been acquired mainly by casting the patient. Casting is a time-proven method for obtaining surface geometry, but it can be inconvenient in certain situations. For example, casting might not be suitable for postoperative and trauma patients owing to the risk of further injury. Such prohibitive cases can still be handled safely by X-ray CT or MR scanning. This article presents an alternative method for data acquisition of TLSO patients' anatomic dimensions using CT/MRI. The experimental results show the method to be statistically accurate, efficient, and feasible compared with the conventional casting method.
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PMID:Design of thoracolumbosacral orthosis (TLSO) braces using CT/MR. 1171 12

MRI is increasingly being used for etiologic examination of scoliosis and for intervertebral disc disorder analysis, but until now has not been applied to geometric modeling. The aim of this study was to develop a new geometric model of intervertebral discs using MRI and to quantify the migration of the nucleus zone within scoliotic intervertebral discs. Fourteen lumbar scoliotic children (Cobb angles 22 +/- 7 degrees ) were examined using MRI. The protocol consisted of sagittal and coronal plane acquisitions of the entire spine. An image processing software allowed the outline detection of the nucleus zone (intervertebral high intensity portion). The vertebral bodies were also reconstructed. Using a pre-post processor, the nucleus zone migration and a wedging angle were quantified. Statistical tests showed the repeatability of the method (p > 0.4). Nucleus zone migration was correlated to the wedging angle (r(2) = 0.488, p < 0.0001) in the coronal plane. Our results were in agreement with the literature: when two vertebrae move deforming the disc, the nucleus moves into the convexity of the curvature. But should we talk about the nucleus? Despite image processing software allowing the highlighting of image features (automatic color lookup tables applied to grayscale images using pixel intensity measurements), it is impossible to differentiate the nucleus from the annulus on T2 weighting images of adolescent spine. This new geometric model of the intervertebral disc, used for the quantification of the nucleus zone migration, should be of interest for further investigation of stiffness parameters of spine.
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PMID:Intervertebral disc modeling using a MRI method: migration of the nucleus zone within scoliotic intervertebral discs. 1175 36

Pelizaeus Merzbacher disease (PMD) is an X-linked recessive disorder of the central nervous system myelination caused by mutations involving the proteolipid protein gene (PLP). Early nystagmus and developmental delay, progressive pyramidal, cerebellar and dystonic signs as well as white matter changes in brain MRI are typical for PMD. The PLP gene can be affected by two major types of mutations. A duplication of the whole PLP gene is the most common mutation and results usually in the milder classical phenotype, whereas point mutations in PLP gene often result in the rarer and more severe connatal form of PMD. The PLP protein is a higly conserved across species and is identical in human, mouse and rat. We describe a 13-year-old Czech boy with an early and severe developmental delay. His maternal uncle died at the age of one year and was also early and severely psychomotoricly retarded. The patient was the first child of healthy unrelated parents born after an uneventful pregnancy and delivery in 1988. Hyperbilirubinemia and bronchopneumonia and early stridor complicated his neonatal period. Diffuse hypotonia, nystagmus, psychomotor retardation, visual and hearing impairment have been observed in the patient since the age of 6 weeks. White matter abnormalities, cortical and periventricular atrophy were detected by MRI at the age of 6 and 11 years, respectively. Despite these signs and results an accurate clinical diagnosis was unclear until the age of 11 years. Last neurological examination in 1999 showed no nystagmus anymore, but extremely dystrophic limbs, truncal deformation, due to severe scoliosis, tetraplegia with hyperreflexia in C5C7 and areflexia L2S2 and positive pyramidal signs. The boy had no visual or speech contact. DNA tests followed the clinical suspicion for PMD. At first, duplication of PLP gene was excluded by quantitative comparative PCR. Direct sequencing of PLP gene detected a novel mutation in exon 6, a missense mutation 725C-->A (Ala242Glu) in the patient and in his mother and later also in his maternal grandmother. The same codon, but to valine (Ala242Val) is mutated in jimpy(msd) mouse, which is the frequently used animal model for PMD. Prenatal diagnosis for the next pregnancy has been offered to the family. The patient died recently at the age of 13 years due to respiratory failure. Our results support the data on the importance of this conserved amino acid alanine at codon 242.
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PMID:A severe connatal form of Pelizaeus Merzbacher disease in a Czech boy caused by a novel mutation (725C>A, Ala242Glu) at the 'jimpy(msd) codon' in the PLP gene. 1178 21

Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what has already been reported in literature, we consider that scoliosis associated with disc herniation in young patients is most likely to be only an anthalgic position, not indicative of further structural changes.
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PMID:Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report. 1206 64

Patients with "idiopathic-like" spinal deformities associated with syringomyelia were retrospectively reviewed. Ten patients had surgical stabilization of their curvatures with at least a 2-year follow-up, and an additional five patients were evaluated for deformity pattern with <2 years of follow-up. Paralytic curve patterns, scoliosis associated with spina bifida, congenital scoliosis, or other associated syndromes were discarded. All 10 patients with surgery who were followed for an average of 46 months lost 10 degrees correction above, through, or below the instrumented segments. A total of 50% lost correction through the instrumented segments. Anterior fusion stabilized the instrumented portion of the spine better than posterior instrumentation alone. Eighty percent of the 15 patients had thoracic kyphosis >40 degrees. Only one patient was lordoscoliotic. Syringomyelia deformities tend to be kyphoscoliotic in 80% of cases and behave more like paralytic curvatures postoperatively. MRI is recommended for apparent idiopathic scoliotic curvatures that are kyphoscoliotic and not lordoscoliotic.
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PMID:Outcomes in surgical treatment of "idiopathic-like" scoliosis associated with syringomyelia. 1217 46

In a 15-year-old girl with pain in the right lower abdomen and a 9-year-old boy with pain in the left thigh, an elevated sedimentation rate and C-reactive protein were reason to suspect osteomyelitis. Although no abnormalities could be seen on X-rays, skeletal scintigraphy revealed pathology in Liv-v and the sacroiliac joint, respectively. In the girl, Staphylococcus aureus was cultivated from material obtained by puncture and biopsy. After treatment with antibiotics, rest and gradual mobilisation, the girl retained a scoliosis; the boy was cured without residual complaints or abnormalities. Osteomyelitis of the spine and sacroiliac joint are rare disorders in children. The subtle and non-specific symptoms sometimes make the diagnosis difficult. Conventional X-ray is the primary radiological investigation. Bone scintigraphy (99mTc-oxidronate) is useful in the initial evaluation of children with suspected osteomyelitis. It is sensitive, relatively inexpensive, often does not require sedation and can detect multiple foci of disease. MRI is also highly sensitive and more specific than bone scintigraphy, but it cannot be used as a screening technique when the site of pathology is unclear. MRI is useful when the bone scintigram is inconclusive and in complicated cases for better anatomic details.
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PMID:[Osteomyelitis in children: sometimes hard to recognize]. 1221 3

Scoliosis is frequent, especially during the peripubertal period, which corresponds to the period of greatest activity. About 75% of scoliosis are idiopathic, while the remaining 25% can be divided into neuromuscular, congenital and miscellaneous etiologies. When it is associated with pain, a comprehensive work up should be undertaken to identify the underlying etiology of the scoliosis. Idiopathic scoliosis is typically evaluated using standard radiographs. The number of follow-up radiographs and radiation exposure must be maintained to a minimum. Radiation safety guidelines and protocols must be implemented. Large cassettes can be replaced by digital acquisitions using units with reconstruction software. The technique of evaluation of these scoliosis series radiographs as well as their results will be reviewed. Recent data regarding the evaluation of spinal and pelvic balance parameters in the standing position will be introduced. Atypical idiopathic and other scoliosis require additional evaluation. Computed tomography, with 2D and 3D reformations, is ideal for evaluation of bony anomalies. MRI is ideal for evaluation of the spinal canal and cord, from the skull base down to the sacrum, for all patients with surgical scoliosis or patients with neurological symptoms. The increased availability of MR imaging has resulted in an increased number of so-called idiopathic asymptomatic scoliosis where an underlying anomaly can be identified.
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PMID:[Imaging of chilhood and adolescent scoliosis]. 1222 71


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