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Biomedical subjects

E Ascani

Publications and source records attributed to E Ascani.

11 recordsLinked to original sources
PubMed1998

Surgical treatment of scoliosis associated with myelomeningocele.

Twenty-nine patients (mean age 12 years) with severe thoracolumbar and lumbar scoliosis due to myelomeningocele were treated by spinal fusion (7 by posterior arthrodesis with instrumentation, 3 by anterior arthrodesis with instrumentation, 19 by combined anterior and posterior fusion with instrumentation). Fusion was extended to the sacrum in 15 patients. Mean period of follow-up was 6.2 years. The average Cobb angle changes were as follows: thoracic and thoracolumbar curves preoperatively 86 degrees to 45 degrees at follow-up (the final average curve correction was 47%); lumbar curves preoperatively 97 degrees to 48 degrees at follow-up (the final average curve correction was 50%). Average pelvis obliquity changed from 26 degrees to 13 degrees at follow-up with an average correction of 49%. The combined anterior and posterior instrumentation and fusion gave the best correction of deformity (the final average thoracic and thoracolumbar curve correction was 55%; the final average lumbar curve correction was 61%). Independent of the method of stabilization, post-operative wound infection was a serious problem (24%). The combined fusion-instrumentation method reduced the rate of pseudoarthrosis to 14%.

Child↗
PubMed1994

[Static-dynamic computerized tomography in the diagnosis of traumatic lesions of alar ligaments. Preliminary results].

The patients affected with cervical injuries often complain of cervical pain, headache and dizziness even when no bone fractures are detected. Such patients are likely to have a post-traumatic injury of the cervical ligaments. Twenty-five symptomatic patients (19 women and 6 men) were examined with upper spine CT and functional CT scans (right and left rotation) to detect ligament injuries and hypermotility of the craniocervical junction, both related to traumatic events. Eleven patients showed no alterations, while unilateral densitometric alterations of the alar ligaments were observed in 14 cases and thought to be related to trauma. On axial CT scans, the normal alar ligaments were identified as paramedian, quadrangular soft-tissue structures at the apex of the dens epistrophei and right above it. In 14 patients with alar ligament injuries, CT showed incomplete ligament interruption and thinning in 12 cases and its total absence on all images in 2 cases. The laterodental space in the affected side was hypodense due to fat tissue replacement. Of 14 patients with alar ligament injuries, only 14 patients with alar ligament injuries, only 4 exhibited rotatory hypermotility at C0-C1 and C1-C2. The low frequency of rotatory hypermotility is probably due to the high rate of incomplete alar ligament injuries as well as to cervical muscle stiffness, which is marked in some subjects. In conclusion, static and functional CT of the upper spine is not only useful to predict trauma outcome, but also allows the detection of the alar ligaments, of their morphodensitometric changes and of the segmental instability of the craniocervical junction.

Adolescent↗
PubMed1988

Anatomy of the lumbar spine in achondroplasia.

The authors analyze the achondroplastic lumbar spine in the pre-puberal and post-puberal periods until adulthood by means of standard X-rays, CT scan, MRI, and myelography. The small spinal canal in achondroplasts must be considered the result of developmental and congenital conditions. Orthopaedic and surgical possibilities are reviewed with the goal of reducing to a minimum the developmental factors.

Achondroplasia↗
PubMed1986

Natural history of untreated idiopathic scoliosis after skeletal maturity.

A total of 187 random cases of untreated idiopathic scoliosis, seen from a minimum of 15 to a maximum of 47 years after the end of growth, were reviewed. All curves increased after skeletal maturity (average progression: 0.4 degrees per year). Thoracic curves tend to progress more than lumbar, lumbar more than thoracolumbar, and thoracolumbar more than double major curves. Pain was present in 114 cases (61%) and appeared more frequently in women, after pregnancies, and with fatigue. Cardiopulmonary symptoms were present in 42 patients (22%), especially those with thoracic and thoracolumbar curves greater than 40 degrees. Psychologic disturbances were found in 35 cases (19%), mostly female patients with thoracic curves greater than 40 degrees. The cosmetic appearance of these patients at long-term follow-up was better compared with that at the end of growth, even though the curves progressed. Patients with decompensation of the trunk at the end of growth seemed to improve with time. In an unselected group of patients with severe curves a mortality rate of 17% was found, twice as much as in the Italian general population.

Adolescent↗
PubMed1977

The incidence and early detection of spinal deformities. A study based on the screening of 16,104 schoolchildren.

Screening for spinal curvature (scoliosis and kyphosis) was carried out on children aged six to fourteen at schools in the Lazio region from 1972 to 1976 and this revealed a significant incidence of deformities. Out of 16,104 children examined, 1,163 (7.2 per cent) were affected by scoliotic or kyphotic curves. Of these, 56.5 per cent were scoliotic and 43.4 per cent were kyphotic. The female/male ratio in cases requiring orthopaedic or surgical treatment was 3.7:1. Of the total number of cases examined (16,104) the percentage of slight deformities requiring only physiotherapy or exercise treatment was 6.3 per cent (1,016 cases). 0.85 per cent (137 cases) required conservative orthopaedic treatment (plaster and corset), while 0.06 per cent (ten cases) required operation. This investigation is the first step towards the early diagnosis and treatment of vertebral deformities in Italy.

Adolescent↗
PubMed1975

Spondylolysis and spondylolysthesis.

On the basis of our own experience and the most up-to-date reports, we present some of the most controversial features of spondylolysis and spondylolisthesis. In particular, the importance of stress in the etiology of the lysis has been revealed by research carried out on athletes practicing strenuous sports. It has also been shown how the slipping of the olisthesic vertebra does not necessarily cease around the age of 20, but may continue, under certain conditions, even in the young adult. Finally, advice on treatment is given in relation to the various surgical techniques, emphasizing the importance of the reduction of slipping, and giving directions on the use of this technique, and its limitations.

Adolescent↗
PubMedDate not supplied

Juvenile kyphosis: an ultrastructural study.

Biopsy specimens of the spine, including intervertebral disc, vertebral plate, growth plate, and part of the vertebral body, were obtained from seven patients with juvenile kyphosis treated by anterior spinal arthrodesis. Histological and histochemical studies showed abnormal loose-appearing cartilage in both the vertebral plate and the growth plate. Both plates were missing in some vertebrae. Ultrastructurally the abnormal cartilage had a matrix rich in proteoglycans and very thin collagen fibrils. The mineralization and ossification of the vertebral plates were irregular. Vertebral bone growth was stunted under the areas of abnormal growth plates.

Adolescent↗