Biomedical subjects

H Saraste

Publications and source records attributed to H Saraste.

29 records · Page 2Linked to original sources

PubMed1986

Spondylolysis and pregnancy--a risk analysis.

A possible interference of various musculo-skeletal anomalies with pregnancy is often discussed by obstetricians. Pregnancy as a risk factor for progression of spondylolisthesis, olisthesis as a risk factor for pregnancy complications, and pregnancy in women with spondylolysis as the cause of increased low-back symptoms, are questions hitherto not analysed. In the present study, a comparison between men, non-pregnant women, and women who had been pregnant, was made with respect to the degree of spondylolisthesis and its subsequent progression over an observation period of at least 20 years. Occurrence and intensity of low-back symptoms, and functional impairment due to low-back symptoms (such as change of work, sick-leave, sick-pension, limitation in non-occupational activities, and treatment) during this long observation time were also analysed. The mean values for the group of women who had been pregnant did not differ from those of the other groups as regards any of these variables. On the basis of these results, it is concluded that pregnancy does not constitute a risk for progression of spondylolisthesis, or for increased low-back symptoms in a woman with spondylolysis. Nor is spondylolysis, with or without olisthesis, a risk factor for pregnancy complications.

Back Pain↗

PubMed1986

The effect of a device for transverse traction on vertebral rotation in surgery for scoliosis as studied by X-ray stereophotogrammetry.

The effect of a device for transverse traction (DTT) on vertebral rotation in surgery for scoliosis has been analysed with an X ray stereophotogrammetric method in 17 patients. Six of them underwent conventional Harrington rod instrumentation and eleven patients received additional treatment with the DTT. The DTT exerted a positive effect on vertical rotation at the apex, and derotation average 10 degrees as compared with 5 degrees in the group in whom the device was not used.

Adolescent↗

PubMed1985

Radiographic measurement of the lumbar spine. A clinical and experimental study in man.

The accuracy of radiographic measurements of lumbosacral lordosis, vertebral size, spondylolisthesis, and disc height were studied. Errors caused by lateral tilt or longitudinal axis rotation of the lumbosacral spine were assessed in an experimental study on 12 cadavers. In a series of 170 normal individuals, the distribution of radiographic variables describing lumbosacral lordosis, size of vertebrae, and disc height was investigated. The interobserver measurement variation was studied with respect to all measured variables. The differences between radiographs of 125 spondylolytic patients in the recumbent and standing positions were analyzed with respect to vertebral slipping and lumbosacral lordosis. There were only minor projectional and interobserver measurement errors in the variables describing vertebral size and lumbosacral lordosis, which make these variables suitable for radiographic assessment at repeated examination. The absolute measurements of disc height were too inaccurate to be used as a basis for conclusions. A semiquantitative approach is more reliable, and can be recommended for the comparison of radiographic assessments of disc height. In adults, the radiographic evaluation of vertebral slipping and lumbosacral lordosis is equally reliable in the recumbent and standing positions.

Adult↗

PubMed1985

The etiology of spondylolysis. A retrospective radiographic study.

One hundred and thirty-five patients with lysis in the fifth (lowest) lumbar vertebra and 24 patients with L4 lysis were compared retrospectively with respect to radiographic variables and the occurrence of trauma before symptom onset. Hypoplasia occurred only in the L5 lysis group, whereas trauma as a symptom-precipitating factor was frequent in the L4 group. These observations suggest the possibility of different etiologies: trauma may contribute to lysis in a normal L4 vertebra, and inherited hypoplasia of the lumbosacral junction may lead to L5 lysis.

Adolescent↗

PubMed1984

Relationship between radiological and clinical variables in spondylolysis.

A clinical and radiological follow-up investigation with at least 20 years observation time was made of 255 persons with lumbar spondylolysis with or without spondylolisthesis. The main purposes were to study the relationship between clinical and radiological features and to look for radiological and other variables of prognostic value. There was a clear positive correlation of symptoms and functional impairment during the observation period to disc degeneration and vertebral slipping at follow-up, as well as to a decrease in lumbar index at the time of diagnosis. Individual factors and radiological signs at the time of diagnosis were shown to have prognostic value for the course of the disease. The risk factors for severe symptoms and need for treatment were more than 10 mm of vertebral slipping, low lumbar index, increased lumbar lordosis, lysis in the fourth lumbar vertebra and early onset of symptoms.

Adult↗

PubMed1984

Radiographic assessment of anatomic deviations in lumbar spondylolysis.

A series of 202 patients (133 men, 69 women) with spondylolysis were examined with respect to radiographic variables describing lumbosacral lordosis, size of lumbar vertebrae, transverse processes and disc height. An age-standardized and sex-stratified comparison was made with a control group of 170 subjects (68 men, and 102 women) without lumbar spine disorders. The difference in lumbosacral lordosis between the spondylolysis and control groups was considered to be secondary to olisthesis, and to lack an etiologic role for the genesis of lysis. The lengths of the transverse processes and their distances to the crista iliaca posterior demonstrated no differences between the groups and therefore did not seem relevant to the context of the pathogenesis of spondylolysis. The fifth lumbar vertebra in the spondylolytic patients was more wedged and less wide than in the controls. The question of the primary or secondary nature of this change has not yet been clearly elucidated, and should be given further attention. The spondylolytic patients demonstrated a decrease in the height of the L5-S1 disc much earlier than the controls, and the degree of narrowing of the disc space was much more marked.

Adult↗

PubMed1984

Prognostic radiographic aspects of spondylolisthesis.

A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

Adolescent↗

PubMedDate not supplied

Ambulation in patients with myelomeningocele: a 12-year follow-up.

Factors determining change in ambulatory status were studied over a 12-year observation time in 60 ambulating patients with myelomeningocele. There were 26 female and 34 male subjects with a median age of 22 years (range, 12-54). We used the method of Lindseth to define the neurologic level of the lesion and classified walking ability according to the criteria of Hoffer. The prevalence of spasticity and spine and lower-limb deformities was assessed. Orthopedic and neurosurgical interventions and other medical events were registered, as well as occurrence of pressure sores, musculoskeletal pain, and use of orthoses. There were 19 patients with downward transitions in ambulatory level during the follow-up time. Factors explaining deterioration in these 19 patients included deterioration of the neurologic level of lesion, spasticity, knee and hip flexion contractures, low-back pain, lack of motivation, as well as those of major medical events like stroke, recurrent septicemia, lower limb edema, and invasive surgical interventions.

Adolescent↗

PubMedDate not supplied

Boston brace in the treatment of idiopathic scoliosis.

In a retrospective follow-up study of 64 patients with adolescent idiopathic scoliosis, the initial correction of Boston brace with straight lumbar profile strongly predicted good treatment results at follow-up (mean, 4.8 years). If the initial correction was > 50%, the curve was permanently reduced with an average of 7.2 degrees. The average initial correction was 62%. This initial brace effect was preserved in another comparable group of 60 patients treated with a Boston brace with 15 degrees lumbar lordosis. It is concluded that the Boston brace is effective in the conservative treatment of idiopathic scoliosis, and the corrective ability seemingly does not deteriorate with a change in the brace design from 0 to 15 degrees lordosis.

Adolescent↗

PubMedDate not supplied

Brace treatment in neuromuscular spine deformity.

We reviewed 90 consecutive patients with various neuromuscular diseases and a progressive spine deformity treated with a prefabricated Boston-type underarm corrective brace. Of these, 38 patients had spastic tetraplegia; seven, syndrome-related muscular hypertonia; 24, muscular hypotonia; and 21, myelomeningocele. The mean age at the treatment start was 9.2 years (range, 1.4-17.7 years). Twenty-four were ambulating and 66 wheelchair-bound. Hypotonia was the dominant type of muscle involvement in 49, spasticity in 28, and athetosis in 13 patients. The mean pretreatment Cobb angle was 47 degrees, with a range from 23 to 95 degrees. The mean brace-induced Cobb-angle correction was 60%, thus well comparable to that in idiopathic scoliosis. However, this did not predict favorable treatment results. At the follow-up, on average 3.1 years (range, 1-5.5 years) after weaning from the brace, the brace treatment was successful in 23 patients. Successful was defined as <10 degrees curve progression during the observation time and a good brace compliance. Forty-one patients discontinued the brace treatment, and 19 progressed despite adequate brace wear. Five patients are still in treatment, and two have died. Successful treatment was seen in ambulating patients with muscle hypotonia and short thoracolumbar/lumbar curves measuring <40 degrees as well as in nonambulating patients with spastic short lumbar curves. These types of neuromuscular scoliosis may be the only ones to respond to brace treatment. In other cases, the brace treatment cannot be expected to have a lasting corrective effect although it can be used as sitting support.

Adolescent↗

PubMedDate not supplied

Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis.

A clinical and radiological follow-up study with at least 20 years of observation was made of 255 spondylolysis and spondylolisthesis patients for examination of the clinical course and its possible correlation to radiographic findings. The progression of slipping was small and not correlated to age at diagnosis and initial degree of spondylolisthesis. Disc height reduction at the spondylolytic level occurred at an earlier age and was more severe than in a normal control group. Symptoms were correlated to radiographic pathology. Risk factors for low-back symptoms were greater than 25% slipping, low lumbar index in L5 spondylolysis, spondylolysis at the L4 level, and early disc degeneration.

Adolescent↗