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Biomedical subjects

M Poussa

Publications and source records attributed to M Poussa.

At least 19 recordsLinked to original sources
PubMed1992

Spinal mobility and posture in 8- to 16-year-old children.

Spinal mobility and posture were measured in 294 8-16-year-old boys and girls, divided into five age groups. The upper thoracic sagittal alignment was more vertical among girls, but the postural curves showed no significant age-related differences for either sex. Among both boys and girls thoracic extension, lateral flexion, and rotation decreased significantly between the ages of 12 and 13, but with the exception of extension they returned to the previous level by age 16. Girls were significantly different from boys at 13 years of age. In the thoracic spine, girls had less kyphosis, and were stiffer in forward and lateral flexion, with more rotation to the right than to the left. In the lumbar spine, lateral flexion increased after the age of 10 in both sexes. Between the ages of 8 and 14 lumbar lateral flexion was significantly greater among girls than among boys, whereas extension and rotation was greater only at the ages of 8 and 10 years. With increasing age, a shift from left to right dominance in lumbar lateral flexion was found in girls only.

Adolescent↗
PubMed1992

Cementless hip arthroplasty in diastrophic dysplasia.

Diastrophic dysplasia results in severe disproportionate growth failure, generalized joint dysplasia, and early osteoarthrosis of the hips. A total hip arthroplasty is often necessary in patients afflicted with diastrophic dysplasia by time they reach early middle age. During 1983-1988, total hip arthroplasties were performed on six women and four men (15 hips) with diastrophic dysplasia at the Orthopaedic Hospital of the Invalid Foundation. The mean age of the patients at the time of operation was 37 years and the mean height was 133 cm. A Lord endoprosthesis was used in nine hips and a Biomet endoprosthesis in six. Cementless fixation was used in all cases. Autogenous bone grafting to the acetabulum was performed in six hips. Simultaneous corrective osteotomy of the proximal femur and transposition of the greater trochanter was performed in three cases. Soft tissue release and tenotomies were performed in 10 hips. The average follow-up period was 5 years. Overall clinical results were good, with marked relief of pain and improvement of hip joint mobility. Aseptic loosening of the acetabular component was noted in two hips. As for complications, two femoral nerve paresis and two perioperative fractures of the proximal femur occurred, which all healed.

Adult↗
PubMed1992

Leg-length inequality and low-back pain after Perthes' disease: a 28-47-year follow-up of 96 patients.

A follow-up of 96 patients with Perthes' disease was made 28-47 years after onset of the disease. We paid special attention to leg-length inequality and its consequences and low-back disability. Leg-length inequality was a common finding, but low-back pain was not a significant problem. Leg-length inequality and lumbar scoliosis correlated poorly with low-back disorders. Degeneration of the lumbar spine was the only factor that correlated well with low-back pain.

Adult↗
PubMed1992

Spinal mobility and posture in adolescent idiopathic scoliosis at three stages of curve magnitude.

Spinal posture and mobility were studied in 71 girls with progressive adolescent idiopathic thoracic scoliosis. Measurements were carried out by inclinometers and a compass in three planes; sagittal, frontal, and horizontal. The patients were divided into three groups according to the curve magnitude. Group 1 had curves smaller than 25 degrees, group 2 had curves between 25 and 35 degrees, and group 3 had curves greater than 35 degrees. The positional inclines of sacrum, upper lumbar and upper thoracic areas became more vertical as the curve size increased resulting in smaller lumbar lordosis and thoracic kyphosis. In the thoracic spine flexion and bending to the right was smaller in group 3 than in the other groups. Rotations in both clockwise and counterclockwise directions decreased as the curve size increased. In the lumbar spine only bending to the left decreased significantly with the curve size increase. All thoracic and lumbar movements except lumbar rotations had a general tendency to stiffening as the curve size increased. Of the mobility measurements thoracic rotation most clearly decreased with increased curves, which together with straightening of the spine can be important features in the pathomechanism of a progressive idiopathic thoracic curve.

Adolescent↗
PubMed1992

Foot deformities in diastrophic dysplasia. An analysis of 102 patients.

The exceptionally high prevalence of diastrophic dysplasia in Finland has enabled us to analyse the foot deformities of 102 patients at their first orthopaedic evaluation and classify 204 feet into five categories. The most common finding (43%) was a foot with tarsal valgus deformity and metatarsus adductus; 37% showed either equinovarus adductus (29%) or equinus (8%) deformities. At the first examination 13% showed metatarsus adductus deformity alone, and 7% were clinically normal. The expression 'club foot', generally used for the foot deformity in diastrophic dysplasia is a misnomer. There is a wide spectrum of deformities, some of them specific for the condition.

Adolescent↗
PubMed1992

Poor prognosis in atypical Perthes' disease. Radiographic analysis of 19 hips after 35 years.

We analyzed clinical and radiographic long-term results in 96 patients (106 hips) with Perthes' disease 35 years after nonoperative treatment. 19 hips in 17 patients had early radiographic signs indicating atypically severe course of the disease and poor prognosis. None of them was radiographically good at skeletal maturity; 2 cases were fair and 17 poor. At the final follow-up 12 hips had radiographic arthrosis.

Child↗
PubMed1991

Intervertebral disc changes in adolescents with isthmic spondylolisthesis.

The lower lumbar discs in adolescent patients with isthmic L5 spondylolisthesis requiring operative treatment were evaluated by means of plain radiography, discography, and magnetic resonance imaging (MRI). There were 14 girls and 13 boys, mean age on admission 14.4 (range, 11-18) years. The mean slip in girls was 45 +/- 23% and in boys 27 +/- 17% (p less than 0.05). Discography was performed in 23 patients (42 discs) and MRI in 16. In 12 patients, both examinations were made. In plain radiographs, normal presacral disc height was seen in 11 patients with mean 14.5% slip, narrowing of the disc height less than 50% in four patients with mean 24% slip, and greater than 50% in 12 patients with mean 52.6% slip. In discograms and MRIs, the presacral disc was pathologic in all patients. Pathologic changes of the fourth lumbar disc were frequent. Concerning disc degeneration, there was poor correlation between findings in plain radiography compared with those seen in MRI or discography. MRI findings correlated with those of discography in most cases. However, MRI was normal in two discs with a pathologic discogram.

Adolescent↗
PubMed1991

Progression of spondylolisthesis in children and adolescents. A long-term follow-up of 272 patients.

The radiologic progression of spondylolisthesis during a long-term follow-up was studied in 272 children and adolescents. There were 134 girls and 138 boys. The mean age at the first visit was 14.3 years (girls, 13.8 years; boys, 14.9 years). The radiologic follow-up time was 14.8 years on average (range, 5-32). The operation was done in 190 patients younger than 20 years of age. Fusion in situ, using a posterior or posterolateral technique, had no statistically significant effect on progression. Surgically treated patients did not differ from conservatively treated patients. Ninety percent of the slip, on average, had already occurred at the first radiologic examination compared with the final amount of slip. More than 10% progression occurred in 62 patients, mainly within the first year postoperatively or after the first examination. Progression of the lumbosacral kyphosis and sinking of the vertebral body was noted in severe slips. Although female gender and dysplasia (spina bifida) at the lumbosacral junction were more frequent in severe slips, they statistically had no value in predicting progression. A wedge form of L5 or sacral rounding also had no prognostic value. These were secondary to the slip and expressed it but did not predict it. The only radiologic variable with predictive value of progression was the percentage amount of the primary slip. In age groups corresponding to the growth spurt in early puberty (girls, 9-12 years; boys, 11-14 years), there was a tendency to progress.

Adolescent↗
PubMed1991

The spine in diastrophic dysplasia.

Diastrophic dysplasia is an autosomal recessive disorder of the skeleton, characterized by disproportionate short stature, generalized joint deformities, club feet, deformed ear pinnae, and, frequently, spinal deformity and cleft palate. Diastrophic dysplasia is more common in Finland than elsewhere. We studied 101 patients with an age range from newborns to 79 years to find out the frequency and type of spinal deformities, the early signs of progressive cases, and to follow the natural history of the disease. In the follow-up study, 17 patients were under 10 years, 21 under 21 years, and 63 over 21 years of age. One-third of the patients had cervical kyphosis; in the most severe case the kyphosis was 180 degrees and led to quadriplegia during anesthesia. In three patients, cervical kyphosis resolved spontaneously before the age of 5 years. The overall frequency of scoliosis was 37%; 49% in women and 22% in men. Only 13 patients had curves greater than 50 degrees; these curves constituted distinct rotation at the apex from the early evolution of the curve. The early signs of severe curves were detectable at the age of 2 to 4 years. Only two patients were operated on because of scoliosis; one with fusion in situ and the other instrumented with the pediatric Cotrel-Dubousset instrumentation. Three patients had a brace, which did not prevent the progression of the curve. Symptoms referring to a narrow spinal canal were registered in four patients, two of which were operated on; a lumbar posterior decompressive procedure was made at adult age.

Adolescent↗
PubMed1991

Intertrochanteric varus osteotomy for Perthes' disease. Radiographic changes after 2-16-year follow-up of 126 hips.

We analyzed various prognostic factors in 112 children operated on for Perthes' disease (Catterall's groups II-IV); special attention was paid to acetabular changes and postoperative containment. The radiographic results of 126 intertrochanteric femoral varus osteotomies were analyzed 2-16 years postoperatively. Catterall's grouping or head-at-risk phenomenon, bicompartmentalization of the acetabulum, and preoperative subluxation of the femoral head did not correlate with the result. The result was worse in cases operated on in the healing phase of the disease and in patients operated on at the age of 9 years or older. The strongest prognostic factor was containment of the femoral head after osteotomy.

Acetabulum↗
PubMed1991

Scoliosis in growing rabbits induced with an extension splint.

An external splint was applied to 49, 6-week-old rabbits to induce lordosis in the thoracolumbar junction. The splint was retained for 8 weeks, and the animals were killed after 6 months. Scoliosis developed in 23 rabbits during the splinting period. The deformity occurred about the thoracolumbar junction, and was more frequent in rabbits whose lordosis was sustained when the splint was removed after 8 weeks. The results support the view that sagittal changes are primarily or secondarily involved in the pathomechanics of scoliosis.

Animals↗
PubMed1991

[Early signs of poor prognosis in Legg-Perthes-Calve disease treated by femoral varus osteotomy].

A total of 126 Perthes diseases (112 patients) were studied. The treatment comprised intertrochanteric femoral varus osteotomy in every patient. In 20 patients (25 hips), the course of the disease was more severe than expected. The early radiological criteria for this severe course were: 1. Lateral calcification extending far laterally towards the greater trochanter, 2. Deformation and widening of the femoral head before the fragmentation phase, 3. The Saturn phenomenon; a sclerotic epiphysis surrounded by a ring of looser bony tissue, 4. Deformation and widening of the femoral neck at the initial phase of the disease, 5. Early wide sclerotic changes in the metaphysis. The overall results were poor. Two hips obtained a fair and 23 poor results. These described radiological changes are readily recognized at early phase of Perthes disease and indicate poor prognosis. In these cases varus osteotomy gave unsatisfactory results which means that other type of treatment in these patients should be considered.

Adolescent↗
PubMed1990

Lumbar isthmic spondylolisthesis in children and adolescents. Radiologic evaluation and results of operative treatment.

A clinical and radiologic follow-up study of a group of 75 children and adolescents, comprised of both boys and girls, who underwent spondylodesis for spondylolisthesis between the years 1979 and 1984 is reported. Sagittal rotation, lumbosacral joint angle, lumbar lordosis, wedging of olisthetic vertebrae, and the rounding of the upper sacrum showed considerable statistical correlation to the amount of slipping and accordingly should be noted when estimating the risk of progression of the spondylolisthesis. When the spondylolisthesis was accompanied by scoliosis, it was noted that seriousness of the former was closely correlated to that of the latter. Most patients profited by the operation, and solid fusion was achieved in almost all cases. The posterolateral spondylolysis performed using graft from the iliac crest, the interbody fusion technique, or their combination turned out to be the most reliable surgical methods. The combined technique was especially required in cases with a high degree of slipping.

Adolescent↗
PubMed1990

Severe spondylolisthesis in children and adolescents. A long-term review of fusion in situ.

From 1948 to 1980, 93 children and adolescents had fusion in situ for severe spondylolisthesis with a slip of 50% or more, at a mean age of 14.8 years. Of these, 52 girls and 35 boys were reviewed after a mean follow-up of 13.8 years. The mean pre-operative slip was 76% and pain frequency correlated with the severity of the lumbosacral kyphosis but not with that of the slip. Posterior fusion was used in 54, posterolateral in 30 and anterior fusion in three patients. There were no major complications but 16 had re-operations for non-union or root symptoms. At follow-up there were three non-unions. After operation, 19 patients had 10% or more progression of the slip, but 10 showed correction by more than 10% as a result of remodelling. The lumbosacral kyphosis had increased by more than 10 degrees in 45%. Postoperative progression of the slip and of lumbosacral kyphosis was significantly more if the posterior element had been removed. At follow-up 77 patients were subjectively improved, four were unchanged, and one was worse. These results did not correlate with either the degree of the slip, or the angle of lumbosacral kyphosis. Fusion in situ is safe and gives good long-term clinical results. Secondary changes are associated with increased lumbosacral kyphosis, so reduction of this should be considered in severe cases.

Adolescent↗
PubMed1990

[Experiences with lateral electric surface stimulation in the treatment of idiopathic scoliosis].

Lateral electrical surface stimulation (LESS) was used for treatment of idiopathic scoliosis in 20 children and adolescents (mean age 10.9 years, mean Cobb angle 26 drs.). Six patients were treated until skeletal maturity showing a mean curve progression of 8 degrees at follow-up. In 14 patients treatment failed due to skin irritation, sleeping disturbances or progression. Five patients had to be operated on. Twenty patients of a control group treated with Boston brace (mean age 11.9 years, mean Cobb angle 34 drs.) showed mean curve improvement of 2 degrees at follow-up. Only one patient of the control group had to be operated on. Brace treatment was superior to stimulation in this small patient group presented.

Adolescent↗