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Biomedical subjects

M Poussa

Publications and source records attributed to M Poussa.

31 records · Page 2Linked to original sources

Spinal mobility in adolescent girls with idiopathic scoliosis and in structurally normal controls.

Spinal mobility and posture were studied in 29 adolescent girls (mean age, 13.9 years) with thoracal idiopathic scoliosis, and in 30 healthy girls (mean age, 14.0 years) of the same age. Measurements of the mobility were conducted by inclinometers and a compass in three planes; sagittal, frontal, and horizontal. The structurally healthy girls were taller and heavier than the scoliotics; the difference was statistically significant for weight (P less than 0.01). The positional inclines of sacrum, upper lumbar and thoracic areas were significantly smaller in the scoliotics, resulting in smaller lumbar lordosis and thoracic kyphosis in them (P less than 0.001). In the thoracic spine, forward flexion was smaller (P less than 0.01), whereas extension (P less than 0.001) and the total sagittal mobility (P less than 0.01) were greater in the scoliotics. In the healthy controls, the thoracic clockwise rotation was significantly (P less than 0.05) larger than the counterclockwise. This side difference had disappeared in the scoliotics, and their total thoracic rotation was indicatively smaller than in the controls. In the lumbar spine, extension was smaller (P less than 0.01) in the scoliotics than in the controls. All spinal mobility measurements noted there was no change of general spinal flexibility in the scoliotics.

Adolescent

Trunk asymmetry and scoliosis, Anthropometric measurements in prepuberal school children.

A total of 1060 children (515 girls, 545 boys) were examined for screening of trunk asymmetry ans scoliosis at an average age of 10.8 years. The physical examination consisted of height, sitting height, total arm length and leg length inequality determinations and moiré topography. Trunk asymmetry was measured by forward bending test and a posteroanterior standing radiograph of the spine was taken of those 188 (17.7%) children who had a trunk hump greater than or equal to 6 mm. Only 20.1% of the children were found to be exactly symmetric in the forward bending test, 47.3% had a right-sided hump and 32.6% had a left-side hump. Humps of 6 mm or more were significantly (p = 0.03) more prevalent among girls (21.7%) than boys (16.3%). Moré fringe asymmetry was provided to be common: only 9% of the material was totally symmetric, two thirds has asymmetry of less than or equal to 1 fringe, 26.6% has asymmetry greater than 1 and less than or equal or 2 and 5.4% greater than 2. The prevalence of scoliosis (trunk hump greater than or equal to 6 mm and Cobb angle less than or equal to 10 degree) was 4.1%. The majority (72.1%) of the curves were left convex.

Anthropometry

Spinal mobility and posture and their correlations with growth velocity in structurally normal boys and girls aged 13 to 14.

Spinal mobility and posture were measured and their correlations with growth velocity were calculated in 30 boys and 30 girls aged 13 to 14. The spinal measurements were carried out by noninvasive goniometric methods. In the thoracic spine kyphosis (P less than 0.01), forward flexion (P less than 0.01) and the sum of lateral flexions (P less than 0.05) were reduced in the girls compared with the boys. In the boys and girls alike, thoracic rotation to the left was smaller than to the right, but the difference was statistically significant (P less than 0.05) only for the girls. In the girls, thoracic forward flexion and rotation to the left had negative correlations (r = -0.38 and -0.39, P less than 0.05) with growth velocity. The hypothetical significance of the results for the explanation of the development of adolescent idiopathic scoliosis is discussed.

Adolescent

Scoliosis associated with lumbar spondylolisthesis. A clinical survey of 190 young patients.

A series of 190 patients with lumbar spondylolisthesis treated operatively during the years 1948-80 at the mean age of 15.2 years (8-19 years) and reexamined 4-36 years (mean 11.2 years) later are presented. In 92 of them (48%) scoliosis (more than 5 degrees) in association with olisthesis was seen. The slipping affected the fifth segment in 90 and fourth segment in two patients. The female predominance was characteristic in the scoliotic group. Dysplastic changes of the posterior arc were more often seen in the group of patients with scoliosis than in the nonscoliotic group, and they also presented a more severe grade of slipping and lumbosacral kyphosis. The curve was usually mild and was situated in the lumbar area. Patients with a higher degree of lumbosacral kyphosis and more severe slipping also had a statistically higher degree of lumbar scoliosis. Operative treatment of spondylolisthesis consisted of posterior or posterolateral fusion in situ, but two patients were treated using ventral fusion and three severe cases with removal of loose posterior element. Lumbar scoliosis classified as sciatic type disappeared in 25 out of 39 patients after lumbosacral fusion, suggesting the "sciatic muscle spasm" as an etiologic factor. The torsional type of curve resulting from asymmetrical slipping of the vertebra was also corrected in 19 out of 28 cases after fusion. At follow-up patients with remaining lumbar scoliosis represented more low-back pain than those without any curve. In our opinion lumbosacral fusion is indicated before lumbar curve changes to structural scoliosis in symptomatic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Three-year results of bracing in scoliosis.

We treated 107 patients with idiopathic scoliosis with the Boston brace. The primary correction was good in all the curve patterns. The follow-up time after weaning averaged 3 years. The best final result was achieved in thoracic and lumbar curves (mean 2 degrees). The final correction was worse in patients with an initial curve less than 30 degrees when compared with the patients with larger curves. Except the double major curves, there was a positive correlation between the primary correction, duration of the treatment, and the final result. The results in 14 patients with bracing for 12 hours daily did not differ from the remainder. Progression of the initial curve more than 5 degrees after the treatment was noted in 24 patients. Three patients were operated on later because of progression. We conclude that bracing can prevent progress of scoliosis.

Adolescent

Radiographic mobility of the lumbar spine and its relation to clinical back motion.

A sample of 194 examinees (117 women and 77 men), representative of the population, with a history of low back pain, were examined clinically and radiographed. The angles between vertebrae at the levels of L4-L5 and L5-S1 were measured from the lateral lumbar erect, maximal flexion, and maximal extension views. Average mobility at L4-L5 was 14.5 degrees in women and 13.4 in men, and at L5-S1 11.5 degrees in women and 12.1 in men. Mobility became more restricted with increasing age both in women and men; especially at L4-L5. In women decreased radiographic mobility at L4-L5 was significantly (p = 0.002) correlated with restricted side-bending and rotation found at the physical examination. These correlations were clearly less significant among men. At L5-S1, restricted extension in women but restricted flexion and Schober's test in men were significantly correlated with decreased radiographic mobility.

Adult

The osteogenic capacity of free periosteal and osteoperiosteal grafts. A comparative study in growing rabbits.

The behaviour of free periosteal and 200 micron thick osteoperiosteal grafts was studied histologically in 40 six-week-old rabbits. The grafts were taken from the tibia and fixed on either side of the same lumbar vertebra between the spinous and mamillary processes. The free stripped periosteum had better osteogenic activity than the 200 micron thick osteoperiosteum. The new bone was formed by the osteogenic cells of the cambium layer in both types of graft.

Age Factors

Intraosseous lipoma of the calcaneus. Report of a case and a short review of the literature.

One case of an intraosseous lipoma of the calcaneus bone is presented together with a short review of the literature. Only 20 cases of tumors in the extremities have so far been published. The typical X-ray picture shows a cystic, sharply demarcated cavity, which macroscopically at operation is filled with yellowish, adipose tissue. In the present case and one previously published a central sclerotic mass was observed. The histological picture is typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.

Adult

Intertrochanteric varus osteotomy in Legg-Calvé-Perthes disease: a report of 112 hips.

The results of 112 intertrochanteric femoral varus osteotomies performed on 102 children with Legg-Calvé-Perthes disease were analyzed. The result worsened with the increasing age of the patient at operation. It was seldom good when the patients age was greater than or equal to 9 years. Catterall grouping and the concept of head at risk were of prognostic significance in patients operated on before 9 years of age and before the disease had reached the healing phase. No correlation was observed between the result and the femoral neck-shaft angle measured preoperatively and after consolidation of the osteotomy.

Age Factors

Spondylolisthesis in children under 12 years of age: long-term results of 56 patients treated conservatively or operatively.

Thirty-six girls and 20 boys who were diagnosed with spondylolisthesis of L5 when aged less than 12 years (10 months to 11 years) were reexamined clinically and radiologically at skeletal maturity, 5-30 years (average 14.5 years) later. Thirty-two children were treated operatively: 20 patients by posterior, 10 by posterolateral, and one child by anterior fusion. One patient had laminectomy only. None of the patients treated conservatively had later operative treatment. Clinical symptoms leading to operative or conservative treatment, results of treatment, and radiologic changes are reported. Girls had more severe displacement, earlier worsening of deformity, and more clinical symptoms than boys. The role of growth spurt in progression of the slip is discussed. The importance of regular clinical checks of young children with spondylolisthesis is stressed.

Child

Biological factors and predictability of bracing in adolescent idiopathic scoliosis.

Biological factors that could have a predictive value in treating idiopathic scoliosis by brace were studied in 107 patients (102 girls and 5 boys). The mean age of the patients was 14 years 6 months, and the mean Cobb angle of the curves was 36 degrees at start of treatment. The Boston brace was used for an average of 1 year 6 months, and mean follow-up time after weaning was 3 years. Scoliosis with an apex of Th 10-12 proved to be the most favorable for the final result, with a mean correction of 2 degrees. All other curves remained unchanged. Patients who had a period of rapid growth just before or during treatment had a better final result than the others. The final result was also better when treatment was started before menarche.

Adolescent

Metaphyseal distraction for lower limb lengthening and correction of axial deformities.

Metaphyseal distraction with the Orthofix apparatus was performed on 10 patients (five femora and five tibiae). A retrospective review is presented. The follow-up time was 10-38 months. A satisfactory correction of leg length and axial deformity was achieved in all cases. There was no need for plating or bone grafting. All patients showed solid bony fusion at follow-up. Pin tract infections in seven patients resolved under antibiotic treatment. Problems of pin loosening and mechanical weakness of the distraction device are discussed.

Adolescent