PubMed Health⌕ Search

Biomedical subjects

M Stamatakis

Publications and source records attributed to M Stamatakis.

24 records · Page 2Linked to original sources
PubMed1996

Vertical transmission of the hip rolls due to wearing of TLSO for scoliosis.

Cosmesis is important in the treatment of adolescent patients with idiopathic scoliosis. It has been shown that although bracing reduces the rib hump, it induces several complications. The aim of this study was to describe a new disturbing complication due to wearing a thoracolumbosacral orthosis (TLSO) for adolescent idiopathic scoliosis: the vertical transmission of the hip rolls (trochanteric lipomatosis) in girls and its pathogenetic mechanisms. Trochanteric lipomatosis is common in the female population, particularly after adolescence, and is responsible for the characteristic appearance of the hip rolls. No data have been reported concerning vertical transmission of normal trochanteric lipomatosis with subsequent disturbance of aesthetic appearance while wearing the TLSO. In this prospective study, 300 consecutive adolescent girls who were treated with the TLSO for progressive idiopathic scoliosis were followed and evaluated for development of any vertical transmission of the hip rolls after application of the brace for an average of 2.5 years after termination of the treatment. Almost simultaneously, 290 age-matched, randomly selected adolescent girls served as controls and were examined by two unbiased observers during the school screening program to estimate the prevalence of trochanteric lipomatosis in female adolescents of the same geographic area. In this series, bracing reduced the thoracic scoliosis from 34.4 +/- 5 degrees to 18.5 +/- 6 degrees and the lumbar scoliosis from 29.4 +/- 4 degrees to 16.7 +/- 4 degrees 6 months after initiation of brace wearing. The average prevalence of normal trochanteric lipomatosis in girls in the control group was 26% (range, 12.2-68.4%) for the ages 9-14 years and was increasing with the age and weight. No correlation was found between amount of reduction of scoliosis and prevalence of the complication. Vertical transmission of the hip rolls was observed in 69 (23%) of the girls with scoliosis 6 months after initiation of brace wearing and was positively correlated with the rigidity of the scoliotic curvature (p < 0.05) and the amount of reduction of the curvature (p < 0.05). Seven (8.8%) girls discontinued brace wearing because of psychological distress related to the deformity around the hip rolls, whereas 51 (73%) additional girls underwent suction lipoplasty during or after the termination of the brace wearing, because of persistent and disturbing lipomatosis. Recurrence of significant lipomatosis was observed in 3 (5.8%) of the girls who underwent lipoplasty. Physicians who are involved with treatment of scoliosis with bracing should be aware of this aesthetic complication. Brace wearing should not attempt maximum correction of scoliosis, thus avoiding excessive force on the body, and should be ordered only in patients with immature spines, curves of > 25 degrees, and radiologically justified progression. Suction lipoplasty seems to be a safe method of treatment and should be advised in cases with unaesthetic vertical transmission of the hip rolls.

Adipose Tissue↗
PubMed1996

Relapsing pancreatitis after combined anterior and posterior instrumentation for neuropathic scoliosis.

We report a case of pancreatitis in a 28-year-old woman who underwent a combined anterior Zielke procedure followed by Luque-TSRH (Texas Scottish Rite Hospital) operation in the same session for severe polioscoliosis. To our knowledge, only one case of a child with acute pancreatitis after posterior instrumentation for spondylolisthesis has been reported. In the early postoperative period, the patient developed acute pancreatitis that was diagnosed by a marked increase in plasma amylase and was confirmed by ultrasonography. The symptoms of pancreatitis in this patient temporarily resolved a few weeks after conservative treatment (diet, infusions, antibiotics). Six, 16, and 32 months after the combined operation, there were repeated relapsing episodes of pancreatitis with elevated amylase levels and concomitant symptoms. In the last follow-up evaluation in December 1995, the patient was well and the amylase levels were within normal limits. Although the etiology of pancreatitis in this case is obscure, we believe that the correction of the severe biplane spinal deformity, achieved by the two major operations on the spine in the same session, may have contributed to the pathogenesis of the disease. This observation suggests that pancreatitis after major scoliosis surgery should be suspected when abdominal symptoms persist associated with elevated serum amylase levels. Some cases of acute pancreatitis, such as this case, can persist in chronic-relapsing form for long periods postoperatively.

Abdominal Pain↗
PubMed1995

Latent solitary tuberculous psoas abscess 52 years after healed thoracolumbar tuberculous spondylitis.

STUDY DESIGN: This study reports on an extremely rare case of tuberculous psoas abscess and describes the mode of diagnosis and treatment. OBJECTIVE: This patient is presented to emphasize that cases of solitary psoas abscess resulting from tuberculosis exist today. SUMMARY OF BACKGROUND DATA: No recent cases of latent solitary tuberculous psoas abscess have been reported, to the authors' knowledge. METHODS: A tuberculous psoas abscess associated with fistula to the greater trochanter may remain dormant for years after tuberculous spondylitis has healed, as a distinct entity without concomitant active bone infection. In our 58-year-old female patient, the diagnosis of a psoas abscess was greatly aided by the "three pass" technetium bone scan and computed tomography, but the anamnesis also was important. RESULTS: Anti-tuberculosis medication (streptomycin, aminosalicylic, and isoniazid) combined with open drainage, curettage of the psoas, and simultaneous revision of the fistula eradicated the disease, making the course of the disease uneventful until the 5-year follow-up evaluation. CONCLUSIONS: Orthopedic surgeons must be aware of the rare, delayed appearance of a solitary psoas abscess after tuberculous spondylitis.

Female↗
PubMed1995

Primary osteosarcoma of the L2 lamina presenting as "silent" paraplegia: case report and review of the literature.

Primary osteosarcomas of the vertebral column are not common, and to our knowledge a total of 78 cases, mostly located in the vertebral body, have been previously reported. We report a primary osteosarcoma of the spine with an extremely rare location--the lamina of the second lumbar vertebra. The patient, a 38-year-old woman, was admitted with paraplegia of a short duration without pain. Preoperatively, the patient underwent CT scanning for staging (Enneking IIB) followed by a needle biopsy and local preoperative arterial embolization. An emergency decompressive laminectomy was performed, and stabilization was carried out using methylacrylate. The patient showed a complete neurologic recovery. Combined chemotherapy and local irradiation did not prevent tumor recurrences, which occurred 12 and 19 months after the initial intervention and were associated with recurrent neurologic impairment. The patient died 19 months after the initial presentation, while in paraplegia, from lung metastases. Based on our unique observation, it seems that in primary osteosarcomas located in the posterior elements of the spin, the symptoms are not specific, and the disease may only become manifest when the tumor is no longer resectable. When the tumor is associated with neurologic impairment, spinal canal decompression should be performed even though it does not radically resect the tumor because it significantly improves the quality of the patient's life.

Adult↗
PubMed1994

Anterior decompression and fusion for Aspergillus osteomyelitis of the lumbar spine associated with paraparesis.

STUDY DESIGN: A very rare case of Aspergillus fumigatus osteomyelitis of the spine is described. The differential diagnosis, medical and operative treatment, and follow-up evaluation are reported. OBJECTIVES: To increase knowledge about the pathogenesis and treatment of vertebral osteomyelitis resulting from Aspergillus and to emphasize that such cases still exist. SUMMARY OF BACKGROUND DATA: Vertebral osteomyelitis from Aspergillus species is an infrequently described disease in Europe and only few cases have been previously reported. METHODS: A 48-year-old woman with Aspergillus fumigatus spondylitis in the lumbar spine and tuberculosis-lung infection and concomitant debilitating systemic disease was afflicted with incomplete paraplegia and underwent successful combined operative and medical treatment. RESULTS AND CONCLUSIONS: Early anterior decompression with spinal fusion, combined with Amphotericin B therapy, was crucial in bringing about complete neurologic recovery and maintaining the sagittal lumbar profile. Excellent clinical and radiologic results were shown in the 42-month follow-up period.

Aspergillosis↗