Biomedical subjects

R W Coonrad

Publications and source records attributed to R W Coonrad.

14 recordsLinked to original sources

PubMed2006

Total elbow arthroplasty with the Coonrad/Coonrad-Morrey prosthesis. A 10- to 31-year survival analysis.

There have been few reports in the literature of total elbow arthroplasty extending beyond 10 to 15 years. We reviewed 40 patients (41 elbows) with a mean age of 56 years (19 to 83) who had undergone a Coonrad/Coonrad-Morrey elbow arthroplasty by one surgeon for various diagnoses between 1974 and 1994. Surgical selection excluded patients with previous elbow infection or who refused to accept a sedentary level of elbow activity postoperatively. Objective data were collected from charts, radiographs, clinical photographs and supplemented by the referring orthopaedic surgeons' records and radiographs if health or distance prevented a patient from returning for final review. Subjective outcome was defined by patient satisfaction. Of the 41 elbows, 21 were functional between 10 and 14 years after operation, ten between 15 and 19 years and ten between 20 and 31 years. There were 14 complications and 13 revisions, but no cases of acute infection, or permanent removal of any implant.

Adult↗

PubMed1998

A logical coronal pattern classification of 2,000 consecutive idiopathic scoliosis cases based on the scoliosis research society-defined apical vertebra.

STUDY DESIGN: Two thousand consecutive idiopathic scoliosis records and radiographs were reviewed for coronal pattern typing and categorization, based on Scoliosis Research Society definitions of the apical vertebra. Apical frequency was determined for each of the patterns identified, and represents a database from a large series of cases for the already accepted Scoliosis Research Society definitions. OBJECTIVES: To identify and numerically pattern-type a large series of idiopathic coronal curves, for the basic purpose of written and oral communication. Some pattern types were not described previously. SUMMARY OF BACKGROUND DATA: Although spinal deformity must be considered three dimensional for treatment in 1998, no comprehensive, databased, and user friendly coronal or sagittal classification of idiopathic scoliosis has been reported. METHODS: Two thousand idiopathic curve patterns from charts and radiographs were reviewed and the coronal patterns categorized by the apical vertebra. The resulting classification was tested for inter- and intraobserver reliability by 12 spine surgeons and 6 orthopedic residents. Apical frequencies were determined for each pattern type. RESULTS: Twenty-one pattern categories were identified, and all were right or left mirror image patterns (except for a quadruple pattern) that permitted separation into 11 types. Incorporating the widely recognized five numbered King types mad pattern recognition simple. Interobserver reliability testing was 98.2%. The left single thoracic curve pattern was included in this classification because only 9 (20.4%) of 44 patients with left thoracic curves had intraspinal pathology. CONCLUSION: Two thousand consecutive idiopathic coronal curve patterns separated into eleven readily identifiable types, and incorporating the widely referenced five King types, makes recognition simple for purposes of identification and communication. Sagittal and 3D factors excluded from this classification are equally important in the process of treatment decisions. Apical frequency data determined in this study lends credence to Scoliosis Research Society definitions for idiopathic curve patterns.

Adolescent↗

PubMed1995

Snapping brachialis tendon associated with median neuropathy. A case report.

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Adult↗

PubMed1993

An assessment of the reliability of the Scoliometer.

Accurate noninvasive measurements of spinal curvature are crucial in planning treatment and assessing curve progression in adolescent idiopathic scoliosis. An inter-rater agreement trial and an intrarater agreement trial were undertaken to estimate the reliability of axial rotation measurement using the Scoliometer (Orthopedic Systems, Inc., Haywood, California). In the inter-rater trial, two orthopedic surgeons and two orthopedic surgery residents independently measured the thoracic and lumbar axial rotations of 22 patients with idiopathic scoliosis using the Scoliometer. In the intrarater, trial a single orthopedic surgeon measured the thoracic and lumbar axial rotations of 25 patients on four separate occasions with the Scoliometer. Inter-rater agreement using the Scoliometer to estimate the magnitude of the hump (in centimeters) in the thoracic and lumbar regions was poor (intraclass correlation coefficient, Rho = 0.57 and Rho = 0.76 for the thoracic and lumbar regions, respectively). Inter-rater agreement using the Scoliometer to estimate the degree of axial trunk rotation was better (Rho = 0.81 and Rho = 0.82 for the thoracic and lumbar regions, respectively). Intrarater agreement using this device to estimate the magnitude of the hump (in centimeters) in the thoracic and lumbar regions was good (Rho = 0.90 and Rho = 0.84 for the thoracic and lumbar regions, respectively). Intrarater agreement using the Scoliometer to estimate the degrees of curvature was outstanding (Rho = 0.995 and Rho = 0.998 for the thoracic and lumbar regions, respectively). These results indicate that the Scoliometer can be a reliable noninvasive method for repetitively assessing spinal axial rotation when used by a single trained observer.

Adolescent↗

PubMed1992

Choosing fusion levels in progressive thoracic idiopathic scoliosis.

The selection of fusion levels in thoracic idiopathic scoliosis was subjected to multicenter retrospective review to test the validity of the classification system and recommendations of King et al. The 253 patients reviewed were treated by posterior fusion and Harrington instrumentation. Bending films were of little help in selecting fusion levels. Standing radiographs alone were usually adequate. King Type II curves may yield better lumbar correction if the lumbar curve is partially included in the fusion. Type IV curves may be safely fused one level proximal to the stable vertebrae.

Adolescent↗

PubMed1991

The elbow.

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Adult↗

PubMed1988

Degenerative adult onset scoliosis.

There are people who have no history of scoliosis who develop spinal deformity of a progressive nature as adults, associated with severe degenerative disc disease. The clinical syndrome associated with this deformity is not well documented. In an attempt to describe this clinical syndrome more precisely, 21 patients with the diagnosis of degenerative scoliosis were identified and reviewed. Review included history with pain drawings when available, physical examination, bone densities, and standing spinal roentgenograms. Patients with spinal compression fractures, spondylolyses, prior history of scoliosis or radiographic findings consistent with an idiopathic scoliosis were excluded. Our review shows that these patients can develop, along with progressive scoliosis, loss of lumbar lordosis with a resulting flat back deformity. These patients commonly present in the sixth decade with a predominantly stenotic symptom complex, but often lack the classic feature of relief in a sitting posture. The number of male and female patients was approximately equal. Roentgenogram findings show a high angle deformity over a short number of spinal segments and an absence of bony features associated with idiopathic scoliosis such as lateral vertebral wedging and alterations of the lamina. The incidence of this condition remains to be established.

Adult↗

PubMed1988

Spinous process segmental instrumentation for scoliosis.

Spinous process segmental instrumentation (SPSI) for spinal fusion was devised in 1983 by Drummond et al. in an attempt to achieve the stability of segmental fixation without the known neurologic risks of passing sublaminar wires. We used SPSI in 75 scoliosis patients. Sixty-one had idiopathic scoliosis, 12 had neurogenic scoliosis, and 2 had congenital scoliosis. There were no deep infections, pseudarthroses, or neurologic complications. Two patients experienced upper hook dislodgement with 10 degrees loss of correction. We concluded that SPSI can achieve the correction of Harrington rod instrumentation and the stability of Luque rod segmental instrumentation, without the neurologic risk of sublaminar wiring.

Adolescent↗

PubMed1986