The height and skeletal age of girls with idiopathic scoliosis were studied. The skeletal age was evaluated by two independent methods and was compared with the chronological age and the corrected height of the patients. With both methods the same tendency was noticed. Early in the adolescence (ages 11 and 12 years) the skeletal development was more advanced in girls with idiopathic scoliosis than expected. Later (ages 16 and 17 years) the reverse condition was found. The standing height, corrected for the deformity, was significantly greater in idiopathic scoliosis patients than in controls of either the same chronological or skeletal age. These observations indicate that girls with adolescent idiopathic scoliosis have a growth pattern differing from normal, and that growth factors are connected to the disease.

Adolescent↗

PubMedDate not supplied

Kinematic analysis of spinal fusions.

Two cases with clinical suspicion of incompletely healed anterior fusion between L5 and S1 were examined by means of a roentgen stereophotogrammetric method. In both cases a pseudarthrosis was found. The method makes it possible to disclose rotations and translations between veretebrae with an accuracy of about 0.2degree and 30-120 mum, respectively.

Biomechanical Phenomena↗

PubMedDate not supplied

The effect of lumbar flexion and Boston Thoracic Brace on the curves in idiopathic scoliosis.

The correction of scoliosis induced by pure lumbar flexion was compared with the correction with the so-called Boston Thoracic Brace. Ten patients with idiopathic scoliosis were studied. There were 11 primary curves (31 +/- 6 degrees) (mainly thoracic) and four secondary curves (22 +/- 1 degree). Pure lumbar flexion reduced the primary curves by 6 +/- 2 degrees and the secondary curves by 8 +/- 3 degrees. The brace reduced the curves by 16 +/- 6 degrees and 14 +/- 5 degrees, respectively. Lumbar flexion per se produces a correction of the scoliosis of the same degree as the Milwaukee brace. Our results emphasize the importance of reduction of the lumbar lordosis in the conservative treatment of scoliosis.

Adolescent↗

PubMedDate not supplied

A successful methodology for improving the quality of clinical data.

In search of accurate, timely, and consistent information, Kaiser Permanente's Northern California Region set out to improve the quality of its clinical data. Analysis of documentation patterns resulted in consistency of clinical data, improved reimbursement, and a new dialogue between coding and medical staffs.

Abstracting and Indexing↗

PubMedDate not supplied

Can you manage managed care?

HIM professionals' data management skills make them a hot property in many settings, but none more so than managed care. In this second installment of the Journal of AHIMA's special series on managed care, the author describes the ways managed care organizations use data and how HIM professionals can contribute.

Database Management Systems↗

PubMedDate not supplied

Long-term follow-up of patients with adolescent idiopathic scoliosis treated conservatively: an analysis of the clinical value of progression.

In a retrospective study, 217 patients with conservatively treated adolescent idiopathic scoliosis (AIS) were investigated. Forty-nine cases were operated and 168 were treated only conservatively and had been out of the brace for at least 4 years at the time of the investigation. The progression between cessation of brace treatment and follow-up (a mean of 6.9 years later) was 5.1 degrees. Almost all progression (4.5 degrees) occurred within 2 years of the end of weaning, however. The incidence of failure with regard to the length of follow-up was also studied. A follow-up of 2 years was sufficient to predict with great accuracy (97%) all incidences of failure.

Adolescent↗

PubMedDate not supplied

Mobility in the lumbosacral spine after fusion studied with the aid of roentgen stereophotogrammetry.

Twelve cases operated upon with fusion in the lumbosacral spine were studied with a roentgen stereophotogrammetric method. With this method the movements in the area supposed to be fused can be studied with high accuracy in 3 dimensions. The precision is 0.3 degrees for the rotation about the x-axis (transversal axis), 0.2 degrees for the rotation about the y-axis (longitudinal axis), and 0.1 degrees for that about the z-axis (sagittal axis) and of the magnitude of 0.1 mm for the translations. It was found that the possible stabilization of a fusion takes place within 180 days. The supposed gain of internal fixation with a sacral bar device was not verified. It was recommended that the supine and erect standing positions should be investigated and compared with this method and that standing with flexion should be added as soon as the healing process is supposed not to be injured by flexion movements.

Adolescent↗