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At least 19 recordsLinked to original sources
PubMed1979

Surgical management of thoracic kyphosis in adolescents.

Twenty-seven patients of a group of twenty-nine who underwent posterior spine fusion using Harrington compression instrumentation for Scheuermann's disease or postural roundback deformity were reviewed with a mean follow-up of 27.6 months. The mean curve before operation was 72 degrees and at review, 46.1 degrees. The mean loss of correction in the fusion from initial examination to final follow-up was 5.7 degrees. This procedure can achieve satisfactory correction of deformity as well as pain relief. We think that Harrington compression instrumentation and spine fusion is indicated in selected cases of roundback deformity.

Adolescent↗
PubMed1978

Unusually mild course of beta-glucuronidase deficiency in two brothers (mucopolysaccharidosis VII).

Two brothers with oligosymptomatic mucopolysaccharidosis VII were observed from age 11 8/12 to 16 years, and 15 1/2 to 19 years, respectively. Asymptomatic thoracic kyphosis and mild scoliosis were the prominent clinical features. Herniae, hepatosplenomegaly, corneal clouding and shortness of stature were absent. Both had Alder type granulations in polymorphonuclear leukocytes and to a lesser degree in monocytes. Ultrastructural analysis of blood leukocytes revealed polymorphous inclusions of probably more than one class of organic substances. Radiological signs were mild, confined to the spine and consisted of irregularities of upper and lower vertebral plates, of vertebral flattening and some osteophytic changes. Both patients excreted excessive amounts of acid mucopolysaccharides in urine and also globoside. Cultured skin fibroblasts of both patients contained metachromatic granules, had only approx. 10% of normal beta-glucuronidase activity and degraded sulfated mucopolysaccharides at a slower than normal rate. Sera of the patients had none or minimal beta-glucuronidase activity, the mother's serum had subnormal and the father's serum low-normal activity. The older brother is the oldest known case of mucopolysaccharidosis VII. As this hereditary disorder may take a remarkably mild clinical course, beta-glucuronidase-deficient juveniles may exist undetected in the general population.

Adolescent↗
PubMed1977

[Hypertrophic obstructive cardiomyopathy and lentiginosis (author's transl)].

Progressive cardiomyopathic lentiginosis was first described in 1972 by Polani and Moynahan. It is characterised by pigmentation of the skin (multiple symmetrical lentigines), hypertrophic obstructive cardiomyopathy and retarded growth. There may also be mental retardation. All characteristics of the syndrome were present in a 46-year-old woman. In addition there were also other features: lentigo developed at only 35 years of age, there was hypertelorism, thoracic kyphosis, and intermittent severe depression. Cyclic adenosine monophosphate in plasma was raised to 90.5 nmol/1.

Cardiomyopathies↗
PubMed2026

Characteristics of early-onset, rapidly progressive scoliosis in spinal muscular atrophy type I treated with disease-modifying therapy -a multicenter retrospective study conducted in Japan.

In the era of disease-modifying therapy (DMT), almost all patients with spinal muscular atrophy (SMA) type I treated after onset, but before 6 months of age, develop early-onset, rapidly progressive scoliosis by 2 years of age, despite improvements in their motor function. Seven symptomatic patients with SMA type I who were treated before the age of 6 months were included in this retrospective observational study. Scoliosis had developed in all patients by 27 months of age. Among them, the patients who could stand with support or independently (standing patients; n = 3) tended to present with more progressive scoliosis than the sitters (n = 4). All standing patients demonstrated thoracic hyperkyphosis before or at the time of their scoliosis diagnosis. Despite receiving DMT, these patients continued to show residual key manifestations of SMA type I. Chronic difficulty maintaining posture due to trunk muscle weakness in the lying, sitting, or standing position was considered to be the main contributor to the development and progression of the scoliosis. The development and progression of such scoliosis, which begins in infancy, may be related to inappropriate postural management, which is not currently recognized as such by clinicians, caregivers, or guardians. In this population, it is important to closely monitor patients for such scoliosis from soon after the diagnosis of SMA. As this type of scoliosis progresses rapidly during the early developmental stage, when surgery is not possible, it is necessary to establish a proactive non-surgical management strategy for it.

Humans↗
PubMed1977

Techniques of anterior spinal surgery for the management of kyphosis.

Experience with the techniques of spinal surgery for the management of thoracic and lumbar kyphosis suggests that the anterior approach is useful for correcting fixed deformity (achieving solid arthrodesis and decompressing the spinal cord when necessary). The insertion of an anterior bone graft alone does not guarantee a solid arthrodesis. Meticulous technique, autologous bone, and efficient immobilization are essential for a satisfactory result.

Abdomen↗
PubMedDate not supplied

Modern orthotics for spinal deformities.

Four basic types of orthoses are now being used at the Twin Cities Scoliosis Center for the treatment of spinal curvatures. The Milwaukee Brace, either custom-made or using a prefabricated pelvic section is the orthosis of choice for thoracic scoliosis and kyphosis in the ambulatory child. For lumbar and thoracolumbar curves, the one-piece "TLSO" has proven the most effective design. For the collapsing spine of myelomeningocele, childhood paraplegia, and spinal muscular atrophy, the 2-piece bivalved polypropylene body jacket is excellent. For the severely involved cerebral palsy or Duchenne Dystrophy patient, the Chair Insert type Sitting Support Orthodosis is preferable.

Braces↗
PubMedDate not supplied

A modified brace (Prenyl) for scoliosis.

Sixty-six skeletally immature patients with idiopathic scoliosis were treated with a Prenyl brace and their results were analyzed. Fifty-three patients (80%) showed a satisfactory response. The best results were obtained in patients with lumbar curves and thoracolumbar curves less than 40 degrees. Advantages of this brace are simplicity of fabrication and fitting, patient comfort, patient acceptance and relatively low cost. The disadvantages of this brace are that it is less effective in thoracic curves in the upper thoracic spine, double major curves and kyphosis. It probably causes more significant chest restriction than the Milwaukee brace.

Adolescent↗
PubMed1979

Spinal osteotomy to correct kyphosis in spinal tuberculosis.

Twenty-seven patients with severe tuberculous kyphosis have been treated at the National Murayama Hospital between 1966 and 1977. We have undertaken curettage of the foci and vertebral osteotomy through an anterior approach, followed by gradual correction with a halo pelvic distraction apparatus and subsequent vertebral fusion. Choice of this method depends upon the age of the patient, the degree of kyphosis before correction, and the presence of concomitant lesions. Details of postoperative management are given and their importance is emphasized. The major risks of correction are discussed and precautions suggested.

Adolescent↗
PubMed1979

[Effect of increased motor activity on changes in posture during puberty].

The purpose of this longitudinal study was to investigate the dynamics of changes of anteroposterior curvatures and scoliosis during puberty in relation to the level of physical activity. The material consisted of 111 children. Their mean age was 11.5 years at the beginning of the study. One group (n = 53) was from a sport's class (athletics, rowing-- 2 hours training, 4-5 times a week), and the other (n = 58) from a control class. The anthropostereometric method, according to Jachowicz was used to determine the posture. Measurements were taken once a year for a period of 3 years. The analysis of the material showed a great individual variations in values and dynamics of changes of anteroposterior curvatures. Differences between trained and untrained children were observed. The results suggest a certain "stability" of stature in trained children (especially boys), probably due to increased muscular mass. During 3 years of study a lability of posture and appearance of structural defects (especially scoliosis) were observed. This indicates the need for regular control of posture and in some cases corrective exercises in the training programme. It was found, that the graphic method of evaluation of defects is more useful in practice than the descriptive one.

Adolescent↗
PubMed1977

Radiological features of tuberculosis of the spine in Ibadan, Nigeria.

In Nigeria, tuberculosis of the spine remains an important medical problem in the diagnosis and management of which radiology plays an invaluable role. The present study reviewed sixty-nine cases seen in 1966-1972 at the University College Hospital, Ibadan, Nigeria. The possible radiological classification of the disease was grouped into seven different types:- (i) disc space narrowing only (ii) kissing lesions; (iii) wedge collapse of vertebra; (iv) vertebra plana; (v) lesions localised in the vertebral body and/or its appendages; (vi) para-spinal abscesses; (vii) complete destruction of vertebral body. The dorsolumbar region was the most frequently involved with D.11 vertebra being most often affected. The maximum number of vertebrae involved was eight but involvement of two was the most frequent. Some uncommonly reported radiological features encountered include bone sclerosis, intervertebral non-osteophytic bony bridge formation and skip lesions.

Abscess↗
PubMed1978

A controlled trial of anterior spinal fusion and débridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in two centres in South Africa. Seventh Report of the Medical Research Council Working Party on tuberculosis of the spine.

In 2 centres in South Africa 159 patients with a diagnosis of tuberculosis of the thoracic and/or lumbar spine were allocated at random to operation by radical resection of the spinal lesion and insertion of autologous bone grafts (Rad. series) or by débridement of the spinal focus (Deb. series). All the patients were treated with isoniazid plus PAS daily for 18 months and daily streptomycin for the first 3 months. They have been followed up to 36 months. The main analysis of this report concerns 55 Rad. and 52 Deb. patients. The clinical and radiographic condition of the 2 series on admission was similar. Central nervous system involvement was common; 27% of the patients were paraplegic and 12% paraparetic. The mean period of initial stay in hospital was 179 days for the Rad. and 133 days for the Deb. patients and of strict recumbency 97 and 37 days, respectively. Seven per cent of the Rad. and 12% of the Deb. patients had a sinus and/or clinically evident abscess initially, all of which resolved by 18 months. Of 23 Rad. and 8 Deb. patients with a radiographyically evident mediastinal abscess initially, but never a sinus or clinically evident abscess, the shadow had disappeared by 12 months in 91% and 88%, respectively. It was still present in only 1 patient (Rad.) at 36 months. Radiographically complete bony fusion of the affected vertebral bodies had occurred in 11% of 46 Rad. and 13% of 45 Deb. patients by 6 months, in 39% and 22% by 12 months, in 59% and 33% by 18 months (P = 0.05) and 74% and 69% by 36 months. The mean vertebral loss on admission was 1.0 vertebra in the Rad. and 1.1 in the Deb. series. At 36 months there was a mean loss of a further 0.2 of a vertebra in each series. The mean angulation of the spine at the start of treatment was 33 degrees for the Rad. and 35 degrees for the Deb. series and the mean increase at 3 years was 15 degrees and 8 degrees (P = 0.06), respectively. At 18 months, 64% of the Rad. and 69% of the Deb. patients had a favourable response to treatment and at 3 years 81% and 88%, respectively, non-significant differences. Patients with central nervous system (CNS) involvement on admission stayed in hospital initially for an average of 204 days compared with 129 days for those with no CNS involvement, the period of strict recumbency being 84 days compared with 60 days. The prognosis was also less favourable, 14% compared with 2%, respectively, died (P = 0.03) and 32% compared with 3%, respectively, had an unfavourable response at 36 months (P = 0.0003). At 6 months the paralysis had resolved in 6 (21%) of the 29 paraplegic patients compared with 7 (54%) of the 13 paraparetic patients (P = 0.07). The corresponding proportions at 21 months were 72% and 69%. At 18 months, 28% of the paraplegics responded favourably compared with 62% of the paraparetics (P = 0.08) but at 36 months the proportions were similar, namely 65% and 67%. Specimens from spinal lesions were obtained at operation in 149 patients...

Adolescent↗
PubMedDate not supplied

Simultaneous anterior and posterior surgical approach to the thoracic and lumbar spine.

A technique for the simultaneous anterior and posterior surgical approach to the thoracic and lumbar spine is presented. No intraoperative repositioning of the patient is required. The procedure requires a surgical team of two spinal surgeons and two assistant surgeons, as well as an anesthesiologist familiar with hypotensive techniques. The procedure as utilized in 14 cases has proven to be safe and expeditious. The simultaneous anteroposterior approach has proven to be especially useful in cases with combined anterior and posterior instability. The technique described provides the experienced spinal surgeon with the best solution to certain complex spinal problems.

Adult↗
PubMed1977

Spontaneous spondylolisthesis in embryonic and adult chick.

The incidence of spontaneous avian spondylopathy was maintained between 58 and 66% in the progeny of one flock (Flock A) and less than 40% in the progeny of another (Flock B), by proper selection and breeding for 4 generations. Spondylolisthesis, the major type of spondylopathy present, was observed at the first and sixth vertebral levels. Spondylolisthesis was progressive in nature and consisted of a ventrodorsal rotation of the 1st and/or 6th thoracic vertebrae leading to spinal cord injury and paraplegia or partial crippling in some birds. There was occasionally extensive muscle degeneration and connective tissue proliferation around the distorted vertebrae and the spinous ligaments bridging the defect were stretched and appeared heavier than normal. Spondylopathy was also observed in 20-day chick embryos. Spondylolisthesis was observed in 33% of the embryos examined from Flock A-G2 and the other conditions present consisted of scoliosis and abnormal lordosis and kyphosis. Using a grading scale of +1 (mild) to +3 (severe), all cases of embryonic spondylopathy were graded as +1. The back defects present in Flock B-G2 embryos were entirely due to abnormal kyphosis.

Animals↗
PubMed1977

Post-laminectomy kyphosis.

Post-laminectomy spinal deformity occurs in 50% of children undergoing laminectomies for cord tumors. Kyphosis is the most frequent deformity found. The integrity of the facet joints appears to be one of the most important factors in the development of this kyphosis. More children are surviving after treatment of these tumors and a pessimistic attitude is not warranted. Observation of a progressing deformity is not acceptable treatment. When kyphosis develops, early prompt bracing must be started. For a progressive or severe kyphosis, an anterior spine fusion is indicated. This is reinforced by a posterior fusion with Harrington instrumentation. Surgical reconstruction is indicated in children recovering from extensive laminectomies but with a good prognosis.

Adolescent↗
PubMed1977

Kyphotic deformity of the spine in ankylosing spondylitis.

Patients who present with apparent kyphotic deformity of the spine associated with ankylosing spondylitis may have their main deformity in the hip joints, in the lumbar spine, the thoracic spine, or it may be primarily cervical in situation. If any major correction is to be carried out, then the correction should be done in the area of the main deformity. Deformity in each of these areas is amenable to surgical correction, but this requires a very careful assessment, meticulous preoperative planning, and very precise attention to operative technique to allow reasonably consistent success without major risk to the patient.

Adult↗