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Biomedical subjects

J H Moe

Publications and source records attributed to J H Moe.

64 records · Page 4Linked to original sources
PubMedDate not supplied

Scoliosis and cor pulmonale.

Twenty patients with cor pulmonale due to scoliosis and associated spine deformities seen at the Twin Cities Scoliosis Center in the past 20 years have been reviewed. The average age was 37 years. The average scoliosis was 135 degrees and ranged from 90 degrees to 200 degrees. Fifteen patients were placed in halo traction, nine of whom went on to surgical stabilization. Of the nine patients having surgical treatment, five had postpoliomyelitis curves, two had congenital, one had infantile idiopathic, and one had frontometaphyseal dysplasia. The best results were in the postpoliomyelitis group, with an average pretreatment vital capacity of 595 cc and posttreatment vital capacity of 1071 cc; the average PaO2 increased from 55 to 64 mm Hg, and the average PaCO2 decreased from 52 to 43 mm Hg. The only death in the postpoliomyelitis group occurred six years postoperatively. Of the four nonpoliomyelitis patients having surgery, only one survived, the patient with frontometaphyseal dysplasia. The difference between the poliomyelitis and nonpoliomyelitis groups was striking. Patients with cor pulmonale due to spine deformity should have careful evaluation and a trial of halo traction. If the vital capacity improves, the PaO2 increases, and the PaCO2 decreases, then surgical stabilization can often be successfully accomplished. If these parameters do not improve in traction, then surgical treatment can be abandoned.

Adult↗
PubMedDate not supplied

The incidence of Klippel-Feil syndrome in patients with congenital scoliosis and kyphosis.

A retrospective review of the radiographs of 1215 patients with congenital scoliosis and kyphosis disclosed 298 (25%) to have segmentation defects in the cervical spine. A single level defect was seen in 82 patients, 52 of which were at C2-C3. Of the 298 patients, 235 had scoliosis, (6 cervical, 42 cervicothoracic, 75 thoracic, 4 thoracolumbar, and 1 lumbar), 36 had kyphoscoliosis, 10 lordoscoliosis, and 17 pure kyphosis.

Child↗
PubMedDate not supplied

Adult idiopathic scoliosis treated by posterior spinal fusion and Harrington instrumentation.

Ninety-one patients with idiopathic scoliosis, who underwent posterior spinal fusion and instrumentation from January 1977 to December 1982, were reviewed. All patients were 20 years or older at the time of surgery and none had undergone a prior surgical procedure. Indications for surgery included pain, progressive deformity, and pulmonary symptoms. All patients had a posterior spinal fusion with Harrington instrumentation and autogenous iliac bone graft, with the addition of segmental wiring in only eight. No patient had an anterior fusion or fusion to the sacrum. Follow-up averaged 3.5 years (range: 2-7 years). The average correction at the time of surgery was 38%, and 32% at the time of last follow-up. Seventy-nine percent of the patients reported complete relief of the symptom(s) for which they had surgery. There were 34 complications in 30 (33%) patients. Pseudarthrosis occurred in 14 (15%), requiring 15 additional procedures to achieve a solid arthrodesis. Urinary tract infection occurred in 8 (9%) patients and Harrington hook dislodgement in 5 (5%). One patient sustained a partial paraparesis with recovery to a minimal deficit. No deaths occurred. Although largely successful, posterior fusion with Harrington instrumentation for adult scoliosis has a significant incidence of pseudarthrosis and instrumentation problems.

Adult↗
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Scheuermann's juvenile kyphosis. A histologic study.

The case histories and gross and microscopic findings of two adolescent patients with Scheuermann's kyphosis demonstrate that the anterior longitudinal ligament is bowstrung across the apex of the hyphosis. The microscopic findings include markedly irregular end plates and end plate disruption with protrusion of disk material into the vertebral body. The ring apophysis does not show avascular necrosis. The intervertebral disk is interpreted as normal both by routine histology and electron microscopy. It is postulated that Scheuermann's kyphosis may be secondary to vertebral osteoporosis occurring during the juvenile period rather than to an intrinsic abnormality in the intervertebral disk or ring apophysis.

Adolescent↗
PubMedDate not supplied

Lumbosacral hemivertebrae. A review of twenty-four patients, with excision in eight.

Twenty-four cases of lumbosacral hemivertebrae are reviewed. The treatment groups consisted of observation, bracing, posterior spinal fusion with and without Harrington instrumentation, and two-stage hemivertebral excision. Clinical and radiographic spine decompensation was found to be an important parameter in following these patients. Results with observation and bracing were variable and unpredictable. The best surgical correction was obtained with lumbosacral hemivertebral excision.

Adolescent↗
PubMedDate not supplied

Modern concepts of treatment of spinal deformities in children and adults.

This is a review of 30 years' experience with spinal deformities and includes the methods of analysis and treatment that have stood the test of time and are still basic in the treatment of scoliosis and kyphosis. Experience with all newer forms of treatment of the common idiopathic types of scoliosis, juvenile kyphosis, both the postural and the progressive forms, and the basic problems of ordinary congenital malformations of the spine, including recorrection of iatrogenic failures of treatment in adults, is evaluated in terms of the responses to newer modalities of treatment.

Adolescent↗
PubMedDate not supplied

Scheuermann's kyphosis: a form of osteoporosis?

A high frequency of abnormalities were noted in radiographic measurements of bone density, microradiography of the iliac crest, serum alkaline phosphatase, urinary hydroxyproline and dietary calcium intake in 12 patients with Scheuermann's juvenile kyphosis. Scheuermann's kyphosis may be a manifestation of generalized skeletal disease which becomes symptomatic during the growth spurt of puberty.

Adolescent↗