Biomedical subjects

S Seitsalo

Publications and source records attributed to S Seitsalo.

41 records · Page 3Linked to original sources

PubMed1990

Operative and conservative treatment of moderate spondylolisthesis in young patients.

We made a retrospective study of 149 children and adolescents with moderate spondylolisthesis (slip less than or equal to 30%), 77 treated by fusion and 72 conservatively at an average follow-up of 13.3 years. Both groups were fully comparable with regard to age at diagnosis, sex distribution (46% girls), and mean slip. The patients who were treated operatively had more pain before treatment and showed more initial progression of the slip. They had better clinical results and less pain at latest review, but the total progression of the slip over the whole follow-up showed no statistical differences between the two groups. Patients with a pseudarthrosis after attempted fusion had had a longer period of postoperative pain, but at the latest review had no more pain than those with sound fusion. None of those treated conservatively came to fusion later and the long-term results in 18 patients who had refused the advised operation were no worse than those for other conservatively treated patients. Our results suggest that a moderate grade of spondylolisthesis in adolescents usually has a benign course. It seems that spontaneous segmental stabilisation occurs as a result of degeneration of the disc at the level of the slip.

Adolescent↗

PubMed1988

The significance of arthroscopy and examination under anaesthesia in the diagnosis of fresh injury haemarthrosis of the knee joint.

Arthroscopy and examination under anaesthesia were performed for 328 consecutive knee injuries with haemarthrosis. These examinations were grouped according to a modified classification (Jackson and Abe, 1972) into very useful (117/328, 36 per cent), useful (98/328, 30 per cent) and useless (113/328, 34 per cent) categories. The probability of arthroscopy being useful was estimated mathematically. The factors which made this procedure useful were knee pain on exertion before the injury (P = 0.0561), the mechanism of the injury (P less than 0.0001) and the clinical stability of the patella (P = 0.0007). On arrival in the emergency department it was first decided whether the leg should be mobilized, immobilized in a plaster cast, operated on or, if a definitive diagnosis could not be reached, arthroscopy was deemed necessary. This resulted in the treatment following arthroscopy, and examination under anaesthesia, being altered from conservative to operative (P less than 0.0001). Results suggest that arthroscopy and examination under anaesthesia should always be considered to help in the diagnosis of acute injury haemarthrosis of the knee especially after a valgus or varus strain.

Adolescent↗

PubMed1988

Scoliosis associated with lumbar spondylolisthesis. A clinical survey of 190 young patients.

A series of 190 patients with lumbar spondylolisthesis treated operatively during the years 1948-80 at the mean age of 15.2 years (8-19 years) and reexamined 4-36 years (mean 11.2 years) later are presented. In 92 of them (48%) scoliosis (more than 5 degrees) in association with olisthesis was seen. The slipping affected the fifth segment in 90 and fourth segment in two patients. The female predominance was characteristic in the scoliotic group. Dysplastic changes of the posterior arc were more often seen in the group of patients with scoliosis than in the nonscoliotic group, and they also presented a more severe grade of slipping and lumbosacral kyphosis. The curve was usually mild and was situated in the lumbar area. Patients with a higher degree of lumbosacral kyphosis and more severe slipping also had a statistically higher degree of lumbar scoliosis. Operative treatment of spondylolisthesis consisted of posterior or posterolateral fusion in situ, but two patients were treated using ventral fusion and three severe cases with removal of loose posterior element. Lumbar scoliosis classified as sciatic type disappeared in 25 out of 39 patients after lumbosacral fusion, suggesting the "sciatic muscle spasm" as an etiologic factor. The torsional type of curve resulting from asymmetrical slipping of the vertebra was also corrected in 19 out of 28 cases after fusion. At follow-up patients with remaining lumbar scoliosis represented more low-back pain than those without any curve. In our opinion lumbosacral fusion is indicated before lumbar curve changes to structural scoliosis in symptomatic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1984

Fractures of the talus.

A total of 35 patients treated in the years 1970 to 1977 for fractures of the talus were investigated for an analysis of the long-term clinical end results. Falling from height was the most common cause of injury (15 patients), the next most common being road traffic accidents (13 patients). The mean followup time was 8 years. At followup, 19 patients were free of any discomfort and none had pain at rest. The incidence of pain was correlated significantly (p less than 0.01) with the grade of dislocation both before and after reduction. In severely dislocated fractures open reduction and osteosynthesis with a compression screw are recommended.

Adult↗

PubMedDate not supplied

Spondylolisthesis in children under 12 years of age: long-term results of 56 patients treated conservatively or operatively.

Thirty-six girls and 20 boys who were diagnosed with spondylolisthesis of L5 when aged less than 12 years (10 months to 11 years) were reexamined clinically and radiologically at skeletal maturity, 5-30 years (average 14.5 years) later. Thirty-two children were treated operatively: 20 patients by posterior, 10 by posterolateral, and one child by anterior fusion. One patient had laminectomy only. None of the patients treated conservatively had later operative treatment. Clinical symptoms leading to operative or conservative treatment, results of treatment, and radiologic changes are reported. Girls had more severe displacement, earlier worsening of deformity, and more clinical symptoms than boys. The role of growth spurt in progression of the slip is discussed. The importance of regular clinical checks of young children with spondylolisthesis is stressed.

Child↗