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At least 307 records · Page 17Linked to original sources
PubMed1977

Paraplegia following trauma in a patient with kyphosis.

The reported incidence of paraplegia following acute spinal trauma in patients with kyphosis is very low. One such case is presented here and discussed. Although deterioration of spinal cord function in patients with kyphosis who have not sustained trauma is treated by surgical decompression and stabilization of the spine, a more conservative approach may be beneficial in those patients with a history of trauma. Thus, the treatment appears to follow that now recommended for acute spinal injuries in patients with a premorbidly normal spine.

Humans↗
PubMed1997

Spinal fusion using a vascularized fibular bone graft for a patient with cervical kyphosis due to neurofibromatosis.

We performed an anterior spinal fusion using a vascularized fibular bone graft combined with posterior fusion for a patient with severe cervical kyphosis due to neurofibromatosis. The kyphosis was corrected from 85 degrees preoperatively to 38 degrees postoperatively. A vascularized fibular bone graft is a useful surgical procedure in selected patients to obtain successful bony union.

Adolescent↗
PubMedDate not supplied

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↗
PubMed1977

The classic: kyphosis dorsalis juvenilis.

Kyphosis dorsalis juvenilis, the so-called apprentice or muscular kyphosis, is caused by disturbances in the vertebral epiphyses and not as originally suggested by muscular spinal insufficiency. The pathology resembles Calvé-Perthes osteochondritis deformans juvenilis coxae and can therefore be labelled as Osteochondritis deformans juvenilis dorsi.

Adolescent↗
PubMed1977

Juvenile kyphosis.

Scheuermann's disease is a common cause of kyphosis developing in the juvenile period. Untreated, the deformity may progress, producing significant pain and, rarely, neurologic signs and symptoms. Successful treatment is possible with the Milwaukee brace, provided that the child has not reached skeletal maturity. Bracing will produce a superior result in terms of correcting the deformity and reversing vertebral wedging. Surgery may occasionally be necessary for severe kyphosis, especially in the adult who presents with pain and/or neurologic problems. Combined anterior and posterior approach is the preferred surgical procedure.

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↗
PubMed2005

Neurologic compression by thoracic disc in a case of scheuermann kyphosis - an infrequent combination.

Scheuermann disease is a rigid kyphosis due to vertebral wedging in the thoracic or lumbar spine. It is very rarely associated with neurologic compromise. Thoracic disc herniation leading to dural sac compression is also an infrequent pathology. We describe here a young man with Scheuermann disease who presented with symptoms and signs of neural compression. The cause of compression was a thoracolumbar disc, rendering him non-ambulant without support. He required transthoracic surgical decompression. The neurological status of the patient improved rapidly after surgery. At his latest follow-up he was independently ambulant with full restoration to activities of daily living.

Adult↗
PubMed1991

The treatment of spinal kyphosis.

The modern management of kyphosis depends on the diagnosis, but there are common factors on which rational treatment can be based. An understanding of the biomechanics is very important, especially in planning operations on the spine. The greatest single advance has been the anterior approach. Scheuermann's disease in children is best treated by bracing, but most other deformities need anterior and posterior fusion. Modern instrumentation benefits both the patient and the surgeon.

Humans↗
PubMed1983

Scoliosis and kyphosis in dwarfing conditions.

Structural scoliosis and kyphosis are mainly caused by asymmetric ossification of the vertebrae. Dynamic factors influence the development of the deformities. Rotational instabilities, the combined result of asymmetric ossification and dynamic forces, have a particular severe prognosis. Progressing curvatures need adequate treatment. In peculiar cases early fusion is indicated.

Braces↗
PubMed1994

Progressive cord compression secondary to thoracic disc lesions in Scheuermann's kyphosis managed by posterolateral decompression, interbody fusion and pedicular fixation. A new approach to management of a rare clinical entity.

During a brief period of 21 months (November 1988 to August 1990) the neurospinal unit of our institution registered three cases of Scheuermann's kyphosis with herniation of the thoracic discs. Local and intercostal pain, progressive spasticity with gait disturbance and urinary hesitancy were the most common presenting symptoms. All of the patients were surgically managed by posterolateral decompression, interbody fusion (posterolateral approach) and pedicular screw plate fixation. The average length of follow-up was 25 months. Results were excellent in two patients and good in one. All patients had improvement in neurological status, were pain-free and demonstrated sound fusion within 5 months. A new approach to management of this rare clinical entity is documented.

Adolescent↗
PubMed1997

Prevention of postoperative late kyphosis in Pott's disease by anterior decompression and intervertebral grafting.

A total of 185 patients with Pott's disease were operated on between 1973 and 1992. Anterior decompression by preserving the pleura (extrapleural approach) was the preferred method in the thoracic spine. In the lumbar spine the approach was retroperitoneal, and interbody fusion was performed in both for the thoracic and the lumbar regions. Anterior decompression and intervertebral grafting comprised the treatment. In five patients, internal fixation accompanied anterior decompression and intervertebral grafting. The aim of instrumentation was to enhance anterior spinal stability, and Alici spinal instrumentation was the preferred device. Graft destruction and a late increase in kyphosis was prevented by this means. The mean follow-up period was 7.5 years. Thirty-two of the cases were admitted to the clinic because of Pott's paraplegia: 19 of the cases recovered completely following anterior decompression; partial recovery was observed in 5 cases; but 3 cases did not recover. Various complications, including seven deaths, were observed in 42 of the cases.

Adolescent↗
PubMed2001

[Atlanto-axial kyphosis].

Atlantoaxial kyphosis (AAK) is a rare sagittal deformity of the occiptoatlantoaxial junction. It is defined as a subgroup of anterior translatory atlantoaxial instability. AAK is a symptom of several ligamentours or bony disorders of the craniocervical junction; however, rheumatoid arthritis and trauma are the most common causes for AAK. AAK can be diagnosed on lateral radiographic views of the upper cervical spine if the angle between McGregor's line and the atlas plane is less than-15 degrees or the atlas-axis angle is greater 105 degrees. Treatment modalities for AAK depend on the ability to reduce the deformity. If closed reduction is achieved, posterior atlantoaxial fusion by sublaminar wiring according to Brooks or transarticular screw fixation according to Magerl are possible choices. Irreducible AAK can be treated with a combined transoral decompression, anterior plating according to Harms, and posterior wiring according to Brooks. This staged therapy for AAK was successful in our rheumatoid patient population with AAK.

Atlanto-Axial Joint↗
PubMed2001

[Principles of surgical treatment of upper thoracic and cervicothoracic kyphosis].

Idiopathic upper thoracic and cervicothoracic kyphoses are rare. More frequently they are the consequence of spinal instability as in neurofibromatosis (von Recklinghausen's disease), after laminectomies, in tumors, congenital disorders, spondylodiscitis, and fractures. Neurologic problems with severe pareses complicate these deformities. Anterior bone loss (fracture, tumor, spondylodiscitis), posterior instability (post-laminectomy kyphosis) or a combination of both are responsible for the deformity. The operative treatment of the anatomically unfavorable localization requires great experience in spinal surgery; the procedures often are salvage surgeries. In the absence of a successful conservative treatment, early posterior/anterior or anterior/posterior reconstruction of the sagittal profile with primary stable implants is necessary to minimize the risk of renewed surgery. Transplantation of stable bone grafts such as the fibula is a precondition for postoperative treatment without external support. The indication is restrictive in the presence of malignant primary and secondary tumors with poor prognosis. Restitution of existing neurologic deficits is unpredictable.

Adolescent↗
PubMed2001

[Correction of lumbosacral kyphosis in high grade spondylolisthesis and spondyloptosis].

Spondyloptoses, but also high-grade spondylolistheses, usually only develop at the lumbosacral junction and are nearly always classed among dysplastic spondylolistheses. Kyphosis of the lumbosacral junction leads to compensation mechanisms with increased lumbar lordosis and straightening of the pelvic tilt with involvement of the hip and knee joints. Reconstructing a physiological sagittal profile by more or less complete repositioning with permanent fusion of only the lumbosacral motion segment is thus of primary importance in the surgical management of high-grade spondylolisthesis and spondyloptosis. This aim led to the following treatment modality: Dorsal repositioning following sacral dome resection with subsequent intersomatic fusion with the posterior lumbar interbody fusion (PLIF) technique. This procedure was performed in 11 patients between January 1995 and January 1998 for six grade IV spondylolistheses and five spondyloptoses. Four patients had undergone previous surgery. Measurements of the slip angle (Boxall), sagittal translation (Taillard), sacral inclination (Boxall), and sagittal rotation (Wiltse and Winter) were done in the follow-up and to check the postoperative results. Denis' pain scale was used to classify pre- and postoperative complaints as well as those of the last examination. Only one inadequate repositioning occurred in a previously operated patient who required instrumentation from L4 to S1 after a pedicle screw had been torn out at L5. In another previously operated patient, the dura was damaged intraoperatively and managed accordingly. Postoperatively, this patient developed a unilateral nerve root syndrome, which did not improve in the further course. Another patient developed decompensation of the adjacent cranial motion segment in the follow-up period. In ten cases complete or nearly complete reposition was achieved. Firm bone consolidation was seen in all patients. Complaints were markedly reduced in all patients compared to the preoperative status.

Adolescent↗
PubMed2004

Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength.

This controlled trial was designed to investigate the influence of osteoporosis-related kyphosis (O-K) on falls. Twelve community-dwelling women with O-K (Cobb angle, 50-65 degrees measured from spine radiographs) and 13 healthy women serving as controls were enrolled. Mean age of the O-K group was 76 years (+/-5.1), height 158 cm (+/-5), and weight 61 kg (+/-7.9), and mean age of the control group was 71 years (+/-4.6), height 161 cm (+/-3.8), and weight 66 kg (+/-11.7). Quantitative isometric strength data were collected. Gait was monitored during unobstructed level walking and during stepping over an obstacle of four different heights randomly assigned (2.5%, 5%, 10%, and 15% of the subject's height). Balance was objectively assessed with computerized dynamic posturography consisting of the sensory organization test. Back extensor strength, grip strength, and all lower extremity muscle groups were significantly weaker in the O-K group than the control group (P <0.05), except right ankle plantar flexors (P =0.09). There was a significant difference in the anteroposterior and mediolateral displacements and velocities. The O-K subjects had less anteroposterior displacement, greater mediolateral displacement, reduced anteroposterior velocity, and increased mediolateral velocity compared with controls for all conditions of unobstructed and obstructed level walking. Obstacle height had a significant effect on all center-of-mass variables. The O-K subjects had significantly greater balance abnormalities on computerized dynamic posturography than the control group (P =0.002). Data show that thoracic hyperkyphosis on a background of reduced muscle strength plays an important role in increasing body sway, gait unsteadiness, and risk of falls in osteoporosis.

Accidental Falls↗
PubMed2001

Severe cervical kyphosis in osteopathia striata with cranial sclerosis: case report.

We report a 29-month-old girl with osteopathia striata with cranial sclerosis (OS-CS), who showed several unusual manifestations, including short stature, muscular hypotonia, short lingual frenulum, an accessory ear and a granuloma at the oral edge. The most unusual distressing finding was severe cervical kyphosis with a dysplastic cervical spine. MRI revealed impingement of the upper spinal cord. To clarify the mode of inheritance of this disease in this patient, we performed a methylation-specific PCR analysis. It eventually showed random inactivation of X-chromosomes, suggesting an autosomal dominant trait.

Bone Diseases, Developmental↗
PubMed2001

Surgical correction of Scheuermann's kyphosis.

This is a retrospective study of eight consecutive patients of mean age 19 (13-27) years with severe Scheuermann's kyphosis who underwent anterior and/or posterior fusion using the Cotrel-Dubousset (CD) instrumentation. In two an anterior release and fusion with rib grafts had been previously performed. The mean follow-up was 5 years. The preoperative hyperkyphosis averaged 86 degrees (71 degrees - 99 degrees), which was postoperatively 44 degrees (32 degrees - 58 degrees). The average loss of correction was 4.6 degrees (1 degrees - 12 degrees). The lumbar hyperlordosis spontaneously improved from -67 degrees to -48 degrees. Two patients, who had chronic back pain refractory to conservative treatment, improved considerably after surgery.

Adolescent↗