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At least 343 records · Page 19Linked to original sources
PubMed2000

Case study: acceleration/deceleration injury with angular kyphosis.

OBJECTIVE: To discuss the case of a patient who received upper cervical chiropractic care after trauma-induced arcual kyphosis in the cervical spine. A practical application of conservative management for posttrauma cervical spine injury in the private office setting is described. CLINICAL FEATURES: A 17-year-old female patient suffered an unstable C3/C4 motor segment after a lateral-impact motor vehicle collision. Additional symptoms on presentation included vertigo, tinnitus, neck and shoulder pain, and confusion. INTERVENTION AND OUTCOME: Conservative management consisted exclusively of upper cervical-specific adjustments guided by radiographic analysis and paraspinal bilateral skin temperature differential analysis of the cervical spine. During 10 weeks of care and 22 office visits, all symptoms subsided and the instability of C3/C4 motor segment appeared to be completely resolved. CONCLUSION: This study provides support for the use of upper cervical chiropractic management in cervical spine trauma cases. The clinical work-up consisted of physical examination, radiographic analysis, computer-administered and scored cognitive function testing, and audiometric examination. After conservative care, these examinations were repeated and demonstrated that the objective findings concurred with the subjective improvements reported by the patient.

Acceleration↗
PubMed1999

Biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis: a pilot study.

OBJECTIVES: Patients with ankylosing spondylitis may experience a progressive spinal kyphosis, which induces a forward and downward displacement of the centre of mass (COM) of the trunk. In this pilot study, the possible mechanisms used to compensate for the displacement of the trunk COM were analysed. METHODS: Joint angles of hip, knee and ankle were determined in four patients with ankylosing spondylitis and compared to data of 18 healthy subjects. Each patient stood on a force platform and had to adopt several predefined postures, which were recorded by a video camera. RESULTS: In three patients, the hips were flexed when standing relaxed, and in all patients hip extension was limited. The knee angles of three patients were smaller and in two patients the angle of the ankles was larger compared to healthy subjects. CONCLUSIONS: The results suggest that the hip joints are at least no longer involved in balance control. This may imply that conservative therapy should focus on the prevention of restriction of the hip joints.

Adult↗
PubMedDate not supplied

Cognitive strategies and self-esteem as predictors of brace-wear noncompliance in patients with idiopathic scoliosis and kyphosis.

Psychological determinants of brace-wear compliance were analyzed among 113 patients who used a brace because of an adolescent idiopathic scoliosis (92%), kyphosis (5%), or both (3%). The results showed that noncompliant girls did not expect to succeed in dealing with scoliosis and that they were anxious about the possibility of failure. They also had low self-esteem and did not seek social support from other people. Noncompliant boys, in contrast, had high self-esteem and high achievement success expectation. Among patients with a short time of brace use, low compliance was best predicted by low amount of reflective thinking and a good body-image. In turn, among patients who had used the brace for >6 months, low compliance was best predicted by high amount of reflective thinking, poor body-image, low social success expectation, and low master orientation in social behavior. Only sleeping problems predicted compliance across gender and the time of brace use: the more the patients experienced sleeping problems, the less they used the brace.

Adolescent↗
PubMedDate not supplied

Determination of "normal" thoracic kyphosis: a roentgenographic study of 121 "normal" children.

The purpose of this prospective study was to determine the range of "normalcy" in the radiologic measurement of thoracic kyphosis in children by using a standardized position and full-length radiograph in 121 normal children. Using +/- two standard deviations from the mean as the definition of "normal," a range of 20 degrees - 50 degrees was determined. There was no difference between the various age subgroups or between genders.

Adolescent↗
PubMedDate not supplied

Anterior vascular pedicle bone grafting for the treatment of kyphosis.

A technique of anterior strut grafting for the management of kyphosis is presented. The procedure consists of rotating a rib on its intact intercostal blood supply and then keying it in over the appropriate length of spine to be fused. This technique appears to be an attractive alternative to an avascular rib or fibula allograft where a graft fracture may develop during the process of bony consolidation.

Adolescent↗
PubMedDate not supplied

Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis.

In order to establish a sagittal plane curve reference table for standing subjects examined laterally, we determined an easily reproducible standard posture. A sample of 100 healthy subjects from 20 to 29 years of age, was chosen (43 women, 57 men). The reciprocal angulations of each vertebral body in relation to the others were fed into a digitalizer and studied by computer. The study particularly concerns maximum kyphosis, maximum lordosis, sacral base slopes, and the tilt of intermediate vertebral bodies. The dispersion of the results is remarkably wide and, within the extreme values, the distribution is irregular. Individual correlations of these values are often dispersed, but spinal morphotypology. For considerable lengths, average values cannot be used as norms, given the wide span of values. Only the extreme limits are useful for the appreciation of curves as excessive, insufficient, or inverted.

Adult↗
PubMed1985

Surgical reconstruction of late post-traumatic thoracolumbar kyphosis.

Thirty-four patients underwent surgery for late post-traumatic thoracolumbar kyphosis. Indications for surgery included increasing kyphotic deformity, pain, or increasing neurologic deficit. Procedures included anterior spinal fusion only, posterior spinal fusion only, anterior and posterior fusions as staged procedures, and anterior and posterior fusions under the same anesthetic. Eighteen of the patients with anterior fusions also underwent decompression of the spinal cord by resection of the vertebral body. Stable fusion with halt in progression of deformity was obtained in 33 of the 34 patients by following basic biomechanical principles.

Adolescent↗
PubMed1987

Double L-rod instrumentation in the treatment of severe kyphosis secondary to Scheuermann's disease.

Patients with untreated kyphosis secondary to Scheuermann's disease occasionally develop significant deformities associated with pain in adult life. When these painful deformities do not respond to conservative measures, surgery may be indicated. This report describes a two-stage surgical technique for correction of the deformity. First, an anterior spinal release and fusion is performed and is followed 7-10 days later by a posterior spinal fusion with double L-rod instrumentation. L-rod instrumentation has the advantage that no postoperative immobilization is necessary, which allows the patient to return to a relatively normal life-style in the immediate postoperative period. Excellent maintenance of correction of the deformity in these patients has occurred with no serious complication to date in 24 patients followed from 19 months to 4 years although "transient hyperesthesia" occurred in 16% of patients. A longer follow-up will be necessary to evaluate fully possible late pseudarthrosis and instrumentation failure in this group of patients.

Adolescent↗
PubMed1988

Combined single stage anterior and posterior osteotomy for correction of iatrogenic lumbar kyphosis.

Fifty-four patients were treated by a standardized single stage anterior opening wedge and a posterior closing extension wedge osteotomy for back pain associated with postoperative loss of lumbar lordosis (iatrogenic flat back syndrome). Presenting complaints were fatigue, pain and a stooped posture. Etiological factors were, in descending order of frequency, distraction instrumentation with the lower end at the L5 or S1 vertebra, thoracolumbar junction kyphosis greater than 15 degrees, especially if associated with a hypokyphotic thoracic spine, and degenerative changes above and below a previous fusion. Kostuik-Harrington instrumentation was used anteriorly for the opening wedge and Dwyer cables and screws together with a midline plate were used posteriorly for the closing extension osteotomy. Malunion occurred in three patients, one requiring recorrection. Pain relief occurred in 48 (90%). Neurological complications occurred in two patients, one with permanent deficient. Follow-up averaged 4 years. Average preosteotomy lordosis L1-S1 was 21.5 degrees and was restored to 49 degrees (equal to the lordosis before the initial surgery) for an average correction of 29 degrees, (range 24 degrees to 63 degrees). Prevention of this complication can be accomplished by maintaining normal lordosis at the time of initial surgery.

Adolescent↗
PubMed1989

Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis.

Thirty-seven patients underwent surgery for late post-traumatic kyphosis in the lumbar, thoracolumbar, or thoracic spine. Indications for surgery included: increasing deformity, pain, and persistent neurologic deficit with paraparesis in eight, and development of late spinal stenosis in a further nine patients. All patients underwent anterior correction with Kostuik-Harrington instrumentation. Seventeen patients with neurologic deficit underwent decompression over appropriate levels as well. No posterior fusions or instrumentation were carried out. Stable arthrodesis with correction of the deformity occurred in 36 of 37 patients with only one nonunion. Pain was reduced significantly in 78% of patients. Late neurologic improvement of a significant functional degree occurred in three of eight paraparetics. All patients with spinal stenosis had relief of their symptoms and signs.

Adult↗
PubMed1989

Anterior extension of the thoracic vertebral bodies in Scheuermann's kyphosis. An anatomic study.

Changes consistent with Scheuermann's kyphosis were noted in 103 specimens (7.4%) of a sample of 1,384 thoracic spines in the Hamann-Todd collection of human skeletons. In 94% of the affected vertebrae, a distinct anterior elongation of the vertebral centrum was present. This anterior extension was composed of mature cancellous bone and was morphologically and roentgenographically different from marginal osteophyte formation. It was not present in any vertebrae of a control group of 50 unaffected spines. Associated findings included vertebral wedging and Schmorl's nodes.

Adolescent↗
PubMed1993

One-stage "front" and "back" correction for rigid cervical kyphosis. A safer technique of correction for a rare case of adult-onset Still's disease.

This report describes a new safe technique for surgical correction of rigid cervical kyphosis, in a very rare case of adult-onset Still's disease. It differs from all the previously mentioned reports of similar corrective osteotomies, the essential difference being a combined anterior (front) and posterior (back) approach performed at one stage (under a single anesthesia). The "front" is a release procedure of an open-wedge variety, and the "back" is a closed-wedge type of osteotomy. Such a double procedure ensures a slow and controlled correction at the preoperatively determined level, rather than a snapshot, rapid, and often a violent correction, which may occur at an undesired level. This osteotomy is performed under general anesthesia after an endotracheal intubation by a special "guided" maneuver. This new technique, the authors believe, is only a more comfortable option for the surgeon, but also a safer alternative for the patient.

Adult↗
PubMed1994

Computer-assisted curvature assessment and Cobb angle determination of the thoracic kyphosis. An in vivo and in vitro comparison.

STUDY DESIGN: A retrospective survey of thoracic spinal curvature compared postmortem radiographs with recent clinical films in 22 cases. OBJECTIVES: This study was performed to determine whether spinal curvature measured from postmortem radiographs is a valid measure of curvature in vivo. SUMMARY OF BACKGROUND DATA: Little quantitative data have been cited on whether sagittal plane thoracic spinal curve characteristics change after death. METHODS: Thoracic kyphosis was measured using the Cobb method and the mean radius of curvature from computer-assisted digitizing of the vertebral contour. Thoracic segments visualized on the chest films were referenced to the postmortem radiograph. RESULTS AND CONCLUSIONS: The in vivo and in vitro measurements strongly correlated (Cobb angle r = 0.95, curvature r = 0.78). Trends decreased slightly in Cobb angle (1.3%, -2.6%) and increased slightly in curvature (10.7 mm, 4.1%). Differences were not significant, however, supporting the use of spinal curvature analysis with postmortem radiographs.

Aged↗
PubMed1997

Twenty-eight-year follow-up of anterior and posterior fusion for congenital kyphosis. A case report.

STUDY DESIGN: Case report and long-term follow-up. OBJECTIVES: To answer the question of whether the operation performed was worthwhile and lasting. SUMMARY OF BACKGROUND DATA: Congenital kyphosis due to defects of vertebral body formation has a high incidence of paraplegia if not surgically stabilized. Traditional posterior spine fusion failed for such problems. METHODS: Radiographic and photographic evidence of the patients's problem, the combined anterior and posterior surgery, and at a 28-year follow-up available. RESULTS: Surgery at age 13 prevented paraplegia, but also gave correction of deformity and permitted a normal life. CONCLUSIONS: Combined anterior and posterior spinal fusion is a good operation with lasting value for this condition.

Adolescent↗
PubMed1997

Chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture. Report of three cases.

STUDY DESIGN: A description of the clinical picture of chylous leakage after spinal surgery. OBJECTIVES: To present the clinical course of three cases of chylous leakage after spinal surgery and to discuss the pathogenesis of the disease. SUMMARY OF BACKGROUND DATA: Chylous leakage is a rare complication after spinal surgery. It has been attributed to direct injury of a lymphatic trunk or one of its major tributaries by surgical maneuver. METHODS: Three cases of chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture were reported. RESULTS: All of the three cases were managed successfully; two cases of chyloretroperitoneum detected within 4 days after surgery were healed conservatively, but one case of chylothorax of which the onset was noticed 5 weeks after spinal surgery, required surgical ligation of the thoracic duct and pleurodesis. CONCLUSION: Early detection of this disease is important for a good prognosis. Retroperitoneal drainage is necessary for the detection and management of chyloretroperitoneum. The pathogenesis and management of the chylous leakage are discussed in this report.

Adult↗
PubMed2002

Partial lumbosacral kyphosis reduction, decompression, and posterior lumbosacral transfixation in high-grade isthmic spondylolisthesis: clinical and radiographic results in six patients.

BACKGROUND: In an attempt to increase fusion while decreasing the neurologic risk associated with complete reduction of high-grade spondylolisthesis, the authors have used a technique of partial lumbosacral kyphosis reduction, posterior decompression, and pedicle screw transfixation of the lumbosacral junction. OBJECTIVE: To determine if this technique is effective in treatment of high-grade spondylolisthesis. STUDY DESIGN: A retrospective review of six patients with high-grade spondylolisthesis treated by this technique was performed. There were four female patients (ages 16 years [n=2], 23 years [n=1], and 29 years [n=1]) and two male patients (both 13 years of age) with spondylolisthesis ranging from Grade IV to Grade V. All patients presented with pain and radiculopathy. After surgery the patients were evaluated for resolution of symptoms, sagittal alignment, fusion, and satisfaction. The radiographic measurements included the slip angle, the percentage slip, and the sacral inclination. An SRS outcome score was also obtained on all six patients to evaluate postoperative outcome, in terms of pain control, self-image perception, and return to function. RESULTS: The average length of follow-up was 42.6 months (range 24-60 months). All patients evidenced solid fusion by the 6-month follow-up (based on oblique radiographs showing lateral bridging bone masses). The slip angle was improved from 62 degrees to 28 degrees (P < 0.5), whereas there was no significant improvement in the percentage slip or the sacral inclination (89-80% and 28-37 degrees, respectively). No progression of the slip angle or percentage slip was noted on the follow-up radiographs. Complications included two intraoperative dural tears that were identified and repaired. There were no neurologic complications. The SRS outcome instrument demonstrated good postoperative pain control, function, self-image, and satisfaction in all patients. CONCLUSION: In high-grade spondylolisthesis, this posterior approach is safe and effective in obtaining a solid arthrodesis, restoring sagittal balance, and improving function. These results reinforce the impression that it is the partial reduction of the slip angle, not the percentage slip, in high-grade spondylolisthesis that is important in obtaining optimal results.

Adolescent↗
PubMed1983

Xeroradiography in spinal kyphosis.

An attempt was made to evaluate the usefulness of xerozonography in spinal kyphosis in children. A direct comparison with conventional film zonography showed that xerozonography yielded considerably better visualisation of all the lesions examined. The procedure, however, resulted in a higher radiation dose. For this reason its clinical use should be restricted to cases in which film radiography fails to demonstrate a lesion adequately.

Child↗