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At least 55 records · Page 3Linked to original sources
PubMed1986

[Stabilization of thoraco-lumbar spinal fractures using Harrington's equipment. Study of the evolution of spinal curvatures].

The radiographic results of treatment of unstable thoracolumbar spinal injuries by Harrington rods are reviewed. The loss of initial correction of kyphosis is 8 degrees on average. Correlation between good anatomical reduction and lapse of time before operation, level of instrumentation and solid spinal fusion exists. But, in burst fracture with deficient anterior pilar, the incidence of loss of reduction is important. The influence of Harrington rods on the spine is significant.

Adult↗
PubMed1983

Zielke instrumentation (VDS) for the correction of spinal curvature. Analysis of results in 66 patients.

Sixty-six patients who underwent anterior spinal fusion with Zielke instrumentation for thoracolumbar and lumbar curvatures were reviewed. Results compared favorably with reported series in which the Dwyer instrumentation system was used. The best corrections were obtained in the idiopathic single-curve group (45% correction of upper curve, 87% correction of lower curve, and 95% correction of instrumented curve) as compared with the double-curve group (33% correction of upper curve, 53% correction of lower curve, and 62% correction of instrumental curve). Vertebral body lateral translation (subluxation) was completely corrected in 87% of the patients. Instrumentation kyphosis can be prevented by placement of anterior wedge grafts in the intervertebral spaces. Complications were frequent but usually insignificant. The use of the Zielke instrumentation system offers the advantage of improved ability to derotate the spine while obtaining significant curve correction in a short fusion area.

Adolescent↗
PubMedDate not supplied

Subcutaneous rodding for progressive spinal curvatures: early results.

This study retrospectively reviewed the clinical records and radiographs of 11 patients with progressive early-onset scoliosis who failed to respond to nonoperative management and who underwent consecutive distraction of subcutaneous rods. Eleven children were treated by consecutive distraction of subcutaneous rods, and in two patients with rodding and anterior apical fusion. At surgery, the average patient age was 5.66 years, with a mean Cobb angle of 74 degrees and an average Pedriole angle of 39 degrees. The etiology of the scoliosis included four syndromic and one each congenital, post-rib resection, post-spinal tumor resection, neurofibromatosis, myelomeningocele, infantile idiopathic, and juvenile idiopathic. Subcutaneous rodding halted curve progression in all patients. At an average of 5.1 years after surgery, one patient showed no deterioration of the curve and nine patients showed an improvement of > or =40% in the magnitude of the original curvature. Eight of these patients had already had definitive surgery performed with segmental spinal instrumentation and fusion. Spinal growth occurred in all 11 patients and ranged from 0.5 to 4.5 cm (mean 2.0). Early results from these patients show that subcutaneous rodding with consecutive distraction allows correction of progressive early-onset scoliosis that failed to respond to nonsurgical management, preserving the individual growth potential of the spinal column and delaying definitive surgical treatment. Rotational deformity did not deteriorate radiographically, but clinical deformity increased subjectively. The amount of growth achieved and the number of procedures required to obtain these results raises the question of whether patients would be better served by a single anterior, posterior fusion and instrumentation at a young age.

Child↗
PubMed1999

[Correlation study between spinal curvatures and vertebral and disk deformities in idiopathic scoliosis].

Idiopathic scoliosis involves complex tridimensional (3D) deformations of the spine associated with intrinsic alterations (wedging) of vertebral bodies (VB) and intervertebral disks (ID). This study intends to evaluate analytically in vivo 2D and 3D scoliotic descriptors, based on clinical data from 40 thoracic curves of scoliotic adolescents, and to establish relationships between the regional curve deformations and the local VB and ID deformities. A multiplanar radiographic technique provided 3D positioning of vertebral landmarks. Cobb angle in the postero-anterior (PA) view, in the plane of maximum deformity (CobbP.Max) and the angular orientation of the plane of maximum deformity were used as regional descriptors. Vertebral body endplates were modeled as 3D oriented ellipses. Axial rotation, global PA and local frontal wedgings (inclinations of projected ellipses in the global and vertebral frontal planes), 3D maximum wedging (real inclination of adjacent ellipses) as well as the angular orientation of 3D wedging were calculated to characterize local deformations at the thoracic apex. Mean values for CobbPA, CobbP.Max and the angular orientation of the maximum deformity (with respect to the sagittal plane) reached 44 degrees, 48 degrees and 67 degrees respectively. On average, vertebral axial rotation, global PA, local frontal and 3D wedging angles were respectively 15 degrees, 8.3 degrees, 8.2 degrees and 9.7 degrees. Analyses indicated statistical correlation between: a) Cobb angles and vertebral wedging; b) the orientations of the maximum deformity and of 3D vertebral wedging; c) the axial rotation and CobbPA; d) the axial rotation and the angular orientation of 3D vertebral wedging. At the thoracic level, statistical analyses indicated that vertebral wedging and axial rotation increase with curve progression. Scoliosis severity, as measured by Cobb angles, evolves simultaneously to a coronalization of the plane of maximum deformity, revealing an hypokyphotic phenomenon, and to a real vertebral wedging shifting towards the frontal plane of the vertebra. These 3D in vivo analyses allowed interpretation of spatial relationships between regional and local scoliotic deformities. Compared to 2D in vivo or 3D in vitro analyses alone, this 3D in vivo study provides a more complete assessment of spinal curve progression to fully interpret the real 3D curvature and intrinsic deformations as well as their evolution processes.

Adolescent↗
PubMed1986

Spinal curvature, hand dominance and prolonged upper-extremity use of wheelchair-dependent DMD patients.

A study of 26 wheelchair-dependent patients with Duchenne muscular dystrophy aged between 11 and 23 years (average 16.5 years) showed no correlation between handedness or prolonged use of one upper extremity and convexity of the spinal curve. Severe, untreated scoliosis results in loss of function. A straight, stable spine allows patients to use their upper extremities functionally rather than for supporting the trunk.

Adolescent↗
PubMed1997

Analysis of symmetry of vertebral body loading consequent to lateral spinal curvature.

STUDY DESIGN: A biomechanical model was used to calculate muscle and intervertebral forces in a spine with and without a lumbar scoliosis. OBJECTIVES: To quantify the loading of the motion segments in a lumbar scoliosis. SUMMARY OF BACKGROUND INFORMATION: Scoliosis is thought to cause asymmetric loading of vertebral physes, causing asymmetric growth according to the Hueter-Volkmann principle. The magnitude of vertebral loading asymmetry as a function of scoliosis magnitude is unknown, however, as is the sensitivity of growth to asymmetric loading. METHODS: The analysis included five lumbar vertebrae, the thorax, and the sacrum/pelvis and 90 pairs of multijoint muscles. Five spinal geometries were analyzed: the mean spinal shape of 15 patients with left lumbar scoliosis (38 degrees Cobb angle, apex at L1-L2, the reference or "100%" geometry), and the geometry scaled to 0%, 33%, 67%, and 132% of the asymmetry of the reference shape. The muscle and intervertebral forces for maximum efforts opposing moments applied to the T12 vertebra in each of the three principal directions were calculated. The loading at each intervertebral level was expressed as the resultant force (P), the axial torque, the lateral and anteroposterior offset of P from the disc center, and the angle of P from the axial direction. RESULTS: With increasing scoliosis, there was a weak trend of increasing lateral offset of P, but not consistently to either the convex or concave direction. There was a much stronger trend of increasing angle between the force P and the motion segment longitudinal axis with increasing Cobb angle. Typically, this angle was 10-30 degrees for the largest scoliosis (51 degrees Cobb) and in a direction tending to increase the scoliosis. This angulation of the force results from shear loading of the disc. Axial torques tending to increase the transverse plane deformity increased with scoliosis for extension efforts. CONCLUSIONS: These analyses indicate that lumbar scoliosis produces asymmetric spinal loading characterized by shear forces tending to increase the scoliosis, but with little increase in the asymmetric compression of motion segments. If scoliosis progression results from asymmetric loading, it appears that the shear force component is responsible.

Adolescent↗
PubMed2004

[Role of sagittal spinal curvature in early dislocation after revision total hip arthroplasty: prospective analysis of 49 revision procedures].

PURPOSE OF THE STUDY: Hip dislocation after revision total hip arthroplasty (RTHA) is a frequent post-operative complication. Certain risk factors are well identified (nonunion of the greater trochanter, history of recurrent dislocation or infection, multiple procedures), the role of spine morphological remains to be fully examined. The purpose of this prospective analysis was to assess the role of spine morphology in post-operative dislocations. MATERIAL AND METHODS: Forty-nine patients who underwent RTHA between September 2002 and March 2002 were evaluated prospectively. A complete pre- and postoperative spinal work-up was available for all patients to evaluate the lumbopelvic static using the Legaye and Duval Beaupère morphology criteria and the pelvic-femoral angle to assess hip joint extension. Pre-, per- and post-operative data including the usual risk factors for dislocation related to the clinical situation and the technique used were recorded on a digital datasheet. Five patients developed postoperative dislocation despite the absence of defective implant position. There was no relation with access (p=0.832) or pelvic-femoral angle (p=0.515). RESULTS: The mean value of the sacral slope was significantly different (p=0.006) in patients who developed dislocation in comparison with the other patients. This difference remained significant (p=0.017) for the cohort of 33 patients who had no associated risk factor for postoperative dislocation (history of recurrent dislocation or infection, multiple procedures, tight nonunion of the greater trochanter). DISCUSSION: Our results suggest that the morphology of the lumbar spine can be involved in the risk of postoperative dislocation. The morphology of the lumbar spine affects the pelvic static and thus the landmarks usually used for implantation, but it can also limit the amplitude of pelvic movement when changing from the sitting to the standing position, which would be compensated for by greater hip movement, particularly extension. The method we used did not fully take into account the consequences of changes in spinal balance due to thoracic deformations nor to analgesic (or not) hip flexion and subsequent deformation of the lumbar spine.

Hip Dislocation↗