Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SCOLIOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed1995

Variability in Cobb angle measurements in children with congenital scoliosis.

The variability in measurement of angles in congenital scoliosis is not known, but it is postulated that it is larger than that in adolescent idiopathic scoliosis due to skeletal immaturity, incomplete ossification, and anomalous development of the end-vertebrae. To determine this variability, we selected 54 radiographs of adequate quality showing 67 scoliotic curves from children with congenital scoliosis. The end-vertebrae were preselected. Each curve was measured by the Cobb method on two separate occasions by six different observers, using the same goniometer and marker. The intraobserver variability was +/- 9.6 degrees and the interobserver variability +/- 11.8 degrees. If 'significant progression' is to be used as a criterion for surgical fusion in congenital scoliosis, there should be at least a 23 degrees increase, the entire range of the interobserver variability, in the curvature to ensure that the perceived increase is not due to variability in measurement.

Analysis of Variance↗
PubMed1995

Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis.

STUDY DESIGN: This retrospective clinical study compared the results of correction of idiopathic thoracic scoliosis using Cotrel-Dubousset segmental pedicle screw fixation with those of hooks and screws inserted in a hook pattern. OBJECTIVES: The study's objective was to evaluate the efficacy and safety of segmental pedicle screw fixation in the management of idiopathic thoracic scoliosis. SUMMARY OF BACKGROUND DATA: Seventy-eight idiopathic thoracic scoliosis patients were treated with Cotrel-Dubousset instrumentation from 1987 to 1991. Thirty-one were treated with hooks; 23 were treated with pedicle screws inserted in a hook pattern; and 24 were treated with segmental pedicle screws. METHODS: After a minimum follow-up of 2 years (range, 25-52 months), the results of frontal, sagittal, and rotational correction of each group were compared and statistically analyzed using analysis of variance. RESULTS: Major curve correction was 55% with hooks, 66% with hook pattern screws, and 72% with segmental screws, with loss of correction of 6%, 2%, and 1%, respectively. Compensatory curve correction was 57% with hooks, 67% with hook pattern screws, and 70% with segmental pedicle screws. In patients with hypokyphosis, all showed significant improvement with best restoration in segmental screws. Rotational correction of the apical vertebra measured by the Perdriolle method was 19% with hooks, 26% with hook pattern screws, and 59% with segmental screws. Thirteen screws (3%) were malpositioned, but they did not cause neurologic impairment or adversely affect the results of treatment. CONCLUSIONS: Segmental pedicle screw fixation is a safe and effective method for correcting the triplanar deformity of the idiopathic thoracic scoliosis.

Adult↗
PubMedDate not supplied

Effectiveness of TLSO bracing in the conservative treatment of idiopathic scoliosis.

A clear understanding of the effectiveness of the thoracolumbosacral orthosis (TLSO) as a conservative treatment for idiopathic scoliosis is still necessary. In the past few years, the review of pertinent literature has emphasized the lack of properly matched control studies and erroneous interpretations of results due to the use of univariate analysis. Also, in a previous controlled study evaluating the bracing of idiopathic scoliosis, the researchers mixed different types of braces and patients. Therefore, their findings were not specific to any kind of orthosis. In our study, we responded to these criticisms by providing a homogeneous group of patients with a control group and by conducting a multivariate analysis to assess the effectiveness of the TLSO. All the patients at the University Pediatric Hospital Scoliosis Clinic aged 8 through 15 with initial Cobb's angle between 20 and 40 degrees and evidence of progression were assessed. All the patients who used the TLSO and showed full compliance with treatment (n = 54) were compared with a control group. The control group consisted of the patients who needed the treatment with the brace but did not use it for several reasons (n = 47). Neither group showed significant differences in sex, initial age, initial Cobb's angle, menarche, Risser sign, or curve pattern. The mean follow-up period was 3.3 years after skeletal maturity. The results were analyzed using a multivariate analysis because the natural history of scoliosis is determined by multiple factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Scoliosis in the patients with both severe mental retardation and severe physical disability--computed tomography of paraspinal muscles].

Patients with both severe mental retardation and severe physical disability, so-called "jushouji", often have scoliosis as one of the complications. The correlation between radiological findings of paraspinal muscles and progression of scoliosis was investigated by computed tomography (CT) in 15 patients. We took the CT of paraspinal muscles at the apical vertebral level in each patient, and measured the size of cross-sectional area and the CT value of paraspinal muscles of the both concave and convex side. There was no significant difference of the size of cross-sectional area of the muscles between the convex and concave side. The average CT value of the muscles was normal on the convex side, but abnormally lower on the concave side. Scattered low density areas were recognized in the fascicles of both sides like moth eaten appearance, which was speculated as fatty tissue. The CT value of remaining muscles was within normal range. The CT value on the concave side became lower as the degree of scoliosis progressed. The group who could not keep sitting position independently showed lower CT value on the concave side and had more severe scoliotic curves than the group who could sit independently or with slight support. From the above results, it may be concluded that the paraspinal muscles of the concave side become secondarily atrophic due to disuse, and may not be responsible for the progression of the scoliosis.

Adolescent↗
PubMed1994

Scoliosis secondary to rib resection.

The case histories of 11 patients (five adults and six children) who presented with scoliosis after multiple rib resection for several disorders were reviewed. All 11 cases developed scoliosis with the convexity directed toward the side of the rib resection. The natural history of the scoliosis was progressive, and the younger the age at the time of rib resection, the more severe the progression. The rate of progression was greatest during the first 10 years after rib resection. The five patients who presented as adults were treated in several ways, only one requiring spine fusion. However, five of the six children required spine fusion to prevent progression of scoliosis.

Adolescent↗
PubMed1994

Scoliosis in Rett syndrome.

Scoliosis is the most common orthopaedic problem encountered in Rett syndrome. It is characterized by a long C-shaped thoracolumbar curve of neurologic origin. The occurrence of scoliosis in Rett syndrome is age-dependent, with a reported incidence of 36% to 100%. The onset of scoliosis is usually before age 8 years, and rapid curve progression is usually detected early in the second decade. In Rett syndrome, sagittal deformity with excessive kyphosis can progress and necessitates close observation. Orthotic treatment does not alter the natural history of scoliosis or kyphosis. Indications for surgery are curve progression exceeding a 40 degree or 45 degree Cobb angle or curves that cause pain or loss of function. Anterior discectomy, interbody fusion, and posterior fusion with instrumentation can achieve improved correction in young adolescents with significant curves. Surgical intervention should include fusing the scoliotic and the excessively kyphotic segments.

Adolescent↗
PubMed1994

[The value of MRI in the preoperative assessment of scoliosis].

Clinical and radiological data of 48 patients with scoliosis who underwent routine MRI were reviewed to elicit the value of MRI in the preoperative assessment of complex spine deformities. Because of its high diagnostic sensitivity MRI gives a new insight into the true incidence of spinal cord pathology in scoliosis. Moreover, it identifies clinically unsuspected dysraphia in a surprisingly high percentage of neurologically asymptomatic patients with left-sided scoliosis. Exact planning of operative interventions is facilitated by the comprehensive diagnostic information gained through MRI. Furthermore, MRI generally allows one to refrain from invasive, high-irradiation techniques such as myelography and contrast-enhanced CT. On the basis of the presented investigational data, routine use of MRI is conclusively recommended in patients with congenital or idiopathic left-sided scoliosis.

Adolescent↗
PubMed1975

Experimental scoliosis in primates. Failure of a technique.

An attempt to produce scoliosis in young baboons by excision of the heads of ribs failed in thirteen growing animals observed for up to a year after operation. Other investigators have failed to produce scoliosis in primates by similar and other techniques that had successfully produced scoliosis in quadruped animals. The possible reasons for this are discussed, especially in the light of clinical trials that are being carried out with techniques transposed from the quadruped experimental animal to the scoliosis clinic.

Animals↗
PubMed1993

[Good results of surgical treatment of idiopathic scoliosis using the Cotrel-Dubousset technique].

OBJECTIVE: To determine the results and complications of the Cotrel-Dubousset (CD) operation in idiopathic scoliosis. DESIGN: Retrospective. SETTING: Wilhelmina Children's Hospital, Utrecht, and University Hospital, Leiden. METHOD: Of the first 22 patients with idiopathic scoliosis operated on with CD instrumentation the results were determined: the Cobb angle, the percentage of rotational correction achieved, duration of the operation, amount of blood loss, complications and duration of the postoperative hospital stay. RESULTS: Compared with the Harrington technique, there were fewer complications resulting from instrumental failure (three in all), while the correction of the scoliosis was the same and in some cases even better. Advantages of the CD operation for the patient were rapid mobilization, short postoperative hospital stay and short duration of the after-treatment with use of a removable light plastic corset. CONCLUSION: The Cotrel-Dubousset operation appears to be a promising method for the treatment of patients with idiopathic scoliosis.

Adolescent↗
PubMed1996

Urological problems after surgical treatment of scoliosis in children with myelomeningocele.

PURPOSE: We assessed urological problems and complications after scoliosis surgery in children with myelomeningocele. MATERIALS AND METHODS: A total of 16 children with myelodysplasia underwent surgery for scoliosis using different surgical techniques and instrumentation systems. Mean patient age at operation as 11 years and mean postoperative followup was 3 years. All patients had urological assessment before and after surgery, including urodynamics. RESULTS: Urological problems after surgical correction of scoliosis developed in 6 patients (38%). Three girls had difficulty performing clean intermittent self-catheterization postoperatively because of altered body posture, a genital pressure sore and a plaster body cast, respectively. In 4 patients, including 1 girl with problems performing clean intermittent self-catheterization, lower urinary tract function was altered, leading to upper urinary tract deterioration in 1 and worsening of urinary incontinence in 3. CONCLUSIONS: Children with myelomeningocele have a high incidence of urological complications after surgical treatment of scoliosis. Anticipation of the problems and a thorough postoperative urological evaluation, including urodynamics, can reduce morbidity and facilitate appropriate treatment.

Child↗
PubMed1996

[Screening for scoliosis in western Galilee schools].

Scoliosis screening is still under debate. It is generally agreed that it is not cost-effective, but some still favor it as integral to preventive medicine. Among 2940 school children, aged 9 - 13, from several Moslem-Arab villages in the western Galilee, 55 (1.9%) were found to have some deformity on physical examination and were referred for spinal X-ray. Of these, 24 were X-rayed and in 20 of them there was a scoliosis of more than 7 degrees. The prevalence of in-family marriage in those with deformities was 31%, not significantly different from the 35% found in their communities. Using the worst-case analysis, the Moslem-Arab population of western Galilee cannot be regarded as a population at risk for scoliosis. Considering the poor cooperation of the parents with further investigation, we conclude that scoliosis screening should not be performed in this community.

Adolescent↗
PubMed1996

Radiological parameters associated with the evolution of degenerative scoliosis.

The risk factors related to the evolution of the degenerative adult scoliosis are investigated. A review was conducted of the the radiographs of 162 women (mean age 65 years) with degenerative scoliosis who were examined at the Research Center for Diseases of the Musculoskeletal System "Th. Garofalidis" Orthopaedic Department, at the Medical School of Athens University, during the period of 1985 through 1994. Only patients with degenerative lumbar curves greater than 10 degrees and only patients with no previous history of scoliosis were included in the study. The mean follow-up was 8 years (range 5-30 years) and for 30 patients the follow-up period was more than 10 years. The research demonstrated that the degenerative changes of the spine may relate to appearance and evolution of scoliotic curves in adults. Additionally, it was found that the risk factors that are associated with the evolution of the degenerative adult scoliosis are: curves over 30 degrees; curves having Grade II and III rotation; curves that are imbalanced and have a secondary compensatory curve that is sharp and angular at the L4-S1 level; curves in which the apex is at the L2-L3 and L3-L4 area; an intercrest line through the L5 vertebra; and vertebral translation equivalent to or more than 6 mm.

Aged↗
PubMed1996

Juvenile progressive scoliosis and congenital horizontal gaze palsy.

Eleven articles reporting 39 patients with the combination of progressive scoliosis and familial congenital gaze palsy have now been published. This disorder appears to be caused by a malfunction of the normal equilibrial control mechanism related to the brainstem or the central nervous system. The scoliosis progresses when the children begin to walk. Even when they are treated with physiotherapy or brace, they often require early operation. We consider that progressive juvenile or infant scoliosis associated with familiar congenital horizontal gaze palsy constitutes a clinical entity. We report two sisters with congenital gaze palsy, in one of whom scoliosis of at least 70 degrees (Cobb) developed, and review and analyze all cases published until now.

Child, Preschool↗
PubMed1996

[Dorso-lumbal pain and idiopathic scoliosis in adolescence].

Current knowledge on the association between back pain and idiopathic scoliosis is often contradictory. The presence, localisation and importance of pain was evaluated for a cohort of 426 adolescents with AIS. Patients were recruited from a scoliosis clinic in a pediatric hospital. A questionnaire and an analogue visual scale graduated from 0 (no pain) to 100 (maximal pain) were used in order to verify more precisely, the importance of the association between AIS and back pain. Chisquare, linear regression and Student T-test were used for statistical analysis. 239 patients with right thoracic and left lumbar curves (RTLL) had a prevalence of pain of 54%. The mean of maximum pain intensity was 49 mm +/- 20. No relation was found between the severity of the scoliosis and back pain. The two groups (with and without pain) were comparable. Cobb angles were about the same for the thoracic and lumbar regions, as well as kyphosis and lordosis, weight, height and age. Risser sign, sex, brace and pelvic tilt were the only variables associated with pain (p < 0.0001). Association between AIS and pain is more frequent than generally reported. Pain appears to be more related with pelvic tilt than severity of the scoliosis.

Adolescent↗
PubMed1996

Deliberate hypotensive anesthesia with labetalol in reconstructive surgery for scoliosis.

BACKGROUND: Anesthesia for surgical reconstruction of scoliosis presents a great challenge for anesthesiologists. One of the main concerns is massive bleeding. Hypotensive anesthesia has been advocated for the purpose of diminishing operative blood loss. On the other hand, some authors reported that the blood loss mostly depends on surgical technique, rather than anesthetic technique. We hereby evaluate the efficacy of deliberate hypotensive anesthesia and compare its merits and faults with that of normotensive anesthesia in scoliosis surgery performed by a single surgical and anesthetic team. METHODS: The effect of deliberate hypotensive anesthesia on intraoperative blood loss, blood transfusion, and length of surgery in patients who underwent Cotrel Duvosset Instrumentation for scoliosis was assessed. Twenty patients (Group A) were given isoflurane as the main anesthetic agent and their blood pressure was maintained at the preoperative level. These patients were compared with twenty patients (Group B) who were anesthetized with isoflurane and their intraoperative mean blood pressure was lowered and controlled at 50 mmHg by intravenous labetalol. All these forty operations were done by a single surgical and anesthetic team. The results were analyzed by the Student's t-test. RESULTS: Deliberate hypotensive anesthesia was found to significantly decrease the average blood loss by nearly 55 per cent, reduce the need for transfusion by nearly 53 per cent, and shorten the average operating time by over one hour. No complications attributable to the specific anesthetic technique occurred. CONCLUSIONS: The findings of this study suggest that deliberate hypotensive anesthesia with labetalol and isoflurane may be of benefit in scoliosis surgery by reducing blood loss, the need of blood replacement and operating time.

Adolescent↗
PubMed1997

Direct spinal curvature digitization in scoliosis screening--a comparative study with Moiré contourgraphy.

The forward bending test, widely used in scoliosis screening, is associated with high false-positive rates. We postulate that direct surface measurement of the spinal curvature by digitization of the spinous processes used in combination with the forward bending test could increase the predictive value of detecting scoliosis without sacrificing sensitivity. Sixty consecutive patients referred from a school screening program were included in this study. All had moiré contourgraphy, spinous process digitization, and erect frontal radiographs of the spine. The number of false positives from the forward bending test was 35. Moiré contourgraphy did not reduce the number of false positives significantly. A posterior spinal deformity of 10 degrees or more predicted scoliosis in all patients, with 15 false-positive readings. Direct measurement of the spinal curvature by spinous process digitization can be an effective second-stage screening tool for scoliosis in centers where all the screened positives are referred to a single center.

Adolescent↗
PubMed1997

Prevalence of perioperative complications after anterior spinal fusion for patients with idiopathic scoliosis.

Anterior spinal fusion (ASF) has been proven to improve curve correction, save motion segments, and decrease the rate of pseudarthrosis when compared with posterior spinal fusion alone. However, in patients with idiopathic scoliosis, the complication rate of the anterior approach to the spine using current techniques has only been scantly defined in the literature. This is a retrospective review of consecutive patients who underwent primary ASF for idiopathic scoliosis to determine the prevalence and types of complications specifically related to the anterior approach. All patients who underwent primary ASFs for idiopathic scoliosis done by one of two orthopaedic surgeons between October 1986 and July 1992 were reviewed. Adequate records were available for 98 of 103 patients. The average age at time of surgery was 22 years (range, 10-60 years). Complications were divided into three groups: major (resulting in permanent sequelae or necessitating a second major operation); minor (resulting in a prolonged hospital stay, necessitating a minor operation, and/or resulting in a significant temporary hardship or persistent minor problem); and insignificant (anything less than minor). One of 98 patients had a major complication (a pelvic deep venous thrombosis that required operative thrombectomy). Twenty-five of 98 patients had 28 complications classified as minor, and 28 of 98 patients had 30 complications classified as insignificant. Smoking was a significant risk factor for the development of minor complications. There was no statistically significant relationship between the development of complications and the degree of curve, the approach used, the procedure performed, or the performance of rib resections. The anterior approach to the spine in patients with idiopathic scoliosis in this series was very safe, with only one major complication in 98 patients. However, minor and insignificant complications were quite common, occurring in 45 of 98 patients (46%). Smoking was a significant risk factor for minor complications.

Adolescent↗
PubMed1998

Adverse reproductive outcomes among women exposed to low levels of ionizing radiation from diagnostic radiography for adolescent idiopathic scoliosis.

In a cohort of women followed up for adolescent idiopathic scoliosis, we assessed the association between exposure to ionizing radiation from diagnostic radiography received in adolescence and subsequent adverse reproductive outcomes in adulthood. We estimated risk for unsuccessful attempts at pregnancy, spontaneous abortions, low birthweight (<2,500 gm), congenital malformations, and stillbirths according to dose to the ovaries. We used regression models for binary and continuous outcomes, accounting for key covariates and for clustering in the data that arose from women having multiple pregnancies. Risks in the adolescent idiopathic scoliosis cohort were higher than in the reference group for unsuccessful attempts at pregnancy [adjusted odds ratio (OR) = 1.33; 95% confidence interval (CI) = 0.84-2.13], spontaneous abortions (OR = 1.35; 95% CI = 1.06-1.73), and congenital malformations (OR = 1.20; 95% CI = 0.78-1.84), but the odds ratios did not increase monotonically by dose to the ovaries. There were fewer stillbirths (OR = 0.38; 95% CI = 0.15-0.97) and low-birthweight infants in the adolescent idiopathic scoliosis cohort (OR = 0.84; 95% CI = 0.59-1.21). Nevertheless, when the analysis of low birthweight was restricted to the adolescent idiopathic scoliosis cohort, the adjusted odds ratios were found to increase by quartiles of dose (median dose of 0.69 cGy): 1; 1.43 (95% CI = 0.54-3.90); 2.24 (95% CI = 0.89-5.94); and 2.34 (95% CI = 1.02-5.62). We also found that the adjusted mean birthweight decreased with increasing dose by 37.6 gm per cGy (standard error = 23.5 gm per cGy). Associations between adverse reproductive outcomes and radiotherapy have been observed previously, but this is the first study in which an association with birthweight has been found with diagnostic radiography.

Abortion, Spontaneous↗