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At least 109 records · Page 6Linked to original sources
PubMed1991

[A new design of internal fixation for scoliosis-multi-screw fixed distractor-compressor via the vertebral pedicle and its clinical application].

A new scoliotone, which is made up of screws, sockets, clamps, distraction rod and compression rod, was used stabilize immobilization of the spine in 10 cases. This scoliotone can produce free motion in three different levels, and has a strong power of fixation, distraction, compression and antitraction. In 10 cases when the patient's spinal curvature (cobb's angle) was less than 50 degrees, the average range of correction was 78.2% and the correction rate of kyphosis peak was 90%. When the spinal curvature was between 50 to 100 degrees, the average range of correction was 68.2%, and the correction rate of kyphosis peak was 87.7%. If the spinal curvature was more than 100 degrees, the average range of correction rate of kyphosis peak was 82%. After the operation, the patient might not be immobilized. In this paper, the biomechanical features of the vertebral arch, internal fixation and correction of kyphosis peak were discussed.

Adolescent↗
PubMedDate not supplied

Scoliosis associated with lumbar spondylolisthesis: a case presentation and review of the literature.

BACKGROUND CONTEXT: The association between scoliosis and spondylolisthesis is well documented, but criteria and methods for managing the deformity in patients with debilitating pain are not clear. PURPOSE: To describe correction of scoliosis by internal fixation of the spondylolisthesis. STUDY DESIGN: Case report of a patient with scoliosis developing in association with spondylolisthesis. METHODS: A 17-year-old female presented with a 6-month history of back and leg pain. No spinal curvature was noted in radiographs taken at the onset of symptoms. Significant curvature appeared during the 6-month history of pain in association with an L5-S1 spondylolisthesis. The spondylolisthesis was repaired with posterior pedicle screw instrumentation. RESULTS: The pain and the spinal curvature almost completely resolved after surgery, and the outcome remained excellent 14 months after surgery. CONCLUSION: In the properly diagnosed patient, surgical repair of the spondylolisthesis can relieve pain and correct spinal curvature.

Adolescent↗
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↗
PubMed2003

Osteogenesis imperfecta in childhood: effects of spondylodesis on functional ability, ambulation and perceived competence.

We studied the effects of spondylodesis on spinal curvature, functional outcome, level of ambulation and perceived competence in 11 children with osteogenesis imperfecta (OI). Mean age at surgical intervention was 13.1 years (SD 2.5 years) and follow-up amounted to 3.4 years (SD 2.3 years). Spinal curvature was measured according to Cobb. The level of ambulation was scored according to the modified criteria of Bleck. Functional abilities and the amount of parental assistance were scored using the Dutch version of the Pediatric Evaluation of Disability Inventory (PEDI). Perceived competence was measured using the Harter Self-Perception Profile for Children. The amount of fatigue, spinal pain and presence of subjective dyspnea were scored with a visual analog scale. The median progression per year before spondylodesis was 6.1 degrees (interquartile range 2.9 degrees -12.9 degrees ) and after the spondylodesis it was 5.0 degrees (interquartile range 1.6 degrees -11.0 degrees ). No significant progression or regression in the level of ambulation was found. Perceived competence improved slightly. In the total score of the perceived competence, a borderline significant increase was found ( P-value 0.068). We concluded that spinal fusion in children with OI does not materially influence functional ability and level of ambulation. Self-perceived competence seemed to improve after surgery. The amount of pain, fatigue and subjective dyspnea seemed to diminish after spinal surgery. Progression of scoliosis proceeded, as did development of spinal curvature at the junction of the spondylodesis. Therefore, oral or intravenous bisphosphonates before and after spinal surgery should be considered.

Activities of Daily Living↗
PubMed1995

Increased femoral neck-shaft angles in adolescent idiopathic scoliosis.

STUDY DESIGN: Ninety-four females from Southern China, 61 with adolescent idiopathic scoliosis and 33 normal subjects, were evaluated for femoral neck shaft angles and associated asymmetry between the hips. For statistical analysis, the groups were divided into adolescent and adult, and the scoliosis group was further divided into sub-groups according to the type of spinal curvature. OBJECTIVES: To evaluate femoral neck-shaft angle and asymmetry between the hips, and their relation to adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Recently published studies have suggested there is an association between asymmetry of the hip and lower limb and the curvature in AIS. In this study, femoral neck-shaft angle in patients with adolescent idiopathic scoliosis and in normal subjects was evaluated. METHODS: Femoral neck-shaft angles of both hips and lateral spinal curvature (using Cobb's method) were measured from standard standing anteroposterior radiographs of the pelvis, including upper femora and spine. Methods of measuring femoral neck-shaft angles were evaluated in an intra- and inter-observer study and were found to be accurate. RESULTS: Patients with scoliosis had highly significantly greater femoral neck-shaft angles of both hips compared with normal subjects. In normal subjects, the femoral neck-shaft angle difference between the hips (asymmetry) was not statistically significant. This asymmetry in the scoliosis group also was not statistically significant when the results were analyzed upon grouping them all together, irrespective of curve pattern. CONCLUSION: Our new findings show that patients with scoliosis have abnormally increased femoral neck-shaft angles, and the asymmetry is characteristic and significantly different from that of normal subjects. Moreover, increased femoral neck-shaft angle is related to type and side of spinal curvature.

Adolescent↗
PubMed2002

Computer-assisted Cobb measurement of scoliosis.

This study was devised to develop a simple computerised method for measuring and quantifying the magnitude of spinal curvatures. A digitally scanned antero-posterior radiographic image was used. The vertebral column was defined as a line that can be subdivided into a number of segments, rather than into the exact number of vertebrae. The technique developed allows an observer to measure the spinal curvature with a high resolution and accuracy. One important advantage of the technique is that the assessor does not need to be skilled or experienced in measurement of a spinal curvature.

Diagnosis, Computer-Assisted↗
PubMed2000

New approach to cervical flexion deformity in ankylosing spondylitis. Case report.

The treatment of cervical fixed flexion deformity in ankylosing spondylitis presents a challenging problem that is traditionally managed by a corrective cervicothoracic osteotomy. The authors report a new approach to this problem that involves performing a two-level osteotomy at the level of maximum spinal curvature, thereby achieving complete anatomical correction in a one-stage procedure. This 48-year-old woman with ankylosing spondylitis presented with a 30-year history of progressive neck deformity that left her unable to see ahead and caused her to experience difficulty eating, drinking, and breathing on exertion. On examination, she exhibited a 90 degrees fixed flexion deformity of the cervical spine, which was maximum at C-4; this was confirmed on imaging studies. A two-level osteotomy was performed at C3-4 and C4-5 around the area of maximum spinal curvature, and the deformity was corrected by extending the head on its axis of rotation through the uncovertebral joints. The spine was stabilized using a Ransford loop. An excellent anatomical position was achieved, as was complete correction of the deformity. A two-level midcervical osteotomy performed at the level of maximum spinal curvature in ankylosing spondylitis enables complete correction of severe fixed flexion deformity in a single procedure. Preservation of the uncovertebral joints allows smooth and safe correction of the deformity about their axis of rotation.

Cervical Vertebrae↗
PubMedDate not supplied

[Transpedicular reconstruction of vertebral body height with simultaneous interbody spondylodesis].

BACKGROUND AND PURPOSE: Surgical treatment of traumatic spinal injury should include fast and complete decompression of spinal cord and radices wits reduction of broken vertebral body, restoration of physiological spinal curvatures and spondylodesis of injured segments. Restoration of natural spinal curvatures is only possible when the height of broken vertebral body is reconstructed. MATERIAL AND METHODS: Between 1992 and 2001, 75 patients were operated on because of traumatic injuries of thoracolumbar spine in the Ortopaedic and Traumatology Department Skubiszewski Medical University of Lublin. 48 patients had broken vertebral body reduction with simultaneous filling of bone loss with autogenic bone grafts inserted through pediculum. Only in 4 cases posterior spondylodesis was carried out on arches and spinous processes. Transpedicular plasty of 44 broken vertebral bodies was connected with posterior interbody fusion with PLIF technique using graft application to interbody space. RESULTS: The operative protocol presented above allowed for the height of the anterior vertebral wall to be restored on average to 81.5% of the original height. We did not observe either fatigue breakage of the screws or screws loosening with kyphosis recurrence. We did not note serious postoperative complications, including neurological compromise. The operative procedure did not significantly change the neurological status of the patients. In 9 cases we noted neurological improvement: usually by 1 or 2 grades in Frankel's score. CONCLUSIONS: Restoration of the fractured vertebral body with bone grafts combined with posterior interbody spondylodesis effectively prevents the recurrence of the kyphotic deformation.

Adolescent↗
PubMed2004

Loss of regularity in the curvature of the thoracolumbar spine: a measure of structural failure.

UNLABELLED: Departure from regularity (smoothness) in the curvature of the spine was quantified and correlated with the number of fractures, deficits in height, BMD, and identified women with vertebral fractures. INTRODUCTION: Differences in anterior and posterior vertebral heights (VHs) form the thoracolumbar curvature needed for stability in bipedal gait. Modest differences in VHs within and between adjacent vertebrae allow the spine curve to change its trajectory gently. Large differences in VHs, as occur following a fracture, produce abrupt changes in the direction of the curve, producing a departure from regularity (i.e., irregularity or loss of smoothness). MATERIALS AND METHODS: VHs and BMD were measured using DXA in 697 Lebanese women 20-87 years of age. Regularity of the spinal curvature was measured by comparing the ratio of the anterior to the posterior VHs of one vertebra to this ratio of adjacent vertebrae. If these ratios are similar, there is a smooth transition in the trajectory of the spinal curve. Departure from this regularity (smoothness) was measured at each pair of adjacent vertebrae in each individual and expressed as the spinal curvature irregularity index (SCII) for the entire thoracolumbar spine. RESULTS AND CONCLUSIONS: In premenopausal women, the mean SCII was 8.5% (range, 4-15%); that is, regularity was 91.5%. Only 0.8% of women had a SCII >17%. In postmenopausal women, the mean SCII was 10% (range, 4-36%) and was correlated with age (r = 0.25), height (r = -0.21), BMD (r = -0.13), and the number of deformities assessed by quantitative vertebral morphometry (QVM; r = 0.31-0.60; all p < 0.001). About 5% of women had an SCII >17%, and this group had 3- to 9-fold more deformities (as defined by QVM) than women with SCII <17%, reduced lumbar spine BMD (-1.01 SD), and 2- to 4-fold greater height deficits (-0.5 SD) than women with deformities (by QVM). The SCII is a robust method of identifying structural failure that is easy to compute and does not require controls.

Adult↗
PubMed2005

Acquired structural kyphoscoliosis in a captive adult female rhesus macaque (Macaca mulatta).

A female, wild-caught, rhesus macaque (Macaca mulatta), in captivity for 23 years and estimated to be older than 26 years, had an 8-year history of progressive spinal curvature. Scoliosis was initially noted 1 year after a therapeutic bilateral ovariectomy to treat endometriosis. Eight years after the initial diagnosis, the curvature had progressed to a structural (nonflexible), lumbar scoliosis with a curvature to the left and a structural thoracolumbar kyphosis. The spinal curvature was characterized radiographically by a severe, major lumbar curve to the left with vertebral rotation and severe thoracolumbar kyphosis. The Cobb method of measurement identified a major left lumbar curve of 80 degrees. When the animal's condition deteriorated, the animal was euthanized, and a necropsy with postmortem radiographic and microscopic examination was performed. Radiographically and grossly, multiple intervertebral disc spaces were narrowed along the entire spine with ventral bridging intervertebral spondylosis of the lumbar spine. Radiographically, vertebral bodies appeared to be less radiodense and multiple features of degenerative disc disease were present. No clinical evidence of concurrent neuromuscular or mesenchymal disease was noted, and development of lesions after bilateral ovariectomy suggested the kyphoscoliosis was secondary to osteopenia that developed as the result of a surgically induced estrogen deficiency.

Animals↗
PubMedDate not supplied

Life spans and senescent phenotypes in two strains of Zebrafish (Danio rerio).

Zebrafish have become a widely used model organism in developmental biology research. In order to initiate an experimental foundation for aging studies, we have determined some basic gerontological parameters for populations of outbred zebrafish, and the golden sparse strain. Outbred zebrafish manifested a mean life span of about 42 months, with the longest living individual surviving for 66 months. The golden sparse populations had a mean life span of 36 months and a maximum longevity of 58 months. Skeletal length at death increased with age, suggestive of indeterminate growth. A common age-related phenotype was spinal curvature. Radiographic analysis excluded bony changes as the cause of the spinal curvature, suggesting muscle abnormalities as a primary mechanism. These data and a growing abundance of related biological resources suggest that the zebrafish may be a compelling model organism for studies on aging.

Aging↗
PubMed1989

Hip joint mobility and spinal angles in standing and in different sitting postures.

The spinal angles of 25 female subjects were measured in standing and in four different sitting postures with various trunk-thigh angles. Additionally, measurements of hip and lumbar mobility were made in an attempt to relate mobility to spinal curvature in the different sitting postures. Lumbar curvature was observed to decrease as the trunk-thigh angle decreased across the different sitting postures, and reduction in curvature was associated with hip mobility. An exploratory analysis of interrelationships among hip mobility, spinal mobility, and spinal curvature was also carried out. A significant correlation between lumbar and thoracic angular deviations in standing and hip flexion/extension range was obtained. The findings are discussed with reference to theories of sitting posture and the influence of hip joint mobility on postural adaptations to furniture. Further investigations, including studies of male subjects, are indicated.

Adult↗
PubMed2002

Natural History of Untreated Scoliosis in beta-Thalassemia.

STUDY DESIGN: A prospective study was performed. OBJECTIVES: To investigate the natural history of untreated scoliosis in beta-thalassemia patients in a 10-year period. SUMMARY OF BACKGROUND DATA: Several previous studies have demonstrated the bone deformities, particularly the high incidence of scoliosis, that is associated with beta-thalassemia. However, little is known about the evolution of scoliosis curvatures, and almost nothing is known about the natural history of this type of scoliosis and its associated lateral spinal curvatures. METHODS: From a group of 115 patients with beta-thalassemia who were evaluated for scoliosis 10 years ago, 43 patients (37%) were re-evaluated 10 years later to study the evolution of the untreated scoliosis and lateral spinal curvatures. Scoliosis, thoracic kyphosis, thoracolumbar kyphosis, and lumbar lordosis were measured both in the initial and last observation and were compared with each other. All changes in scoliosis curve location, direction, and rate of resolving, as well as the changes in the magnitude of the lateral spine curves, were recorded. RESULTS: Scoliosis curves of more than 5 degrees were present in 34 (79%) of the 43 patients who were followed. Scoliosis progressed but was not statistically significant in 12% of the patients with thalassemia in a 10-year span. Ten years ago, 12 patients (28%) showed scoliosis of 10 degrees to 14 degrees, whereas in the last evaluation, 15 patients (35%) had scoliosis of 10 degrees to 19 degrees. The S-shaped scoliosis curve pattern was the most common (29%). In 10 years, the scoliosis curve pattern remained unchanged in 38% of the patients, and it changed in 38%, whereas 24% of the minor curves (5-9 degrees ) showed spontaneous "self-resolving" character. In the last evaluation, there were seven patients (16%) with new cases of scoliosis de novo. There was no sex-related predominance in prevalence of scoliosis in this series. There was a significant skeletal mature retardation in the patients with beta-thalassemia. There was a significant increase of thoracic and thoracolumbar kyphosis and a decrease of lumbar lordosis. The changes in the sagittal profile were not correlated to scoliosis in this group of patients. CONCLUSIONS: Scoliosis in beta-thalassemia appeared with increased prevalence but with small curves of 5 degrees to 19 degrees that did not need active orthopedic treatment. However, a few cases progressed to curves less than 20 degrees, and only one patient (2.9%) showed a severe curve that showed much progression. The behavior of scoliosis in beta-thalassemia differs significantly from that in idiopathic scoliosis. The skeletal disorders that are caused by this hematologic dysfunction seem to be responsible for the spinal deformities and their evolution.

Adolescent↗
PubMed2002

Curvature progression in patients treated with scoliosis in-patient rehabilitation--a sex and age matched controlled study.

The aim of this study is to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS because progression of spinal curvature in patients with idiopathic scoliosis (IS) is of paramount concern in treatment strategies. Follow-up of the outcome of two prospective studies using the outcome parameter, incidence of progression (> or = 5 degrees), in treated and untreated patient groups matched by age, sex, and degree of curvature at diagnosis. A six-week scoliosis in-patient rehabilitation (SIR) program offering patient-specific physiotherapy including intensive therapist-assisted exercise in diagnosis-matched groups. A followup home therapy regime is designed for each patient. Incidence of progression in groups of untreated patients ranged from 1.5-fold (71.2% vs 46.7%) to 2.9-fold (55.8% vs 19.2%) higher than in groups of patients treated with SIR, even when SIR-treated groups included patients with more severe curvatures. Statistically, the differences were highly significant. Postural imbalance is a component of spinal curvature and can be a causative mechanism. However, efforts to test the hypothesis that physical therapies addressing postural imbalance can be used effectively in the treatment of IS have been limited. The results of this study indicate that a supervised program of exercise-based therapies can reduce incidence of progression in children with IS.

Adolescent↗
PubMed2003

Reposition sense of lumbar curvature with flexed and asymmetric lifting postures.

STUDY DESIGN: Reposition sense of lumbar curvature was assessed as a function of trunk flexion, trunk asymmetry, and target lumbar curvature using a repeated-measures design and an active-active proprioception paradigm. OBJECTIVE: The objectives of the research were to measure the ability of the subjects to sense and control the lumbar curvature in different lifting postures and to see if error in the lumbar curvature would increase in high-risk postures. SUMMARY OF BACKGROUND DATA: The risk of low back disorders (LBDs) is related to trunk posture, with greater risk reported in flexed and asymmetric trunk positions. Spinal posture, including trunk position and lumbar lordosis, influences spinal stability. Hence, the ability to accurately sense and control spinal curvature may be an important factor in the control of LBD risk. METHODS: Eleven subjects were trained to assume specified lumbar curvatures using visual feedback. The ability of the subjects to reproduce this curvature without feedback was then assessed. This procedure was repeated for different trunk postures, including flexion and asymmetry, and with different target lumbar curvatures. RESULTS: These measurements demonstrated reposition error was increased in flexed trunk positions but was unchanged with trunk asymmetry. This increase in reposition error with flexion was diminished when the target posture and lumbar curvature were highly flexed and kyphotic. CONCLUSIONS: This research suggests that it may be difficult to control spinal curvature in flexed positions, leading to an increased risk of injury. For jobs in which flexed working postures are unavoidable, therefore, it is important to minimize potentially unstable events such as slipping or shifting loads to avoid injury.

Adult↗
PubMed1996

Adolescent idiopathic scoliosis: an update.

Adolescent idiopathic scoliosis is defined as a lateral spinal curvature of greater than 10 degrees, for which no pathologic cause can be determined. The initial assessment of adolescents with scoliosis focuses on identification of any treatable underlying pathology. Adolescents with scoliosis typically are asymptomatic and have normal neurologic and physical examinations, with the exception of curvature of the spine. Treatment strategies are determined by the risk of progression. This risk depends on the extent of the curvature and anticipated future spinal growth. The extent of the curvature may be estimated by use of a scoliometer and verified by calculation of the Cobb angle on radiographic evaluation. Skeletal maturity may be estimated by several methods, including radiologic estimates of ossification by bone atlas or Risser sign. Treatment strategies include bracing and surgery.

Adolescent↗
PubMed2005

Effects of abnormal posture on capsular ligament elongations in a computational model subjected to whiplash loading.

Although considerable biomechanical investigations have been conducted to understand the response of the cervical spine under whiplash (rear impact-induced postero-anterior loading to the thorax), studies delineating the effects of initial spinal curvature are limited. This study advanced the hypothesis that abnormal curvatures (straight or kyphotic) of the cervical column affect spinal kinematics during whiplash loading. Specifically, compared to the normal lordotic curvature, abnormal curvatures altered facet joint ligament elongations. The quantifications of these elongations were accomplished using a validated mathematical model of the human head-neck complex that simulated three curvatures. The model was validated using companion experiments conducted in our laboratory that provided facet joint kinematics as a function of cervical spinal level. Regional facet joint ligament elongations were investigated as a function of whiplash loading in the four local anatomic regions of each joint. Under the normal posture, greatest elongations occurred in the dorsal anatomic region at the C2-C3 level and in the lateral anatomic region from C3-C4 to C6-C7 levels. Abnormal postures increased elongation magnitudes in these regions by up to 70%. Excessive ligament elongations induce laxity to the facet joint, particularly at the local regions of the anatomy in the abnormal kyphotic posture. Increased laxity may predispose the cervical spine to accelerated degenerative changes over time and lead to instability. Results from the present study, while providing quantified level- and region-specific kinematic data, concur with clinical findings that abnormal spinal curvatures enhance the likelihood of whiplash injury and may have long-term clinical and biomechanical implications.

Cervical Vertebrae↗
PubMed2003

Body posture in elderly, physically active males.

The objective of this study was to evaluate the shape of anterior-posterior curvatures of the spine and to determine the values of body symmetry deviations in the frontal plane, in elderly males. The study group consisted of 34 males aged between 61 and 83 years, attending two hour-long training sessions a week. The comparative group consisted of 30 students. The photogrammetric method based on the Moire phenomenon was used to evaluate the body posture. The obtained data confirm characteristic tendencies of physiological spinal curvatures to change with the aging process. A decrease of the lumbar-sacral spinal-segment inclination and an increase of the upper thoracic spinal-segment inclination were observed in the elderly males. Whereas, the value of thoracic kyphosis lower-segment inclination was similar to the value obtained in young adult males. The stated differences indicate a flattening of lumbar lordosis and a deepening of the upper arch of thoracic kyphosis, which results in a characteristic body posture in the standing position with the head protruding and the upper trunk segment inclined. The above-mentioned observations indicate a dominance of the angular thoracic kyphosis value over the remaining spinal curvatures. These differences occur to a greater degree in elderly males.

Aged↗