Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LORDOSIS”

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 1,081 records · Page 60Linked to original sources
PubMed2006

Sagittal translation in opening wedge osteotomy for the correction of thoracolumbar kyphotic deformity in ankylosing spondylitis.

STUDY DESIGN: Retrospective. OBJECTIVES: To document sagittal translation (ST) of the vertebral column in opening wedge osteotomy (OWO) for ankylosing spondylitis (AS) kyphosis. SUMMARY OF BACKGROUND DATA: Surgeons recognize displacement at the hinge of correction in OWO as an accidental event between the vertebrae on the side of OWO rather than ST of the cranial or caudal vertebral column. No report documents ST in this context. METHODS: We evaluated radiographic and clinical results in 127 patients (aged 17-49 years) for ST, or displacement of more than 2 mm between the cranial and caudal vertebral columns at the OWO level, over 5 years. RESULTS: Thirty-four (27%) patients had ST. In 31 (94%), the kyphotic apex was at T11 to L4. ST was positively correlated with the correction of lumbar lordosis and preoperative lumbar kyphosis. Five (15%) of 34 patients with ST had neurologic complications compared with 2 (2%) of 93 who did not. CONCLUSIONS: ST is a basic mechanism for correcting sagittal imbalance and is likely to occur when the level of OWO is near the apex of deformity. Patients needing more correction of lumbar lordosis than others for best correction of sagittal imbalance need ST more to join the mechanism of correction.

Adolescent↗
PubMed2006

Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine.

STUDY DESIGN: This prospective randomized study compared 3 fusion methods: posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), and PLIF combined with PLF (PLF+PLIF). OBJECTIVES: To compare the outcomes of the 3 fusion methods and find a useful fusion method. SUMMARY OF BACKGROUND DATA: Many studies have shown clinical results, advantages, and postoperative complications of each fusion method, but few have compared the 3 fusion methods prospectively. METHODS: A total of 167 patients who underwent 1 or 2-level fusion surgery because of degenerative lumbar disease from January 1996 to September 2000 were studied. Minimum follow-up was 3 years. The patients were randomized into 1 of 3 treatment groups: group 1 (PLF; n = 62); group 2 (PLIF; n = 57); and group 3 (PLF+PLIF; n = 48). A visual analog scale, the Oswestry Disability Questionnaire, and Kirkaldy-Willis criteria were used to measure low back pain, leg pain, and disability. For radiologic evaluation, disc height, lumbar lordosis, segmental angle, and bone union were examined. Postoperative complications were also analyzed. RESULTS: At the last follow-up, good or excellent results were obtained in 50 cases of PLF (80.7%), 50 cases of PLIF (87.8%), and 41 cases of PLF+PLIF (85.5%). No statistical differences were found among the 3 groups (P = 0.704). All methods indicated significant improvement in the disc height (P < 0.05), with PLF having the highest loss in disc height. Lumbar lordosis and segmental angle increased significantly, and improvement of the segmental angle in the 3 fusion methods had statistically significant differences. The nonunion rates at the last follow-up in the 3 fusion groups were not statistically significant, with 8% in group 1, 5% in group 2, and 4% in group 3 (P > 0.05). Complications included deep infection in 3 cases, transient nerve palsy in 4, permanent nerve palsy in 1, and donor site pain in 6. CONCLUSIONS: No significant differences in clinical results and union rates were found among the 3 fusion methods. PLIF had better sagittal balance than PLF. PLIF without PLF had advantages of the elimination of donor site pain, shorter operating time, and less blood loss.

Adult↗
PubMed2006

Creation of an experimental idiopathic-type scoliosis in an immature goat model using a flexible posterior asymmetric tether.

STUDY DESIGN: Longitudinal follow-up of animals after a surgically initiated scoliosis. OBJECTIVE: To create a progressive, structural, idiopathic-type, lordoscoliotic curve convex to the right in the thoracic spine of the immature goat using a flexible posterior asymmetric tether with minimal disruption of the spinal elements along the curve. SUMMARY OF BACKGROUND DATA: Our previous work created an experimental scoliosis model using a rigid posterior asymmetric tether to study the safety and efficacy of fusionless scoliosis treatments. Posterior asymmetric tethers, whether rigid or flexible, represent the most reliable method of creating an experimental deformity that approximates idiopathic scoliosis. Although our initial rigid model was unique in creating progressive structural scolioses without violation of the essential spinal elements along the curve, there were a number of shortcomings associated with the model. These included substantially stiff curves and unpredictability of curve progression. METHODS: Scoliosis was created in 24 Spanish Cross X female goats (age, 6-8 weeks; weight, 8-12 kg) using a braided synthetic ligament as a left posterior asymmetric tether from T5 to L1. Convex rib resection and concave rib tethering from ribs 8 to 13 were performed without disruption of the spinal elements before tensioning of the posterior tether. All goats were followed over an 8-week period with serial radiographs to document progression of the deformity. At the end of 8 weeks, the 20 goats with progressive curves were randomized into treatment groups for a separate study. However, 6 of these 20 remained untreated in the subsequent study and, therefore, were followed for an additional 12 to 16 weeks. RESULTS: There were two deaths in the early postoperative period due to pulmonary complications. Of the remaining 22 goats, 20 (91%) developed progressive, structural, idiopathic-type, lordoscoliotic curves convex to the right in the thoracic spine. Initial scoliosis after tethering measured 55.4 degrees on average (range, 37 degrees-75 degrees) and progressed to 74.4 degrees on average (range, 42 degrees-93 degrees) over 8 weeks. The average progression of 19.0 degrees (range, 5 degrees-33 degrees) was statistically significant (P < 0.001). The average initial lordosis after tethering measured -18.9 degrees (range, -13 degrees to -27 degrees) and progressed to -40.7 degrees on average (range, -28 degrees to -56 degrees) over 8 weeks. The average progression in lordosis of -21.8 degrees (range, -5 degrees to -43 degrees) was significant (P < 0.001). CONCLUSIONS: This study demonstrated the effectiveness of a flexible posterior asymmetric tether in creating idiopathic-type deformities in a shorter tethering period than previously described. With substantial remaining spinal growth after the 8-week tethering period and preservation of the essential spinal elements in an undisturbed state, this model is suitable for the study of scoliosis progression and various fusionless scoliosis treatment methods.

Animals↗
PubMedDate not supplied

Boston brace in the treatment of idiopathic scoliosis.

In a retrospective follow-up study of 64 patients with adolescent idiopathic scoliosis, the initial correction of Boston brace with straight lumbar profile strongly predicted good treatment results at follow-up (mean, 4.8 years). If the initial correction was > 50%, the curve was permanently reduced with an average of 7.2 degrees. The average initial correction was 62%. This initial brace effect was preserved in another comparable group of 60 patients treated with a Boston brace with 15 degrees lumbar lordosis. It is concluded that the Boston brace is effective in the conservative treatment of idiopathic scoliosis, and the corrective ability seemingly does not deteriorate with a change in the brace design from 0 to 15 degrees lordosis.

Adolescent↗
PubMed1984

Prognostic radiographic aspects of spondylolisthesis.

A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

Adolescent↗
PubMedDate not supplied

The association between athletic training time and the sagittal curvature of the immature spine.

Strenuous physical activity is known to cause structural abnormalities in the immature vertebral body. Concern that exposure to years of intense athletic training may increase the risk for developing adolescent hyperkyphosis in certain sports, as well as the known association between hyperkyphosis and adult-onset back pain, led us to examine the association between cumulative hours of athletic training and the magnitude of the sagittal curvature of the immature spine. A sample of 2,270 children (407 girls and 1,863 boys) between 8 and 18 years of age were studied. An optical raster-stereographic method was used to measure the mid-sagittal curvatures of the surface of the back while the subject was in the upright standing position to quantify the angles of thoracic kyphosis and lumbar lordosis. These data were then correlated with self-reported hours of training measured by interview and questionnaire. The possible effects of age, sex, sport, and upper and lower body weight training were investigated. The results in these young athletes showed that larger angles of thoracic kyphosis and lumbar lordosis were associated with greater cumulative training time. Gymnasts showed the largest curves. Lack of sports participation, on the other hand, was associated with the smallest curves. Age and sex did not appear to affect the degree of curvature.

Adolescent↗
PubMed1986

Dyspnoea and thoracic spinal deformation in rats after oral prizidilol (SK&F 92657-A2).

Prizidilol (SK&F 92657-A2), an anti-hypertensive agent, has undergone a range of prescribed toxicity studies required for the investigation of possible adverse drug effects. During the second year of the 2-year rat oral study, a variety of symptoms were exhibited by males receiving 1600 mg of the compound day-1kg-1 by gavage. These animals became lethargic, slouched and developed dyspnoea which became progressively more severe during the course of the study. Necropsy of the affected rats revealed severely haemorrhagic lungs, cardiac hypertrophy and lordosis of the spine into the thoracic cavity. At the 2-year terminal kill, a proportion of the male rats receiving 100 and 400 mg of prizidilol day-1kg-1 were identified with similar but less severe spinal deformation. No female was found with spinal changes but all the rats receiving prizidilol showed haemorrhagic lungs and enlarged hearts. The lordosis of the affected males was always confined to the thoracic spine and this, along with the cardiac hypertrophy, presumably led to marked reduction in the volume of the thoracic cavity, inducing the dyspnoea. Thoracic vertebral body damage, possibly a precursor to the spinal deformities, was found in male rats from both drug-treated and control groups. The nature of the spinal lesion is at present under investigation.

Adrenergic beta-Antagonists↗
PubMed1989

Curve patterns in idiopathic scoliosis. A clinical and radiographic study.

We have developed a simple technique for demonstrating the sagittal profile of each rotated level of a scoliotic spine and used it to determine the patterns of lordosis and kyphosis in each of six clinical types of idiopathic scoliosis. The currently accepted classification of scoliosis is inaccurate and a modification is proposed. The three main types of scoliosis were shown to have sagittal profiles distinctly different from each other and from normal. Single structural curves had short lordotic sections at their apices, limited above and below by kyphosis. Double curves showed longer lordotic sections limited only by one area of kyphosis. Lordosis throughout the thoracic and lumbar spine was associated with triple curve patterns. The biomechanical effects of the abnormal sagittal profiles provide a simple explanation for the genesis and progression of the different types of scoliosis, and the recognition of the pattern of the sagittal abnormalities permits treatment to be designed on a sound anatomical basis for individual cases.

Adolescent↗
PubMed1993

The lumbar spine in spastic diplegia. A radiographic study.

Some radiological features of the lumbar spine of 84 patients with spastic diplegia were compared with 50 control subjects. The average age of the patients was 20.1 years (3 to 39). Spondylolysis of the fifth lumbar vertebra was found in 21%, four times more frequently than in normal subjects. No patient under nine years of age had spondylolysis and the frequency increased with age. The average angle of lumbar lordosis in spastic patients in the standing position was greater than in normal subjects, and increased with age. The patients had a decreased sacrofemoral angle which caused an increase in Ferguson's angle and explained the increased angle of lumbar lordosis.

Adolescent↗
PubMed2000

Curvature and range of motion of the cervical spine after laminaplasty.

BACKGROUND: The curvature and range of motion of the cervical spine decrease after laminaplasty. However, to our knowledge these changes have not been studied prospectively. Also, the effect of laminaplasty on the mobility of the occipito-atlanto-axial joints has not been studied in detail. The purpose of our study was to prospectively evaluate the range of motion and curvature of the cervical spine, including the occipito-atlanto-axial joints, following laminaplasty. METHODS: We conducted a prospective study of twenty-six patients who underwent cervical laminaplasty. They were followed for a mean of 6.7 years (range, five to nine years). Radiographs were made before the operation and at one, three, and five years after the operation. The curvature index, the angle of each vertebra in the neutral position from the occiput to the seventh cervical vertebra, and the range of motion in the sagittal plane were measured. RESULTS: The curvature index, the angle of the axis and the sixth cervical vertebra, and the angle of the axis and the seventh cervical vertebra in the neutral position were reduced after the operation. The rate of reduction declined between the third and fifth postoperative years. On the other hand, the mean distance between the occiput and the atlas as well as the mean angle of the axis and the atlas did not change significantly. The range of motion of the axis and the seventh cervical vertebra was decreased after the operation, and it continued to decrease slowly over the study period. The range of motion of the occipito-atlanto-axial complex increased slightly, which may represent a compensation for the decreased mobility of the middle and caudad parts of the cervical spine. CONCLUSIONS: Laminaplasty diminishes lordosis and straightens the cervical spine. The range of motion and lordosis continued to decrease, though at a diminishing rate, between the third and fifth postoperative years.

Adult↗
PubMed2005

Spinal deformities after selective dorsal rhizotomy for spastic cerebral palsy.

OBJECT: Spinal deformities are significant problems in children with spastic cerebral palsy. The treatment of their spasticity by selective dorsal rhizotomy (SDR) may worsen or improve these problems. The purpose of this study was to determine the incidence of and change in degree of thoracolumbar scoliosis, thoracic kyphosis, and lumbar lordosis in children who have undergone SDR. METHODS: A retrospective review was conducted of children younger than 18 years of age, who had undergone SDR at British Columbia's Children's Hospital from 1987 to 2001 and in whom preoperative and postoperative spine radiographs have been obtained. Angles for thoracolumbar scoliosis, thoracic kyphosis, and lumbar lordosis were measured. The study group comprised 105 patients. The mean age at surgery was 5.2 years (range 2.7-14.6 years), with a mean time to most recent follow-up radiographs of 4.3 years (1-13.6 years). Sixty-two children had spastic diplegia (59%), 34 spastic quadriplegia (32%), and nine quadriplegia and intellectual delay (9%). A total of 104 children underwent laminoplasty with replacement of the laminae, usually from L-1 to S-1 and 54.8% of children had scoliosis at last follow up, with 25% having worsening of 10 degrees or more. The incidence of abnormal kyphosis at the last follow-up visit was 38.6%, with 31.8% having worsening of 15 degrees or more. The incidence of hyperlordosis at last follow up was 21.3%, with 36% having worsening of 15 degrees or more. The factors in this series impacting development of spinal deformities have been analyzed and are discussed. CONCLUSIONS: The relatively high incidence of spinal deformity in children who have undergone SDR via multi-level lumbosacral laminoplasties should raise some concern.

Adolescent↗
PubMed2002

[Sagittal alignment of the spine: comparison between soccer players and subjects without sports activities].

PURPOSE OF THE STUDY: The purpose of this study was to compare the sagittal alignment of the spine in a population of soccer players and a population of volunteers with no sports activities in order to assess the effect of sports activities on stress fractures of the isthmic region. MATERIAL AND METHODS: The group of athletes included 31 soccer players and the volunteer group 47 subjects with no sports activities selected from a 131 subjects database. The two groups were matched for sex and age. All athletes were licensed members of a soccer club and participated in regular sports activities at a moderate level (at least 4 hours per week for at least 2 years). Plain radiographs of the entire spine (lateral view) in the same reference position were obtained for all subjects. The following parameters were recorded: thoracic kyphosis, lumbar lordosis, sacral tilt, anteversion of the pelvis, sagittal alignment. The following morphology data were also recorded in this exclusively male population: weight, height, arm spread. RESULTS: Considering the other radiographic parameters, the sagittal alignment of the spine was comparable between the two groups. However, the statistical analysis demonstrated that the distribution of the spinal and pelvic parameters was different between the athletic and the non-athletic subjects. In athletes, spinal alignment was achieved by a less pronounced thoracic kyphosis and a more pronounced angle, sacral tilt and lumbar lordosis. DISCUSSION AND CONCLUSION: The particular spinal morphology observed in soccer players is comparable with that described in the literature for patients with or treated for spondylolisthesis with isthmic lysis.

Adult↗
PubMed2002

Relation between hallux valgus deformity and lumbar and lower extremity biomechanics.

Hallux valgus (HV) is a static subluxation of the first metatarsophalangeal joint with lateral deviation of the great toe and medial deviation of the first metatarsal. Our aim was to evaluate the interference of HV deformity with changes in lumbar lordosis and some foot deformities. Twenty HV patients and 20 healthy subjects were selected for the study. Hallux valgus angle, metatarsus primus varus (MPV), metatarsus omnis varus (MOV), first intermetatarsal (1.IMT), second metatarsal (2. MT) and hallux interphalangeal (HIP) angles were estimated from the anteroposterior foot X-rays. Lumbosacral (LSA) and sacrohorizontal angles (SHA) were measured from lateral lumbar x-rays and pes planus was detected from lateral and anteroposterior ankle and foot radiographs. There was a significant difference between HV angle mean values of two groups. MPV, MOV, 1.IMT, 2. MT and HIP angles did not show significant difference between groups. HV angle was found to be correlated with MPV. HIP angle was found to be correlated with LSA and SHA, indicating a relation with lordosis. HV and pes planus were correlated with each other. HV also showed weak correlation with hyperlordosis. Transmission of variations in body mechanics through pelvis and lower extremity plays an important role for certain foot deformities. Some factors affecting HV development are correctable; early diagnosis and treatment of MPV and pes planus, suggesting healthy rather than fashionable footwear and preventing obesity may lower HV incidence.

Adult↗
PubMed1975

[Malalignment of lumbar spine with lumbar PID (author's transl)].

In 322 cases of lumbar PID proved by myelography the radiologically recognizeable malalignment of the lumbar spine was related to site and direction of the prolaps. Scoliosis towards the side of the prolapse was seen in about 70 per cent. Scoliosis convex towards the normal side was significantly more common with right-sided than with left-sided prolapses. Scoliosis was the more pronounced the higher the site of prolapse. The degree of lumbar lordosis, too, appeared to depend on the level of prolapse. The lower the prolapse the less the lordosis. In the individual case one cannot draw any conclusions as to site or direction of a prolapse from radiologically detectable malalignment.

Back Pain↗
PubMed1978

Curves of the achondroplastic spine: a new hypothesis.

The profile of the achondroplastic dwarf reflects abnormalities in the shape of the spine, particularly in the lumbosacral area. We hypothesize that these abnormalities and the resultant symptoms are secondary and avoidable rather than heritable and inevitable. Because the heads of achondroplastic children are enlarged (n = 50), loading of the vertical spine is increased. Unusually lax ligaments and misshapen vertebrae predispose the spine to yielding under vertical stress. Children and adults uniformly have hip flexion contractures (n 105); these are hypothesized to be the result of uncorrected lumbosacral lordosis. The volume of the spinal canal, reduced by the spinal stenosis of achondroplasia, is decreased additionally by lordosis; some neurologic deficits of achondroplasia are caused by this abnormal curvature. This hypothesis bears practically on treating this common form of dwarfism.

Achondroplasia↗
PubMed2002

Relation between the pelvis and the sagittal profile in adolescent idiopathic scoliosis: the influence of curve type.

Previous studies have shown a correlation between pelvic parameters and the lumbar lordosis in normal subjects and in scoliotic adults. This study investigates the relationship between pelvic and spinal geometries in the sagittal plane for adolescent idiopathic scoliosis (AIS) patients having various curve types. The study group was composed of 129 AIS patients classified according to their curve type: King I, King II, King III or lumbar curve. The SpineView software (Surgiview, France) was used to compute five parameters on sagittal x-rays: thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI). The TK was significantly lower for King I, II and III curves as compared to the lumbar curves. The LL tended to be higher for patients having a major lumbar scoliotic (King I and lumbar) curve, although not significantly. No significant change between the groups was observed for the SS, PT and PI. The PI was significantly correlated to the LL, SS and PT for all groups. The SS was strongly related to the LL in all cases. However, no relationship was found between the TK and the LL in any group. This study showed that the TK mostly depends on the thoracic scoliotic curve and therefore on the shape and orientation of the vertebrae, which explains that many King I, II and III patients are hypokyphotic. Conversely, the LL is mainly influenced by the pelvic configuration. Since the pelvic parameters are similar for all groups, these parameters are not likely to be important in the development of a specific type of scoliotic curve.

Adolescent↗
PubMed1988

Brace treatment for symptomatic spondylolisthesis.

The literature documents progression of spondylolisthesis, most commonly during the adolescent growth spurt. Twenty-eight patients with Grades I and II spondylolisthesis were treated with antilordotic braces. Presenting signs and symptoms included back pain (61%), tight hamstrings (53%), increased lordosis (25%), and mild scoliosis (21%). Three patients presented with spondylolysis and progressed to a slip prior to initiation of brace treatment. Mean duration of brace treatment was 25 months. In the brace, lateral roentgenograms demonstrated a significant reduction of lumbar lordosis and sacral inclination. At the conclusion of brace treatment all patients were pain-free and none had demonstrated a significant increase in slip percent.

Adolescent↗
PubMed1988

Severe spondylolisthesis. Reduction and internal fixation.

The authors have developed and algorithm for management of spondylolysis and spondylolisthesis. Since March 1983, 15 patients with an average age of 20 years and with greater than 50% anterior displacement have been treated. The mean follow-up period is 24 months. Before surgery the average anterior displacement was 72%, the average delta angle at L5-S1 representing kyphosis was 73 degrees, and the average lumbar lordosis from L1 to L5 was 64 degrees. An anterior release and fusion was combined with a posterior reduction and instrumentation using the internal fixator. Correction of the anterior displacement averaged 46%, while the kyphosis was corrected a mean of 20 degrees and the lordosis a mean of 12 degrees. The L4 segment was preserved in 13 cases and the L4-L5 angle was improved by a mean of 7 degrees. Postoperative pain and function were improved in all cases. Neurologic complications occurred in four patients, three permanent and one temporary. Hardware failure occurred in two patients, and reoperation has been required in one. Further follow-up evaluation of this technique is required.

Adolescent↗