ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Cerebral palsy patients (31 hips) were evaluated using radiographic and three-dimensional (3-D) images to quantify hip anatomy. The 3-D images overcome distortions caused by joint contractures. Changes were more pronounced in the non-ambulators and characterized by shallow sockets with increased neck-shaft angles. These hips tended to subluxate in a posterior-superior direction and most had defects in the femoral heads. Ambulators had increased femoral anteversion but other hip parameters tended to improve with age. The 3-D measures of roof steepness and socket depth were found to correlate strongly with radiographic parameters of subluxation.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Sixty-four dislocated hip joints in 47 patients with spastic cerebral palsy were reconstructed surgically for pain or physical impairment. The procedure included a femoral and pelvic osteotomy, an anterior iliopsoas transfer, and further soft-tissue surgery. The study was based on a research questionnaire (mean follow-up 6.8 years) and radiographs (3.0 years). Upon review of radiographs, it was discovered that three hips had redislocated and that 23 were insufficiently covered. Four complications (one deep infection, three femoral fractures) occurred. Pain was relieved fully in 28 of 37 patients and eased in 9 of 37. Weight-bearing improved sitting problems in 22 of 26 patients and enabled nine of 36 nonwalkers to take at least a few steps.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Thirty-three patients with cerebral palsy had iliopsoas transfers as part of their surgery for hip instability. All had total-body involvement, spastic cerebral palsy and none could walk. At the time of surgery, eight hips were subluxated and 39 were dislocated or severely subluxated. Mean follow-up was 8 years in patients between 8–25 years old. Forty-five of the 47 hips were located. Thirty patients had an accompanying scoliosis, and, in 10 patients, the rib cage impinged on the pelvis. Hip flexion had decreased in most patients. Sitting ability had not improved in any patient, and had in fact deteriorated in 50%.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:In order to evaluate further the efficacy of local intramuscular injections of botulinum-A toxin (BAT-A) in the management of dynamic equinus deformity associated with cerebral palsy, a randomized, double-blind, placebo-controlled study was undertaken. When evaluated using our Physician Rating Scale, 83% (five of six) of patients receiving toxin showed improvement, versus 33% (two of six) receiving placebo. There were no major complications. BAT-A injections appear to be safe and effective in children, and merit further prospective study.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:We endeavored to determine the prevalence of occipitoatlantal hypermobility in individuals with Down syndrome, to establish objective radiographic criteria for this entity, and to correlate this with neurologic abnormality. In a retrospective analysis, upper cervical spine radiographs of 210 patients with Down syndrome were compared with those of 102 normal individuals. Radiographs were evaluated using the Powers ratio. Patients identified with radiographic evidence of posterior occipitoatlantal hypermobility were then examined clinically and compared with a matched group of patients with Down syndrome and normal Powers ratios. Of the patients with Down syndrome, 8.5% had a Powers ratio of <0.55, which was indicative of posterior occipitoatlantal hypermobility (POAH). Furthermore, 66% of those with an abnormal Powers ratio had positive neurologic findings upon physical exam, a finding that was statistically significant when compared to a matched group of patients with Down syndrome and normal Powers ratio.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:A retrospective review of 25 patients with scoliosis secondary to syringomyelia was conducted. All patients had large syrinxes, but only 10 patients had abnormal neurologic findings, suggesting that subtle neurologic findings in patients with scoliosis should not be underestimated and supporting liberal use of magnetic resonance imaging (MRI). The results of three approaches to the care of these patients were reviewed: passive observation, bracing, and spinal fusion. Curves progressed ≥5° in patients aged <10 years who were observed, but in children aged >10 years, curves progressed ≥10°. Curves responded well to bracing, but correction was not maintained out of brace for patients with progressive and/or severe curves. Good correction was achieved safely during operation.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:Eighty-eight patients were treated at the Alfred I. duPont Institute for disc disease from 1940 to 1989. Forty-eight patients, with an average age of 16 years, underwent discectomy. Twenty-three patients were followed for an average of 6 years after initial presentation. Thirteen patients, with an average age of 15 years, and who had radiographic documentation of disc disease, were treated nonoperatively. Eight patients were followed for an average of 6.3 years. The results of discectomy were rated as excellent or good in 91% of the patients, and poor in 9% at follow-up. In the patients treated nonoperatively, the results were rated as excellent or good in 25%, and poor in 75%. Our 6 year follow-up study suggests that discectomy yields excellent to good long-term results in children and adolescents.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:We reviewed the cases of 16 patients with myelomeningocele and congenital kyphosis. Ten patients underwent kyphectomy with wire fixation and spinal fusion for severe-curve progression and problems with decubiti ulcers. The average curve magnitude at presentation for these 10 patients was 87° (range 47–146°); at an average follow-up of 5 + 8 years (range 2 + 9 to 9 + 9 years) after surgery, it was 60° (range 15–80°). A stable fusion was achieved in nine patients, and all 10 had improved status of their skin at their last follow-up. Six patients were managed by nonoperative means such as modified wheelchairs and orthoses. The average curve magnitude at the presentation for this group was 70° (range 42°–93°); at an average follow-up of 19 years (range 5 + 5 to 27 + 3 years), it was 106° (range 65°–130°). Two of these patients continue to have problems with skin breakdown. Kyphectomy enables patients to sit straighter and is the proper treatment for these patients. If operative treatment is prohibitive or denied for some reason, then suitable wheelchair modifications can enable these patients to function with reasonable comfort.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Summary:We studied somatosensory evoked potentials (SEPs) in 20 chickens with experimentally induced scoliosis after pinealectomy and in 100 patients with idiopathic scoliosis. We also studied 20 chickens without scoliosis and 20 healthy youngsters. In the chickens, SEPs after leg stimulation was significantly delayed in the scoliosis group compared to the controls. In patients, the latency of cortical potential (N37) after stimulation of tibial nerve was longer in the scoliosis group than in the controls. Our findings in both experimental and clinical studies strongly support the hypothesis that idiopathic scoliosis results from dysfunction in the central nervous system. The type of SEPs abnormalities described in idiopathic scoliosis suggest a pathology from the midbrain to the cortex.

ISSN:0271-6798    

出版商:OVID    

年代:1994

数据来源: OVID