摘要:

This study was designed to investigate the relationship between postural deformities—including both the spine and lower extremities—and clinical symptoms in spinal osteoporotics. Lateral roentgenographic films of 100 osteoporotic patients taken in a standing position were analyzed. Thoracic kyphosis, a primary deformity of the osteoporotic spine, appeared compensated by the lumbar spine, sacroiliac joint, hip joint, and knee joint, respectively. Low-back pain was highly associated with decreased lumbar lordosis and increased sacropelvic angle, suggesting that the sacroiliac joint was one of the causes of low-back pain.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Eighty-four patients were objectively evaluated with a weight-bearing pattern analyzer to determine whether spine deformity has an effect on the amount of weight borne on the right versus left foot and on the fore versus the hind foot. Patients with idiopathic scoliosis treated with bracing and surgery and patients with Scheuermann's kyphosis treated with bracing were compared with control subjects. Patients with right thoracic and thoracolumbar curves did not bear more weight on the right foot, as was previously thought. Patients with relatively unaffected lumbar spines exhibited normal sagittal plane weight-bearing patterns, whereas patients with double major and lumbar curves did show abnormalities in the weight-bearing pattern. Bracing of curves less than 40° did not alter the plantar weight-bearing pattern, but it did significantly alter the pattern in curves greater than 40°. Surgically treated patients were found to have increased hindfoot weight-bearing irrespective of the curve type or surgery.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The cause of adolescent idiopathic scoliosis remains an enigma. Several studies have demonstrated abnormalities of posture, proprioception, and equilibrium control in patients with adolescent idiopathic scoliosis. These functions are integrated by structures in and around the brain stem. Twenty-seven patients with adolescent idiopathic scoliosis were studied with magnetic resonance imaging to delineate the anatomy of the brain stem in such patients. Imaging was conducted from the hypothalamus to the spinal cord at C3 in 26 patients; the remaining patient underwent an incomplete study because of a claustrophobic reaction. The study group consisted of 25 females and 2 males with an average age of 16 + 5 years. There were 19 right thoracic curves, 5 thoracolumbar curves, and 3 left lumbar curves. The mean primary curve size was 27° at the most recent clinical evaluation. Seven patients were treated with observation, 14 with bracing, and 6 with surgery. The magnetic resonance imaging studies were read independently by three attending radiologists in a randomized, blinded fashion along with the magnetic resonance imaging studies of 11 controls. Asymmetry in the ventral pons or medulla in the area of the corticospinal tracts was noted in seven study patients and one control; one study patient had an enlarged cisterna magna and one an inconclusive (incomplete) study. These findings may support previous studies that have suggested a central nervous system abnormality as a cause of adolescent idiopathic scoliosis.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Four patients are described with a triad of neuroectodermal abnormalities consisting of lumbosacral kyphosis, tethered cord, and dyplomyelia. Of utmost importance is the recognition of the association between this type of kyphosis and the underlying spinal cord pathology and the progressive nature of the deformity. The patient presenting with lumbosacral kyphos and the presence of sacral hypoplasia should have a neuroradiographic evaluation (magnetic resonance imaging scanning or enhanced computed tomography) to rule out the presence of a tethered cord or other neural abnormalities. Early surgical intervention for release of the tether and fusion should be carried out to prevent neurologic deterioration and curve progression.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

From 1985 to 1987,82 patients with idiopathic scoliosis followed 12 to 44 months underwent selective fusion and correction of their right thoracic curves by Cotrel—Dubousset instrumentation using the “derotation” maneuver. Preoperative, postoperative, and follow-up standing anteroposterior roentgenograms of the spine were analyzed. For curves in which there was deviation from the midline (plumb line) and rotation of the lumbar segments, an increased incidence of decompensation was produced after surgery, when posterior Cotrel—Dubousset instrumentation and fusion were carried to the “stable” vertebra with one rod bend and hook alignment on the left sided derotation rod. Previous guidelines established for selective fusion with conventional posterior instrumentation (Harrington or Luque rods) may not be applicable to derotation with Cotrel—Dubousset instrumentation.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purposes of this study were to determine the longterm correction achieved by excision of lumbar hemivertebrae and the risk attendant. Seven patients had a followup of 41.14 months for lumbar hemivertebral excisions. Six had two-stage anterior vertebral body excision and, 7-8 days later, posterior lamina and pedicle excision with fusion. One patient had a single-stage correction. After surgery, the patients were in pantaloon casts or braces for a minimum of 6 months (supine, first 6-12 weeks). Hemivertebrae were at L2 (N = 1), L3 (N = 1), L4-L5 (N = 1), and L5-S1 (N = 4). Preoperative curves or hemivertebral angles averaged 36.6° (range, 30-52°). Average age was 7.5 years (range, 22 months to 12.5 years). Mean follow-up was 41.14 months. Surgical correction of the seven cases averaged 28.0°. Two-stage procedures yielded 29.7° correction with no complications; singlestage yielded 18° correction, and the only complication was an L5 nerve root paresis.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The attachments and orientation of every fascicle of the lumbar erector spinae were determined in five cadavers and recorded radiographically. Little variation was found in the sites of muscle attachment, which enabled the construction of maps whereby these sites could be plotted on clinical radiographs or models of the lumbar spine. When all fascicles were plotted on 21 clinical radiographs using the maps previously developed, no significant difference in the orientation of fascicles was found compared with that observed in cadavers. This result vindicates the technique used to plot the location of individual fascicles of the lumbar back muscles.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The intersegmental and multisegmental musculature of the lumbar spine was studied in a biomechanical model to compare their lateral stabilizing potential. By approximating the active and passive behavior of the stretch reflex as a variable stiffness spring whose stiffness was proportional to activation, the critical muscle stiffness required for mechanical stability was calculated. The model demonstrated that the intersegmental muscles were the least efficient at laterally stabilizing the spine. At any given load, multisegmental muscles were more efficient, and their efficiency increased with the number of segments spanned. The most efficient muscles were those that originated from the pelvis, spanning the maximum number of segments. The muscular model was unstable, regardless of the muscular stiffness, when any vertebral segment was devoid of muscle. Moreover, when the load on the spine is increased, buckling can be prevented most efficiently with the pelvic muscles and least efficiently with the intersegmental muscles.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purpose of this investigation was to assess the reliability of isokinetic trunk muscle performance. Sixtyone volunteers participated (29 men, 32 women; age range, 20-60 years). All subjects were without low-back symptoms at the time of testing. All testing was performed with the subject initially standing, using speeds of 60, 120, and 180° per second. Ten repetitions of flexion and extension were performed reciprocally at each speed, with a 3-minute rest period between speeds. Testretest intervals were 1 and 3 weeks from the initial test. Peak torque-to-body-weight ratios, extension-to-flexion ratios, and average work per repetition were calculated for each speed for flexion and extension. Data were analyzed with analysis of variance, intraclass correlation coefficients, and Pearson correlation coefficients. Intraclass correlation coefficient values ranged from .74 to .88 for measurements derived from peak torque, and from .88-.93 for measurements derived from work (with the exception of .69 for men at 180°/sec). Standard error of measurements ranged from 8 to 32 ft-lb, with a tendency to increase with increasing speeds. It was concluded that, when using this protocol, isokinetic measurements of muscle function offer the clinician sensitive and reliable measurements of trunk muscle performance and that incorporating increased practice with women and longer rest periods with men may further decrease error associated with these isokinetic trunk strength measurements.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purpose of this study was 1) to provide normative data for isokinetic trunk strength as measured by peak torque, best work repetition, and a new composite variable, “muscle performance index” and 2) to examine the effects of protocol velocity, subject age, gender, height, and weight on these measurements. A significant decrease in peak torque of extension for females (P < 0.0001) was seen as protocol velocity increased, but no differences were seen in males. A statistically significant amount (0.5-0.7) of the variance in isokinetic measurements was explained by subject age, height, and weight. Multivariant analysis of covariance showed the effects of these variances to be significant on all measurements except for the muscle performance index, which was unaffected by protocol velocity and remained stable without adjustments for subject age, weight, or height.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID