ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Multiple morphologic parameters were studied in 50 normal adult vertebral columns ranging in age from 20 to 40 years at the time of death. Posterior element morphology is highly variable and largely unpredictable. Minimum pedicle diameters ranged from 1.8 mm at T6 to 6.4 mm at L5, and did not correlate with any more readily measured vertebral dimensions. Penetration of 5 mm screw threads through pedicle cortex can be expected to occur routinely in the lower thoracic spine, and in a lesser but significant number of lumbar vertebrae.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The authors reviewed 43 patients with the onset of Idiopathic scoliosis between 4 and 9 years who were followed to skeletal maturity to document the natural history, effects of bracing, and factors associated with progression. Average age at onset was 7.1 years for female and 6.7 for male patients. Twelve were treated with observation only; six improved, five progressed, and one refused an orthosis and required surgery. Thirty-one patients wore an orthosis; five patients improved or were unchanged, and 26 progressed, including 13 who subsequently required surgery. All patients treated with observation had a rib vertebral angle difference (RVAD) of less than 10°; whereas patients progressing despite orthosis and all but one patient requiring operation had an RVAD greater than 10°. Thoracic hypokyphosis (<20°) was present In 20% of observed patients, 64% of those treated with an orthosis, and 78% of those requiring operation.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Curve behavior of idiopathic scoliosis in an exclusively male population was investigated, since it has not been previously reported. Fifty males with idiopathic scoliosis satisfied entry requirements for this study: standing posteroanterlor (PA) spine radiograph measuring a curve greater than 20°, preoperative observation for greater than 1 year (mean, 4.4 years), and nonoperative patients with greater than 5 years of radiographic follow-up beyond skeletal maturity (mean, 10.7 years). Mean rate of curve progression from presentation to Risser 4 maturation was 3.0°/year. Forty-four percent of the curves progressed 5° or more between Risser 4 and 5. The rate of curve progression following Risser 5 was 0.18°/year. Thoracic curves were associated with a higher degree of curve progression than other curve types (P < 0.05). There was no statistically significant association between curve progression and family history, vertebral rotation, Risser sign, or curve magnitude. Curve progression secondary to growth usually terminates at Risser 4 in females with idiopathic scoliosis. This study indicated that scollotic male curves demonstrated clinically significant progression until Risser 5 rather than Risser 4. Thus, the authors conclude that males with idiopathic scoliosis curves greater than 20° should be followed radiographically until Risser 5. In females, scoliosis beyond Risser 4 can be considered as an adult curve; however, in males, scoliosis can be evaluated as an adult curve only after Risser 5. Beyond Risser 5, male curves demonstrate minimal progression.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

In a retrospective cohort study of 1,409 persons diagnosed with scoliosis between 1927 and 1965 In Minneapolis and St. Paul, Minnesota, mailed questionnaires were obtained for 846 white women. Six hundred and eight (72%) of these women had ever been pregnant, and they reported a total of 1,733 pregnancies and 1,413 live-births. Adverse outcomes among the pregnancies and livebirths of the 608 women were reported, including spontaneous abortion, stillbirth, low birth weight, prematurity, congenital anomalies, and complications of pregnancy or delivery. Rates of these events for the scoliosis patients were compared with corresponding expected rates. Comparison of the overall rates suggested that the scoliosis patients had more premature births than expected,' but their rates of other adverse reproductive events did not differ from expected.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A prospective study was undertaken to evaluate osteoporosis in Scheuermann's disease. Ten consecutive untreated patients with thoracic Scheuermann's were studied. The mean age was 16 years, 1 month, and the mean kyphosis was 64°. Osteoporosis was quantitated by single and dual photon absorptiometry. Seven age-, sex-, height-, and weight-matched subjects were used as controls. The mean bone mineral density (BMD) of the lumbar spine was 0.975, compared with 1.130 for the control group, significant atP< 0.025. For patients with a kyphosis > 45°, the BMD was 0.913, significant atP< 0.005. The mean BMD of the femoral neck was 1.00, compared with 1.22, significant atP< 0.005. For patients with a kyphosis > 45°, the femoral neck BMD is 0.983, significant atP< 0.005. The BMD of the radius by single photon absorptiometry was 0.689, compared with 0.748 in the controls, which was not significant. In patients with a kyphosis > 45°, the BMD was 0.655, which is significant atP< 0.01. A highly significant association exists between osteoporosis and Scheuermann's disease. Further investigation is indicated to determine the role of medical management in the treatment of these patients.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thirty-four adolescent female patients with right thoracic idiopathic scoliosis were followed for a mean of 8.6 months to document progression of scoliosis curvature during bracewear. Prediction of change by deviation of the lateral asymmetry index on ISIS examination were compared with measured change on standard upright roentgenograms. A one-to-one correlation was found in 50% of the patients; five patients were predicted to have stayed the same or decreased by ISIS and showed increase on x-ray measurement. Eight patients were predicted to have stayed the same or decreased by x-ray measurement and showed increase by ISIS. Although a weak positive correlation exists between change by x-ray examination and change by ISIS examination in a braced population, the clinical usefulness of the ISIS method in following a braced population has not been proven.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A major concern in school screening programs as well as in the clinical assessment of spinal curvature has been the frequent radiation exposure required to ascertain curve progression. Various techniques have been developed to identify scoliosis such as the Moire and ISIS techniques, but these are very sophisticated and expensive. The authors have developed a simple procedure of Identifying and documenting spinal curvature during the performance of the Adams forward bend test, using an ultrasonic sound probe, four sound receivers, and a micro-computer. The probe is run along the spinous processes emitting an ultrasonic sound, which is picked up by four receivers mounted at the corners of a rectangle above the patient. The signal is fed into a micro-computer and the spinal curvature is plotted out. The magnitude of the curve is calculated by the computer, and the actual curve plus the magnitude Is printed In hard copy to be placed in the chart. The reproducibility error and intermeasurer error has been less than 5%. A series of 30 patients with varying magnitudes of scoliosis from 15° to 73° were examined. The results of the ultrasonic digitization were compared with standard scoliosis radiographs of the patient taken the same week. The average curvature measured from the radiographs was 38°, and from the ultrasonic digitization technique, 30°: The forward bend position contributed to smaller curvature measurement, and measurement in the standing position was thought to be a better technique. Ultrasonic digitization as a method of curve measurement is most accurate In curves over 30°. Computerized ultrasonic digitization is a simple and effective technique to detect and monitor spinal curvature, and may offer a method of reducing the need for multiple radiographs.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The purpose of this study was to report the effects of spinal cord compression, ischemia, and distraction on clinical status, and somatosensory (SEP) and neurogenic-motor evoked potentials (NMEPs) in animals. The authors also reported their clinical experience with NMEPs elicited from humans undergoing surgery for spinal deformities. Results from the animal studies Indicate that NMEPs are more sensitive and specific to the effects from spinal cord compression, ischemia, and distraction than SEPs. In every situation, NMEPs always correlated with the animal's post-surgical clinical status, while SEPs demonstrated an unacceptable false positive and false negative rate. In the 111 clinical cases in which NMEPs were administered, reliable NMEPs were easily elicited in more than 90% of the cases. In the remaining cases, no reliable NMEPs could be recorded because of procedural errors, which have been resolved. The results from this study suggest that the use of NMEPs should be considered as an adjunct to SEPs when monitoring spinal cord function during surgery.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID