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Adult kyphosis and braces

D C Jaffray, S M Eisenstein, B Balain, J M Trivedi, M Newton Ede
AIMS: The authors present the results of a cohort study of 60 adult patients presenting sequentially over a period of 15 years from 1997 to 2012 to our hospital for treatment of thoracic and/or lumbar vertebral burst fractures, but without neurological deficit. METHOD: All patients were treated by early mobilisation within the limits of pain, early bracing for patient confidence and all progress in mobilisation was recorded on video. Initial hospital stay was one week...
January 2016: Bone & Joint Journal
Alfredo Pompili, Fabrizio Caroli, Francesco Crispo, Maddalena Giovannetti, Laura Raus, Antonello Vidiri, Stefano Telera
BACKGROUND: Spinal intradural tumors are usually removed with laminectomy/laminotomy with a midline dural incision. Pain, discomfort, postoperative kyphosis, and instability may be minimized with unilateral microsurgery. METHODS: Seventy patients with schwannoma (73 tumors) and 27 patients with meningioma (29 tumors) were operated on with unilateral hemilaminectomy (June 2000 to March 2014). Surgery was generally kept to 1 or 2 levels, removing all the craniocaudal ligamentum flavum...
January 2016: World Neurosurgery
Raheel Ahmed, Arnold H Menezes, Olatilewa O Awe, Kelly B Mahaney, James C Torner, Stuart L Weinstein
OBJECT: Spinal deformity in pediatric patients with intramedullary spinal cord tumors (IMSCTs) may be either due to neurogenic disability or due to secondary effects of spinal decompression. It is associated with functional decline and impairment in health-related quality-of-life measures. The authors sought to identify the long-term incidence of spinal deformity in individuals who had undergone surgery for IMSCTs as pediatric patients and the risk factors and overall outcomes in this population...
June 2014: Journal of Neurosurgery. Pediatrics
Loyola V Gressot, Sudhakar Vadivelu, Steven W Hwang, Daniel H Fulkerson, Thomas G Luerssen, Andrew Jea
OBJECT: Cervical spondylolysis is a rare condition that results from a pars interarticularis defect. The C-6 level is the most frequently involved site in the cervical spine. Its clinical presentations range from incidental radiographic findings to neck pain and, rarely, neurological deficits. Although 150 patients with subaxial cervical spondylolysis have been reported, a mere 24 adult and pediatric patients with C-2 spondylolysis have been described. The long-term outcomes of very young children with bilateral C-2 spondylolysis are of great interest, yet only a few longitudinal studies exist...
February 2014: Journal of Neurosurgery. Pediatrics
Luigi A Nasto, Debora Colangelo, Valentina Mazzotta, Eugenia Di Meco, Valentina Neri, Riccardo A Nasto, Massimo Fantoni, Enrico Pola
BACKGROUND CONTEXT: Currently, treatment for patients diagnosed with noncomplicated (ie, known infectious agent, no neurologic compromise, and preserved spinal stability) pyogenic spondylodiscitis (PS) is based on intravenous antibiotics and rigid brace immobilization. Since January 2010, we started offering our patients percutaneous posterior screw-rod instrumentation as an alternative approach to rigid bracing. Supposed benefits of posterior percutaneous instrumentation over rigid bracing are earlier free mobilization, increased comfort, and faster recovery...
July 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Avraam Ploumis, Andrew K Simpson, Thomas D Cha, Joshua P Herzog, Kirkham B Wood
STUDY DESIGN: This study was a retrospective one. OBJECTIVE: The objective of the study was to analyze the causes, prevalence of, and risk factors for coronal decompensation in long adult lumbar spinal instrumentation and fusion (from thoracic or upper lumbar spine) to L5 or S1. SUMMARY OF BACKGROUND DATA: Coronal and sagittal decompensation after long fusions for spinal deformities can affect outcomes negatively. There is no study reporting the natural history of coronal spinal balance after long spinal fusions...
November 2015: Journal of Spinal Disorders & Techniques
F Tomé-Bermejo, A I Tsirikos
Scheuermann kyphosis is a structural deformity of the thoracic or thoracolumbar spine that develops prior to puberty and deteriorates during adolescence. There is limited information on its natural history but many patients are expected to have a benign course. Severe kyphosis can progress into adult life and cause significant deformity and debilitating back pain. Conservative treatment includes bracing and physical therapy, but although widely prescribed they have not been scientifically validated. Surgical treatment may be considered in the presence of a progressive kyphosis producing severe pain resistant to conservative measures, neurological compromise, or unacceptable deformity...
November 2012: Revista Española de Cirugía Ortopédica y Traumatología
Irfan Öztürk, Erden Ertürer, Mehmet Mesut Sönmez, Seçkin Sarı, Ali Şeker, Mustafa Faik Seçkin
OBJECTIVE: This study aimed to research the effectiveness of customized thoracolumbosacral orthosis treatment for stable burst type thoracolumbar vertebral fractures without neurological deficits. METHODS: The study included 26 patients (14 males, 12 females; mean age: 46.03 years; range: 18 to 64 years) conservatively treated for thoracolumbar (T11-L2) burst type vertebral fractures according to Denis classification between 2002 and 2009. Etiology were a fall from various heights in 12 patients (46...
2012: Acta Orthopaedica et Traumatologica Turcica
Heiko Koller, Oliver Meier, Juliane Zenner, Michael Mayer, Wolfgang Hitzl
INTRODUCTION: With progression of cervicothoracic kyphosis (CTK), ankylosing spondylitis (AS) patients suffer functional disability. Surgical correction still poses neurologic risks, while evidence of an ideal technique preventing its complications is weak. MATERIALS AND METHODS: We report our results with non-instrumented correction in perspective of a review of literature, serving as an important historical control. Database review identified 18 AS patients with CTK correction...
April 2013: European Spine Journal
Mohammed F Shamji, Darren M Roffey, Darryl K Young, Rudy Reindl, Eugene K Wai
STUDY DESIGN: Prospective, 2-center, observer-blinded, randomized controlled trial. OBJECTIVE: Investigate clinical and radiologic outcomes of bracing versus no-bracing in the treatment of stable thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Management of thoracolumbar burst fractures depends upon clinical presentation of neurological deficit and radiographic features of fracture severity. Neurologically intact patients with mild deformity and biomechanical stability may be treated with conservative therapy...
October 2014: Journal of Spinal Disorders & Techniques
A I Tsirikos, G Smith
We reviewed 31 consecutive patients with Friedreich's ataxia and scoliosis. There were 24 males and seven females with a mean age at presentation of 15.5 years (8.6 to 30.8) and a mean curve of 51° (13° to 140°). A total of 12 patients had thoracic curvatures, 11 had thoracolumbar and eight had double thoracic/lumbar. Two patients had long thoracolumbar collapsing scoliosis with pelvic obliquity and four had hyperkyphosis. Left-sided thoracic curves in nine patients (45%) and increased thoracic kyphosis differentiated these deformities from adolescent idiopathic scoliosis...
May 2012: Journal of Bone and Joint Surgery. British Volume
D Krappinger, T J Kastenberger, R Schmid
OBJECTIVE: Reduction and stabilization of osteoporotic vertebral body fractures using posterior short-segment instrumentation. Cement augmentation of the pedicle screws in order to improve the screw’s holding power in osteoporotic bone and to reduce postoperative loss of reduction. Quick and painless postoperative mobilization without further bracing. INDICATIONS: Burst fractures (type A3 according to Magerl). Posttraumatic kyphosis following osteoporotic vertebral body fractures...
February 2012: Operative Orthopädie und Traumatologie
Xuesong Zhang, Xuelian Zhang, Yonggang Zhang, Zheng Wang, Yan Wang
BACKGROUND: Posttraumatic thoracolumbar deformities can occur in patients after conservative or inadequate surgical treatment. Anterior, posterior, or combined anterior and posterior procedures of Smith-Peterson osteotomy technique have been developed to correct thoracolumbar kyphosis to various degrees. Recently, many reports have addressed the specific problem of local posttraumatic thoracolumbar deformity; however, there is significant controversy over the ideal management. The objectives are to illustrate the technique of modified closing wedge osteotomy for the treatment of posttraumatic kyphosis and to report the radiographic results and clinical outcome of patients treated with the technique...
July 2011: Journal of Trauma
A I Tsirikos, A K Jain
This review of the literature presents the current understanding of Scheuermann's kyphosis and investigates the controversies concerning conservative and surgical treatment. There is considerable debate regarding the pathogenesis, natural history and treatment of this condition. A benign prognosis with settling of symptoms and stabilisation of the deformity at skeletal maturity is expected in most patients. Observation and programmes of exercise are appropriate for mild, flexible, non-progressive deformities...
July 2011: Journal of Bone and Joint Surgery. British Volume
Andrea Piazzolla, G Solarino, S De Giorgi, C M Mori, L Moretti, G De Giorgi
The study design is retrospective. The aim is to describe our experience about the treatment of patients with neuromuscular scoliosis (NMS) using Cotrel-Dubousset instrumentation. Neuromuscular scoliosis are difficult deformities to treat. A careful assessment and an understanding of the primary disease and its prognosis are essential for planning treatment which is aimed at maximizing function. These patients may have pelvic obliquity, dislocation of the hip, limited balance or ability to sit, back pain, and, in some cases, a serious decrease in pulmonary function...
May 2011: European Spine Journal
Charles E Johnston, B Stephens Richards, Daniel J Sucato, Keith H Bridwell, Lawrence G Lenke, Mark Erickson et al.
STUDY DESIGN: Clinical study correlating preoperative pulmonary function tests (PFTs) to radiographic measures of thoracic deformity severity in adolescent idiopathic scoliosis (AIS) patients. OBJECTIVE: To determine (1) the incidence of clinically relevant (<65% predicted value) pulmonary impairment in AIS patients; (2) if patients with more severe deformity have greater impairment of PFTs than those with lesser deformity; (3) the effect, if any, of juvenile onset deformity (onset<age 10) on preoperative PFTs...
June 15, 2011: Spine
Jia-hu Fang, Lian-shun Jia, Xu-hui Zhou, Li-jun Song, Wei-hua Cai, Xiang Li
OBJECTIVE: To analyze the clinical characteristics and the surgical treatment strategy of cervical kyphosis. METHODS: From March 2006 to October 2009, 31 cases of cervical kyphosis were treated. According to the clinical features and imaging findings, different treatment methods were used. There were 9 patients in operation group, including 4 male and 5 female patients, aged from 17 to 72 years (average age of 35 years). Among them, 5 cases were idiopathic kyphosis and 4 cases were caused by laminectomy or other reasons...
October 15, 2010: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Wendy B Katzman, Linda Wanek, John A Shepherd, Deborah E Sellmeyer
SYNOPSIS: Age-related hyperkyphosis is an exaggerated anterior curvature in the thoracic spine that occurs commonly with advanced age. This condition is associated with low bone mass, vertebral compression fractures, and degenerative disc disease, and contributes to difficulty performing activities of daily living and decline in physical performance. While there are effective treatments, currently there are no public health approaches to prevent hyperkyphosis among older adults. Our objective is to review the prevalence and natural history of hyperkyphosis, associated health implications, measurement tools, and treatments to prevent this debilitating condition...
June 2010: Journal of Orthopaedic and Sports Physical Therapy
M Akbar, S Almatrod, C H Fürstenberg, S Hemmer, J P Kretzer, R Abel, T M Seyler, T Bruckner, C Carstens, B Wiedenhöfer
BACKGROUND: The conservative and surgical management of lumbar kyphosis is difficult and is a challenge for the orthopaedic surgeon. A kyphotic deformity of the lumbar spine is present in 8% to 20% of these patients. Most curves have very rigid components, often exceed 80 degrees at birth. The options for conservative management are limited. Bracing is extremely difficult, rarely effective, and in advanced stages impossible. We have been using the Warner and Fackler kyphectomy technique at our institution since 1994 as a standard procedure for treating children with lumbar kyphosis due to myelomeningocele...
August 2010: Der Orthopäde
Myung-Sang Moon, Sung-Soo Kim, Bong-Jin Lee, Jeong-Lim Moon, Young-Wan Moon
To assess the effectiveness of deformity correction and safety of the two major corrective spinal surgical procedures, 35 patients, aged 14-47 years, were placed into two groups according to procedures performed. Sixteen patients (group A) had four-stage procedures including initial halo-pelvic distraction after anterior release and a subsequent three procedural steps plus brace. Nineteen patients (group B) had one-set two-stage procedures: wire segmental stabilisation in eight cases and rod/hook and/or pedicle screw stabilisation in 11 cases...
January 2011: International Orthopaedics
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