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Marc Dreimann, Michael Hoffmann, Lennart Viezens, Lukas Weiser, Patrick Czorlich, Sven Oliver Eicker
PURPOSE: Metastatic epidural spinal cord compression (MESCC) often requires anterior-posterior decompression and stabilization. To reduce approach-related complications, single-stage posterolateral vertebrectomy and 360° fusion is often performed. However, a sufficient reduction of kyphotic deformity through this approach has not been reported. The purpose of this study is to investigate the efficacy of kyphotic deformity reduction by this approach in MESCC. METHODS: A retrospective analysis and chart review was performed for 14 consecutive patients who underwent a vertebrectomy and decompression from a posterolateral approach...
October 11, 2016: European Spine Journal
Tayebeh Roghani, Minoo Khalkhali Zavieh, Farideh Dehghan Manshadi, Nicole King, Wendy Katzman
The present study aims to qualitatively review the contributing factors and health implications of age-related hyperkyphosis. We conducted a narrative review of observational and cohort studies describing the risk factors and epidemiology of hyperkyphosis from 1955 to 2016 using the following key words: kyphosis, hyperkyphosis, posture, age-related hyperkyphosis, kyphotic posture, aetiology and causes. This review included 77 studies. Approximately 60-70 % of the most severe hyperkyphosis cases have no evidence of underlying vertebral compression fractures...
August 18, 2016: Aging Clinical and Experimental Research
Michelle S Yau, Serkalem Demissie, Yanhua Zhou, Dennis E Anderson, Amanda L Lorbergs, Douglas P Kiel, Brett T Allaire, Laiji Yang, L Adrienne Cupples, Thomas G Travison, Mary L Bouxsein, David Karasik, Elizabeth J Samelson
Hyperkyphosis is a common spinal disorder in older adults, characterized by excessive forward curvature of the thoracic spine and adverse health outcomes. The etiology of hyperkyphosis has not been firmly established, but may be related to changes that occur with aging in the vertebrae, discs, joints, and muscles, which function as a unit to support the spine. Determining the contribution of genetics to thoracic spine curvature and the degree of genetic sharing among co-occurring measures of spine health may provide insight into the etiology of hyperkyphosis...
July 25, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Gina N Woods, Mei-Hua Huang, Peggy M Cawthon, Gail A Laughlin, John T Schousboe, Corinne McDaniels-Davidson, Jane A Cauley, Eric Orwoll, Elizabeth Barrett-Connor, Deborah M Kado
Accentuated kyphosis is associated with adverse health outcomes including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4 degrees to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high SHBG, are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We therefore hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross-sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis...
June 29, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Amanda L Lorbergs, George T O'Connor, Yanhua Zhou, Thomas G Travison, Douglas P Kiel, L Adrienne Cupples, Hillel Rosen, Elizabeth J Samelson
BACKGROUND: Hyperkyphosis reduces the amount of space in the chest, mobility of the rib cage, and expansion of the lungs. Decline in pulmonary function may be greater in persons with more severe kyphosis; however, no prospective studies have assessed this association. We conducted a longitudinal study to quantify the impact of kyphosis severity on decline in pulmonary function over 16 years in women and men. METHODS: Participants included a convenience sample of 193 women and 82 men in the Framingham Study original cohort (mean age: 63 years; range: 50-79 years), who had measurements of kyphosis angle from lateral spine radiographs obtained in 1972-1976 and forced expiratory volume in 1 second (FEV1) from spirometry taken four times over 16 (±1...
June 23, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Justin A Iorio, Patrick Reid, Han Jo Kim
The number of surgeries performed for adult spinal deformity (ASD) has been increasing due to an aging population, longer life expectancy, and studies supporting an improvement in health-related quality of life scores after operative intervention. However, medical and surgical complication rates remain high, and neurological complications such as spinal cord injury and motor deficits can be especially debilitating to patients. Several independent factors potentially influence the likelihood of neurological complications including surgical approach (anterior, lateral, or posterior), use of osteotomies, thoracic hyperkyphosis, spinal region, patient characteristics, and revision surgery status...
September 2016: Current Reviews in Musculoskeletal Medicine
Friederike Lattig, Rita Taurman, Anna K Hell
STUDY DESIGN: Case Series. OBJECTIVE: To describe the post-VEPTR (vertical expandable prosthetic titanium rib) treatment changes in early-onset spinal deformity (EOSD), which may influence the final correction spondylodesis. SUMMARY OF BACKGROUND DATA: The VEPTR device, originally developed for the treatment of congenital rib cage malformation, is nowadays more widely used in the treatment of EOSD. At present, only a few reports describe the possible complications that may occur with repeated lengthening procedures of the VEPTR, thereby making the final spondylodesis more complicated and less satisfactory...
June 2016: Clinical Spine Surgery
Isuzu Meyer, Tatum A McArthur, Ying Tang, Jessica L McKinney, Sarah L Morgan, Holly E Richter
OBJECTIVES: To characterize the association between thoracic (T) and lumbar (L) spinal curvature and pelvic floor (PF) symptoms (pelvic organ prolapse, urinary incontinence [UI], fecal incontinence [FI]). METHODS: Of women undergoing a bone mineral density scan from January 2007 to October 2010, patients who completed PF symptom questionnaires and had T and/or L spine radiographs or computed tomography examinations within 3 years of questionnaire completion were included in this study...
July 2016: Female Pelvic Medicine & Reconstructive Surgery
Michael Schwake, Tarek Zoubi, Stephanie Schipmann, Walter Stummer, Christian Ewelt
BACKGROUND: Ankylosing spondylitis (AS) is an autoimmune inflammatory arthritis causing ossifications and rigidity of the spinal column. Patients with AS have a high incidence of spinal fractures, especially in the cervical spine, with a high rate of epidural hematomas. These have hazardous consequences, including neurological sequelae, and high morbidity and mortality. Diagnostics rely on CT and MRI scans, and therapy, usually open decompression and fixation, has to be done as soon as possible to enable recovery...
April 2016: Acta Neurochirurgica
Ahmet Karakaşlı, Eyad Sekik, Ahmet Karaarslan, Ceren Kızmazoğlu, Hasan Havıtçıoğlu
OBJECTIVES: This study aims to biomechanically evaluate and compare four well-known types of terminal spinal constructs to a novel construct composed of a transpedicular screw with a lateral hook screw in terms of axial pullout strength in terminal vertebral segment fixation. MATERIALS AND METHODS: Forty fresh-frozen lamb spines were divided into five groups with eight spines each. To stabilize the transverse process, a pedicular screw alone was used in group 1, a sublaminar hook alone was used in group 2, a sublaminar hook and a pedicular screw were used in group 3, claw hook alone was used in group 4, and a pedicular screw with a lateral hook screw was used in group 5...
2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Fahimeh Kamali, Sara Abolahrari Shirazi, Samaneh Ebrahimi, Maryam Mirshamsi, Ali Ghanbari
OBJECTIVE: To compare the efficacy of a manual therapy and an exercise therapy program in improving postural hyperkyphosis among young adults. METHODS: Forty-six women between the ages of 18 to 30 years with thoracic kyphosis diagnosed by flexicurve ruler were randomly assigned to either an exercise therapy or a manual therapy group. The exercise therapy program focused on stretching and strengthening exercises in 15 sessions over 5 weeks. The manual therapy group received 15 sessions of manual techniques including massage, mobilization, muscle energy and myofascial release...
2016: Physiotherapy Theory and Practice
Mahboobeh Mehdikhani, Hamid Behtash, Mohammad S Ganjavian, Nafiseh Khalaj
BACKGROUND: Hyperkyphosis with unknown reason is common in teenagers and can be corrected by orthotic management. OBJECTIVES: Investigation of orthotic outcomes by Milwaukee brace. METHODS: Sixty-one patients with idiopathic hyperkyphosis (> 45 degrees) were given Milwaukee brace before skeletal maturity. Hyperkyphosis was measured during the first visit without brace, in-brace, at the end of full-time and part time duration of treatment...
August 10, 2016: Journal of Back and Musculoskeletal Rehabilitation
Javier Pizones, Alberto Núñez-Medina, Felisa Sánchez-Mariscal, Lorenzo Zúñiga, Enrique Izquierdo
PURPOSE: To analyze the sagittal thoracic parameters of different types of progressive thoracic adolescent idiopathic scoliosis (AIS) patients and compare them with healthy adolescents. METHODS: 115 AIS patients with main thoracic curves (Cobb: 59.4 ± 12.7) were prospectively compared with 116 healthy adolescents. The AIS and control (C) groups were homogeneous in terms of age and gender. Standing sagittal radiographs were analyzed for differences in T5-T12 kyphosis, T5-T8 and T9-T12 segmental kyphosis, the change between these two angles, and the double rib contour sign...
January 28, 2016: European Spine Journal
W B Katzman, E Vittinghoff, D M Kado, N E Lane, K E Ensrud, K Shipp
SUMMARY: Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. INTRODUCTION: Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities...
March 2016: Osteoporosis International
Melvin Mohokum, Samuel Schülein, Adrian Skwara
To investigate and monitor the progression of scoliosis and other spinal deformities in patients following idiopathic scoliosis (IS), non-invasive and radiation-free techniques are recommended because of the need for repeated radiographs. In a clinical setting, spine parameters can be quickly, cheaply and easily assessed using rasterstereography (RS). To assess the validity of the radiation-free technique RS based on surface topography compared with radiographs. MEDLINE, the Cochrane Library and EMBASE were systematically searched for studies which investigate the validity of rasterstereography compared with x-ray measurements...
September 28, 2015: Orthopedic Reviews
Howard Y Park, Hiroko Matsumoto, Nicholas Feinberg, David P Roye, Wajdi W Kanj, Randal R Betz, Patrick J Cahill, Michael P Glotzbecker, Scott J Luhmann, Sumeet Garg, Jeffrey R Sawyer, John T Smith, John M Flynn, Michael G Vitale
BACKGROUND: The Classification for Early-onset Scoliosis (C-EOS) was developed by a consortium of early-onset scoliosis (EOS) surgeons. This study aims to examine if the C-EOS classification correlates with the speed (failure/unit time) of proximal anchor failure in EOS surgery patients. METHODS: A total of 106 EOS patients were retrospectively queried from an EOS database. All patients were treated with vertical expandable prosthetic titanium rib and experienced proximal anchor failure...
November 13, 2015: Journal of Pediatric Orthopedics
Piotr Janusz, Marcin Tyrakowski, Tomasz Kotwicki, Kris Siemionow
STUDY DESIGN: Retrospective evaluation of radiographs. OBJECTIVE: The aim of this study was to assess sagittal cervical balance in patients with the two types Scheuermann disease (SD). SUMMARY OF BACKGROUND DATA: The structural hyperkyphosis characterizing SD may be localized in the thoracic (SDT) or thoraco-lumbar (SDTL) spine segments. This may affect sagittal cervical balance. METHODS: Seventy-one patients (41 males and 30 females), aged 16...
December 2015: Spine
Morgan L Brubaker, Mehrsheed Sinaki
BACKGROUND: Iliocostal impingement syndrome is a rare, painful, and disabling condition associated with thoracic hyperkyphosis and kyphoscoliosis. There is little published literature regarding management of this syndrome. The purpose of this case series is to report treatment outcomes for iliocostal impingement syndrome with improving posture and back muscle strength. CASE DESCRIPTION AND METHODS: Thirty-eight women with thoracic hyperkyphosis or kyphoscoliosis and back and/or flank pain were diagnosed with iliocostal impingement syndrome on the basis of symptoms and spine radiographs...
June 2016: Prosthetics and Orthotics International
Sabrina Donzelli, Salvatore Poma, Luca Balzarini, Alberto Borboni, Stefano Respizzi, Jorge Hugo Villafane, Fabio Zaina, Stefano Negrini
Scoliosis is a complex three dimensional (3D) deformity: the current lack of a 3D classification could hide something fundamental for scoliosis prognosis and treatment. A clear picture of the actually existing 3D classifications lacks. The aim of this systematic review was to identify all the 3D classification systems proposed until now in the literature with the aim to identify similarities and differences mainly in a clinical perspective.After a MEDLINE Data Base review, done in November 2013 using the search terms "Scoliosis/classification" [Mesh] and "scoliosis/classification and Imaging, three dimensional" [Mesh], 8 papers were included with a total of 1164 scoliosis patients, 23 hyperkyphosis and 25 controls, aged between 8 and 20 years, with curves from 10° to 81° Cobb, and various curve patterns...
2015: Journal of Neuroengineering and Rehabilitation
Tamir Ailon, Christopher I Shaffrey, Lawrence G Lenke, James S Harrop, Justin S Smith
Thoracic kyphosis tends to increase with age. Hyperkyphosis is defined as excessive curvature of the thoracic spine and may be associated with adverse health effects. Hyperkyphosis in isolation or as a component of degenerative kyphoscoliosis has important implications for the surgical management of adult spinal deformity. Our objective was to review the literature on the epidemiology, etiology, natural history, management, and outcomes of thoracic hyperkyphosis. We performed a narrative review of literature on thoracic hyperkyphosis and its implications for adult spinal deformity surgery...
October 2015: Neurosurgery
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