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Molly K Lewis, Omar Ramos-Williams, Hasan M Syed, Theodore K Gregorius
CASE: A 9-year-old boy sustained intrasubstance tears of the rotator cuff and periscapular muscles due to a fall, resulting in scapular winging and severely decreased shoulder range of motion. Treatment consisted of a modified thoracolumbosacral orthosis (TLSO) with a shoulder immobilizer attachment (to reduce the scapula to the thoracic wall and hold the arm in 10° of abduction). The brace was worn for 8 weeks. The patient recovered full, pain-free shoulder function and range of motion, and returned to high-level athletics...
March 14, 2018: JBJS Case Connector
Christopher Elia, Katie Huynh, Fanglong Dong, Dan Miulli
Spinal orthotic bracing is a common modality for treating nonoperative spinal fractures with risks. This study aimed to assess the effect of an intervention on critical care nurses to improve their clinical knowledge and comfort level of managing patients. A literature review was conducted regarding common complications associated with spinal orthotics. This information was compiled and used to create a questionnaire and spinal orthotic course for nurses. Pre- and postassessments of nurses' knowledge regarding spinal orthotics were conducted...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
O Ersen, S Bilgic, K Koca, T Ege, E Oguz, A B Bilekli
Although there are several conservative treatment options, only bracing has been found to be effective in preventing curve progression and a subsequent need for surgery in adolescent idiopathic scoliosis. The objective of this study is to compare the results of SpineCor brace and thoracolumbosacral orthosis (TLSO) for treatment of adolescent idiopathic scoliosis radiologically and clinically. Sixty-four patients with adolescent idiopathic scoliosis treated with brace included in this study. Height, T1-Coccygx distance, and gibbosity were measured...
December 2016: Acta Orthopaedica Belgica
Dong Kwang Seo, Jin-Hoon Park, Sun Kyu Oh, Yongchel Ahn, Sang Ryong Jeon
OBJECT: Serious postoperative wound problems can frequently develop after surgery with perioperative RT for upper thoracic metastatic lesions. The figure-of-eight bandage can restrict excessive shoulder motion, which could prevent wound dehiscence. The purpose of this study was to describe the efficacy of using the figure-of-eight bandage to prevent postoperative wound dehiscence. METHODS: Between February 2005 and July 2015, we retrospectively evaluated the medical records of cancer patients who underwent surgery with or without RT for spinal metastasis involving the upper thoracic spine...
November 10, 2017: British Journal of Neurosurgery
Edmond H Lou, Doug L Hill, Andreas Donauer, Melissa Tilburn, Douglas Hedden, Marc Moreau
BACKGROUND: Four factors have been reported to affect brace treatment outcome: (1) growth or curve based risk, (2) the in-brace correction, (3) the brace wear quantity, and (4) the brace wear quality. The quality of brace design affects the in-brace correction and comfort which indirectly affects the brace wear quantity and quality. This paper reported the immediate benefits and results on using ultrasound (US) to aid orthotists to design braces for the treatment of scoliosis. METHODS: Thirty-four AIS subjects participated in this study with 17 (2 males, 15 females) in the control group and 17 (2 males, 15 females) in the intervention (US) group...
2017: Scoliosis and Spinal Disorders
Keita Amagai, Haruo Ikeda, Junko Hashimoto, Ikuko Kozone, Miho Izumikawa, Fumitaka Kudo, Tadashi Eguchi, Takemichi Nakamura, Hiroyuki Osada, Shunji Takahashi, Kazuo Shin-Ya
Telomestatin, a strong telomerase inhibitor with G-quadruplex stabilizing activity, is a potential therapeutic agent for treating cancers. Difficulties in isolating telomestatin from microbial cultures and in chemical synthesis are bottlenecks impeding the wider use. Therefore, improvement in telomestatin production and structural diversification are required for further utilization and application. Here, we discovered the gene cluster responsible for telomestatin biosynthesis, and achieved production of telomestatin by heterologous expression of this cluster in the engineered Streptomyces avermitilis SUKA strain...
June 13, 2017: Scientific Reports
Rachel M Thompson, Elizabeth W Hubbard, Chan-Hee Jo, Donald Virostek, Lori A Karol
BACKGROUND: Curve magnitude and skeletal maturity are important factors in determining the efficacy of bracing for the treatment of adolescent idiopathic scoliosis, but curve morphology may also affect brace success. The purpose of this study was to determine the influence of curve morphology on the response to bracing with a thoracolumbosacral orthosis (TLSO). METHODS: A retrospective review of patients managed with an orthosis for the treatment of adolescent idiopathic scoliosis who were prospectively enrolled at the initiation of brace wear and followed through completion of bracing or surgery was performed...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
Jennifer C Urquhart, Osama A Alrehaili, Charles G Fisher, Alyssa Fleming, Parham Rasoulinejad, Kevin Gurr, Stewart I Bailey, Fawaz Siddiqi, Christopher S Bailey
OBJECTIVE A multicenter, prospective, randomized equivalence trial comparing a thoracolumbosacral orthosis (TLSO) to no orthosis (NO) in the treatment of acute AO Type A3 thoracolumbar burst fractures was recently conducted and demonstrated that the two treatments following an otherwise similar management protocol are equivalent at 3 months postinjury. The purpose of the present study was to determine whether there was a difference in long-term clinical and radiographic outcomes between the patients treated with and those treated without a TLSO...
July 2017: Journal of Neurosurgery. Spine
Miriam K Minsk, Kristen D Venuti, Gail L Daumit, Paul D Sponseller
BACKGROUND: Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type. We compared outcomes of AIS patients treated with Rigo Chêneau orthoses (RCOs) or custom-molded Boston-style thoracolumbosacral orthoses (TLSOs). METHODS: We retrospectively reviewed patient records from one scoliosis center from 1999 through 2014. Patients were studied from initial treatment until skeletal maturity or surgery...
2017: Scoliosis and Spinal Disorders
E Pola, D Colangelo, L A Nasto, V Pambianco, G Autore, V M Formica, G Maccauro
PAO is an uncommon condition affecting pregnant women during last trimester or early post-delivery period; it is often asymptomatic or presents with pain related to some acute fragility fractures. The diagnosis is often delayed or missed, the etiology remains unknown and no guidelines about treatment have been published. We present one case of PAO in a 33-year-old primigravid woman presenting acute worsening back pain. Our patient was treated with a TLSO brace, oral 25 (OH)-vitamin D supplementation and Teriparatide for 6 months...
October 2016: Journal of Biological Regulators and Homeostatic Agents
Marco Corradin, Federico Canavese, Alain Dimeglio, Jean Dubousset
PURPOSE: Thoraco-lumbo-sacral orthosis (TLSO) is an effective treatment in adolescent idiopathic scoliosis (AIS) patients, but cervical sagittal alignment (CSA) variations after bracing have never been evaluated. The purpose of this study was to assess changes in CSA before, during and after TLSO treatment, and to determine whether patients developed cervical pain. METHODS: This was a retrospective study in 38 AIS patients (33 females; mean age 10.8 years) treated by TLSO...
April 2017: European Spine Journal
Hyeon-Nam Song, Young Mi Kim, Kyoung Kim
[Purpose] This study attempted to examine the impact on the pattern of walking on both level ground and stairs after restricting the movement of the spine and the trunk of the body by using a spinal orthosis. [Subjects and Methods] Forty healthy males in their 20s were selected as the sample, which was randomly and evenly divided into two groups: (1) the WT group (with a thoracolumbosacral orthosis group) and (2) the WOT group (Without a thoracolumbosacral orthosis group). The spinal orthosis used in this study was a thoracolumbosacral orthosis called a plastic body jacket...
July 2016: Journal of Physical Therapy Science
Hesham M Soliman, Ha Nguyen, Frank A Pintar, Narayan Yoganandan, Shekar N Kurpad, Dennis J Maiman
INTRODUCTION: According to the latest version of the Abbreviated Injury Scale (AIS), all Thoraco-Lumbar Compression Fractures (TLCF) with >20% loss of height, were branded code 3 injuries, reflecting a threat for life or permanent disability. However, clinical observation suggests that that TLCF with <40% loss of height and without neurological deficits, have been noted to have a better clinical prognosis, prompting the need to segregate these injuries differently, revise the classification, and review outcomes...
August 2016: Neurosurgery
Winward Choy, Zachary A Smith, Stephanus V Viljoen, Timothy E Lindley, Nader S Dahdaleh
We report a unique instance of a 66-year-old male patient with an unstable three-column thoracic extension injury at the level of T4/5 who was treated with recumbency and bracing without surgery. A posterior long segment fixation was attempted three times on two separate occasions over the course of a week with failure due to difficulty in ventilating the patient during prone positioning, cardiopulmonary arrest, and hemodynamic instability during prone positioning for surgery. The decision then was to treat this fracture with recumbency...
2016: Curēus
Martin Matthews, Suzanne Blandford, Jonathan Marsden, Jennifer Freeman
BACKGROUND: To date the main treatment approach for neuropathic onset scoliosis has utilised thoracic lumbar sacral orthoses (TLSO) to stabilize the spine and enable stable sitting. Dynamic elastomeric fabric orthoses (DEFOs) may achieve both of these aims if used as an early intervention. Due to a lack of evidence in this area, a retrospective audit of case notes was undertaken to understand current orthotic practice investigating the usage, outcomes and clinical characteristics of treated children with neuropathic onset scoliosis...
2016: Scoliosis and Spinal Disorders
N Cobetto, C E Aubin, S Parent, J Clin, S Barchi, I Turgeon, Hubert Labelle
PURPOSE: Clinical assessment of immediate in-brace effect of braces designed using CAD/CAM and FEM vs. only CAD/CAM for conservative treatment of AIS, using a randomized blinded and controlled study design. METHODS: Forty AIS patients were prospectively recruited and randomized into two groups. For 19 patients (control group), the brace was designed using a scan of patient's torso and a conventional CAD/CAM approach (CtrlBrace). For the 21 other patients (test group), the brace was additionally designed using finite element modeling (FEM) and 3D reconstructions of spine, rib cage and pelvis (NewBrace)...
October 2016: European Spine Journal
Devon J O Guinn, Demitre Serletis, Noojan Kazemi
INTRODUCTION: We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. PRESENTATION OF CASE: A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis...
2016: International Journal of Surgery Case Reports
Ben Cason, Jack Rostas, Jon Simmons, Mohammed A Frotan, Sidney B Brevard, Richard P Gonzalez
BACKGROUND: The purpose of this study was to prospectively assess the sensitivity of clinical examination to screen for thoracolumbar spine (TLS) injury in awake and alert blunt trauma patients with distracting injuries. METHODS: From December 2012 to June 2014, all blunt trauma patients older than 13 years were prospectively evaluated as per standard TLS examination protocol at a Level 1 trauma center. Awake and alert patients with Glasgow Coma Scale (GCS) score of 14 or greater underwent clinical examination of the TLS...
January 2016: Journal of Trauma and Acute Care Surgery
Edmond H M Lou, Douglas L Hill, Jim V Raso, Marc Moreau, Douglas Hedden
PURPOSE: To determine the reliability of a prognostic curve progression model and the role of the quantity and quality of brace wear for adolescent idiopathic scoliosis (AIS) brace treatment. METHODS: To develop a curve progression model for full-time AIS brace treatment, 20 AIS subjects (Group 1) prescribed full-time thoracolumbar sacral orthosis (TLSO) were monitored and followed for 2 years beyond maturity. The developed curve progression model was: curve progression (in degrees) = 33 + 0...
February 2016: European Spine Journal
Serkan Erkan, Koray Tosyalı, Taçkın Özalp, Hüseyin Yercan, Güvenir Okcu
INTRODUCTION: Burst fractures of the low lumbar spine constitute approximately one percent of all lumbar fractures. There is still no consensus on the optimal treatment of low lumbar burst factures. We aimed to evaluate the functional and radiographic outcomes of conservative treatment in patients with low lumbar burst fracture. METHODS: 15 patients (11 males, 4 females; mean age 32±8) who had low lumbar spine burst fracture treated with a custom-moulded thoracolumbosacral orthosis (TLSO) with a thigh extension were enrolled...
July 2015: Injury
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