The Height Gain in Scoliotic Deformity Correction: Assessed by New Predictive Formula

Height gain after scoliosis correction is of a special interest for the patient and family. Ylikoski was the first to suggest a formula predicting height loss in untreated scoliotic patients. Stokes has recently suggested a new formula by using Cobb angle to determine height loss in idiopathic curves. We hypothesized that new additional variables to Cobb angle such as apical vertebral translation (AVT), number of instrumented segments (N), and disc heights may increase the accuracy of predicted height gain. According to our findings simple expression for height gain by simplified version of the formula is: SPΔH = 0.0059X1θ1 + 2.3(1 − (θ2/θ1))N, where θ1 is preoperative Cobb angle, X1 is preoperative AVT, θ2 is postoperative Cobb angle, and N is the number of instrumented vertebra. The purpose of this study is to analyze a new mathematical formula to predict height gain after scoliotic deformity correction

Juvenile idiopathic scoliosis treated with posterior arthrodesis and segmental pedicle screw instrumentation before the age of 9 years: a 5-year follow-up

<p>Abstract</p> <p>Study design</p> <p>Retrospective study.</p> <p>Objective</p> <p>To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up.</p> <p>Summary of background data</p> <p>Progression of spinal deformity after posterior instrumentation and fusion in immature patients has been reported by several authors. Segmental pedicle screw fixation has been shown to be effective in controlling both coronal and sagittal plane deformities. However, there is no long term study of fusion with segmental pedicle screw fixation in these group of patients.</p> <p>Methods</p> <p>Seven patients with juvenile idiopathic scoliosis treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 7.4 years (range 5–9 years) at the time of the operation. All the patients were followed up 5 years or more (range 5–8 years) and were all Risser V at the most recent follow up. Three dimensional reconstruction of the radiographs was obtained and 3DStudio Max software was used for combining, evaluating and modifying the technical data derived from both 2d and 3d scan data.</p> <p>Results</p> <p>The preoperative thoracic curve of 56 ± 15° was corrected to 24 ± 17° (57% correction) at the latest follow-up. The lumbar curve of 43 ± 14° was corrected to 23 ± 6° (46% correction) at the latest follow-up. The preoperative thoracic kyphosis of 37 ± 13° and the lumbar lordosis of 33 ± 13° were changed to 27 ± 13° and 42 ± 21°, respectively at the latest follow-up. None of the patients showed coronal decompensation at the latest follow-up. Four patients had no evidence of crankshaft phenomenon. In two patients slight increase in Cobb angle at the instrumented segments with a significant increase in AVR suggesting crankshaft phenomenon was seen. One patient had a curve increase in both instrumented and non instrumented segments due to incorrect strategy.</p> <p>Conclusion</p> <p>In juvenile idiopathic curves of Risser 0 patients with open triradiate cartilages, routine combined anterior fusion to prevent crankshaft may not be warranted by posterior segmental pedicle screw instrumentation.</p

Osteoblastoma of the Os Capitatum

An osteoblastoma is a primary benign bone tumor, which is rarely seen in hand bones. Osteoblastoma is generally seen in spine, pelvis, and long bones. However, there are a few case reports of osteoblastoma in wrist and hand bones. To our knowledge, up to now, only one male patient with osteoblastoma in capitate bone was reported. We report the first female case of osteoblastoma of capitate bone and discuss diagnosis and treatment

The effect of pregnancy and body mass index in patients with knee osteoarthritis

Amaç: Kadınlarda diz osteoartriti ( gonartroz) ile vücut kitle indeksi (VKİ), doğum sayısı ve yaş gibi değişkenlerin ilişkisini araştırmak. Yöntem: Kliniğimize başvuran ve gonartroz tanısı alan ortalama yaşları 60,4 (40 -88) yıl olan 88 hasta değerlendirmeye alınmıştır. Hastaların yaşları, kilo ve boy değerleri, doğum sayıları, kaydedilmiştir. Şikayeti olan diz için AP -Yan grafil erinden radyolojik evreleme, WOMAC OA indeksi ( The We stern Ontario and Mcmaster Universities Osteoarthritis İndeks) ve Lequesne Diz Osteoartrit Şiddet İndeksi kullanılarak skorlama yapılmıştır. Bulgular : Çalışmada değerlendirilen 88 kadın hastanın ortalama VKİ leri 28,3 (19,8 - 42,7) idi. Ortalama doğum sayısı ise 7 (0 -13). Kellgren -Lawrance evreleme sistemine göre 2 hasta evre 1, 37 evre 2, 36 evre 3, 13 hasta ise evre 4 idi. Hastal arın ortalama toplam WOMAC OA skorları 66,7 (22 -91) iken WOMAC Ağrı skoru ortalama 13,2 (4 -20), Tutukluluk orta lama 4,8(2 -8 ), fonksiyon ortalama 48,6 (16 -65). Lequesne ağrı skoru ortalama 5,2 (2 -8), yürüme mesafesi ortalama 4 (1 -7), günlük aktivite ortalama 4,6 (1 -8) iken toplam Lequesne skoru ise ortalama 13,9 (5 - 23) idi. Hastanın yaşı ile WOMAC toplam, ağrı ve fonksiyon, Lequesne toplam ve yürüme mesafesi skorları arasında istatistiki olarak anlamlı ve pozitif korelasyon bulunurken, WOMAC tutukluluk, Lequesne ağrı, günlük aktivite skorları arasında anlamlı korelasyon bulu nmamıştır. VKİ ile WOMAC toplam skor hari cindeki tüm parametrelerde istatistiki olarak anlamlı pozitif ilişki bulunmuştur. Doğum sayıları incelendiğinde Doğum sayısı arttıkça yine WOMAC toplam skor haricindeki tüm parametrelerde istatistiki olarak anlamlı dercede artış olmaktadır Sonuç : VKİ, yaş ve doğum oranı arttıkça diz ekleminde dejenerasyon artmakta ve yaşam kalitesi azalmaktadır.Objective : To evaluate the association between knee oste oarthritis and either body mass index (BMI) or pregnancy in women. Method : 88 patients with average age of 60,4 (40 -88) years were evaluated. Age, weight, height, and number of pregnancy of the patients were recorded. Radiographic staging was detected from Anterior Posterior- Lateral radi o graphs of the knee. WOMAC OA index (The Western Ontario and Mcmaster Uni versities Osteoarthritis Index) and Lequesne Knee Osteoarthritis severity scores were used to investigate clinical scoring . Results : The mean BMI was 28,3 (19,8 - 42,7). The mean pregnancy was 7 (0 -13). According to Kellgren -Lawrance staging system; 2 Patients were stage 1, 37 were stage 2, 36 were stage 3 and 13 were stage 4. The mean total WOMAC OA score of the patients was 66,7 (22 -91), while the mean pain score was 13,2 (4 -20), Stiffness was 4,8(2 -8 ), function was 48,6 (16 -65). The mean Lequesne score was 13,9 (5 - 23), pain was 5,2 (2 -8), mean walking distance was 4 (1 -7) and the mean daily activity score was 4,6 (1 -8). There was stati stically significant positive correlation between age and WOMAC total, pain, function, Lequesne total, walking di stance s cores while there was no statistically significant b etween WOMAC stiffness, Lequesne pain, daily activity scores. With respect to BMI and pregnancy all parameters except WOMAC total score were statistically significant positive correlated with either BMI or pregna ncy. Conclusion : Degeneration in the knee joint increases and quality of life decreases with increasing of age, BMI, pregnancy