The comparative results of treatment in idiopathic thoracolumbar and lumbar scoliosis using the Harrington, Dwyer, and Zielke instrumentations

Forty-five patients with idiopathic thoracolumbar or lumbar scoliosis were treated with the Harrington, Dwyer, and Zielke instrumentation and fusion. The Harrington group achieved a 55% correction of the primary curves, while the Dwyer and the Zielke groups achieved 88 and 91%, respectively. Overcorrection of the curves occurred in a total of nine cases in the latter two groups. The Dwyer and Zielke instrumentations enabled better correction of the curves with a shorter fusion. At subsequent follow-up, the 'adding on' phenomenon as a result of the shorter fusion in the Dwyer group was unchanged, while that in the Zielke group became gradually resolved. The Zielke instrumentation appears to be the apparatus of choice for treatment of thoracolumbar and lumbar scoliosis.link_to_subscribed_fulltex

The effect on the lumbosacral spine of long spinal fusion for idiopathic scoliosis. A minimum 10-year follow-up

The effect on the lumbosacral spine of long spinal fusion in adolescent idiopathic scoliosis was studied in 22 patients. The average duration of follow-up was 12.8 years. Corrections of the coronal curves through instrumentations were satisfactory. However, a kyphosis was produced at the fused segment of the lumbar spine in more than half of the cases. The unfused intervertebral spaces distally were hypermobile in extension, which probably indicated early disc degeneration. The incidences of back pain and radiological degeneration were found to be low. There was no relationship between back symptoms and type of employment, pregnancies or radiological degeneration. Preservation of normal lumbar lordosis during spinal fusions was emphasized.link_to_subscribed_fulltex

Tuberculosis of the lumbosacral junction. Long-term follow-up of 26 cases

Of 37 consecutive patients suffering from tuberculosis of the lumbosacral spine, 26 were reviewed after an average follow-up of 20 years. Those presenting at under 10 years of age usually had a discharging sinus or a pointing abscess and a visible kyphosis. In older patients, low back pain was the predominant presenting symptom. Neurological involvement was uncommon. Both operative and conservative treatment had resulted in fusion but all patients treated conservatively ended up with a kyphosis associated with trunk shortening. They had a higher incidence of back pain and more complications in pregnancy. Anterior debridement and fusion with a strut graft can reduce the incidence and size of kyphosis, but is technically demanding. Treatment remains difficult and requires individual consideration.link_to_subscribed_fulltex

A comparative study of computed tomographic and plain radiographic methods to measure vertebral rotation in adolescent idiopathic scoliosis

A comparative analysis of two methods of measuring vertebral rotation in adolescent idiopathic scoliosis is reported in this article. Nash and Moe's pedicle shift method (using plain anteroposterior radiographs) is compared with a new method using computed tomographic scans. The computed tomographic scans of the whole length of the major curve and the scout films obtained from seventeen girls aged 12.5-14 years were measured for rotation of each vertebra of the curve (total number of vertebrae measured by two methods = 173). This study has three interesting new findings: 1) Those vertebrae with Nash and Moe grade 0 had up to 11 degrees of vertebral rotation when measured using the computed tomographic method. Therefore, Nash and Moe's grade '0' is not a neutrally rotated vertebra; 2) For Nash and Moe grade 1 and 2, the computed tomographic method revealed statistically significantly greater rotation for lumbar vertebrae than thoracic vertebrae. There was a similar pattern for Nash and Moe grade 0 but these differences were not statistically significant; and 3) Simple formulae are reported to convert Nash and Moe's grades into angle of vertebral rotation as obtained by CT method separately for thoracic and lumbar vertebrae.link_to_subscribed_fulltex

An EcoRI RFLP in the human α2 (XI) (COL 11A2) gene

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