7 research outputs found
Correction to: Leg length discrepancy and adolescent idiopathic scoliosis: clinical and radiological characteristics (Spine Deformity, (2022), 10, 2, (307-314), 10.1007/s43390-021-00417-0)
The original version of this article unfortunately contained a mistake. In Fig
Konjenital Skolyoz Tanı ve Tedavisi
Omurganın en sık görülen konjenital deformitesi konjenital skolyozdur. Deformiteyi oluşturan sebep, oluşum veya
ayrışma kusuru veya bu iki bozukluğun birlikte olduğu karma tiptir. Kliniğe yansıması, stabil hemivertebradan,
pulmoner, kardiyak, genitoüriner ve nörolojik komplikasyonlara yol açabilen karmaşık ve ilerleyici deformitelere
kadar geniş bir aralıktadır. Tabloya sıklıkla diğer organ sistemlerindeki anomaliler eşlik eder. Tanıda; prenatal
ultrason, fizik muayene ve röntgen kullanılır. Manyetik rezonans eşlik eden intradural patolojilerin ortaya konulmasında
yardımcıdır. Bilgisayarlı tomografi cerrahi planlamada yardımcı olabilir. Tedavi planı eğriliğin yeri ve
derecesi, hastanın yaşı, deformitenin tipine ve öngörülen ilerleme beklentisine göre her hastaya özel olarak yapılır.
Tedavi temel olarak kontrollü gözlem, konservatif ve cerrahi tedavilerden oluşur. Tek hemivertebra varlığında
genellikle erken yaşta hemivertebrektomi ve limitli füzyon önerilir. Daha karmaşık deformitelerde hemiepifizyodez,
distraksiyon temelli füzyonsuz cerrahi yöntemler veya bunların kombinasyonları kullanılabilir. Günümüzde
teknolojik ilerlemeler sayesinde spinal deformite ve intradural patolojilerin cerrahisi eş zamanlı olarak güvenli
şekilde yapılabilmektedir. İhmal edilmiş ileri deformitelerde düzeltici osteotomiler gerekebilir. Düzeltici osteotomiler
barındırdıkları nörolojik yaralanma riski ve uygulamadaki teknik zorluklar nedeniyle donanımlı merkezlerde
deneyimli cerrahlar tarafından gerçekleştirilmelidir
An investigation of the effects of total hip arthroplasty with femoral shortening in unilateral Crowe type-IV dysplastic hips on sagittal spinopelvic parameters
It has been reported that sagittal spinal alignment may become abnormal in patients with hip osteoarthritis. There is limited data in the literature on how spinopelvic parameters change after total hip arthroplasty (THA) with femoral shortening in unilateral Crowe type IV dysplastic hips. We aimed to investigate the effects of THA with femoral shortening in unilateral Crowe type IV dysplastic hips on sagittal spinopelvic parametres. Patients who underwent THA for Crowe type IV dysplastic hips at our institution between 2014-2019 were included in the study. Pre- and postsurgical standing anteroposterior and lateral spine X-Ray images of the each patient were uploaded to SURGIMAP© (Nemaris Inc.. USA) (https://www.surgimap.com/). The radiographic data of all patients were reviewed and measurements performed for each patient by two senior spinal surgeons. All of the parameters were retrieved from the SURGIMAP© measurement system. There were 18 patients aged 27-60 (mean, 45.5±7.9) years. The mean follow-up duration was 27.5 ± 8.9 (range, 13–42) months. There was no statistically difference between pre-and postoperative values of Sacral Slope (SS), Pelvic incidence (PI) Lumbar Lordosis (LL), PI-LL mismatch and Thoracic Kyphosis (TK), Global Tilt (GT), T1 Pelvic Angle (TPA), Cervical Lordosis (CL) and T1 slope (T1S). We also found no significant change between pre-and postsurgical values of global alignment and proportion (GAP) scores. The only significant change was in detected pre-and postsurgical values of PT, T1Spi, T9Spi ( p = 0.022, p = 0.035, and p = 0.033 respectively). THA with femoral shortening in unilateral Crowe type-IV dysplastic hips does not effect a change in sagittal spinopelvic parameters. Except for PT, T9SPi, and T1SPi do. [Med-Science 2022; 11(2.000): 734-9
Comparison of MRI and MR with diffusion-weighted imaging for assessing peritoneal implants in patients with oncologic diagnoses
Amaç: Çalışmada sabit insörtlü arka çapraz bağ koruyan total diz protezi yapılan hastalarda tibial eğimin diz skorları ve diz hareket açıkları üstüne olan etkileri araştırıldı. Gereç ve Yöntem: Gonartroz tanısı konmuş ileri derecede deformitesi olmayan 41 dize arka çapraz bağ koruyan sabit insörtlü total diz protezi ameliyatı yapıldı. Ameliyat öncesi dizlerin hareket açıklıkları ve diz skorlamaları yapıldı. Son kontrollerinde hastaların diz skorlamaları ve hareket açıklıkları tekrar değerlendirildi. Tibial eğimi 5 derece ve daha fazla olan 18 diz ve tibial eğimi 5 derece altında olan 23 diz iki grup halinde istatistiksel olarak değerlendirildi. Bulgular: 5 derece altında tibial eğimi olan grupta ameliyat öncesi ortalama fleksiyon 100.3±10.59 derece ölçüldü. 5 derece ve üstünde tibial eğimi olan grupta ameliyat öncesi ortalama fleksiyon 98.5±7.31 derece ölçüldü. Ameliyat sonrası son kontrollerde 5 derece ve altında tibial eğimi olan grupta fleksiyon ortalama 111,8±12,23 derece, 5 derece ve üstünde tibial eğimi olan grupta ortalama fleksiyon 109±11.48 derece ölçüldü. 5 derece altında tibial eğimi olan grupta ameliyat öncesi ortalama diz skoru 35.9±6.63 fonksiyonel diz skoru ortalama 23.7±16.18 olarak belirlendi. Ameliyat sonrası son kontrollerde 5 derece altında tibial eğimi olan grupta ortalama diz skoru 83.9±8.16, fonksiyonel diz skoru ortalama 82.4±12.51 olarak belirlendi. 5 derece ve üstünde tibial eğimi olan grupta ameliyat öncesi ortalama diz skoru 42.2±12.73, fonksiyonel diz skoru ortalama 23.6±17.97 olarak belirlendi. Ameliyat sonrası son kontrollerde yapılan değerlendirmede 5 derece ve üstünde eğimi olan dizlerde ortalama diz skoru 83±9,08, ortalama fonksiyonel diz skoru 84.1±16.29 olarak belirlendi. Sonuç: Her iki gruptaki pre op ve post op diz skorlarındaki değişimler anlamlı olarak bulundu Diz hareket açıkları açısından posterior tibial eğimin 5 derece ve üstü olan grupla 5 derece altında olan grup arasında istatistiksel olarak anlamlı bir fark bulunmadı. Tibial eğim ile diz hareket açıklıkları arasında istatiksel olarak anlamlı bir ilişki bulunmadı. Diz değerlendirme skorlarında tibial eğimden bağımsız olarak anlamlı bir artış tespit edilmiştir.Objective: Effect of the tibial posterior slope on knee scores and knee range of motion in knees that were performed PCL retaining total knee arthroplasty with fixed bearing. Material and methods: 41 gonarthrosis diagnosed knee have been performed PCL retaining total knee arthroplasty with fixed bearing. Knee scoring was performed and range of motion was measured before surgery. Patients were re-evaluated with knee scores and knee range of motion. Patients divided into two groups. First group is 18 patients with posterior tibial slope 5° and greater than 5°, second group is 23 patients with posterior tibial slope less than5°. Both groups were evaluated statistically. Results: In the group with posterior tibial slope less than 5° mean preoperative flexion was measured 100.3°±10.59, in the group with posterior tibial slope 5° and greater mean preoperative flexion was measured 98.5°±7.31. At the last postoperative control in the group with posterior tibial slope less than5° the mean flexion was measured 111.8°±12.23. In the group with posterior tibial slope 5° and greater the mean flexion was measured 109° ±11,48 at the last postoperative control. Preoperativly in the group with posterior tibial slope less than5° the mean knee score was 35.9±6.63, the mean functional knee score was 23.7±16.18. In the postoperative last control the mean knee score was 83.9±8.16, mean functional knee score was 82.4±12.51. In the group with posterior tibial slope 5° and greater the mean knee score was 42.2±12.73, the mean functional knee score was 23.6±17.97 preoperatively. In the postoperative last control the mean knee score was 83±9.08, the mean knee functional score was 84.1±16.29 for group with posterior tibial slope 5° and greater Conclusion: The pre operative and post operative knee scores in both groups were found to be statisticaly significantly different. In terms of knee motion there was no statistically significant difference between the groups. Statistically significant relationship was not found between range of motion of the knee with the tibial slope. Knee scores had a significant increase after surgery, but it was determined independently from tibial slope
Implant-Related Complications Do Not Interfere with Corrections with the Shilla Technique in Early Onset Scoliosis: Preliminary Results
Growth-preservation techniques are utilized in early onset scoliosis (EOS) cases requiring surgical intervention. The Shilla technique corrects the deformity by reducing additional surgeries with its growth-guidance effect. As with other techniques, various problems can be encountered following the administration of the Shilla technique. The aim of this study was to examine the effect of complications encountered with the Shilla treatment on correction and growth. Sixteen patients with a follow-up period of at least one year after receiving Shilla growth guidance for EOS were included in this retrospective study. No complications occurred, and no unplanned surgery was required in 50% of the cases. Of the remaining eight patients with postoperative implant-related complications (50%), six (37.5%) required unplanned surgery; this consequently caused implant failure in the proximal region in five cases (31.25%) and deep tissue infection around the implant in one case (6.25%). Deformity correction, spine length, and quality-of-life scores significantly improved in EOS through Shilla growth guidance. In terms of spinal growth and deformity correction, there were no significant differences between patients with implant-related problems and individuals without occurrences. Although implant-related problems were detected in our dataset and corresponding unexpected surgeries were necessary, these complications had no significant unfavorable influence on correction and spine growth