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

Important Allergenic Pollens in Manisa Atmosphere

Dünyada alerjik hastalıklara sahip insanların sayısı artmaktadır. Bitki gruplarından olan Gymnosperm ve Angiosperm’lerin üreme süreçlerinde atmosfere salınan polenler alerjik hastalıkların önemli bir nedenidir. Atmosfere yayılan önemli allerjen polenler ve onların konsantrasyonlarının belirlenmesi polen alerjisine karşı duyarlı bireyler için önem taşımaktadır. Bu nedenle, Manisa il merkezinin hava kaynaklı alerjik polenlerinin ortaya konulması amaçlanmış ve 01 Şubat 2015- 31 Ocak 2016 tarihleri arasında (1 yıl) volumetrik yöntem uyarınca çalışan “Lanzoni VPPS 2000” cihazı kullanılmıştır. Bir yıllık çalışma sürecinde, havada 43 taksona ait toplam 9121 polen/m3 adet polen tespit edilmiştir. Odunsu taksonlara ait polenler toplam polenlerin %72.39’unu, otsu taksonlar %26.64’sini ve tanımlanamayan polenler ise %0.96’sını oluşturmaktadır. Diğer taraftan, atmosferde allerjik etkileri yüksek olan Quercus spp. L., Pinaceae, Poaceae, Olea europaea L., Cupressaceae/Taxaceae, Platanus orientalis L., Urticaceae, Plantago spp. L., Amaranthaceae ve Morus spp. gibi taksonlara ait polenlere rastlanmıştır. Bu taksonlara ait polen yoğunluklarındaki değişimler ortalama sıcaklık, ortalama nem, toplam yağış ve rüzgar hızı gibi meteorolojik parametrelerle ilişkilendirilmiştir.The number of people with allergic diseases in the world has increased. A major cause of allergic diseases is the pollen grains Gymnospermae and Angiospermae spreading into the atmosphere from during their reproduction process. Determination of important allergenic pollen spreading atmosphere and their concentrations is important for individuals who are susceptible to pollen allergy. in this study, airborne pollen distribution in the city of Manisa was investigated volumetrically from February 01, 2015 to January 31, 2016 using Lanzoni VPPS 2010. During the study period daily, monthly and annualy distributions of obtained pollen were identified.. During the one-year study period, 9.121 pollen grains/m³ which belonged to 43 taxa were observed. of the pollen grains, 72.36% belonged to arboreal plants, 13.16% to Poaceae plants, 12.82% to other nonarboreal plants and 1.66% to unidentified plants. on the other hand, high allergenic taxa followed the trend as; Quercus spp. L., Pinaceae, Poaceae, Olea europaea L., Cupressaceae/Taxaceae, Platanus orientalis L., Urticaceae, Plantago spp. L., Amaranthaceae and Morus spp.. Changes in pollen concentrations of these taxa were associated with meteorological parameters such as average temperature, average humidity, total precipitation and wind speed