A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

Study DesignRetrospective study.PurposeTo identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis.Overview of LiteratureCongenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis.MethodsNinety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed.ResultsWe found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients).ConclusionsWe determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups

A comparison of the effects of two different techniques on shoulder balance in the treatment of congenital scoliosis: Vertical expandable prosthetic titanium rib and dual growing rod

Purpose: The purpose of this study is to compare the effects of two different growth guidance techniques (dual growing rod and vertical expandable prosthetic titanium rib [VEPTR]) on shoulder balance, in the surgical treatment of congenital scoliosis. Materials and Methods: Thirteen patients who were operated due to congenital scoliosis are divided into two groups. The coracoid height difference and clavicular tilt angle difference were measured on standing anteroposterior X-ray images in the preoperative, early postoperative periods, and during the last follow-up. Results: Clinical improvement in shoulder balance was obtained in VEPTR during the last follow-up, but there was no significance in the comparison among the two groups during the last follow-up. Conclusion: The effect of the growth guidance techniques on shoulder balance positively contributes in the surgical treatment of congenital scoliosis

Analysis of complications following posterior vertebral column resection for the treatment of severe angular kyphosis greater than 100°

Objective: The aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°. Methods: The medical records of 17 patients (mean age 17.9 (range, 9–27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24–64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients. The sagittal plane parameters (local kyphosis angle, lumbar lordosis, sagittal vertical axis, pelvic tilt, sacral slope and pelvic incidence) were measured in the preoperative and the early postoperative periods and during the last follow-up on the lateral radiographs. Results: The mean preoperative localized kyphosis angle was 121.8° (range, 101°–149°). The mean local kyphosis angle (LKA) was 71.5° at postoperatively evaluation (p < 0.05). Complications were detected in 12 patients (70.6%) with spinal shock in 4 patients, hemothorax in 3 patients, postoperative infection in 2 patients, dural laceration in 2 patients, neurological deficit in 2 patients (1 paraplegia and 1 root injury), the shifted cage in 2 patients and rod fracture in 2 patients. Neurological events occurred in six patients (35%) with temporary neurological deficit in 5 patients and permanent neurological deficit in 1 patient. Conclusion: PVCR is an efficient and a successful technique for the correction of SAK. However, it can lead to a large number of major complications in SAK greater than 100°. Level of evidence: Level IV, therapeutic study. Keywords: Posterior vertebral column resection, Severe angular kyphosis, Complication, Neurological deficit, Neuromonitorin

The effect of distraction-based growth friendly spinal instrumentation on growth in early-onset scoliosis

The benefits and drawbacks of growth friendly spinal instrumentation have been reported as a result of developments in the treatment of early-onset scoliosis. Seventeen patients who underwent growth friendly spinal instrumentation surgery with a minimum 2-year follow-up were included in the review. The mean number of lengthenings was 3, initial surgery age took place at 108.1 ± 30.2 months and follow-up at 40.6 ± 16.6 months. Spinal height (T1–S1 and T1–T12), space available for the lungs, major Cobb angle for scoliosis, maximum thoracic kyphosis, lumbar lordosis, shoulder and pelvic balance, and coronal and sagittal balance were assessed preoperatively and during the latest follow-up. Treatment with growth friendly spinal instrumentation provided an evident increase in spine height and space available for the lungs, and a significant decrease in scoliosis and thoracic kyphosis. In growth friendly spinal instrumentation treatment, the most commonly observed complications were proximal anchor problems (76.4%) and proximal junctional kyphosis (58.8%). In treatments using growing rods, excessive thoracic kyphosis correction should not be made to avoid proximal junctional kyphosis

The effect of Kinesio taping on back pain in patients with Lenke Type 1 adolescent idiopathic scoliosis: A randomized controlled trial

Purpose: This study investigated the short-term effects of KT on back pain (BP) in patients with Lenke Type 1 adolescent idiopathic scoliosis (AIS). Methods: We chosen Lenke Type 1 scoliosis who have had only back pain (the localization of the pain: the only in the apical convex edge). Forty patients suffering from BP with Lenke Type 1 AIS were randomly separated into two groups, Group 1 (20 patients) and Group 2 (20 patients). Group 1 was given KT with tension and home exercises and Group 2 was given KT without tension and home exercises. KT and home exercises was applied to the thoracic area of the patients in both groups for four weeks. Pain intensity was measured using a visual analog scale (VAS) and SRS-22 (subtotal SRS-20) before and after treatment. Results: Mean age of both groups was 16.1 years. Mean Cobb angle of the thoracic scoliosis was 31.8° (range: 17°–44°) in Group 1 and 32.8° (range: 19°–43°) in Group 2 before the treatment. The decrease in VAS score of Group 1 after taping was higher than that of Group 2. The difference between the pre- and post-treatment VAS scores of both groups was statistically significant (p < 0.05). The increase in mean SRS-20 score of Group 1 following taping application was significantly higher than the increase in the control group (p < 0.05). Conclusion: Results demonstrated that KT application with tension effectively leads to back pain relief shortly after application. In addition, KT has a positive impact on quality of life. Thus, KT may be a suitable intervention in treating back pain of patients with AIS. Level of Evidence: Level 1, Therapeutic study Keywords: Adolescent idiopathic scoliosis, Back pain, Exercise, Kinesio tapin