BackBone: Interdisciplinary Creative Practice and Body Positive Resilience Full Report

Scoliosis is an abnormal lateral curvature of the spine with the large majority of cases classed as idiopathic, meaning there is no known cause. Typically, most cases occur in children and young people affecting approximately 3% of the adolescent populace with five out of six cases being female. The BackBone: Interdisciplinary Creative Practices and Body Positive Resilience pilot research study aimed to use art as a form of interdisciplinary research practice to measure the impact of Adolescent Idiopathic Scoliosis (AIS) on wellbeing and body perception. The research aimed to contribute to a better understanding of alternative treatments towards improving quality of life in young females diagnosed with AIS. In particular, concentrating on two highlighted priorities from the Scoliosis Priority Setting Partnership: 1. How is quality of life affected by scoliosis and its treatment? How can we measure this in ways that are meaningful to patients? 2. How are the psychological impacts (including on body image) of diagnosis and treatment best managed. Through interdisciplinary art-based workshops and focus groups with post-operative Adolescent Idiopathic Scoliosis participants and their families, objective analytical data plus empirical data from transcripts and artefacts was gathered using qualitative and quantitative methods. Workshops explored the aesthetics of imperfection through material investigations that focus on the body as both an object and how it is experienced using the metaphor of tree images. By drawing parallels between the growth patterns of trees that, for complex and often unknown reasons, have grown unexpectedly we explored questions around ideological notions of perfect growth through art making. Uniquely, the pilot project sought to draw upon insights from across the combined disciplines, thinking across boundaries to evoke different ways of knowing and understanding the complexities of body perception through image making

Late presentation of superior mesenteric artery syndrome following scoliosis surgery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Obstruction of the third part of the duodenum by the superior mesenteric artery (SMA) can occur following surgical correction of scoliosis. The condition most commonly occurs in significantly underweight patients with severe deformities during the first few days to a week following spinal surgery.</p> <p>Case presentation</p> <p>We present the atypical case of a patient with normal body habitus and a 50° adolescent idiopathic thoracolumbar scoliosis who underwent anterior spinal arthrodesis with instrumentation and developed SMA syndrome due to progressive weight loss several weeks postoperatively. The condition manifested with recurrent vomiting, abdominal distension, marked dehydration, and severe electrolyte disorder. Prolonged nasogastric decompression and nasojejunal feeding resulted in resolution of the symptoms with no recurrence at follow-up. The spinal instrumentation was retained and a solid spinal fusion was achieved with good spinal balance in both the coronal and sagittal planes.</p> <p>Conclusion</p> <p>SMA syndrome can occur much later than previously reported and with potentially life-threatening symptoms following scoliosis correction. Early recognition of the condition and institution of appropriate conservative measures is critical to prevent the development of severe complications including the risk of death.</p

Aetiological process of idiopathic scoliosis: from a normal growing spine into a complex 3D spinal deformity

In more than a century of dedicated research into its aetio-pathogenesis, many attempts have been made to understand the exact cause of idiopathic scoliosis. In the literature, the number of causal theories is overwhelming and the aetiology of adolescent idiopathic scoliosis (AIS) is regarded as ‘multi-factorial’. This overview focusses on recent studies that describe the changes from a normal spinal anatomy into the complex three-dimensional deformation and support the hypothesis that several paediatric deformities are a consequence of the unique way the human spine is biomechanically loaded. This has nothing to do with bipedalism, but with the way gravity and muscle tone translate to the unique sagittal shape of the spine, with its pelvic and lumbar lordosis, and the possibility to simultaneously extend the hips and knees. This leads to three rather than two forces acting continuously on the spine axial, anterior and posterior shear. An excess of anterior shear can result in spondylolisthesis and an excess of axial loading can cause osteochondrotic lesions. Unique for human are posterior shear forces, an excess of these result in decreased rotational stiffness of the involved vertebral segments. Certain sagittal spinal profiles, especially in girls around the pubertal growth spurt, predispose for development of a rotational deformity, as is idiopathic scoliosis. Once the growing spine decompensates into an idiopathic scoliosis, it will follow the right-sided rotational pattern that is already present in the non-scoliotic adolescent spine. The rotational deformation ultimately leads to rotatory lordosis around the apices of the curvatures and has major impact on lung function and quality of life

Surgical management of early-onset scoliosis: indications and currently available techniques

Early-onset scoliosis (EOS) is a heterogeneous group of spinal deformities affecting children under the age of 10 years of which the aetiology, natural history and treatment options vary considerably. In progressive EOS, treatment is based on exhausting conservative measures (casting or bracing) to halt curve progression while allowing for continuous growth of the spine and chest development. Early spinal fusion leads to loss of longitudinal spinal growth and restriction of cardiopulmonary function. In rapidly progressive curves that have failed conservative treatment a range of ‘growth-friendly’ surgical techniques have been developed to control curve deterioration. The indications and characteristics of distraction-based or compression-based methods, growth guidance and promising new techniques are discussed according to aetiology of EOS. Definitive spinal fusion remains reserved for patients ideally towards the end of their spinal growth and for short-segment treatment in congenital scoliosis

Staged surgical treatment for severe and rigid scoliosis

<p>Abstract</p> <p>Background</p> <p>A retrospective study of staged surgery for severe rigid scoliosis. The purpose of this study was to evaluate the result of staged surgery in treatment of severe rigid scoliosis and to discuss the indications.</p> <p>Methods</p> <p>From 1998 to 2006, 21 cases of severe rigid scoliosis with coronal Cobb angle more than 80° were treated by staged surgeries including anterior release and halo-pelvic traction as first stage surgery and posterior instrumentation and spinal fusion as second stage. Pedicle subtraction osteotomy(PSO) was added in second stage according to spine rigidity. Among the 21 patients, 8 were male and 13 female with an average age of 15.3 years (rang from 4 to 23 years). The mean pre-operative Cobb angle was 110.5° (80°-145°) with a mean spine flexibility of 13%. Radiological parameters at different operative time points were analyzed (mean time of follow-up: 51 months).</p> <p>Results</p> <p>External appearance of all patients improved significantly. The average correction rate was 65.2% (ranging from 39.8% to 79.5%) with mean correction loss of 2.23° at the end of follow-up. No decompensation of trunk has been found. Mean distance between the midline of C7 and midsacral line was 1.19 cm ± 0.51. Two patients had neurological complications: one patient had motor deficit and recovered incompletely.</p> <p>Conclusion</p> <p>Staged operation and halo-pelvic traction offer a safe and effective way in treatment of severe rigid scoliosis. Patients whose Cobb angle was more than 80° and the flexibility of the spine was less than 20% should be treated in this way, and those whose flexibility of the spine was less than 10% and the Cobb angle remained more than 70° after 1st stage anterior release and halo-pelvic traction should undergo pedicle subtraction osteotomy (PSO) in the second surgery.</p

A rare case of spinal injury: bilateral facet dislocation without fracture at the lumbosacral joint

AbstractLumbosacral dislocations are rare disorders; since they were first reported by Watson-Jones [1], only 100 cases have appeared in the literature [2]. A traumatic bilateral lumbosacral dislocation is even rarer, with a mere 10 cases reported [3]. Because of its low incidence and atypical location, the lesion may often go unnoticed on initial clinical assessment [4]. Surgical treatment modalities are not defined, but open reduction and internal fixation are often necessary because of a three-column involvement [5]. In this paper, we report on an initially misdiagnosed case of lumbosacral dislocation treated with open reduction and internal fixation