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Adolescent Idiopathic Scoliosis (adolescent + idiopathic_scoliosis)
Selected AbstractsGeneralized Low Areal and Volumetric Bone Mineral Density in Adolescent Idiopathic Scoliosis,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 8 2000J. C. Y. Cheng Abstract Adolescent idiopathic scoliosis (AIS) may be associated with generalized low bone mineral status. The bone mineral density (BMD) of 75 girls of 12,14 years of age and diagnosed as having AIS were compared with 94 age-matched female control subjects. Areal BMD (aBMD) of the lumbar spine (L2-L4) and the bilateral proximal femur were measured using -energy X-ray absorptiometry (DEXA), and volumetric BMD (vBMD) of the nondominant distal radius and bilateral distal tibias was measured with peripheral quantitative computer tomography (pQCT). Relevant anthropometric parameters and the severity of the spinal deformity (Cobb's angle) also were evaluated and correlated with the BMD measurements. Results revealed the presence of a generalized lower bone mineral status in AIS patients. Detailed analysis showed that the aBMD and vBMD measured at the bilateral lower extremities were significantly lower in AIS patients when compared with the same in the normal controls. The most significant effect was seen in the trabecular BMD (tBMD) of the distal tibias. Of all the AIS girls, 38% of the aBMD and 36% of the vBMD were below ,1 SD of the normal. BMD was found to correlate better with "years since menarche" (YSM) than with chronological age. When the BMD was evaluated for the 3 YSM groups, aBMD of the proximal femur and tBMD of distal tibias were found to be significantly lower in the AIS patients. Neither the aBMD nor the vBMD of AIS patients was found to be associated with the severity of spinal deformity. In addition, anthropometric measurements showed significantly longer arm span and lower extremities in the AIS girls. We concluded that the AIS girls had generalized lower aBMDs and vBMDs. [source] Pain-Sensitive Temperament and Postoperative PainJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 3 2007Charmaine Kleiber PURPOSE.,To describe the relationship between pain-sensitive temperament and self-report of pain intensity following surgery. DESIGN AND METHODS.,Fifty-nine adolescents and young adults (average age 14 years) undergoing spinal fusion for adolescent idiopathic scoliosis completed the Sensitivity Temperament Inventory for Pain,Child version (STIP-C). The Pearson correlation between STIP-C scores and the highest pain intensity for each of the first three postoperative days was investigated. RESULTS.,There was a small but significant correlation between the Perceptual Sensitivity and Symptom Reporting subscales of the STIP-C and pain intensity measured on the third postoperative day. PRACTICE IMPLICATIONS.,Aspects of the pain-sensitive temperament may be important in understanding the variability in postoperative pain. This is the first investigation of the relationship between pain-sensitive temperament and surgical pain. More research is needed in this area. [source] Effects of alternative instrumentation strategies in adolescent idiopathic scoliosis: A biomechanical analysisJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2009Martin Robitaille Abstract The recent advent of modern instrumentation systems has improved the correction of scoliosis, but complicated the surgical decision-making process, especially with the introduction of diverse spinal fixation devices, new preoperative corrective maneuvers, and the reevaluation of many rules concerning the selection of fusion levels and other guidelines for surgical correction. Our objective was to assess the biomechanical effects of different instrumentation strategies for the same scoliotic cases. Several instrumentation strategies suggested by a group of 32 experienced senior surgeons for five cases were individually simulated using a validated computer model implemented in a spine surgery simulator. The resulting geometric indices varied among the five cases (e.g., range of main thoracic Cobb angles: 5,17°, 16,29°, 25,44°, 15,34°, 16,32°; kyphosis: 22,33°, 20,54°, 33,55°, 24,49°, 29,46°; and lordosis: 10,52°, 24,38°, 26,54°, 8,28°, 34,53°). The average correction was better with pedicle screws (71%) than with hooks (51%) and hybrid constructs (67%). For the first time, to our knowledge, the effect of different instrumentation strategies was compared on the same patients, which is possible only with a surgery simulator. A large variability of instrumentation strategies existed among experienced surgeons and produced rather different results. This study questions the criteria for optimal configuration and standards to design the best surgical construct. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:104,113, 2009 [source] Posterior pedicle screws combined with shortening and release techniques for lumbar and thoracolumbar adolescent idiopathic scoliosisORTHOPAEDIC SURGERY, Issue 1 2009Su-xi Gu MD Objective:, To prospectively evaluate the clinical and radiographic effects of posterior surgery with wide posterior shortening release and segmental pedicle screws techniques in a consecutive group of patients with thoracolumbar /lumbar adolescent idiopathic scoliosis. Methods:, Between April 2002 and July 2005, 114 patients (86 women and 28 men) were enrolled in this study. There were 72 Lenke type 5, 32 Lenke type 6, and 10 Lenke type 3C curves. Radiographic parameters such as coronal plane Cobb angle; lordosis angle; lowest instrumented vertebrae (LIV) angulation; and the distances from the central sacral vertical line (CSVL) to the LIV, to the apical vertebra and to the C7 plumb line, were analyzed. Complication rates were also recorded during follow-up. Results:, The average coronal correction was from 61° to 13° (78.6%). In the sagittal plane, lumbar lordosis was normalized from 36° with a wide range (23°,67°) to 42° with a normal range (34°,55°). The LIV had 79% correction of coronal angulations. The center sacral line to LIV was improved from 2.3 cm to 0.5 cm, apex to center sacral line from 5.0 cm to 1.6 cm, and CSVL from 2.7 cm to 0.8 cm. A total of 1460 pedicle screws were placed safely, average 9.6 levels (5,14) were fused. The patients were followed up for an average of 30 months (range, 12,50). There was excellent maintenance of correction at final follow-up. Conclusion:, Wide posterior release and segmental pedicle screw instrumentation has excellent radiographic and clinical results with minimal complications. [source] Association of calmodulin1 gene polymorphisms with susceptibility to adolescent idiopathic scoliosisORTHOPAEDIC SURGERY, Issue 1 2009Dong Zhao MD Objective:, To investigate whether: (i) rs12885713 (,16C > T) and rs5871 polymorphisms in the Calmodulin1 (CALM1) gene are predisposing factors for adolescent idiopathic scoliosis (AIS); and (ii) different single nucleotide polymorphisms (SNP) correlate with different subtypes of AIS. Methods:, A total of 100 AIS patients with Cobb angle above 30° were recruited for this study together with 100 healthy controls. Curve pattern, Cobb angle, and Risser sign were recorded. Two polymorphic loci, rs12885713 (,16C > T) and rs5871 loci, of the CALM1 gene were analyzed. All patients were grouped according to the Peking Union Medical College (PUMC) classification, the apical location of the major curve, and the Cobb angle. Results:, There was a statistically significant difference in the distribution of rs12885713 site polymorphism (P = 0.034) between PUMC type II (double curve) patients and controls, in the distribution of rs12885713 site polymorphism (P = 0.009) between lumbar curve cases and controls and in the distribution of rs5871 site polymorphism (P = 0.035) between thoracic curve patients and controls. Conclusion:, Different subtypes of AIS might be related to different SNP. The susceptibility of PUMC type II (double curve) AIS and lumbar curve might be related to CALM1 rs12885713 site polymorphism, while rs5871 site polymorphism might be a risk indicator for thoracic curve cases. [source] | ||||||||||