Spine
-
Review Case Reports
Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.
A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. ⋯ Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.
-
This report details the sudden catastrophic neurologic deterioration concerning a patient with an acute fracture of T5 associated with osteoporosis. ⋯ With increasing awareness of the morbidity attached to the osteoporotic spine, investigation and pharmacologic treatment are warranted and may reduce the possibility of catastrophic neurologic impairment as occurred in this case.
-
Multicenter Study Clinical Trial
A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.
A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). ⋯ Preoperative pain exists in our adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with adolescent idiopathic scoliosis.
-
Retrospective clinical, radiographic, and patient outcome review of surgically treated adolescent idiopathic scoliosis. ⋯ The clavicle angle, not T1 tilt, upright proximal thoracic, or side-bending proximal thoracic Cobb, provided the best preoperative radiographic prediction of postoperative shoulder balance. In each of the four groups, postoperative shoulder balance and clinical appearance also improved and correlated with patient postoperative assessments.
-
Multicenter Study
Radiographic markers in spondyloptosis: implications for spondylolisthesis progression.
Radiographic analysis of spinopelvic morphology and posterior element dysplasia in spondyloptosis. ⋯ Prognostic factors for spondylolisthesis progression, such as percent of slippage, do not identify lower-grade slips at risk for progression. Progression is linked to increased shear stress across the lumbosacral junction and inability to resist it. Increased stress is related to increased verticality of the lumbosacral joint, which is individually predetermined by pelvic incidence and sacral anatomy. Pelvic incidence is fundamental in determining sagittal spine curvature required for economic spinopelvic balance. Pelvic incidence is independent of adaptive changes in higher-grade spondylolisthesis. Pelvic incidence in our spondyloptosis series (76 degrees) is higher than in normal (48.2-53.2 degrees ) and low-grade spondylolisthesis (64.5 degrees). Posterior element dysplasia decreases mechanical resistance to lumbosacral shear stress. Incidence of dysplasia in our series (62%) is higher than that reported in low-grade spondylolisthesis. Analysis of pelvic incidence and posterior element dysplasia may aid in estimation of risk for progression of spondylolisthesis.