European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Scoliosis among children and adolescents is a persistent problem. Worldwide, it afflicts between 0.3 to 15.3% of the population. One of the treatment methods of this disorder is to administer lateral electrical surface stimulation (LESS) for 9 h/day; unfortunately, however, this results in side-effects. ⋯ The degree of scoliotic deformity (according to the Cobb method) ranged from 21 degrees to 410 degrees (mean, 31.2 degrees) and from 23 degrees to 330 degrees (mean, 30 degrees) in groups 1 and 2, respectively. LESS resulted in spinal deformity to a similar degree in the rabbits treated for either 9 or 2 h/day over a 3-month period. Short LESS therapy (2 h/day) significantly reduced detrimental effects associated with the treatment on internal organs of laboratory animals.
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This paper examines the following speculative hypothesis: "that in some patients with scoliosis there is disproportionate neuro-osseous growth--the longitudinal growth of the spinal cord fails to keep pace with the growth of the vertebral column and, as a consequence, the spine buckles into a scoliosis deformity". A literature review of the morphology and neurology of scoliosis does not deny the hypothesis. Several mechanisms are suggested as to why the spinal cord growth could become uncoupled from osseous growth.
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Capillary haemangioma is a benign tumour frequently encountered in the skin and other soft tissues. Histologically, these vascular lesions are characterised by nodules of capillary-sized vessels lined by flattened endothelium, each of which is subserved by a feeding vessel. Capillary haemangioma of the central and peripheral nervous system is extremely rare. ⋯ Complete resection is the treatment of choice, and during surgery the vascular tumour is usually found encapsulated and sharply bordered from the surrounding parenchyma of the spinal cord and affected nerve roots. In the present account we give an overview of the clinical features, neuroradiological findings, therapeutic options and histopathological differential diagnostic aspects of spinal intradural capillary haemangioma. In general, vascular lesions of this entity are preoperatively misdiagnosed as neoplasms, and a higher level of clinical and radiological suspicion may avoid surgical overtreatment of these benign tumours.
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The purpose of this study was to evaluate the healing capacity of fatigue fractures of the pars interarticularis in young elite athletes. Between 1991 and 2000, a fatigue fracture of the pars interarticularis was diagnosed in 34 highly competitive athletes. The study group included 28 athletes with a mean age of 17.2 years at diagnosis (range 12-27 years). ⋯ Our data suggest that osseous healing is most likely to occur in unilateral active spondylolysis. Chances of bony healing diminish when the fracture is bilateral, and diminish even further when it is pseudo-bilateral. Non-union does not seem to compromise the overall outcome or sports resumption in the short term.
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The short segmental pedicle screw device is widely used for the decompression of neural elements and reduction of normal anatomy. Many biomechanical studies concerning proper decompression are available. However, no study has determined the optimal device adjustment for reduction of the burst fracture to the normal anatomy. ⋯ With this adjustment, on average the spine became 0.9 mm compressed and 2.0 degrees lordotic, compared to the intact. The results of the study show that the device adjustments of axial translation and sagittal angulation can be applied in any sequence, with the same results. The combination of 5 mm distraction with 6 degrees extension was the device adjustment that produced the closest anatomical reduction.