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[PMID]: 29225115
[Au] Autor:Court C; Mansour E; Bouthors C
[Ad] Address:Centre hospitalier universitaire de Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address: charles.court@aphp.fr.
[Ti] Title:Thoracic disc herniation: Surgical treatment.
[So] Source:Orthop Traumatol Surg Res;104(1S):S31-S40, 2018 Feb.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:Thoracic disc herniation is rare and mainly occurs between T8 and L1. The herniation is calcified in 40% of cases and is labeled as giant when it occupies more than 40% of the spinal canal. A surgical procedure is indicated when the patient has severe back pain, stubborn intercostal neuralgia or neurological deficits. Selection of the surgical approach is essential. Mid-line calcified hernias are approached from a transthoracic incision, while lateralized soft hernias can be approached from a posterolateral incision. The complication rate for transthoracic approaches is higher than that of posterolateral approaches; however, the former are performed in more complex herniation cases. The thoracoscopic approach is less invasive but has a lengthy learning curve. Retropleural mini-thoracotomy is a potential compromise solution. Fusion is recommended in cases of multilevel herniation, herniation in the context of Scheuermann's disease, when more than 50% bone is resected from the vertebral body, in patients with preoperative back pain or herniation at the thoracolumbar junction. Along with complications specific to the surgical approach, the surgical risks are neurological worsening, dural breach and subarachnoid-pleural fistulas. Giant calcified herniated discs are the largest contributor to myelopathy, intradural extension and postoperative complications. Some of the technical means that can be used to prevent complications are explored, along with how to address these complications.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:In-Data-Review

  2 / 659 MEDLINE  
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[PMID]: 28888389
[Au] Autor:Viciano J; López-Lázaro S; Pérez-Fernández Á; Amores-Ampuero A; D'Anastasio R; Jiménez-Triguero JM
[Ad] Address:Operative Unit of Anthropology, Department of Medicine and Ageing Sciences, 'G. d'Annunzio', University of Chieti-Pescara, Via dei Vestini 29, 66100 Chieti, Italy. Electronic address: joanviciano@gmail.com.
[Ti] Title:Scheuermann's disease in a juvenile male from the late Roman necropolis of Torrenueva (3rd-4th century CE, Granada, Spain).
[So] Source:Int J Paleopathol;18:26-37, 2017 Sep.
[Is] ISSN:1879-9825
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:This study details a severe case of Scheuermann's disease (SD) in a well-preserved skeleton of a juvenile male (designated TOR302), dated to 3rd-4th century CE, from the late Roman necropolis of Torrenueva (Granada, Spain). Individual TOR302 shows an evident kyphotic curve in the thoraco-lumbar spine, which is characterised by: (i) vertebral bodies of thoracic vertebra T2, thoracic segment T4-T9, and thoraco-lumbar segment T12-L2 wedged at >5°; (ii) slight anterior extensions of the epiphyseal ring; (iii) Schmorl's nodes on the superior and/or inferior plates; and (iv) a Cobb angle of 75°, derived from thoracic segments T4-T9. In addition, TOR302 shows other skeletal malformations as the secondary results of abnormal growth, due to altered biomechanical forces imposed by the spinal deformity, including: (i) lateral distortion of the spine that causes a slight secondary scoliotic curve; (ii) pelvic obliquity; and (iii) discrepancy in the length of the limbs. We argue that the secondary skeletal abnormalities allowed the individual to adapt to his spinal deformity meaning he was able to walk without the aid of a stick. Despite SD being a common modern clinical finding, few cases have been reported in ancient skeletal remains. This case therefore represents an important contribution to the palaeopathological literature.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170910
[Lr] Last revision date:170910
[St] Status:In-Data-Review

  3 / 659 MEDLINE  
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[PMID]: 28795014
[Au] Autor:Patel DR; Kinsella E
[Ad] Address:Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.
[Ti] Title:Evaluation and management of lower back pain in young athletes.
[So] Source:Transl Pediatr;6(3):225-235, 2017 Jul.
[Is] ISSN:2224-4344
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Lower back pain in young athletes is a common problem. The prevalence of back pain from different causes in adolescent age group is between 20% and 30%. However, the incidence of low back pain in young athletes varies widely in different sports. Overuse injuries are the most common cause of low back pain in young athletes. In case of overuse injuries, the cause and effect relationship between back pain and specific condition is often difficult to establish. In adolescent athletes, the most common underlying identified cause of low back pain is lumbar spondylolysis. During adolescent growth spurt, the severity of the pain generally correlates with adolescent growth spurt. Participation in sports starting at an early age and for a longer duration tends to increase the risk for back pain. Numerous conditions cause low back pain in athletes. These include acute trauma, chronic overuse or repetitive trauma, and referred pain. Our focus in here will be on selected conditions that cause recurrent or chronic low back pain.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170813
[Lr] Last revision date:170813
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.21037/tp.2017.06.01

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[PMID]: 28694598
[Au] Autor:Etemadifar MR; Jamalaldini MH; Layeghi R
[Ad] Address:Department of Orthopedic Surgery, Al Zahra Educational Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
[Ti] Title:Successful brace treatment of Scheuermann's kyphosis with different angles.
[So] Source:J Craniovertebr Junction Spine;8(2):136-143, 2017 Apr-Jun.
[Is] ISSN:0974-8237
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND: Scheuermann's disease is regarded as the most common cause of structural hyperkyphosis within adolescents without any proper treatment. It may lead to progressive deformity and back pain which influences patient's quality of life during adolescence and adulthood. Treatment approach to Scheuermann's kyphosis has not been clearly defined due to its different definitions and obscure natural history. The goal of treatment is not only to prevent progression but also to obtain permanent correction. Bracing, especially Milwaukee brace and physiotherapy are two of the common nonoperative treatment modalities. Hence, the present study intended to evaluate the effectiveness of Milwaukee brace on progression control as well as correction of Scheuermann's kyphosis. MATERIALS AND METHODS: In a retrospective, observational study, all the patients diagnosed with Scheuermann's kyphosis were reviewed in 2003-2013, who were treated by Milwaukee brace at a single center. There was a minimum of 2-year follow-up after completion of bracing, during which clinical and radiological parameters were identified and recorded. RESULTS: The mean angle of kyphosis in these patients at the presentation was 63.24 ± 9.96 and at the end of this study was 36.5° ± 13.4° ( < 0.001). Moreover, mean improved angle in those patients with <75° of kyphosis was 25.26° ± 7.78° and in those with 75° or more than 75° of kyphosis was 26.77° ± 19.76° ( < 0.001). CONCLUSION: Conservative treatment with Milwaukee brace and physiotherapy was effective in our hand for halting kyphosis progression in 97.5% of Scheuermann's kyphosis, which could be advised for cases up to 90° of kyphosis before skeletal maturity. As a result, a trial of brace treatment could be recommended in patients with severe kyphosis (up to 90°) which can open a new insight in conservative treatment of Scheuermann's kyphosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/jcvjs.JCVJS_38_16

  5 / 659 MEDLINE  
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[PMID]: 28640085
[Au] Autor:Dai Y; Li Y; Li P; Li L; Tu Z; Wang B
[Ad] Address:Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
[Ti] Title:Familial lumbar Scheuermann disease with idiopathic scoliosis in China: First case report.
[So] Source:Medicine (Baltimore);96(25):e7100, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Given that Scheuermann disease rarely occurs in the lumbar region and that the co-occurrence of Scheuermann disease and idiopathic scoliosis (IS) has not been reported-the etiology of Scheuermann disease and IS is not clear. In this case report, we present familaiar lumbar Scheuermann disease with IS, in a Chinese proband, who was successfully treated with surgery. PATIENT CONCERNS: A 16-year-old boy presented at the Second XiangYa Hospital of Central South University with a chief complaint of kyphotic deformity in the lower back for 4 years and obvious lower back pain. In addition, he complained of limited lumbar activity. And The proband's family history was obtained by routine inquiring. In this Chinese family with 17 members over 3 generations. The 3 patients (proband, proband's sister and father) shared the characteristics of vertebral wedging from L1 to L3 and a kyphosis Cobb angle of 37°, 70°, or 73°, respectively. The main deformity of the proband's mother was at T7-L1 with a Cobb angle of 102° in the coronal plane at T7-L1, thoracic kyphosis of 73°, and lumbar lordosis of 62°. DIAGNOSES: Scheuermann's disease. INTERVENTIONS: Clinical history, physical examination, laboratory tests, and radiographs of those in the pedigree were recorded, and the related literature was reviewed. The proband accepted osteotomy and orthopedic surgery for treatment. OUTCOMES: After 3 months of treatment, postoperative lateral radiographs showed a significantly improved sagittal vertical axis (SVA). The other patients were continued to be seen in follow-up visits. LESSONS: This series of lumbar Scheuermann patients with IS in a pedigree support the genetic contribution to Scheuermann disease. Therefore, this study provides some insight into the genetic etiology of Scheuermann disease with IS.
[Mh] MeSH terms primary: Scheuermann Disease/complications
Scheuermann Disease/surgery
Scoliosis/complications
Scoliosis/surgery
[Mh] MeSH terms secundary: Adolescent
China
Diagnosis, Differential
Humans
Lumbar Vertebrae/diagnostic imaging
Lumbar Vertebrae/surgery
Male
Scheuermann Disease/diagnostic imaging
Scoliosis/diagnostic imaging
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170717
[Lr] Last revision date:170717
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170623
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007100

  6 / 659 MEDLINE  
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[PMID]: 28420562
[Au] Autor:Ristolainen L; Kettunen JA; Kujala UM; Heinonen A; Schlenzka D
[Ad] Address:Orton Orthopaedic Hospital and Orton Research Institute, Orton Foundation, Tenholantie 10, PL 29, 00281, Helsinki, Finland. Electronic address: leena.ristolainen@invalidisaatio.fi.
[Ti] Title:Progression of untreated mild thoracic Scheuermann's kyphosis - Radiographic and functional assessment after mean follow-up of 46 years.
[So] Source:J Orthop Sci;22(4):652-657, 2017 Jul.
[Is] ISSN:1436-2023
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:BACKGROUND: There is no data available on the radiographic development of the Scheuermann's deformity. Our purpose was to investigate radiographic deformity progression and the relation between kyphosis progression and clinical outcome in patients with untreated Scheuermann's kyphosis. METHODS: Thoracic kyphosis (Th4-Th12) was measured from standing lateral radiographs in 19 patients at baseline and after mean 46-year follow-up. Mean age at baseline was 19.2 and at follow-up 64.7 years. At follow-up, height, weight, hand grip strength, and hamstring tightness were measured, and sit-to-stand and walking tests were performed. Additionally general health and quality of life questionnaires were administered. RESULTS: The mean thoracic kyphosis increased from 46° (range 25°-78°) at baseline to 60° (34°-82°) (p < 0.001) at follow-up. Mean of the vertebrae wedge increased from 8.8° to 9.9° (p = 0.046). There was no correlation between extent of kyphosis progression and function at follow-up. CONCLUSIONS: Among patients with Scheuermann's disease the degree of radiographic deformity progressed slightly during long-term follow-up. Progression did not predict symptoms.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170713
[Lr] Last revision date:170713
[St] Status:In-Process

  7 / 659 MEDLINE  
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[PMID]: 28328806
[Au] Autor:Al Kaissi A; Marrakchi Z; Nassib NM; Hofstaetter J; Grill F; Ganger R; Kircher SG
[Ad] Address:aLudwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital bOrthopedic Hospital of Speising, Pediatric Department, Vienna, Austria cDepartment of Neonatology, Charles Nicolle Hospital, Tunisia dDepartment of Pediatric Orthopedic Surgery, Children Hospital of Tunis, Tunisia. eInstitute of Medical Chemistry, Medical University of Vienna, Austria.
[Ti] Title:Craniosynostosis, Scheuermann's disease, and intellectual disability resembling Shprintzen-Goldberg syndrome: a report on a family over 4 generations: Case report.
[So] Source:Medicine (Baltimore);96(12):e6199, 2017 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Craniosynostosis is a disorder characterized by premature fusion of cranial sutures with subsequent development of abnormal craniofacial contour associated with variable skeletal and extra-skeletal abnormalities. In this family syndromic type of craniosynostosis was recognized and the etiology behind diverse forms of deformities have been diagnosed. PATIENT CONCERNS: The negative impact of the disorder on the child and his family is enormous. Particularly when the diagnosis is late and little can be done. Though counselling the family through discussing the whole picture of the disorder might lessens their concern. DIAGNOSES: Diagnosis is the corner stone of management. In this paper we aimed to sensitize pediatricians, physicians, and orthopedic surgeons concerning the necessity to recognize syndromic associations early on. INTERVENTIONS: Patients with syndromic craniosynostosis are usually associated with a complexity of malformation complex. Craniofacial surgery can be of remarkable help if the diagnosis is made early. It requires a series of corrections to avoid intellectual disability and other neurological deficits.The timing of interventions is strongly correlated on the timing of diagnosis. OUTCOMES: The earliest the diagnoses, the much better the outcomes are. And consequently avert the psychological and the financial cost on the patient and his family. LESSONS: The golden principle of medicine should prevail in all medical disciplines, which states: The more you see, the more you know and conversely the more you know is the more you see.
[Mh] MeSH terms primary: Craniosynostoses/diagnosis
Craniosynostoses/physiopathology
Intellectual Disability/physiopathology
Scheuermann Disease/diagnosis
Scheuermann Disease/physiopathology
[Mh] MeSH terms secundary: Adult
Arachnodactyly/diagnosis
Arachnodactyly/physiopathology
Child
Diagnosis, Differential
Exophthalmos
Female
Humans
Male
Marfan Syndrome/diagnosis
Marfan Syndrome/physiopathology
Syndrome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170410
[Lr] Last revision date:170410
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170323
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006199

  8 / 659 MEDLINE  
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[PMID]: 28302104
[Au] Autor:Zhang Z; Liu Z; Zhu Z; Qiu Y
[Ad] Address:Department of Spine Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
[Ti] Title:Spinal epidural lipomatosis - an easily ignored secondary intraspinal disorder in spinal kyphotic deformities.
[So] Source:BMC Musculoskelet Disord;18(1):112, 2017 Mar 16.
[Is] ISSN:1471-2474
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: A previous study reported a high prevalence of spinal epidural lipomatosis (SEL) in patients with Scheuermann kyphosis (SK) and suggested that it may play a role in the pathogenesis of this disease. According to our observation, however, SEL occurs in other spinal kyphotic deformities as well. The aim of this study was to test the hypothesis that SEL commonly occurs in patients with different types of kyphotic deformities as a secondary intraspinal disorder. METHODS: MR images of 16 patients with congenital kyphosis (CK), 40 patients with SK, 13 patients with tuberculotic kyphosis (TK), and 69 age- and sex-matched controls were retrospectively evaluated. The body mass index (BMI), kyphosis Cobb angle, and sagittal diameters of spinal epidural fat (EF) and the dural sac (DS) in the apical region (EF , DS ) and non-kyphotic region (EF , DS ) were measured. The EF ratios at the apical vertebral level (EFR ) and in the non-kyphotic region (EFR ) were calculated as EF / (EF + DS). RESULTS: EF and EFR were significantly higher among patients with CK, SK, and TK than among controls (P < 0.05). Seven CK patients (43.8%), 8 SK patients (20.0%), and 11 TK patients (84.6%) fulfilled the diagnostic criteria for SEL, while only 6.3, 2.5, and 0% of patients in the control groups did (P = 0.019, 0.014, and < 0.001, respectively). Spearman's correlation analysis showed statistically significant correlations between the kyphosis Cobb angle and the amount of EF in all three patient groups. CONCLUSIONS: SEL is a common secondary intraspinal disorder in different types of kyphotic deformities, and surgeons should pay increased attention to this intraspinal anomaly because excessive EF may compress the spinal cord and cause neurological deficits.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 170323
[Lr] Last revision date:170323
[St] Status:In-Process
[do] DOI:10.1186/s12891-017-1467-7

  9 / 659 MEDLINE  
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[PMID]: 28194535
[Au] Autor:Ghasemi A; Stubig T; Nasto LA; Ahmed M; Mehdian H
[Ad] Address:Center for Spinal Studies, Queens Medical Center, Nottingham University, Derby Road, Nottingham, NG7 2UH, UK. amir.ghasemi@nuh.nhs.co.uk.
[Ti] Title:Erratum to: Distal junctional kyphosis in patients with Scheuermann's disease: a retrospective radiographic analysis.
[So] Source:Eur Spine J;26(5):1564, 2017 May.
[Is] ISSN:1432-0932
[Cp] Country of publication:Germany
[La] Language:eng
[Pt] Publication type:PUBLISHED ERRATUM
[Em] Entry month:1702
[Cu] Class update date: 171011
[Lr] Last revision date:171011
[St] Status:In-Data-Review
[do] DOI:10.1007/s00586-017-4994-x

  10 / 659 MEDLINE  
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[PMID]: 28141687
[Au] Autor:Polly DW; Ledonio CG; Diamond B; Labelle H; Sucato DJ; Hresko MT; Emans JB; Vitale MG; Erickson MA; Larson AN; Spinal Deformity Study Group
[Ad] Address:*Department of Orthopaedic Surgery, University of Minnesota, Minneapolis **Mayo Clinic, Rochester, MN †Edwards Life Sciences, Irvine, CA ‡St. Justine's Hospital, Montreal, QC, Canada §Texas Scottish Rite Hospital for Children, Dallas, TX ∥Boston Children's Hospital, Boston, MA ¶Columbia University, New York, NY #Children's Hospital, Aurora, CO.
[Ti] Title:What are the Indications for Spinal Fusion Surgery in Scheuermann Kyphosis?
[So] Source:J Pediatr Orthop;, 2017 Jan 30.
[Is] ISSN:1539-2570
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Surgical indications for Scheuermann kyphosis are variable. We sought to evaluate the characteristics of patients undergoing operative versus nonoperative treatment of Scheuermann kyphosis to better understand current practices and the factors which contribute to the decision for surgical management. METHODS: Multicenter prospective cohort study. We evaluated consecutive patients presenting with Scheuermann kyphosis. Patients underwent either surgical or nonoperative management according to surgeon and patient discretion. Preoperative patient-reported outcome measures (Scoliosis Research Society and Spinal Appearance Questionnaire scores), demographics, and radiographic characteristics were assessed. RESULTS: Overall, 150 patients with Scheuermann kyphosis were enrolled, with 77 choosing nonoperative treatment and 73 treated operatively. Compared with the nonoperative cohort, patients treated operatively were older (16.3±2.0 vs. 15.1±2.2, P=0.0004), and had higher body mass index (26.3±7.2 vs. 22.7±6.5, P=0.003), had greater T2-T12 kyphosis (71±14 degrees vs. 61±12 degrees, P<0.001), increased pelvic incidence (46 vs. 41 degrees, P=0.03) and pelvic tilt (10 vs. 3 degrees, P=0.03). There was no detected difference in maximal sagittal Cobb angle in the operative versus nonoperative patients (73±11 vs. 70±12 degrees, P=0.11). Functionally, the operative patients had worse Scoliosis Research Society pain scores (3.7±0.9 vs. 4.1±0.7, P=0.0027) and appearance scores (2.9±0.7 vs. 3.4±0.8, P <0.0001). CONCLUSIONS: Patients undergoing surgical management of Scheuermann disease were more likely to have large body mass index and worse pain scores. Other factors beyond radiographic measurement likely contribute to the decision for surgical management of Scheuermann kyphosis. LEVEL OF EVIDENCE: Level II.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1702
[Cu] Class update date: 170131
[Lr] Last revision date:170131
[St] Status:Publisher
[do] DOI:10.1097/BPO.0000000000000931


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