No abstract available.
Kyphosis*

No abstract available.
Kyphosis*

OBJECTIVE: In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. METHODS: Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. RESULTS: The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were 6.9 +/- 1.34 mm, 8.23 +/- 1.18 mm, 30.93 +/- 4.65 mm, 26.42 +/- 7.91 degrees, 25.9 +/- 4.83 degrees, and 10.6 +/- 3.39 degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. CONCLUSION: C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.
Humans ; Kyphosis

STUDY DESIGN: In this prospective study, we measured the pad pressures of the Milwaukee brace in adolescent hyperkyphosis treatment. PURPOSE: We evaluated the skin-brace interface forces exerted by the main pads of the Milwaukee brace. OVERVIEW OF LITERATURE: A fundamental factor associated with brace effectiveness in spinal deformity is pad force adjustment. However, few studies have evaluated the in-brace force magnitude and its effect on curve correction. METHODS: Interface forces at four pads of the Milwaukee brace were measured in 73 patients withround back deformity (mean age, 14.04±1.97 years [range, 10–18]; mean initial Cobb angle,67.70°±9.23° [range, 50°–86°]). We used a modified aneroid sphygmomanometer to measure the shoulder and kyphosis pad pressures. Each patient underwent measurement in the standing and sitting positions during inhalation/exhalation. RESULTS: The mean pad pressures were significantly higher in the standing than in thesitting position, and significantly higher pressures were observed during inhalation compared toexhalation (p=0.001).There were no statistically significant differences between right and left shoulder pad pressures (p>0.05); however, the pressure differences between the right and left kyphosis pads were statistically significant (p<0.05). In a comparison of corrective forces with bracing for less or more than 6 months, corrective force was larger with bracing for less than 6 months (p=0.02). In the standing position, there were no statistically significant correlations between pad pressures and kyphosis curve correction. CONCLUSIONS: In the sitting position, there was a trend toward lower forces at the skin-brace interface; therefore, brace adjustment in the standing position may be useful and more effective. There was no significant correlation between the magnitude of the pad pressures and the degree of in-brace curve correction.
Adolescent* ; Braces* ; Congenital Abnormalities* ; Humans ; Inhalation ; Kyphosis ; Posture ; Prospective Studies ; Scheuermann Disease ; Shoulder ; Sphygmomanometers

Morphologically, kyphosis is devided into two groups, pure kyphosis and kyphoscoliosis, according to whether or not scoiiosis is combined. Or kyphosis can be devided into round kyphosis or angular kyphosis. The examples of round kyphosis are Scheuermanns kyphosis or ankylosing spondylitis. Acute angular kyphosis are of congenital kyphosis or old healed tuberculosis. The purpose of surgical correction of fixed kyphosis is to correct deformity as well as to prevent or to recover from paraplegia. The operation also improve respiratory and digestive function by diminishing compression of abdomen. However, the correction of this deformity is more dangerous in eliciting paraplegia than any other spinal deformity. In considering surgical correction of kyphosis we have to decide which approach is the best for that particular patient at that particular time. Usually majority of patient need combined anterior and posterior approach. The extent of fusion depends upon the flexibility of the kyphosis. Anterior fusion should encompass at least the rigid and inflexible portion of the kyphosis as determined by the hyperextension x-ray of the spine. Posterior fusion should encompass the full extent of the kyphosis. The purpose of this study is to report our results for surgical correction and to find the operative procedure which shows the best result. We hereby report surgically corrected 14 cases of fixed kyphosis who were hospitalized here from April 1988 to February 1995.
Abdomen ; Congenital Abnormalities ; Humans ; Kyphosis* ; Paraplegia ; Pliability ; Scheuermann Disease ; Spine ; Spondylitis, Ankylosing ; Surgical Procedures, Operative ; Tuberculosis

No abstract available.
Kyphosis* ; Spine* ; Tuberculosis*

Over 100 years ago, Hermann Kummell described a clinical condition in which patients sustained a trivial trauma, had essentially asymptomatic period lasting weeks to months, then developed a painful, progressive angular kyphosis. Since then, many post-traumatic delayed kyphosis have been reported as a Kummell's disease. As a radiologic finding of intravertebral cleft sign was related to this delayed collapse, this abnormal gas or fluid signal in the involved vertebral body was considered as a pathognomic sign. However, recent evidences indicate this delayed progressive collapse and kyphosis of the spine is related to osteoporotic spine fracture in many reports. At this point, by defining and reviewing the definition and etiology of Kummell's disease, we have to look into whether Kummell's disease is a distinct or rare pathophysiologic entity or a complicated clinical result of osteoporotic spine fracture. In this review, author tried to clearly define the definition and diagnosis criteria to diagnose Kummell's disease as a complicated osteoporotic spine fracture and review treatment modalities for this complicated clinical condition.
Humans ; Kyphosis ; Spine

STUDY DESIGN: Retrospective study (level of evidence: level 3). PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of the posterior-only approach with pedicle screws for the treatment of Scheuermann's kyphosis (SK). OVERVIEW OF LITERATURE: The correction of SK with instrumentation can be performed using posterior-only or combined anterior-posterior procedures. With the use of all-pedicle screw constructs in spine surgery, the posterior-only approach has become a popular option for the definitive treatment of SK. In a nationwide study involving 2,796 patients, a trend toward posterior-only fusion with lower complication rates was reported. METHODS: We retrospectively reviewed the data of patients who underwent posterior-only correction for SK between January 2005 and May 2013. Patients with a definite diagnosis of SK who fulfilled the minimum follow-up criterion of 24 months were included. The thoracic kyphosis (T5–T12), lumbar lordosis (L1–S1), and thoracolumbar junction (T10–L2) angles were measured from preoperative, postoperative, and last control radiographs. Sagittal balance, thoracic length, thoracic diameter, Voutsinas index and the sacral slope, pelvic tilt, proximal junction kyphosis, and distal junction kyphosis angles were also measured. RESULTS: Forty-five patients underwent surgery for the treatment of SK between 2005 and 2013. After applying the exclusion criteria, 20 patients (18 males and 2 females) with a mean age of 19 years were included. The mean thoracic kyphosis angle was 79.8 degrees preoperatively, 44.6 degrees postoperatively, and 44.9 degrees at the last control. There were statistically significant differences between preoperative and postoperative values in the thoracic kyphosis and lumbar lordosis angles, thoracic length, thoracic diameter, and Voutsinas index (p<0.05). CONCLUSIONS: The clinical and radiological results of the current study suggest that posterior-only fusion is an efficient technique for the treatment of SK.
Animals ; Diagnosis ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Pedicle Screws* ; Retrospective Studies ; Scheuermann Disease* ; Spinal Fusion ; Spine

No abstract available.
Catheterization ; Catheters ; Humans ; Kyphosis ; Pneumothorax

OBJECTIVE: The authors evaluate results of transfacet pedicle sparing approach for high lumbar disc herniation to avoid injury of nerve roots and the cauda equina. METHODS: Seven patients treated by transfacet pedicle sparing approach for high lumbar disc herniation were reviewed. Some thoracolumbar kyphotic patients on whom posterior procedures underwent additional posterior lumbar interbody fusion and posterolateral fusion using the mesh cage and spinal instrumentation. RESULTS: Clinical symptoms improved in all seven patients. Rigid spinal stability and correction of thoracolumbar kyphosis could be performed by the spinal instrumentation methods. CONCLUSION: The advantages of the transfacet pedicle sparing approach are less invasive, easy decompression the nerve root directly and avoidance of the risk of injury to the cauda equina while the dura is being retracted. Additionally, thoracolumbar kyphosis could be corrected. Transfacet pedicle sparing approach is an useful procedure in the surgical treatment of high lumbar disc herniation.
Cauda Equina ; Decompression ; Humans ; Kyphosis