STUDY DESIGN: A retrospective clinical and radiographic review. OBJECTIVES: The purpose of this study is to suggest the indications and more ideal objective amount of corrections of for upper and lower curves. SUMMARY OF LITERATURE REVIEW: There are many controversies exist about the diagnosis and treatment of double thoracic scoliosis yet. MATERIALS AND METHODS: Thirty-nine double thoracic scoliosis patients with left shoulder elevation and/or positive T1 tilt and an upper curve of 25 degrees or more were divided into two groups. Group I (24 patients) underwent fusion on both curves, and Group II (15 patients), on the lower curve alone. Cobb angles, T1 tilt, left first rib elevation (represents trapezial prominence), and shoulder level difference were measured from standing on pre- and post-operative standing films. The correction ratio [Upper curve correction(%)/Lower curve correction(%)] was used to represent describe how much the upper curve was had been corrected compared to versus the lower curve. RESULTS: T1 tilt did not correlate well with left shoulder elevation, but correlated with left first rib elevation. In Group I, T1 tilt and left first rib elevation improved significantly after fusion of the upper curve, whereas these were aggravated in Group II. In Group I, most of the patients with the a correction ratio of more than 0.8, showed balanced shoulder levels finally. CONCLUSIONS: In double thoracic scoliosis patients, T1 tilt and left first rib elevation should be considered in addition to not only left shoulder elevation and the rigidity of upper curve, but also the T1 tilt and left first rib elevation should be considered as the indication of the extension of fusion to upper curve. The amount of upper curve correction should be more than at least 80% of that of the lower curve for a balanced correction in the treatment of double thoracic scoliosis.
Diagnosis ; Humans ; Retrospective Studies ; Ribs* ; Scoliosis* ; Shoulder

PURPOSE: To evaluate the first results of surgical treatment using newly developed magnetically controlled growing rods (MCGR) for early onset scoliosis (EOS). MATERIALS AND METHODS: From January 2013 to January 2017, 5 patients, who underwent surgical treatment with MCGR for EOS and were followed for more than one year, were analyzed retrospectively. The demographic and radiology data, including age at surgery, diagnosis, number of lengthening, Cobb angle, T1–S1 length, T1–T12 length, and complications, were analyzed. RESULTS: The mean age of the patients was 6.0±2.7 years old. The subjects were 3 males and 2 females: 2 with neuromuscular scoliosis, 1 with syndromic scoliosis, 1 with idiopathic scoliosis, and 1 with congenital scoliosis. The mean number of lengthening was 9.8±2.9 times and the follow-up was 21.6±5.7 months. The Cobb angle improved from 82.0°±28.5° to 48.3°±28.8° at the last follow-up. The T1–S1 length increased from 283.1±72.7 mm to 342.6±86.3 mm at the last follow-up. The T1–T12 length increased from 163.1±50.5 mm to 202.3±65.5 mm at the last follow-up. One screw loosening complication was encountered and there were no neurological complications. CONCLUSION: The treatment using MCGR for EOS is effective and useful.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis*

Adult ; Anterior Cruciate Ligament ; pathology ; Bone Diseases, Developmental ; diagnosis ; Female ; Hip Dislocation, Congenital ; diagnosis ; Humans ; Scoliosis ; diagnosis

PURPOSE: The purposes of this study were to evaluate the usefulness and limitations of chest radiographs in scoliosis screening and to compare these results with those of thoraco-lumbar standing radiographs (TLSR). MATERIALS AND METHODS: During Korean conscription, 419 males were retrospectively examined using both chest radiographs and TLSR to confirm the scoliosis and Cobb angle at the Regional Military Manpower. We compared the types of spinal curves and Cobb angles as measured from different radiographs. RESULTS: In the pattern of spinal curves, the overall matching rate of chest radiographs using TLSR was about 58.2% (244 of 419 cases). Cobb angle differences between chest radiographs and TLSR with meaningful difference was observed in 156 cases (37.2%); a relatively high proportion (9.5%) of Cobb angle differences more than 10 degrees was also observed. The matching rate of both spinal curve types and Cobb angle accuracy between chest radiographs and TLSR was 27.9% (117 among 419 cases). Chest radiographs for scoliosis screening were observed with 93.94% of sensitivity and 61.67% of specificity in thoracic curves; however, less than 40% of sensitivity (38.27%, 20.00%, and 25.80%) and more than 95% of specificity (97.34%, 99.69%, and 98.45%) were observed in thoraco-lumbar, lumbar, and double major curves, respectively. CONCLUSION: The accuracy of chest radiographs for scoliosis screening was low. The incidence of thoracic curve scoliosis was overestimated and lumbar curve scoliosis was easily missed by chest radiography. Scoliosis screening using chest radiography has limited values, nevertheless, it is useful method for detecting thoracic curve scoliosis.
Adult ; Humans ; Male ; Radiography, Thoracic/methods ; Retrospective Studies ; Scoliosis/*diagnosis/*radiography ; Young Adult

OBJECTIVES: To report the surgical technique and effectiveness in treating rigid adult scoliosis with one stage vertebral column resection and pedicle screw fixation through a single posterior approach(PVCR). MATERIALS AND METHODS: Twenty-one patients with low flexibility(less than 20~30%) subjected to PVCR were evaluated after a mean follow-up of 18.5 months(12~29 months). There were 10 males and 11 females. The mean age at the time of the operation was 32.1 years(19~61 years). Etiological diagnoses were idiopathic in 7, congenital in 12, neuromuscular in 2. Preoperatively, all the patients showed moderate to severe derangement of pulmonary function with reduced vital capacity(30%~57%). RESULTS: An average of 1.3 vertebrae(1~3 vertebrae) were removed. The resection of body was in thoracic in 12 and lumbar in 15. Posterior fusion was carried out in 6.8(3~12) levels. Following the surgery, preoperative thoracic scoliosis of 86degree(55~130degree) and lumbar scoliosis of 64degree( 35~110degree) were corrected to 38degree(15~65degree) and 25degree(14~61degree), showing a correction of 56.2%(39~78%) and 61.1% (44~82%) respectively. Preoperative kyphosis of 59degree(16~104degree) was corrected to 24degree(2~58degree), showing a correction of 60.2%(41~74%). Preoperative coronal imbalance and shoulder height difference was corrected to 0.6 cm and 1.0 cm respectively. The average operation time and transfusion were 253 minutes and 2835 ml. The complications comprised two transient neurological deficits, one aggravated neurological deficits, one monoparesis, one infection, and one pneumothorax. CONCLUSIONS: One stage posterior vertebral column resection is a promising new technique for rigid scoliosis, significantly reducing the operative time and morbidity of combined anterior-posterior resection.
Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Male ; Operative Time ; Paresis ; Pneumothorax ; Scoliosis* ; Shoulder ; Spine*

The Freeman-Sheldon syndrome (FSS) is a rare congenital syndrome, characterized with myopathy and dysplasia. The musculoskeletal and soft-tissue manifestations often require orthopedic and plastic surgery. We reported a case of 8-year-old girl with FSS operated on for scoliosis.
Anesthetics ; therapeutic use ; Child ; Craniofacial Dysostosis ; diagnosis ; surgery ; Female ; Humans ; Scoliosis ; surgery

The association between pediatric Chiari malformation and the development of syringomyelia has been well documented. Scoliosis in the patient with syringomyelia is thought to be secondary to anterior horn cell damage, which innervate the muscles of trunk, by an asymmetrically expanded syrinx. In pediatric patients, the neurologic signs and symptoms due to Chiari malformation and syringomyelia show much lower frequency but the incidence of scoliosis is very high. Thus, the MRI study for the diagnosis of the underlying syringomyelia and Chiari malfornation is essential in pediatric scoliosis patients, which may otherwise be misdiagnosed for idiopathic scoliosis. We present a case of Chiari type I malformation associated with syringomyelia and scoliosis.
Anterior Horn Cells ; Child* ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Muscles ; Neurologic Manifestations ; Scoliosis* ; Syringomyelia*

Early detection of spine deformities by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 1,620 middle and high school male students Seoul who were chosen arbitrarily, to determine the incidence rates of scoliosis. Authors diagnosed scoliosis on a combination of at least one positive physical sign and a lateral curvature more thar 5 degrees on an antero-posterior standing X-ray. According to this criteria 12 students were diagnosed as having scoliosis. They were analyzed for positive physical signs, etiology, degree of curvature. distribution of size of curvature, patterns of curvature, direction of curvation, and following results were obtained. 1. The overall incidence of scoliosis was 0.74%. 2. Idiopathic scoliosis was found in 10 students, congenital scoliosis in 1, and paralytic scoliosis in 1. 3. Rib humps, whose right to left ratio was 5, were found in 6 students, lumbar humps, whose right to left ratio was 0. 2. in 6 students, and shoulder elevation, whose direction were all to right, in 4 students. 4. Close observations were required for all the 12 students and treatment was required in 2 students who had more than 20 degrees, one for Milwaukee brace, and the other for surgical correction. 5. The most common pattern of curvature was thoracic curve. 6. in single curve right to left ratio was 2.7.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Ribs ; Scoliosis ; Seoul ; Shoulder ; Spine

Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

Limb-body wall complex, also known as the short umbilical cord syndrome or the body stalk anomaly, is a poorly defined, sporadic group of congenital anomaly characterized by a collection of protean fetal malformation, deformation and disruption. Accurate diagnosis is often difficult because of its variable presentation pattern and the absence of exactly same case. Ultrasonographic detection of abdominoschisis, scoliosis, abnormalities of the lower extremities, a single umbilical artery and a short umbilical cord is important for the prenatal diagnosis. This complex should be distinguished from other body wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall complex is uniformly poor. We experienced a case of limb-body wall complex in a fetus of intrauterine pregnancy at 15 weeks who was terminated because of ultrasonographic demonstration of a large abdominal defect with eventration of abdominal organs, short umbilical cord and kyphoscoliosis. Thus, we report a case with brief review of the literatures.
Diagnosis ; Fetus ; Gastroschisis ; Hernia, Umbilical ; Lower Extremity ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Scoliosis ; Single Umbilical Artery ; Ultrasonography, Prenatal* ; Umbilical Cord