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Paralytic scoliosis is a disease characterized by its long severe curve and the continuous progression of the deformity even after cessation of growth. It is also resistent to conservative treatment and more patients require surgical treatment than those with idiopathic or congenital curvature. Patients suffer from marked limitation of normal activities in walking and sitting due to imbalanced paralysis of trunk muscles and pelvic obliquity. The indication for the conservative treatment with Milwaukee brace allowing for skeletal growth in a straight alignment is much limited and surgical correction and fusion are almost always indicated even in a young age. This paper was aimed to review our experience with ninteen patients with paralytic scoliosis who were treated with various methods of preoperative corrections and surgery from Jan. 1970 to Dec. 1981 and the following results were obtained. 1. The average age when scoliosis was observed was 7.7 years but the average age of surgery was deferred to 17.7 years. 2. No treatment had been done until most of the patients could no longer maintain balanced posture in sitting and walking due to collapsing spine and marked pelvic obliquity. 3. The causes of paralysis were poliomyelitis in 15 cases, meningocele in two, cerebral palsy and Charcots disease in each one. 4. Preoperative average degree of scoliosis was 107.8° and the final correction was 47.9°(44.4%) with loss of correction 3.6° (3.4%) after 5.6 years of follow-up in average. 5. The more severe the curve was, the more flail was the spine and the more correction could be obtained. 6. Preoperative correction was performed for 16 cases and Harrington instrumentation and posterior fusion were performed for all cases except one meningocele with defect of posterior element in which Dwyer instrumentation was indicated. 7. Breakage of Harrington rod was observed in two cases 1.3 and 3.8 years postoperatively but no problem arose from it in seven and two years of follow-up respectively. 8. Significant pelvic obliquity was observed in seven cases, which were treated by Harrington instrumentation with sacral bar or sacral hook and posterior fusion extended to sacrum.
Braces ; Cerebral Palsy ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Meningocele ; Muscles ; Paralysis ; Poliomyelitis ; Posture ; Sacrum ; Scoliosis ; Spine ; Walking

Stasis dermatitis is one of the important skin manifestations of venous stasis. Therefore, the searching for the cause of venous stasis is importrnt. Two cases of stasis dermatitis with inferior vena caval obstruction are reported and possible etiologic factor is discussed. Case I The patient, 38-year-old carpenter, was admitted at Choong Buk Medical Center in April, 1974 with superficial venous engorgement of the lower extremities which had begun to appear two years after severe blunt trauma to both legs in 1962. 5 years prior to admission, abdomial venous engorgement and abdominal fullness developed and was exaggerated gradually. Since 2 years prior to admission, he has been suffered from the recurrent exudative ulcer on the right lower leg The physical examination revealed mild icteric sclera, hepatomegaly, abdominal distension, tortuous venous engorgement on the abdomen, the lateral chest wall and the lower extremities, and edematous scaly brawny pigmentation of the lower legs. Esphagogram showed no esphageal varices. Inferior vena cavogram showed complete obstruction at the level of upper border of 2nd lumbar vertebra and well developed collateral circulation, Findings of skin biopsy on the right lower leg showed moderate acanthosis, increased pigmentation of bosal cell layer in the epidermis, capillary proliferation, diffuse inflammatory cell infiltration with increased fibrosis and hemosiderin granules in the dermis. Case II The patient. 36-year-old farmer, was admitted at Dept. of Dermatology, St. Mary's Hospital, Catholic Medical College in Sept., 1973.The physical examination revealed hepatomegaly, abdominal distension, superficial venous engorgement on the abdomen, the neck and the lower extrcmities, severe edema and pigmentation of the lower legs, and the multiplc. Exudative ulcers on the left lower leg. Liver scanning showed somewhat general enlargement with some mottlings along the margin and relative prominance of the left lobe. Liver biopsy revealed findings of non specific chrcnic hepatitis. Inferior vena cavogram through the left femoral vein showed complete obstruction at the level between 11th and 12th thoracic vertebrae.His peripheral edema and ascites was much subsided after adequate bed rest and the skin lesion improved with scar formation.
Abdomen ; Adult ; Ascites ; Bed Rest ; Biopsy ; Capillaries ; Cicatrix ; Collateral Circulation ; Dermatitis* ; Dermatology ; Dermis ; Edema ; Epidermis ; Femoral Vein ; Fibrinogen ; Fibrosis ; Hemosiderin ; Hepatitis ; Hepatomegaly ; Humans ; Hyperemia ; Leg ; Liver ; Lower Extremity ; Neck ; Physical Examination ; Pigmentation ; Sclera ; Skin ; Skin Manifestations ; Spine ; Thoracic Wall ; Ulcer ; Varicose Veins