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2001 Abstract Management of fixed sagittal plane deformity results of the transpedicular wedge resection osteotomy
Spine. 2001 Sep 15;26(18):2036-43.Links
Management of fixed sagittal plane deformity: results of the transpedicular wedge resection osteotomy.
Berven SH, Deviren V, Smith JA, Emami A, Hu SS, Bradford DS. Department of Orthopaedic Surgery, University of California, San Francisco, California, USA.
CONCLUSIONS: The transpedicular wedge resection osteotomy is an effective procedure for the management of fixed sagittal deformity and is generalizable for multiple etiologies. Simultaneous correction of coronal deformity is possible. The clinical value of the procedure is demonstrated in high rates of patient satisfaction.
Berven SH, Deviren V, Smith JA, Emami A, Hu SS, Bradford DS. Department of Orthopaedic Surgery, University of California, San Francisco, California, USA.
CONCLUSIONS: The transpedicular wedge resection osteotomy is an effective procedure for the management of fixed sagittal deformity and is generalizable for multiple etiologies. Simultaneous correction of coronal deformity is possible. The clinical value of the procedure is demonstrated in high rates of patient satisfaction.
2001 Abstract Management of Fixed Sagittal Plane Deformity SRS
Management of Fixed Sagittal Plane Deformity: Outcome of Combined Anterior and Posterior Surgery
Abstract from the Scoliosis Research Society 2001 Annual Meeting
Sigurd H. Berven MD Vedat Deviren MD Jason A. Smith MD Serena H. Hu MD David S. Bradford MD UC San Francisco, San Francisco, CA, USA
CONCLUSIONS: Patients with regional hypolordosis in the lumbar spine, with global sagittal imbalance were effectively treated with a combined anterior and posterior arthrodesis as measured by radiographic parameters. Patient satisfaction with surgery, and overall clinical outcomes were best in cases that resulted in an increase in lumbar lordosis. A combined anterior and posterior arthrodesis for management of fixed sagittal imbalance is most effective in patients with pre-operative regional hypolordosis of the lumbar spine.
Sigurd H. Berven MD Vedat Deviren MD Jason A. Smith MD Serena H. Hu MD David S. Bradford MD UC San Francisco, San Francisco, CA, USA
CONCLUSIONS: Patients with regional hypolordosis in the lumbar spine, with global sagittal imbalance were effectively treated with a combined anterior and posterior arthrodesis as measured by radiographic parameters. Patient satisfaction with surgery, and overall clinical outcomes were best in cases that resulted in an increase in lumbar lordosis. A combined anterior and posterior arthrodesis for management of fixed sagittal imbalance is most effective in patients with pre-operative regional hypolordosis of the lumbar spine.
2001 Abstract Relevance of Cobb method in progressing sagittal plane spinal deformity
Med J Malaysia. 2001 Dec;56 Suppl D:48-53.Links
Relevance of Cobb method in progressing sagittal plane spinal deformity.
Harwant S. Orthopaedic Unit, Universiti Putra Malaysia, 8th Floor, Grand Seasons Avenue, 72, Jalan Pahang, 53000, Kuala Lumpur.
Non-traumatic, progressing sagittal plane deformities are uncommon, but can lead to neurological deficit if untreated. The currently used Cobb method in assessing sagittal spinal curves is based on measuring the tilt of the end vertebrae. This study describes a method which quantifies the apex of the sagittal curve based on the apical quality as measured by the radius of curvature. Both this and the Cobb methods are compared to determine which has relevance in determining neurological deficit. Radiographs of 36 consecutive patients diagnosed with congenital kyphosis were reviewed. Twenty-four had normal neurology and 12 had neurological deficit as a result of sagittal curve progression. Both groups of patients had their weight bearing lateral radiographs analysed to measure the sagittal curve by the usual Cobb method and the Radius of Curvature method. There was no difference for the Cobb values for negative neurology and patients with positive neurological deficit (p = 0.3). There was a difference in these two groups when the radius of curvature method was used (p <0.0005). The Radius of Curvature method has more relevance than Cobb method in quantifying sagittal plane deformity in congenital kyphosis when assessing neurological deficit.
Harwant S. Orthopaedic Unit, Universiti Putra Malaysia, 8th Floor, Grand Seasons Avenue, 72, Jalan Pahang, 53000, Kuala Lumpur.
Non-traumatic, progressing sagittal plane deformities are uncommon, but can lead to neurological deficit if untreated. The currently used Cobb method in assessing sagittal spinal curves is based on measuring the tilt of the end vertebrae. This study describes a method which quantifies the apex of the sagittal curve based on the apical quality as measured by the radius of curvature. Both this and the Cobb methods are compared to determine which has relevance in determining neurological deficit. Radiographs of 36 consecutive patients diagnosed with congenital kyphosis were reviewed. Twenty-four had normal neurology and 12 had neurological deficit as a result of sagittal curve progression. Both groups of patients had their weight bearing lateral radiographs analysed to measure the sagittal curve by the usual Cobb method and the Radius of Curvature method. There was no difference for the Cobb values for negative neurology and patients with positive neurological deficit (p = 0.3). There was a difference in these two groups when the radius of curvature method was used (p <0.0005). The Radius of Curvature method has more relevance than Cobb method in quantifying sagittal plane deformity in congenital kyphosis when assessing neurological deficit.
2003 Abstract Sagittal plane deformity in the thoracic spine
Sagittal plane deformity in the thoracic spine: A clue to the presence of syringomyelia as a cause of scoliosis
Auteur(s) / Author(s)
OUELLET Jean A. (1) ; LAPLAZA Javier (2) ; ERICKSON Mark A. (3) ; BIRCH John G. (3) ; BURKE Stephen (2) ; BROWNE Richard (3) ;
Author(s) Affiliation(s)
(1) McGill University Hospital Centre, CANADA
(2) Hospital for Special Surgery, NY, New York, ETATS-UNIS
(3) The Texas Scottish Rite Hospital for Children, Dallas, TX, ETATS-UNIS
Abstract Study Design. A retrospective review of scoliosis radiographs of 93 patients with either idiopathic scoliosis or syringomyelia-associated scoliosis were assessed, defining their sagittal alignment. Objective. To validate an observation regarding the absence of Dickson's sagittal deformity of the thoracic spine in patients with syringomyelia-associated scoliosis. of Background Data. Patients with adolescent idiopathic scoliosis have a classic sagittal deformity. Dickson described that patients with adolescent idiopathic scoliosis (AIS) have an associated lordotic deformity at the apex of their coronal deformity. Materials and Methods. Retrospective reviews of standard scoliosis series radiographs of 93 patients with idiopathic or syringomyelia-associated scoliosis from two institutions were compared. Particular attention was given to the lateral radiograph of the spine assessing presence or absence of Dickson's apical lordosis. Nine patients had to be excluded because of inadequate imaging. The study group consisted of 30 patients with scoliosés from TSRH with documented syringomyelia identified between 1985 and 1997. The demographic and radiographic features of this group were compared with those of a control group consisting of a consecutive series of 54 patients from HSS with adolescent idiopathic and normal MRI. The groups were comparable for age (mean age: control 13 y; syrinx 12 y) and curve pattern but differed in curve magnitude (mean Cobb: control 50°; syrinx 40°). Results. Apical lordosis was present in 97% of patient with AIS and a normal MRI but was absent in 75% of patients with syringomyelia-associated scoliosis (P <0.0001). The results also confirmed that male patients with scoliosis and left-side curves have a predisposition to having a syringomyelia (P <0.0001). Conclusions. Sagittal plane deformity in scoliosis can be an indicator of the presence of a syringomyelia. Our results reinforce tne necessity of assessing sagital plane deformity when treating scoliosis. If apical lordotic deformity is absent, a diagnosis of idiopathic scoliosis should be made with caution.
Spine (Spine) ISSN 0362-2436 CODEN SPINDD 2003, vol. 28, no18, pp. 2147-2151 [5 page(s) (article)] (14 ref.)
Abstract Study Design. A retrospective review of scoliosis radiographs of 93 patients with either idiopathic scoliosis or syringomyelia-associated scoliosis were assessed, defining their sagittal alignment. Objective. To validate an observation regarding the absence of Dickson's sagittal deformity of the thoracic spine in patients with syringomyelia-associated scoliosis. of Background Data. Patients with adolescent idiopathic scoliosis have a classic sagittal deformity. Dickson described that patients with adolescent idiopathic scoliosis (AIS) have an associated lordotic deformity at the apex of their coronal deformity. Materials and Methods. Retrospective reviews of standard scoliosis series radiographs of 93 patients with idiopathic or syringomyelia-associated scoliosis from two institutions were compared. Particular attention was given to the lateral radiograph of the spine assessing presence or absence of Dickson's apical lordosis. Nine patients had to be excluded because of inadequate imaging. The study group consisted of 30 patients with scoliosés from TSRH with documented syringomyelia identified between 1985 and 1997. The demographic and radiographic features of this group were compared with those of a control group consisting of a consecutive series of 54 patients from HSS with adolescent idiopathic and normal MRI. The groups were comparable for age (mean age: control 13 y; syrinx 12 y) and curve pattern but differed in curve magnitude (mean Cobb: control 50°; syrinx 40°). Results. Apical lordosis was present in 97% of patient with AIS and a normal MRI but was absent in 75% of patients with syringomyelia-associated scoliosis (P <0.0001). The results also confirmed that male patients with scoliosis and left-side curves have a predisposition to having a syringomyelia (P <0.0001). Conclusions. Sagittal plane deformity in scoliosis can be an indicator of the presence of a syringomyelia. Our results reinforce tne necessity of assessing sagital plane deformity when treating scoliosis. If apical lordotic deformity is absent, a diagnosis of idiopathic scoliosis should be made with caution.
Spine (Spine) ISSN 0362-2436 CODEN SPINDD 2003, vol. 28, no18, pp. 2147-2151 [5 page(s) (article)] (14 ref.)
2003 Management of Iatrogenic Flat-Back Syndrome Medscape
From Neurosurg Focus 15(3), 2003
Management of Iatrogenic Flat-Back Syndrome
Posted 11/03/2003 Gregory C. Wiggins, M.D., Stephen L. Ondra, M.D., Christopher I. Shaffrey, M.D.
Abstract
Iatrogenic loss of lordosis is now frequently recognized as a complication following placement of thoracolumbar instrumentation, especially with distraction instrumentation. Flat-back syndrome is characterized by forward inclination of the trunk, inability to stand upright, and back pain. Evaluation of the deformity should include a full-length lateral radiograph obtained with the patient's knees and hips fully extended. The most common cause of the deformity includes the use of distraction instrumentation in the lumbar spine and pseudarthrosis.
Surgical treatment described in the literature includes opening (Smith-Petersen) osteotomy, polysegmental osteotomy, and closing wedge osteotomy. The authors will review the literature, cause, clinical presentation, prevention, and surgical management of flat-back syndrome.
Management of Iatrogenic Flat-Back Syndrome
Posted 11/03/2003 Gregory C. Wiggins, M.D., Stephen L. Ondra, M.D., Christopher I. Shaffrey, M.D.
Abstract
Iatrogenic loss of lordosis is now frequently recognized as a complication following placement of thoracolumbar instrumentation, especially with distraction instrumentation. Flat-back syndrome is characterized by forward inclination of the trunk, inability to stand upright, and back pain. Evaluation of the deformity should include a full-length lateral radiograph obtained with the patient's knees and hips fully extended. The most common cause of the deformity includes the use of distraction instrumentation in the lumbar spine and pseudarthrosis.
Surgical treatment described in the literature includes opening (Smith-Petersen) osteotomy, polysegmental osteotomy, and closing wedge osteotomy. The authors will review the literature, cause, clinical presentation, prevention, and surgical management of flat-back syndrome.
Google Search for Flat-Back or Sagittal Plane Deformity
Search string (flat-back OR ("sagittal plane" deformity)) yielded 79,300 results August 2007
PubMed Literature Search for Lordosis Flat-back or Sagittal Plane Deformity
Search string (lordosis[title] OR (flat-back[title] OR ("sagittal plane"[title] deformity[title]))) with limits - human, after 1990, with abstract.
Yielded 131 citations Aug 2007. Use the Create Bibliography button for this link.
Yielded 131 citations Aug 2007. Use the Create Bibliography button for this link.
Stiff Person Syndrome eMedicine Neurology
Synonyms and related keywords: SPS, stiff man syndrome, SMS, stiff baby syndrome, SBS, hyperekplexia, Moersch-Woltmann syndrome, stiff woman syndrome, stiff limb syndrome
Author: Nancy Rodgers-Neame, MD, Assistant Professor, Department of Pharmacology and Therapeutics, University of South Florida, Florida Comprehensive Epilepsy and Seizure Disorders Program
Clinically, stiff person syndrome is characterized by muscle rigidity that waxes and wanes with concurrent spasms. Usually, it begins in the axial muscles and extends to the proximal limb muscles, but the severity of the limb muscle involvement may overwhelm the axial muscle involvement (stiff limb syndrome).
Author: Nancy Rodgers-Neame, MD, Assistant Professor, Department of Pharmacology and Therapeutics, University of South Florida, Florida Comprehensive Epilepsy and Seizure Disorders Program
Clinically, stiff person syndrome is characterized by muscle rigidity that waxes and wanes with concurrent spasms. Usually, it begins in the axial muscles and extends to the proximal limb muscles, but the severity of the limb muscle involvement may overwhelm the axial muscle involvement (stiff limb syndrome).
