Kyphosis
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STUDY DESIGN: Retrospective, blinded analysis of imaging studies. OBJECTIVE: The aim of this study is compare the use of magnetic resonance imaging (MRI) to lateral radiograph using bolster in the evaluation of Scheuermann kyphosis (SK) curve flexibility measurement. SUMMARY AND BACKGROUND DATA: The flexibility of the thoracic curve [thoracic kyphosis (TK)] in SK is of primary importance in its preoperative planning. Several methods have been described for SK curve flexibility measurement. The most commonly used method is lateral hyperextension radiography on hard bolster [hyperextension radiograph (HE)]. No current methods use MRI for flexibility assessment. MATERIALS AND METHODS: Flexibility of TK in SK patients was measured as a difference between standing radiograph and bolster-assisted lateral HE or supine MRI. The sagittal Cobb angle of the TK was measured between the superior endplate of T4 and the inferior endplate of T12 vertebral body. Flexibilities measured by these 2 methods were compared and analyzed using the generalized estimating equation analysis and the correlation analysis. RESULTS: We assessed 18 SK patients (14 males and 4 females) with mean age of 20.06±6.03 years. The standing TK x-rays showed 83.8±6.1 degrees. On HE, TK curve reduced by 39.3 degrees (95% confidence interval, 35.8-42.9) to 44.5±6.2 degrees (P<0.001). Preoperative MRI images showed TK of 53.8±5.9 degrees which means reduction by 30 degrees (95% confidence interval, 26.6-33.4) from the standing radiographs (P<0.001). Linear dependency between HE and MRI flexibility with a mean difference of 9.3 degrees was found (R=0.61, P<0.001). CONCLUSIONS: Our study shows that preoperative MRI can be used for SK flexibility assessment with similar predictive value as routinely used bolster-assisted hyperextension lateral radiograph. Consequently, patient exposure to preoperative hyperextension ionizing radiation may be reduced.
- MeSH
- biomechanika MeSH
- dospělí MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mladiství MeSH
- mladý dospělý MeSH
- ohebnost (fyzika) MeSH
- Scheuermannova nemoc diagnóza patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY Evaluation of efficiency and safety in surgically treated patients with Scheuermann hyperkyphosis using posterior-only surgical approach. MATERIAL AND METHODS Our study retrospectively evaluates the results of surgical correction in group of 20 patients with Scheuermann ́s hyperkyphosis, with an average age of 13 years and 8 month and with follow-up 4 years and 5 month. We evaluated changes of thoracic kyphosis as well as lumbar lordosis in correlation with surgical correction. Furthermore we compared ability of kyphosis to be corrected while performing reclination X-rays befroe surgery in comparation with rate of surgical correction. RESULTS The average correction of thoracic kyphosis was 52% - from preoperative 92° to postoperative 44°. We observed of 36% improvement of correction while surgically corrected in comparision with preoperative recklination X-ray pictures. Secondary correction of lumbar lordosis was from preoperative 84° to posoperative 55°. DISCUSSION Conservative treatment of hyperkyphosis offers only limited treatment results. Combined surgical approach with anterior release and posterior stabilization increase risk of anterior approach and secondary decreasing of lung capacity. Posterior vertberal osteotomies allows quality release and preparation for consecutive correction. Transpedicular instrumentation makes possible segmental correction of kyphotic spine using compression method. CONCLUSIONS Posterior-only surgical approach in combination with vertebral osteotomies allow efective and safe correction of hyperkyhosis in Scheuermann disease.
- MeSH
- dospělí MeSH
- hrudní obratle chirurgie patologie MeSH
- konzervativní terapie MeSH
- kostní šrouby MeSH
- kyfóza patofyziologie rehabilitace terapie MeSH
- lidé MeSH
- mladiství MeSH
- osteotomie metody MeSH
- retrospektivní studie MeSH
- Scheuermannova nemoc * chirurgie diagnostické zobrazování patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Cílem tohoto příspěvku bylo zjistit změnu tvaru hrudní kyfózy při kurzu vodní turistiky. Tvar hrudní kyfózy byl měřen u 25 mužů, ve věku 20-25 let, před a následně po skončení vodáckého výcvikového kurzu VSK MU pomocí diagnostického systému DTP-2 pro hodnocení tvaru a funkce páteře. Pro vyhodnocení byl použit úhel mezi třemi základními hrudními obratli (Th1, Th7 a Th12).
The aim of these contribution was detected a modofication of kyphotic rachiocampsis at white-water riding. The shape of thoracal spine was measured by diagnostic system DTP-2 for classification spine shape and function before and after white-water riding course. 25 men (aged 20-25 years) underwent the measuring of spine. For evaluation was used an angel betwen three main thoracal vertebrae (Th1, Th7, Th12).
- MeSH
- ankylózující spondylitida * chirurgie MeSH
- biologické markery MeSH
- elektrokardiografie metody využití MeSH
- hematologické testy využití MeSH
- kyfóza * chirurgie komplikace MeSH
- lidé MeSH
- ortopedické výkony dějiny metody využití MeSH
- radiografie metody využití MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
