Ebrahim Ameri; Hossein Vahidtari; Hassan Ghandhari; Hamid Behtash; Bahram Mobini; Mohammad Saleh Ganjavian; Afshin Ahmadzadeh Heshmati; Arash Motaghi
Abstract
Background: Standing and bending radiographies are pre-operative studies performed in patients with scoliosis to determine flexibility and appropriate treatment planning. The purpose of this study is to find correlation between pre-operative supine bending radiography and final scoliosis correction after ...
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Background: Standing and bending radiographies are pre-operative studies performed in patients with scoliosis to determine flexibility and appropriate treatment planning. The purpose of this study is to find correlation between pre-operative supine bending radiography and final scoliosis correction after surgery to find out if pre-operative bending radiographies could predict post operative final scoliosis correction. Methods: In a cross-sectional study, 83 patients with idiopathic scoliosis were studied and grouped based on Lenke classification of idiopathic scoliosis. Scoliosis curve was measured in standing and bending radiographs by 2 spine surgeons separately and the measurements were compared with post-operative curves. Results: The post-operative measurements were always different from pre-operative bending film values. Conclusion: We cannot predict final scoliosis precisely from pre-operative supine bending radiographs in patients with idiopathic scoliosis.
Bahram Mobini, MD; Ebrahim Ameri, MD; Hamid Behtash, MD; Hassan Ghandhari, MD; Mohammad Khakinahad, MD
Abstract
Background: Postural round back is a common entity with unknown etiology. Reports on the results of brace treatment are scarce. The purpose of this study was to determine the effect of bracing in different stages of treatment and also the amount of preservation of kyphosis after stopping the brace.Methods: ...
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Background: Postural round back is a common entity with unknown etiology. Reports on the results of brace treatment are scarce. The purpose of this study was to determine the effect of bracing in different stages of treatment and also the amount of preservation of kyphosis after stopping the brace.Methods: from 1991 through 2005, 165 cases (39 male, 126 female) who had a diagnosis of idiopathic postural kyphosis were treated with a Milwaukee brace. The mean age at the initiation of treatment was 13.06 years (8-16 years), at the completion of treatment was 15.06 years (11-17 years) and at the final follow-up was 17.9 years (12-25 years). The mean initial kyphosis was 59.26° (51°-74°). The patients were evaluated after an average follow-up of 34 months (6-102 months).Results: The mean angle of kyphosis was 42° (28°-68°) at completion of treatment, and 47.9° (28°-75°) at the final follow-up. Angle of kyphosis was 50° or less in 85.9% at the end of treatment and in 74.7% of patients at final follow-up. 5.9 degrees of original correction was lost in final follow-up. Two cases underwent surgery. Brace was effective in correction of kyphosis (p < /em>=.001).Conclusion: Milwaukee brace is effective in treatment of postural kyphosis. Longer period of treatment, even after maturity, is needed in more stiff deformities.
Mohammad Saleh Ganjavian, MD; Hamid Behtash, MD; Ebrahim Ameri, MD; Bahram Mobini, MD; Seyed Hossein Vahid Tari, MD; Marzieh Nojoomi, MD
Abstract
Background: Reports on associated intraspinal and other organ anomalies in congenital scoliosis are variable. We are reporting such findings in two orthopaedic referral centers in Tehran-Iran.Methods: During a period of 15 years, in a case series study, 381 patients with congenital scoliosis were evaluated ...
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Background: Reports on associated intraspinal and other organ anomalies in congenital scoliosis are variable. We are reporting such findings in two orthopaedic referral centers in Tehran-Iran.Methods: During a period of 15 years, in a case series study, 381 patients with congenital scoliosis were evaluated for intraspinal abnormalities with physical examination, radiographs, MRI and/or myelograms. They were also assessed for cardiac urogenital or anomalies in other areas by physical exam, sonography and echocardiography.Results: Cord anomaly was present in 83 (21%) cases, 26 of whom had neurologic abnormality. Tethered cord syndrome was the most common neurologic problem in 38 patients (45.8%). Anomalies in other parts of body detectable by physical examination were observed in 155 patients, and detected by help of clinical evaluation in 121 and paraclinical tests in 34 patients. 84 cases had trunk anomalies, 4 genitourinary and 10 heart anomaly, 37 head and neck, 7 maxillofacial, 3 upper and 23 lower extremities, 14 Urogenital, 10 heart and 8 cases of gastrointestinal anomalies were also detected.Conclusion: The anomalies of nervous system associated with congenital scoliosis are often without clinical manifestations. Cardiac and urogenital anomalies are not very common in congenital scoliosis.
Mohammad Saleh Ganjavian, MD; Hamid Behtash, MD; Seyed Hossein Vahid Tari, MD; Ebrahim Ameri, MD; Bahram Mobini, MD; Marzieh Nojumi, MD
Abstract
Background: Bracing is the most common non-operative treatment for idiopathic adolescent scoliosis. Milwaukee brace is the best – known orthosis for this purpose. We wish to report our results with the use of this brace in idiopathic scoliosis.Methods: In a retrospective study, among 681 patients who ...
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Background: Bracing is the most common non-operative treatment for idiopathic adolescent scoliosis. Milwaukee brace is the best – known orthosis for this purpose. We wish to report our results with the use of this brace in idiopathic scoliosis.Methods: In a retrospective study, among 681 patients who had been treated for idiopathic scoliosis form 1994 to 2004 in two hospitals in Tehran, 335 cases had received non-operative treatment with Milwaukee brace. The radiographs of these patients were reviewed to evaluate the treatment outcome. These patients, who were 12.1 years old on average and had received no other prior treatment, had started with 23 hours per day bracing and continued in accordance with Scoliosis Research Society (SRS) protocol.Results: Milwaukee brace reduced the cobb ankle from an average of 32.8 to 30.6 degrees. The brace had no appreciable effect on curves of upper thoracic, double or triple curves. Initial thoracic kyphosis had no effect on final bracing outcome. Curve progression, while in brace, was more commonly seen in association with Risser signs "0" to "1". The best prognostic evidence in terms of control of progression was initial reduction of over 30 percent in curve magnitude in the first post-bracing visit. A reduction in curve magnitude of less than 17 percent after the first visit was associated with poor final outcome.Conclusions: Milwaukee brace can effectively reduce and control idiopathic scoliotic curves. However, good patient selection and close follow-up is mandatory.
Hamid Behtash, MD; Mohammad Saleh Ganjavian, MD; Ebrahim Ameri, MD; Bahram Mobini, MD; Seyed Hossein Vahid Tari, MD; Marzieh Nojoumi, MD
Abstract
Background: Congenital vertebral development produces the congenital scoliosis which is often progressive requiring surgical intervention. Convex hemiepiphysiodesis of the involved segments is a useful technique in young children. We are reporting our experience with such a treatment.Methods: Among the ...
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Background: Congenital vertebral development produces the congenital scoliosis which is often progressive requiring surgical intervention. Convex hemiepiphysiodesis of the involved segments is a useful technique in young children. We are reporting our experience with such a treatment.Methods: Among the congenital scoliotic curves treated in Shafa hospital in Tehran in 19-year period, the ones that had undergone convex hemiepiphysiodesis were identified. Twenty three patients (13 females, 10 males) with a mean follow-up of 5.6 years (2-19 years) were clinically and radiographically evaluated, and the pre and post operative findings were analyzed.Results: Improvement in curve magnitude was best observed in hemivertebra cases. Nine cases of hemivertebra obtained 18 degrees correction while in 14 cases of type III (mixed type) anomally 15 degrees correction was observed (p < /em>=.04). Failure (continued progression of scoliotic curve) had a large kyphotic angle at the beginning.Conclusions: Convex vertebral hemiepiphysiodesis in congenital scoliosis, especially hemivertebral cases is a useful procedure when performed in early childhood.
Bahram Mobini, MD; Hamid Behtash, MD; Ebrahim Ameri, MD; Seyed Alireza Bassampoor, MD
Abstract
Background: Spinal stenosis is a common reason for referral to a spine center by adults. Pain and numbness in buttochs and lower limbs after a period of standing or walking are the common complaints. History, supplemented with good physical exam radiography and MRI of spine are the mainstays of diagnosis. ...
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Background: Spinal stenosis is a common reason for referral to a spine center by adults. Pain and numbness in buttochs and lower limbs after a period of standing or walking are the common complaints. History, supplemented with good physical exam radiography and MRI of spine are the mainstays of diagnosis. Spinal decompression is the final step in treatment, which is not always associated with long term patients’ satisfaction.Methods: 38 patients with mean age of 56 years who had undergone posterior spinal decompression were retrospectively studied. The pre and post operative activity level and their degree of satisfaction were assessed.Results: In a 2-4 year follow-up period, 30 patients were satisfied with their operations, and no surgical complication had been experienced. In 30 patients (79%) back pain had aggravated. 3 folds improvement in standing or walking was reported by 29 cases, and 21 patients (57%) returned to their previous activity level. Conclusions: In short time, spinal decompression can effectively relieve the symptoms, but can not reduce back pain symptoms. Despite higher age range for this surgery, early complication rate is very low.
Hamid Behtash, MD; Ebrahim Ameri, MD; Bahram Mobini, MD; Seyed Alireza Bassampoor, MD
Abstract
Bioactive glass materials are being, commonly, used in spinal fusion as substitute for bone graft. Continuous serous discharge as a reaction to this foreign material has not been previously reported. The following case is a report of a patient who developed non-infected continuous serous discharge following ...
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Bioactive glass materials are being, commonly, used in spinal fusion as substitute for bone graft. Continuous serous discharge as a reaction to this foreign material has not been previously reported. The following case is a report of a patient who developed non-infected continuous serous discharge following the use of bioactive glass material “Nova Bone” for anterior and posterior spinal fusion.
