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.
