ABSTRACT
PURPOSE: Anterior cervical discectomy and fusion (ACDF) has become a common spine procedure, however, there have been no previous studies on whole spine alignment changes after cervical fusion. Our purpose in this study was to determine whole spine sagittal alignment and pelvic alignment changes after ACDF. MATERIALS AND METHODS: Forty-eight patients who had undergone ACDF from January 2011 to December 2012 were enrolled in this study. Cervical lordosis, thoracic kyphosis, lumbar lordosis, sagittal vertical axis (SVA), and pelvic parameters were measured preoperatively and at 1, 3, 6, and 12 months postoperatively. Clinical outcomes were assessed using Visual Analog Scale (VAS) scores and Neck Disability Index (NDI) values. RESULTS: Forty-eight patients were grouped according to operative method (cage only, cage & plate), operative level (upper level: C3/4 & C4/5; lower level: C5/6 & C6/7), and cervical lordosis (high lordosis, low lordosis). All patients experienced significant improvements in VAS scores and NDI values after surgery. Among the radiologic parameters, pelvic tilt increased and sacral slope decreased at 12 months postoperatively. Only the high cervical lordosis group showed significantly-decreased cervical lordosis and a shortened SVA postoperatively. Correlation tests revealed that cervical lordosis was significantly correlated with SVA and that SVA was significantly correlated with pelvic tilt and sacral slope. CONCLUSION: ACDF affects whole spine sagittal alignment, especially in patients with high cervical lordosis. In these patients, alteration of cervical lordosis to a normal angle shortened the SVA and resulted in reciprocal changes in pelvic tilt and sacral slope.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Cervical Vertebrae/physiopathology , Cross-Sectional Studies , Diskectomy , Lordosis/etiology , Magnetic Resonance Imaging , Neck/surgery , Retrospective Studies , Spinal Diseases/complications , Spinal Fusion/methods , Spine , Treatment OutcomeABSTRACT
Crianças respiradoras bucais apresentam alterações no sistema estomatognático que resultam em projeção da cabeça, aumento da tensão de músculos do complexo da cintura escapular e adaptações posturais. Apesar da conformação torácica e postura influenciarem a dinâmica ventilatória, não encontramos estudos que tenham avaliado a função pulmonar de crianças respiradoras bucais. OBJETIVOS: O objetivo deste estudo foi analisar a postura de crianças respiradoras nasais e bucais e verificar a existência de correlação da postura com os volumes pulmonares. MATERIAIS E MÉTODOS: Estudo prospectivo, observacional do tipo transversal, no qual a postura e função pulmonar de 17 crianças respiradoras bucais e de 17 crianças respiradoras nasais foram avaliadas por meio de fotogrametria e espirometria forçada. RESULTADOS: Quando comparados com os respiradores nasais, os respiradores bucais apresentaram aumento da projeção de cabeça e da lordose cervical, deslocamento anterior do centro de gravidade e redução dos volumes pulmonares. Houve correlação da projeção da cabeça com a capacidade vital forçada e das alterações posturais com a idade. CONCLUSÃO: Crianças respiradoras bucais apresentam alterações posturais que aumentam em função da idade, além de redução dos valores espirométricos. A redução da capacidade vital correlaciona-se negativamente com a projeção da cabeça.
Mouth-breathing children have changes in their stomatognathic system, which result in head projection, stress increase in the scapular belt muscles and postural adaptations. Although thoracic shape and posture can influence ventilatory dynamics, we didn't find studies addressing pulmonary function of mouth-breathing children. AIMS: this study aimed at analyzing the posture of mouth-breathing children, and studying the existence of correlations between posture and pulmonary volumes. MATERIAL AND METHODS: prospective, observational and cross-sectional study, where the posture and pulmonary function of 17 mouth-breathing children and of 17 nasal-breathing children were evaluated by means of photogrammetry and forced spirometry. RESULTS: when compared to nasal-breathing, mouth-breathing subjects presented an increment in head projection and cervical lordosis, forwarded gravity center and reduced pulmonary volumes. There was an association between head projection and forced vital capacity, and between postural alterations and age. CONCLUSION: mouth-breathing children have postural alterations which increases with age and also reduced spirometry values. The vital capacity reduction correlates negatively with head projection.
Subject(s)
Child , Female , Humans , Male , Lung/physiopathology , Mouth Breathing/physiopathology , Posture/physiology , Age Factors , Cross-Sectional Studies , Head/physiology , Lordosis/etiology , Prospective Studies , Respiration , Spirometry , Statistics, Nonparametric , Vital Capacity/physiologyABSTRACT
Background: Alterations in the head position and in cervical curvature are associated with mandibular dysfunction, an increased vertical occlusal dimension, upper airways obstruction and bad postural behaviors at work among other conditions. Aim: To perform a cephalometric analysis in young adults. Subjects and methods: Lateral cervical X-ray examinations were performed in 46 university students (26 female) aged 19 years old as a mean. Cephalometric landmarks and planes reported by Sollow & Tallgren, determined by investigators, were used for radiographic analysis. Results: The combined error of the method did not exceed 0.9 for any studied variable. Mean craniocervical angulations were 102 for OPT-SNL, 109 for CVT-SNL, 94.8 for craneum-C2 and 105 for SN-vertical. There were significant sex differences in craniocervical angulations and these were abnormal in two thirds of subjects studies. The Forward Head Position is characterized by a cervical compensation with head inclination. This abnormal postural position showed a dolichofacial growth and an alteration of hyoid angle. Conclusions: The craniocervical position appeared to be related to a vertical craniofacial growth pattern
Subject(s)
Humans , Female , Male , Adolescent , Adult , Cephalometry , Lordosis/etiology , Lordosis , Cephalometry/methods , Vertical DimensionABSTRACT
Se presenta una serie de 15 pacientes con distrofia muscular progresiva (DMP) que fueron instrumentados en el Hospital Shiriners para Niños Lisiados de la Ciudad de México, de 1976 a 1990. El criterio para la cirugía se basó en la disminución de la capacidad vital a un mínimo de 30%, a la progresión de la deformidad de la columna en pacientes no ambulatorios, o a ambas cosas. El seguimiento fue de seis años como promedio y la medición de las curvas xifoescolióticas fue de 26.5 grados en promedio. La edad al momento de la cirugía fue entre cinco y 14 años. En seis pacientes se instrumentó de C2 a S1 para obtener control de la cabeza, ocho pacientes de C5 a S1 y un paciente de T1 a S1. El resultado fue la estabilidad y el equilibrio cifolordótico de la columna, la mejoría en la capacidad vital, la disminución de los cuadros infecciosos respiratorios y principalmente una mejor calida de vida de los pacientes.
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Male , Female , Scoliosis/etiology , Scoliosis/rehabilitation , Lordosis/etiology , Lordosis/rehabilitation , Muscular Dystrophies/complications , Muscular Dystrophies/diagnosis , Muscular Dystrophies/therapyABSTRACT
Foi apresentado um caso inusitado de lipodistrofia localizada na regiäo glútea, que simulava lordose da coluna lombo-sacra. Na consulta à literatura näo foram identificados casos parecidos. Indicada a lipoaspiraçäo através de incisäo na extremidade superior do sulco interglúteo, o procedimento foi de fácil execuçäo e proporcionou resultado francamente positivo