Efficacy of Corrective Surgery for Gait and Energy Expenditure in Patients with Scoliosis: A Literature Review

The aim of this literature review was to evaluate selected original papers that measured gait parameters and energy expenditure in idiopathic scoliosis (IS) treated with surgical intervention. IS is a progressive growth disease that affects spinal anatomy, mobility, and left–right trunk symmetry. Consequently, IS can modify human gait. Spinal fusions remain the primary approach to correcting scoliosis deformities, thereby halting progression. Using the population intervention comparison outcome measure framework and selected keywords, 15 studies that met the inclusion criteria were selected. Alteration of spatial and temporal variables in patients with IS was contradictory among the selected studies. Ankle and foot kinematics did not change after surgery; however, pelvic and hip frontal motions increased and pelvic rotation decreased following surgery. Patients with IS continued to show excessive energy expenditure following surgery in the absence of a physical rehabilitation protocol. Spinal surgery may be considered for gait improvement and IS treatment. There were inadequate data regarding the effect of corrective surgery on the kinetics, energy expenditure, and muscle activity parameters.

Timing of surgery for aneurysmal subarachnoid hemorrhage

Despite the many studies about timing for surgery in subarachnoid hemorrhage [SAH], the optimum time is still unclear. The aim of this study was to determine the results of early and late surgery for aneurysmal subarachnoid hemorrhage. In this cross-sectional study we evaluated the results of 70 consecutive surgery for aneurysmal subarachnoid hemorrhage in in Firuzgar hospital from 2005 to 2008. Surgery was performed in 50 cases [71.4%] in early period after SAH [first 4 days] and in 20 cases [28.6%] in at least 7 days after SAH. Statitical analysis was done by SPSS software, using Chi-square and t-test. Mean age of patients was 48.54 +/- 13.4 years. 41.4% of patients were male and 58.6% were female. Most [77.2%] of patients had clinical grade I or II. 92.9% of aneurysms were single. Hypertension was the most common associated disease [34.3%]. The most common site of aneurysms was anterior communicating artery [41.4%], followed by middle cerebral artery [35.7%]. The outcome of surgery was favorable in 70% and unfavorable in 30%. Mortality rate was 24.3%. Outcome was favorable in 66% of early surgeries and 80% of late surgeries. There was no statistically significant difference between early and late surgery in terms of complications and outcome. Mean hospital stay of patients in the early surgery group was significantly lower than late group [16.46 +/- 9.36 vs. 22.5 +/- 7.97 days; P=0.01]. The results of early and late surgery for aneurismal subarachnoid hemorrhage is similar and decision making for timing of surgery should be based on each patient individual clinical conditions, age, size and site of aneurysm

Timing of surgery for aneurysmal subarachnoid hemorrhage

Despite the many studies about timing for surgery in subarachnoid hemorrhage [SAH], the optimum time is still unclear. The aim of this study was to determine the results of early and late surgery for aneurysmal subarachnoid hemorrhage. In this cross-sectional study we evaluated the results of 70 consecutive surgery for aneurysmal subarachnoid hemorrhage in in Firuzgar hospital from 2005 to 2008. Surgery was performed in 50 cases [71.4%] in early period after SAH [first 4 days] and in 20 cases [28.6%] in at least 7 days after SAH. Statitical analysis was done by SPSS software, using Chi-square and t-test. Mean age of patients was 48.54 +/- 13.4 years. 41.4% of patients were male and 58.6% were female. Most [77.2%] of patients had clinical grade I or II. 92.9% of aneurysms were single. Hypertension was the most common associated disease [34.3%]. The most common site of aneurysms was anterior communicating artery [41.4%], followed by middle cerebral artery [35.7%]. The outcome of surgery was favorable in 70% and unfavorable in 30%. Mortality rate was 24.3%. Outcome was favorable in 66% of early surgeries and 80% of late surgeries. There was no statistically significant difference between early and late surgery in terms of complications and outcome. Mean hospital stay of patients in the early surgery group was significantly lower than late group [16.46 +/- 9.36 vs. 22.5 +/- 7.97 days; P=0.01]. The results of early and late surgery for aneurysmal subarachnoid hemorrhage is similar and decision making for timing of surgery should be based on each patient individual clinical conditions, age, size and site of aneurysm