ABSTRACT
Se presenta el caso de una paciente diagnosticada de neurofibromatosis en la infancia que fue intervenida por escoliosis torácica, y se le practicó fusión torácica T1-T12. En controles posteriores se evidenció subluxación progresiva C7-T1 por lo que se extendió la artrodesis hasta C2, consiguiéndose la corrección, así como la detención de la progresión de la deformidad. La unión cervicotorácica es una zona de potencial inestabilidad y la afectación cervical en la neurofibromatosis suele ser subclínica, por lo que es necesario prestar especial atención a estos pacientes realizando controles radiográficos periódicos (AU)
Subject(s)
Adolescent , Female , Humans , Neurofibromatoses/complications , Scoliosis/surgery , Postoperative Complications/surgery , Intervertebral Disc Displacement/surgeryABSTRACT
OBJECTIVE: To study the evolution and ventilatory function measured by spirometry after surgery with the Harrington method for idiopathic thoracic scoliosis. PATIENTS AND METHODS: A prospective study with evaluation of changes in scoliosis angle following the Cobb method, as well as ventilatory parameters after surgery, measured after a mean time of 19.2 +/- 11.8 (range: 9-60) months post-surgery. Twenty patients were studied, 6 men and 14 women, with no previous respiratory conditions, with ages ranging from 12 and 35 years, and a mean of 16.3 +/- 4.6 years, and all of them with the diagnosis of idiopathic thoracic scoliosis and with pre-surgery angle of 59.9 degrees +/- 13.5 degrees. RESULTS: No statistically significant changes were observed in any of the ventilatory parameters considering both the absolute value and percentage of the theoretical value, although there was indeed a significant improvement in the scoliosis angle. CONCLUSIONS: In our study no ventilatory function improvement was observed after scoliosis surgery, although we cannot say that the results were the same if the previous thoracic deformity were more remarkable and caused greater changes in ventilatory parameters.
Subject(s)
Lung/physiopathology , Scoliosis/surgery , Adolescent , Adult , Child , Female , Forced Expiratory Volume , Humans , Male , Prospective Studies , Scoliosis/physiopathology , Spirometry , Thoracic Vertebrae , Vital CapacityABSTRACT
The results of Cotrel-Dubousset instrumentation in 50 patients with idiopathic scoliosis were evaluated. The patients were followed for 24 to 108 months with a mean follow-up of 5 years. Their average age was 15 years and 3 months. The scoliotic curves were classified according to King et al. There were 4 type I, 20 type II, 10 type III, 10 type IV and 1 type V. Five curves could not be included in this classification: 2 double lumbar, 1 right lumbar and 2 left thoracic curves. Coronal plane analysis showed an average postoperative correction of 56% for thoracic curves and 57% for lumbar curves. The loss of correction at the most recent follow-up was 14% and 15%, respectively. Higher corrections were obtained in King types III and IV than in types I and II. Mild increase of thoracic kyphosis was noted in previously hypokyphotic curves. The normal sagittal curve in the lumbar spine was maintained at the most recent follow-up. There were no major neurological deficits. A symptomatic pseudarthrosis developed in one patient with a concomitant L5-S1 spondylolisthesis. Another patient developed a delayed deep wound infection that resolved after the instrumentation was removed. The data from this study suggest that Cotrel-Dubousset instrumentation achieves a satisfactory correction of the curves with an acceptable loss of correction over time. The system also preserves lumbar lordosis when fusion to the lower lumbar spine is required.
Subject(s)
Orthopedic Fixation Devices , Scoliosis/surgery , Adolescent , Adult , Child , Female , Follow-Up Studies , Humans , Kyphosis/etiology , Lordosis/surgery , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Male , Orthopedic Fixation Devices/adverse effects , Patient Satisfaction , Pseudarthrosis/etiology , Radiography , Recurrence , Scoliosis/classification , Scoliosis/diagnostic imaging , Spondylolisthesis/surgery , Surgical Wound Infection/etiology , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/surgeryABSTRACT
A case of cervical spine metastasis from an extraocular sebaceous carcinoma of the scalp is presented. Anterior decompression and fusion were performed and resulted in complete relief of symptoms. Postoperatively the primary tumor behaved in a very aggressive manner, with visceral metastases leading to the death of the patient in a few weeks.
