Pedicle Screw Fixation in Pediatric Spinal Deformities: Results for patients under 10 years old / 대한정형외과학회잡지

PURPOSE: We wanted to determine the efficacy of performing pedicle screw fixation to treat pediatric spinal deformities and we also wanted to evaluate its long-term effects on the growing spine. MATERIALS AND METHODS: Thirty-eight consecutive spinal deformity patients (25 congenital, 9 idiopathic and 4 other etiologies) under 10 years old at the time of the surgery who underwent pedicle screw instrumentation were reviewed after a minimum follow up of 2 years (range: 2 to 7 years). To evaluate the effect of the pedicle screws on the growing spine, a thin slice CT scan was performed in 27 patients (72%) at the last follow up. The patients were treated by posterior fusion with segmental pedicle screw fixation being performed in 21 patients, vertebral column resection combined with segmental pedicle screw fixation was done in 16 patients and combined anterior and posterior correction was done in 1 patient. RESULTS: The frontal correction was 67.2% in the posterior fusion group, 71.5% in the posterior resection group and 64.7% in the patients who underwent combined anterior and posterior correction. A mean correction of 20degrees was obtained in the sagittal plane. A total of 341 pedicle screws were inserted (an average of 8.9 screws per patient). The complications were comprised of 7 screw malpositions (2.1%), 1 loss of fixation (screw pull-out), 1 recurrence of deformity and one superficial infection. There were no significant neurological or vascular complications. Any Symptoms or radiological evidence suggestive of spinal stenosis were not detected in any of the patients. CONCLUSION: Pedicle screw fixation may be used with the same efficacy for pediatric spinal deformities, and even for the patients under 10 years old, without causing any hazard of iatrogenic spinal stenosis.

Epidemiologic study of lumbar scoliosis with plain abdominal X-ray / 대한척추외과학회지

STUDY DESIGN: A retrospective cross-sectional study OBJECTIVES: To analyze the prevalence and characteristics of lumbar scoliosis using plain abdominal X-rays, according to age. LITERATURE REVIEW SUMMARY: The single lumbar curves of adolescents have shown 10 ~20% idiopathic scoliosis, but the reported prevalence of adult lumbar scoliosis ranges from 2.5 to 7.5%. In Korea, there is no useful basic data concerning lumbar scoliosis. MATERIALS AND METHODS: A total of 2877 plain abdominal radiographies (supine and erect), taken at our hospital, between August 2001 and June 2002, were retrospectively investigated. The ages of the patients ranged from 11 to 80 years, and the patients were grouped according to age. The prevalence, Cobb angle, ratio of males and females, ratio of right and left curves, location of end and apex vertebra, the number of involved vertebra in primary curve, amount of rotation and osteophytes were all examined. RESULTS: The overall prevalence of lumbar scoliosis was 4.3% (N=124), but rapidly increased after the sixth decade. The average Cobb angle was 16.2 degree. A positive correlation was found between the Cobb angle and age (r=0.275, P<0.05). The ratios of males to females and of the right to left curves were both about 1:2. The most common sites of upper end vertebra were T12 and L1, that of the lower end vertebra L4 and those of the apex L2 (N=48) and L3 (N=40). Most (N=111) had grade 1 rotation. With regard to the magnitude of the curves, no other factors were statistically significant. CONCLUSIONS: De novo scoliosis can be considered to develop rapidly after the sixth decade. The Cobb angle had a positive correlation with age (r=0.275, p<0.05). These data are thought could be useful and valuable for future study of lumbar scoliosis.

Epidemiologic study of lumbar scoliosis with plain abdominal X-ray / 대한척추외과학회지

STUDY DESIGN: A retrospective cross-sectional study OBJECTIVES: To analyze the prevalence and characteristics of lumbar scoliosis using plain abdominal X-rays, according to age. LITERATURE REVIEW SUMMARY: The single lumbar curves of adolescents have shown 10 ~20% idiopathic scoliosis, but the reported prevalence of adult lumbar scoliosis ranges from 2.5 to 7.5%. In Korea, there is no useful basic data concerning lumbar scoliosis. MATERIALS AND METHODS: A total of 2877 plain abdominal radiographies (supine and erect), taken at our hospital, between August 2001 and June 2002, were retrospectively investigated. The ages of the patients ranged from 11 to 80 years, and the patients were grouped according to age. The prevalence, Cobb angle, ratio of males and females, ratio of right and left curves, location of end and apex vertebra, the number of involved vertebra in primary curve, amount of rotation and osteophytes were all examined. RESULTS: The overall prevalence of lumbar scoliosis was 4.3% (N=124), but rapidly increased after the sixth decade. The average Cobb angle was 16.2 degree. A positive correlation was found between the Cobb angle and age (r=0.275, P<0.05). The ratios of males to females and of the right to left curves were both about 1:2. The most common sites of upper end vertebra were T12 and L1, that of the lower end vertebra L4 and those of the apex L2 (N=48) and L3 (N=40). Most (N=111) had grade 1 rotation. With regard to the magnitude of the curves, no other factors were statistically significant. CONCLUSIONS: De novo scoliosis can be considered to develop rapidly after the sixth decade. The Cobb angle had a positive correlation with age (r=0.275, p<0.05). These data are thought could be useful and valuable for future study of lumbar scoliosis.