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The spine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Idiopathic scoliosis accounts for 70% of presentations. It can be classified into early onset (before 8 years of age) (Figure33.8) and late onset (after 8 years of age; typical adolescent idiopathic scoliosis). The distinction is important, as the number of alveoli in the lung does not increase after the age of 8 years. Patients with severe curves in the early-onset group may develop cor pulmonale and right ventricular failure resulting in premature death. Adolescent idiopathic scoliosis is associated with a normal or near-normal life expectancy.
Paediatric orthopaedic disorders
Published in Maneesh Bhatia, Tim Jennings, An Orthopaedics Guide for Today's GP, 2017
Sunil Bajaj, Nicholas Nicolaou
This occurs most commonly in adolescents, although idiopathic cases do occur in juveniles. Adolescent idiopathic scoliosis presents between 10 years of age and skeletal maturity. Age is an important factor, as the younger the patient, the more the growth potential remains for the deformity to progress. The cause is not described although there are genetic factors as demonstrated by twin concordance and familial associations. Early mild deformities can be managed with bracing, although for more severe deformities, spinal surgery is sometimes required (Figures 1.34 and 1.35).
Spine
Published in David A Lisle, Imaging for Students, 2012
Adolescent idiopathic scoliosis (AIS) accounts for 90 per cent of patients with scoliosis. The key clinical test for the diagnosis of AIS is the forward bend test. A positive forward bend test is indicated by convex bulging of the contour of the back on the side of the convexity of the spinal curve, due to rotation of the spine producing prominence of the posterior ribs on the convex side.
A review of the hemivertebrae and hemivertebra resection
Published in British Journal of Neurosurgery, 2022
Beixi Bao, Hui Yan, Jiaguang Tang
The distal adding-on phenomenon is a postoperative loss of correction accompanied by the progressive deviation and rotation of the lumbar spine or wedging of the disc space that is distal to the instrumented vertebra. The cause of the distal adding-on phenomenon is unclear but it may be a compensatory change for preserving a well-balanced spine such as balanced shoulder level and truncal shift and listing. This phenomenon is most common in patients with adolescent idiopathic scoliosis (AIS). Though, it can also occur after surgery for congenital scoliosis (CS). Chang et al. first reported the adding-on phenomenon after completing HV resection. According to their research, two of the patients showed distal adding-on deformity with a progression of the Cobb angle of more than 10° during the postoperative follow-up and they were treated with a brace. They also reported the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. Five patients displayed distal adding-on deformity with a progression of the curve. Among these 5 patients, 2 were fitted with a brace.
Evaluation of the efficiency of Boston brace on scoliotic curve control: A review of literature
Published in The Journal of Spinal Cord Medicine, 2020
Mohammad Taghi Karimi, Timon Rabczuk
The efficiency of Boston brace was also compared with other available braces in some studies. Actually there were three studies on this topic with quality varied between 16 and 21. Howard et al. studied 319 patients with Adolescent Idiopathic Scoliosis. They compared the efficiency of the Boston and Charleston braces.24 83% of the subjects with curve 36 and 45 (treated with Charleston brace) had curve progression more than 5 degrees, compared with 43% with Boston brace. The results confirmed that the Boston brace is recommended to the Charleston brace. Another study compared the Boston brace and the Milwaukee brace. It was indicated that bracing did not influence the natural progression of scoliosis.25 However, Howard et al. study demonstrated that the Boston brace controlled mean correction more so that than Milwaukee and Charleston braces.24 Montgomery and Willer’s study demonstrates that the Milwaukee brace failed five times more than the Boston Brace.26 Therefore, it can be concluded that Boston brace is more effective than other available braces to control the progression of scoliotic curve.
Structural Deprioritization and Stigmatization of Mental Health Concerns in the Educational Setting
Published in The American Journal of Bioethics, 2020
Rachel C. Conrad, Rebecca Weintraub Brendel
A range of precedents demonstrates that schools have a duty to protect their students’ safety. For example, schools routinely take measures to identify preexisting risks to their students’ health and well-being, and regularly screen students for conditions that might lead to long-term health problems. Schools mandate routine physical exams by a medical professional to assure the students’ physical health will not interfere with school attendance or physical activity. Compulsory vaccination laws as a precursor to school attendance aim to prevent risk of harm to individual students due to contagion, as well as to address the potential risk of harm to peers, teachers, and their community from contagion. Vision and hearing screenings assess whether students have limitations that would interfere with their capacity to learn and function effectively in the educational setting, and schools are mandated to provide accommodations when required for learning. Even more, the screening of middle school students for adolescent idiopathic scoliosis remains routine, notwithstanding the facts that adolescent idiopathic scoliosis is condition that does not manifest consequences for decades, and that there is little evidence that identification of idiopathic scoliosis during adolescence improves long-term outcomes (U.S. Preventive Services Task Force et al. 2018).