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  #31  
Old 18th November 2005, 09:34 PM
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Hyperlordosis

Has some great definitions and easy to understand diagrams
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  #32  
Old 18th November 2005, 09:40 PM
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Paper

Maybe of interest to members about to undergo surgery in understanding procedures (or scare the hell out of them)
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  #33  
Old 18th November 2005, 10:01 PM
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that link won't work for me, mark. i don't know if the site is down or something?
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Diagnosed in March 2001 by family GP after my mum noticed an asymmetry in my spine. Referred to a consultant at the RNOH, Stanmore and started attending consultations for x-rays twice a year. Prescribed a TLSO brace to be worn 16 hours per day. Began with double major curves at approx 48 degrees. Offered surgery in 2003 aged 16 and declined to continue with school. Requested surgery in 2005 instead. Had T11-L3 fused on 16th July 2005 and haven't looked back! Released for all activities in March 2006, having been driving and riding horses with consultant's permission since 7 weeks post op.
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  #34  
Old 18th November 2005, 10:17 PM
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Sorry my fault i missed a w of the www.bit
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  #35  
Old 18th November 2005, 10:51 PM
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Flatback

Iatrogenic loss of lordosis is now frequently recognized as a complication following placement of thoracolumbar
instrumentation, especially with distraction instrumentation. Flat-back syndrome is characterized by forward inclination
of the trunk, inability to stand upright, and back pain. Evaluation of the deformity should include a full-length lateral
radiograph obtained with the patient’s knees and hips fully extended. The most common cause of the deformity
includes the use of distraction instrumentation in the lumbar spine and pseudarthrosis.
Surgical treatment described in the literature includes opening (Smith-Petersen) osteotomy, polysegmental osteotomy,
and closing wedge osteotomy. The authors will review the literature, cause, clinical presentation, prevention, and
surgical management of flat-back syndrome.
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  #36  
Old 19th November 2005, 11:38 AM
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Interesting paper. I hadn't realised that flatback had been identified and named by Moe as far back as 1976 - that's a full 18 years before my surgery which left me with significant positive sagittal balance. Generally the turning point is given as LaGrone's study and paper in the late 1980s, which managed to capture the interest required to make a change. Most surgeons had stopped using Harrington rods by around 1990, and it was widely enough recognised as a problem that my first surgeon, a local hip and knee guy with "an interest" knew about the risks (although ironically enough, it would have been better if he hadn't - a Harrington would have done me less damage, but only because he was not specialised enough to handle the kind of instrumentation that he actually used).
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Diagnosed at 15 with 50° curve, but probably juvenile IS. Fused in kyphosis (by non-specialised ortho) with a/p surgery T10-L2 @ 21, posterior only revision surgery to correct kyphosis @ 29. Now 38 with further revision surgery and extension of fusion to sacrum required to correct residual kyphosis, restore lordosis and address spinal stenosis.
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  #37  
Old 19th November 2005, 10:25 PM
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European paper on management of chronic lower back pain

chronic lower back pain
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  #38  
Old 3rd December 2005, 08:17 PM
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http://erj.ersjournals.com/cgi/content/full/22/3/525

A bit complicated but maybe of interest to members
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  #39  
Old 4th December 2005, 03:57 AM
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I wish they'd also studied the ventilation without supplemental oxygen. I want to know how my treatment is likely to do.

Thanks for the link, Mark. Very interesting.
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congenital scoliosis, thoracic fusion without instrumentation in 1974 (age 11mos), re-operated in 1975 (age 17mo.s) ~ lung volume 25-30%
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  #40  
Old 4th December 2005, 08:38 AM
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Sleep fragmentation in kyphoscoliotic individuals with alveolar hypoventilation treated by NIPPV
JR Bach, D Robert, P Leger and B Langevin
Department of Reanimation Medicale l'Hopital de la Croix Rousse, Lyon, France.

Intermittent positive pressure ventilation (IPPV) delivered via nasal access can normalize alveolar ventilation for individuals with chronic alveolar hypoventilation (CAH) due to neuromuscular disease, spinal cord injury, or skeletal deformity. The purpose of this study was to evaluate the effect of nasal IPPV (NIPPV) air leakage-associated oxyhemoglobin desaturations (dSATs) on the sleep efficiency of kyphoscoliotic individuals with severe pretreatment nocturnal dSATs. Only individuals using nocturnal NIPPV without supplemental oxygen therapy were studied. Seven such individuals were able to maintain PaO2 greater than 60 mm Hg without supplemental oxygen therapy (five had been using oxygen therapy in the pretreatment period), had fewer hospitalizations, and had improvements in symptoms, arterial blood gas values, and nocturnal oxyhemoglobin saturation (SAT) by nocturnal NIPPV. This occurred despite polysomnographically observed sleep disruption and sleep stage changes associated with frequent transient dSATs and massive insufflation leakage. Arousals and dSATs were most frequent during rapid eye movement (REM) sleep with the latter occurring at a frequency of 10/h. The dSATs resulted in brief arousals or lightening of sleep stage 76% of the time. With or without arousal, central nervous system mediated reflex muscular activity occurred to diminish leak and normalize SAT. We conclude that the effectiveness of nocturnal NIPPV is dependent in part on central mediated muscular activity.

http://www.chestjournal.org/cgi/reprint/107/6/1552

Thats the link to the report

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  #41  
Old 10th December 2005, 11:10 PM
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http://www.srs.org/professionals/resources...white_paper.pdf

Matina/Becky - I hope this gives you a better understanding of measuring Kyphotic curves. It baffled the hell out of me so good luck any questions just post away.
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  #42  
Old 2nd January 2006, 02:40 PM
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Just found this article while running a search, guys any idea what this is all about and how safe it is?
-----------------------------------------------------

Revolutionary device used in spine surgery

Our Correspondent
Noida, January 1
Fortis Hospital, Noida, is the first hospital in South East Asia which claims to have used DIAM (Device for Intervertebral Assisted Motion) in spine surgery. This revolutionary device in spine surgeries overcomes the shortcomings of the stereotype mode of surgery in which screws and rods are used to support the spine. Therefore, post-operation stiffness of the back troubles the patient.
The device has been invented by Prof Jean Taylor, Monaco, France.
Prof A K Singh, Director Neurosciences, Fortis Hospital and Dr Samjeev Dua, Sr Consultant Neurosurgery, had conducted the first surgery using this device.
In DIAM surgery, a bag filled with silicon gel is inserted between the two vertebras after creating a proper bed for it. This process helps in restoring the space between the adjacent vertebrae and opens up the canals through which the nerves can easily pass, thus relieving pressure on the nerves. The process enables the complete range of movement as the silicon bag adjusts to pressures by molding itself temporarily and then regaining its shape.
The spine is made of individual bones called vertebrae, which provide support for the spine.
These vertebrae are connected in front of spine by intervertebral discs that help support the spine and also allow it to move. Neck and lower back pain are the most common existing spine problems.
Though the surgical treatment for it has existed for long, but with DIAM the efficiency and results of spine surgeries will reach next level in India.
Prof. A. K. Singh, Director, Neurosciences, Fortis Hospital, Noida said, “At this moment, DIAM has been implanted in three patients at Fortis. It has been well received by the patients. The greater patient satisfaction will encourage the widespread use of DIAM in India in future.”
DIAM is suitable for patients who are unable to walk because of leg pain or weakness of legs brought on by walking.

http://www.tribuneindia.com/2006/20060102/delhi.htm#9
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  #43  
Old 2nd January 2006, 05:34 PM
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It seems that it is a special kind of disc replacement to be used for conditions such as degenerated discs and cord compression. In some cases it is necessary to fuse a couple of vertebrae, but sometimes a disc replacement can be performed - it seems here that some cases that would originally have warranted fusion may be able to be treated with this device instead, without fusion.

Traditional disc replacements are made from hard materials but this one seems to be made of silicone. Supposedly it opens up the spine better and helps with blood supply and nerve freedom.

Unfortunately it won't work for spinal deformity, but it may be interesting for those who are suffering disc degeneration above or below their fusion. Thanks for the link!
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  #44  
Old 27th January 2006, 07:48 PM
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https://www.aans.org/education/journal/neur...an03/14-1-1.pdf

History of surgery for the correction of spinal deformity
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  #45  
Old 1st February 2006, 08:08 PM
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http://www.rcsed.ac.uk/journal/vol47_2/4720004.html

Congenital anomalies of the vertebrae producing a scoliosis, kyphoscoliosis or kyphosis are potentially serious conditions, which can, on occasion, result in an extremely severe rigid spinal deformity with possible spinal cord compression. The key to successful management depends on: (1) Early diagnosis while the curve is still small. (2) Anticipation of the likely prognosis based on the type and site of the vertebral anomaly, the degree of growth imbalance it produces and the amount of spinal growth remaining. (3) Preventing progression of the deformity and this may necessitate surgical treatment in the first few years of life. It is much better to carry out a relatively simple operation to balance the growth of the spine at an early stage than to wait and perform potentially hazardous anterior and posterior spinal surgery as a salvage procedure at a later stage.
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