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Wheeless' Textbook of Orthopaedics
- 2 subtypes: idiopathic and dystrophic; - dysplastic type: (dystrophic) - short, sharply angulated curve which involve only few vertebra; - associated w/: ...

Wheeless' Textbook of Orthopaedics
Discussion: - preadolescents w/ spinal cord injury have> 95% prevalence of scoliosis & 50% of pts have a pelvic obliquity; - progressive kyphoscoliosis results from effects of gravity & loss of spinal musculature; - upto 2/3 of these patients will requre arthrodesis to prevent severe curve progression

Respect for patient autonomy is an important ethical principle for medical practitioners; however, previous investigators have reported inconsistent attitudes amongst practitioners towards respect for patient autonomy. This study in empirical ethics used qualitative methods to investigate GPs' attitudes towards respect for patient autonomy in consultations for low back pain. Wendy...

Wheeless' Textbook of Orthopaedics
Links to selected references with abstracts

Wheeless' Textbook of Orthopaedics
Discussion: - most common cause of structural kyphosis of thoracic & thoracolumbar spine; - most commonly seen in skeletally immature adolescents; - there is usually a strong hereditary tendency (may be autosomal dominant); - etiology is not known; - criteria for diagnosis: - thoracic kyphosis>...

Wheeless' Textbook of Orthopaedics
scoliosis is almost universal in pts who have DMD, and it usually develops after they lose the ability to walk (after age 10 yrs); - early scoliosis develops in 25 % of pts while they are...

Wheeless' Textbook of Orthopaedics
by definition juvenile scoliosis develops before age 10; - majority of idiopathic curvatures are right thoracic curves; - left thoracic scoliosis is unusual; - clinically, juvenile scoliosis shows slow progression prior to age 10, but after age 10...

Wheeless' Textbook of Orthopaedics Scoliosis Menu; includes-
- Congenital Scoliosis - Childhood Scoliosis ...

Wheeless' Textbook of Orthopaedics
Treatment based on King et al Algorithm - Discussion: - fusion mass needs to include distal vertebra of structural curve; - if a more distal vertebra appears rotated in the same direction as more ...

Wheeless' Textbook of Orthopaedics
Non Operative Treatment: - many patients can achieve functional sitting with body jackets or molded wheelchair inserts; - custom molded seat insertes allow better positioning but do not prevent curve progression; - Surgical Treatment: - w/ spastic quadriplegia scoliosis...

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics
scoliosis is present in> 20% pts who have symptomatic spondylolisthesis but in only 13 per cent of those who have spondylolysis; - incidence of scoliosis is higher in pts w/ dysplastic spondylolisthesis...

Wheeless' Textbook of Orthopaedics
tethered cord syndrome is more frequent in children who have a myelomeningocele at level of L4 & L5 as opposed to those who have a lesion at thoracic level

Wheeless' Textbook of Orthopaedics
progression: - rt thoracic curves> 50 deg are at highest risk for progression (1 deg/yr) followed by Rt lumbar curves; - single thoracic curves> 70-75 deg at growth...

Wheeless' Textbook of Orthopaedics
Choices for Instrumentation: - Zielke Instrumentation: - used for treatment of rigid or mobile lumbar or thoracolumbar ...