MyMedR

Radiological and clinical outcome of selective thoracic fusion for patients with Lenke 1C and 2C adolescent idiopathic scoliosis with a minimum follow-up of 2 years

Kwan MK, Chiu CK, Tan PH, Chian XH, Ler XY, Ng YH, et al.

Spine J, 2018 12;18(12):2239-2246.

PMID: 29733900 DOI: 10.1016/j.spinee.2018.05.007

BACKGROUND CONTEXT: In Lenke 1C and 2C curves, the choice between selective thoracic fusion (STF) versus non-selective thoracic fusion as the optimal surgical treatment is controversial.

OBJECTIVE: This study aimed to assess the radiological and clinical outcome of patients with Lenke 1C and 2C curves treated with STF.

STUDY DESIGN: This is a retrospective study.

PATIENT SAMPLE: A total of 44 patients comprised the study sample.

METHODS: Forty-four patients with Lenke 1C and 2C curves with adolescent idiopathic scoliosis who underwent STF were reviewed. Radiological parameters and Scoliosis Research Society (SRS)-22r scores were assessed preoperatively, postoperatively, and on final follow-up. The incidence of coronal decompensation, lumbar decompensation, and adding-on phenomenon were reported.

RESULTS: Mean follow-up duration was 45.1±12.3 months and mean age was 17.0±5.1 years. The preoperative middle thoracic and thoracolumbar/lumbar (MT:TL/L) Cobb angle ratio was 1.4±0.3 and the MT:TL/L apical vertebra translation (AVT) ratio was 1.6±0.8. Final follow-up coronal balance was -13.0±11.5 mm, main thoracic AVT was 6.9±11.8 mm, and lumbar AVT was -20.4±13.8 mm (pLumbar Cobb angle improved from 47.5°±7.8° to 24.9°±8.2° after operation and 23.3°±9.8° at final follow-up. The spontaneous lumbar curve correction rate was 50.9%. There were 9 patients (20.5%) who had coronal decompensation, 4 patients (9.1%) who had lumbar decompensation, and 11 patients (25.0%) who had adding-on phenomenon. We did not perform any revision surgery. The SRS-22r scores improved significantly in the overall scores, self-image, and mental health domain.

CONCLUSIONS: Selective thoracic fusion led to improvement in the radiological and clinical outcome for patients with Lenke 1C and 2C. Although no patients required revision surgery, the rate of coronal decompensation, lumbar decompensation, and adding-on phenomenon are significant.

Matched MeSH terms: Lumbar Vertebrae/surgery

A follow-up study on the effects of a milk supplement on bone mineral density of postmenopausal Chinese women in Malaysia

Ting GP, Tan SY, Chan SP, Karuthan C, Zaitun Y, Suriah AR, et al.

J Nutr Health Aging, 2007 Jan-Feb;11(1):69-73.

PMID: 17315084

A previous study on a randomized controlled trial in 173 postmenopausal Chinese women in Kuala Lumpur showed that milk supplementation was effective to reduce bone loss at the total body, lumbar spine, femoral neck and total hip compared to the control group on a usual diet (Chee et al. 2003).

Matched MeSH terms: Lumbar Vertebrae/chemistry

The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws

Chiu CK, Kwan MK, Chan CY, Schaefer C, Hansen-Algenstaedt N

Bone Joint J, 2015 Aug;97-B(8):1111-7.

PMID: 26224830 DOI: 10.1302/0301-620X.97B8.35330

We undertook a retrospective study investigating the accuracy and safety of percutaneous pedicle screws placed under fluoroscopic guidance in the lumbosacral junction and lumbar spine. The CT scans of patients were chosen from two centres: European patients from University Medical Center Hamburg-Eppendorf, Germany, and Asian patients from the University of Malaya, Malaysia. Screw perforations were classified into grades 0, 1, 2 and 3. A total of 880 percutaneous pedicle screws from 203 patients were analysed: 614 screws from 144 European patients and 266 screws from 59 Asian patients. The mean age of the patients was 58.8 years (16 to 91) and there were 103 men and 100 women. The total rate of perforation was 9.9% (87 screws) with 7.4% grade 1, 2.0% grade 2 and 0.5% grade 3 perforations. The rate of perforation in Europeans was 10.4% and in Asians was 8.6%, with no significant difference between the two (p = 0.42). The rate of perforation was the highest in S1 (19.4%) followed by L5 (14.9%). The accuracy and safety of percutaneous pedicle screw placement are comparable to those cited in the literature for the open method of pedicle screw placement. Greater caution must be taken during the insertion of L5 and S1 percutaneous pedicle screws owing to their more angulated pedicles, the anatomical variations in their vertebral bodies and the morphology of the spinal canal at this location.

Matched MeSH terms: Lumbar Vertebrae/surgery*

Fulltext Correction of severe thoracolumbar spondylolisthesis (grade 4) secondary to neurofibromatosis with posterior spinal instrumented fusion alone. A case report

Muhammad MT, Kwan MK, Chan CY, Lim BS, Goh DW

Med J Malaysia, 2012 Dec;67(6):633-5.

PMID: 23770965 MyJurnal

A 15-year-old teenager with Type 1 Neurofibromatosis presented with grade 4 spondylolisthesis over T12/L1 junction resulting paraparesis (Frankel D). Radiograph showed a Cobb angle of 88 degrees. Computed tomography scan showed dysplastic vertebral bodies, pedicles and facet joints of T11, T12 and L1 vertebra with complete T12/L1 facets dislocation. Magnetic resonance imaging confirmed presence of spinal cord compression. He underwent posterior instrumentation and posterolateral fusion (T8 to L4) using hybrid instrumentation. Extensive corticotomy of the posterior elements was followed by the use of large amount of bone graft. Post operatively, his neurology improved markedly back to normal. Radiographs showed a good correction of the deformity. He was immobilized in a thoracolumbar orthosis for six months. A solid posterior fusion was achieved at six months follow up. At 36-month follow up, he remained asymptomatic. This case report illustrates a successful treatment of a grade 4 thoracolumbar spondylolisthesis secondary to neurofibromatosis with posterior spinal fusion alone.

Matched MeSH terms: Lumbar Vertebrae

Fulltext COBB syndrome treated by staged intravascular embolisation and surgery

Sayuthi S, Moret J, Pany A, Sobri A, Shafie M, Abdullah J

Med J Malaysia, 2006 Jun;61(2):239-41.

PMID: 16898321 MyJurnal

A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.

Matched MeSH terms: Lumbar Vertebrae

Fulltext Resection and reconstruction of retroperitoneal sarcoma of spinal roots

Imran Y, Zulmi W, Faisham WI, Zainal M

Med J Malaysia, 2004 Dec;59 Suppl F:75-7.

PMID: 15941171

Matched MeSH terms: Lumbar Vertebrae

Fulltext Vitamin E deficiency reduced lumbar bone calcium content in female rats

Norazlina M, Chua CW, Ima-Nirwana S

Med J Malaysia, 2004 Dec;59(5):623-30.

PMID: 15889565

Vitamin E deficiency has been found to impair bone calcification. This study was done to determine the effects of vitamin E deficiency and supplementation on parathyroid hormone, i.e. the hormone involved in bone regulation. Female Sprague-Dawley rats were divided into 4 groups: 1) normal rat chow (RC), 2) vitamin E deficiency (VED), vitamin E deficient rats supplemented with 3) 60 mg/kg alpha-tocotrienol (ATT) and 4) 60 mg/kg (alpha-tocopherol (ATF). Treatment was carried out for 3 months. Vitamin E deficiency caused hypocalcaemia during the first month of the treatment period, increased the parathyroid hormone level in the second month and decreased the bone calcium content in the 4th lumbar bone at the end of the treatment. Vitamin E supplementation (ATT and ATF) failed to improve these conditions. The bone formation marker, osteocalcin, and the bone resorption marker, deoxypyridinoline did not change throughout the study period. In conclusion vitamin E deficiency impaired bone calcium homeostasis with subsequent secondary hyperparathyroidism and vertebral bone loss. Replacing the vitamin E with pure ATF or pure ATT alone failed to correct the changes seen.

Matched MeSH terms: Lumbar Vertebrae/metabolism*

Fulltext Thoracolumbar fracture--dislocation results of surgical treatment

Razak M, Mahmud M, Mokhtar SA, Omar A

Med J Malaysia, 2000 Sep;55 Suppl C:14-7.

PMID: 11200038

Fifteen cases of unstable fracture-dislocation of the thoracolumbar spine have been treated by open reduction, short segment transpedicular fixation and fusion in Universiti Unit, Kuala Lumpur Hospital from January 1994 until December 1997. Twelve male and three female patients were injured; their age ranged from 18 to 45 years. Five fracture-dislocations occurred in the lower thoracic spine (T8 to T11), eight at the thoracolumbar junction (T12 to L2) and two in the lumbar spine (L3 to L5). All the patients had neurological deficit. Seven patients with incomplete or cauda equina lesions regained some neural function, while all eight with complete lesions remained unchanged. Ten of the fifteen cases were grossly unstable and translated beyond 50% of the width of the spinal column. At the time of follow up (more than one year in all patients), no loss of reduction or of fixation was noted in any patient. Solid fusion was achieved in all patients. The advantages of this method of treatment include stable fixation, with maintenance of sagittal and coronal spinal alignments, to allow early rehabilitation.

Matched MeSH terms: Lumbar Vertebrae/injuries*

Fulltext Iatrogenic instability of the lumbar spine

Sivananthan KS

Med J Malaysia, 2001 Jun;56 Suppl C:1-2.

PMID: 11814241

Matched MeSH terms: Lumbar Vertebrae/surgery*

Fulltext Short segment posterior instrumentation, reduction and fusion of unstable thoracolumbar burst fractures--a review of 26 cases

Razak M, Mahmud MM, Hyzan MY, Omar A

Med J Malaysia, 2000 Sep;55 Suppl C:9-13.

PMID: 11200050

From January 1994 to January 1998, 26 patients of unstable thoracolumbar burst fracture were treated by a short segment posterior instrumentation (pedicular screw plate/rod system), reduction and fusion in Kuala Lumpur and Universiti Kebangsaan Malaysia Hospital. Majority of them were young and in a productive age group (mean age were 30 year-old). The mean duration of follow-up was 24.4 months. The injuries were caused by fall from height (69%) and motor vehicle accident (31%). Most of the fracture occurred at 1st and 2nd lumbar vertebrae (24/26). Twelve of the patients did not have neurological deficits. Out of 14 patients with neurological deficits, 64.4% of them showed an improvement of at least one Frankel's grade. There was no defect correlation between canal compromise and neurological deficit. Kyphotic angle improved from 20 degrees to 7 degrees immediately after surgery. In the last follow-up average kyphotic angle was 9 degrees with average lost of 2 degrees. The average length of hospitalization following surgery was 24 days. A posterolateral bony fusion was achieved in all cases at an average of 3 months. Complication included 2 loosening and 3 misplacement of pedicle screw fixation. We concluded that short-segment fixation with posterolateral decompression and fusion is effective in the treatment of unstable thoracolumbar burst fracture.

Matched MeSH terms: Lumbar Vertebrae/injuries*

Fulltext Arteriovenous fistula simulating deep vein thrombosis as a complication of lumbar disc surgery

Teh A, Jeyamalar R, Habib ZA

Med J Malaysia, 1993 Dec;48(4):440-2.

PMID: 8183169

Acquired arteriovenous fistula is an unusual complication of lumbar disc surgery. Diagnosis is often late because of the lack of awareness of this complication and also because it may simulate other vascular diseases. A case diagnosed initially as deep vein thrombosis of the leg is described.

Matched MeSH terms: Lumbar Vertebrae/surgery*

Fulltext Spinal tuberculosis: a five-year review of cases at the National Tuberculosis Centre

Jalleh RD, Kuppusamy I, Mahayiddin AA, Yaacob MF, Yusuf NA, Mokhtar A

Med J Malaysia, 1991 Sep;46(3):269-73.

PMID: 1839924

We reviewed 31 cases (19 males and 12 females) of spinal tuberculosis seen at the National Tuberculosis Centre from 1985 to 1989. The mean age was 35.4 years. The predominant clinical feature was backache (90.3%), while neurological features were found in 30.9%. An elevated erythrocyte sedimentation rate (in 80.0%) and a positive Mantoux test (in 70.9%) served as useful investigations. Spinal x-ray was abnormal in all cases, the lumbar spine being most commonly involved. Bacteriological or histopathological confirmation was obtained in only 29.0% of cases. The mainstay of treatment was anti-tuberculous chemotherapy with surgery being performed in 41.9% of patients.

Matched MeSH terms: Lumbar Vertebrae*

Fulltext Primary osteogenic sarcoma of spine in a 12 year old boy--a case report

Kareem BA, Abdullah WA, Kassim ZM, Myint H, Sengupta

Med J Malaysia, 1990 Sep;45(3):257-9.

PMID: 2152090

A case of primary osteogenic sarcoma of the lumbar spine in child is reported and the difficulties in diagnosis and management are discussed.

Matched MeSH terms: Lumbar Vertebrae*

Fulltext Haemorrhagic lumbar synovial cyst

Soon CK, Razak M

Med J Malaysia, 2001 Dec;56 Suppl D:57-60.

PMID: 14569769

Hemorrhagic lumbar synovial cysts are not commonly reported in English literature. Post-resection recurrence of synovial cyst is unusual and therefore recurrence symptoms required repeat MRI or CT scan. We reported a case of hemorrhagic lumbar synovial cyst presented with neurological deficit that recovered initially after surgery but subsequently developed recurrent of symptoms at a higher level due to fibrous tissue.

Matched MeSH terms: Lumbar Vertebrae/pathology; Lumbar Vertebrae/radiography; Lumbar Vertebrae/surgery

Review of cases of fractures of the spine at the university hospital

Silva JF

Med J Malaysia, 1978 Jun;32(4):268-73.

PMID: 732618

Matched MeSH terms: Lumbar Vertebrae/injuries

POEMS syndrome: A rare paraneoplastic presentation of spinal plasmacytoma

Low JM, Basiam S, Ahlam Naila K

Med J Malaysia, 2019 08;74(4):335-337.

PMID: 31424045

The acronym POEMS syndrome was coined for a unique multisystem disorder characterised by peripheral neuropathy, organomegaly, endocrinopathies, monoclonal gammopathy and skin changes. We report a male patient presenting to us with spinal plasmacytoma complicated with paraplegia. He was subsequently diagnosed to have POEMS syndrome and successfully treated with thalidomide and dexamethasone. Post treatment, he is able to ambulate independently.

Matched MeSH terms: Lumbar Vertebrae*

Fulltext Steroid-induced osteoporosis--a cause for concern?

Tan TT, Lau IS, Kong NC, Zainal AG

Malays J Pathol, 1997 Jun;19(1):27-33.

PMID: 10879239

Matched MeSH terms: Lumbar Vertebrae/drug effects; Lumbar Vertebrae/metabolism

Fulltext Accuracy of Computed Tomography Attenuation Value of Lumbar Vertebra to Assess Bone Mineral Density

Chia KK, Haron J, Nik Malek NFS

Malays J Med Sci, 2021 Feb;28(1):41-50.

PMID: 33679219 DOI: 10.21315/mjms2021.28.1.6

Background: Computed tomography (CT) attenuation (Hounsfield unit [HU]) value of lumbar vertebra may provide an alternative method in the detection of osteoporosis during CT scans.

Methods: A cross-sectional study on 50 patients of age 50 and above with contrast-enhanced CT (CECT) and dual-energy X-ray absorptiometry (DXA) was conducted from November 2018 to November 2019. Single region of interest (ROI) was placed at the anterior trabecular part of L1 vertebra on CECT to obtain HU value. Correlation of CT HU value of L1 vertebra and DXA T-score, interrater reliability agreement between HU value of L1 vertebra and T-score in determining groups of with and without osteoporosis, ROC curve analysis for diagnostic accuracy and cut-off value of CT for detection of osteoporosis were identified.

Results: Significant correlation between HU value of L1 vertebra and L1 T-score (r = 0.683)/lowest skeletal T-score (r = 0.703) (P < 0.001). Substantial agreement between HU value of L1 vertebra and DXA in determining the groups with and without osteoporosis (k = 0.8; P < 0.001). The area under the receiver operating characteristic (AUROC) curve was 0.93 (95% CI: 0.86, 1.00) using HU value (P < 0.001). Cut-off value for osteoporosis was 149 HU.

Conclusion: HU value of lumbar vertebra is an effective alternative for the detection of osteoporosis with high diagnostic accuracy in hospitals without DXA facility.

Matched MeSH terms: Lumbar Vertebrae

Patterns of psoriatic arthritis in Orientals

Thumboo J, Tham SN, Tay YK, Chee T, Mow B, Chia HP, et al.

J Rheumatol, 1997 Oct;24(10):1949-53.

PMID: 9330937

OBJECTIVE: To determine the clinical features of psoriatic arthritis (PsA) in a multiethnic Oriental population and to study the effect of ethnicity on disease patterns.
METHODS: A retrospective study of 80 patients with PsA seen at either a rheumatology or dermatology referral center. Patients and case records were reviewed and data abstracted according to a standard protocol. Eighty consecutive patients with psoriasis without PsA seen at the dermatology center were recruited as controls.
RESULTS: Asymmetric polyarthritis developing in the 4th decade with an equal male to female ratio was the commonest pattern of arthritis among Chinese, Indians, and Malays. Clinically apparent lumbar spondylitis was significantly more common in Indians than Chinese (10/11 vs 11/20, respectively; p = 0.046), although the prevalence of lumbar spondylitis was similar in all ethnic groups. Eighty-nine percent of subjects required nonsteroidal antiinflammatory drugs and 51% required disease modifying antirheumatic drugs at some time for control of joint disease. PsA was significantly more common among Indians compared to the ethnic distribution of the Singapore population (p < 0.000001). Multiple logistic regression identified Indian ethnicity as a risk factor for the development of PsA (OR 2.39, 95% confidence interval 1.02 to 5.60).
CONCLUSION: The commonest pattern of PsA in all ethnic groups was asymmetric polyarthritis. Ethnicity affected the development and presentation of PsA in our series: Indians with psoriasis had double the risk of developing PsA compared to Chinese with psoriasis, and lumbar spondylitis when present in Chinese subjects was asymptomatic in 45%, being detectable only on radiological examination.

Matched MeSH terms: Lumbar Vertebrae/pathology

Associations between ethnicity, body composition, and bone mineral density in a Southeast Asian population

Yang PL, Lu Y, Khoo CM, Leow MK, Khoo EY, Teo A, et al.

J Clin Endocrinol Metab, 2013 Nov;98(11):4516-23.

PMID: 24037892 DOI: 10.1210/jc.2013-2454

Chinese men in Singapore have a higher incidence of hip fractures than Malay and Indian men. We investigated whether there were corresponding ethnic differences in peak bone mineral density (BMD) in young men and whether differences in body composition influenced peak BMD.

Matched MeSH terms: Lumbar Vertebrae

Displaying publications 1 - 20 of 76 in total