Search

Background: Gender differences in adolescent idiopathic scoliosis (AIS) have been documented in curve progression, response to bracing, and outcomes of surgical treatment. However, limited information is available about the relation between gender and scoliosis curve patterns and radiographical characteristics., Objectives: To evaluate the effect of gender on curve pattern and compare clinical and radiographical characteristics between male and female patients with AIS., Methods: We conducted a retrospective review of prospectively collected data that compared clinical and radiographical characteristics between male and female surgical candidates. Demographic and clinical data including age at presentation, gender, family history of scoliosis, brace treatment history, clinical coronal balance, shoulder asymmetry, and hump size were recorded. All patients graded their pain with the use of a visual analogue scale (VAS) on a scale from 0 to 10. Radiographs of the spine were reviewed to determine the type of curve according to the Lenke classification, Cobb angle, thoracic kyphosis angle, and the Risser sign. Radiologic coronal balance was recorded. Curve flexibility was determined by measuring the thoracic and lumbar curves magnitude on side bending radiographs., Results: The study included 163 patients with AIS including 35 males and 128 females patients. Although a trend toward more flexible major thoracic curves in females was noticed, there was no statistically significant difference between the 2 groups., Conclusions: In this study we were not able to demonstrate any clinical nor radiological statistical differences between male and female patients who are candidate for surgical treatment.

Background: Diabetes mellitus is a multi-organ disorder affecting many types of connective tissues, including bone and cartilage. Certain skeletal changes are more prevalent in diabetic patients than in non-diabetic individuals. A possible association of diabetes mellitus and lumbar spinal stenosis has been raised., Objectives: To compare the prevalence of diabetes mellitus in patients with spinal stenosis, degenerative disk disease or osteoporotic vertebral fractures., Methods: A cross-sectional analysis was performed of 395 consecutive patients diagnosed with spinal stenosis, degenerative disk disease or osteoporotic vertebral fractures. All the patients were examined by one senior author in the outpatient orthopedic clinic of a large general hospital between June 2004 and January 2006 and diagnosed as having lumbar spinal stenosis (n=225), degenerative disk disease (n=124), or osteoporotic vertebral fractures (n=46)., Results: The prevalence of diabetes mellitus in the three groups (spinal stenosis, osteoporotic fracture, degenerative disk disease) was 28%, 6.5% and 12.1%, respectively, revealing a significantly higher prevalence in the spinal stenosis group compared with the others (P=0.001). The higher prevalence of diabetes in the stenotic patients was unrelated to the presence of degenerative spondylolisthesis., Conclusions: There is an association between diabetes and lumbar spinal stenosis. Diabetes mellitus may be a predisposing factor for the development of lumbar spinal stenosis.

Background and Purpose: The appearance of vacuum clefts (VCs) of the vertebral bodies has frequently been considered pathognomonic for avascular necrosis. Until recently, this was considered to be a rare finding that might indicate excessive motion at the fracture site. Our aim in this retrospective study was to determine the occurrence and location of these clefts in patients with osteoporotic vertebral fractures and evaluate the risk factors involved for developing these clefts in such patients., Methods: The records of 66 patients with 101 painful osteoporotic vertebral fractures who were treated by vertebroplasty in our department were reviewed. All the fractures with VCs were collected. Age, sex, degree of deformity, and extent of degenerative changes in the adjacent disk space were compared with those found in the patients without clefts., Results: VCs were found in 26 fractured vertebrae of 26 patients. They were significantly more common in elderly men who had deformed fractures located at the thoracolumbar junction, when compared with fractures without clefts, especially when degenerative changes were observed in the adjacent disk space., Conclusion: This study suggests that VCs, which have long been considered pathognomonic for avascular necrosis (Kümmell disease), are not rare and most probably represent fracture nonunion. Elderly patients who have deformed fractures at the thoracolumbar area have a higher risk for developing clefts, mainly when there is degeneration of the adjacent disk space.