NUMERIEKE INSTABILITEIT

4/7/2014
NUMERIEKE INSTABILITEIT
- NUMERIEK
LUMBALISATIE
SACRALISATIE
- TRAUMATISCH
- SCOLIOSE
“NORMAAL”
1
1
2
2
3
3
4
4
5
5 paaltjes
=
4 gaatjes
Rosenberg collectie:
Museum Bleulandinum, Utrecht
1
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This study is consistent with previous research,
indicating that the prevalence of LTV (lumbar
transitional vertebra) is not significantly higher
amongst patients with LBP (low back pain).
TRAUMATISCHE
INSTABILITEIT
Research Article
The clinical assessment of
transitional vertebrae and back pain
K. Murtaugh, W. F. Kean
Inflammopharmacology 16 (2008)
278–283
2
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SCOLIOSE
SAGITTALE
INSTABILITEIT
3
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Thoracale
scoliose:
Lumbale
scoliose:
Procc. Spin.
roteren in de
concaviteit.
“Midden” corpus vertebrae
Procc. Spin.
roteren in de
concaviteit.
Proc. spinosus
Naar R. Dickson (2004)
Current Orthopaedics (2004) 18, 411–425
MINI-SY MPOSIUM: THE SPINE
(i) Spinal def ormity —basic principles
Robert A. Dickson
4
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Geometric Torsion in Idiopathic Scoliosis
T hree-Dimensional Analysis and Proposal for
a New Classification
Philippe Poncet, MSc,*‡ Jean Dansereau,
PhD,†‡ and Hubert Labelle, MD,‡
SPINE Volume 26, Number 20, pp 2235–
2243 2001
CONCLUSIE:
BIJ EEN SCOLIOSE
- LUMBAAL OF
THORACAAL DRAAIEN DE PROCC.
SPINOSI IN DE
CONCAVITEIT!
Poncet P. et al Spine, 2001
PA
AP
Lordose:
Lateraal flexie +
Heteronyme Rotatie
WAAROM DRAAIEN DE
WERVELS VAN EEN
THORACALE SCOLIOSE,
NET ALS DIE VAN EEN
LUMBALE SCOLIOSE,
IN DE CONCAVITEIT?
CONCAVITEIT?
Aanzicht
Hoek van Cobb
5
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128o
87o
128o
87o
14o
(Schijnbare) kyfose
Werkelijke lordose
61o
61o
14o
The etiology and pathogenesis of idiopathic scoliosis.
Dickson RA (1992).
University Department of Orthopaedic Surgery, St James's University Hospital,
Leeds, United Kingdom.
Idiopathic scoliosis is a complex threedimensional deformity and in the thoracic
region the essential lesion lies in the sagittal
plane in the form of an area of inappropriate
lordosis.
14o
THE PATHOGENESIS OF IDIOPATHIC SCOLIOSIS
BIPLANAR SPINAL ASYMME TRY
R. A. DICKSON, J. 0. LAWTON, I. A. ARCHER, W. P. BUTT (1984)
Idiopathic kyphoscoliosis cannot and does
not exist, from the mildest cases in the
community to the most severe cases in
pathology museums.
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SCOLIOSE PREPARAAT
X-FOTO PREPARAAT
Naar:
Dickson
LATERAAL AANZICHT
PREPARAAT: KYFOSE
LATERAAL AANZICHT
X-FOTO: KYFOSE
Naar:
Dickson
L
O
K
R
Y
D
F
O
O
S
S
E
E
LATERAAL AANZICHT
SCOLIOSE: LORDOSE
LATERAAL AANZICHT
SCOLIOSE: LORDOSE
Naar:
Dickson
APPREPARAAT
LATERAALPREPARAAT
LATERAALSCOLIOSE
Naar:
Dickson
Sagittal Plane Correction in Idiopathic Scoliosis
de Jonge, Tamás MD,*†; Dubousset, Jean F. MD, DSc,† and; Illés, Tamás MD, PhD*
Spine Issue: Volume 27(7), 1 April 2002, pp 754-760 2002
-22
+14
Scoliosis: a rev iew
Colin Nnadi
Jeremy Fairbank
PAEDIATRICS AND CHILD
HEALTH 20:5 215 2009
7
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Carolin Schmidt • Ulf Liljenqvist • Thomas Lerner • Tobias L. Schulte • Viola Bullmann
Sagittal balance of thoracic lordoscoliosis: anterior dual rod instrumentation versus
Eur Spine J (2011) 20:1118–1126
posterior pedicle screw fixation
Alleen achterste benadering:
Pediculus schroeven:
Resterende hypokyfose van 50
Pre-op.
Carolin Schmidt • Ulf Liljenqvist • Thomas Lerner • Tobias L. Schulte • Viola Bullmann
Sagittal balance of thoracic lordoscoliosis: anterior dual rod instrumentation versus
Eur Spine J (2011) 20:1118–1126
posterior pedicle screw fixation
Posterior pedicle screw
instrumentation and
anterior dual rod
instrumentation allow
restoration of thoracic
ky phosis, with
comparable coronal
plane correction. In
patients who hav e
hy poky photic thoracic
curv es preoperativ ely,
howev er,
better restoration of
thoracic ky phosis can
be achiev ed with
anterior
Alleen voorste benadering: instrumentation in
contrast to posterior
Dual rod:
pedicle screw
instrumentation.
Grotere kyfose: 140
Post-op.
Post-op.
Ant. release Post. Instr.
PA-opnamen
SPINE Volume 38 , Number 26,
pp 1662 – 1668 ©2013
Michael Ruf , Lynn Letko , Nora Matis ,
MD Harry R. Merk ,and Juergen Harms
Post-op.
Ant. release
Pre-op.
Post-op.
Post. Instr.
Poncet P. et al Spine, 2001
Poser Scoliose
juni 2007
jan 2008
mrt 2012
dec 2012
8
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Boston Brace
Spine core
Milwaukee Brace
9
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Draagduur: gem.: 18 mnd
Draagduur:
Follow--up: gem.: 8 jaar
Follow
Frontaal
Sagittaal
Frontaal
Sagittaal
Grijs: zonder brace
Zwart: met brace
Treatment of Idiopathic Scoliosis in the Milw aukee Brace: Long-term results.
By w illiam A. Carr, John H. Moe, Robert B. Winter, and John E. Lonstein
The journal of bone and joint surgery, vol. 62-a, no. 4, june 1980
To date, a major criticism of the bracing literature
remains the absence of a prospective, randomized study
to determine the efficacy of brace treatment.
Results of brace treatment of adolescent idiopathic scoliosis in boys compared with girls: a
retrospective study of 102 patients treated with the Boston brace
Timo Yrjönen, Mauno Ylikoski, Dietrich Schlenzka, Mikko Poussa
Eur Spine J (2007) 16:393–397
Topwervel
/ Apex
10
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The End
0
30
60
90
60
30
0
Hoek van Cobb
en de
aanzichts-hoek.
90
RETURN
RETURN
11

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