Radionuclide Evaluation of Pulmonary Perfusion in Patients with Severe Thoracic Scoliosis Before and After Surgery

2013 ◽  
Vol 20 (3) ◽  
pp. 3-10
Author(s):  
AV. V Karalkin ◽  
I. N Lisyanskiy ◽  
A. A Kuleshov ◽  
M. S Vetrile
Keyword(s):  
Deformity Correction ◽  
Vertical Axis ◽  
Concave Side ◽  
External Respiration ◽  
Thoracic Scoliosis ◽  
Severe Scoliosis ◽  
Combined Application ◽  
Pulmonary Scintigraphy ◽  
Before And After ◽  
Pulmonary Microcirculation

The purpose of the study was to evaluate the influence of severe scoliosis surgical correction upon pulmonary microcirculation. The study included 8 patients aged 12— 27 years with severe thoracic scoliosis. Angle deformity by Cobb ranged from 80 to 140° (mean 120.4°). Deformity correction and fixation was performed on the concave side of thorax using multilevel CotrelDubousset instrumentation (CDI) and elevating thoracoplasty (ET). Perfusion radionuclide pulmonary scintigraphy was performed prior to, 3 months and 1 year after surgery. Analysis of pulmonary scintigrams included both the qualitative (visual) and quantitative assessments. Besides, examination of external respiration function (spirometry and spirography) was performed. Mean postoperative Cobb angle made up 67.4°. No loss of correction was noted. Prior to surgical intervention pulmonary scintigrams showed deformation of lung fields, displacement along the vertical axis towards opposite to curvature side, decreased perfusion in the zone of intercostal retraction on the concave side of thorax. Postoperatively restoration of vertical axis, increase of lungs size and improvement of perfusion were observed. Mean vital lung capacity increased from 1510 (540-2280) to 2090 (640-3010) ml. Thus, combined application of CDI and ET enabled to perform adequate correction of severe thoracic scoliosis as well as to improve pulmonary microcirculation and radionuclide perfusion scintigraphy was a highly informative method for the evaluation of lung condition.

scholarly journals EVALUATION OF PECULIARITIES OF SPINAL BLOOD CIRCULATION, SPINAL ARACHNOID MICROCIRCULATION AND NEUROVEGETATIVE REGULATIONS IN SCOLIOSIS

2006 ◽  
pp. 038-048
Author(s):  
Sergey Pavlovich Mironov ◽  
Stepan Timofeyevich Vetrile ◽  
Zurab Georgyevich Natsvlishvili ◽  
Aleksandr Konstantinovich Morozov ◽  
Aleksandr Ilyich Krupatkin ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Blood Circulation ◽  
Soft Tissues ◽  
Deformity Correction ◽  
Supply System ◽  
Spine Deformity ◽  
Doppler Flowmetry ◽  
Severe Scoliosis ◽  
Before And After ◽  
Angiographic Data

Objective. To study aorta topography, spinal cord blood circulation, and spinal arachnoid microcirculation, as well as to evaluate thermographically microcirculation in soft tissues of the back and peculiarities of its neurovegetative regulation in scoliotic spine deformity. Material and Methods. Seventy four angiographies have been performed in 69 patients with scoliosis. In 21 patients laser doppler flowmetry was used intraoperatively to study spinal arachnoid microcirculation in red and infrared spectra before and after deformity correction. In 26 patients microcirculation and trophism of soft tissues of the back was studied in pre- and postoperative period. Results. Angiographic data show that in severe and extremely severe scoliosis the shape of aorta, but not its diameter, is changed. Examination of patients with secondary kyphoscoliosis showed a system of posterior arteries that was not visualized in patients with dysplastic scoliosis. Study of microcirculation in spinal arachnoid revealed that correction of relatively light scoliosis with CDI system improved the indices of microcirculation. In extremely severe scoliosis there is a tendency towards blood circulation disturbance in deeper layers of the arachnoid. Normalization of vegetative segmental regulation takes place in 2/3 of patients within a postoperative period. Conclusion. Spinal blood supply system in patients with scoliosis is a self-regulating mechanism of hemodynamic interactions, the compensation degree of which depends on localization of afferent spinal arteries, deformation of vertebral canal and permeability of anterior spinal artery system.

Coupling Between Sagittal and Frontal Plane Deformity Correction in Idiopathic Thoracic Scoliosis and Its Relationship With Postoperative Sagittal Alignment

Spine ◽  
2010 ◽  
Vol 35 (11) ◽  
pp. 1158-1164 ◽  
Author(s):  
Keith D. K. Luk ◽  
Srinivasa Vidyadhara ◽  
D. S. Lu ◽  
Y. W. Wong ◽  
W. Y. Cheung ◽  
...  
Keyword(s):  
Sagittal Alignment ◽  
Deformity Correction ◽  
Frontal Plane ◽  
Thoracic Scoliosis ◽  
Plane Deformity

Lateral Thoracolumbar Listhesis as an Independent Predictor of Disability in Adult Scoliosis Patients: Multivariable Assessment Before and After Surgical Realignment

Neurosurgery ◽  
2021 ◽  
Author(s):  
Alan H Daniels ◽  
Wesley M Durand ◽  
Renaud Lafage ◽  
Andrew S Zhang ◽  
David K Hamilton ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Multivariable Analysis ◽  
Deformity Correction ◽  
Adult Scoliosis ◽  
Leg Pain ◽  
Minimally Clinically Important Difference ◽  
Before And After ◽  
Plane Deformity ◽  
Numeric Scale

Abstract BACKGROUND Lateral (ie, coronal) vertebral listhesis may contribute to disability in adult scoliosis patients. OBJECTIVE To assess for a correlation between lateral listhesis and disability among patients with adult scoliosis. METHODS This was a retrospective multi-center analysis of prospectively collected data. Patients eligible for a minimum of 2-yr follow-up and with coronal plane deformity (defined as maximum Cobb angle ≥20º) were included (n = 724). Outcome measures were Oswestry Disability Index (ODI) and leg pain numeric scale rating. Lateral thoracolumbar listhesis was measured as the maximum vertebral listhesis as a percent of the superior endplate across T1-L5 levels. Linear and logistic regression was utilized, as appropriate. Multivariable analyses adjusted for demographics, comorbidities, surgical invasiveness, maximum Cobb angle, and T1-PA. Minimally clinically important difference (MCID) in ODI was defined as 12.8. RESULTS In total, 724 adult patients were assessed. The mean baseline maximum lateral thoracolumbar listhesis was 18.3% (standard deviation 9.7%). The optimal statistical grouping for lateral listhesis was empirically determined to be none/mild (<6.7%), moderate (6.7-15.4%), and severe (≥15.4%). In multivariable analysis, listhesis of moderate and severe vs none/mild was associated with worse baseline ODI (none/mild = 33.7; moderate = 41.6; severe = 43.9; P < .001 for both comparisons) and leg pain NSR (none/mild = 2.9, moderate = 4.0, severe = 5.1, P < .05). Resolution of severe lateral listhesis to none/mild was independently associated with increased likelihood of reaching MCID in ODI at 2 yr postoperatively (odds ratio 2.1 95% confidence interval 1.2–3.7, P = .0097). CONCLUSION Lateral thoracolumbar listhesis is associated with worse baseline disability among adult scoliosis patients. Resolution of severe lateral listhesis following deformity correction was independently associated with increased likelihood of reaching MCID in ODI at 2-yr follow-up.

CONDITIONED REFLEX MECHANISMS OF ADAPTATION TO ADDITIONAL BREATHING RESISTANCE

2021 ◽  
pp. 97-105
Author(s):  
Yu.Yu. Byalovskiy ◽  
I.S. Rakitina
Keyword(s):  
Conditioned Reflex ◽  
External Respiration ◽  
Respiratory Resistance ◽  
Conditioned Signal ◽  
Unconditioned Reflex ◽  
Breathing Resistance ◽  
Before And After ◽  
Resistive Loads ◽  
Aversive Behavior ◽  
Respiratory Reflex

The problem of adaptation to additional breathing resistance has recently become more urgent due to the growth of bronchopulmonary diseases. Therefore, there is a natural interest in non-drug strategies compensating resistive breathing in humans. The aim of the study was to assess conditioned reflex changes in the functional state of the subjects under additional breathing resistance. Materials and Methods. The work was carried out on 55 practically healthy subjects of both sexes, aged 18–36. Additional breathing resistance was modeled by inspiratory resistive loads of 40, 60, 70, and 80 % of the maximum intraoral pressure. The conditioned respiratory reflex to resistive respiratory load was developed as a short-delayed conditioned signal with a 30-second period of isolated action. The authors examined behavioral, vegetative, gas and energy indicators of the organism before and after the formation of a conditioned reflex. Results. It was observed that conditioned reflex shifts of physiological parameters in the process of adaptation to additional breathing resistance differ significantly from the corresponding unconditioned reflex changes both in nature and in intensity. Conditioned reflex mechanisms reduce the intensity of shifts in the motor component of the external respiration system, which, apparently, is the main reason to decrease the aversive behavior. Conclusion. Behavioral changes after the formation of a conditioned respiratory reflex to additional respiratory resistance are characterized by a decrease in aversive behavior patterns. The conditioned reflex realization of increasing resistive loads is expressed in a lower physiological cost of adaptation to additional respiratory resistance relative to the unconditioned reflex type of realization. Keywords: adaptation, conditioned respiratory reflex, additional breathing resistance. Проблема приспособления к дополнительному респираторному сопротивлению в последнее время становится все более актуальной в связи с ростом бронхолегочных заболеваний. Поэтому естественен интерес к нелекарственным механизмам компенсации резистивного дыхания человека. Целью исследования являлась оценка условно-рефлекторных изменений функционального состояния испытуемых в условиях дополнительного респираторного сопротивления. Материалы и методы. Работа проведена на 55 практически здоровых испытуемых обоего пола в возрасте от 18 до 36 лет. Дополнительное респираторное сопротивление моделировалось инспираторными резистивными нагрузками величиной 40, 60, 70 и 80 % от максимального внутриротового давления. Условный дыхательный рефлекс на резистивные дыхательные нагрузки вырабатывался по типу короткоотставленного с периодом изолированного действия условного сигнала 30 с. Исследовались поведенческие, вегетативные, газовые и энергетические показатели организма до и после формирования условного рефлекса. Результаты. Показано, что условно-рефлекторные сдвиги физиологических показателей в процессе приспособления к дополнительному респираторному сопротивлению существенно отличаются от соответствующих безусловно-рефлекторных изменений как по характеру, так и по интенсивности. Условно-рефлекторные механизмы уменьшают интенсивность сдвигов моторного компонента системы внешнего дыхания, что, по-видимому, является основной причиной снижения вероятности появления аверсивного поведения. Выводы. Поведенческие изменения после формирования условного дыхательного рефлекса на дополнительное респираторное сопротивление характеризуются снижением вероятности появления аверсивных форм поведения. Условно-рефлекторная реализация возрастающих по интенсивности резистивных нагрузок выражается в меньшей физиологической стоимости приспособления к дополнительному респираторному сопротивлению относительно безусловно-рефлекторного типа реализации. Ключевые слова: приспособление, условный дыхательный рефлекс, дополнительное респираторное сопротивление.

scholarly journals Implant Distribution Versus Implant Density in Lenke Type 1 Adolescent Idiopathic Scoliosis: Does the Position of the Screw Matter?

2020 ◽  
pp. 219256822094145
Author(s):  
Brian L. Dial ◽  
Valentine R. Esposito ◽  
Anthony A. Catanzano ◽  
Robert D. Fitch ◽  
Robert K. Lark
Keyword(s):  
Pedicle Screw ◽  
Multivariable Analysis ◽  
Deformity Correction ◽  
Concave Side ◽  
Convex Side ◽  
Coronal Balance ◽  
Screw Density ◽  
Coronal Correction ◽  
Implant Density

Study Design: Retrospective study. Objective: Previous studies have demonstrated that increased implant density (ID) results in improved coronal deformity correction. However, low-density constructs with strategically placed fixation points may achieve similar coronal correction. The purpose of this study was to identify key zones along the spinal fusion where high ID statistically correlated to improved coronal deformity correction. Our hypothesis was that high ID within the periapical zone would not be associated with increased percent Cobb correction. Methods: We identified patients with Lenke type 1 curves with a minimum 2-year follow up. The instrumented vertebral levels were divided into 4 zones: (1) cephalad zone, (2) caudal zone, (3) apical zone, and (4) periapical zone. High and low percent Cobb correction groups were compared, high percent Cobb group was defined as percent correction >67%. Total ID, total concave ID, total convex ID, and ID within each zone of the curve were compared between the groups. A multivariable analysis was performed to identify independent predictors for coronal correction. Subsequently increased and decreased thoracic kyphosis (TK) groups were compared, increased TK was defined as post-operative TK being larger than preoperative TK and decreased TK was defined as post-operative TK being less than preoperative TK. Results: The cohort included 68 patients. The high percent Cobb group compared with the low percent Cobb group had significantly greater ID for the entire construct, the total concave side, the total convex side, the apical convex zone, the periapical zone, and the cephalad concave zone. The high percent Cobb group had greater pedicle screw density for the total construct, total convex side, and total concave side. In the multivariate model ID and pedicle screw density remained significant for percent Cobb correction. Ability to achieve coronal balance was not statistically correlated to ID ( P = .78). Conclusions: Increased ID for the entire construct, the entire convex side, the entire concave side, and within each spinal zone was associated with improved percent Cobb correction. The ability to achieve coronal balance was not statistically influence by ID. The results of this study support that increasing ID along the entire length of the construct improves percent Cobb correction.

scholarly journals The Effect of Traditional Single Growing Rod Technique on the Growth of Unsegmented Levels in Mixed-Type Congenital Scoliosis

2020 ◽  
pp. 219256822097208
Author(s):  
Tianhua Rong ◽  
Jianxiong Shen ◽  
Yipeng Wang ◽  
Zheng Li ◽  
Youxi Lin ◽  
...  
Keyword(s):  
Mixed Type ◽  
Case Series ◽  
Congenital Scoliosis ◽  
Concave Side ◽  
Convex Side ◽  
Retrospective Case ◽  
Growing Rod ◽  
Before And After ◽  
Spine Radiographs

Study Design: Retrospective case series. Objectives: To present outcomes concerning patients with early-onset mixed-type congenital scoliosis (EOMTCS) treated with the traditional single growing rod (TSGR), focusing on the growth of unsegmented levels (USLs). Methods: Patients with EOMTCS who underwent TSGR and had a minimum of 4 USLs, 4 distractions, and 3-year follow-up were enrolled. Spine radiographs before and after index surgery and at the latest follow-up were evaluated. The length of the concave and convex side of USLs and thoracic parameters were measured. The absolute value and percentage of growth were calculated. Results: Fourteen patients (mean age, 7.3 ± 2.8 years) were enrolled. The average follow-up duration was 4.9 ± 1.2 years, during which time 84 distractions and 8 final fusions were performed. The average number of USLs was 6.3 ± 2.2. The total and annual percent growth of concave side of USLs was significantly higher than convex side (32.2 ± 13.3% vs. 23.9 ± 9.5%, p = 0.007; 6.8 ± 2.7%/year vs. 5.1% ± 2.2%/year, p = 0.007, respectively). The concave-to-convex ratio of USLs increased from 58.6 ± 6.4 ± 7.6% at baseline to 68.8 ± 9.3% at the latest follow-up (p < 0.001). The Campbell’s space available for lung ratio increased from 74.9 ± 11.1% at baseline to 89.6 ± 7.0% at the latest follow-up (p < 0.001). Conclusions: In patients with EOMTCS, unilateral repetitive lengthening with TSGR can accelerate the growth of the concave side of USLs and improve the symmetry of the thorax.

Motion Parallax and Distance Estimation Underwater

1974 ◽  
Vol 38 (3) ◽  
pp. 747-750
Author(s):  
Steven H. Ferris
Keyword(s):  
Head Movement ◽  
Distance Perception ◽  
Motion Parallax ◽  
Distance Estimation ◽  
Vertical Axis ◽  
Improve Performance ◽  
Water Turbidity ◽  
Position Constancy ◽  
Before And After ◽  
Positive Results

The possible value of monocular motion parallax for improving distance perception underwater was investigated. Submerged Ss either kept their heads stationary or rotated their heads about a vertical axis while judging the distance of objects placed 4 to 15 ft. away. Both before and after training with feedback to increase accuracy of judgment, head movement did not significantly improve performance. Water turbidity and loss of position constancy are two probable reasons for the failure to replicate the positive results previously obtained in air.

scholarly journals Estimation of Factors that Affect the Metrological Characteristics of Target Flow Meters

2020 ◽  
pp. 27-34
Author(s):  
I. V. Korobko ◽  
A. V. Pysarets ◽  
A. M. Rak
Keyword(s):  
Vertical Axis ◽  
Positive Cone ◽  
Metrological Characteristics ◽  
Measuring Instruments ◽  
Flow Meters ◽  
Minimal Impact ◽  
Before And After ◽  
Effective System ◽  
Spatial Configurations ◽  
Abrupt Contraction

The article is devoted to the effective system crea­tion for recording liquids and gases flows. There is extremely relevant for creating metering units of fuel and energy resources. The aim of the work is to determine the influence of the flowed body geometric configuration of the sensitive element and its orientation relative to the direction of the flow on the hydrodynamic flow meter metrological characteristics, as well as determining the instruments’ rational location in the technological line Based on the example of the hydrodynamic class measuring transducers factors that have a significant impact on their metrological characteristics are determined, the degree of the transducers sensitivity to the measured medium flows asymmetry is revealed. The flows asymmetry is simulated by hydraulic resistan­ces of different spatial configurations (spatial elbow, elbow, double elbow, contraction, abrupt contraction). Simulation modeling of the operation of such devices is performed. Sensitive elements of different Gaussian curvatures such as zero (cylinder), positive (cone) and negative (hollow hemisphere) were studied. The value of the registration result uncertainty depends on the flow asymmetry and the instrument spatial orientation relative to the vertical axis in the technological network. The obtained results make it possible to clearly determine the instrument installation place in the technological network under conditions of maximum accuracy and minimal impact on the measured medium. This allows effectively using transducers in places of the technological network, taking into account the specific conditions for the metering units creation. There is no ne­cessary to make straight pipeline sections before and after the instruments. The researches results show that measuring instruments with flow bodies in the shape of a cone oriented the apex toward the flow are the best.

scholarly journals Pregnancy and delivery in patients with idiopathic scoliosis

2020 ◽  
Vol 17 (2) ◽  
pp. 15-22
Author(s):  
A. A. Snetkov ◽  
S. V. Kolesov ◽  
D. S. Gorbatyuk ◽  
A. A. Panteleyev ◽  
V. V. Shvets ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Spinal Anesthesia ◽  
Anesthetic Management ◽  
Mode Of Delivery ◽  
Deformity Correction ◽  
Reproductive Age ◽  
Lumbar Pain ◽  
Spine Deformity ◽  
Before And After ◽  
Pregnancy And Delivery

Objective. To analyze the course of pregnancy and delivery that occurred before and after surgical correction of idiopathic scoliosis with  instrumented fixation of the spine.Material and Methods. The paper presents a retrospective randomized study of 100 patients of reproductive age (18–35 years) with Lenke type 2–6 idiopathic scoliosis. The following aspects of pregnancy were analyzed: the possibility of independent conception, the pain severity according to VAS during each of the three trimesters of pregnancy, and the mode of delivery (naturally or by C-section). A comparative analysis of the data of patients operated on for the spine deformity correction before and after pregnancy and delivery was carried out. Data was collected using a questionnaire survey of patients. Detection and analysis of differences between groups were carried  out using the χ 2 criterion.Results. A statistical relationship was found between the presence of instrumentation installed before delivery (during or before pregnancy) and the need for C-section. It was revealed that the lower the caudal end of instrumentation within the L3–S1 region, the higher the C-section occurrence. Predominantly thoracic scoliosis (Lenke types 2–4) is characterized by higher likelihood of independent conception and lower lumbar pain intensity during pregnancy than predominantly lumbar scoliosis (Lenke types 5–6). There are also certain difficulties in conducting spinal anesthesia in patients with installed instrumentation, which negatively affects the possibility of its use.Conclusion. The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons who supervise them. The solution to this issue is impossible without cooperation with obstetrician gynecologists and anesthetists planning and administering anesthetic management during delivery (which is especially important in case of impossibility or significant restriction of spinal anesthesia use in such patients).

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