Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report

Introduction: This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD).Patient presentation, management and outcome: Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve of 65° Cobb. Because of the high risk for progression, immediate brace treatment was proposed as the father declined surgery. The patient received intensive treatment according to the Schroth Best Practice® programme and a Gensingen Brace® designed for large thoracic curves. Over the 18 months following the initial visit, she received two additional braces. As a result, the progression of the main curve was prevented. The patient continues to maintain an improved cosmetic result and is currently at a Risser 2.Conclusion: Surgery performed for CHD in rare cases may lead to stiff spinal deformity as a consequence of that surgery. Progression of a severe and stiff curve was prevented during the most vulnerable phase of the pubertal growth spurt with an improved clinical result. Therefore, we assume that the patient may have a normal life in adulthood with minor restrictions only. Supported by pattern-specific high correction exercises and braces, these typical single thoracic curves can be re-compensated to a more balanced appearance, less prone to progression in adulthood.Clinical implications: Because of the relative high risks of spinal fusion and the long-term unknowns of such an intervention, high-impact conservative treatment should be implemented first before surgical correction is considered.

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A Smartphone-based System to Improve Adherence in Scoliosis Therapy

i-com ◽

10.1515/icom-2016-0035 ◽

2016 ◽

Vol 15 (3) ◽

Author(s):

Susanne Dannehl ◽

Diana Seiboth ◽

Laura Doria ◽

Michael Minge ◽

Katharina Lorenz ◽

...

Keyword(s):

Feedback System ◽

Growth Spurt ◽

Term Therapy ◽

User Centered Design ◽

Pubertal Growth Spurt ◽

Therapeutic Success ◽

Therapy Goals ◽

Education Tool ◽

Long Term Therapy

AbstractThis project developed and evaluated a smartphone-based feedback system to improve adherence in long-term therapy of scoliotic curves occurring in pubertal growth spurt. A scoliosis means a physical deformity in spine, which can be treated with wearing a thoraco-lumbar orthosis (brace). The therapy is promising if the medical device is worn at least 16 hours a day for several years. To support the adolescent patients reaching their therapy goals, the barriers and resources for a successful bracing treatment were explored in several interviews and workshops with scoliosis patients. In scoliosis therapy, patients usually experience therapeutic success at the beginning of the treatment, whereas after six months the progress normally stagnates and motivation for long-term therapy decreases. In this article we describe the user-centered design of a quiz function as a health education tool within the aforementioned smartphone-based feedback system to improve adherence in long-term therapy of scoliotic curves.

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Generalised versus Regional Odontodysplasia: Diagnosis, Transitional Management, and Long-Term Followup—A Report of 2 Cases

Case Reports in Dentistry ◽

10.1155/2013/519704 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Mostafa Ibrahim Mostafa ◽

Nehad Samir Taha ◽

Mennat Allah Ismail Mehrez

Keyword(s):

Case Report ◽

Conservative Treatment ◽

Conservative Management ◽

Tooth Extraction ◽

Treatment Plan ◽

Treatment Options ◽

Uncommon Condition ◽

Regional Odontodysplasia ◽

Left Quadrant

Background. Odontodysplasia is an uncommon condition. It can be localised or generalised, isolated or part of a syndrome.Case Report. We first report the case of an 8.5-year-old boy who presented with abnormally shaped teeth and multiple intraoral abscesses. Findings of clinical and radiographic examinations were consistent with those of generalised odontodysplasia. A 2-step, conservative treatment plan was executed with a 10-year followup. Step 1 was root canal treatment of nonvital teeth. Step 2 was crowning without preparation of new vital, erupted, and malformed teeth. The second case is that of a 12-year-old girl who presented with lack of teeth in the upper-left quadrant. The impacted teeth were exposed surgically, and fixed restoration was performed for temporary aesthetic improvement.Conclusion. Instead of tooth extraction, an approach previously used in similar cases, conservative management is feasible and offers better prosthetic treatment options for the future.

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Use of a Modified Twin Block Appliance following Partial Maxillectomy: Case Report

British Journal of Orthodontics ◽

10.1179/bjo.23.2.103 ◽

1996 ◽

Vol 23 (2) ◽

pp. 103-108 ◽

Cited By ~ 1

Author(s):

H. C. Moseley ◽

E. N. Horrocks ◽

R. R. Welfare

Keyword(s):

Case Report ◽

Orthodontic Treatment ◽

Class Ii ◽

Growth Spurt ◽

Class Ii Malocclusion ◽

Pubertal Growth Spurt ◽

Twin Block ◽

Pubertal Growth ◽

Skeletal Pattern ◽

The Right

A case is described in which a Class II malocclusion with severe Class II skeletal pattern was treated with a modified Twin Block Appliance. The patient, an II-year-old girl, had initially presented with an ameloblastoma located in the right maxilla. The subsequent defect produced by surgery was obturated by the appliance during her orthodontic treatment, which was undertaken during her pubertal growth spurt Two years later the result was stable, allowing the provision of a more definitive prothesis to restore the occlusion.

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Challenging Regimen for Long-Term Conservative Treatment of Endometrial Adenocarcinoma in Young Women: A Case Report and Review of the Literature

Case Reports in Oncology ◽

10.1159/000321731 ◽

2010 ◽

Vol 3 (3) ◽

pp. 380-385 ◽

Cited By ~ 3

Author(s):

Prasong Tanmahasamut ◽

Thanyarat Wongwananuruk

Keyword(s):

Case Report ◽

Conservative Treatment ◽

Young Women ◽

Endometrial Adenocarcinoma ◽

Review Of The Literature

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Control of juvenile idiopathic scoliosis during pubertal growth spurt through conservative treatment: a retrospective observational study

Scoliosis ◽

10.1186/1748-7161-5-s1-o74 ◽

2010 ◽

Vol 5 (S1) ◽

Author(s):

Claudia Fusco ◽

Fabio Zaina ◽

Stefano Negrini

Keyword(s):

Conservative Treatment ◽

Observational Study ◽

Idiopathic Scoliosis ◽

Retrospective Observational Study ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Juvenile Idiopathic Scoliosis ◽

Pubertal Growth

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Delayed Pubertal Growth Spurt and Normal Adult Height Attainment in Boys Receiving Long-term Alternate-day Prednisone Therapy

Clinical Pediatrics ◽

10.1177/000992289903800505 ◽

1999 ◽

Vol 38 (5) ◽

pp. 279-285 ◽

Cited By ~ 7

Author(s):

Cesare Polito ◽

Angela La Manna ◽

Maria Rosaria Papale ◽

Giuseppina Villani

Keyword(s):

Adult Height ◽

Normal Adult ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Prednisone Therapy ◽

Pubertal Growth

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Prepubertal Glucocorticoid Status and Pubertal Timing

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-2935 ◽

2011 ◽

Vol 96 (6) ◽

pp. E891-E898 ◽

Cited By ~ 13

Author(s):

Lijie Shi ◽

Stefan A. Wudy ◽

Anette E. Buyken ◽

Christiane Maser-Gluth ◽

Michaela F. Hartmann ◽

...

Keyword(s):

Pubertal Timing ◽

Tanner Stage ◽

Peak Height ◽

Pubic Hair ◽

Height Velocity ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Peak Height Velocity ◽

Adrenal Androgen ◽

Pubertal Growth

Context: Whether prepubertal glucocorticoid status impacts on the timing of puberty is not clear. Objective: The objective of the study was to examine the relationship between prepubertal glucocorticoid status and early or late pubertal markers, independent of adrenarchal and nutritional status. Design and Participants: Prospective cohort study of healthy Caucasian children (n = 111, 56 boys) who provided both 24-h urine samples and weighed dietary records 1 and 2 yr before the start of pubertal growth spurt [age at take-off (ATO)]. Measurements: Major urinary glucocorticoid and androgen metabolites determined by gas chromatography-mass spectrometry analysis were summed to assess daily overall cortisol (ΣC21) and adrenal androgen secretion; urinary free cortisol and cortisone measured by RIA were summed (UFF+UFE) as an indicator of potentially bioactive free glucocorticoids. Main Outcomes: The main outcomes included ATO, age at peak height velocity, age at menarche/voice break, ages at Tanner stage 2 for breast (girls) and genital (boys) development, and pubic hair. Results: In girls ΣC21, but not UFF+UFE, was associated with pubertal markers after adjusting for overall adrenal androgen, urinary nitrogen, and body fat. Girls with higher ΣC21 (fourth quartile) reached ATO 0.7 yr (P = 0.01) and menarche 0.9 yr later (P = 0.006) than girls with lower ΣC21 (first quartile). The ΣC21 tended to be also positively associated with age at Tanner stage 2 for breast (P = 0.1), Tanner stage 2 for pubic hair (P = 0.1), and age at peak height velocity (P = 0.06). In boys, neither the ΣC21 nor UFF+UFE was related to pubertal timing. Conclusion: An individually higher prepubertal glucocorticoid secretion level, even in physiological range, appears to delay early and late pubertal timing of healthy girls, particularly their onset of pubertal growth spurt and menarche.

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