Infantile idiopathic scoliosis in the newborn.

We have reviewed 7 patients (5 boys and 2 girls) with infantile idiopathic scoliosis which was present at birth and was diagnosed at ages from 1 day to 1 month. The mean follow up was 16 years. The objectives were to discover whether intrauterine forces play a role in the aetiology and to determine whether early treatment of a potentially progressive curve can induce resolution. Two infants were male conjoined twins and were united by skin over the posterior sacrum. Six infants had a rib vertebral angle difference greater than 20 degrees in the first radiograph and 5 had stiff curves. In 2 with flexible curves, the deformity disappeared by the end of the first year. The 5 with stiff curves were treated conservatively for 6 to 24 months. Growth has now been completed in 5; 4 have a straight spine and one developed an adolescent curve of 26 degrees. The 2 who are still growing have no scoliosis. Intrauterine moulding was only demonstrated in the conjoined twins. There was a correlation between the rib vertebral angle difference above 20 degrees and the rigidity of the curve. Early treatment of a potentially progressive curve can lead to resolution.

[Peripheral arterial vasoocclusive disease: no absolute contraindication to beta receptor blockers (author's transl)]. / Periphere arterielle Verschlusskrankheit: keine absolute Kontraindikation von Beta-Rezeptorenblockern.

An initial dosis of 40 mg followed by 40 mg propranolol (Dociton) t.i.d. for 4 weeks was administered to 16 hypertensive patients with manifest arterial vasoocclusive disease of the pelvic and thigh type (stage II according to Fontaine). Blood pressure decreased 90 minutes after the first oral administration from 174/106 to 155/93 mm Hg. Cardiac frequency was lowered significantly from 75 to 66/min. Occlusion plethysmography and Doppler pressure estimation were not changed significantly either in the acute nor in long-term assessment. The painfree walking distance remained constant 90 minutes after propranolol initially (baseline value 230 m, after 90 minutes 220 m). It rose to 330 m after two weeks and to 350 m after four weeks. Use of beta receptor blocker in arterial vasoocclusive disease is thus not contraindicated, at least as far as stage II is concerned.