RESUMO
STUDY DESIGN: Retrospective, multicenter review of the spinopelvic parameters in young children with scoliosis. OBJECTIVES: To describe sagittal alignment of the spine and pelvis in young children with scoliosis. SUMMARY OF BACKGROUND DATA: The natural history of spinopelvic parameters has been defined for the first 10 years of life in normal children; however, they have not been described for children with scoliosis. Such information is important because these values can be used as a baseline for the assessment of radiographic outcomes after surgical intervention. METHODS: Seven measures of sagittal alignment were taken from standing lateral radiographs of 80 children with scoliosis (coronal Cobb angle greater than 50°) and compared with age-matched normal children described in the literature. Statistical analysis was performed using 2-tailed Student t tests (level of significance = .05) and Pearson correlation coefficient. RESULTS: Patients had a mean age of 4.8 years (range, 1-10 years) and a mean Cobb angle of 72.0° ± 16°. Mean sagittal spine parameters were sagittal balance (2.2 ± 4 cm), thoracic kyphosis (38.0° ± 20.8°), and lumbar lordosis (49.0° ± 16.6°). These values were similar to those of children without scoliosis. Mean sagittal pelvic parameters were: pelvic incidence (46.5° ± 15.8°), pelvic tilt (10.7° ± 13.6°), sacral slope (35.5° ± 12.1°), and pelvic radius (55.7° ± 21.3°). Pelvic incidence was not significantly different from that of age-matched normal children; however, pelvic tilt was significantly higher and sacral slope was significantly lower in children with scoliosis. CONCLUSIONS: Sagittal plane spine parameters and some pelvic parameters were similar for young children with scoliosis versus age-matched normal children; however, children with scoliosis showed signs of increased pelvic tilt and decreased sacral slope. These values can be used as a baseline for both the natural history and the assessment of radiographic outcomes after surgical intervention.
RESUMO
Carpometacarpal (CMC) arthritis of the thumb affects half of postmenopausal women and up to 25% of elderly men. This disease can cause significant disability in affected patients often necessitating surgical intervention. Various surgical options have been used to treat refractory CMC arthritis. Any successful surgical intervention must address three goals: removal of diseased joint surfaces, reconstruction of ligamentous stabilizers, and preservation of the joint space. In this article we will discuss various interposition arthroplasty options for CMC arthritis of the thumb.