Effects of living environment on the postoperative Scoliosis Research Society-24 results in females with adolescent idiopathic scoliosis.

BACKGROUND: There are many factors influencing postoperative health-related quality of life of adolescent idiopathic scoliosis patients, including the degree of the deformity, culture, differences in geography, rural versus urban living environments, and social factors. The objective of this study was to analyze the significance of geographic factors and their differences influencing the postoperative quality of life in females with adolescent idiopathic scoliosis residing in urban and rural environments, by use of the Polish version of the SRS-24 questionnaire. MATERIAL/METHODS: Forty urban and 20 rural postoperative patients with adolescent scoliosis with a minimum 2-year follow-up period after surgery were included in the study. The process of cross-cultural adaptation was performed according to the IQOLA Project. RESULTS: General results of the Polish SRS-24 equalled 4.1 (SD 0.5) and 4.0 (SD.0.5) in the rural and urban groups of patients, respectively. The 2 groups do not differ in incidence of floor and ceiling effects. The Cronbach's alpha values are excellent for the general result of SRS-24 in urban and rural groups (0.85 and 0.85, respectively). The sub-groups differed significantly in the self-image after surgery domain (p=0.048). CONCLUSIONS: Patients from the rural group scored higher in the self-image after surgery domain but reported higher pain levels when compared to urban patients. The associations between SRS-24 results and radiographic parameters in the rural group of patients were strong, compared with moderate relations reported in the urban group.

Limb shortening in the course of solitary bone cyst treatment--a comparative study.

OBJECTIVE: The aim of this paper is to evaluate the frequency of limb shortening in the course of solitary bone cyst treatment. The correlation between the mode of treatment as well as the occurrence of pathological fracture, cyst location, volume, and locularity were examined. MATERIALS AND METHODS: A retrospective analysis was carried out on 135 patients where 80 underwent curettage and bone grafting and 55 were administered methylprednisolone injection with a mean time to follow-up of 12 years. RESULTS: Based on clinical and radiological evaluation, limb shortening was found in ten patients when the data before and after treatment was compared. Limb shortening ranging from 1 to 5 cm during the course of the treatment was observed: six in humerus, two in femur, two in tibia. Those with epiphyseal changes, magnetic resonance imaging to evaluate the degree of growth plate damage was performed. Patients with and without limb shortening did not differ statistically regarding the applied method of treatment. The cyst volume was significantly larger in the group of patients with limb shortening when compared to the group of patients with no limb shortening. CONCLUSIONS: In patients treated with curettage and bone grafting, the mode of treatment does not increase the frequency of occurrence of iatrogenic limb shortening. In patients with limb shortening, a statistically significant larger volume of the cyst was observed.

Differences in deformity and bracing-related stress between rural and urban area patients with adolescent idiopathic scoliosis treated with a Cheneau brace.

The aim of the study was to compare the difference in stress levels between adolescent female groups of patients from urban and rural areas who were treated conservatively with an idiopathic scoliosis. The study comprised 2 groups of patients, 34 from an urban and 30 from a rural area, with a minimum application of a Cheneau brace for 12 hours a day, for a minimum of 1 month. Two study groups completed the Polish version of both Bad Sobernheim Stress Questionnaire-Deformity and Bad Sobernheim Stress Questionnaire-Brace. Both groups of patients felt moderate stress connected with conservative treatment and low stress related to trunk deformation. No difference was observed in stress level related to body disfigurement and conservative treatment between the 2 groups of patients. In the rural group of patients, a correlation between the apical translation and stress related to deformity was observed. No significant differences were stated in stress levels and coping mechanisms between patients from rural and urban areas, treated conservatively due to idiopathic scoliosis. A difference was observed, however, regarding the correlation connected with the apical translation and stress level.

Evaluation of volume and solitary bone cyst remodeling using conventional radiological examination.

OBJECTIVE: To evaluate cyst remodeling, including complete healing and recurrence, and its relation to the cyst volume in two groups of patients, using curettage and bone grafting or methylprednisolone injection. MATERIALS AND METHODS: A retrospective analysis was carried out on data from 132 patients with solitary bone cyst, where 79 (59.9%) had undergone curettage and bone grafting and 53 (40.1%) had been administered methylprednisolone injection, with a mean time to follow up of 12 years. The cyst volume was evaluated from conventional radiographs and the method originally reported by Göbel et al. to evaluate the volume of Ewing's sarcoma. The results were analyzed using the criteria of Neer et al. and Capanna et al. RESULTS: The mean cyst volume was 36.8 cm(3). Recurrence was noted in 16 (20.2%) patients treated with curettage and in nine (17.0%) treated with methylprednisolone. Cyst volume in patients treated with curettage and bone grafting ranged from 8.3 cm(3) to 100.0 cm(3) and with methylprednisolone from 14.0 cm(3) to 50.6 cm(3) . In neither group was the cyst volume related to recurrence. Volumes from 1.3 cm(3) to 81.9 cm(3) were stated for patients treated with curettage and bone grafting, when complete healing was observed; they were significantly lower than for those of the total group of patients who underwent curettage and bone grafting. CONCLUSIONS: 1. An association between solitary cyst volume and recurrence in patients treated with either bone curettage and grafting or methylprednisolone was not found. 2. The frequency of complete healing in patients treated with bone curettage and grafting decreased with an increase in the cyst volume.