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Title: Osteoporosis in unstable adult scoliosis

Abstract

New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

Authors:
; ;
Publication Date:
Research Org.:
Hospital for Special Surgery, New York, NY (USA)
OSTI Identifier:
6516267
Resource Type:
Journal Article
Resource Relation:
Journal Name: Clin. Orthop. Relat. Res.; (United States); Journal Volume: 237
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; SKELETAL DISEASES; DIAGNOSIS; SKELETON; EMISSION COMPUTED TOMOGRAPHY; AGE DEPENDENCE; MINERALS; OSTEOPOROSIS; PATIENTS; BODY; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DISEASES; ORGANS; TOMOGRAPHY; 550602* - Medicine- External Radiation in Diagnostics- (1980-)

Citation Formats

Velis, K.P., Healey, J.H., and Schneider, R. Osteoporosis in unstable adult scoliosis. United States: N. p., 1988. Web. doi:10.1097/00003086-198812000-00019.
Velis, K.P., Healey, J.H., & Schneider, R. Osteoporosis in unstable adult scoliosis. United States. doi:10.1097/00003086-198812000-00019.
Velis, K.P., Healey, J.H., and Schneider, R. 1988. "Osteoporosis in unstable adult scoliosis". United States. doi:10.1097/00003086-198812000-00019.
@article{osti_6516267,
title = {Osteoporosis in unstable adult scoliosis},
author = {Velis, K.P. and Healey, J.H. and Schneider, R.},
abstractNote = {New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.},
doi = {10.1097/00003086-198812000-00019},
journal = {Clin. Orthop. Relat. Res.; (United States)},
number = ,
volume = 237,
place = {United States},
year = 1988,
month =
}
  • By a combination of balance and isotope techniques, the following parameters of Ca metabolism were measured: pool size, rate of loss from pool, urinary excretion, fecal excretion, intake, endogenous fecal Ca, absorption, balance, bone formation, and bone resorption. The subjects were two normal women and five women with postmenopausal osteoporosis, aged 41 to 74 years, and four patients with scoliosis, aged 12 to 22 years. The latter were studied before, shortly after, and many months after immobilization in plaster casts. On the basis of observed relationships, it appeared that the negative Ca balance observed in the older women was duemore » to the low intensity of the various vectors of Ca metabolism, without clearcut distinction between the subjects with and without osteoporosis. Conversely, in the young patients with scoliosis, the negative balance incident to treatment by immobilization was associated with vectors of relatively high intensity whose relationships were altered temporarily.« less
  • In vivo activation analysis was compared with ashing and atomic absorption spectrophotometry for the determination of total skeletal calcium content in mice. The results were close to identical. The possible mutagenic-carcinogenic effect of repeated exposure to whole body neutron irradiation was studied by chromosome analysis. Under the conditions of these experiments, no significant chromosome changes were seen.
  • Radiation exposure to the breasts of adolescent females can be reduced significantly through the use of one or all of the following methods: fast, rare-earth screen-film combinations; specially designed compensating filters; and breast shielding. The importance of exposure reduction during scoliosis radiography as well as further details on the above described methods are discussed. In addition, the early results of a Center for Devices and Radiological Health study, which recorded exposure and technique data for scoliosis radiography, is presented.
  • The radiation exposure resulting from standard scoliosis radiographs was determined for eighteen adolescent girls. The risk of inducing breast cancer was estimated from the skin-exposure doses. The average skin exposure to the breasts was 59.6 millirads (0.59 mGy) for the anteroposterior radiograph. Assuming a total of twenty-two anteroposterior radiographs during a course of treatment, the cumulative exposure would result in a 1.35% relative increase in the risk of development of breast cancer. By utilizing collimation of the x-ray beam and proper selection of grids, films, and screens, the radiation risk of scoliosis radiographs is minimized.