BackgroundCerebral Palsy (CP) is the most common motor disability reason of childhood that occurs secondarily to non-progressive damage in the brain whose development is still ongoing.Methods6-year-old dystonic-spastic male CP patient received allogenic mesenchymal stem cells treatment four times as 1×106/kg in intrathecal and intravenous administration of Umbilical Cord-derived mesenchymal stem cells (UC-MSCs) ways. Before and after the treatment, the patient was followed-up with FIM (Functional Independent Measurement), GMFCS (Gross Motor Function Classification System 88), Tardieu Scale, TCMS (Trunk Control Measurement Scale), MACS (Manual Ability Classification Scale), CFSS (Communication Function Classification System) for 18 months and received intensive rehabilitation.ResultsImprovements were observed especially in functional scales except for the Tardieu Scale, and no adverse effects were detected aside from a slight pain in the back.ConclusionWider future case studies on UC-MSCs will enable us to assess the efficacy of UC-MSCs which have positive impacts especially on functional scales.
Purpose There exist not much data regarding the surgical treatment of pure congenital kyphosis (CK) in the literature. The purpose of this study was to evaluate the results of closing wedge osteotomy with posterior instrumented fusion in patients with congenital kyphotic deformity. Methods We retrospectively evaluated the radiographical results of 10 patients who were subject to closing wedge vertebral osteotomy and posterior instrumented fusion due to CK. The mean age of the patients at surgery was 12.6 ± 3.72 years (range 8-18 years). Radiographical measurements including local kyphosis, correction loss, global kyphosis and sagittal balance values were noted for the preoperative, postoperative and final follow up periods, respectively. The data obtained from those periods underwent statistical analysis. Results Average follow-up period was 51.8 ± 29.32 months (range 26-96 months). The mean local kyphosis angle was 67.7°± 15.64°(range 42°-88°) prior to the surgery, 31.5°± 17.12 (range 14°-73°) following the surgery and 31.9°± 15.98°(range 14°-71°) during the follow up-period, respectively (p \ 0.05). A correction rate of 53.5 % was reported at the final follow up. Average sagittal balance was measured as 33.1 ± 24.48 mm (range 2-77 mm) prior to the surgery, 20.8 ± 15.46 mm (range 5-46 mm) following the surgery (p \ 0.05) and 14.1 ± 9.2 mm (range 0-30 mm) during follow-up period (p [ 0.05).
Long-term clinical and radiographic outcomes of primary resection for Mason type III radial head fractures were evaluated in 13 patients (14 elbows) with a mean age of 38.8 years (range, 20-67 years) at the time of surgery. All patients had isolated radial head fractures without associated injuries. Mean follow-up was 14.7 years (range, 9-26 years). Proximal migration of the radius and the carrying angle were measured, and radiographs were reviewed for degenerative elbow and wrist arthritis and periarticular ossification. Five results were excellent and 9 were good. In 8 cases, the radii had migrated proximally and the carrying angle had increased an average 6.3°; the increases in both ulnar variance and the carrying angle were significant, and a significant negative correlation was found between the carrying angles and the clinical scores. Degenerative changes occurred in 8 elbows and 4 wrists, and periarticular heterotopic ossification was present in 3 elbows. Despite the satisfactory long-term outcomes, radial head resection resulted in proximal migration of the radius and an increase in the carrying angle; in addition, osteoarthritic changes in both elbows and wrists as well as periarticular heterotopic ossification were frequent findings without pronounced functional impairment.
Significant improvement was found in the global thoracic kyphosis angle, by comparing the preoperative, the early postoperative and the last follow-up parameters statistically (p < 0.05). There was no statistically significant improvement in the spinopelvic parameters (p > 0.05). We claim that growing rod technique doesn't provide statistically significant improvement, in the sagittal spinal and the spinopelvic parameters, except for the kyphosis, in the treatment of EOS patients.
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