Publications (7) View all
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Article: Predictors of Back Pain in Adolescent Idiopathic Scoliosis Surgical Candidates.
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ABSTRACT: BACKGROUND:: There are contradictory reports on the overall prevalence of back pain in the adolescent population compared with adolescent idiopathic scoliosis (AIS) patients. Most reports do not investigate pain in patients with AIS but try to identify in which subgroup of patients with AIS an underlying pathology should be excluded. The objective of this study was to find whether AIS in operative candidate patients is a painful condition and to try and find clinical and radiologic predisposing factors, which will help us to predict patients who are going to have pain. METHODS:: Candidates who had to undergo an operative treatment for AIS between October 2004 and October 2009 in our institution, were enrolled to the study. Pain was graded with the use of visual analogue scale (VAS) on a scale from 0 to 10. We recorded the age at presentation, sex, menarchal status, family history of scoliosis, brace treatment history, and neurological findings. Radiologic parameters recorded were: the type of curve according to the Lenke classification, Cobb angle, thoracic kyphosis angle, apex vertebra rotation, Risser grade, coronal balance, and curves flexibility. RESULTS:: Seventy patients with AIS were included in this study. Fifty patients (71%) reported of some kind of back pain with 34 patients (48%) grading their pain as ≥5 on the VAS.Patients in whom scoliosis was diagnosed in older age and patients with a more rigid lumbar curve had statistically significant higher VAS scores (P=0.014, P=0.036). Patients who were treated with a brace had a statistically significant lower VAS scores (P=0.019). CONCLUSIONS:: Back pain is common in patients with AIS who are candidates for operative treatment. The following parameters correlate with worse back pain: older age at diagnosis, no use of brace, and rigid lumbar curve. LEVEL OF EVIDENCE:: Type III.Journal of pediatric orthopedics 04/2013; 33(3):289-292. · 1.23 Impact Factor -
Article: [The thumb in agony--osteoarthritis of the thumb].
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ABSTRACT: Osteoarthritis of the basal joint of the thumb is common, particuLarLy in postmenopausal females. The male to female ratio is 1:10 respectively. Basal joint arthritis can cause considerable pain and disability. Incompetence of the volar beak ligament is thought to be the pivotal injury that will eventually lead to joint degeneration. Patient history and physical examination can reliably lead to the diagnosis. Radiographs are used for the evaluation of the severity of the arthritis and for treatment strategy. Conservative treatment can be effective in the early stages of the disease. Operative treatment has been shown to be successful in relieving pain and restoring thumb function. The majority of reconstructive procedures include partial or complete trapezectomy with beak ligament reconstruction and tendon interposition.Harefuah 10/2011; 150(10):797-800, 813. -
Article: Metastasis of parotid basal cell adenocarcinoma to the hand-a case report.
Hand 09/2011; 6(3):321-3. -
Article: [Treatment for Pott's disease with neurological complication].
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ABSTRACT: Tuberculosis of the spine (Pott's disease) is the most common skeletal involvement in tuberculosis, and is often accompanied with neurological deficiency. Surgical treatment was previously the mainstay of therapy in cases of Pott's disease with neurological deficiency, but since clinical recovery was found in patients awaiting surgery, conservative management with antibiotic treatment as a first Line treatment has been advocated. This conservative approach may improve the patients' neurological status while avoiding the morbidity and mortality of surgical treatment.Harefuah 05/2011; 150(5):480-3, 489, 488. -
Article: Neonatal course and outcome of twins from reduced multifetal pregnancy versus non-reduced twins.
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ABSTRACT: Multifetal pregnancy reduction has been implemented for improving the outcome of multifetal pregnancies. Recent studies reported no difference in pregnancy outcome between reduced twins and non-reduced twins, but the neonatal course and subsequent outcome in reduced twin pregnancies were not well documented. To compare the neonatal course and outcome, as well as the gestational and labor characteristics in twins from reduced multifetal pregnancies and in non-reduced twins. This is a retrospective case-control study of the neonatal course of twins from reduced multifetal pregnancies. We found 64 mothers with multifetal pregnancy reduction who delivered twins during 1989-1997; 64 gestational age-matched non-reduced twin pregnancies served as controls. The following neonatal variables were examined: major malformations; small birth weight for gestational age; and neonatal morbidities including respiratory distress syndrome, apnea, pneumothorax, bronchopulmonary dysplasia, hyperbilirubinemia, sepsis, necrotizing enterocolitis, retinopathy of prematurity, seizures, intraventricular hemorrhage, periventricular leukomalacia, ventriculomegaly, and hydrocephalus. In addition, we evaluated several neonatal interventions (surfactant replacement, mechanical ventilation, phototherapy, total parenteral nutrition), and some laboratory abnormalities (thrombocytopenia, leukopenia, anemia, and hypoglycemia), duration of hospitalization, and neonatal mortality. Gestational and labor variables were not significantly different between multifetal pregnancies reduced to twins and non-reduced twin pregnancies. The neonatal morbidity and mortality were not significantly different between twin neonates from multifetal pregnancy reduction and non-reduced control twins. Multifetal pregnancy reduction to twins appears to bear no adverse effect on the intrauterine course of the remaining fetuses or their neonatal course and outcome when born after 28 weeks of gestation.The Israel Medical Association journal: IMAJ 05/2003; 5(4):245-8. · 1.02 Impact Factor
