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• #56: CIFOSIS O ESPALDA REDONDEADA GIBA O JOROBA GIBA DE DOWAGER ESPALDA PLANA
• #58: Background Scheuermann disease (juvenile kyphosis) is a deformity in the thoracic or thoracolumbar spine in children. Patients have an increased kyphosis in the thoracic or thoracolumbar spine with associated backache and localized changes in the vertebral bodies. Pathophysiology Scheuermann disease refers to osteochondrosis of the secondary ossification centers of the vertebral bodies. The lower dorsal and upper lumbar vertebrae are involved initially. The process may be limited to several bodies or may involve the entire dorsal and lumbar spine. Scheuermann disease probably is heterogeneous (ie, not a single entity but a group of conditions sharing similar features). The etiology and pathogenesis are a matter of debate. Many theories have been advanced, including mechanical, metabolic, and endocrinologic causes. A definite hereditary component is involved in the development of the condition, but the mode of inheritance has been debated. Reports of identical radiological changes in monozygotic twins and transmission over 3 generations suggested underlying heritability. In study by by McKenzie and Sillence, 12 probands were referred, and, upon radiological examination of their parents and siblings, 7 were shown to have familial Scheuermann disease with an autosomal dominant pattern of inheritance. Of the remaining 5 probands, 4 had chromosomal anomalies. Patients with Scheuermann kyphosis generally are affected at 13-16 years, are taller than comparably aged peers, and have advanced skeletal versus chronologic age. Some affected children have disproportionate limb lengths. In a Finnish study, left-handedness was found to be a powerful determinant of hyperkyphosis in school children before puberty. An increased incidence of spondylolysis and spondylolisthesis also was reported in patients with Scheuermann kyphosis, and scoliosis in the region of kyphosis is reported in 20-30% of patients as well. According to some authors, the presence of an adjacent area of lordoscoliosis below the region of hyperkyphosis testifies to the common nature of the pathogenesis of idiopathic scoliosis and Scheuermann disease. Scheuermann kyphosis may be associated with an epidural cyst with an ensuing neurologic deficit. Osteochondrosis is a family of orthopedic diseases of the joint that occur in children and in rapidly growing animals, particularly pigs, horses, and dogs. They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis, [1] followed by localized bony necrosis,[2] and later, regrowth of the bone.[3] This disorder is defined as a focal disturbance of enchondral ossification and is regarded as having a multifactorial etiology, so no one thing accounts for all aspects of this disease.[1] Today 40% to 80% of people suffer from osteochondrosis. This disease mainly affects people who are older than 30, but sometimes young people may experience its symptoms at the age of 15 to 20. Women are more succeptable to osteochondrosis than men, but men experience more acute pains. The ultimate cause for these conditions is unknown, but the most commonly cited etiologic factors are rapid growth, heredity, trauma (or overuse), anatomic conformation, and dietary imbalances; however, only anatomic conformation and heredity are well supported by scientific literature. The way that the disease is initiated has been debated. Although failure of chondrocyte differentiation, formation of a fragile cartilage, failure of blood supply to the growth cartilage, and subchondral bone necrosis all have been proposed as the starting point in the pathogenesis, recent literature strongly supports failure of blood supply to growth cartilage as most likely.[1] Osteochondrosis in pigs has been shown to be a condition responsive to supplementation with the essential trace element boron and may be a manifestation of boron deficiency
• #81: http://escuela.med.puc.cl/publ/OrtopediaTraumatologia/Trau_Secc02/Trau_Sec02_08.html y magee.