By Stuart L. Weinstein MD
ISBN-10: 0781719089
ISBN-13: 9780781719087
Written by means of a world, multidisciplinary crew of specialists, this quantity is a definitive reference on all nonoperative points of the pediatric backbone. insurance starts off with developmental anatomy, biomechanics, an in-depth evaluation of imaging, and a close advisor to sufferer review. next sections hide all issues affecting the pediatric spine--congenital and developmental abnormalities, aggravating accidents, inflammatory and infectious stipulations, neoplasms and malformations, metabolic affliction, and neuromuscular ailments. The participants provide authoritative recommendation at the clinical and/or surgical operation innovations for every situation. each one bankruptcy incorporates a entire bibliography. additionally incorporated is a close appendix of radiographic measurements, classifications, and definitions.
A Brandon-Hill advised title.
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Additional info for The pediatric spine : principles and practice
Example text
The notochord is evident within C2 and C3. Ossification is beginning in C6 and C7. The incompletely closed neural canal extends from the brain to C4. B, C: Higher-power views demonstrate these hypertrophic preossification centers (B, sagittal; C, transverse). The ingrowing cartilage canals still do not reach these regions, and there is no peripheral bone collar, as in primary ossification of a long bone. FIGURE 20. A: Irregular ossification of a cervical vertebral centrum. This variable ossification may be the basis for the concept of six ossification centers.
34). These growth plates are characterized by an area of rapidly maturing cartilage that grades imperceptibly into the other cartilage of the chondroepiphysis. Although the primary function of the physis is to provide a mechanism for longitudinal growth, it also contributes greatly to circumferential expansion of the vertebral centrum. These physes change to variably undulated structures as the centrum increases in height and postnatal biomechanical demands change (260). Measurements of static diaphyseal regions such as the entrance of the nutrient artery suggest relatively equal contributions of each end plate physis to the height of the individual vertebrae.
Radiolucent cartilaginous, vascular, and neuromuscular structures may be altered or deficient and may thwart well-planned attempts at improvement if treatment is based only on radiologically evident changes (62). Acquired diseases and injuries can alter normal patterns of growth and necessitate modification of otherwise standard approaches, especially if the principles of adult surgery are applied. Deformities may recur among children because of inability to correct the causal (whether genetic or acquired) growth aberration.