Anterior intervertebral disc herniations in children. Report of four cases

Four boys with anterior lumbar disc herniations probably secondary to chronic trauma are reported. Anterior disc herniations may appear as separate lesions-as in our patients-or coexist with Scheuermann's disease. Although Scheuermann's disease, discitis and tuberculosis are regarded as the most common causes of intervertebral disc lesions in childhood, trauma should be excluded as a possible cause in all children with chronic back pain who show localised radiographic signs of narrowed disc spaces with erosive and sclerotic changes in the adjacent vertebrae. Localised mild platyspondly may be the result of abnormal, prolonged stress and early osteoarthritic changes are to be expected.

[The radiology of Egyptian mummies (author's transl)]

The technique used for the radiological examination of a well preserved mummy is described. Problems of identification and determination of age, size and sex are discussed. Post mortem changes consist of subluxation of the cervical spine and fractures of the ribs and fibulae. Of medical interest, it was possible to diagnose definitely Scheuermann's disease with a scoliosis and marked reactive spondylotic and spondylo-arthritic changes. The radiological findings provided further information regarding the technique of mummification and the method of burial. Some findings of mythological significance could be demonstrated radiologically, such as the fact that the heart and kidneys had been left in the body, the presence of a scarab, various gold plates and amulets and a fayence-decorated shroud.

Scheuermann's kyphoscoliosis associated with Charcot-Marie-Tooth syndrome

Much confusion and disagreement exists regarding the classification and characteristics of inherited disorders manifesting neurogenic muscular atrophy. Many authors consider Charcot-Marie-Tooth syndrome (CMTS) and Roussy Levy syndrome (RLS) forme fruste or variants of Friedreich's ataxia (FA). Familial kyphoscoliosis has often been described in FA and RLS but not with CMTS. The purpose of this paper is to present detailed clinical and laboratory findings in a family with three cases of Scheuermann's kyphoscoliosis and CMTS in three generations. In all cases Scheuermann's kyphoscoliosis was associated with pes cavus, markedly diminished vibratory and position sensation in the lower extremities, absent deep tendon reflexes and muscular atrophy, predominantly of the distal muscles. Fine rhythmic tremor of outstretched hands and positive Romberg sign were present in one case only. Serum creating phosphokinase was elevated in two cases. Motor nerve conduction studies revealed impaired function in the median, ulnar, tibial and peroneal nerves. Sensory nerve conduction wal also impaired in median and ulnar nerves. There was evidence of left ventricular hypertrophy in one case only. The nosology and relationship between CMTS, RLS and FA are discussed.

Scheuermann's kyphosis. Results of surgical treatment by posterior spine arthrodesis in twenty-two patients

Twenty-two patients with Scheuermann's kyphosis were treated with correction, Harrington instrumentation (in twenty-one), and posterior spine fusion. This procedure relieved pain and corrected deformity in all patients but loss of correction of 5 degrees or more occurred in sixteen of the twenty-two patients, including all those whose initial kyphosis was greater than 70 degrees. The incidence of complications was so high that this procedure should ordinarily be performed only for disabling pain or spinal cord compression.