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Title: Deformities of the spine
Author: McMaster, M. J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2011
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Deformities of the spine occur as a consequence of a number of different aetiologies each with a differing pathogenesis and natural history. The resulting deformity may be a scoliosis which is a lateral curvature of the spine in the frontal plane, a kyphosis which is an abnormal posterior curvature in the sagittal plane or a kyphoscoliosis which is a combination of both deformities. Significant progression of the curvature can occur with spinal growth and result in a very severe deformity with a major effect on general health, longevity and quality of life. If the deformity develops and progresses in early childhood, it can result in an impairment of lung growth and development possibly leading to cor pulmonale and death in early adult life. A kyphosis or kyphoscoliosis can cause spinal cord compression and if left untreated can result in paraplegia. Some patients develop back discomfort in later life, due to secondary degenerative arthritic changes, and others have a reduced selfimage leading to psychological disturbances. Knowledge of the natural history is essential in anticipating problems and is the benchmark by which treatment is evaluated. This collection of work is based on my studies of the aetiology, pathogenesis, natural history and management of patients with deformities of the spine seen over a period of 35 years while working as a spinal surgeon in Edinburgh. In 1975, I was appointed Senior Lecturer and Consultant Orthopaedic Spine Surgeon, working with Prof. J I P James in the Department of Orthopaedic Surgery, University of Edinburgh. It was here that I was able to establish a large database of patients, especially those with congenital deformities of the spine, who had previously received little or no treatment. This provided me with invaluable information and stimulated my lifelong interest in the natural history and allowed me to formulate an appropriate course of management for these conditions. In 1978, when Prof. James retired I took over his clinical practice and established the Edinburgh Spine Deformity Centre which later became, under my directorship, the Scottish National Spine Deformity Centre treating all patients from the whole of Scotland. At present there is virtually no severity of spinal deformity which cannot be significantly improved by surgery. However, it should be recognized that the necessity for surgical salvage procedures at a late stage, to correct severe deformities for conditions commencing as minor curves in infancy or adolescence, indicates a failure of management. This thesis emphasizes the need for early detection and prevention of severe deformity and depends on a thorough knowledge of the pathogenesis and natural history of the various conditions which can produce a scoliosis, kyphosis or kyphoscoliosis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available