The pediatric spine : principles and practice

1096 Pages·2001·87.084 MB·English

by  Stuart L. Weinstein MD

The Pediatric Spine Principles and Practice 
Second Edition
2001

Lippincott Williams & Wilkins

Philadelphia

530 Walnut Street, Philadelphia, PA 19106 USA, http://www.lww.com/
0-7817-1908-9

All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form
or by any means, including photocopying, or utilized by any information storage and retrieval system
without written permission from the copyright owner, except for brief quotations embodied in critical
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Printed in the USA

Library of Congress Cataloging-in-Publication Data

The pediatric spine : principles and practice/editor, Stuart L. Weinstein.—2nd ed.
p.; cm.
Includes bibliographical references and index.
ISBN 0-7817-1908-9 (casebound)
1. Spine—Diseases. 2. Spinal cord—Diseases. 3. Pediatric orthopedics. I. Weinstein, Stuart L.
[DNLM: 1. Spinal Diseases—Child. 2. Spinal Diseases—Infant. 3. Spinal
Diseases—surgery—Child. 4. Spinal Diseases—surgery—Infant. 5. Spinal Injuries—Child.
6. Spinal Injuries—Infant. 7. Spine—abnormalities. WE 725 P3713 2000]
RD768.P363 2000
618.92′73—dc21
00-042430

Care has been taken to confirm the accuracy of the information presented and to describe generally
accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions
or for any consequences from application of the information in this book and make no warranty, expressed
or implied, with respect to the currency, completeness, or accuracy of the contents of the publication.
Application of this information in a particular situation remains the professional responsibility of the
practitioner.

The authors, editors, and publisher have exerted every effort to ensure that drug selections and dosages set
forth in this text are in accordance with current recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government regulations, and the constant flow of
information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosage and for added warnings and precautions. This is
particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of the health care provider
to ascertain the FDA status of each drug or device planned for use in their clinical practice.
10 9 8 7 6 5 4 3 2 1
Dedication
To L.K.W. and W.S.W. for their love, encouragement, understanding, and continued support
Editor Wilton H. Bunch PhD
Beeson Divinity School, Samford University 800 Lakeshore
Dr., Birmingham, Alabama 35339
Stuart L. Weinstein MD
Ignacio V. Ponseti Chair of Orthopaedic Surgery
Vincent J. Caiozzo PhD
Department of Orthopaedic Surgery, University of Iowa
Neuromuscular Research Laboratory, Department of
Hospitals, Iowa City, Iowa
Orthopaedics, University of California, Irvine College of
Medicine, Irvine, California 92717
Secondary Editors
Laura Campanacci MD
Robert Hurley Staff Orthopaedic Surgeon
Acquisitions Editor Department of Skeletal Oncology, Ospedale Maggiore,
Orthopaedics and Traumatology, Largo B. Nigrisoli, 2,
Anne Snyder Bologna, Italy 40133
Developmental Editor
Henry G. Chambers MD
Steven P. Martin Clinical Associate Professor
Production Editor Department of Orthopaedic Surgery, University of California,
San Diego, San Diego, California 92123; Chairman,
Colin J. Warnock Department of Orthopaedic Surgery, Children's Hospital and
Manufacturing Manager Health Center, 3030 Children's Way, Suite 410, San Diego,
California 92123
Mark Lerner
Cover Designer Po-Quang Chen MD, PhD
Professor and Chief of Spine Section
Department of Orthopaedic Surgery, National Taiwan
Maryland Composition
University Hospital, 7, Chung-Shan South Road, Taipei 100,
Compositor
Taiwan
Edwards Brothers
Alvin H. Crawford MD
Printer
Professor
Department of Pediatric Orthopaedic Surgery, University of
Contributing Authors
Cincinnati, Goodman Street, Cincinnati, Ohio 45229;
Department Director, Department of Pediatric Orthopaedics,
Behrooz A. Akbarnia MD Children's Hospital Medical Center, 3333 Burnet Avenue,
Clinical Professor Cincinnati, Ohio 45229-3039
Department of Orthopaedic Surgery, University of California,
San Diego; Medical Director, San Diego Center for Spinal Mark S. Dias MD
Disorders, 8010 Frost Street, Suite 401, San Diego, California Associate Professor
92123 Department of Neurosurgery, State University of New York at
Buffalo, Buffalo, New York 14222; Chief of Pediatric
Vincent Arlet MD Neurosurgery, Departments of Pediatric Surgery and
Associate Professor Neurosurgery, Children's Hospital of Buffalo, 219 Bryant
Department of Orthopaedic Surgery, McGill University Health Street, Buffalo, New York 14222
Center, Montreal Children's Hospital, 2300 Tupper Street,
Montreal, Quebec, H3H 1P3 Canada Robert A. Dickson MA, ChM, FRCS, DSC
Professor
Elio Ascani MD University Department of Orthopaedic Surgery, Level 5,
Ospedale Bambino Gesu, Centro Cura Delle Deformita, Della Room 5.8, Clinical Sciences Building, St. James University
Colonna, Vertebrale, Via Torre de Palidoro, Passoscuro, Hospital, Leeds, LS9 7TF, United Kingdom
Rome 1 00050, Italy
Frederick Dietz MD
Gary M. Banks MD Professor
Advanced Spine, Plymouth, Minnesota 55441 Department of Orthopaedic Surgery, University of Iowa, 200
Hawkins Drive, Iowa City, Iowa 52242
Michael J. Barnes MB, ChB, FRACS
Pediatric Spine Surgeon Carl DiRaimondo
Starship Children's Hospital, Eastwood Orthopaedic Clinic, 99 Department of Orthpaedic Surgery, Northwestern University,
Remuera Road, Auckland 5, New Zealand Chicago, Illinois 60611
Randal R. Betz MD Jean Dubousset MD
Department of Orthopaedic Surgery, Temple University Professor of Pediatric Orthopaedics
School of Medicine, Temple University Hospital, 3401 N. Université René Descartes, Hôpital Saint Vincent de Paul, 82
Broad Street; Chief of Staff, Shriners Hospitals for Children, avenue Denfert-Rochereau, 75674 Paris, France
3551 North Broad Street, Philadelphia, Pennsylvania 19140
Frank J. Eismont MD
Stefano Boriani MD Department of Orthopaedics and Rehabilitation, University
Chief of Miami School of Medicine, Miami, Florida 33101
Department of Orthopaedics and Traumatology, Ospedale
Maggiore, Largo B. Nigrisoli, 2, Bologna, Italy 40133 Georges Y. El-Khoury MD
Department of Radiology University of Iowa, 200 Hawkins
J. Richard Bowen MD Drive, Iowa City, Iowa 52242-1077
Chairman
Department of Orthopaedics, duPont Hospital for Children, François Fassier MD
1600 Rockland Road, PO Box 269, Wilmington, Delaware Department of Orthopaedic Surgery, McGill University Health
19803 Center, The Montreal Children's Hospital, 2300 Tupper
Street, Montreal, Quebec H3H 1P3, Canada
David S. Bradford MD
Professor and Chairman Timothy M. Ganey PhD
Department of Orthopaedic Surgery, University of California, Director of Research
San Francisco, San Francisco, California 94143-0728 Atlanta Medical Center, Department of Orthopaedics, 303
Parkway Drive, NE, Director, co. don Tissue Engineering, Inc.,
Keith H. Bridwell MD 6104 River Terrace, Tampa, Florida 33604
Professor of Orthopaedic Surgery, Chief
Adult and Pediatric Spinal Surgery, Division of Orthopaedic Thomas M. Gavin CO
Surgery, Washington University School of Medicine, One Teaching Associate
Barnes-Jewish Hospital Plaza, Suite 11300 West Pavilion, St. Department of Orthopaedic Surgery, Loyola University
Louis, Missouri 63110 Medical Center, 2160 First Avenue, Building 54, Maywood,
Illinois 60153; President, Director of Clinical Services, Bio- Associate Professor
Concepts, Inc., Orthotic-Prosthetic Centers, 100 Tower Drive, Department of Neurological Surgery, USC Keck School of
Suite 101, Burr Ridge, Illinois 60521 Medicine, Division of Neurosurgery, Children's Hospital Los
Angeles, 1300 North Vermont Ave #906, Los Angeles,
Teddy S. Govender MD, FRCS California 90027
Professor and Chairman
Department of Orthopaedics, University of Natal Medical Mark A. Liker MD
School, 719 Umbilo Road, Durban 4013, South Africa; Chief, Clinical Instructor
Department of Spine Surgery, King George V Hospital, PO Box Department of Neurological Surgery, USC Keck School of
Domerton, Durban 4091, South Africa Medicine; Division of Neurosurgery, Children's Hospital Los
Angeles, 1300 North Vermont Ave #906, Los Angeles,
Paul A. Grabb MD California 90027
Department of Surgery, Division of Neurosurgery, University
of Alabama at Birmingham, Children's Hospital of Alabama, Richard E. Lindseth MD
Birmingham, Alabama 35233 Chairman and Professor
Department of Orthopaedic Surgery, Indiana University
Walter B. Greene MD School of Medicine, 541 Clinical Drive, Room 600,
Chairman and Professor Indianapolis, Indiana 46202-5111
Department of Orthopaedic Surgery, University of Missouri
Health Services Center, One Hospital Drive, MC213, Glenn E. Lipton
Columbia, Missouri 65212 Temple University School of Medicine Philadelphia,
Pennsylvania 19140,
James T. Guille MD
Chief Resident Randall T. Loder MD
Department of Orthopaedic Surgery, Hahnemann University Chief Surgeon
Hospital, Broad & Vine Streets, Philadelphia, Pennsylvania Shriners Hospitals for Children, Twin Cities Unit, 2025 East
19120 River Parkway, Minneapolis, Minnesota 55414
Gregory V. Hahn MD John E. Lonstein MD
Department of Orthopaedic Surgery, All Children's Hospital, Clinical Professor
880 Sixth Street South, St. Petersburg, Florida 33701 Department of Orthopaedic Surgery, University of Minnesota,
Minneapolis, Minnesota 55455; Staff Physician, Twin Cities
Robert N. Hensinger MD Spine Center, 913 East 26th Street, Minneapolis, Minnesota
Chairman and Professor 55404
Section of Orthopaedic Surgery, University of Michigan
Medical School, 1500 East Medical Center Drive, Ann Arbor, John P. Lubicky MD, FAAOS, FAAP
Michigan 48109 Professor
Department of Orthopaedic Surgery, Rush Medical College,
Eric K. W. Ho FRCS (Glasg.), FRACS 600 S. Paulina, Chicago, Illinois 60612; Chief of Staff,
Department of Orthopaedic Surgery, University of Hong Shriners Hospitals for Children, 2211 North Oak Park Avenue,
Kong, Queen Mary Hospital, Hong Kong Chicago, Illinois 60707
Serena S. Hu MD Keith D. K. Luk MCh, FRACS
Associate Professor and Staff Physician Department of Orthopaedic Surgery, University of Hong
Department of Orthopaedic Surgery, University of California, Kong, Queen Mary Hospital, Hong Kong
San Francisco, 500 Parnassus, Room MU 320W, San Francisco,
California 94143-0728 Aurelio G. Martinez-Lozano MD
Professor
Mark B. Kabins MD Department of Orthopaedic Surgery, Universidad Autonoma
Department of Orthopaedics, University of Nevada Medical de Nuevo Leon, Av. La Clinica, 2520 Number 214, Monterey,
Center, 600 South Rancho Drive, #107, Las Vegas, Nevada Mexico 64710
89106
Richard E. McCarthy MD
Howard A. King MD Arkansas Spine Center, 500 South University, Suite 815,
St. Lukes Regional Medical Center, 190 E. Bannock Street, Little Rock, Arkansas 72205
Boise, Idaho 83702
J. Gordon McComb MD
S. Jay Kumar MD Professor
Clinical Professor Department of Neurological Surgery, USC Keck School of
Department of Orthopaedics Thomas Jefferson University Medicine; Head, Division of Neurosurgery, Children's Hospital
Hospital, Philadelphia, Pennsylvania 19107; Senior Attending, Los Angeles, 1300 North Vermont Avenue, Los Angeles,
Department of Orthopaedics, Alfred I. duPont Hospital for California 90027
Children, 1600 Rockland Road, Wilmington, Delaware 19803
David G. McLone MD, PhD
Hubert Labelle MD Professor of Neurosurgery
Clinical Professor Northwestern University, 233 E. Erie, Chicago, Illinois 60611;
Department of Surgery, University of Montreal, C.P. 6128, Division Head, Pediatric Neurosurgery, Children's Memorial
Succursale Centre-Ville, Montreal, Quebec, Canada H3C 3J7; Hospital, 2300 Children's Plaza, Chicago, Illinois 60614
Staff Member, Division of Orthopaedics, Sainte-Justine
Mother-Child University Hospital, 3175 Cote STE-Catherine Michael J. McMaster MD, FRCS
Montreal, Quebec H3T 1C5, Canada Consultant Orthopaedic Spine Surgeon
Royal Hospital for Sick Children, Edinburgh EH10 7ED,
Guido La Rosa MD Scotland
Ospedale Bambino Gesu, Centro Cura Delle Deformita, Della
Colonna, Vertebrale, Via Torre de Palidoro, Passoscuro, Kevin P. Meade PhD
Rome 1 00050, Italy Department of Mechanical, Materials and Aerospace
Engineering, Illinois Institute of Technology, Chicago, Illinois
Nathan H. Lebwohl MD 60616
Associate Professor
Department of Orthopaedics and Rehabilitation, University Arnold H. Menezes MD
of Miami School of Medicine, PO Box 016960 D-27, Miami, Professor and Vice Chairman
Florida 33101 Division of Neurosurgery, University of Iowa, 200 Hawkins
Drive, Iowa 52242
John C. Y. Leong FRCS, FRCSE, FRACS
Department of Orthopaedic Surgery, University of Hong Nancy H. Miller MS, MD
Kong, Queen Mary Hospital, Hong Kong Assistant Professor
Michael L. Levy MD
Department of Orthopaedic Surgery, Johns Hopkins Hospital, Department of Radiology, University of Iowa, 200 Hawkins
601 N. Caroline Street #5254, Baltimore, Maryland 21287- Drive, Iowa City, Iowa 52242-1077
0882
Donald G. Schurr CPO, PT
Mary D. Moore MD American Prosthetics and Orthotics, Incorporated, The
Department of Pediatrics, University of Iowa, 200 Hawkins University of Iowa Hospitals and Clinics, Iowa City, Iowa
Drive, Iowa City, Iowa 52242 52242
Scott J. Mubarak MD James D. Schwender MD
Clinical Professor Twin Cities Spine Center, 913 East 26th Street, Minneapolis,
Department of Orthopaedics, University of California, San Minnesota 55404
Diego, 200 W. Arbor Drive, San Diego, California 92123;
Medical Director, Department of Orthopaedics, Children's Young-Shung Shen MD
Hospital, 3020 Children's Way, San Diego, California 92123 Director
Po-Cheng Orthopaedic Institute, 100, Po-Ai 2nd Road,
Mary Jane Mulcahey MS, OTR/L Kaohsiung 813, Taiwan
Director
Department of Rehabilitation and Clinical Research, Shriners Russell D. Snyder MD
Hospitals for Children, 3551 North Broad Street, Professor
Philadelphia, Pennsylvania 19140 Department of Neurology and Pediatrics, University of New
Mexico School of Medicine, 915 Camino de Salud,
Virinder Nohria MD, PhD Albuquerque, New Mexico 87131-5281; Attending Physician,
Project Team Director Department of Neurology, University of New Mexico Hospital,
DevCo Pharmaceuticals Incorporated, 4825 Creekstone 2211 Lomas, NE, Albuquerque, New Mexico 87106
Drive—Suite 200, Research Triangle Park, Durham, NC 27703
Paul D. Sponseller MD
Kenneth J. Noonan MD Chief of Pediatric Orthopaedics and Professor
Assistant Professor Department of Orthopaedic Surgery, Johns Hopkins
Department of Orthopaedics, Indiana University School of University, 601 North Carolina Street #5253, Baltimore,
Medicine, Riley Hospital for Children, 702 Barnhill Drive, Maryland 21287-0882
Room 1134, Indianapolis, Indiana 46202
Ian A. F. Stokes PhD
W. Jerry Oakes MD Department of Orthopaedics and Rehabilitation, The
Professor and Chief of Neurosurgery University of Vermont, Stafford Hall 434, Burlington,
Department of Surgery, University of Alabama, Birmingham, Vermont 05405-0084
Children's Hospital of Alabama, 1600 7th Avenue, ACC 400,
Birmingham, Alabama 35233 Ensor E. Transfeldt MD
University of Minnesota; Twin Cities Spine Center, 913 East
John A. Ogden MD 26th Street, Suite 600 Minneapolis, Minnesota 55404
Atlanta Medical Center, 303 Parkway Drive, NE, Box 203,
Atlanta, Georgia 30312 William C. Warner Jr. MD
Associate Professor
Avinash G. Patwardhan PhD University of Tennessee—Campbell Clinic, Department of
Department of Orthopaedic Surgery and Rehabilitation, Orthopaedic Surgery 910 Madison Avenue, Suite 500,
Loyola University Medical Center, Maywood, Illinois 60143 Memphis, Tennessee 38103
Joseph H. Perra MD James N. Weinstein DO, MS
Department of Orthopaedic Surgery, University of Minnesota, Professor
420 Delaware Street SE, Box 492, Minneapolis, Minnesota Department of Community and Family Medicine, Dartmouth
55455; Staff Surgeon, Twin Cities Spine Center, Piper Medical School, 7251 Strasenburgh Hall, Hanover, New
Building, 913 East 26th, Suite 600, Minneapolis, Minnesota Hampshire 03755; Director, The Spine Center, Dartmouth-
55404-4515 Hitchcock Medical Center, One Medical Center Drive,
Lebanon, New Hampshire 03756
William A. Phillips MD
Chief Stuart L. Weinstein MD
Texas Children's Hospital, Professor, Orthopaedic Surgery and Ignacio V. Ponseti Chair of Orthopaedic Surgery
Pediatrics, Baylor College of Medicine, 6221 Fannin, Suite Department of Orthopaedic Surgery, University of Iowa, 200
MC3-2295, Houston, Texas 77030 Hawkins Drive, Iowa City, Iowa 52242
Thomas S. Renshaw MD Dennis R. Wenger MD
Professor of Orthopaedic Surgery Clinical Professor
Department of Orthopaedics, Yale University School of Department of Orthopaedic Surgery, University of California,
Medicine, 800 Howard Avenue, YPB 133, New Haven, San Diego; Director of Pediatric Orthopaedics, Children's
Connecticut 06510; Attending Physician, Department of Hospital of San Diego, 3030 Children's Way, Suite 410, San
Orthopaedic Surgery, Yale-New Haven Hospital, 20 York Diego, California 92123
Street, New Haven, Connecticut 06510
David Ring MD
Instructor
Department of Orthopaedic Surgery, Harvard Medical School;
Director of Research, Department of Orthopedic Surgery,
Massachusetts General Hospital, Harvard Combined
Orthopaedic Program, Boston, Massachusetts 02114
Timothy C. Ryken MD
Division of Neurosurgery, University of Iowa Hospitals and
Clinics, University of Iowa, 200 Hawkins Drive, Iowa City,
Iowa 52242-1061
John F. Sarwark MD
Associate Professor
Department of Orthpaedic Surgery, Northwestern University,
Chicago, Illinois 60611; Interim Division Head, Division of
Orthopaedic Surgery, Children's Memorial Hospital, 2300
Children's Plaza, No. 69, Chicago, IL 60614-3394
Yutaka Sato MD
Preface
The practice of medicine is in an exciting era of change because of explosive advances in molecular genetics and biophysics, and the
development of new biomaterials. The concepts and principles developed in the laboratory must be rapidly applied to the clinical
setting. Pediatric patients with a disease or disorder of the spine often requires a multidisciplinary team of health care
professionals. The effective management of these patients requires collaboration between basic scientists and clinicians of various
disciplines to deal with these complex problems.
The Pediatric Spine brings together international experts from several disciplines to provide a definitive reference text for the
health care professional interested in problems related to the pediatric spine. This book is the only comprehensive text devoted
exclusively to this subject. It provides the reader with an in-depth study of disorders of the pediatric spine and related conditions.
Strong emphasis is given to the basic sciences in the introductory chapters and throughout the text. The authors of each chapter,
with their considerable experience and expertise, provide complete and in-depth coverage of each subject. The chapters focusing
on disease entities place strong emphasis on natural history, diagnosis, pathobiology of disease, and scope and breadth of operative
and nonoperative management options.
The text also provides the reader with an in-depth look at related topics of imaging of the spine, and a detailed appendix of
radiographic measurements, classifications, and definitions. Each chapter is accompanied by a comprehensive bibliography on the
subject.
The Pediatric Spine is aimed at the senior resident and the practicing pediatric spine specialist. It should also be of interest to
orthopaedic surgeons, pediatricians, neurosurgeons, bioengineers, therapists and orthotists, and anyone who has interest in patients
with pediatric spinal disorders.
Stuart L. Weinstein MD
Acknowledgements
The completion of the first edition of The Pediatric Spine: Principles and Practice would not have been possible without the
guidance, direction, encouragement, and hard work of Kathey Alexander of Lippincott Williams & Wilkins. Ms. Alexander's work ethic,
dedication to purpose, and professional manner of dealing with the complex aspects of producing a high-quality textbook are greatly
appreciated. Ms. Alexander was assisted by the equally capable and hardworking Beth Weiselberg. While their responsibilities and
ongoing projects at Lippincott Williams & Wilkins are many, Ms. Alexander and Ms. Weiselberg always made me feel that The
Pediatric Spine: Principles and Practice was their only concern. For this second edition, I would also like to thank Ms. Anne Snyder
for her dedication to task and particularly for her perseverance.
I would also like to express my appreciation and gratitude to medical illustrators Tom Weinzeril of the University of Iowa and Paul
Gross of Vanderbilt University, who worked very closely with each chapter author and the editor to bring the authors' words,
principles, and techniques to life.
To Joyce Roller, my secretary and colleague over the last 22 years, I owe an extreme debt of gratitude for keeping me organized
and on track. She never let being overworked interfere with her pleasant and professional manner in dealing with patients, families,
and professional colleagues; she is an inspiration to all.
Finally, and most importantly, I am indebted to an outstanding group of experts who assembled their considerable knowledge and
experience in the form of text chapters. Their spirit of cooperation and sense of common purpose was displayed time and time again
during the production of this text in meeting editorial deadlines, revising and re-revising chapters, and sharing case photos and case
materials. It is to these caring and talented health care providers that credit for this text is due.
Stuart L. Weinstein M.D.
Contents
Dedication
Author
Preface
Acknowledgements
Contents
Section I Developmental Anatomy
1 Development and Maturation of the Axial Skeleton
Section II Biomechanics
2 Spinal Biomechanics
3 Clinical Application of Biomechanics
Section III Imaging Techniques
4 Imaging Modalities
Section IV Patient Evaluation
5 Back Pain in Children
6 Evaluation of the Patient with Deformity
Section V Congenital Abnormalities
7 Congenital Scoliosis
8 Congenital Kyphosis and Lordosis
9 Sacral Agenesis
10 Congenital and Developmental Spinal Stenosis
11 Craniovertebral Junction Abnormalities in the Pediatric Spine
12 Congenital Abnormalities of the Cervical Spine
13 Neurosurgical Management of Spinal Dysraphism
14 The Spine in Skeletal Dysplasias
Section VI Developmental Abnormalities
15 Developmental Abnormalities of the Cervical Spine
16 Early-Onset Idiopathic Scoliosis
17 Juvenile Idiopathic Scoliosis
18 Adolescent Idiopathic Scoliosis: Etiology
19 Adolescent Idiopathic Scoliosis: Natural History
20 Adolescent Idiopathic Scoliosis: Nonsurgical Techniques
21 Adolescent Idiopathic Scoliosis: Surgery
22 Scheuermann Kyphosis
23 Spondylolysis and Spondylolisthesis
24 Herniated Nucleus Pulposus and Slipped Vertebral Apophysis
25 Neurofibromatosis
26 Iatrogenic Spinal Deformities
27 Marfan Syndrome
28 Chiari Malformations, Syringomyelia, and the Tethered Cord Syndrome
Section VII Traumatic Conditions
29 The Cell Biology of Spinal Cord Injury
30 Cervical Spine Injuries in Children
31 Thoracic, Lumbar, and Sacral Spine Fractures and Dislocations
32 Spinal Cord Injury and Posttraumatic Deformities
33 Spinal Cord Injury Rehabilitation
Section VIII Inflammatory and Infectious Conditions
34 Pyogenic Infectious Spondylitis in Children
35 Tuberculosis of the Spine
36 Fungal Infections of the Spine
37 Rheumatic Diseases
38 Inflammatory Diseases of the Spinal Cord, Leptomeninges, and Dura
Section IX Neoplasms and Malformations
39 Spine Neoplasms
40 Spinal Cord Tumors
Section X Metabolic Disease
41 Idiopathic Juvenile Osteoporosis
42 The Spine in Osteogenesis Imperfecta
43 Mucopolysaccharidosis, Mucolipidoses, and Homocystinuria
Section XI Neuromuscular Disease
44 Neuromuscular Spinal Deformities
45 Spine Deformities Due to Cerebral Palsy
46 Spinal Deformities in Friedreich's Ataxia
47 Muscular Dystrophy
48 Spinal Muscular Atrophy
49 Myelomeningocele Spine
50 Poliomyelitis Scoliosis
51 Other Neuromuscular Deformities
Section XII Orthotics
52 Orthotic Treatment for Spinal Disorders
Section XIII Appendices
A Terminology and Definitions
B Embryology, Growth and Maturation
C Radiographic Measurements
D Classifications
Index