Disorders of the skeletal system : scoliosis.

London : University of London Audio-Visual Centre, 1976.

1 encoded moving image (38 min.) : sound, black and white

00:38:22

University of London

Restricted

In English

Presented by Dr. M.H. Mehta, Mr. C.W. Manning and Mr. M.A. Edgar, Institute of Orthopaedics (University of London), Royal National Orthopaedic Hospital. Directed by Trevor A. Scott.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Mr Manning explains what scoliosis is. A picture of a female standing in profile is shown, and Manning points out the affected areas of her spine. She is shown from behind, and no evidence of a curve is seen. A table is seen, listing classifications of two types of scoliosis, postural and structural. Photographs of a female patient with asymmetry of the spine are seen and Manning points out the affected areas. An illustration of a spinal bone structure is shown to explain why curvature occurs. An illustration of thoracic scoliosis is seen and Manning points out the deviation of the spine. A skeleton of a normal spine is shown, and Manning compares this with bones affected by severe scoliosis. Time start: 00:00:00:00 Time end: 00:06:04:00 Length: 00:06:04:00

Segment 2 A photograph of a female patient is seen. Manning asks how such a deformity was allowed to take place without parents noticing. A booklet by the Scoliosis Research Society is seen and Manning suggests that the patient may have been ashamed or frightened to seek advice. A series of drawings of females is seen and Manning points out the different curvatures. A table is seen that lists the causes of scoliosis, including osteogenic, neurogenic, thoracogenic and myogenic. An x-ray of a spine is seen, and Manning points out an extra piece of bone. Time start: 00:06:04:00 Time end: 00:10:29:05 Length: 00:04:25:05

Segment 3 A photograph of a female who had poliomyelitis is seen. Two x-rays of curved spines are shown and Manning says that they are examples of curves that may occur in neurofibromatosis. Mike Edgar is then introduced and he talks about what can be done for a spine that is already curved. A chart showing the incidence of idiopathic scoliosis against the age of young patients is seen. A table listing treatments is seen, and Edgar explains the three types of treatment. Footage of a girl in a spinal brace is seen, and Edgar explains that this brace, the Milwaukee, is best for preventing deterioration in a mild curve. The brace is shown in detail. Time start: 00:10:29:05 Time end: 00:14:52:19 Length: 00:04:23:14

Segment 4 A table lists methods of correction for a more severe curve, including traction on the spine or lateral flexion on the reverse direction of the curve. Edgar demonstrates manipulation using malleable strips. Footage of a female in traction is shown. Footage of two girls in traction to treat more severe curves is shown and Edgar explains the technique. Footage of a female in bed wearing a Risser turnbuckle jacket is seen. Next, Edgar talks about surgical correction of adolescent scoliosis. He demonstrates where the surgery would take place on a skeleton. X-rays of a recently treated teenage girl are seen from before and after traction and surgery. The patient is seen after surgery in a plaster jacket. Photographs of another girl with severe scoliosis are seen, and then x-rays show her spine after treatment two years later. Time start: 00:14:52:19 Time end: 00:20:02:01 Length: 00:05:09:07

Segment 5 Edgar explains the 'localiser cast', which is used when the Milwaukee brace fails. Footage of a young girl in a plaster jacket is seen. Edgar hands over to Min Mehta, who outlines areas of research into the aetiology of idiopathic scoliosis. A table listing types of research is seen, and first she explains genetic studies. Photographs of non-identical male twins with differing thoracic scoliosis are seen. Photographs of a mother and her twin daughters are seen. The mother and one of the daughters have idiopathic scoliosis. Tables show the results of various surveys looking at the incidence of idiopathic scoliosis in the general population. Mehta explains the results of the surveys. Time start: 00:20:02:01 Time end: 00:25:04:21 Length: 00:05:02:20

Segment 6 Mehta next explains biochemical research into idiopathic scoliosis. An example into research into defects in connective tissues is that of Marfan syndrome. Photographs of a 4-year-old girl with the syndrome and thoracic scoliosis are seen. Photographs of a 5-year-old boy with mucopolysaccharidosis and kyphoscoliosis are seen. A x-ray of a patient with osteogenesis imperfecta and a thoracic curve is shown. She talks about the kinds of connective tissues that have been investigated, including collagen. She says that although research has differed, it is clear on the relevance of collagen metabolism to scoliosis. Time start: 00:25:04:21 Time end: 00:30:11:00 Length: 00:05:06:04

Segment 7 Next, Mehta looks at the results of experimental production of scoliosis in animals. First, she explains the theory of scoliosis being caused by an imbalance of forces acting on the spine. A photograph of the bones of a young rabbit is seen. The rabbit's ribs were resected to produce scoliosis. Mehta finishes by saying that scientists are yet to identify the nature of the genetic factor in scoliosis. Time start: 00:30:11:00 Time end: 00:33:07:00 Length: 00:02:56:00

Segment 8 Mr Manning speaks again and discusses the work of Dr Bobechko in Toronto, who has been using electrical stimulation of normal muscles to try to reduce curves in idiopathic scoliosis. The three experts are seen seated at a table, and they discuss possible future developments. Edgar hopes for improved diagnosis. Min Mehta hopes to identify tissue defects. End credits. Time start: 00:33:07:00 Time end: 00:38:22:17 Length: 00:05:15:17