Duke orthopaedics presents wheeless' textbook of orthopaedics site map search site by word home advertising info editorial board contact us my account myelomeningocele scoliosis - see:        - orthopaedic manifestations of myelomeningocele: - discussion:     - scoliosis in myelomenigocele may have a multifactorial etiology:            - idiopathic causes;            - myelomeningocele structural defect;            - congenital defects            - paralytic etiology;     - 15-20% of children who have myelomeningocele have congenital vertebral abnormalities in addition to congenital scoliosis;     - over-all incidence of scoliosis in pts who have thoracic-level lesion is 85%;     - all children who are born with an osseous dysraphism at level of t12 or higher, are at risk for the development of a severe scoliotic             deformity for which arthrodesis is needed;     - progression of scoliosis in myelomeningocele is natural;     - progressive scoliosis in myelomeningocele:            - may manifest as lower extremity spasticity;            - mri is helpful in evaluating these children;            - diff dx:                   - tethered cord:                          - if curve continues to progress despite neurosurgical release of tethered cord, then curve must be stabilized with spinal fusion;                   - non-functioning shunt:                          - must be corrected before attempt is made to correct the scoliotic deformity;                   - arnold chiari malformation:                   - syringomyelia:                   - hydromyelia:                   - hydrocephalus:     - treatment considerations:            - goal is to have a compensated spine of normal height over level pelvis, w/ preservation of normal sagittal alignment;            - documented progression of curve is indication for early fusion, just as in child who does not have myelomeningocele; - bracing:     - orthotic treatment is helpful for the more common paralytic curve until the child reaches puberty;     - although bracing does not alter natural history of deformity, it promotes spinal growth & preserves better sitting posture, esp in pts who             have lesion at thoracic level;     - carefully fitted, custommolded, bivalve plastic total-contact  thoracolumbosacral orthosis provides maximum support and allows             moni. cheap viagra buy viagra without prescription buy viagra 20mg online viagra for men price in bangalore viagra coupon much 50mg viagra order viagra viagra canada online order viagra canada pharmacy cost comparison viagra versus viagra online pharmacy no prescription needed viagra
Welcome to the DC Children's Literature Book Club
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The DC Kidlit book club meets monthly in the Washington, DC area. Our members include librarians, teachers, authors, illustrators, parents, booksellers, and anyone who would like to discuss children's books. The club's selections feature a variety of book genres. We hope you will join in the discussion, either in-person or online.
Susan Kusel

The book club was founded in 2008 by children's librarian Susan Kusel. Join Our Book Club!

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