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Sample records for childhood idiopathic scoliosis

  1. Idiopathic scoliosis.

    Science.gov (United States)

    Yaman, Onur; Dalbayrak, Sedat

    2014-01-01

    Scoliosis refers to curves exceeding 10 degrees observed through posterioanterior direct radiography. In fact, the diagnosis for idiopathic scoliosis is accepted to exclude already available causes. The aim of this paper was to review the etiopathogenesis, classification systems and the treatment management of idiopathic scoliosis. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' was performed. For the literature review, papers concerning the etiopathogenesis, classification and treatment were selected among these articles. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' yielded 4518 articles published between 1947 and 2013. The main hypothesis put forward included genetic factors, hormonal factors, bone and connective tissue anomalies. King, Lenke, Coonrad and Peking Union Medical College (PUMC) classifications were the main classification systems for idiopathic scoliosis. Exercise, bracing and anterior, posterior or combined surgery when indicated are the choices for the treatment. Every idiopathic scoliosis case has to be managed to its own characteristics. It is the post-operative appearance that the surgeons are perhaps the least interested but the adolescent patients the most interested in. The aim of scoliosis surgery is to restore the spine without neurological deficit.

  2. Idiopathic Scoliosis

    OpenAIRE

    2014-01-01

    Introduction. Idiopathic scoliosis is a structural and lateral curvature of the spine for which a currently recognizable cause has not been found and there is no basic evidence for physical and radiographic pathology. Complications. Scoliosis could be a cause of the back pain, deformities, respiratory and cardiology problems. There is a higher risk for decreasing of bone mineral density. Diagnosis and Management. Physical examination, radiography and stereophotogrametry are used in diag...

  3. Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Jens Ivar Brox

    2014-07-01

    Full Text Available Idiopathic scoliosis (IS is a lifetime condition and is defined as a structural, lateral rotated curvature of the spine of >10° on standing coronal plane radiographs. It should be distinguished from other causes of scoliosis. It can be classified as infantile, juvenile, and adolescent according to age. As a rule of thumb, about 80% of all curves are idiopathic, right convex thoracic, and present in otherwise healthy girls at the beginning of puberty. A family member most commonly detects scoliosis. The structural asymmetry of the spine is best observed by asking the patient to bend forward. IS is often seen in more than one member of a family, but the aetiology remains unknown. Multiple genes are likely to be involved with incomplete penetrance and variable expressivity. Early detection by screening allows for monitoring curve progression and timely initiation of bracing, but school screening is controversial and practises vary worldwide. Most patients have minor scoliosis and treatment is generally not recommended for patients with curves 45°. Scoliosis surgery was not successful until the introduction of Harrington’s instrumentation in the 1960s. Modern instrumentation has evolved from the Cotrel-Dubousset system in the 1980s, and a variety of methods are available today. Although scoliosis may be a burden, long-term studies suggest that a good quality of life is maintained in most patients.

  4. Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci

    2014-06-01

    Full Text Available Scoliosis is called idiopathic when no other underlying disease can be identified. The etiology of adolescent idiopathic scoliosis (AIS is still unknown despite many years of research effort. Theories on AIS's etiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Skeletally immature patients with adolescent idiopathic scoliosis are at risk of curve progression. The adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. Scoliosis in children of school age and above primarily occurs in girls. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20 and deg; or more should be treated with a brace, and scoliosis of 45 and deg; or more with surgery. [Arch Clin Exp Surg 2014; 3(3.000: 174-182

  5. Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hawes Martha C

    2009-12-01

    Full Text Available Abstract Background Some patients with mild or moderate thoracic scoliosis (Cobb angle Case presentation A diagnosis of thoracic scoliosis (Cobb angle 45 degrees with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52 was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996; outpatient psychological therapy (1992-1993; a daily home exercise program focused on mobilization of the chest wall (1992-2005; and manipulative medicine (1994-1995, 1999-2000. Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature. Conclusion This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis.

  6. Inheritance and genetics in idiopathic scoliosis

    OpenAIRE

    Grauers, Anna

    2015-01-01

    Idiopathic scoliosis is the most common spine deformity, affecting approximately 3% of children and adolescents. Its aetiology is still unknown. However, relatives of individuals with idiopathic scoliosis have a higher risk of developing scoliosis compared to the general population. The aim of this thesis was to improve our understanding of the hereditary and genetic background of idiopathic scoliosis. Self - reported data on scoliosis in twins (n=64,578) i...

  7. Adolescent idiopathic scoliosis: current perspectives

    Directory of Open Access Journals (Sweden)

    Miyanji F

    2014-01-01

    Full Text Available Firoz MiyanjiBritish Columbia Children's Hospital, Vancouver, BC, CanadaAbstract: Adolescent idiopathic scoliosis (AIS remains a common and potentially severe musculoskeletal disorder. Although its etiology is largely unknown, ongoing research endeavors continue to improve our understanding of its potential origin and its natural history. Advances in understanding its true three-dimensional nature have sought to improve classification and management strategies. This review will attempt to highlight and give an overview of the current concepts in adolescent idiopathic scoliosis.Keywords: AIS, current, natural history, management strategies

  8. Epidemiology of adolescent idiopathic scoliosis

    OpenAIRE

    Konieczny, Markus Rafael; Senyurt, Hüsseyin; Krauspe, Rüdiger

    2012-01-01

    Adolescent idiopathic scoliosis is a common disease with an overall prevalence of 0.47–5.2 % in the current literature. The female to male ratio ranges from 1.5:1 to 3:1 and increases substantially with increasing age. In particular, the prevalence of curves with higher Cobb angles is substantially higher in girls than in boys: The female to male ratio rises from 1.4:1 in curves from 10° to 20° up to 7.2:1 in curves >40°. Curve pattern and prevalence of scoliosis is not only influenced by gen...

  9. Posterior asymmetry and idiopathic scoliosis

    CERN Document Server

    Rousie, D L; Berthoz, A

    2009-01-01

    Study design Are there neuro-anatomical abnormalities associated with idiopathic scoliosis (IS)? Posterior Basicranium (PBA) reflects cerebellum growth and contains vestibular organs, two structures suspected to be involved in scoliosis. Objective The aim of this study was to compare posterior basicranium asymmetry (PBA) in Idiopathic scoliosis (IS) and normal subjects. Method: To measure the shape of PBA in 3D, we defined an intra-cranial frame of reference based on CNS and guided by embryology of the neural tube. Measurements concerned three directions of space referred to a specific intra cranial referential. Data acquisition was performed with T2 MRI (G.E. Excite 1.5T, mode Fiesta). We explored a scoliosis group of 76 women and 20 men with a mean age of 17, 2 and a control group of 26 women and 16 men, with a mean age of 27, 7. Results: IS revealed a significant asymmetry of PBA (Pr>|t|<.0001) in 3 directions of space compared to the control group. This asymmetry was more pronounced in antero-posterior...

  10. Adolescent idiopathic scoliosis: current perspectives

    OpenAIRE

    2014-01-01

    Firoz MiyanjiBritish Columbia Children's Hospital, Vancouver, BC, CanadaAbstract: Adolescent idiopathic scoliosis (AIS) remains a common and potentially severe musculoskeletal disorder. Although its etiology is largely unknown, ongoing research endeavors continue to improve our understanding of its potential origin and its natural history. Advances in understanding its true three-dimensional nature have sought to improve classification and management strategies. This review will attem...

  11. Idiopathic scoliosis: etiological concepts and hypotheses

    OpenAIRE

    2013-01-01

    Scoliosis is diagnosed as idiopathic in 70 % of structural deformities affecting the spine in children and adolescents, probably reflecting our current misunderstanding of this disease. By definition, a structural scoliosis should be the result of some primary disorder. The goal of this article is to give a comprehensive overview of the currently proposed etiological concepts in idiopathic scoliosis regarding genetics, molecular biology, biomechanics, and neurology, with particular emphasis o...

  12. [Orthopedic and surgical treatment of idiopathic scoliosis in childhood and adolescence].

    Science.gov (United States)

    Vialle, Raphaël

    2006-01-31

    Any evolutive scoliosis must be treated actively. The orthopaedic treatment by brace makes it possible to slow down the spinal deformity evolution. In many cases, physiotherapy could be of great help during the conservative treatment phase. Thus, it is possible to contain the scoliosis progression during the rapid growth phase of the spine, in adolescence. In some patients, spinal deformity can remain moderate, making it possible to keep a satisfying function and balance of the spine in adulthood. Sometimes, the orthopaedic treatment alone is not sufficient and surgery is necessary to provide a well-balanced spine with an acceptable residual spinal deformity. The aims of surgical treatment are to correct spinal deformity by means of vertebral osteosynthesis and to stabilize the final correction by means of bone grafting. These surgical procedures made according to strict rules, give excellent functional results and make it possible to carry out a strictly normal adult life.

  13. Diagnosis and treatment of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Burton, Monique S

    2013-11-01

    Scoliosis is defined as a lateral curvature of the spine greater than 10 degrees on radiography that is typically associated with trunk rotation. The three major types of scoliosis are congenital, idiopathic, and neuromuscular. Idiopathic scoliosis is divided into three subcategories based on the age of onset. Infantile idiopathic scoliosis affects patients younger than 3 years, juvenile idiopathic scoliosis appears in children between 3 and 10 years, and adolescent idiopathic scoliosis (AIS) occurs in skeletally immature patients older than 10 years. AIS is the most common form of idiopathic scoliosis. Approximately 2% to 4% of children aged 10 to 16 years have some degree of spinal curvature. Although some researchers view routine screening for AIS as controversial, well-child examinations and sports physicals are an optimal time to evaluate for AIS in the clinical setting. In 2008, the American Academy of Orthopaedic Surgeons, the Scoliosis Research Society, the Pediatric Orthopaedic Society of North America, and the American Academy of Pediatrics convened a task force to review the issues related to scoliosis screening and issued an information statement concluding that although screening has limitations, the potential benefits that patients with idiopathic scoliosis receive from early treatment can be substantial. Recommendations are now that females are screened twice, at age 10 and 12 years, and males once at age 13 or 14 years. Screening during routine well-child examinations and/or school-based evaluations will help identify patients who need ongoing monitoring. The evaluation of curvatures in conjunction with the level of skeletal maturity will help to guide the management of the curvature.

  14. Optimal management of idiopathic scoliosis in adolescence

    Directory of Open Access Journals (Sweden)

    Kotwicki T

    2013-07-01

    Full Text Available Tomasz Kotwicki,1 Joanna Chowanska,1,2 Edyta Kinel,3 Dariusz Czaprowski,4,5 Marek Tomaszewski,1 Piotr Janusz1 1Department of Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland; 2National Scoliosis Foundation, Stoughton, MA, USA; 3Department of Rehabilitation, University of Medical Sciences, Poznan Poland; 4Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, 5Rehasport Clinic, Poznan, Poland Abstract: Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid

  15. Optimal management of idiopathic scoliosis in adolescence

    OpenAIRE

    Kotwicki T; Chowanska J; Kinel E; Czaprowski D; Tomaszewski M; Janusz P

    2013-01-01

    Tomasz Kotwicki,1 Joanna Chowanska,1,2 Edyta Kinel,3 Dariusz Czaprowski,4,5 Marek Tomaszewski,1 Piotr Janusz1 1Department of Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland; 2National Scoliosis Foundation, Stoughton, MA, USA; 3Department of Rehabilitation, University of Medical Sciences, Poznan Poland; 4Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, 5Rehasport Clinic, Poznan, Poland Abstract: Idiopathic scoliosis is a three-dimension...

  16. Pulmonary function in children with idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Tsiligiannis Theofanis

    2012-03-01

    Full Text Available Abstract Idiopathic scoliosis, a common disorder of lateral displacement and rotation of vertebral bodies during periods of rapid somatic growth, has many effects on respiratory function. Scoliosis results in a restrictive lung disease with a multifactorial decrease in lung volumes, displaces the intrathoracic organs, impedes on the movement of ribs and affects the mechanics of the respiratory muscles. Scoliosis decreases the chest wall as well as the lung compliance and results in increased work of breathing at rest, during exercise and sleep. Pulmonary hypertension and respiratory failure may develop in severe disease. In this review the epidemiological and anatomical aspects of idiopathic scoliosis are noted, the pathophysiology and effects of idiopathic scoliosis on respiratory function are described, the pulmonary function testing including lung volumes, respiratory flow rates and airway resistance, chest wall movements, regional ventilation and perfusion, blood gases, response to exercise and sleep studies are presented. Preoperative pulmonary function testing required, as well as the effects of various surgical approaches on respiratory function are also discussed.

  17. Optimal management of idiopathic scoliosis in adolescence.

    Science.gov (United States)

    Kotwicki, Tomasz; Chowanska, Joanna; Kinel, Edyta; Czaprowski, Dariusz; Tomaszewski, Marek; Janusz, Piotr

    2013-01-01

    Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%-3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical

  18. Etiology and pathogenesis of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Schlösser, Tom P C; Colo, Dino; Castelein, RM

    2015-01-01

    Despite many years of dedicated research into the etio-pathogenesis, not one single cause for adolescent idiopathic scoliosis has been identified. The purpose of this review is to give a comprehensive overview of the current evidence and main etiological theories. Intrinsic causal mechanisms are fou

  19. Selective fusion in adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    WANG Ting; XU Jian-guang; ZENG Bing-fang

    2008-01-01

    @@ Despite the continual evolution in the surgical treatment of adolescent idiopathic scoliosis (AIS), the goals of surgery remain to correct and stabilize the deformity in three dimensions, to maintain equilibrium of the shoulders and trunk, and to leave as many mobile spinal segments as possible.

  20. Physiotherapeutic scoliosis-specific exercises for adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Bettany-Saltikov, J; Parent, E; Romano, M; Villagrasa, M; Negrini, S

    2014-02-01

    The use of exercises for the treatment of Adolescents with Idiopathic Scoliosis is controversial. Whilst exercises are routinely used in a number of central and southern European countries, most centres in the rest of the world (mainly in Anglo-Saxon countries), do not advocate its use. One of the reasons for this is that many health care professionals are usually not conversant with the differences between generalised physiotherapy exercises and physiotherapeutic scoliosis-specific exercises (PSSE): while the former are generic exercises usually consisting of low-impact stretching and strengthening activities like yoga, Pilates and the Alexander technique, PSSE consist of a program of curve-specific exercise protocols which are individually adapted to a patients' curve site, magnitude and clinical characteristics. PSSEs are performed with the therapeutic aim of reducing the deformity and preventing its progression. It also aims to stabilise the improvements achieved with the ultimate goal of limiting the need for corrective braces or the necessity of surgery. This paper introduces the different 'Schools' and approaches of PSSE currently practiced (Scientific Exercise Approach to Scoliosis - SEAS, Schroth, Barcelona Scoliosis Physical Therapy School - BSPTS, Dobomed, Side Shift, Functional Individual Therapy of Scoliosis - FITS and Lyon) and discusses their commonalities and differences.

  1. Brace Treatment in Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Ali Sehirlioglu

    2012-01-01

    Full Text Available Adolescent idiopathic scoliosis (AIS, the most common pediatric spine problem, is a structural lateral and rotatory curvature of the spine arising in otherwise normal children during puberty. It occurs before skeletal maturity. Although there is still no cause for AIS, the natural history of AIS has been established in the literature very well. The aim of nonoperative treatment is mainly an attempt to prevent progression of the curve. Bracing and surgery have been used for large and or progressive curves currently. Many conservative treatments are available for adolescents with idiopathic scoliosis (AIS. Although there are numerous studies in literature that have tried to summarize the results of treatment, the evidence for their accepted use is still unclear. Many clinicians skeptical about the efficacy of conservative treatments. Because there is no consistency of both the inclusion criteria and the definitions of brace effectiveness. The definition of success or who should be included in the analysis have never been universally agreed upon. The Scoliosis Research Society established parameters for all future AIS bracing studies to be able to make comparison among studies more valid and reliable. These guidelines may standardize orthotic studies by recommending inclusion and assessment criteria and allow the promotion of the effectiveness of different braces and decrease the suspicion about their usefulness. Orthotic treatment in adolescent idiopathic scoliosis is used to control spinal curvatures while waiting for skeletal maturation.

  2. The genetic epidemiology of idiopathic scoliosis

    OpenAIRE

    Gorman, Kristen Fay; Julien, Cédric; Moreau, Alain

    2012-01-01

    Purpose Idiopathic scoliosis is a complex developmental syndrome defined by an abnormal structural curvature of the spine. High treatment costs, chronic pain/discomfort, and the need for monitoring at-risk individuals contribute to the global healthcare burden of this musculoskeletal disease. Although many studies have endeavored to identify underlying genes, little progress has been made in understanding the etiopathogenesis. The objective of this comprehensive review was to summarize geneti...

  3. Perceived health status in self-reported adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Andersen, Mikkel Ø; Thomsen, Karsten; Kyvik, Kirsten O

    2010-01-01

    A questionnaire-based identification of adolescent idiopathic scoliosis (AIS) patients and measure of Short Form-12 (SF-12) in a big twin-cohort.......A questionnaire-based identification of adolescent idiopathic scoliosis (AIS) patients and measure of Short Form-12 (SF-12) in a big twin-cohort....

  4. Effect of physical therapy scoliosis specific exercises using breathing pattern on adolescent idiopathic scoliosis

    Science.gov (United States)

    Yoon, Sungyoung; Rhee, Min-Hyung

    2016-01-01

    [Purpose] This study was performed to confirm physical therapy scoliosis specific exercises on adolescent idiopathic scoliosis patients. [Subject and Methods] A 15-year-old male middle school student with scoliosis. Cobb’s angle, angle of rotation of the spine, and breathing pattern were measured before and after 8 weeks training. [Results] After 8 weeks training, Cobb’s angle, angle of rotation of the spine, and breathing pattern were improved better. [Conclusion] These results indicate that physical therapy scoliosis specific exercises improves scoliosis curves and could provide an effective intervention and management of scoliosis. PMID:27942163

  5. Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients

    Directory of Open Access Journals (Sweden)

    Mercier Pierre

    2009-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis is characterized by a three-dimensional deviation of the vertebral column and its etiopathogenesis is unknown. Various factors cause idiopathic scoliosis, and among these a prominent role has been attributed to the vestibular system. While the deficits in sensorimotor transformations have been documented in idiopathic scoliosis patients, little attention has been devoted to their capacity to integrate vestibular information for cognitive processing for space perception. Seated idiopathic scoliosis patients and control subjects experienced rotations of different directions and amplitudes in the dark and produced saccades that would reproduce their perceived spatial characteristics of the rotations (vestibular condition. We also controlled for possible alteration of the oculomotor and vestibular systems by measuring the subject's accuracy in producing saccades towards memorized peripheral targets in absence of body rotation and the gain of their vestibulo-ocular reflex. Results Compared to healthy controls, the idiopathic scoliosis patients underestimated the amplitude of their rotations. Moreover, the results revealed that idiopathic scoliosis patients produced accurate saccades to memorized peripheral targets in absence of body rotation and that their vestibulo-ocular reflex gain did not differ from that of control participants. Conclusion Overall, results of the present study demonstrate that idiopathic scoliosis patients have an alteration in cognitive integration of vestibular signals. It is possible that severe spine deformity developed partly due to impaired vestibular information travelling from the cerebellum to the vestibular cortical network or alteration in the cortical mechanisms processing the vestibular signals.

  6. Prevalence of Back Problems in 1069 Adults With Idiopathic Scoliosis and 158 Adults Without Scoliosis.

    Science.gov (United States)

    Grauers, A; Topalis, C; Möller, H; Normelli, H; Karlsson, Mk; Danielsson, A; Gerdhem, P

    2014-04-08

    Study Design. Multi-center case-control studyObjective. To investigate the prevalence of back problems in adults with idiopathic scoliosis.Summary of Background Data. Information on the prevalence of back problems in adults with idiopathic scoliosis is scarce, especially in untreated individuals, males and individuals with an age at onset of the scoliosis of less than 10 years.Methods. 1069 individuals with idiopathic scoliosis and 158 individuals without scoliosis, all aged 20-65 years, answered a questionnaire on back problems. Individuals with scoliosis were diagnosed between ages 4 and 20 years and any treatment was terminated before age 20. Logistic regression or ANCOVA was used for group comparisons.Results. Mean (SD) age at the time of investigation in individuals with scoliosis (123 men and 946 women) was 41 (9) years, and in individuals without scoliosis (75 men and 83 women) 45 (13) years. 374 individuals with scoliosis were untreated, 451 had been brace treated and 244 surgically treated. The mean prevalence of back problems was 64% in the individuals with scoliosis and 29% in the individuals without scoliosis (pscoliosis, 69% reported back problems, among the brace treated 61%, and among the surgically treated 64% (p = 0.06). When comparing females and males with scoliosis, and individuals with juvenile and adolescent scoliosis, there were no statistically significant differences in the prevalence of back problems (p = 0.10 and p = 0.23, respectively).Conclusion. Adults with idiopathic scoliosis have a higher prevalence of back problems than individuals without scoliosis. Treatment, gender and juvenile or adolescent onset of diagnosis was not related to the prevalence of back problems in adulthood.

  7. Idiopathic Adolescent Scoliosis: Living with a Physical Deformity

    OpenAIRE

    2016-01-01

    A qualitative, phenomenological, hermeneutical study with the aim of explaining the experience of having a body deformity diagnosed as idiopathic adolescent scoliosis. A semistructured interview conducted with scoliosis patients admitted to the unit of spinal cord at the Vall d’Hebron Hospital was used. The youth defined their scoliosis based on how they perceived their deformity. They spoke of pain and deformity as characteristic symptoms of suffering, and explained how this symptom affected...

  8. Effect of physical therapy scoliosis specific exercises using breathing pattern on adolescent idiopathic scoliosis

    OpenAIRE

    2016-01-01

    [Purpose] This study was performed to confirm physical therapy scoliosis specific exercises on adolescent idiopathic scoliosis patients. [Subject and Methods] A 15-year-old male middle school student with scoliosis. Cobb’s angle, angle of rotation of the spine, and breathing pattern were measured before and after 8 weeks training. [Results] After 8 weeks training, Cobb’s angle, angle of rotation of the spine, and breathing pattern were improved better. [Conclusion] These results indicate that...

  9. Adult idiopathic scoliosis: the tethered spine.

    Science.gov (United States)

    Whyte Ferguson, Lucy

    2014-01-01

    This article reports on an observational and treatment study using three case histories to describe common patterns of muscle and fascial asymmetry in adults with idiopathic scoliosis (IS) who have significant scoliotic curvatures that were not surgically corrected and who have chronic pain. Rather than being located in the paraspinal muscles, the myofascial trigger points (TrPs) apparently responsible for the pain were located at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine. Asymmetries in these muscles appear to tether the spine in such a way that they contribute to scoliotic curvatures. Evaluation also showed that each of these individuals had major ligamentous laxity and this may also have contributed to development of scoliotic curvatures. Treatment focused on release of TrPs found to refer pain into the spine, release of related fascia, and correction of related joint dysfunction. Treatment resulted in substantial relief of longstanding chronic pain. Treatment thus validated the diagnostic hypothesis that myofascial and fascial asymmetries were to some extent responsible for pain in adults with significant scoliotic curvatures. Treatment of these patterns of TrPs and muscle and fascial asymmetries and related joint dysfunction was also effective in relieving pain in each of these individuals after they were injured in auto accidents. Treatment of myofascial TrPs and asymmetrical fascial tension along with treatment of accompanying joint dysfunction is proposed as an effective approach to treating both chronic and acute pain in adults with scoliosis that has not been surgically corrected.

  10. TACTIC IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS IN CHILDREN

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    S. V. Vissarionov

    2010-01-01

    Full Text Available The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI. Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.

  11. Idiopathic scoliosis; a biomechanical and functional anatomical study.

    NARCIS (Netherlands)

    Veldhuizen, Albert Gerrit

    1985-01-01

    Although many types of causes of scoliosis are known, the idiopathic variety comprises the largest group and as its name indicates, its a etiology is unknown. Idiopathics coliosis develops in a previously normal vertebral column and has been recognized as an entity for more than a century.

  12. Idiopathic Scoliosis: Evaluation of Screening and Treatment

    NARCIS (Netherlands)

    E.M. Bunge (Eveline)

    2009-01-01

    textabstractScoliosis is a rather common condition of the back. Scoliosis is a deformation of the spine consisting of a lateral curvature combined with a fixed rotation of one or more vertebrae and a rotational deformation of those vertebrae1 (Figure 1.1). The severity of scoliosis can be assessed b

  13. The natural history of adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Wong Hee-Kit

    2010-01-01

    Full Text Available There have been great advances in the conservative and surgical treatment for adolescent idiopathic scoliosis in the last few decades. The challenge for the physician is the decision for the optimal time to institute therapy for the individual child. This makes an understanding of the natural history and risk factors for curve progression of significant importance. Reported rates of curve progression vary from 1.6% for skeletally mature children with a small curve magnitude to 68% for skeletally immature children with larger curve magnitudes. Although the patient′s age at presentation, the Risser sign, the patient′s menarchal status and the magnitude of the curve have been described as risk factors for curve progression, there is evidence that the absolute curve magnitude at presentation may be most predictive of progression in the long term. A curve magnitude of 25º at presentation may be predictive of a greater risk of curve progression. Advances in research may unlock novel predictive factors, which are based on the underlying pathogenesis of this disorder.

  14. Study on Treatment with Respect to Idiopathic Scoliosis

    Science.gov (United States)

    Takeuchi, Kenzen; Azegami, Hideyuki; Murachi, Shunji; Kitoh, Junzoh; Ishida, Yoshito; Kawakami, Noriaki; Makino, Mitsunori

    A hypothesis that the thoracic idiopathic scoliosis is buckling phenomenon of the fourth mode induced by the growth of thoracic vertebral bodies was presented in the previous work by the authors using numerical simulations with finite element model of the spine. If the hypothesis is acceptable, sensitivity function with respect to the critical growth of thoracic vertebrae on the maximization problem of buckling load with the fourth buckling mode gives us useful information to improve and develop treatments for the idiopathic scoliosis. The numerical results analyzed by the finite element method demonstrated that the sensitivity function is high at the articular capsules of the intervertebral joints, the intervertebral disks, the costotransverse joints and the constovertebral joints around the apex of the curvature in the case of the thoracic idiopathic scoliosis.

  15. Breast asymmetry pattern in women with idiopathic scoliosis.

    Science.gov (United States)

    Cruz, Norma I; Korchin, Leo

    2013-01-01

    Breast asymmetry is frequent in women with idiopathic scoliosis. To understand the pattern of breast asymmetry in these women a clinical study was performed in which 54 female patients with idiopathic scoliosis were evaluated. The information recorded for each patient included: age, weight, height, scoliosis type, Cobb angle, breast measurements, and presence of rib cage asymmetry. Breast volume was calculated using anatomic measurements (anthropomorphic method). The mean age of the group was 25 +/- 7 years. A right convex thoracic curve occurred in 85%, with a mean Cobb angle of 32 +/- 15 degrees. Our study indicated that women with idiopathic scoliosis consistently presented breast asymmetry that followed a predictable pattern. The breast on the side of the convex thoracic scoliosis curve is always smaller in volume (mean difference 59 +/- 39 mi). The affected side also presents a smaller areola, a higher position of the nipple (mean difference 2.2 +/- 1.3 cm) and a higher position of the inframammary fold (mean difference 2.1 +/- 1.4 cm) when compared to the opposite breast. Though the asymmetry is predictable, the degree to which the patient presents these changes does not correlate with the severity of the scoliosis (Cobb angle). We believe that the severity of the asymmetry is a result of the difference between the hypoplastic breast and the normal breasts. In women with very large opposite breasts the asymmetry appears to be worse.

  16. Idiopathic Scoliosis: Evaluation of Screening and Treatment

    OpenAIRE

    Bunge, Eveline

    2009-01-01

    textabstractScoliosis is a rather common condition of the back. Scoliosis is a deformation of the spine consisting of a lateral curvature combined with a fixed rotation of one or more vertebrae and a rotational deformation of those vertebrae1 (Figure 1.1). The severity of scoliosis can be assessed by X-ray and is expressed in the size of the Cobb angle, which is the angle between the upper most inclined vertebra and the lower most inclined vertebra. Someone is being diagnosed to have scoliosi...

  17. Scoliosis

    Science.gov (United States)

    Scoliosis causes a sideways curve of your backbone, or spine. These curves are often S- or C-shaped. Scoliosis is most common in late childhood and the ... but not always. Children may get screening for scoliosis at school or during a checkup. If it ...

  18. The aetiology of idiopathic scoliosis : biomechanical and neuromuscular factors

    NARCIS (Netherlands)

    Veldhuizen, AG; Webb, PJ

    2000-01-01

    The aetiology of adolescent idiopathic scoliosis (AIS) remains an enigma. In the literature there are two opinions: one believes a deviating growth pattern is responsible for the condition - patients with AIS lend to be growing faster/be taller - while the other opinion assumes that the growth patte

  19. Curve progression and spinal growth in brace treated idiopathic scoliosis

    NARCIS (Netherlands)

    Tonseth, KA; Veldhuizen, AG; Cool, JC; van Horn, [No Value

    2000-01-01

    The risk of progression of idiopathic scoliosis is correlated primarily to factors that predict potential remaining skeletal growth. The aim of the current study was to evaluate spinal growth, measured as the length of the scoliotic spine on serial longitudinal radiographs, and its relationship to p

  20. Factors affecting pelvic rotation in idiopathic scoliosis

    Science.gov (United States)

    Zhao, Yunfei; Qi, Lin; Yang, Jun; Zhu, Xiaodong; Yang, Changwei; Li, Ming

    2016-01-01

    Abstract Pelvic rotation (PR) is commonly seen in patients with idiopathic scoliosis (IS), but factors contributing to this phenomenon and its relationship with the surgical outcome are not well established. This retrospective study included 85 IS patients in 2 groups: thoracic curve dominance group (group A) and lumbar curve dominance group (group B). Pre- and postoperative PR was measured on standing posteroanterior radiographs by the left/right ratio (L/R ratio) of horizontal distance between the anterior superior iliac spine (ASIS) and the inferior ilium (SI) at the sacroiliac joint on the same side in both groups. Other radiographic data, age, sex, and Risser sign of each patient were recorded to analyze their correlations with PR before and after operation. The patients ranged in age from 10 to 35 years with a mean of 17.0 ± 5.2 years. The mean L/R ratio of PR before operation was 0.99 (0.73–1.40) versus 0.98 (0.87–1.26) after operation. The L/R ration was beyond the range of 1 ± 0.1 (indicating the presence of PR) in 17 (20%) patients before operation and in 14 (16.5%) patients after operation. There was no significant difference in PR between the 2 groups of patients either before (P = 0.468) or after (P = 0.944) surgery. The preoperative PR showed a very low correlation with Risser sign (r = 0.220, P = 0.043), apex vertebral rotation (AVR) in the proximal thoracic curve (r = 0.242, P = 0.026), and AVR in the lumbar curve (r = 0.213, P = 0.049), while the postoperative PR showed a very low correlation with Risser sign (r = −0.341, P = 0.001) and postoperative trunk shift (TS) (r = −0.282, P = 0.009). Multiple stepwise regression analysis showed that preoperative PR was affected by proximal thoracic curve AVR and lumbar curve AVR. There was no significant difference between PR before operation and 2 years after operation. Preoperative PR was mainly correlated with Risser sign and the rotation

  1. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes

    OpenAIRE

    Mihas Constantinos; Mouzakis Vasilios; Vasiliadis Elias; Grivas Theodoros B; Koufopoulos Georgios

    2006-01-01

    Abstract Background Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among nor...

  2. Minimally invasive scoliosis surgery: an innovative technique in patients with adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Gambassi Melanie

    2011-08-01

    Full Text Available Abstract Minimally invasive spine surgery is becoming more common in the treatment of adult lumbar degenerative disorders. Minimally invasive techniques have been utilized for multilevel pathology, including adult lumbar degenerative scoliosis. The next logical step is to apply minimally invasive surgical techniques to the treatment of adolescent idiopathic scoliosis (AIS. However, there are significant technical challenges of performing minimally invasive surgery on this patient population. For more than two years, we have been utilizing minimally invasive spine surgery techniques in patients with adolescent idiopathic scoliosis. We have developed the present technique to allow for utilization of all standard reduction maneuvers through three small midline skin incisions. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, and allows adequate facet osteotomy to enable fusion. There are multiple potential advantages of this technique, including: less blood loss, shorter hospital stay, earlier mobilization, and relatively less pain and need for pain medication. The operative time needed to complete this surgery is longer. We feel that a minimally invasive approach, although technically challenging, is a feasible option in patients with adolescent idiopathic scoliosis. Although there are multiple perceived benefits, long term data is needed before it can be recommended for routine use.

  3. Adolescent idiopathic scoliosis in twins: a population-based survey

    DEFF Research Database (Denmark)

    Andersen, Mikkel O; Thomsen, Karsten; Kyvik, Kirsten O

    2007-01-01

    STUDY DESIGN: A questionnaire-based identification of adolescent idiopathic scoliosis (AIS) patients in a twin cohort. OBJECTIVE: The purpose of this study was to establish a scoliosis twin cohort to provide data on the heritability of AIS. SUMMARY OF BACKGROUND DATA: The etiology of AIS is still...... environmental factors. METHODS: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a questionnaire, which included questions about scoliosis. A total of 34,944 (75.3%) representing 23,204 pairs returned the questionnaire. RESULTS: A subgroup of 220 subjects considered...... to have AIS was identified, thus giving a prevalence of 1.05%. The concordant twin pairs were all monozygotic. Pairwise, the concordance rate was 0.13 for monozygotic and zero for dizygotic twin pairs; proband-wise concordance was 0.25 for monozygotic and zero for dizygotic pairs. The concordance...

  4. Candidate gene analysis and exome sequencing confirm LBX1 as a susceptibility gene for idiopathic scoliosis

    DEFF Research Database (Denmark)

    Grauers, Anna; Wang, Jingwen; Einarsdottir, Elisabet;

    2015-01-01

    BACKGROUND CONTEXT: Idiopathic scoliosis is a spinal deformity affecting approximately 3% of otherwise healthy children or adolescents. The etiology is still largely unknown but has an important genetic component. Genome-wide association studies have identified a number of common genetic variants...... that are significantly associated with idiopathic scoliosis in Asian and Caucasian populations, rs11190870 close to the LBX1 gene being the most replicated finding. PURPOSE: The aim of the present study was to investigate the genetics of idiopathic scoliosis in a Scandinavian cohort by performing a candidate gene study...... of four variants previously shown to be associated with idiopathic scoliosis and exome sequencing of idiopathic scoliosis patients with a severe phenotype to identify possible novel scoliosis risk variants. STUDY DESIGN: This was a case control study. PATIENT SAMPLE: A total of 1,739 patients...

  5. MUSCLE DISORDERS IN ADOLESCENT IDIOPATHIC SCOLIOSIS: LITERATURE REVIEW

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    Débora Pinheiro Lédio Alves

    2016-03-01

    Full Text Available ABSTRACT Scoliosis is characterized by three-dimensional changes of the spine and is estimated to be present in 4% of the population worldwide. The most common form is the adolescent idiopathic. The purpose of this study is to identify the major muscle abnormalities found in patients with adolescent idiopathic scoliosis through a literature review. We conducted an electronic search of the national databases PubMed, Lilacs, PEDro, and EMBASE using the keywords "scoliosis", "biomechanics", "exercise", "physical therapy specialty", "idiopathic", and "muscles", from January 2003 to April 2015. The most relevant articles in English, Portuguese and Spanish were selected by title and abstract. It was also performed a manual search of the references of the selected articles. From a total of 4,319 articles, 11 were selected. We conclude that individuals with AIS have changes in the paraspinal muscles, with a difference in activation between the concave and convex sides, suggesting an increase in EMG activity on the convex side, although there is still no consensus among the authors.

  6. Adolescent idiopathic scoliosis: Indications and efficacy of nonoperative treatment

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    Federico Canavese

    2011-01-01

    Full Text Available The strategy for the treatment of idiopathic scoliosis depends essentially upon the magnitude and pattern of the deformity, and its potential for progression. Treatment options include observation, bracing and/or surgery. During the past decade, several studies have demonstrated that the natural history of adolescent idiopathic scoliosis can be positively affected by nonoperative treatment, especially bracing. Other forms of conservative treatment, such as chiropractic or osteopathic manipulation, acupuncture, exercise or other manual treatments, or diet and nutrition, have not yet been proven to be effective in controlling spinal deformity progression, and those with a natural history that is favorable at the completion of growth. Observation is appropriate treatment for small curves, curves that are at low risk of progression, and those with a natural history that is favorable at the completion of growth. Indications for brace treatment are a growing child presenting with a curve of 25°-40° or a curve less than 25° with documented progression. Curves of 20°-25° in patients with pronounced skeletal immaturity should also be treated. The purpose of this review is to provide information about conservative treatment of adolescent idiopathic scoliosis. Indications for conservative treatment, hours daily wear and complications of brace treatment as well as brace types are discussed.

  7. Exome sequencing identifies a rare HSPG2 variant associated with familial idiopathic scoliosis.

    Science.gov (United States)

    Baschal, Erin E; Wethey, Cambria I; Swindle, Kandice; Baschal, Robin M; Gowan, Katherine; Tang, Nelson L S; Alvarado, David M; Haller, Gabe E; Dobbs, Matthew B; Taylor, Matthew R G; Gurnett, Christina A; Jones, Kenneth L; Miller, Nancy H

    2014-12-12

    Idiopathic scoliosis occurs in 3% of individuals and has an unknown etiology. The objective of this study was to identify rare variants that contribute to the etiology of idiopathic scoliosis by using exome sequencing in a multigenerational family with idiopathic scoliosis. Exome sequencing was completed for three members of this multigenerational family with idiopathic scoliosis, resulting in the identification of a variant in the HSPG2 gene as a potential contributor to the phenotype. The HSPG2 gene was sequenced in a separate cohort of 100 unrelated individuals affected with idiopathic scoliosis and also was examined in an independent idiopathic scoliosis population. The exome sequencing and subsequent bioinformatics filtering resulted in 16 potentially damaging and rare coding variants. One of these variants, p.Asn786Ser, is located in the HSPG2 gene. The variant p.Asn786Ser also is overrepresented in a larger cohort of idiopathic scoliosis cases compared with a control population (P = 0.024). Furthermore, we identified additional rare HSPG2 variants that are predicted to be damaging in two independent cohorts of individuals with idiopathic scoliosis. The HSPG2 gene encodes for a ubiquitous multifunctional protein within the extracellular matrix in which loss of function mutation are known to result in a musculoskeletal phenotype in both mouse and humans. Based on these results, we conclude that rare variants in the HSPG2 gene potentially contribute to the idiopathic scoliosis phenotype in a subset of patients with idiopathic scoliosis. Further studies must be completed to confirm the effect of the HSPG2 gene on the idiopathic scoliosis phenotype.

  8. Effects of living environment on the postoperative Scoliosis Research Society-24 results in females with adolescent idiopathic scoliosis

    OpenAIRE

    Misterska, Ewa; Głowacki, Maciej; Panek, Sławomir; Ignyś-O’Byrne, Anna; Głowacki, Jakub; Ignyś, Iwona; Krauss, Hanna; Piątek, Jacek

    2012-01-01

    Summary Background There are many factors influencing postoperative health-related quality of life of adolescent idiopathic scoliosis patients, including the degree of the deformity, culture, differences in geography, rural versus urban living environments, and social factors. The objective of this study was to analyze the significance of geographic factors and their differences influencing the postoperative quality of life in females with adolescent idiopathic scoliosis residing in urban and...

  9. The role of intrinsic spinal mechanisms in the pathogenesis of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Kouwenhoven, J.W.M.

    2007-01-01

    Despite numerous years of dedicated research into the origin of idiopathic scoliosis, the pathogenesis of this classic orthopaedic disorder has so far remained elusive. A striking feature of idiopathic scoliosis is the fact that it does not occur in vertebrates other than humans, despite many simila

  10. Adolescent Idiopathic Scoliosis: From Normal Spinal Anatomy To Three-Dimensional Deformity

    NARCIS (Netherlands)

    Schlösser, T.P.C.

    2014-01-01

    Adolescent idiopathic scoliosis is a three-dimensional deformity of the spine and trunk that primarily affects previously healthy children. It is a classic orthopedic disorder. Despite many years of dedicated research into the etio-pathogenesis of idiopathic scoliosis, there is not one distinct caus

  11. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes

    Directory of Open Access Journals (Sweden)

    Mihas Constantinos

    2006-05-01

    Full Text Available Abstract Background Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among normal girls in various geographic latitudes. An attempt is also made to implicate a possible role of melatonin in the above association. Material-methods 20 peer-reviewed published papers reporting adolescent idiopathic scoliosis prevalence and 33 peer-reviewed papers reporting age at menarche in normal girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included regression of the adolescent idiopathic scoliosis prevalence and age at menarche by latitude. Results The regression of prevalence of adolescent idiopathic scoliosis and age at menarche by latitude is statistically significant (p Conclusion Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis.

  12. Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

    Science.gov (United States)

    Korbel, Krzysztof; Kozinoga, Mateusz; Stoliński, Łukasz; Kotwicki, Tomasz

    2014-07-28

    According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

  13. Patients' experience of adolescent idiopathic scoliosis surgery: a phenomenological analysis.

    Science.gov (United States)

    Honeyman, Cheryl; Davison, Jean

    2016-09-12

    Background Adolescent idiopathic scoliosis is a three-dimensional curvature of the spine of unknown cause that occurs in often otherwise fit young people. A complex surgical procedure is required for the most severe curves. Quantitative literature suggests scoliosis surgery improves patients' lives, while qualitative literature focuses on patients' concerns rather than their experience. Aims To explore how adolescents interpret their perioperative experience. Method Six participants, aged 15-18, were interviewed and transcripts were analysed. Findings Four themes were identified: shock, fears and worries; parental interaction; coping; and motivation and positivity. Conclusion Participants were reluctant to share concerns, however those they shared related more to fear of the unknown and lack of control than specific issues such as pain. Participants depended on their parents, especially their mothers, during the perioperative period, and they recognised their parents' stress. Participants coped well, were motivated and had a positive outlook.

  14. Postural Rehabilitation for Adolescent Idiopathic Scoliosis during Growth.

    Science.gov (United States)

    Weiss, Hans-Rudolf; Moramarco, Marc Michael; Borysov, Maksym; Ng, Shu Yan; Lee, Sang Gil; Nan, Xiaofeng; Moramarco, Kathryn Ann

    2016-06-01

    Long-term follow-up of untreated patients with adolescent idiopathic scoliosis (AIS) indicates that, with the exception of some extremely severe cases, AIS does not have a significant impact on quality of life and does not result in dire consequences. In view of the relatively benign nature of AIS and the long-term complications of surgery, the indications for treatment should be reviewed. Furthermore, recent studies have shown that scoliosis-specific exercises focusing on postural rehabilitation can positively influence the spinal curvatures in growing adolescents. Experiential postural re-education is a conservative, non-invasive approach, and its role in the management of AIS warrants further study. This article reviews current evidence for the inclusion of various forms of postural reeducation in the management of AIS. Recent comprehensive reviews have been researched including a manual and PubMed search for evidence regarding the effectiveness of physical/postural re-education/physiotherapy programs in growing AIS patients. This search revealed that there were few studies on the application of postural re-education in the management of AIS. These studies revealed that postural re-education in the form of exercise rehabilitation programs may have a positive influence on scoliosis; however, the various programs were difficult to compare. More research is necessary. There is at present Level 1 evidence for the effectiveness of Schroth scoliosis exercises in the management of AIS. Whether this evidence can be extrapolated to include other forms of scoliosis- pattern-specific exercises requires further investigation. Because corrective postures theoretically reduce the asymmetric loading of the spinal deformities and reverse the vicious cycle of spinal curvature progression, their integration into AIS programs may be beneficial and should be further examined.

  15. Idiopathic scoliosis: the tethered spine II: post-surgical pain.

    Science.gov (United States)

    Whyte Ferguson, Lucy

    2014-10-01

    The treatment of severe chronic pain in young people following surgery for the correction of curvatures of idiopathic scoliosis (IS) is presented through two case histories. Effective treatment involved release of myofascial trigger points (TrPs) known to refer pain into the spine, and treatment of related fascia and joint dysfunction. The TrPs found to be contributing to spinal area pain were located in muscles at some distance from the spine rather than in the paraspinal muscles. Referred pain from these TrPs apparently accounted for pain throughout the base of the neck and thoracolumbar spine. Exploratory surgery was considered for one patient to address pain following rod placement but the second surgery became unnecessary when the pain was controlled with treatment of the myofascial pain and joint dysfunction. The other individual had both scoliosis and hyperkyphosis, had undergone primary scoliosis surgery, and subsequently underwent a second surgery to remove hardware in an attempt to address her persistent pain following the initial surgery (and because of dislodged screws). The second surgery did not, however, reduce her pain. In both cases these individuals, with severe chronic pain following scoliosis corrective surgery, experienced a marked decrease of pain after myofascial treatment. As will be discussed below, despite the fact that a significant minority of individuals who have scoliosis corrective surgery are thought to require a second surgery, and despite the fact that pain is the most common reason leading to such revision surgery, myofascial pain syndrome (MPS) had apparently not previously been considered as a possible factor in their pain.

  16. Current concepts and controversies on adolescent idiopathic scoliosis: Part I

    Directory of Open Access Journals (Sweden)

    Alok Sud

    2013-01-01

    Full Text Available Adolescent idiopathic scoliosis is the most common spinal deformity encountered by General Orthopaedic Surgeons. Etiology remains unclear and current research focuses on genetic factors that may influence scoliosis development and risk of progression. Delayed diagnosis can result in severe deformities which affect the coronal and sagittal planes, as well as the rib cage, waistline symmetry, and shoulder balance. Patient′s dissatisfaction in terms of physical appearance and mechanical back pain, as well as the risk for curve deterioration are usually the reasons for treatment. Conservative management involves mainly bracing with the aim to stop or slow down scoliosis progression during growth and if possible prevent the need for surgical treatment. This is mainly indicated in young compliant patients with a large amount of remaining growth and progressive curvatures. Scoliosis correction is indicated for severe or progressive curves which produce significant cosmetic deformity, muscular pain, and patient discontent. Posterior spinal arthrodesis with Harrington instrumentation and bone grafting was the first attempt to correct the coronal deformity and replace in situ fusion. This was associated with high pseudarthrosis rates, need for postoperative immobilization, and flattening of sagittal spinal contour. Segmental correction techniques were introduced along with the Luque rods, Harri-Luque, and Wisconsin systems. Correction in both coronal and sagittal planes was not satisfactory and high rates of nonunion persisted until Cotrel and Dubousset introduced the concept of global spinal derotation. Development of pedicle screws provided a powerful tool to correct three-dimensional vertebral deformity and opened a new era in the treatment of scoliosis.

  17. The Level of Self-Esteem and Sexual Functioning in Women with Idiopathic Scoliosis: A Preliminary Study.

    Science.gov (United States)

    Durmała, Jacek; Blicharska, Irmina; Drosdzol-Cop, Agnieszka; Skrzypulec-Plinta, Violetta

    2015-08-12

    A person's image, which is determined through physical appearance, considerably affects self-esteem developed from early childhood. Scoliosis causes multiple trunk deformations that can affect a person's perception of the body. The aim of the study was to analyze the impact of scoliosis dimension and the degree of trunk deformation on the level of self-esteem and sexual functioning in women with idiopathic scoliosis. Thirty-six women diagnosed with idiopathic scoliosis were recruited to a prospective, double-blind, randomized controlled trial. The subjects were divided into two groups depending on the value of the Cobb angle. The level of self-esteem was determined by means of the Rosenberg Self-Esteem Scale (SES), whereas the sexual functioning was assessed via the Female Sexual Function Index (FSFI). The trunk deformations were specified with the Posterior Trunk Symmetry Index (POTSI). A statistically significant correlation was proved between the amount of points received in the Rosenberg scale evaluation and the POTSI index in Group A (R = -0.56, p = 0.04). Subjects with smaller deformations within the coronal plane had a higher level of self-confidence. The trunk asymmetries in the coronal plane may have a negative effect on women with scoliosis and their self-appraisal.

  18. The Level of Self-Esteem and Sexual Functioning in Women with Idiopathic Scoliosis: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Jacek Durmała

    2015-08-01

    Full Text Available A person’s image, which is determined through physical appearance, considerably affects self-esteem developed from early childhood. Scoliosis causes multiple trunk deformations that can affect a person’s perception of the body. The aim of the study was to analyze the impact of scoliosis dimension and the degree of trunk deformation on the level of self-esteem and sexual functioning in women with idiopathic scoliosis. Thirty-six women diagnosed with idiopathic scoliosis were recruited to a prospective, double-blind, randomized controlled trial. The subjects were divided into two groups depending on the value of the Cobb angle. The level of self-esteem was determined by means of the Rosenberg Self-Esteem Scale (SES, whereas the sexual functioning was assessed via the Female Sexual Function Index (FSFI. The trunk deformations were specified with the Posterior Trunk Symmetry Index (POTSI. A statistically significant correlation was proved between the amount of points received in the Rosenberg scale evaluation and the POTSI index in Group A (R = −0.56, p = 0.04. Subjects with smaller deformations within the coronal plane had a higher level of self-confidence. The trunk asymmetries in the coronal plane may have a negative effect on women with scoliosis and their self-appraisal.

  19. [Genome-wide association study for adolescent idiopathic scoliosis].

    Science.gov (United States)

    Ogura, Yoji; Kou, Ikuyo; Scoliosis, Japan; Matsumoto, Morio; Watanabe, Kota; Ikegawa, Shiro

    2016-04-01

    Adolescent idiopathic scoliosis(AIS)is a polygenic disease. Genome-wide association studies(GWASs)have been performed for a lot of polygenic diseases. For AIS, we conducted GWAS and identified the first AIS locus near LBX1. After the discovery, we have extended our study by increasing the numbers of subjects and SNPs. In total, our Japanese GWAS has identified four susceptibility genes. GWASs for AIS have also been performed in the USA and China, which identified one and three susceptibility genes, respectively. Here we review GWASs in Japan and abroad and functional analysis to clarify the pathomechanism of AIS.

  20. Adolescent idiopathic scoliosis: natural history and long term treatment effects

    Directory of Open Access Journals (Sweden)

    Asher Marc A

    2006-03-01

    Full Text Available Abstract Adolescent idiopathic scoliosis is a lifetime, probably systemic condition of unknown cause, resulting in a spinal curve or curves of ten degrees or more in about 2.5% of most populations. However, in only about 0.25% does the curve progress to the point that treatment is warranted. Untreated, adolescent idiopathic scoliosis does not increase mortality rate, even though on rare occasions it can progress to the >100° range and cause premature death. The rate of shortness of breath is not increased, although patients with 50° curves at maturity or 80° curves during adulthood are at increased risk of developing shortness of breath. Compared to non-scoliotic controls, most patients with untreated adolescent idiopathic scoliosis function at or near normal levels. They do have increased pain prevalence and may or may not have increased pain severity. Self-image is often decreased. Mental health is usually not affected. Social function, including marriage and childbearing may be affected, but only at the threshold of relatively larger curves. Non-operative treatment consists of bracing for curves of 25° to 35° or 40° in patients with one to two years or more of growth remaining. Curve progression of ≥ 6° is 20 to 40% more likely with observation than with bracing. Operative treatment consists of instrumentation and arthrodesis to realign and stabilize the most affected portion of the spine. Lasting curve improvement of approximately 40% is usually achieved. In the most completely studied series to date, at 20 to 28 years follow-up both braced and operated patients had similar, significant, and clinically meaningful reduced function and increased pain compared to non-scoliotic controls. However, their function and pain scores were much closer to normal than patient groups with other, more serious conditions. Risks associated with treatment include temporary decrease in self-image in braced patients. Operated patients face the usual

  1. IDIOPATHIC SCOLIOSIS. /LECTURE, PART I. «PARADOXES»/

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    Михаил Георгиевич Дудин

    2013-03-01

    Full Text Available In the paper we discussed and analyzed the issues that confront practicing orthopedists with the most mysterious and at the same time the most studied vertebral column lesion in children and adolescents - idiopathic scoliosis. Nowadays a great amount of information on its various aspects has been already accumulated, but a practical output in the form of a system of effective treatment has not been yet found and (we can’t even speak about there is no speech at all about the prevention (prophylactic of the disease (scoliosis. On the basis of the own many year’s experience with this category of patients and the results of a comprehensive multi-faceted survey, the authors acquired the right to form their own point of view on the etiology and pathogenesis of the three-plane deformation in orthograde human (homo erectus. In this paper, the authors present their reflections on the history of the study of scoliosis, the terminology, statistical indicators and the existing views on its origins. Concerning argumentation on the own findings (conclusions and views on the disease the authors plan to tell in the following sections.

  2. Altered sensory-weighting mechanisms is observed in adolescents with idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Allard Paul

    2006-10-01

    Full Text Available Abstract Background Scoliosis is the most common type of spinal deformity. In North American children, adolescent idiopathic scoliosis (AIS makes up about 90% of all cases of scoliosis. While its prevalence is about 2% to 3% in children aged between 10 to 16 years, girls are more at risk than boys for severe progression with a ratio of 3.6 to 1. The aim of the present study was to test the hypothesis that idiopathic scoliosis interferes with the mechanisms responsible for sensory-reweighting during balance control. Methods Eight scoliosis patients (seven female and one male; mean age: 16.4 years and nine healthy adolescents (average age 16.5 years participated in the experiment. Visual and ankle proprioceptive information was perturbed (eyes closed and/or tendon vibration suddenly and then returned to normal (eyes open and/or no tendon vibration. An AMTI force platform was used to compute centre of pressure root mean squared velocity and sway density curve. Results For the control condition (eyes open and no tendon vibration, adolescent idiopathic scoliosis patients had a greater centre of pressure root mean squared velocity (variability than control participants. Reintegration of ankle proprioception, when vision was either available or removed, led to an increased centre of pressure velocity variability for the adolescent idiopathic scoliosis patients whereas the control participants reduced their centre of pressure velocity variability. Moreover, in the absence of vision, adolescent idiopathic scoliosis exhibited an increased centre of pressure velocity variability when ankle proprioception was returned to normal (i.e. tendon vibration stopped. The analysis of the sway density plot suggests that adolescent idiopathic scoliosis patients, during sensory reintegration, do not scale appropriately their balance control commands. Conclusion Altogether, the present results demonstrate that idiopathic scoliosis adolescents have difficulty in

  3. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30

    OpenAIRE

    Hasan Ghandehari; Maryam Ameri Mahabadi; Seyed Mani Mahdavi; Seyed Hossein Vahid Tari; Ali Shahsavaripour; Farshad Safdari

    2015-01-01

    Background: Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). Methods: We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Co...

  4. [Exercise therapy in the treatment of idiopathic adolescent scoliosis: Is it useful?].

    Science.gov (United States)

    Porte, M; Patte, K; Dupeyron, A; Cottalorda, J

    2016-06-01

    Many practitioners, pediatricians, and general practitioners prescribe physical therapy when tracking scoliosis. However, has physical therapy alone proved its efficacy in the care of the scoliosis to slow down progression? Our purpose is to report the results of a literature review on the effectiveness of rehabilitation in idiopathic scoliosis. No current study presents sufficient scientific proof to validate the efficacy of isolated exercise therapy in scoliosis. Learned societies recognize, however, the efficacy of combining conservative therapy (brace+physiotherapy) in idiopathic scoliosis. Should we then still prescribe rehabilitation without brace treatment? Although physical therapy alone does not seem effective in treating scoliosis, it can limit potential painful phenomena and be beneficial for respiratory function. The physical therapist can also teach the teenager the classic principles of hygiene of the back. It may therefore be appropriate to prescribe physical therapy, but the principles and objectives must be explained to the patient and family in light of current evidence-based medicine.

  5. Prevalence of cardiac dysfunction and abnormalities in patients with adolescent idiopathic scoliosis requiring surgery.

    Science.gov (United States)

    Liu, Limin; Xiu, Peng; Li, Qian; Song, Yueming; Chen, Rigao; Zhou, Chunguang

    2010-12-01

    The prevalence of cardiac abnormalities in patients with adolescent idiopathic scoliosis in an Asian population has not been reported. A retrospective study was conducted to evaluate the incidence of cardiac abnormalities in these patients. From January 2007 to April 2009, echocardiography and pulmonary function tests were performed in 80 adolescent idiopathic scoliosis patients who required surgical intervention. A thorough analysis of cardiopulmonary functions and cardiac structures was performed. The risk factors, types of cardiac abnormalities, and associations between severity of scoliosis or pulmonary function and cardiac abnormalities were assessed. Cardiac abnormalities were detected by echocardiogram in 25 patients, including 14 with structural abnormalities and 11 with functional abnormalities. The most common functional abnormality was tricuspid regurgitation (9 of 80; 11.3%), whereas atrial septal defect was the most common structural abnormality (7 of 80). Altered hemodynamics occurred in 5 patients, including 3 with ventricular septal defect and 2 with mitral valve dysplasia. Abnormal electrocardiographic findings presented in only 9 of the 25 patients with cardiac abnormalities. No significant associations were found between severity of scoliosis or pulmonary function and cardiac abnormalities. A high incidence of cardiac abnormality exists in patients with adolescent idiopathic scoliosis in this region. Although most patients tolerated surgery, some patients were at risk of decompensation postoperatively. Electrocardiography is of limited value for detecting cardiac problems in patients with adolescent idiopathic scoliosis, we recommend echocardiography as a routine modality in the preoperative evaluation of patients with adolescent idiopathic scoliosis.

  6. Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis

    OpenAIRE

    2011-01-01

    The aim of this study is to quantify the changes in the sagittal alignment of the cervical spine in patients with adolescent idiopathic scoliosis following posterior spinal fusion. Patients eligible for study inclusion included those with a diagnosis of mainly thoracic adolescent idiopathic scoliosis treated by means of posterior multisegmented hook and screw instrumentation. Pre and post-operative anterior–posterior and lateral radiographs of the entire spine were reviewed to assess the chan...

  7. Providence nighttime bracing, in treatment of adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Simony, A.; Beuschau, Inge; Quisth, Lena

    2015-01-01

    Introduction: Since 2008 the non-surgical treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing with Boston brace, to Providence night-time bracing. Methods: Since 2008, skeletally immature patients diagnosed with AIS and a primary curve...... with apex at T7 or below, were treated with the Providence night-time brace. The patients were evaluated every 6 months, with standing x-rays. Compliance with the treatment was recorded during the study. Bracing was continued up to two years post menarche or, for males upon reaching the expected adult......, and the follow up was 12 months (8-37m). The SRS22r Function score was 4, 32, Mental Health 3, 81, SRS22r total 3, 9 and satisfaction with management 3, 90. The Pain domain was 3, 8. Conclusion: This study shows a good curve control with the Providence Night time brace and an acceptable 20 % curve progression...

  8. Expression Signatures of Long Noncoding RNAs in Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Xiao-Yang Liu

    2015-01-01

    Full Text Available Purpose. Adolescent idiopathic scoliosis (AIS, the most common pediatric spinal deformity, is considered a complex genetic disease. Causing genes and pathogenesis of AIS are still unclear. This study was designed to identify differentially expressed long noncoding RNAs (lncRNAs involving the pathogenesis of AIS. Methods. We first performed comprehensive screening of lncRNA and mRNA in AIS patients and healthy children using Agilent human lncRNA + mRNA Array V3.0 microarray. LncRNAs expression in different AIS patients was further evaluated using quantitative PCR. Results. A total of 139 lncRNAs and 546 mRNAs were differentially expressed between AIS patients and healthy control. GO and Pathway analysis showed that these mRNAs might be involved in bone mineralization, neuromuscular junction, skeletal system morphogenesis, nucleotide and nucleic acid metabolism, and regulation of signal pathway. Four lncRNAs (ENST00000440778.1, ENST00000602322.1, ENST00000414894.1, and TCONS_00028768 were differentially expressed between different patients when grouped according to age, height, classification, severity of scoliosis, and Risser grade. Conclusions. This study demonstrates the abnormal expression of lncRNAs and mRNAs in AIS, and the expression of some lncRNAs was related to clinical features. This study is helpful for further understanding of lncRNAs in pathogenesis, treatment, and prognosis of AIS.

  9. Expression Signatures of Long Noncoding RNAs in Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Liu, Xiao-Yang; Wang, Liang; Yu, Bin; Zhuang, Qian-yu; Wang, Yi-Peng

    2015-01-01

    Purpose. Adolescent idiopathic scoliosis (AIS), the most common pediatric spinal deformity, is considered a complex genetic disease. Causing genes and pathogenesis of AIS are still unclear. This study was designed to identify differentially expressed long noncoding RNAs (lncRNAs) involving the pathogenesis of AIS. Methods. We first performed comprehensive screening of lncRNA and mRNA in AIS patients and healthy children using Agilent human lncRNA + mRNA Array V3.0 microarray. LncRNAs expression in different AIS patients was further evaluated using quantitative PCR. Results. A total of 139 lncRNAs and 546 mRNAs were differentially expressed between AIS patients and healthy control. GO and Pathway analysis showed that these mRNAs might be involved in bone mineralization, neuromuscular junction, skeletal system morphogenesis, nucleotide and nucleic acid metabolism, and regulation of signal pathway. Four lncRNAs (ENST00000440778.1, ENST00000602322.1, ENST00000414894.1, and TCONS_00028768) were differentially expressed between different patients when grouped according to age, height, classification, severity of scoliosis, and Risser grade. Conclusions. This study demonstrates the abnormal expression of lncRNAs and mRNAs in AIS, and the expression of some lncRNAs was related to clinical features. This study is helpful for further understanding of lncRNAs in pathogenesis, treatment, and prognosis of AIS. PMID:26421281

  10. POSTERIOR SELECTIVE THORACIC FUSION IN ADOLESCENT IDIOPATHIC SCOLIOSIS

    Institute of Scientific and Technical Information of China (English)

    Bin Yu; Jian-guo Zhang; Gui-xing Qiu; Yi-peng Wang; Xi-sheng Weng

    2004-01-01

    Objective To define the criteria of posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis.Methods By reviewing the medical records and roentgenograms of 17 patients with adolescent idiopathic scoliosis who underwent posterior selective thoracic fusion, the curve type, Cobb angle, apical vertebral rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed.Results There were 17 King type Ⅱ patients (PUMC type: Ⅱb1 13, Ⅱc3 4). The coronal Cobb angle of thoracic curve before and after operation were 56.9°and 21.6° respectively, the mean correction rate was 60.1%. The coronal Cobb angle of lumbar curve before and after operation were 34.8° and 12.1° respectively, and the mean spontaneous correction rate was 64.8%.At final follow-up, the coronal Cobb angle of thoracic and lumbar curve were 23.5° and 15.2° respectively, there were no significant changes in the coronal Cobb angle, apical vertebral translation and rotation compared with that after operation.One patient had 12° of thoracolumbar kyphosis after operation, no progression was noted at final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.9 levels were saved compared with fusing both the thoracic and lumbar curves.Conclusion Posterior selective thoracic fusion can be safely and effectively performed in King type Ⅱ patients with a moderate and flexible lumbar curve, which can save more mobile segments and at the same time can maintain a good coronal and sagittal balance.

  11. Observation and Early Intervention in Mild Idiopathic Scoliosis via Corrective Exercises in Growing Children.

    Science.gov (United States)

    Sy, Ng

    2016-01-01

    Idiopathic scoliosis afflicts 2-3% of the population. For mild curvatures, observation is the treatment of choice. Though this passive "wait and see" approach has been used for many years, the practice is inconsistent among different countries. In Anglo-Saxon countries where scoliosis specific exercises are not practised, observation is indicated for curvatures below 25° in growing children and adolescents. In countries, such as France, Germany, Italy and Poland where scoliosis specific corrective exercises are employed, only patients with no signs of maturity and with curvatures below 15° are treated by observation. Patients with curvatures between 15 - 25° are treated by scoliosis specific exercises. In view of the unpredictability of the progression of scoliosis curvatures in immature patients and the lack of knowledge of long term biomechanical repercussions of mild idiopathic scoliosis on lumbar spine and lower extremities, it is proposed that active intervention through scoliosis specific exercises rather than passive observation be employed in the treatment of mild adolescent idiopathic scoliosis.

  12. The evaluation of short fusion in idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Wajanavisit Wiwat

    2010-01-01

    Full Text Available Background: Selective thoracic fusion in type II curve has been recommended by King et al. since 1983. They suggested that care must be taken to use the vertebra that is neutral and stable so that the lower level of fusion is centered over the sacrum. Since then there has been the trend to do shorter and selective fusion of the major curve. This study was conducted to find out whether short posterior pedicle instrumentation alone could provide efficient correction and maintain trunk balance comparing to the anterior instrumentation. Materials and Methods: A prospective study was conducted during 2005-2007 on 39 consecutive cases with idiopathic scoliosis cases King 2 and 3 (Lenke 1A, 1B, 5C and miscellaneous. Only the major curve was instrumented unless both curves were equally rigid and of the same magnitude. The level of fusion was planned as the end vertebra (EVB to EVB fusion, although minor adjustment was modified by the surgeons intraoperatively. The most common fusion levels in major thoracic curves were T6-T12, whereas the most common fusion levels in the thoraco-lumbar curves were T10-L3. Fusion was performed from the posterior only approach and the implants utilized were uniformly plate and pedicle screw system. All the patients were followed at least 2 years till skeletal maturity. The correction of the curve were assessed according to type of curve (lenke IA, IB and 5, severity of curve (less than 450, 450-890 and more than 900, age at surgery (14 or less and 15 or more and number of the segment involved in instrumentation (fusion level less than curve, fusion level as of the curve and fusion more than the curve Results: The average long-term curve correction for the thoracic was 40.4% in Lenke 1A, 52.2% in Lenke 1B and 56.3% in Lenke 5. The factors associated with poorer outcome were younger age at surgery (< 11 years or Risser 0, fusion at wrong levels (shorter than the measured end vertebra and rigid curve identified by bending

  13. Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases

    Directory of Open Access Journals (Sweden)

    MR Etemadifar

    2005-05-01

    Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

  14. Human upright spinopelvic alignment and the etio-pathogenesis of idiopathic scoliosis

    NARCIS (Netherlands)

    Janssen, M.M.A.

    2011-01-01

    Idiopathic scoliosis is a classic and intriguing orthopedic disorder in which the spine, usually during the pubertal growth spurt, collapses into a three-dimensional deformity without any known cause. Despite many anatomical similarities between the human spine and other spines in nature, idiopathic

  15. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Ponrartana, Skorn; Fisher, Carissa L.; Aggabao, Patricia C. [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Chavez, Thomas A. [Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Broom, Alexander M.; Wren, Tishya A.L.; Skaggs, David L. [Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Gilsanz, Vicente [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States)

    2016-09-15

    When compared to boys, girls have smaller vertebral cross-sectional area, which conveys a greater spinal flexibility, and a higher prevalence of adolescent idiopathic scoliosis. To test the hypothesis that small vertebral cross-sectional area and tall intervertebral disc height are structural characteristics of patients with adolescent idiopathic scoliosis. Using multiplanar imaging techniques, measures of vertebral cross-sectional area, vertebral height and intervertebral disc height in the lumbar spine were obtained in 35 pairs of girls and 11 pairs of boys with and without adolescent idiopathic scoliosis of the thoracic spine matched for age, height and weight. Compared to adolescents without spinal deformity, girls and boys with adolescent idiopathic scoliosis had, on average, 9.8% (6.68 ± 0.81 vs. 7.40 ± 0.99 cm{sup 2}; P = 0.0007) and 13.9% (8.22 ± 0.84 vs. 9.55 ± 1.61 cm{sup 2}; P = 0.009) smaller vertebral cross-sectional dimensions, respectively. Additionally, patients with adolescent idiopathic scoliosis had significantly greater values for intervertebral disc heights (9.06 ± 0.85 vs. 7.31 ± 0.62 mm and 9.09 ± 0.87 vs. 7.61 ± 1.00 mm for girls and boys respectively; both P ≤ 0.011). Multiple regression analysis indicated that the presence of scoliosis was negatively associated with vertebral cross-sectional area and positively with intervertebral disc height, independent of sex, age and body mass index. We provide new evidence that girls and boys with adolescent idiopathic scoliosis have significantly smaller vertebral cross-sectional area and taller intervertebral disc heights - two major structural determinants that influence trunk flexibility. With appropriate validation, these findings may have implications for the identification of children at the highest risk for developing scoliosis. (orig.)

  16. Influence of pelvic asymmetry and idiopathic scoliosis in adolescents on postural balance during sitting.

    Science.gov (United States)

    Jung, Ji-Yong; Cha, Eun-Jong; Kim, Kyung-Ah; Won, Yonggwan; Bok, Soo-Kyung; Kim, Bong-Ok; Kim, Jung-Ja

    2015-01-01

    The effects of pelvic asymmetry and idiopathic scoliosis on postural balance during sitting were studied by measuring inclination angles, pressure distribution, and electromyography. Participants were classified into a control group, pelvic asymmetry group, scoliosis group, and scoliosis with pelvic asymmetry and then performed anterior, posterior, left, and right pelvic tilting while sitting on the unstable board for 5 seconds to assess their postural balance. Inclination and obliquity angles between the groups were measured by an accelerometer located on the unstable board. Pressure distribution (maximum force and peak pressure) was analyzed using a capacitive seat sensor. In addition, surface electrodes were attached to the abdominal and erector spinae muscles of each participant. Inclination and obliquity angles increased more asymmetrically in participants with both pelvic asymmetry and scoliosis than with pelvic asymmetry or scoliosis alone. Maximum forces and peak pressures of each group showed an asymmetrical pressure distribution caused by the difference in height between the left and right pelvis and curve type of the patients' spines when performing anterior, posterior, left, and right pelvic tilting while sitting. Muscle contraction patterns of external oblique, thoracic erector spinae, lumbar erector spinae, and lumbar multifidus muscles may be influenced by spine curve type and region of idiopathic scoliosis. Asymmetrical muscle activities were observed on the convex side of scoliotic patients and these muscle activity patterns were changed by the pelvic asymmetry. From these results, it was confirmed that pelvic asymmetry and idiopathic scoliosis cause postural asymmetry, unequal weight distribution, and muscular imbalance during sitting.

  17. Chiropractic manipulation in Adolescent Idiopathic Scoliosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Stoline Michael R

    2006-08-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection. Methods Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment, two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index. Results Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful. Conclusion Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial. Trial registration This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.

  18. Sagittal plane analysis of the spine and pelvis in adult idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    LI Wei-shi; LI Gang; CHEN Zhong-qiang; Kirkham B Wood

    2010-01-01

    Background There has been an increasing recognition of the importance of sagittal spinopelvic alignment in patients with scoliosis as it relates to clinical outcomes. However, the changes seen in sagittal spinopelvic alignment in adult idiopathic scoliosis patients is poorly defined. This study was conducted to evaluate the sagittal alignment of pelvis and spine in adult idiopathic scoliosis patients.Methods The sagittal parameters of the spine and pelvis were analyzed in lateral standing radiographs of 124 patients (mean age 47.4 years) with adult idiopathic scoliosis, including thoracic kyphosis (TK), thoracolumbar junction kyphosis (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacrum slope (SS), pelvic tilt (PT) and C7 plumb line (C7PL). The patients were divided into three groups according to the age: 20-40 years, 41-64 years, and ≥65 years. The parameters were compared with those in normal adults and adolescent idiopathic scoliosis (AIS) patients. The relationship between all parameters as well as age and sagittal parameters were analyzed.Results The PI in patients with adult idiopathic scoliosis was 58.1°±13.0°, which was significantly higher than that in normal adults. The PT (19.9°±10.6°) was also higher than that in both normal adults and AIS patients, while the SS (38.1°±12.0°) was similar or smaller. As age increased, C7PL, PT and TJL increased while LL decreased. There was no relationship between age and both PI and TK. PT had the strongest statistical association with the C7PL.Conclusions PI is higher in adult idiopathic scoliosis than normal subjects. The PT is the most relevant pelvic parameter to the global sagittal alignment of the spine. Age significantly influences sagittal parameters of the spine and pelvis except the PI and TK.

  19. The role of routine magnetic resonance imaging in the preoperative evaluation of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ozturk, Cagatay; Karadereler, Selhan; Ornek, Ibrahim; Enercan, Meric; Ganiyusufoglu, Kursat; Hamzaoglu, Azmi

    2010-04-01

    The routine use of magnetic resonance imaging (MRI) in adolescent idiopathic scoliosis remains controversial, and current indications for MRI in idiopathic scoliosis vary from study to study. The purpose of this study was to demonstrate the prevalence of neural axis malformations and the clinical relevance of routine MRI studies in the evaluation of patients with adolescent idiopathic scoliosis undergoing surgical intervention without any neurological findings. A total of 249 patients with a diagnosis of idiopathic scoliosis were treated surgically between the years 2002 and 2007. A routine whole spine MRI analysis was performed in all patients. On the preoperative clinical examination, all patients were neurologically intact. There were 20 (8%) patients (3 males and 17 females) who had neural axis abnormalities on MRI. Three of those 20 patients needed additional neurosurgical procedures before corrective surgery; the remaining underwent corrective spinal surgery without any neurosurgical operations. Magnetic resonance imaging may be beneficial for patients with presumed idiopathic scoliosis even in the absence of neurological findings and it is ideally performed from the level of the brainstem to the sacrum.

  20. Outcome in adolescent idiopathic scoliosis after brace treatment and surgery assessed by means of the Scoliosis Research Society Instrument 24

    OpenAIRE

    Weigert, Karen Petra; Nygaard, Linda Marie; Christensen, Finn Bjarke; Hansen, Ebbe Stender; Bünger, Cody

    2005-01-01

    A retrospectively designed long-term follow-up study of adolescent idiopathic scoliosis (AIS) patients who had completed treatment, of at least 2 years, by means of brace, surgery, or both brace and surgery. This study is to assess the outcome after treatment for AIS by means of the Scoliosis Research Society Outcome Instrument 24 (SRS 24). One hundred and eighteen AIS patients (99 females and 19 males), treated at the Aarhus University Hospital from January 1, 1987 to December 31, 1997, were...

  1. Assessment of angle velocity in girls with adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Tejero Marta

    2009-09-01

    Full Text Available Abstract Background Although it has been demonstrated that the peak height velocity (PHV is a predictive factor of progression in adolescent idiopathic scoliosis (AIS, little is known about the usefulness of angle progression in clinical practice. The purpose of this study was to establish a relationship between height and angle velocities, as well as to determine if peak angle velocity (PAV occurs at the same time than PHV. Methods A retrospective study of a cohort of girls with idiopathic scoliotic curves greater than 10°. Data of 132 girls who participated in a previous retrospective study about growth in AIS were used to calculate height and angle velocities. Relationship between height and angle velocities was estimated by the use of a Linear Mixed Model. Results PHV and PAV take place simultaneously 1 year before menarche in progressive curves managed with a brace in AIS. Changes in angle velocity are influenced by changes in height growth velocity, in such a way that as from 6 months post-menarche, height growth velocity in this group of girls estimates curve progression velocity (β-coefficient -0.88, p = 0.04. Conclusion As from 6 months post-menarche, there is an inverse relationship between height velocity and curve progression in the group of AIS girls with progressive curves managed with a brace. Because height velocity is decreasing from 1 year before menarche, this finding corroborates that at the end of puberty, there is still a risk of progression in this group of girls despite bracing. The assessment of both height and angle velocity might be useful in clinical practice at the time of assessing brace effectiveness and how long bracing has to be indicated.

  2. Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

    Science.gov (United States)

    Karavidas, Nikos; Moramarco, Marc; Moramarco, Kathryn

    2016-01-01

    Currently, adolescent idiopathic scoliosis (AIS) is principally regarded as benign, but some researchers have cited serious or extreme effects, including severe pain, cardiopulmonary compromise, social isolation, and even early death. Therefore, exploration of the long-term effects of AIS, the most common type of idiopathic scoliosis, is warranted. The purpose of this review was to examine the long-term studies on the natural history of AIS and/or reviews concerning the long-term effects of untreated AIS. A PubMed search was conducted using the key words idiopathic scoliosis, long-term effects and idiopathic scoliosis, natural history. For further analysis, references cited in those studies were reviewed for additional, related evidence not retrieved in the initial PubMed search. A review of the pertinent bibliography showed that older natural history studies did not distinguish between late-onset scoliosis (referred to in this paper as AIS) and early-onset scoliosis (EOS). The more recent studies offer such important distinction and reach to the general conclusion that untreated AIS does not lead to severe consequences with respect to signs and symptoms of scoliosis. It is possible that earlier studies may have included patient populations with EOS, leading to the perception of untreated scoliosis as having an unusually high morbidity rate. Studies on the long-term effects of AIS that specifically excluded EOS patients conclude that AIS is a benign disorder. This indicates that for research and reporting purposes, it is important to distinguishing between AIS and EOS. This will allow the practitioner and patient and their families to decide on an optimal treatment plan based on the most appropriate prognosis. PMID:27994795

  3. Geographic latitude and prevalence of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Grivas, Theodoros B; Vasiliadis, Elias; Savvidou, Olga; Mouzakis, Vasilios; Koufopoulos, Georgios

    2006-01-01

    Adolescent Idiopathic Scoliosis (AIS) prevalence has been reported to be different in various geographic latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to record the prevalence of AIS among the general population of boys and girls, aged 10-16 years old, in different geographic latitudes, in order to test the hypothesis that the prevalence of AIS among boys and girls is different in various geographic latitudes and to examine if there is a possible association between them. Seventeen peer-reviewed published papers reporting AIS prevalence in the general population of boys and girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included a linear regression forward modeling procedure of the AIS prevalence by latitude, weighted by sample size. According to the modelling of the data, a significant positive association between prevalence of AIS and latitude was found for girls (p<0.001), following a rather curvilinear trend, but not a significant positive association was found for boys (p<0.111). A positive association between prevalence of AIS and geographic latitude is reported only for girls in the present study. Prevalence of AIS in boys is not associated significantly with geographic latitude. This differing significant association implicates the possible role of environmental factors in the pathogenesis of AIS that may act in a different way between boys and girls.

  4. Why do idiopathic scoliosis patients participate more in gymnastics?

    Science.gov (United States)

    Meyer, C; Cammarata, E; Haumont, T; Deviterne, D; Gauchard, G C; Leheup, B; Lascombes, P; Perrin, Ph P

    2006-08-01

    The influence of physical and sporting activities (PSA) on idiopathic scoliosis (IS) is still obscure. The aim of this study was to investigate whether such an influence exists and if so, to determine its characteristics. Two hundred and one teenagers with IS and a control group of 192 adolescents completed an epidemiological questionnaire. Those practising gymnastics were more numerous in the IS group than in the control group. Moreover, the practice of gymnastics was chosen before IS was diagnosed. As gymnastic activities are considered neither as a therapy nor as a precursor of IS, the distribution observed could be linked to a common factor that both increases the likelihood of IS and favors the practice of gymnastics. Joint laxity (JL) may be such a common factor, and was therefore tested (wrist and middle finger) on 42 girls with IS and 21 girls of a control group. IS patients, practising gymnastics or not, showed a higher JL than the control group practising gymnastics or not. Furthermore, the groups practising gymnastic activities did not show higher JL levels than the other groups. Children with a high JL could be drawn toward gymnastics because of their ability to adapt to the constraints of this sport. Girls with a high JL may therefore be prone to developing IS. The fact that most teenagers with IS practise gymnastics could be related to a higher JL.

  5. Positioning of pedicle screws in adolescent idiopathic scoliosis using electromyography

    Directory of Open Access Journals (Sweden)

    Bruno Moreira Gavassi

    2015-06-01

    Full Text Available OBJECTIVE: To analyze the occurrence of poor positioning of pedicle screws inserted with the aid of intraoperative electromyographic stimulation in the treatment of Adolescent Idiopathic Scoliosis (AIS.METHODS: This is a prospective observational study including all patients undergoing surgical treatment for AIS, between March and December 2013 at a single institution. All procedures were monitored by electromyography of the inserted pedicle screws. The position of the screws was evaluated by assessment of postoperative CT and classified according to the specific AIS classification system.RESULTS: Sixteen patients were included in the study, totalizing 281 instrumented pedicles (17.5 per patient. No patient had any neurological deficit or complaint after surgery. In the axial plane, 195 screws were found in ideal position (69.4% while in the sagittal plane, 226 screws were found in ideal position (80.4%. Considering both the axial and the sagittal planes, it was observed that 59.1% (166/281 of the screws did not violate any cortical wall.CONCLUSION: The use of pedicle screws proved to be a safe technique without causing neurological damage in AIS surgeries, even with the occurrence of poor positioning of some implants.

  6. Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

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    Jean Carlo Frigotto Queruz

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.METHODS: The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.RESULTS: The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels, and Group II presented an average of 6.36 vertebrae (5-11 levels. Complications did not show statistically significant difference.CONCLUSION: Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.

  7. Sensory deprivation and balance control in idiopathic scoliosis adolescent.

    Science.gov (United States)

    Simoneau, Martin; Richer, Nadia; Mercier, Pierre; Allard, Paul; Teasdale, Nomand

    2006-04-01

    Balance control is influenced by the availability and integrity of sensory inputs as well as the ability of the balance control mechanisms to tailor the corrective action to the gravitational torque. In this study, to challenge balance control, visual and ankle proprioceptive information were perturbed (eyes closed and/or tendon vibration). We masked sensory inputs in order: (1) to test the hypothesis that adolescent idiopathic scoliosis (AIS), compared to healthy adolescent, relies more on ankle proprioception and/or visual inputs to regulate balance and (2) to determine whether it is the variation or the amplitude of the balance control commands of AIS that leads to greater body sway oscillations during sensory deprivation. By manipulating the availability of the sensory inputs and measuring the outcomes, center of pressure (CP) range and velocity variability, we could objectively determine the cost of visual and/or ankle proprioception deprivation on balance control. The CP range was larger and the root mean square (RMS) of the CP velocity was more variable for AIS than for control participants when ankle proprioception was perturbed. This was observed regardless of whether vision was available or not. The analysis of the sway density curves revealed that the amplitude rather than the variation of the balance control commands was related to a larger CP range and greater RMS CP velocity for AIS. The present results suggest that AIS, compared to control participants, relies much more on ankle proprioception to control the amplitude of the balance control commands.

  8. [Is it too late to start orthopedic treatment for idiopathic scoliosis with Risser scores of 4?].

    Science.gov (United States)

    Avellanet, M; González Viejo, M-A; Sáenz, A; Hijós, M-E

    2006-12-01

    Orthopaedic treatment for idiopathic scoliosis in adolescence is indicated with a curve of > or =20 degrees and a Risser scoreRisser scores >4. We present the case of a young man with a left lumbar idiopathic scoliosis (T12-L4) with a curve of 10 degrees, which was stable from 13 years (Risser 0) to 16 years old (Risser 4). The scoliosis progressed quickly after a Risser score of 4 was achieved. The man had been wearing a lift on the left foot since he was 13, because of a leg length discrepancy, and had been under clinical and radiological monitoring. When the boy reached 17 years, the scoliosis rapidly progressed, to a curve of 22 degrees and a Risser score of >4. The scoliosis was effectively treated with a Boston brace. At 20 years, the Risser score was 5, and the left lumbar curve was 13 degrees after discontinuing the use of the brace. To our knowledge, no scientific reference indicates a time limit to orthopaedic treatment for idiopathic adolescent scoliosis. Despite the experts' recommendations, a brace might be indicated with a Risser score > or =4 to stop the progression of the curve.

  9. Research progress of the relationship between abnormal vestibular reflexes and adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    Yi-Lin Yang; Jian Zhao; Jie Shao; Fei Wang; Xian-Chao Wei; Hai-Jian Ni; Ming Li

    2017-01-01

    Adolescent idiopathic scoliosis (AIS) is an agnogenic structural scoliosis occurring in adolescence, and the main diagnostic criteria is coronal Cobb angle >10°in total spine X-ray. Studies have shown that AIS may be associated with abnormal postural reflexes, vestibular system is an important component of postural reflexes and its mechanism in the occurrence and development of scoliosis has received wide attention in recent years. In the study, the research progress on the role of abnormal vestibular reflexes in the pathogenesis of AIS was mainly introduced to help the clinicians better understand the pathogenesis of AIS and provide new ideas for AIS study.

  10. Comparative Kinetic Methods used for the Therapy of Idiopathic Scoliosis in Adolescents

    Directory of Open Access Journals (Sweden)

    Elena AMARICĂI

    2013-12-01

    Full Text Available Scoliosis is one of the most common axial deviations of the spine. Because of its incidence and the fact that, with the evolution of technology, adolescents spend increasingly more time sitting at desk, adopting positions often incorrect, this paper aims to study the evolution of adolescent patients diagnosed with scoliosis using different kinetic methods of treatment. Another objective is to highlight the most effective method of treatment in terms of overall rehabilitation period, the time spent by the patient in the rehabilitation centre and the preservation of scoliosis correction. 9 adolescents patients (aged between 14 and 17 years with idiopathic scoliosis were divided into three groups based on the followed kinetic method. Three patients underwent a physical therapy program based on the conventional Klapp and Cotrel method, three patients performed Schroth method, and the other three patients performed Vojta method. All patients were monitored for 6 months. They followed a certain rehabilitation therapy in a specialized centre under the guidance of specialized therapist. Height, weight and scoliosis curvature (measured by the Cobb angle were assessed at the beginning of the program and after 6 months of kinetic program. The small number of patients in each group could not issue conclusions regarding the statistical efficiency of the three methods of therapy. However, besides the conventional therapy, both Schroth method and Vojta method represent possibilities to treat the adolescent patients with idiopathic scoliosis.

  11. Geometric and electromyographic assessments in the evaluation of curve progression in idiopathic scoliosis

    NARCIS (Netherlands)

    Cheung, J; Veldhuizen, AG; Halberts, JPK; Sluiter, WJ; Van Horn, [No Value

    2006-01-01

    Study Design. The natural history of patients with idiopathic scoliosis was analyzed radiographically and electromyographically in a prospective longitudinal study. Objectives. To identify changes in geometric variables and the sequence in which these changes occur during curve progression in the na

  12. Altered head orientation patterns in children with idiopathic scoliosis in conditions with sensory conflict

    NARCIS (Netherlands)

    Eijgelaar, P. N.; Wapstra, F. H.; Otten, E.; Veldhuizen, A. G.

    2014-01-01

    Idiopathic scoliosis (IS) is the most common spinal deformity in adolescents. Defective postural equilibrium may be a contributing factor. The information of the three sensory systems combined enables the formation of a central representation of head position and body posture. Comparison of head ang

  13. A preliminary study on electromyographic analysis of the paraspinal musculature in idiopathic scoliosis

    NARCIS (Netherlands)

    Cheung, J.; Halbertsma, J.P.; Veldhuizen, A.G.; Sluiter, W.J.; Maurits, N.M.; Cool, J.C.; van Horn, J.R.

    2005-01-01

    The paraspinal muscles have been implicated as a major causative factor in the progression of idiopathic scoliosis. Therefore, the objectives of this preliminary study were to measure the electromyographic activity (EMG) of the paraspinal muscles to determine its relationship to progression of the s

  14. Predicting the health economic performance of new non-fusion surgery in adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Hummel, J. Marjan; Boomkamp, Inge S. M.; Steuten, Lotte M. G.; Verkerke, Bart G. J.; IJzerman, Maarten J.

    2012-01-01

    Adolescent idiopathic scoliosis (AIS) can lead to pain, impaired spinal function, and socio-psychological problems. Conventional surgical treatment of severe forms of AIS fuses the vertebrae, thereby restricting spinal function and growth of the adolescents. Non-fusion surgical treatment (NFS) is be

  15. To screen or not to screen for adolescent idiopathic scoliosis? A review of the literature

    NARCIS (Netherlands)

    Deurloo, J.A.; Verkerk, P.H.

    2015-01-01

    Objectives: Over the years, there has been much debate about the desirability and efficacy of screening for adolescent idiopathic scoliosis. To analyse the current evidence from a public health point of view a renewed evaluation of the literature was performed. Study design: Literature review. Metho

  16. Psychological Evaluations of Patients Operated for Idiopathic Scoliosis by the Harrington Method.

    Science.gov (United States)

    Orvomaa, E.

    1998-01-01

    A study of 204 patients operated on for idiopathic scoliosis by the Harrington method between 1970 and 1975 found that patients were content with their lives, tended to form families later in life, and had fewer sexual relationships. The patients felt their illness had mostly influenced their participation in work and in physical activities.…

  17. Adolescent idiopathic scoliosis and spinal fusion do not substantially impact on postural balance.

    NARCIS (Netherlands)

    Schimmel, J.J.; Groen, B.E.; Weerdesteijn, V.G.M.; Kleuver, M. de

    2015-01-01

    BACKGROUND: The spinal curvature in patients with Adolescent Idiopathic Scoliosis (AIS) causes an asymmetry of upper body postural alignment, which might affect postural balance. However, the currently available studies on balance in AIS patients are not consistent. Furthermore, it is not known whet

  18. Zebrafish models of idiopathic scoliosis link cerebrospinal fluid flow defects to spine curvature.

    Science.gov (United States)

    Grimes, D T; Boswell, C W; Morante, N F C; Henkelman, R M; Burdine, R D; Ciruna, B

    2016-06-10

    Idiopathic scoliosis (IS) affects 3% of children worldwide, yet the mechanisms underlying this spinal deformity remain unknown. Here we show that ptk7 mutant zebrafish, a faithful developmental model of IS, exhibit defects in ependymal cell cilia development and cerebrospinal fluid (CSF) flow. Transgenic reintroduction of Ptk7 in motile ciliated lineages prevents scoliosis in ptk7 mutants, and mutation of multiple independent cilia motility genes yields IS phenotypes. We define a finite developmental window for motile cilia in zebrafish spine morphogenesis. Notably, restoration of cilia motility after the onset of scoliosis blocks spinal curve progression. Together, our results indicate a critical role for cilia-driven CSF flow in spine development, implicate irregularities in CSF flow as an underlying biological cause of IS, and suggest that noninvasive therapeutic intervention may prevent severe scoliosis.

  19. Radiological evaluation of treatment with SpineCor brace in children with idiopathic spinal scoliosis.

    Science.gov (United States)

    Plewka, Barbara; Sibiński, Marcin; Synder, Marek; Witoński, Dariusz; Kołodziejczyk-Klimek, Katarzyna; Plewka, Michał

    2013-06-28

    INTRODUCTION. This paper reports on a radiological evaluation of the outcomes of treatment with the SpineCor brace in children with idiopathic spinal scoliosis vs. a control group who had only received 24 months of rehabilitation. The compliance of the SpineCor-treated patients with medical instructions was also assessed. MATERIAL AND METHODS. A prospective evaluation encompassed a group of forty (40) children, treated with a SpineCor brace for idiopathic scoliosis. A control group included forty (40) children who were followed up. The mean age of the children was 12.0 years and sixty-six (66) of the patients were girls. The study group and the control group were comparable in terms of demographic data and radiological parameters of scoliosis. The mean scoliosis angle was 25.3˚ and 26.1˚ in the thoracic and lumbar spine, respectively. RESULTS. In the (SpineCor-treated) study group, stabilisation or improvement of the scoliosis was obtained in 31 (78%) patients, while progression was noted in 9 (22%). In the control group, stabilisation was found in 21 (53%) patients and progression in 19 (47%), while none of the children met improvement criteria. In the brace-treated group, a smaller change in the thoracic curvature angle was observed (R=0.34, p=0.0001) than in the control group, while no such difference was identified at the lumbar spine level (R=0.15, p=0.18). Out of the 40 treated children, 38 used the brace regularly. Four of the children were active in sports above recreation level. CONCLUSIONS. The treatment of idiopathic spinal scoliosis in children by means of the SpineCor dynamic brace solution significantly more frequently led to stabilisation or correction of scoliosis as measured by Cobb's angle. A high compliance of the children and their parents was also observed.

  20. Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation

    OpenAIRE

    Andrea Lebel; Victoria Ashley Lebel

    2016-01-01

    Abstract Background Scoliosis is a complex three-dimensional (3D) spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE) despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving s...

  1. Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis

    Science.gov (United States)

    Prowse, Ashleigh; Aslaksen, Berit; Kierkegaard, Marie; Furness, James; Gerdhem, Paul; Abbott, Allan

    2017-01-01

    AIM To investigate the reliability and concurrent validity of the Baseline® Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes. METHODS This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline® Body Level/Scoliosis meter. Spearman’s correlation analyses were used to estimate concurrent validity between the Baseline® Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer. RESULTS There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627). CONCLUSION The Baseline® Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity. PMID:28144582

  2. Bone mineral density of girls with idiopathic scoliosis: a comparative study

    Directory of Open Access Journals (Sweden)

    E Ameri

    2012-11-01

    Full Text Available Background: Several studies have suggested higher incidence of osteoporosis in patients with idiopathic scoliosis in comparison with the normal population. The aim of this study was to assess the prevalence of low bone mass among adolescent girls with idiopathic scoliosis.Methods: In this cross-sectional study performed in shafa Hospital in Tehran, Iran during 2011-2012, we recruited fifty-seven 12- to-20-year old girls with idiopathic scoliosis and compared them with 100 age-matched healthy girls. The patients had no other diseases including neuromuscular disorders, congenital vertebral anomalies or a history of spinal surgery. Bone mineral densities (BMD of the hip and spine were evaluated and compared in all 157 participants using dual X-ray absorptiometry (DXA. Standard BMD (sBMD was also calculated at the lumbar spine. Results: Analysis of the data revealed that hip BMD was significantly (P=0.004 lower in patients with idiopathic scoliosis versus the controls. Moreover, BMD and sBMD of the Spine were also significantly lower in the patients (respectively, P=0.030 and P=0.030. Curve location had no effect on the values of hip BMD, spine BMD or spine sBMD (respectively, P=0.061 and P=0.274 and P=0.208.Finally, with more severe curves a lower bone mass was detected for sBMD and spine BMD (respectively, P=0.017 and P=0.016, but it was not significant for hip BMD (P=0.069.Conclusion: Adolescent girls with idiopathic scoliosis had lower bone mass compared with their healthy peers. The lower bone mass was correlated with the severity of the curve but not its location. 

  3. A Review of Pinealectomy-Induced Melatonin-Deficient Animal Models for the Study of Etiopathogenesis of Adolescent Idiopathic Scoliosis

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    Man Gene Chi Wai

    2014-09-01

    Full Text Available Adolescent idiopathic scoliosis (AIS is a common orthopedic disorder of unknown etiology and pathogenesis. Melatonin and melatonin pathway dysfunction has been widely suspected to play an important role in the pathogenesis. Many different types of animal models have been developed to induce experimental scoliosis mimicking the pathoanatomical features of idiopathic scoliosis in human. The scoliosis deformity was believed to be induced by pinealectomy and mediated through the resulting melatonin-deficiency. However, the lack of upright mechanical spinal loading and inherent rotational instability of the curvature render the similarity of these models to the human counterparts questionable. Different concerns have been raised challenging the scientific validity and limitations of each model. The objectives of this review follow the logical need to re-examine and compare the relevance and appropriateness of each of the animal models that have been used for studying the etiopathogenesis of adolescent idiopathic scoliosis in human in the past 15 to 20 years.

  4. Health-related quality of life of adolescents conservatively treated for idiopathic scoliosis in Korea: a cross-sectional study

    OpenAIRE

    Lee, Hyejung; Choi, Jihea; Hwang, Jin-Ho; Park, Jung Hyun

    2016-01-01

    Background Young adolescents with scoliosis are more likely than adults to experience psychological distress affecting health-related quality of life (HRQoL). Adolescence is a sensitive period of psychological development, and thus physical deformity from scoliosis can negatively affect body image and appearance of adolescents. The present study evaluated HRQoL in young Korean adolescents with idiopathic scoliosis and identified related factors. Methods One hundred and ten adolescents with id...

  5. The Prevalence of Idiopathic Scoliosis in Eleven Year-Old Korean Adolescents: A 3 Year Epidemiological Study

    OpenAIRE

    Lee, Jin-Young; Moon, Seong-Hwan; Kim, Han Jo; Park, Moon Soo; Suh, Bo-Kyung; Nam, Ji Hoon; Jung, Jae Kyun; Lee, Hwan-Mo

    2014-01-01

    Purpose School screening allows for early detection and early treatment of scoliosis, with the purpose of reducing the number of patients requiring surgical treatment. Children between 10 and 14 years old are considered as good candidates for school screening tests of scoliosis. The purpose of the present study was to assess the epidemiological findings of idiopathic scoliosis in 11-year-old Korean adolescents. Materials and Methods A total of 37856 11-year-old adolescents were screened for s...

  6. Predicting growth and curve progression in the individual patient with adolescent idiopathic scoliosis : design of a prospective longitudinal cohort study

    NARCIS (Netherlands)

    Busscher, Iris; Wapstra, Frits Hein; Veldhuizen, Albert G.

    2010-01-01

    Background: Scoliosis is present in 3-5% of the children in the adolescent age group, with a higher incidence in females. Treatment of adolescent idiopathic scoliosis is mainly dependent on the progression of the scoliotic curve. There is a close relationship between curve progression and rapid (spi

  7. Adolescent Idiopathic Scoliosis and Eating Disorders: Is There a Relation? Results of a Cross-Sectional Study

    Science.gov (United States)

    Zaina, Fabio; Donzelli, Sabrina; Lusini, Monia; Vismara, Luca; Capodaglio, Paolo; Neri, Laura; Negrini, Stefano

    2013-01-01

    A recent study suggests a correlation between idiopathic scoliosis in adolescence and eating disorders. However, this does not correspond with our clinical experience in the same population. The aim of this study was to verify the correlation between scoliosis and eating disorders in adolescence. A cross-sectional study was designed including 187…

  8. Electromyographic Assessment of Functional Symmetry of Paraspinal Muscles during Static Exercises in Adolescents with Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Wiesław Chwała

    2014-01-01

    Full Text Available Background. The question of how to correct and rehabilitate scoliosis remains one of the most difficult problems of orthopaedics. Controversies continue to arise regarding various types of both symmetric and asymmetric scoliosis-specific therapeutic exercises. Objective. The aim of the present paper was to conduct an electromyographic assessment of functional symmetry of paraspinal muscles during symmetric and asymmetric exercises in adolescents with idiopathic scoliosis. Materials and Methods. The study was conducted in a group of 82 girls, mean age 12.4 ± 2.3 years with single- or double-major-idiopathic scoliosis, Cobb angle 24 ± 9.4°. The functional biopotentials during isometric work of paraspinal muscles in “at rest” position and during two symmetric and four asymmetric exercises were measured with the use of the Muscle Tester ME 6000 electromyograph. Results. In general, asymmetric exercises were characterised by larger differences in bioelectrical activity of paraspinal muscles, in comparison with symmetric exercises, both in the groups of patients with single-curve and double-curve scoliosis. Conclusion. During symmetric and asymmetric exercises, muscle tension patterns differed significantly in both groups, in comparison with the examination at rest, in most cases generating positive corrective patterns. Asymmetric exercises generated divergent muscle tension patterns on the convex and concave sides of the deformity.

  9. Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

    Science.gov (United States)

    Rafi, Sohail; Munshi, Naseem; Abbas, Asad; Shaikh, Rabia Hassan; Hashmi, Imtiaz

    2016-01-01

    Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb's angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb's angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis. PMID:27695235

  10. Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

    Directory of Open Access Journals (Sweden)

    Sohail Rafi

    2016-01-01

    Full Text Available Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb's angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb's angle (P = 0.0487. It was showed less loss of correction (P = 0.009 pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001. There seemed a better recovery time with pedicle screw surgery (P = 0.003. Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.

  11. Iphone app use to Cobb angle in adolescent idiopathic scoliosis: Does this apply?

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    Antenor Rafael de Oliveira Mazzuia

    2015-06-01

    Full Text Available OBJECTIVE: To validate a new method of measuring the Cobb angle for scoliosis from the mobile app CobbMeter to facilitate the evaluation and measurement in clinical practice.METHODS: Five observers with minimum experience of two years in the field performed radiographic measurements of Cobb angle in 24 radiographs of patients with adolescent idiopathic scoliosis through the CobbMeter. Observers performed serial measures on the images with the application, which were repeated after one month. The most experienced appraiser of the group, after measurements were made through the application, determined the Cobb angle in each radiography by the traditional method.RESULTS: The mean standard deviation by comparing the angles electronically and manually measured had no clinical significance. Although 40% of electronic measurements are outside the confidence interval when compared to manual measurements, this difference was insignificant in clinical practice.CONCLUSIONS: The CobbMeter is another alternative for measuring Cobb angle in scoliosis.

  12. Supplementation of autogenous bone graft with coralline hydroxyapatite in posterior spine fusion for idiopathic adolescent scoliosis.

    Science.gov (United States)

    Mashoof, A Allen; Siddiqui, Saqib A; Otero, Marilyn; Tucci, James J

    2002-10-01

    Twenty-seven consecutive patients with adolescent idiopathic scoliosis underwent posterior spinal fusion with pediatric Texas Scottish Rite Hospital instrumentation. Coralline hydroxyapatite (Interpore, Irvine, Calif) was mixed with limited autograft from posterior iliac crest (an approximate 70/30 ratio of coralline hydroxyapatite to autograft). Patient evaluation was based on clinical and radiographic findings. On initial radiographic evaluation, a "snowstorm" appearance consistent with the exoskeleton of the coralline hydroxyapatite was observed. After two years, the fusion mass had a "marble-like" appearance with distinct decreased visibility of the disk spaces in the fusion mass. This latter stage of "marbilization correlated with solid fusion clinically. All patients achieved solid fusion at an average follow-up of 27 months. Coralline hydroxyapatite is safe, biocompatible, and effective in augmenting autogenous bone graft in the treatment of idiopathic adolescent scoliosis with posterior spinal fusion. In addition to decreased donor site morbidity, this may be invaluable in cases where there is insufficient autograft available.

  13. Association Study between Promoter Polymorphism of TPH1 and Progression of Idiopathic Scoliosis

    OpenAIRE

    Vasil Yablanski; Svetla Nikolova; Evgeni Vlaev; Alexey Savov; Ivo Kremensky

    2016-01-01

    The concept of disease-modifier genes as an element of genetic heterogeneity has been widely accepted and reported. The aim of the current study is to investigate the association between the promoter polymorphism TPH1 (rs10488682) and progression of idiopathic scoliosis (IS) in Eastern European population sample. A total of 105 patients and 210 healthy gender-matched controls were enrolled in this study. The TPH1 promoter polymorphism was genotyped by amplification followed by restriction. Th...

  14. Selective fusion in adolescent idiopathic scoliosis: a radiographic evaluation of risk factors for imbalance

    OpenAIRE

    Studer, D; Awais, A.; N. Williams; Antoniou, G.; Eardley-Harris, N.; Cundy, P.

    2015-01-01

    Study design Retrospective database, chart and medical imaging review. Objectives To report on the outcome and evaluate possible risk factors for postoperative complications following selective spinal fusion in patients with adolescent idiopathic scoliosis (AIS). Materials and methods All patients with AIS who underwent either a selective thoracic or selective thoracolumbar/lumbar spinal fusion at our institution from January 2001 to December 2011 inclusive were included in this study. The mi...

  15. Role of the IL-6 Gene in the Etiopathogenesis of Idiopathic Scoliosis

    OpenAIRE

    Svetla Nikolova; Milka Dikova; Dobrin Dikov; Assen Djerov; Gyulnas Dzhebir; Ventseslav Atanasov; Alexey Savov; Ivo Kremensky

    2015-01-01

    Scoliotic human nuclei pulposi can respond to exogenous proinflammatory stimuli by secreting increased amounts of interleukin-6 (IL-6). The G/C polymorphism of the promoter region of IL-6 gene influences levels and functional activity of the IL-6 protein. We conducted a case-control study of eighty patients with idiopathic scoliosis (IS) and one hundred sixty healthy unrelated gender-matched controls trying to investigate the association between IS and the IL-6 promoter polymorphism at -174 p...

  16. Perceived self-image in adolescent idiopathic scoliosis: an integrative review of the literature

    OpenAIRE

    2014-01-01

    Objective: To learn about the experiences of adolescents diagnosed with idiopathic scoliosis. Method: Integrative review of the literature published within a specified time frame. Results: For both sexes, the predominant clinical symptom of this condition appears to be the negative effect that the deformity exerts on perceived self-image. Quantitative studies used numerical scores to assess perceptions of body image but did not analyse emotional aspects. Patients treated surgically were found...

  17. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    OpenAIRE

    Dantas, Diego de Sousa; Assis, Sanderson José Costa de; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho,Roberta de Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured b...

  18. Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon: The Changing Role for Neurosurgeons

    OpenAIRE

    2015-01-01

    Objective The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Methods Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis...

  19. Prevalence and Management of Back Pain in Adolescent Idiopathic Scoliosis Patients: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jean Théroux

    2015-01-01

    Full Text Available BACKGROUND: Back pain (BP has often been associated with adolescent idiopathic scoliosis (AIS, which is a three-dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well-being. In this population, BP tends to be persistent and may be a predictor of BP in adulthood.

  20. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2008-01-01

    Full Text Available Abstract Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage; and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis.

  1. Growth related hormones in idiopathic scoliosis. An endocrine basis for accelerated growth.

    Science.gov (United States)

    Skogland, L B; Miller, J A

    1980-10-01

    In a total of 95 children with idiopathic scoliosis and 60 controls between the ages of 7 and 17 years, a prospective study of hormones related to growth and maturation was carried out. The pituitary release mechanism for growth hormone was evaluated using the propanolol/L-dopa stimulation test. In addition the blood levels of testosterone, sex hormone binding globulin, oestradiol, thyroxin, prolactin, cortisol, follicle stimulating hormone and luteinizing hormone were determined. The girls were divided into age groups and all results were evaluated according to chronological and skeletal age. The number of boys was too small (25) to allow subdivision into age groups. The girls with idiopathic scoliosis had a significantly higher response to the growth hormone stimulation test than had the controls between the ages of 7 and 12 years whereas no significant difference could be found for the older girls. In girls with a skeletal age between 9 and 12 years a significantly higher mean serum level of testosterone was found (P less than 0.05). No significant differences could be demonstrated for the remaining hormones. Growth hormone and testosterone are the most important growth factors in prepubertal and pubertal children. Thus, the present findings suggest a hormonal basis for the increased stature in children with idiopathic scoliosis which has previously been reported.

  2. The length and proportions of the thoracolumbar spine in children with idiopathic scoliosis.

    Science.gov (United States)

    Skogland, L B; Miller, J A

    1981-01-01

    The length of the thoracolumbar spine was measured on standardized X-ray films from 274 children (6 1/2--18 1/2 years) with idiopathic scoliosis and 212 controls. Where possible, the height and width (traverse diameter) of two vertebral bodies (T-6 and L-4) were also measured. Although a tendency towards longer spines in the scoliotics could be found, there was no significant difference between children with idiopathic scoliosis and controls in this respect. In girls the pubertal growth-spurt of the spine was found to start about 1 year earlier than in the controls and the growth of the spine seemed to cease later in the scoliotics. The height and width of T-6 was significantly greater in the scoliotics than in the controls for girls under 13 years of age. In the older girls and in the boys no significant difference could be demonstrated. The height of L-4 tended to be greater in the scoliotic boys and younger girls, though the differences were not statistically significant. The index height/width was calculated for T-6 and L-4 in all groups of patients and higher values could be demonstrated in the scoliotics for all test groups. The greatest height of T-6 in scoliotics might indicate a longer thoracic spine in these children. The higher values of the height/width indices suggest that the thoracolumbar spine in children with idiopathic scoliosis has an increased slenderness compared with the spine in non-scoliotic children.

  3. [Preliminary study on the action of hypopressive gymnastics in the treatment of idiopathic scoliosis].

    Science.gov (United States)

    Caufriez, Marcel; Fernández-Domínguez, Juan Carlos; Brynhildsvoll, Nils

    2011-01-01

    Our goal is to describe the results of a hypopressive gymnastics (HG) program applied to 3 children with idiopathic scoliosis. Three children (ages ranging from 8 to 15 years) suffering from idiopathic scoliosis were recruited for this study. Thoracic or thoracolumbar curves showed between 15° and 40° Cobb degrees. The evolutionary character of the curves had been confirmed. A study of different clinical and radiological parameters was carried out to compare the measurements before and after (3 months later) the application of a 5 HG daily exercises programme: A radiological study of the spine was carried out to compare the measurements of the vertebral rotation. A radiological study, a plumb line and a measuring tape were used to assess the vertebral tilt in this study. A Scoliometer was used to measure the deformation of the rib cage (gibbosity). The most significant results were: a trend to reach stabilisation in the vertebral tilt and rotation, and stabilisation of gibbosity, which probably might improve the respiratory function of these subjects. Finally, the performance of an ordinary HG exercise program shows a trend to control and stabilise dorsal idiopathic scoliosis progression.

  4. Pedicle morphology of the thoracic spine in preadolescent idiopathic scoliosis: magnetic resonance supported analysis.

    Science.gov (United States)

    Catan, Hüseyin; Buluç, Levent; Anik, Yonca; Ayyildiz, Erhan; Sarlak, Ahmet Yilmaz

    2007-08-01

    Although several studies have been reported on the adult vertebral pedicle morphology, little is known about immature thoracic pedicles in patients with idiopathic scoliosis. A total of 310 pedicles (155 vertebrae) from T1 to T12 in 10-14 years age group were analyzed with the use of magnetic resonance imaging and digital measurement program in 13 patients with right-sided thoracic idiopathic scoliosis. Each pedicle was measured in the axial and sagittal planes including transverse and sagittal pedicle width and angles, chord length, interpedicular distance and epidural space width on convex and concave sides of the curve. The smallest transverse pedicle widths were in the periapical region and the largest were in the caudal region. No statistically significant difference in transverse pedicle widths was detected between the convex and concave sides. The transverse pedicle angle measured 15.56 degrees at T1 and decreased to 6.32 degrees at T12. Chord length increased gradually from the cephalad part of the thoracic spine to the caudad part as the shortest length was seen at T1 convex level with a mean of 30.45 mm and the largest length was seen at T12 concave level with a mean of 41.73 mm. The width of epidural space on the concave side was significantly smaller than that on the convex side in most levels of the curve. Based on the anatomic measurements, it may be reasonable to consider thoracic pedicle screws in preadolescent idiopathic scoliosis.

  5. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)

    2004-08-01

    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  6. Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children.

    Science.gov (United States)

    Suh, Seung-Woo; Modi, Hitesh N; Yang, Jae-Hyuk; Hong, Jae-Young

    2011-07-01

    .00). We present this report as a guide for studying the prevalence of idiopathic scoliosis in a large population, and the increasing trend in the prevalence of idiopathic scoliosis emphasizes the need for awareness.

  7. Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents : A systematic review of clinical trials

    NARCIS (Netherlands)

    Lenssinck, MLB; Frijlink, AC; Berger, MY; Bierma-Zeinstra, SMA; Verkerk, K; Verhagen, AP

    2005-01-01

    Background and Purpose. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in a

  8. Effect of Schroth exercises on curve characteristics and clinical outcomes in adolescent idiopathic scoliosis: protocol for a multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sanja Schreiber

    2014-12-01

    Discussion: The results will demonstrate whether Schroth exercises combined with standard of care can improve outcomes in adolescents with idiopathic scoliosis. This study has potential to influence clinical practice worldwide, where exercises are not routinely prescribed for adolescents with idiopathic scoliosis.

  9. Adolescent Idiopathic Scoliosis – case report of a patient with clinical deterioration after surgery

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2007-12-01

    Full Text Available Abstract Background Although there is no evidence that the long-term effects of scoliosis surgery are superior to the long-term effects of Adolescent Idiopathic Scoliosis (AIS itself, patients can fear the consequences of not under going this surgery due to incorrect or insufficient information. The main indication for surgical treatment in patients with AIS, is cosmetic. However spinal surgery may, along with other negative side effects, actually cause postoperative clinical deterioration. This complication of surgery has not yet been described in international literature. Case presentation A 15-year old female patient originally presenting with a well-compensated double curve pattern scoliosis. The patient was advised to undergo surgery due to the long-term negative impact of signs and symptoms of scoliosis upon her health. The patient agreed to surgery, which was performed in one of Germanys leading centres for spinal surgery. The thoracolumbar curve was corrected and fused, while the thoracic curve, clearly showing wedged vertebrae, defined as structural scoliosis, remained untreated. This operation left the patient with an unbalanced appearance, with radiological and clinical imbalance to the right. The clinical appearance of the patient though clearly deteriorated post-surgery. Furthermore, the wedged disc space below the fusion area indicates future problems with possible destabilisation accompanied probably by low back pain. Conclusion Scoliosis surgery for patients with AIS is mainly indicated for cosmetic or psychological reasons. Therefore the treatment leading to the best possible clinical appearance and balance has to be chosen. Patients should be informed that surgery will not necessarily improve their health status. Clinical deterioration after surgery may occur, and such information is crucial for an adequate informed consent.

  10. Role of the IL-6 gene in the etiopathogenesis of idiopathic scoliosis.

    Science.gov (United States)

    Nikolova, Svetla; Dikova, Milka; Dikov, Dobrin; Djerov, Assen; Dzhebir, Gyulnas; Atanasov, Ventseslav; Savov, Alexey; Kremensky, Ivo

    2015-01-01

    Scoliotic human nuclei pulposi can respond to exogenous proinflammatory stimuli by secreting increased amounts of interleukin-6 (IL-6). The G/C polymorphism of the promoter region of IL-6 gene influences levels and functional activity of the IL-6 protein. We conducted a case-control study of eighty patients with idiopathic scoliosis (IS) and one hundred sixty healthy unrelated gender-matched controls trying to investigate the association between IS and the IL-6 promoter polymorphism at -174 position (rs1800795 G/C) in Bulgarian population. Molecular detection of the IL-6 genotypes was performed by amplification followed by restriction technology. The statistical analysis was performed by Pearson's chi-squared test. Our case-control study revealed a statistically significant association between the IL-6 (-174 G/C) functional polymorphism and susceptibility to IS. In addition, a significant association between the IL-6 (-174 G/C) polymorphism and curve severity was detected. IL-6 gene could be considered as susceptibility and modifying factor of idiopathic scoliosis. The identification of molecular markers with diagnostic and prognostic value could be useful for early detection of children at risk for the development of scoliosis and for prognosis of the risk for a rapid deformity progression. That would facilitate the therapy decisions and early stage treatment of the patient with the least invasive procedures.

  11. Evidence for Conservative Treatment of Adolescent Idiopathic Scoliosis - Update 2015 (Mini-Review).

    Science.gov (United States)

    Sy, Ng; Bettany-Saltikov, Josette; Moramarco, Marc

    2016-01-01

    Idiopathic scoliosis predominantly afflicts adolescents. Adolescents with mild curvatures do not generally have any symptoms. However spinal fusion is indicated when the deformity exceeds 45°. Treatment is thus necessary to prevent and/or reduce the progression of curvatures to that below which surgery is indicated. Conservative treatment of adolescent idiopathic scoliosis includes observation, scoliosis-specific exercises (SSE) and bracing. There is increasing evidence suggesting that SSE and brace treatment can significantly limit the progression of spinal curvatures. In growing adolescents with curvatures more than 20°, bracing is indicated and should be used in conjunction with SSE. The effectiveness of bracing varies according to the type of brace applied to the patient. In general rigid braces are preferable to soft flexible braces, as the latter falls short of halting curvatures progression. Also, preliminary evidence suggests that asymmetric braces which enable over-correction provide more correction when compared with symmetrical braces. Recently it has also been reported that high quality bracing can also reduce curvatures exceeding 45° in over 70% of growing adolescents. This new knowledge might possibly increase the threshold of surgical indications to beyond 50° or above in the near future.

  12. Role of the IL-6 Gene in the Etiopathogenesis of Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Svetla Nikolova

    2015-01-01

    Full Text Available Scoliotic human nuclei pulposi can respond to exogenous proinflammatory stimuli by secreting increased amounts of interleukin-6 (IL-6. The G/C polymorphism of the promoter region of IL-6 gene influences levels and functional activity of the IL-6 protein. We conducted a case-control study of eighty patients with idiopathic scoliosis (IS and one hundred sixty healthy unrelated gender-matched controls trying to investigate the association between IS and the IL-6 promoter polymorphism at -174 position (rs1800795 G/C in Bulgarian population. Molecular detection of the IL-6 genotypes was performed by amplification followed by restriction technology. The statistical analysis was performed by Pearson’s chi-squared test. Our case-control study revealed a statistically significant association between the IL-6 (-174 G/C functional polymorphism and susceptibility to IS. In addition, a significant association between the IL-6 (-174 G/C polymorphism and curve severity was detected. IL-6 gene could be considered as susceptibility and modifying factor of idiopathic scoliosis. The identification of molecular markers with diagnostic and prognostic value could be useful for early detection of children at risk for the development of scoliosis and for prognosis of the risk for a rapid deformity progression. That would facilitate the therapy decisions and early stage treatment of the patient with the least invasive procedures.

  13. Preoperative Magnetic Resonance Imaging Evaluation in Patients with Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Lee, Choon Sung; Kim, Nam Heun; Noh, Hyun Min; Lee, Mi Young; Yoon, So Jung; Lee, Dong-Ho

    2017-01-01

    Study Design Retrospective case series. Purpose The purpose of this study was to examine the incidence of neural axis abnormalities and the relevant risk factors in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature The use of preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with idiopathic scoliosis is controversial, and indications for such MRI evaluations have not been definitively established. However, we routinely use whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction. Methods A total of 378 consecutive patients with presumed AIS who were admitted for spinal surgery were examined for neural axis abnormalities using MRI. To differentiate patients with normal and abnormal MRI findings, the following clinical parameters were evaluated: age, sex, menarcheal status, rotation angle (using a scoliometer), coronal balance, shoulder height difference, and low back pain. We radiographically evaluated curve type, thoracic or thoracolumbar curve direction, curve magnitude and flexibility, apical vertebral rotation, curve length, coronal balance, sagittal balance, shoulder height difference, thoracic kyphosis, and the Risser sign. Results Neural axis abnormalities were detected in 24 patients (6.3%). Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in terms of the other measured parameters. Conclusions Among the patients with presumed AIS who received preoperative whole-spine MRI, 6.3% had neural axis abnormalities. Males and patients with increased thoracic kyphosis were at a higher risk. PMID:28243367

  14. Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria1

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2012-01-01

    Full Text Available Abstract Background Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT. Materials and methods A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used. Results Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. Conclusion There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents.

  15. Pulmonary function tests correlated with thoracic volumes in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ledonio, Charles Gerald T; Rosenstein, Benjamin E; Johnston, Charles E; Regelmann, Warren E; Nuckley, David J; Polly, David W

    2017-01-01

    Scoliosis deformity has been linked with deleterious changes in the thoracic cavity that affect pulmonary function. The causal relationship between spinal deformity and pulmonary function has yet to be fully defined. It has been hypothesized that deformity correction improves pulmonary function by restoring both respiratory muscle efficiency and increasing the space available to the lungs. This research aims to correlate pulmonary function and thoracic volume before and after scoliosis correction. Retrospective correlational analysis between thoracic volume modeling from plain x-rays and pulmonary function tests was conducted. Adolescent idiopathic scoliosis patients enrolled in a multicenter database were sorted by pre-operative Total Lung Capacities (TLC) % predicted values from their Pulmonary Function Tests (PFT). Ten patients with the best and ten patients with the worst TLC values were included. Modeled thoracic volume and TLC values were compared before and 2 years after surgery. Scoliosis correction resulted in an increase in the thoracic volume for patients with the worst initial TLCs (11.7%) and those with the best initial TLCs (12.5%). The adolescents with the most severe pulmonary restriction prior to surgery strongly correlated with post-operative change in total lung capacity and thoracic volume (r(2)  = 0.839; p pulmonary function, but no correlation was found in cases with normal pulmonary function. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:175-182, 2017.

  16. Significance of peak height velocity as a predictive factor for curve progression in patients with idiopathic scoliosis

    OpenAIRE

    Chazono, Masaaki; Tanaka, Takaaki; Marumo, Keishi; Kono, Katsuki; Suzuki, Nobumasa

    2015-01-01

    Background Much attention has been paid to peak height velocity (PHV) as a possible predictor of curve progression in patients with idiopathic scoliosis (IS). The aim of this study was to analyze the relationship between the magnitude of the Cobb angle at PHV and scoliosis progression, defined as having surgery prior to skeletal maturity in female patients with IS. Methods A retrospective review identified 56 skeletally immature female IS patients who were followed until maturity. The mean ag...

  17. Recommendations for research studies on treatment of idiopathic scoliosis: Consensus 2014 between SOSORT and SRS non-operative management committee.

    Science.gov (United States)

    Negrini, Stefano; Hresko, Timothy M; O'Brien, Joseph P; Price, Nigel

    2015-01-01

    The two main societies clinically dealing with idiopathic scoliosis are the Scoliosis Research Society (SRS), founded in 1966, and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT), started in 2004. Inside the SRS, the Non-Operative Management Committee (SRS-NOC) has the same clinical interest of SOSORT, that is the Orthopaedic and Rehabilitation (or Non-Operative, or conservative) Management of idiopathic scoliosis patients. The aim of this paper is to present the results of a Consensus among the best experts of non-operative treatment of Idiopathic Scoliosis, as represented by SOSORT and SRS, on the recommendation for research studies on treatment of Idiopathic Scoliosis. The goal of the consensus statement is to establish a framework for research with clearly delineated inclusion criteria, methodologies, and outcome measures so that future meta- analysis or comparative studies could occur. A Delphi method was used to generate a consensus to develop a set of recommendations for clinical studies on treatment of Idiopathic Scoliosis. It included the development of a reference scheme, which was judged during two Delphi Rounds; after this first phase, it was decided to develop the recommendations and 4 other Delphi Rounds followed. The process finished with a Consensus Meeting, that was held during the SOSORT Meeting in Wiesbaden, 8-10 May 2014, moderated by the Presidents of SOSORT (JP O'Brien) and SRS (SD Glassman) and by the Chairs of the involved Committees (SOSORT Consensus Committee: S Negrini; SRS Non-Operative Committee: MT Hresko). The Boards of the SRS and SOSORT formally accepted the final recommendations. The 18 Recommendations focused: Research needs (3), Clinically significant outcomes (4), Radiographic outcomes (3), Other key outcomes (Quality of Life, adherence to treatment) (2), Standardization of methods of non-operative research (6).

  18. Concordance Rates of Adolescent Idiopathic Scoliosis in a Danish Twin Population

    DEFF Research Database (Denmark)

    Simony, Ane; Carreon, Leah Y; Højmark, Karen;

    2016-01-01

    STUDY DESIGN: Clinical, radiological and genetic determination of zygosity of twin pairs from the Danish Twin Registry who self-reported having Adolescent Idiopathic Scoliosis (AIS). OBJECTIVE: To establish concordance rates of AIS. SUMMARY OF BACKGROUND DATA: The aetiology of and the true mode...... of inheritance of AIS remains unclear. Studies on concordance in twin pairs provide a basis for analysing the influence of genetic versus environmental factors. In 2007, using self-report of AIS from the Danish Twin Registry, concordance rates of 0.13 in monozygotic twins and 0.00 in dizygotic twins were...... reported. METHODS: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a survey, which included questions about scoliosis. The survey was returned by 34,944 individuals (75.3%) representing 23,204 pairs. From this study, 548 individuals representing 274 complete twin...

  19. Identification of Elongated Primary Cilia with Impaired Mechanotransduction in Idiopathic Scoliosis Patients

    Science.gov (United States)

    Oliazadeh, Niaz; Gorman, Kristen F.; Eveleigh, Robert; Bourque, Guillaume; Moreau, Alain

    2017-01-01

    The primary cilium is an outward projecting antenna-like organelle with an important role in bone mechanotransduction. The capacity to sense mechanical stimuli can affect important cellular and molecular aspects of bone tissue. Idiopathic scoliosis (IS) is a complex pediatric disease of unknown cause, defined by abnormal spinal curvatures. We demonstrate significant elongation of primary cilia in IS patient bone cells. In response to mechanical stimulation, these IS cells differentially express osteogenic factors, mechanosensitive genes, and signaling genes. Considering that numerous ciliary genes are associated with a scoliosis phenotype, among ciliopathies and knockout animal models, we expected IS patients to have an accumulation of rare variants in ciliary genes. Instead, our SKAT-O analysis of whole exomes showed an enrichment among IS patients for rare variants in genes with a role in cellular mechanotransduction. Our data indicates defective cilia in IS bone cells, which may be linked to heterogeneous gene variants pertaining to cellular mechanotransduction. PMID:28290481

  20. Chiropractic Rehabilitation for Adolescent Idiopathic Scoliosis: End-of-Growth and Skeletal Maturity Results

    Science.gov (United States)

    Morningstar, Mark W.; Dovorany, Brian; Stitzel, Clayton J.; Siddiqui, Aatif

    2017-01-01

    The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients’ curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations. PMID:28243430

  1. Predicting growth and curve progression in the individual patient with adolescent idiopathic scoliosis: design of a prospective longitudinal cohort study

    Directory of Open Access Journals (Sweden)

    Veldhuizen Albert G

    2010-05-01

    Full Text Available Abstract Background Scoliosis is present in 3-5% of the children in the adolescent age group, with a higher incidence in females. Treatment of adolescent idiopathic scoliosis is mainly dependent on the progression of the scoliotic curve. There is a close relationship between curve progression and rapid (spinal growth of the patient during puberty. However, until present time no conclusive method was found for predicting the timing and magnitude of the pubertal growth spurt in total body height, or the curve progression of the idiopathic scoliosis. The goal of this study is to determine the predictive value of several maturity indicators that reflect growth or remaining growth potential, in order to predict timing of the peak growth velocity of total body height in the individual patient with adolescent idiopathic scoliosis. Furthermore, different parameters are evaluated for their correlation with curve progression in the individual scoliosis patient. Methods/design This prospective, longitudinal cohort study will be incorporated in the usual care of patients with adolescent idiopathic scoliosis. All new patients between 8 and 17 years with adolescent idiopathic scoliosis (Cobb angle >10 degrees visiting the outpatient clinic of the University Medical Center Groningen are included in this study. Follow up will take place every 6 months. The present study will use a new ultra-low dose X-ray system which can make total body X-rays. Several maturity indicators are evaluated like different body length dimensions, secondary sexual characteristics, skeletal age in hand and wrist, skeletal age in the elbow, the Risser sign, the status of the triradiate cartilage, and EMG ratios of the paraspinal muscle activity. Correlations of all dimensions will be calculated in relationship to the timing of the pubertal growth spurt, and to the progression of the scoliotic curve. An algorithm will be made for the optimal treatment strategy in the individual patient

  2. Joint hypermobility in children with idiopathic scoliosis: SOSORT award 2011 winner

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    Pawłowska Paulina

    2011-10-01

    Full Text Available Abstract Background Generalized joint hypermobility (JHM refers to increased joint mobility with simultaneous absence of any other systemic disease. JHM involves proprioception impairment, increased frequency of pain within joints and tendency to injure soft tissues while performing physical activities. Children with idiopathic scoliosis (IS often undergo intensive physiotherapy requiring good physical capacities. Further, some physiotherapy methods apply techniques that increase joint mobility and thus may be contraindicated. The aim of this paper was to assess JHM prevalence in children with idiopathic scoliosis and to analyze the relationship between JHM prevalence and the clinical and radiological parameters of scoliosis. The methods of assessment of generalized joint hypermobility were also described. Materials and methods This case-control study included 70 subjects with IS, aged 9-18 years (mean 13.2 ± 2.2, Cobb angle range 10°-53° (mean 24.3 ± 11.7, 34 presenting single curve thoracic scoliosis and 36 double curve thoracic and lumbar scoliosis. The control group included 58 children and adolescents aged 9-18 years (mean 12.6 ± 2.1 selected at random. The presence of JHM was determined using Beighton scale complemented with the questionnaire by Hakim and Grahame. The relationship between JHM and the following variables was evaluated: curve severity, axial rotation of the apical vertebra, number of curvatures (single versus double, number of vertebrae within the curvature (long versus short curves, treatment type (physiotherapy versus bracing and age. Statistical analysis was performed with Statistica 8.1 (StatSoft, USA. The Kolmogorov-Smirnov test, U Mann-Whitney test, Chi2 test, Pearson and Spermann correlation rank were conducted. The value p = 0.05 was adopted as the level of significance. Results JHM was diagnosed in more than half of the subjects with idiopathic scoliosis (51.4%, whilst in the control group it was diagnosed in

  3. Prevalence of valvular regurgitation in adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Zhu, Xiao-Dong; Wang, Jia-Lin; Li, Ming

    2011-01-01

    Sixty-seven adolescent scoliosis patients with thoracic curve (Lenke type 1, 3, and 6) and 16 nonthoracic curve patients (Lenke type 5) were evaluated with color Doppler echocardiography to identify and compare the prevalence and frequency of valvular regurgitation. Regurgitation of one or more valves was detected in 36 thoracic curve patients (53.73%) and seven nonthoracic curve patients (43.75%). Regurgitation with tricuspid valve involvement was statistically significant in patients with thoracic curve (P=0.0216). Frequency of tricuspid valve involvement was statistically significant (28.57 vs. 83.33%, P=0.0076) in patients with thoracic curve. Those without cardiac disease had a higher incidence of valvular regurgitation.

  4. A new corrective technique for adolescent idiopathic scoliosis (Ucar′s convex rod rotation

    Directory of Open Access Journals (Sweden)

    Bekir Yavuz Ucar

    2014-01-01

    Full Text Available Study Design: Prospective single-center study. Objective: To analyze the efficacy and safety of a new technique of global vertebral correction with convex rod rotation performed on the patients with adolescent idiopathic scoliosis. Summary of Background Data: Surgical goal is to obtain an optimal curve correction in scoliosis surgery. There are various correction techniques. This report describes a new technique of global vertebral correction with convex rod rotation. Materials and Methods: A total of 12 consecutive patients with Lenke type I adolescent idiopathic scoliosis and managed by convex rod rotation technique between years 2012 and 2013 having more than 1 year follow-up were included. Mean age was 14.5 (range = 13-17 years years at the time of operation. The hospital charts were reviewed for demographic data. Measurements of curve magnitude and balance were made on 36-inch standing anteroposterior and lateral radiographs taken before surgery and at most recent follow up to assess deformity correction, spinal balance, and complications related to the instrumentation. Results: Preoperative coronal plane major curve of 62° (range = 50°-72° with flexibility of less than 30% was corrected to 11.5°(range = 10°-14° showing a 81% scoliosis correction at the final follow-up. Coronal imbalance was improved 72% at the most recent follow-up assessment. No complications were found. Conclusion: The new technique of global vertebral correction with Ucar′s convex rod rotation is an effective technique. This method is a vertebral rotation procedure from convex side and it allows to put screws easily to the concave side.

  5. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

    OpenAIRE

    Lange, Johan Emil; Steen, Harald; Gunderson, Ragnhild; Brox, Jens Ivar

    2011-01-01

    Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%) patient...

  6. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

    OpenAIRE

    Gunderson Ragnhild; Steen Harald; Lange Johan; Brox Jens

    2011-01-01

    Abstract Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%...

  7. Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis.

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    Sophie-Anne Scherrer

    Full Text Available BACKGROUND: Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity. METHODOLOGY: Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50° participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20° from the moderate (20° and over spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body. RESULTS: Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it (F = 1.78, p = 0.101. Main effects of vertebral Positions (apex and above or below it (F = 4.20, p = 0.015 and wedging Planes (F = 34.36, p<0.001 were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6° than the superior group (2.9°, p = 0.019 and a significantly greater wedging (p≤0.03 along the sagittal plane (4.3°. CONCLUSIONS: Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support

  8. Influence of lumbar curvature and rotation on forward flexibility in idiopathic scoliosis

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    Feng-Chun Kao

    2014-04-01

    Full Text Available Background: Lumbar spine facet joints are arranged sagittally and mainly provide forward flexibility. Rotation of the lumbar vertebral body and coronal plane deformity may influence the function of lumbar forward flexibility. We hypothesize that the more advanced axial and coronal plane deformity could cause more limitation on forward flexibility in patients with idiopathic scoliosis. Methods: Between January 2011 and August 2011, 85 patients with adolescent idiopathic scoliosis were enrolled in this study. The proximal thoracic, major thoracic, thoracolumbar/lumbar (TL/L, and lumbar (L1/L5 curves were measured by Cobb's method. Lumbar apical rotation was graded using the Nash-Moe score. Lumbar forward flexibility was measured using the sit and reach (S and R test. Statistical analysis was performed using one-way analysis of variance (ANOVA, Spearman's and Pearson's correlation coefficients. Results: The mean age was 16.1 ± 2.84 years. The mean proximal thoracic, major thoracic, TL/L, and L1/L5 curves were 17.61° ± 8.92, 25.56° ± 11.61, 26.09° ± 8.6, and 15.10° ± 7.85, respectively. The mean S and R measurement was 25.56 ± 12.33 cm. The magnitude of the TL/L and L1/L5 curves was statistically positively related to vertebral rotation (rs = 0.580 and 0.649, respectively. The correlation between the S and R test and both the TL/L and L1/L5 curves was negative (rp = –0.371 and –0.595, respectively. Besides, the S and R test also demonstrated a significant negative relationship with vertebral rotation (rs = –0.768. Conclusion: In patients with idiopathic scoliosis, spinal deformity can diminish lumbar forward flexibility. Higher lumbar curvature and rotation lead to greater restriction of lumbar flexion.

  9. Predictive factors for perioperative blood transfusion in surgeries for correction of idiopathic, neuromuscular or congenital scoliosis

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    Alexandre Fogaça Cristante

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the association of clinical and demographic variables in patients requiring blood transfusion during elective surgery to treat scoliosis with the aim of identifying markers predictive of the need for blood transfusion. METHODS: Based on the review of medical charts at a public university hospital, this retrospective study evaluated whether the following variables were associated with the need for red blood cell transfusion (measured by the number of packs used during scoliosis surgery: scoliotic angle, extent of arthrodesis (number of fused levels, sex of the patient, surgery duration and type of scoliosis (neuromuscular, congenital or idiopathic. RESULTS: Of the 94 patients evaluated in a 55-month period, none required a massive blood transfusion (most patients needed less than two red blood cell packs. The number of packs was not significantly associated with sex or type of scoliosis. The extent of arthrodesis (r = 0.103, surgery duration (r = 0.144 and scoliotic angle (r = 0.004 were weakly correlated with the need for blood transfusion. Linear regression analysis showed an association between the number of spine levels submitted to arthrodesis and the volume of blood used in transfusions (p = 0.001. CONCLUSION: This study did not reveal any evidence of a significant association between the need for red blood cell transfusion and scoliotic angle, sex or surgery duration in scoliosis correction surgery. Submission of more spinal levels to arthrodesis was associated with the use of a greater number of blood packs.

  10. 不同类型成人脊柱侧凸的影像学研究%Imaging diagnosis of degenerative scoliosis and adult idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    吴志宏; 宋海峰; 王以朋; 闫家智; 邱贵兴

    2008-01-01

    目的 探讨成人脊柱侧凸中最常见的退行性脊柱侧凸(DS)的影像学特征,并与成人特发性脊柱侧凸(IS)相比较,以提高诊断准确率.方法 通过对站立位X线、Bending像的相关参数测量及脊髓造影和CTM检查,回顾性分析98例成人脊柱侧凸的临床资料和影像学特点.结果 DS和成人Is的发病年龄、性别、侧凸的解剖位置和顶点分布上有明显区别,冠状面Cobb角分别为(18.67±7.62)°和(56.2±10.10)°,顶椎旋转度(1.36±0.33)°和(2.34±0.61)°,顶椎偏距(27.4±10.7)mm和(44.7±12.1)mm,主弯的节段数(3.7±2.3)节和(7.1±4.4)节,差异有统计学意义(均P<0.05).结论 两种侧凸的影像学表现有明显区别,结合临床表现可做出正确诊断.%Objective To analyze and compare the Imaging findings of adult idiopathic scoliosis and degenerative scoliosis which were the most common adult scoliosis, and evaluate imaging characteristics. Method The radiological and clinical data of 98 case, among them, 41 cases of adult idiopathic scoliosis and 57 cases of degenerative scoliosis,were analyzed retrospectively. Result There were differences at presence age, sex ratio, anatomic area of scoliosis and apex between two types of adult scoliosis. The analyses and comparison between the two groups revealed significant change in the Cobb angle, involved segment and convex side orientation (all P <0. 05). Conclusion Adult idiopathic scoliosis and degenerative scoliosis show distinctive imaging characteristics. These characteristics combining clinical data are decisive in diagnosis.

  11. Mutation of the planar cell polarity gene VANGL1 in adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Andersen, Malene Rask; Farooq, Muhammad; Rasmussen, Karen Koefoed

    2017-01-01

    STUDY DESIGN: Mutation analysis of a candidate disease gene in a cohort of patients with moderate to severe Adolescent idiopathic scoliosis (AIS). OBJECTIVE: To investigate if damaging mutations in the planar cell polarity gene VANGL1 could be identified in AIS patients. SUMMARY OF BACKGROUND DATA......: AIS is a spinal deformity which occurs in 1-3% of the population. The cause of AIS is often unknown, but genetic factors are important in the etiology. Rare variants in genes encoding regulators of WNT/planar cell polarity (PCP) signaling were recently identified in AIS patients. METHODS: We analyzed...

  12. Perceived self-image in adolescent idiopathic scoliosis: an integrative review of the literature

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    Maria Isabel Bonilla Carrasco

    2014-08-01

    Full Text Available Objective: To learn about the experiences of adolescents diagnosed with idiopathic scoliosis. Method: Integrative review of the literature published within a specified time frame. Results: For both sexes, the predominant clinical symptom of this condition appears to be the negative effect that the deformity exerts on perceived self-image. Quantitative studies used numerical scores to assess perceptions of body image but did not analyse emotional aspects. Patients treated surgically were found to have a better self-image than patients treated with a brace. Quality of life was improved by a reduction in the magnitude of the curve. Conclusion: Spinal deformity exerts a psychological effect on adolescent girls.

  13. Initial experience with the providence nighttime bracing in adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Quisth, Lena; Beuschau, Inge; Simony, A.

    2015-01-01

    Background: Since 2008 the primary non-surgical treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing with Boston brace, to Providence nighttime bracing. Aim: To evaluate the effectiveness of nighttime bracing, with the Providence brace......). The mean in-brace correction was 81% (24-100%). After the end of bracing, the mean Cobb angle was 29.1degree (7-50), an average of no progression. There were 11 (18%) brace failures, but only 5 (10%) patients had surgery. (Figure Presented) Discussion & Conclusion : This study shows a good curve control...

  14. Discrepancy in clinical versus radiological parameters describing deformity due to brace treatment for moderate idiopathic scoliosis

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    Szulc Andrzej

    2007-12-01

    Full Text Available Abstract Background The shape of the torso in patients with idiopathic scoliosis is considered to reflect the shape of the vertebral column, however the direct correlation between parameters describing clinical deformity and those characterizing radiological curvature was reported to be weak. It is not clear if the management proposed for scoliosis (physiotherapy, brace, surgery affects equally the shape of the axial skeleton and the surface of the body. The aim of the study was to compare clinical deformity of (1 idiopathic scoliosis girls being under brace treatment for radiological curves of 25 to 40 degrees and (2 non treated scoliotic girls matched for age and Cobb angle. Methods Cross-sectional study of 24 girls wearing the brace versus 26 girls without brace treatment, matched for age and Cobb angle. Hypothesis: Patients wearing the brace for more than 6 months, when comparing to patients without brace, may present different external morphology of the trunk, in spite of having similar Cobb angle. Material. Inclusion criteria: girls, idiopathic scoliosis, growing age (10–16 years, Cobb angle minimum 25°, maximum 40°. The braced group consisted of girls wearing a TLSO brace (Cheneau for more than 6 months with minimum of 16 hours per day. The non-braced group consisted of girls first seen for their spinal deformity, previously not treated. The groups presented similar curve pattern. Methods. Scoliometer exam: angle of trunk rotation at three levels of the spine: upper thoracic, main thoracic, lumbar or thoracolumbar. The maximal angle was noted at each level and the sum of three levels was calculated. Posterior trunk symmetry index (POTSI and Hump Sum were measured using surface topography. Results Cobb angle was 34.9° ± 4.8° in braced and 32.7° ± 4.9° in un-braced patients (difference not significant. The age was 14.1 ± 1.6 years in braced patients and 13.1 ± 1.9 years in un-braced group (p = 0.046. The value of angle of trunk

  15. Association between vitamin d levels and adolescent idiopathic scoliosis

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    Rodrigo Martins Borges Ferreira Batista

    2014-12-01

    Full Text Available Objective: To compare the levels of 25-hydroxyvitamin D in patients with AIS and a control group. Methods: The patients were recruited from the outpatient clinic of our institution during the year of 2013. Children diagnosed with scoliosis before 10 or after 18 years of age, and those suffering from neurological or muscular disorders, congenital malformations or genetic syndromes were excluded. The 25-OHD levels were determined by a fully automated electrochemiluminescence test. The appropriate level of 25-OHD was defined as greater than 30 ng/mL. The results were compared to a group of healthy individuals. Results: In group 1 (control 63,3% showed abnormal vitamin D levels, while 91% of patients with AIS presented a low level of vitamin D. The mean BMI was 19.6 kg/m2 for controls and 20.3 kg/m2 for group 2. Statistical analysis showed significant difference (p<0.0001 between the levels of vitamin D. The average and minimum levels of vitamin D were respectively 27 and 13.6 ng/mL for group 1 and 18.8 and 3.13 ng/mL for AIS group. Conclusions: Patients with AIS had statistically significant lower levels of 25-OHD than healthy patients. Further research should be conducted to investigate the actual impact of serum vitamin D levels on the pathophysiology of AIS.

  16. Understanding the role of the immune system in adolescent idiopathic scoliosis: Immunometabolic CONnections to Scoliosis (ICONS) study protocol

    Science.gov (United States)

    Samaan, M Constantine; Missiuna, Paul; Peterson, Devin; Thabane, Lehana

    2016-01-01

    Introduction Adolescent idiopathic scoliosis (AIS) affects up to 3% of children around the world. There is limited knowledge of AIS aetiopathogenesis, and this evidence is needed to develop new management strategies. Paraspinal muscle in AIS demonstrates evidence of differential fibrosis based on curve sidedness. Fibrosis is the hallmark of macrophage-driven inflammation and tissue remodelling, yet the mechanisms of fibrosis in paraspinal muscle in AIS are poorly understood. Objectives The primary objective of this study is to determine the influence of curve sidedness on paraspinal muscle inflammation. Secondary objectives include defining the mechanisms of macrophage homing to muscle, and determining muscle–macrophage crosstalk in muscle fibrosis in AIS. Methods and analysis This is a cross-sectional study conducted in a tertiary paediatric centre in Hamilton, Ontario, Canada. We will recruit boys and girls, 10–17 years of age, who are having surgery to correct AIS. We will exclude children who have an active infection or are on immunosuppressive therapies within 2 weeks of surgery, smokers and pregnant girls. Paraspinal muscle biopsies will be obtained at the start of surgery. Also, blood and urine samples will be collected from participants, who will fill questionnaires about their lifestyle. Anthropometric measures will also be collected including height, weight, waist and hip circumferences. Ethics and dissemination This study has received ethics authorisation by the institutional review board. This work will be published in peer-reviewed journals and will be presented in oral and poster formats at scientific meetings. Discussion This study will explore the mechanisms of paraspinal muscle inflammation, remodelling and fibrosis in AIS. This will help identify pathways and molecules as potential therapeutic targets to treat and prevent AIS. It may also yield markers that predict scoliosis progression and response to treatment in these children. PMID

  17. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan.

    Science.gov (United States)

    Sato, Tsuyoshi; Hirano, Toru; Ito, Takui; Morita, Osamu; Kikuchi, Ren; Endo, Naoto; Tanabe, Naohito

    2011-02-01

    There have been a few studies regarding detail of back pain in adolescents with idiopathic scoliosis (IS) as prevalence, location, and severity. The condition of back pain in adolescents with IS was clarified based on a cross-sectional study using a questionnaire survey, targeting a total of 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of 785,067), Japan. 32,134 pupils were determined to have valid responses (valid response rate: 73.7%). In Niigata City, pupils from the fourth grade of elementary school to the third year of junior high school are screened for scoliosis every year. This screening system involves a three-step survey, and the third step of the survey is an imaging and medical examination at the Niigata University Hospital. In this study, the pupils who answered in the questionnaire that they had been advised to visit Niigata University Hospital after the school screening were defined as Scoliosis group (51 pupils; 0.159%) and the others were defined as No scoliosis group (32,083 pupils). The point and lifetime prevalence of back pain, the duration, the recurrence, the severity and the location of back pain were compared between these groups. The severity of back pain was divided into three levels (level 1 no limitation in any activity; level 2 necessary to refrain from participating in sports and physical activities, and level 3 necessary to be absent from school). The point prevalence was 11.4% in No scoliosis group, and 27.5% in Scoliosis group. The lifetime prevalence was 32.9% in No scoliosis group, and 58.8% in Scoliosis group. According to the gender- and school-grade-adjusted odds ratios (OR), Scoliosis group showed a more than twofold elevated odds of back pain compared to No scoliosis group irrespective of the point or lifetime prevalence of back pain (OR, 2.29; P = 0.009 and OR, 2.10; P

  18. The natural history of idiopathic scoliosis. A study of the incidence of treatment.

    Science.gov (United States)

    Montgomery, F; Willner, S

    1988-04-01

    The natural history of idiopathic scoliosis has been studied between 1969 and 1985 in a well-controlled population of school children, 66,200 cases, between 7 and 16 years of age. The incidence of scoliosis needing treatment (25 degrees or more in progress in growing children) was studied with a cross-sectional as well as a longitudinal survey. When using a cross-sectional technique, a decrease of cases being treated was seen after the introduction of a conventional screening program--thus indicating a change in the natural history of moderate scoliosis. This could, however, be explained by the consequence of an accumulation of treated cases, formerly diagnosed and treated later on, seen immediately after the introduction of screening. When the longitudinal method was used, this trend could not be observed. And finally, when taking changes of indication of treatment and of the population into consideration, no tendency at all toward a change in the natural history could be seen.

  19. Case Study: Manual Therapy in Patient of 18 Years with Youthful Scoliosis Idiopathic Summary

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    Claudia Yaneth Franco Monsalve

    2007-12-01

    Full Text Available Scoliosis is a lateral deviation of the spine from the mean line, characterized by a lateral curvature and a vertebral rotation. It is generallyof idiopathic character and appears mainly in adolescent females. Multiple techniques of conservative treatment for the scoliosis exist such as the manual therapy that complements the treatment for this pathology. This technique uses manipulation of soft tissue and bone, obtainingtherefore a more effective recovery, improving the quality of life of the patient. The objective of this study of case was to compareand to describe the changes in the conditionsof an eighteen years old patient, with left thoracolumbar scoliosis by the application of manual therapy; integral valuation was carried out by manual therapy, orthopedic, computerizedposition analysis, analyses the place of job, treatments with physical instruments, mobilizationsof the thoracic and lumbar joints (segmentsT5-T6, T6-T7, T7-T8, T8-T9, muscular energy techniques, exercises of global postural re-education, cervical and lumbar stabilization, exercises of fortification for weak musculature and stretching exercises to elongate retracted musculature. At the beginning of the treatment, the angle of Cobb was 24º ,verified through ax-ray, and after the sessions of manual therapy it was 18º, demonstrating significantly improved angle (6º. The effectiveness of the treatment was verified: diminution of the pain, increase of the muscular force, postural realignment, the satisfactionof the patient and significant recovery confirmed by the radiographic studies.

  20. Fully automatic measurements of axial vertebral rotation for assessment of spinal deformity in idiopathic scoliosis

    Science.gov (United States)

    Forsberg, Daniel; Lundström, Claes; Andersson, Mats; Vavruch, Ludvig; Tropp, Hans; Knutsson, Hans

    2013-03-01

    Reliable measurements of spinal deformities in idiopathic scoliosis are vital, since they are used for assessing the degree of scoliosis, deciding upon treatment and monitoring the progression of the disease. However, commonly used two dimensional methods (e.g. the Cobb angle) do not fully capture the three dimensional deformity at hand in scoliosis, of which axial vertebral rotation (AVR) is considered to be of great importance. There are manual methods for measuring the AVR, but they are often time-consuming and related with a high intra- and inter-observer variability. In this paper, we present a fully automatic method for estimating the AVR in images from computed tomography. The proposed method is evaluated on four scoliotic patients with 17 vertebrae each and compared with manual measurements performed by three observers using the standard method by Aaro-Dahlborn. The comparison shows that the difference in measured AVR between automatic and manual measurements are on the same level as the inter-observer difference. This is further supported by a high intraclass correlation coefficient (0.971-0.979), obtained when comparing the automatic measurements with the manual measurements of each observer. Hence, the provided results and the computational performance, only requiring approximately 10 to 15 s for processing an entire volume, demonstrate the potential clinical value of the proposed method.

  1. Mild angle early onset idiopathic scoliosis children avoid progression under FITS method (Functional Individual Therapy of Scoliosis).

    Science.gov (United States)

    Białek, Marianna

    2015-05-01

    Physiotherapy for stabilization of idiopathic scoliosis angle in growing children remains controversial. Notably, little data on effectiveness of physiotherapy in children with Early Onset Idiopathic Scoliosis (EOIS) has been published.The aim of this study was to check results of FITS physiotherapy in a group of children with EOIS.The charts of the patients archived in a prospectively collected database were retrospectively reviewed. The inclusion criteria were:diagnosis of EOIS based on spine radiography, age below 10 years, both girls and boys, Cobb angle between 118 and 308, Risser zero, FITS therapy, no other treatment (bracing), and a follow-up at least 2 years from the initiation of the treatment. The criterion for curve progression were as follows: the Cobb angle increase of 68 or more, for curve stabilization; the Cobb angle was 58 comparing to the initial radiograph,for curve correction; and the Cobb angle decrease of 68 or more at the final follow-up radiograph.There were 41 children with EOIS, 36 girls and 5 boys, mean age 7.71.3 years (range 4 to 9 years) who started FITS therapy. The curve pattern was single thoracic (5 children), single thoracolumbar (22 children) or double thoracic/thoracolumbar (14 children), totally 55 structural curvatures. The minimum follow-up was 2 years after initiation of the FITS treatment, maximum was 16 years, mean 4.8 years). At follow-up the mean age was 12.53.4 years. Out of 41 children, 10 passed pubertal growth spurt at the final follow-up and 31 were still immature and continued FITS therapy. Out of 41 children, 27 improved, 13 were stable, and one progressed. Out of 55 structural curves, 32 improved, 22 were stable and one progressed. For the 55 structural curves, the Cobb angle significantly decreased from 18.085.48 at first assessment to 12.586.38 at last evaluation,p<0.0001, paired t-test. The angle of trunk rotation decreased significantly from 4.782.98 to 3.282.58 at last evaluation, p<0.0001,paired t

  2. Factors as predictors for thoracic and thoracolumbar/lumbar structural curves in adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    CHEN Zi-qiang; ZHAO Yong-fei; HE Shi-sheng; WANG Chuan-feng; ZHANG Jing-tao; ZHAO Ying-chuan; YANG Chang-wei; LI Ming

    2012-01-01

    Background Recent studies have demonstrated that the Lenke system is relatively efficient and consistent in classifying scoliosis curves.Basically,fusion should include the main curve and the structural minor curve.The criteria for defining the structural minor curve were established to help guide these decision-making process.The present study was designed to investigate predictors of the structural curve,and see whether it was possible to prevent the formation of the structural curve by interfering with influencing factors to decrease the fusion level.Methods Age,gender,Cobb angle,Perdriolle rotation,Risser sign and the number of vertebrae included in the curve,brace treatment,and curve location were recorded in 145 idiopathic scoliosis patients from July 2001 to January 2007.The patients were divided into two groups:structural and non-structural groups.Demographics and baseline characteristics were compared between the two groups as an initial screen.Logistic regression was used to analyze factors affecting the minor curve to become the structural curve.Results Compared with the non-structural group,the structural group had a higher Cobb angle ((51.34±13.61)° vs.(34.20±7.21)°,P <0.001),bending angle ((33.94±9.92)° vs.(8.46±5.56)°,P <0.001) and curve rotation ((23.25±12.86)° vs.(14.21±8.55) °,P <0.001),and lower flexibility ((33.48±12.53)% vs.(75.50±15.52)%,P <0.001).There was no significant difference in other parameters between the two groups.The results of the Logistic regression analysis showed that the Cobb angle (OR:9.921,P <0.001) and curve location (OR.4.119,P=0.016) were significant predictors of structural curve in adolescent idiopathic scoliosis.Every 10° change of Cobb angle increased the possibility of turning the minor curve into the structural curve by 10-fold.And thoracic curve showed,on the average,the possibility of becoming the structural curve about 4-fold more often than did the thoracolumbar/lumbar curve

  3. [Advance on genetic mechanism of adolescent idiopathic scoliosis and genetic relationship map].

    Science.gov (United States)

    Wang, Wei; Ma, Jun; Li, Shu-yuan; Wu, Xian; Hu, Bin; Wang, Xiao-feng; Zhou, Xu-hui

    2015-09-01

    Identification of genetic risk factors is the hotspot of adolescent idiopathic scoliosis (AIS). Through candidate gene approach and genome-wide association studies (GWAS), some genes were preliminary identified. To review AIS related genes,and construct the gene network map of AIS gene. We searched on NCBI PubMed and Web of Science database using search terms "adolescent idiopathic scoliosis" and "gene", to classify induction genes. We then constructed gene diagram using string-db. We found 35 AIS genes relating to connective tissue, nervous system active substances, melatonin synthesis and metabolism, puberty and growth, and genes whose function is unknown. Gene diagram shows that a network relationship between gene and other genes,in which IL6, ESR1, ESR2, VDR, TGFB1, IGF1 gene may as the key gene about AIS' genetic mechanism. Two sites of 3 GWAS results outside the network, it is suggesting new pathway that need to be explored. The study about AIS susceptibility gene is still preliminary, requiring in-depth research to identify the new networks.

  4. ATTITUDE TO THE DISEASE IN CHILDREN WITH IDIOPATHIC SCOLIOSIS IN THE CONTEXT OF PARENTAL MINDSET

    Directory of Open Access Journals (Sweden)

    Галина Викторовна Пятакова

    2014-03-01

    Full Text Available The approach to the healing process of idiopathic scoliosis in terms of the biopsychosocial model of disease, which involves consideration of factors of biological, social, psychological nature, is reviewed. Factors of a psychological nature provide adaptive behavior of the patient in the hospital, and coordinated participation of various specialists in the treatment and rehabilitation of the patient in a situation of complicated treatment. Idiopathic scoliosis is a disease that is accompanied with physical and moral suffering and defines the conditions of mental development and functioning of sick children and their parents in a situation of progressive disease. Under these conditions, an important factor in coping with the situation of the disease and the successful rehabilitation treatment is harmonious attitude of the sick child to the disease. Personal problems of parents of sick children, manifested in their disharmonious attitude to the disease, reduce the adaptive capacity of children in hospital. In this connection, it is necessary to perform participation of clinical psychologists who provide the necessary information concerning the interactions of medical staff with patients and their parents on the stages of orthopedic treatment by doctors and other staff, as well as to provide the necessary psychological support for sick children and their parents.

  5. Serum somatomedin A and non-dialyzable urinary hydroxyproline in girls with idiopathic scoliosis.

    Science.gov (United States)

    Skogland, L B; Miller, J A; Skottner, A; Fryklund, L

    1981-06-01

    Serum somatomedin A was determined by radioreceptor assay in 31 girls with idiopathic scoliosis and 30 controls, with ages ranging from 9.7-16.2 years. In the material as a whole no significant difference could be found between scoliotics and controls. Similarly no differences were found in the girls under 13 years of age. However, in girls older than 13 years the controls had significantly higher somatomedin A levels than the scoliotics. In the second part of the study 26 girls with idiopathic scoliosis and 22 controls were examined with regard to the urinary excretion of non-dialyzable hydroxyproline,. which has been suggested to be correlated with collagen synthesis. The percentage non-dialyzable fraction of the total hydroxyproline was found to be significantly higher in the control girls. The mean age was 12.8 years for both groups. The results suggest a higher growth rate in the controls than in the scoliotics for girls over 12 years. There is, however, no definite evidence as to the function of the somatomedins or of the relationship between non-dialyzable hydroxyproline and growth.

  6. Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Canavese, Federico; Turcot, Katia; De Rosa, Vincenzo; de Coulon, Geraldo; Kaelin, André

    2011-07-01

    The aim of this study is to quantify the changes in the sagittal alignment of the cervical spine in patients with adolescent idiopathic scoliosis following posterior spinal fusion. Patients eligible for study inclusion included those with a diagnosis of mainly thoracic adolescent idiopathic scoliosis treated by means of posterior multisegmented hook and screw instrumentation. Pre and post-operative anterior-posterior and lateral radiographs of the entire spine were reviewed to assess the changes of cervical sagittal alignment. Thirty-two patients (3 boys, 29 girls) met the inclusion criteria for the study. The average pre-operative cervical sagittal alignment (CSA) was 4.0° ± 12.3° (range -30° to 40°) of lordosis. Postoperatively, the average CSA was 1.7° ± 11.4° (range -24° to 30°). After surgery, it was less than 20° in 27 patients (84.4%) and between 20° and 40° in 5 patients (15.6%). The results of the present study suggest that even if rod precontouring is performed and postoperative thoracic sagittal alignment is restored, improved or remains unchanged after significant correction of the deformity on the frontal plane, the inherent rigidity of the cervical spine limits changes in the CSA as the cervical spine becomes rigid over time.

  7. Influence of curve magnitude and other variables on operative time, blood loss and transfusion requirements in adolescent idiopathic scoliosis.

    LENUS (Irish Health Repository)

    Nugent, M

    2015-05-03

    Posterior spinal instrumentation and fusion for correction of adolescent idiopathic scoliosis (AIS) typically requires lengthy operating time and may be associated with significant blood loss and subsequent transfusion. This study aimed to identify factors predictive of duration of surgery, intraoperative blood loss and transfusion requirements in an Irish AIS cohort.

  8. The relation between electromyography and growth velocity of the spine in the evaluation of curve progression in idiopathic scoliosis

    NARCIS (Netherlands)

    Cheung, J.; Veldhuizen, A.G.; Halbertsma, J.P.; Maurits, N.M.; Sluiter, W.J.; Cool, J.C.; van Horn, J.R.

    2004-01-01

    Study Design. A prospective study in which patients with idiopathic scoliosis were examined longitudinally by radiographic and electromyographic measurements according to a protocol. Objectives. To measure the growth velocity of the spine and the electromyographic ratio of the paraspinal muscles to

  9. Obliged Removal of the Percutaneous Fixation System on the Thoracolumbar Junction in Patients with Idiopathic Scoliosis

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    Alessandro Landi

    2016-12-01

    Full Text Available Introduction Minimally invasive percutaneous surgery of the spine is used to treat thoracolumbar junction and lumbar spine fractures by percutaneous fixation. Once fusion has been obtained, it is possible to remove the percutaneous instrumentation after 6 - 12 months. We report the case of an obliged removal of the fixation system at 12 months following operation in a patient with a pre-existing compensated and asymptomatic idiopathic scoliosis. Case Presentation A 48-year-old patient affected by a compensated asymptomatic idiopathic scoliosis with an L3 type A3 fracture. The patient underwent a percutaneous short fixation L2 - L4. In the following months the patient presented progressive worsening of the low back pain and walking difficulties. The percutaneous fixation system was then removed using the same surgical access. Conclusions This particular case explains well the importance of biomechanical balance when a spinal fixation should be perform, and demonstrate how an underestimation of this aspect may cause a worsening of symptoms even if the surgical procedure was correctly performed. It is evident that the removal procedure can lead clinical benefit to a patient, in which the fixation system created a decompensation of the curvature of the spine, thus causing biomechanical alterations and generating pain. In these cases, it may be opportune to limit the fracture reduction during the surgical procedure to modify the least possible the pre-existing scoliosis and to increase the patient’s comfort after the operation. The biomechanical behaviour of the spine is specific for each patient so only a careful detection of it could lead to an optimal therapeutic result.

  10. Intervertebral disc biomechanics in the pathogenesis of idiopathic scoliosis.

    Science.gov (United States)

    Grivas, Theodoros B; Vasiliadis, Elias; Malakasis, Marinos; Mouzakis, Vasilios; Segos, Dimitrios

    2006-01-01

    The aim of the present study is to investigate whether the deformation of the intervertebral disc contributes to the progression of idiopathic scoliotic curves. In the standing posteroanterior x-rays of 92 scoliotic curves the following readings were obtained: Cobb angle (CA), apical vertebral rotation (AVR), apical vertebral wedging (AVW) and the adjacent to the apical vertebra Upper (UIVDW) and Lower (LIVDW) InterVertebral Discs Wedging. The statistical analyses included inter - intraobserver reliability test, descriptives, monofactorial linear regression and Pearson correlation coefficient, with p<0.05 considered statistical significant (SS). The mean thoracic CA was 13.4 degrees, lumbar CA 13.8 degrees, thoracic AVR 5.3 degrees, lumbar AVR 4.7 degrees, thoracic AVW 1.4 degrees, lumbar AVW 1.5 degrees, thoracic UIVDW 1.6 degrees, thoracic LIVDW 1 degrees, lumbar UIVDW 1.3 degrees and lumbar LIVDW 2 degrees. Both thoracic and lumbar CA regressed SS with lumbar LIVDW, lumbar UIVDW, thoracic LIVDW and thoracic AVW. Lumbar LIVDW correlates SS with thoracic CA, lumbar CA and thoracic LIVDW. An inter and intra-observer error was below 1 degrees . The eccentric intervertebral disc in the scoliotic spine, through variation in its water concentration produces asymmetrically cyclical load during the 24-hour period and an asymmetrical growth of the vertebral body (Hueter-Volkman's law). The statistical analysis revealed that AVW appears later when already CA increases, the IVDW is more important than AVW and the LIVDW, which is greater than UIVDW, is the most frequent correlated radiographic parameter. The deformation of the apical intervertebral disc seems to be an important contributory factor in the progression of a scoliotic curve.

  11. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2012-01-01

    Full Text Available Abstract Background The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT, that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS. Methods All types of professionals (specialty physicians, and allied health professionals engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. Results The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations, PSE to prevent scoliosis progression during growth (8, PSE during brace treatment and surgical therapy (5, Other conservative treatments (3, Respiratory function and exercises (3, Sports activities (6, Assessment (20. No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. Conclusion These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas

  12. Effectiveness of Chêneau brace treatment for idiopathic scoliosis: prospective study in 79 patients followed to skeletal maturity

    Directory of Open Access Journals (Sweden)

    Kotwicki Tomasz

    2011-01-01

    Full Text Available Abstract Background Progressive idiopathic scoliosis can negatively influence the development and functioning of 2-3% of adolescents, with health consequences and economic costs, placing the disease in the centre of interest of the developmental medicine. The aim of this study was to evaluate the effectiveness of Chêneau brace in the management of idiopathic scoliosis. Methods A prospective observational study according to SOSORT and SRS recommendations comprised 79 patients (58 girls and 21 boys with progressive idiopathic scoliosis, treated with Chêneau brace and physiotherapy, with initial Cobb angle between 20 and 45 degrees, no previous brace treatment, Risser 4 or more at the final evaluation and minimum one year follow-up after weaning the brace. Achieving 50° of Cobb angle was considered surgical recommendation. Results At follow-up 20 patients (25.3% improved, 18 patients (22.8% were stable, 31 patients (39.2% progressed below 50 degrees and 10 patients (12.7% progressed beyond 50 degrees (2 of these 10 patients progressed beyond 60 degrees. Progression concerned the younger and less skeletally mature patients. Conclusion Conservative treatment with Chêneau orthosis and physiotherapy was effective in halting scoliosis progression in 48.1% of patients. The results of this study suggest that bracing is effective in reducing the incidence of surgery in comparison with natural history.

  13. Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

    Directory of Open Access Journals (Sweden)

    Dariusz Czaprowski

    2014-01-01

    Full Text Available The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH in 155 girls with idiopathic scoliosis (IS (age 9–18 years, mean 13.8 ± 2.3. The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02. The prevalence of GJH was significantly (P=0.01 lower in IS girls aged 16–18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11–24°, moderate (25–40°, and severe scoliosis (>40° (P=0.78, between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59, and between girls with thoracic scoliosis length ≤7 and >7 vertebrae (P=0.25. No correlation between the number of points in B and the Cobb angle (P=0.93, as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63, was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found.

  14. Generalised joint hypermobility in caucasian girls with idiopathic scoliosis: relation with age, curve size, and curve pattern.

    Science.gov (United States)

    Czaprowski, Dariusz

    2014-01-01

    The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9-18 years, mean 13.8±2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02). The prevalence of GJH was significantly (P=0.01) lower in IS girls aged 16-18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11-24°), moderate (25-40°), and severe scoliosis (>40°) (P=0.78), between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59), and between girls with thoracic scoliosis length≤7 and >7 vertebrae (P=0.25). No correlation between the number of points in B and the Cobb angle (P=0.93), as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63), was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found.

  15. Gastaut type idiopathic childhood occipital epilepsy.

    Science.gov (United States)

    Ferrari-Marinho, Taissa; Macedo, Eugenia Fialho; Costa Neves, Rafael Scarpa; Costa, Lívia Vianez; Tudesco, Ivanda S S; Carvalho, Kelly C; Carrete, Henrique; Caboclo, Luis Otavio; Yacubian, Elza Marcia; Hamad, Ana Paula

    2013-03-01

    Gastaut type idiopathic childhood occipital epilepsy is an uncommon epileptic syndrome characterised by frequent seizures, most commonly presenting as elementary visual hallucinations or blindness. Other occipital (non-visual) symptoms may also occur. Interictal EEG typically shows occipital paroxysms, often with fixation-off sensitivity. Ictal EEG is usually characterised by interruption by paroxysms and sudden appearance of low-voltage, occipital, fast rhythm and/or spikes. Despite well described clinical and EEG patterns, to our knowledge, there are very few reports in the literature with video-EEG recording of either seizure semiology or fixation-off phenomena. We present a video-EEG recording of a 12-year-old girl with Gastaut type epilepsy, illustrating the interictal and ictal aspects of this syndrome. Our aim was to demonstrate the clinical and neurophysiological pattern of a typical seizure of Gastaut type epilepsy, as well as the fixation-off phenomena, in order to further clarify the typical presentation of this syndrome. [Published with video sequences].

  16. Bracing Patients with Idiopathic Scoliosis: Design of the Dutch Randomized Controlled Treatment Trial

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    de Koning Harry J

    2008-04-01

    Full Text Available Abstract Background The effectiveness of bracing patients with IS has not yet been convincingly established due to a lack of RCTs. Some authors suggest that their results confirm that bracing is effective; others conclude that the effectiveness of bracing is doubtful or recommend a RCT. The aim of this study was to establish whether bracing patients with idiopathic scoliosis (IS in an early stage will result in at least 5 degrees less mean progression of the curvature compared to the control group after two years of follow-up. Methods A randomized controlled trial was designed. Eligible patients are girls and boys in the age group 8–15 years whose diagnosis of IS has been established by an orthopedic surgeon, who have not yet been treated by bracing or surgery, and for whom further growth of physical height is still expected based on medical examination and maturation characteristics (Risser ≤ 2. The Cobb angle of the eligible patient should either be minimally 22 and maximally 29 degrees with established progression of more than 5 degrees, or should be minimally 30 and maximally 35 degrees; established progression for the latter is not necessary. A total of 100 patients will be included in this trial. The intervention group will be treated with full-time Boston brace wear; the control group will not be braced. Every four months, each patient will have a physical and an X-ray examination. The main outcomes will be the Cobb angle two years after inclusion and health-related quality of life. Discussion The results of this trial will be of great importance for the discussion on early treatment for scoliosis. Furthermore, the result will also be important for screening for scoliosis policies. Trial registration Nederlands Trialregister ISRCTN36964733

  17. Improving perioperative care for adolescent idiopathic scoliosis patients: the impact of a multidisciplinary care approach

    Science.gov (United States)

    Borden, Timothy C; Bellaire, Laura L; Fletcher, Nicholas D

    2016-01-01

    The complex nature of the surgical treatment of adolescent idiopathic scoliosis (AIS) requires a wide variety of health care providers. A well-coordinated, multidisciplinary team approach to the care of these patients is essential for providing high-quality care. This review offers an up-to-date overview of the numerous interventions and safety measures for improving outcomes after AIS surgery throughout the perioperative phases of care. Reducing the risk of potentially devastating and costly complications after AIS surgery is the responsibility of every single member of the health care team. Specifically, this review will focus on the perioperative measures for preventing surgical site infections, reducing the risk of neurologic injury, minimizing surgical blood loss, and preventing postoperative complications. Also, the review will highlight the postoperative protocols that emphasize early mobilization and accelerated discharge. PMID:27695340

  18. Curve Magnitude in Patients Referred for Evaluation of Adolescent Idiopathic Scoliosis

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Hallager, Dennis W; Henriksen, Jeppe L.

    2016-01-01

    STUDY DESIGN: Retrospective cross-sectional study. OBJECTIVES: To analyze the referral pattern of patients with adolescent idiopathic scoliosis (AIS) in a tertiary hospital in a nationalized health care system without school screening and to compare curve magnitude on referral with results reported...... in the literature. SUMMARY OF BACKGROUND DATA: In Denmark, school screening for AIS has not been in effect for more than two decades, and there is limited knowledge of curve magnitude and pattern of referral to specialized treatment in our country. Other studies, however, have assessed the effectiveness of school......, recommended treatment, and major curve Cobb angle for all patients aged 10-19 years referred for evaluation of AIS. Major curve magnitude was categorized as 10-19, 20-39, or ≥40 degrees, and the distribution of categories was compared to a screened population reported in the litterature. RESULTS: A total...

  19. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach;

    2016-01-01

    PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence...... of cancer was determined through chart review and follow-up interviews. Using the original radiographic log file that included patient position, mAs, kV and the total number of X-rays taken, a radiation physicist calculated the total radiation dose during treatment and follow-up adjusted for BMI and sex...... radiation exposure was 0.8-1.4 mSV per examination and 2.4-5.6 mSv/year. An average of 16 radiographs were taken during the treatment period. Nine AIS patients developed cancer, mostly breast (3) and endometrial (4). The AIS patients had a relative risk of 4.8 (CI 2.3-5.8, p

  20. ADOLESCENT IDIOPATHIC SCOLIOSIS: EVALUATION ON THE EFFECT OF SCREW DENSITY IN THE CORRECTION

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    Enguer Beraldo Garcia

    2016-03-01

    Full Text Available ABSTRACT Objective: The objective was to investigate implant density or the number of screws correlated with the correction of the main curve in patients undergoing surgery for adolescent idiopathic scoliosis (AIS. Methods: We evaluated 112 medical records: 33 patients with screw density of up to 50%, and 79 patients with a density of 100%; all patients underwent surgical correction by posterior approach with transpedicular fixation. Results: In the group of patients with screw density of up to 50% the residual Cobb median was 10°; in the group with 100% density, the median was 7°. Conclusion: Biostatistical analysis showed that the group with up to 50% of screw density presented correction rate of 82.1% and the group with 100% density had correction of about 86.8%. It is therefore concluded that the difference is statistically significant in favor of the fixation with 100% density (p =0.010.

  1. Learning effect on the dynamical strategies in sitting position on seesaw motion for idiopathic scoliosis patients.

    Science.gov (United States)

    Bruyneel, Anne-Violette; Mesure, Serge

    2013-02-01

    Our study meant to determine, for idiopathic scoliosis patients, the biomechanical processes involved in postural regulation when self-imposed disturbances occur in seated position in both directions during successive trials. 12 female adolescents with right thoracic scoliosis (SG) and 15 control adolescents (CG) were included in this study. Ground reaction forces were studied using a force platform while the subjects were maintaining their balance in sitting position on a seesaw. Every test is recorded with eyes opened, arms on shoulders and legs free. The force platform data (AP and ML forces data) obtained were processed to determine the following normalized force parameters: delta value (difference between maxima and minima), maximal and minimal force values (peak and occurrence), and the variability of AP and ML forces. We used a variance analysis (ANOVA test) to analyze and compare 3 trials and groups. Our results show that, whatever the directions of destabilization (AP versus ML), SG was always in a learning situation. Indeed, the first test is always less stable than the second and third trials. However, for CG, adaptability between the tests is only highlighted during ML imbalance. Significant differences of strategies between the groups are only visible for the AP force component. For all conditions imposed, scoliotic patients perform specific trunk balance strategies. Clinical tests and rehabilitation methods should include the learning effect within the spatio-temporal adaptation to ground reaction forces.

  2. Application of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    ZHU Xiao-dong; LI Ming; ZHANG Qi; HOU Tie-sheng; HE Shi-sheng

    2007-01-01

    Objective:To determine the effectiveness of posterior Moss-Miami transpedicular system for the treatment of adolescent idiopathic scoliosis in 24 patients with a 2-year minimum follow up. Methods:24 patients who underwent operations between September 2002 and November 2003 were evaluated for curve correction, spinal balance, and complications. Age at surgery averaged 13.8 years (range from 10 to20). The spinal deformities were evaluated by Cobb method with anteroposterior and lateral bending radiographs. All patients were right thoracic curves. Posterior instrumentation (Moss-Miami transpedicular system) was used. The transpedicular screws were placed between T2 and L2. All the patients were assessed both clinically and radiographically. Follow-up averaged 2.8 years. Results: There was an average correction of 72% of the primary curve (pre-operation standing average 54 degrees (range from 40 to 67degrees), post-operation average 15.2 degrees (range from 2 to 27 degrees), at last examination average 16.1 degrees (range from 2 to 30 degrees). Infection and neurological complications were not noted. No major complications were observed. Conclusions: Frontal and sagittal thoracic curve correction of thoracic scoliosis can be satisfactorily obtained using Moss Miami transpedicular instrumentation. It seems that control of the three columns of the spine by the transpedicular screws offers sufficient apical translation and coronal realignment.

  3. Melatonin the "light of night" in human biology and adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Savvidou Olga D

    2007-04-01

    Full Text Available Abstract Melatonin "the light of night" is secreted from the pineal gland principally at night. The hormone is involved in sleep regulation, as well as in a number of other cyclical bodily activities and circadian rhythm in humans. Melatonin is exclusively involved in signalling the 'time of day' and 'time of year' (hence considered to help both clock and calendar functions to all tissues and is thus considered to be the body's chronological pacemaker or 'Zeitgeber'. The last decades melatonin has been used as a therapeutic chemical in a large spectrum of diseases, mainly in sleep disturbances and tumours and may play a role in the biologic regulation of mood, affective disorders, cardiovascular system, reproduction and aging. There are few papers regarding melatonin and its role in adolescent idiopathic scoliosis (AIS. Melatonin may play a role in the pathogenesis of scoliosis (neuroendocrine hypothesis but at present, the data available cannot clearly support this hypothesis. Uncertainties and doubts still surround the role of melatonin in human physiology and pathophysiology and future research is needed.

  4. Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

    Science.gov (United States)

    Macke, Jeremy J; Woo, Raymund; Varich, Laura

    2016-06-01

    This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further

  5. School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian children aged 12 years

    Directory of Open Access Journals (Sweden)

    Brox Jens

    2011-10-01

    Full Text Available Abstract Background School screening for adolescent idiopathic scoliosis (AIS is discussed. The aim of the present study was to describe the point prevalence of AIS and to evaluate the effectiveness of school screening in 12-year- old children. Methods Community nurses and physical therapists in the Southern Health region of Norway including about 12000 school children aged 12 years were invited to participate. All participating community nurses and physical therapists fulfilled an educational course to improve their knowledge about AIS and learn the screening procedure including the Adam Forward Bending Test and measurement of gibbus using a scoliometer. Results Sub-regions including 4000 school children participated. The prevalence of idiopathic scoliosis defined as a positive Adam Forward Bending Test, gibbus > 7° and primary major curve on radiographs > 10°, was 0.55%. Five children (0.13% had a major curve > 20°. Bracing was not indicated in any child; all children were post menarche; four had Risser sign of 4, and one with Risser 1 did not have curve progression > 5° at later follow-up. In one of these 5 children however, the major curve progressed to 45° within 7 months after screening and the girl was operated. Conclusion The point prevalence of AIS in 12- year old children is in agreement or slightly lower than previous studies. The screening model employed demonstrates acceptable sensitivity and specificity and low referral rates. Screening at the age of 12 years only was not effective for detecting patients with indication for brace treatment.

  6. Retrospective analysis of idiopathic scoliosis medical records coming from one out-patient clinic for compatibility with Scoliosis Research Society criteria for brace treatment studies

    Directory of Open Access Journals (Sweden)

    Krzysztof Korbel

    2016-10-01

    Full Text Available Abstract Background First author attempted to analyse medical records of patients with idiopathic scoliosis for compliance with the Scoliosis Research Society brace studies criteria. A retrospective analysis of medical records of 2705 girls treated from 1989 to 2002 was carried out. Methods Age, Cobb, Risser and menarchal status were analyzed for compliance with the Scoliosis Research Society brace studies criteria: a age ≥10 years, b Risser 0–2, c 25–40° Cobb angle, d no earlier treatment, e patients before first menses or not more than one year from first menses. Results It has been found that 183 girls out of 2705 were ≥10 years old and in the range 25–40° Cobb angle. One hundred two out of 2705 patients revealed eligible for brace effectiveness study according to SRS 2005 criteria. 120 out of 2705 patients revealed eligible for brace brace effectiveness study according to SRS-SOSORT 2014 criteria. Conclusion The excluded patients revealed too old or with too significant Cobb angles. This indicates the changing criteria for scoliosis brace treatment over the time. Direct comparison of current results of brace treatment with historical series of cases turns out to be very difficult.

  7. In favour of the definition "adolescents with idiopathic scoliosis": juvenile and adolescent idiopathic scoliosis braced after ten years of age, do not show different end results. SOSORT award winner 2014

    OpenAIRE

    Donzelli, Sabrina; Zaina, Fabio; Lusini, Monia; Minnella, Salvatore; Negrini, Stefano

    2014-01-01

    Background The most important factor discriminating juvenile (JIS) from adolescent idiopathic scoliosis (AIS) is the risk of deformity progression. Brace treatment can change natural history, even when risk of progression is high. The aim of this study was to compare the end of growth results of JIS subjects, treated after 10 years of age, with final results of AIS. Methods Design: prospective observational controlled cohort study nested in a prospective database. Setting: outpatient tertiary...

  8. Transverse plane pelvic rotation increase (TPPRI following rotationally corrective instrumentation of adolescent idiopathic scoliosis double curves

    Directory of Open Access Journals (Sweden)

    Asher Marc A

    2010-08-01

    Full Text Available Abstract Background We have occasionally observed clinically noticeable postoperative transverse plane pelvic rotation increase (TPPRI in the direction of direct thoracolumbar/lumbar rotational corrective load applied during posterior instrumentation and arthrodesis for double (Lenke 3 and 6 adolescent idiopathic scoliosis (AIS curves. Our purposes were to document this occurrence; identify its frequency, associated variables, and natural history; and determine its effect upon patient outcome. Methods Transverse plane pelvic rotation (TPPR can be quantified using the left/right hemipelvis width ratio as measured on standing posterior-anterior scoliosis radiographs. Descriptive statistics were done to determine means and standard deviations. Non-parametric statistical tests were used due to the small sample size and non-normally distributed data. Significance was set at P Results Seventeen of 21 (81% consecutive patients with double curves (7 with Lenke 3 curves and 10 with Lenke 6 instrumented with lumbar pedicle screw anchors to achieve direct rotation had a complete sequence of measurable radiographs. While 10 of these 17 had no postoperative TPPRI, 7 did all in the direction of the rotationally corrective thoracolumbar instrumentation load. Two preoperative variables were associated with postoperative TPPRI: more tilt of the vertebra below the lower instrumented vertebra (-23° ± 3.1° vs. -29° ± 4.6°, P = 0.014 and concurrent anterior thoracolumbar discectomy and arthrodesis (5 of 10 vs. 7 of 7, P = 0.044. Patients with a larger thoracolumbar/lumbar angle of trunk inclination or larger lower instrumented vertebra plus one to sacrum fractional/hemicurve were more likely to have received additional anterior thoracolumbar discectomy and arthrodesis (c = 0.90 and c = 0.833, respectively. Postoperative TPPRI resolved in 5 of the 7 by intermediate follow-up at 12 months. Patient outcome was not adversely affected by postoperative TPPRI

  9. Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan

    Directory of Open Access Journals (Sweden)

    Fazal A

    2012-02-01

    Full Text Available Akil Fazal1, Riaz H Lakdawala21Hospital for Joint Disease, New York University, New York, USA; 2Section of Orthopaedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan.Design: Case series.Place and duration of study: The Aga Khan University Hospital after a minimum of 2 years postoperatively.Patients and methods: A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return.Results: Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1–5, with 5 being best for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome

  10. Epidemiology of adolescent idiopathic scoliosis in students of the public schools in Goiânia-GO

    OpenAIRE

    Souza, Fabiano Inácio de; Di Ferreira, Rodrigo Borges; Labres, Daniel; Elias,Rafael; de Sousa, Ana Patrícia Miranda; Pereira,Rafaela Ernesto

    2013-01-01

    OBJECTIVE: To investigate the prevalence of adolescent idiopathic scoliosis in school children from 10 to 14 years in public schools in Goiânia, GO, Brazil. METHODS: In a cross-sectional study, 476 students were randomly selected from 5 public schools, from a total of 33,343 students distributed in 162 schools. These subjects received the informed consent prior, which was returned after being signed by parents on physical examination day. We evaluated the symmetry of the shoulders, the scapul...

  11. Mental Health of Adults Treated in Adolescence with Scoliosis-Specific Exercise Program or Observed for Idiopathic Scoliosis

    OpenAIRE

    2014-01-01

    Objective. To examine general mental health in adult males and females, who in adolescence participated in a scoliosis-specific therapeutic exercise program or were under observation due to diagnosis of scoliosis. Design. Registry-based, cross-sectional study with retrospective data collection. Methods. Sixty-eight subjects (43 women) aged 30.10 (25–39) years, with mild or moderate scoliosis (11–36° Cobb angle), and 76 (38 women) nonscoliotic subjects, aged 30.11 (24–38) years, participated. ...

  12. Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation

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    Andrea Lebel

    2016-10-01

    Full Text Available Abstract Background Scoliosis is a complex three-dimensional (3D spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving scoliosis curves, vital capacity, and overall quality of life in scoliosis patients. This case presentation shows that indeed adult curve progression can be stopped and even reversed with scoliosis specific Schroth physiotherapy (SSSPT in an adult patient with scoliosis. Methods This is a retrospective case presentation involving a 23-year-old female scoliosis patient who began an outpatient Schroth physiotherapy exercise program and was initially monitored monthly and then annually for improvement in measurements of angle of trunk rotation (ATR and chest expansion and improvement in vital capacity measured with incentive spirometry. Photos were taken to document body image periodically throughout Schroth physiotherapy treatment. Additionally, the patient completed SRS-22 quality of life questionnaires every 2 years to evaluate daily function, pain, self-imagine, mental health, and scoliosis management satisfaction. Results Within one month of beginning SSSPT, the patient reported no more back pain and within 2 months, reported improved breathing. The patient also benefitted from improved chest expansion, reduced scoliosis curve angles (measured in Cobb degrees, increased vital capacity, decreased ATR, and higher SRS-22 scores. She became more active and resumed all athletic activity within 8 months of beginning Schroth physiotherapy. Conclusions Adult scoliosis patients are not routinely referred for PSSE in Canada, even though Schroth physiotherapy, a form

  13. Mental Health of Adults Treated in Adolescence with Scoliosis-Specific Exercise Program or Observed for Idiopathic Scoliosis

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    Maciej Płaszewski

    2014-01-01

    Full Text Available Objective. To examine general mental health in adult males and females, who in adolescence participated in a scoliosis-specific therapeutic exercise program or were under observation due to diagnosis of scoliosis. Design. Registry-based, cross-sectional study with retrospective data collection. Methods. Sixty-eight subjects (43 women aged 30.10 (25–39 years, with mild or moderate scoliosis (11–36° Cobb angle, and 76 (38 women nonscoliotic subjects, aged 30.11 (24–38 years, participated. The time period since the end of the exercise or observation regimes was 16.5 (12-26 years. Beck Depression Inventory (BDI and General Health Questionnaire (GHQ-28 scores were analyzed with the χ2 and U tests. Multiple regression analyses for confounders were also performed. Results. Intergroup differences of demographic characteristics were nonsignificant. Scoliosis, gender, participation in the exercise program, employment, and marital status were associated with BDI scores. The presence of scoliosis and participation in the exercise program manifested association with the symptoms. Higher GHQ-28 “somatic symptoms” subscale scores interacted with the education level. Conclusions. Our findings correspond to the reports of a negative impact of the diagnosis of scoliosis and treatment on mental health. The decision to introduce a therapeutic program in children with mild deformities should be made with judgment of potential benefits, risks, and harm.

  14. Effects of Exercise on Spinal Deformities and Quality of Life in Patients with Adolescent Idiopathic Scoliosis

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    Shahnawaz Anwer

    2015-01-01

    Full Text Available Objectives. This systematic review was conducted to examine the effects of exercise on spinal deformities and quality of life in patients with adolescent idiopathic scoliosis (AIS. Data Sources. Electronic databases, including PubMed, CINAHL, Embase, Scopus, Cochrane Register of Controlled Trials, PEDro, and Web of Science, were searched for research articles published from the earliest available dates up to May 31, 2015, using the key words “exercise,” “postural correction,” “posture,” “postural curve,” “Cobb’s angle,” “quality of life,” and “spinal deformities,” combined with the Medical Subject Heading “scoliosis.” Study Selection. This systematic review was restricted to randomized and nonrandomized controlled trials on AIS published in English language. The quality of selected studies was assessed by the PEDro scale, the Cochrane Collaboration’s tool, and the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE. Data Extraction. Descriptive data were collected from each study. The outcome measures of interest were Cobb angle, trunk rotation, thoracic kyphosis, lumbar kyphosis, vertebral rotation, and quality of life. Data Synthesis. A total of 30 studies were assessed for eligibility. Six of the 9 selected studies reached high methodological quality on the PEDro scale. Meta-analysis revealed moderate-quality evidence that exercise interventions reduce the Cobb angle, angle of trunk rotation, thoracic kyphosis, and lumbar lordosis and low-quality evidence that exercise interventions reduce average lateral deviation. Meta-analysis revealed moderate-quality evidence that exercise interventions improve the quality of life. Conclusions. A supervised exercise program was superior to controls in reducing spinal deformities and improving the quality of life in patients with AIS.

  15. Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

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    Doménech, Julio; Tormos, José María; Barrios, Carlos; Pascual-Leone, Alvaro

    2010-02-01

    The aetiology of idiopathic scoliosis (IS) remains unknown; however, there is a growing body of evidence suggesting that the spine deformity could be the expression of a subclinical nervous system disorder. A defective sensory input or an anomalous sensorimotor integration may lead to an abnormal postural tone and therefore the development of a spine deformity. Inhibition of the motor cortico-cortical excitability is abnormal in dystonia. Therefore, the study of cortico-cortical inhibition may shed some insight into the dystonia hypothesis regarding the pathophysiology of IS. Paired pulse transcranial magnetic stimulation was used to study cortico-cortical inhibition and facilitation in nine adolescents with IS, five teenagers with congenital scoliosis (CS) and eight healthy age-matched controls. The effect of a previous conditioning stimulus (80% intensity of resting motor threshold) on the amplitude of the motor-evoked potential induced by the test stimulus (120% of resting motor threshold) was examined at various interstimulus intervals (ISIs) in both abductor pollicis brevis muscles. The results of healthy adolescents and those with CS showed a marked inhibitory effect of the conditioning stimulus on the response to the test stimulus at interstimulus intervals shorter than 6 ms. These findings do not differ from those reported for normal adults. However, children with IS revealed an abnormally reduced cortico-cortical inhibition at the short ISIs. Cortico-cortical inhibition was practically normal on the side of the scoliotic convexity while it was significantly reduced on the side of the scoliotic concavity. In conclusion, these findings support the hypothesis that a dystonic dysfunction underlies in IS. Asymmetrical cortical hyperexcitability may play an important role in the pathogenesis of IS and represents an objective neurophysiological finding that could be used clinically.

  16. Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis.

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    Q Wang

    Full Text Available Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS. As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting.To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI measurements.Thirty curves (ranged 10.2°-68.2° from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC. The validity of this method was analyzed by paired Student's t-test, Bland-Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05.The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K >0.9, p0.9, p<0.05.The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the proposed ultrasound measurement in larger clinical trial and to optimize the ultrasound scanning and measuring procedure.

  17. Usefulness of Simple Rod Rotation to Correct Curve of Adolescent Idiopathic Scoliosis

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    Kim, Ji Yong; Song, Kyungchul; Kim, Kyung Hyun; Rim, Dae Cheol

    2015-01-01

    Objective To correct apical vertebral rotation for adolescent idiopathic scoliosis (AIS), direct vertebral derotation (DVD) or simple rod rotation (SRR) might be considered. The aim of the present study is to introduce the surgical experiences of AIS by a Korean neurosurgeon and to evaluate the effectiveness of SRR for apical vertebral rotation. Methods A total of 9 patients (1 male and 8 females) underwent scoliosis surgery by a neurosurgeon of our hospital. The Lenke classifications of the patients were 1 of 1B, 2 of 1C, 1 of 2A, 1 of 2C, 3 of 5C and 1 of 6C. Surgery was done by manner of simple rod rotation on the concave side and in situ coronal bending. Coronal Cobb's angles, vertebral rotation angles and SRS-22 were measured on a plain standing X-ray and CT before and after surgery. Results The mean follow up period was 25.7 months (range : 5–52). The mean number of screw positioning level was nine (6–12). The mean age was 16.4 years (range : 13–25) at surgery. The mean Risser grade was 3.7±0.9. The apical vertebral rotation measured from the CT scans was 25.8±8.5° vs. 9.3±6.7° (p<0.001) and the Coronal Cobb's angle was 53.7±10.4° vs. 15.4±6.5° (p<0.001) preoperatively and postoperative, respectively. The SRS-22 improved from 71.9 preoperatively to 90.3 postoperatively. There were no complications related with the operations. Conclusion SRR with pedicle screw instrumentation could be corrected successfully by axial rotation without complications. SRR might serve as a good option to correct AIS deformed curves of AIS. PMID:26819688

  18. Bracing for Adolescent Idiopathic Scoliosis (AIS and Scheuermann Kyphosis: the issue of overtreatment in Greece

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    Nikos S. Karavidas

    2016-10-01

    with a brace can cause social, financial and psychological problems. The present study pinpoints the need for an evidence-based approach to conservative treatment of idiopathic scoliosis and kyphosis. Overtreatment can be avoided when the indications are strictly based on the guidelines published internationally.

  19. Surgical correction of spinal deformity with the use of transpedicular screw spinal systems in children with idiopathic thoracic scoliosis

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    Нурбек Надирович Надиров

    2016-06-01

    Full Text Available Aim.To compare the results of surgical correction of spinal deformity in children with idiopathic thoracic scoliosis with the use of transpedicular screw spinal systems with different pedicle screw placement.Material and methods.Thirty-one patients (14–17 years with spinal curvature with a Cobb angle from 40° to 79° were operated on. Surgical correction of the deformity was performed using two methods, depending on the possible placement of a pedicle screw. The first group included 16 patients for whom the transpedicular support elements were placed on both sides, throughout the completely deformed spine. The second group included 15 patients for whom the pedicle screws were not placed for two or more vertebrae on the concave side of the curve, at the top of the main curve.Results.The mean percent correction of the spinal deformity for the first and second groups was 92.5% and 82.6%, respectively. The mean percentage of derotation of the apical vertebra for the first and second groups was 73.9% and 23%, respectively.Conclusion.The use of data based on the anatomical and anthropometric features of the vertebral body with scoliosis facilitates selection of the best option for correction of thoracic curve in children with idiopathic scoliosis using pedicle multi-support metal construction. The use of the spinal pedicle system for correction of spinal deformity in children with idiopathic scoliosis enabled a uniform load distribution along the support elements of the metal construction and maintained the correction in the late postoperative follow-up period.

  20. Haplotypes at LBX1 have distinct inheritance patterns with opposite effects in adolescent idiopathic scoliosis.

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    Rakesh Chettier

    Full Text Available Adolescent idiopathic scoliosis (AIS is a clinically significant disorder with high heritability that affects 2-4% of the population. Genome-wide association studies have identified LBX1 as a strong susceptibility locus for AIS in Asian and Caucasian populations. Here we further dissect the genetic association with AIS in a Caucasian population. To identify genetic markers associated with AIS we employed a genome-wide association study (GWAS design comparing 620 female Caucasian patients who developed idiopathic scoliosis during adolescence with 1,287 ethnically matched females who had normal spinal curves by skeletal maturity. The genomic region around LBX1 was imputed and haplotypes investigated for genetic signals under different inheritance models. The strongest signal was identified upstream of LBX1 (rs11190878, P(trend = 4.18 × 10(-9, OR = 0.63[0.54-0.74]. None of the remaining SNPs pass the genome-wide significance threshold. We found rs11190870, downstream of LBX1 and previously associated with AIS in Asian populations, to be in modest linkage disequilibrium (LD with rs11190878 (r(2 = 0.40, D' = 0.81. Haplotype analysis shows that rs11190870 and rs11190878 track a single risk factor that resides on the ancestral haplotype and is shared across ethnic groups. We identify six haplotypes at the LBX1 locus including two strongly associated haplotypes; a recessive risk haplotype (TTA, Control(freq = 0.52, P = 1.25 × 10(-9, OR = 1.56, and a co-dominant protective haplotype (CCG, Control(freq = 0.28, P = 2.75 × 10(-7, OR = 0.65. Together the association signals from LBX1 explain 1.4% of phenotypic variance. Our results identify two clinically relevant haplotypes in the LBX1-region with opposite effects on AIS risk. The study demonstrates the utility of haplotypes over un-phased SNPs for individualized risk assessment by more strongly delineating individuals at risk for AIS without compromising the effect size.

  1. Haplotypes at LBX1 have distinct inheritance patterns with opposite effects in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Chettier, Rakesh; Nelson, Lesa; Ogilvie, James W; Albertsen, Hans M; Ward, Kenneth

    2015-01-01

    Adolescent idiopathic scoliosis (AIS) is a clinically significant disorder with high heritability that affects 2-4% of the population. Genome-wide association studies have identified LBX1 as a strong susceptibility locus for AIS in Asian and Caucasian populations. Here we further dissect the genetic association with AIS in a Caucasian population. To identify genetic markers associated with AIS we employed a genome-wide association study (GWAS) design comparing 620 female Caucasian patients who developed idiopathic scoliosis during adolescence with 1,287 ethnically matched females who had normal spinal curves by skeletal maturity. The genomic region around LBX1 was imputed and haplotypes investigated for genetic signals under different inheritance models. The strongest signal was identified upstream of LBX1 (rs11190878, P(trend) = 4.18 × 10(-9), OR = 0.63[0.54-0.74]). None of the remaining SNPs pass the genome-wide significance threshold. We found rs11190870, downstream of LBX1 and previously associated with AIS in Asian populations, to be in modest linkage disequilibrium (LD) with rs11190878 (r(2) = 0.40, D' = 0.81). Haplotype analysis shows that rs11190870 and rs11190878 track a single risk factor that resides on the ancestral haplotype and is shared across ethnic groups. We identify six haplotypes at the LBX1 locus including two strongly associated haplotypes; a recessive risk haplotype (TTA, Control(freq) = 0.52, P = 1.25 × 10(-9), OR = 1.56), and a co-dominant protective haplotype (CCG, Control(freq) = 0.28, P = 2.75 × 10(-7), OR = 0.65). Together the association signals from LBX1 explain 1.4% of phenotypic variance. Our results identify two clinically relevant haplotypes in the LBX1-region with opposite effects on AIS risk. The study demonstrates the utility of haplotypes over un-phased SNPs for individualized risk assessment by more strongly delineating individuals at risk for AIS without compromising the effect size.

  2. The changes of the interspace angle after anterior correction and instrumentation in adolescent idiopathic scoliosis patients

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    Fei Qi

    2007-10-01

    Full Text Available Abstract Background In idiopathic scoliosis patients, after anterior spinal fusion and instrumentation, the discs (interspace angle between the lowest instrumented vertebra (LIV and the next caudal vertebra became more wedged. We reviewed these patients and analyzed the changes of the angle. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent anterior spinal fusion and instrumentation, Cobb angle of the curve, correction rate, coronal balance, LIV rotation, interspace angle were measured and analyzed. Results There were total 30 patients included. The mean coronal Cobb angle of the main curve (thoracolumbar/lumbar curve before and after surgery were 48.9° and 11.7°, respectively, with an average correction rate of 76.1%. The average rotation of LIV before surgery was 2.1 degree, and was improved to 1.2 degree after surgery. The interspace angle before surgery, on convex side-bending films, after surgery, at final follow up were 3.2°, -2.3°, 1.8° and 4.9°, respectively. The difference between the interspace angle after surgery and that preoperatively was not significant (P = 0.261, while the interspace angle at final follow-up became larger than that after surgery, and the difference was significant(P = 0.012. The interspace angle after surgery was correlated with that on convex side-bending films (r = 0.418, P = 0.022, and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000. There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007. Conclusion The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up. The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

  3. Assessment of the paraspinal muscles of subjects presenting an idiopathic scoliosis: an EMG pilot study

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    Larivière Christian

    2005-03-01

    Full Text Available Abstract Background It is known that the back muscles of scoliotic subjects present abnormalities in their fiber type composition. Some researchers have hypothesized that abnormal fiber composition can lead to paraspinal muscle dysfunction such as poor neuromuscular efficiency and muscle fatigue. EMG parameters were used to evaluate these impairments. The purpose of the present study was to examine the clinical potential of different EMG parameters such as amplitude (RMS and median frequency (MF of the power spectrum in order to assess the back muscles of patients presenting idiopathic scoliosis in terms of their neuromuscular efficiency and their muscular fatigue. Methods L5/S1 moments during isometric efforts in extension were measured in six subjects with idiopathic scoliosis and ten healthy controls. The subjects performed three 7 s ramp contractions ranging from 0 to 100% maximum voluntary contraction (MVC and one 30 s sustained contraction at 75% MVC. Surface EMG activity was recorded bilaterally from the paraspinal muscles at L5, L3, L1 and T10. The slope of the EMG RMS/force (neuromuscular efficiency and MF/force (muscle composition relationships were computed during the ramp contractions while the slope of the EMG RMS/time and MF/time relationships (muscle fatigue were computed during the sustained contraction. Comparisons were performed between the two groups and between the left and right sides for the EMG parameters. Results No significant group or side differences between the slopes of the different measures used were found at the level of the apex (around T10 of the major curve of the spine. However, a significant side difference was seen at a lower level (L3, p = 0.01 for the MF/time parameter. Conclusion The EMG parameters used in this study could not discriminate between the back muscles of scoliotic subjects and those of control subject regarding fiber type composition, neuromuscular efficiency and muscle fatigue at the level

  4. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis

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    Gunderson Ragnhild

    2011-08-01

    Full Text Available Abstract Background It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. Methods 272 (78% of 360 patients, 251 (92% women, responded to follow-up examination at a mean of 24.7 (range 16 - 32 years after Boston brace treatment. Fifty-eight (21% patients had late-onset juvenile and 214 had adolescent idiopathic scoliosis. All patients had clinical and radiological examination and answered a standardised questionnaire including work status, demographics, General Function Score (GFS (100 - worst possible and Oswestry Disability Index (ODI (100 - worst possible, EuroQol (EQ-5D (1 - best possible, EQ-VAS (100 - best possible, and Scoliosis Research Society - 22 (SRS - 22 (5 - best possible. Results The mean age at follow-up was 40.4 (31-48 years. The prebrace major curve was in average 33.2 (20 - 57°. At weaning and at the last follow-up the corresponding values were 28.3 (1 - 58° and 32.5 (7 - 80°, respectively. Curve development was similar in patients with late-onset juvenile and adolescent start. The prebrace curve increased > 5° in 31% and decreased > 5° in 26%. Twenty-five patients had surgery. Those who did not attend follow-up (n = 88 had a lower mean curve at weaning: 25.4 (6-53°. Work status was 76% full-time and 10% part-time. Eighty-seven percent had delivered a baby, 50% had pain in pregnancy. The mean (SD GFS was 7.4 (10.8, ODI 9.3 (11.0, EQ-5D 0.82 (0.2, EQ-VAS 77.6 (17.8, SRS-22: pain 4.1 (0.8, mental health 4.1 (0.6, self-image 3.7 (0.7, function 4.0 (0.6, satisfaction with treatment 3.7 (1.0. Surgical patients had significantly reduced scores for SRS-physical function and self-image, and patients with curves ≥ 45° had reduced self-image. Conclusion Long-term results were

  5. Radiographic versus ultrasound evaluation of the Risser Grade in adolescent idiopathic scoliosis: a prospective study of 46 patients.

    Science.gov (United States)

    Thaler, Martin; Kaufmann, Gerhard; Steingruber, Iris; Mayr, Eckart; Liebensteiner, Michael; Bach, Christian

    2008-09-01

    The determination of skeletal age is essential in the management of patients with scoliosis. One of the most frequently used techniques to determine skeletal maturity is the method described by Risser. However, repeated X-ray exposure in the follow-up examinations of scoliosis patients may increase the risk of cancer. We compared conventional radiological evaluation of the Risser grade with ultrasound evaluation. For scoliosis patients routine application of ultrasound in the follow-up examinations may significantly reduce radiation exposure. 46 adolescent idiopathic scoliosis patients (median age, 14.5 years) were investigated. Sonographic and radiographic assessment of Risser sign was carried out by two independent senior staff skeletal radiologists. Agreement of Risser Grade between the two diagnostic methods was determined by Kappa statistics. Coefficients 0.80 were rated as poor, fair, moderate, good, and very good agreement. For Risser Grades I-III 100% agreement was found between the two methods. Disagreement between radiographic and sonographic evaluation was found in Risser Grades IV and V. In five patients, X-ray evaluation yielded Risser Grade V while ultrasound showed Risser Grade IV. In one patient, radiographic examination resulted in Risser Grade IV while Grade V was detected in ultrasound. Overall, the Kappa value showed very good agreement between the two diagnostic methods. Our findings suggest that ultrasound can be applied as an alternative method to X-ray evaluation in Risser Grade determination. It should be routinely used in clinical practice to reduce the patients exposure to radiation.

  6. Perception of stress level, trunk appearance, body function and mental health in females with adolescent idiopathic scoliosis treated conservatively: a longitudinal analysis

    OpenAIRE

    Misterska, Ewa; Glowacki, Maciej; Latuszewska, Joanna; Adamczyk, Katarzyna

    2012-01-01

    Purpose In the presented study, we aimed to assess changes over time in the perception of trunk deformity, body function, stress level and mental health in females with adolescent idiopathic scoliosis (AIS) who were treated conservatively with a Cheneau brace, taking the Trunk Appearance Perception Scale (TAPS), Scoliosis Research Society-22 (SRS-22) and Bad Sobberheim Stress Questionnaires (BSSQ) criteria of evaluation into consideration. Methods The study design was comprised of three quest...

  7. Association Study between Promoter Polymorphism of TPH1 and Progression of Idiopathic Scoliosis.

    Science.gov (United States)

    Yablanski, Vasil; Nikolova, Svetla; Vlaev, Evgeni; Savov, Alexey; Kremensky, Ivo

    2016-01-01

    The concept of disease-modifier genes as an element of genetic heterogeneity has been widely accepted and reported. The aim of the current study is to investigate the association between the promoter polymorphism TPH1 (rs10488682) and progression of idiopathic scoliosis (IS) in Eastern European population sample. A total of 105 patients and 210 healthy gender-matched controls were enrolled in this study. The TPH1 promoter polymorphism was genotyped by amplification followed by restriction. The statistical analysis was performed by Fisher's Exact Test. The results indicated that the genotypes and alleles of TPH1 (rs10488682) are not correlated with curve severity, curve pattern, or bracing. Therefore, the examined polymorphic variant could not be considered as a genetic factor with modifying effect of IS. In conclusion, this case-control study revealed no statistically significant association between TPH1 (rs10488682) and progression of IS in Eastern European population sample. These preliminary results should be replicated in extended population studies including larger sample sizes. The identification of molecular markers for IS could be useful for a more accurate prognosis of the risk for a rapid progression of the curve. That would permit early stage treatment of the patient with the least invasive procedures.

  8. A PAX1 enhancer locus is associated with susceptibility to idiopathic scoliosis in females.

    Science.gov (United States)

    Sharma, Swarkar; Londono, Douglas; Eckalbar, Walter L; Gao, Xiaochong; Zhang, Dongping; Mauldin, Kristen; Kou, Ikuyo; Takahashi, Atsushi; Matsumoto, Morio; Kamiya, Nobuhiro; Murphy, Karl K; Cornelia, Reuel; Herring, John A; Burns, Dennis; Ahituv, Nadav; Ikegawa, Shiro; Gordon, Derek; Wise, Carol A

    2015-03-18

    Idiopathic scoliosis (IS) is a common paediatric musculoskeletal disease that displays a strong female bias. By performing a genome-wide association study (GWAS) of 3,102 individuals, we identify significant associations with 20p11.22 SNPs for females (P=6.89 × 10(-9)) but not males (P=0.71). This association with IS is also found in independent female cohorts from the United States of America and Japan (overall P=2.15 × 10(-10), OR=1.30 (rs6137473)). Unexpectedly, the 20p11.22 IS risk alleles were previously associated with protection from early-onset alopecia, another sexually dimorphic condition. The 174-kb associated locus is distal to PAX1, which encodes paired box 1, a transcription factor involved in spine development. We identify a sequence in the associated locus with enhancer activity in zebrafish somitic muscle and spinal cord, an activity that is abolished by IS-associated SNPs. We thus identify a sexually dimorphic IS susceptibility locus, and propose the first functionally defined candidate mutations in an enhancer that may regulate expression in specific spinal cells.

  9. Association of Body Composition with Curve Severity in Children and Adolescents with Idiopathic Scoliosis (IS).

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    Matusik, Edyta; Durmala, Jacek; Matusik, Pawel

    2016-01-28

    The link between scoliotic deformity and body composition assessed with bioimpedance (BIA) has not been well researched. The objective of this study was to correlate the extent of scoliotic-curve severity with the anthropometrical status of patients with idiopathic scoliosis (IS) based on standard anthropometric measurements and BIA. The study encompassed 279 IS patients (224 girls/55 boys), aged 14.21 ± 2.75 years. Scoliotic curve severity assessed by Cobb's angle was categorized as moderate (10°-39°) or severe (≥40°). Corrected height, weight, waist and hip circumferences were measured and body mass index (BMI), corrected height z-score, BMI Z-score, waist/height ratio (WHtR) and waist/hip ratio (WHR) were calculated for the entire group. Body composition parameters: fat mass (FAT), fat-free mass (FFM) and predicted muscle mass (PMM) were determined using a bioelectrical impedance analyzer. The mean Cobb angle was 19.96° ± 7.92° in the moderate group and 52.36° ± 12.54° in the severe group. The corrected body heights, body weights and BMIs were significantly higher in the severe IS group than in the moderate group (p children.

  10. Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review.

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    Agabegi, Steven S; Kazemi, Namdar; Sturm, Peter F; Mehlman, Charles T

    2015-12-01

    The surgical treatment of adolescent idiopathic scoliosis is dependent on several factors, including curve type and magnitude, degree of curve progression, skeletal maturity, and other considerations, such as pain and cosmesis. The most common indication for surgery is curve progression. Most authors agree that surgical treatment should be considered in skeletally mature patients with curves > 50° because of the risk of progression into adulthood. Furthermore, most authors would agree that curves measuring < 40° to 45° in skeletally mature patients should be observed. When a skeletally mature patient with a curve measuring between 45° to 55° is presenting to an orthopaedic surgeon, it is not uncommon that the patient has no pain, no progression, and no imbalance. The generally accepted belief has been that curves that reach 50° are likely to progress into adulthood, progressing at a rate of 1° per year, based largely on the Iowa studies. However, the level of evidence for this is relatively weak, and the existing literature is equivocal in supporting the practice of performing surgery on these patients.

  11. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial.

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    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by "d" Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  12. Asynchronous neuro-osseous growth in adolescent idiopathic scoliosis - MRI-based research

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    Chu, Winnie C.W.; Rasalkar, Darshana D. [The Chinese University of Hong Kong, Department of Diagnostic Radiology and Organ Imaging, Hong Kong, SAR (China); Cheng, Jack C.Y. [The Chinese University of Hong Kong, Department of Orthopaedics and Traumatology, Hong Kong, SAR (China)

    2011-09-15

    Adolescent idiopathic scoliosis (AIS) is a common worldwide problem and has been treated for many decades; however, there still remain uncertain areas about this disorder. Its involvement and impact on different parts of the human body remain underestimated due to lack of technology in imaging for objective assessment in the past. The advances in imaging technique and image analysis technology have provided a novel approach for the understanding of the phenotypic presentation of neuro-osseous changes in AIS patients as compared with normal controls. This review is the summary of morphological assessment of the skeletal and nervous systems in girls with AIS based on MRI. Girls with AIS are found to have morphological differences in multiple areas including the vertebral column, spinal cord, skull and brain when compared with age- and sex-matched normal controls. Taken together, the abnormalities in the skeletal system and nervous system of AIS are likely to be inter-related and reflect a systemic process of asynchronous neuro-osseous growth. The current knowledge about the anatomical changes in AIS has important implications with respect to the understanding of fundamental pathomechanical processes involved in the evolution of the scoliotic deformity. (orig.)

  13. Association Study between Promoter Polymorphism of TPH1 and Progression of Idiopathic Scoliosis

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    Vasil Yablanski

    2016-01-01

    Full Text Available The concept of disease-modifier genes as an element of genetic heterogeneity has been widely accepted and reported. The aim of the current study is to investigate the association between the promoter polymorphism TPH1 (rs10488682 and progression of idiopathic scoliosis (IS in Eastern European population sample. A total of 105 patients and 210 healthy gender-matched controls were enrolled in this study. The TPH1 promoter polymorphism was genotyped by amplification followed by restriction. The statistical analysis was performed by Fisher’s Exact Test. The results indicated that the genotypes and alleles of TPH1 (rs10488682 are not correlated with curve severity, curve pattern, or bracing. Therefore, the examined polymorphic variant could not be considered as a genetic factor with modifying effect of IS. In conclusion, this case-control study revealed no statistically significant association between TPH1 (rs10488682 and progression of IS in Eastern European population sample. These preliminary results should be replicated in extended population studies including larger sample sizes. The identification of molecular markers for IS could be useful for a more accurate prognosis of the risk for a rapid progression of the curve. That would permit early stage treatment of the patient with the least invasive procedures.

  14. In Search of Biomarkers for Idiopathic Scoliosis: Leptin and BMP4 Functional Polymorphisms

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    Svetla Nikolova

    2015-01-01

    Full Text Available Idiopathic scoliosis (IS is the most common spinal disorder in children and adolescents. The current consensus on IS maintains that it has a multifactorial etiology with genetic predisposition factors. In the present study the association of two functional polymorphisms of leptin (rs7799039 and BMP4 (rs4898820 with susceptibility to IS and curve severity was investigated in a Bulgarian population sample. The molecular detection of the genotypes was performed by amplification followed by restriction technology. The statistical analysis was performed by Pearson’s chi-squared test. This case-control study revealed no statistically significant association between the functional polymorphisms of leptin and BMP4 and susceptibility to IS or curve progression (p>0.05. On the basis of these results the examined polymorphic variants of leptin and BMP4 could not be considered as genetic variants with predisposition effect or as risk factors for the progression of the curve. In addition, these results do not exclude a synergistic effect of the promoter polymorphisms of leptin and BMP4 in the etiology and pathogenesis of IS. The identification of molecular markers for IS could be useful for early detection and prognosis of the risk for a rapid progression of the curve. That would permit early stage treatment of the patient with the least invasive procedures.

  15. Predicting success or failure of brace treatment for adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Chalmers, Eric; Westover, Lindsey; Jacob, Johith; Donauer, Andreas; Zhao, Vicky H; Parent, Eric C; Moreau, Marc J; Mahood, James K; Hedden, Douglas M; Lou, Edmond H M

    2015-10-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity. Brace treatment is a common non-surgical treatment, intended to prevent progression (worsening) of the condition during adolescence. Estimating a braced patient's risk of progression is an essential part of planning treatment, so method for predicting this risk would be a useful decision support tool for practitioners. This work attempts to discover whether failure of brace treatment (progression) can be predicted at the start of treatment. Records were obtained for 62 AIS patients who had completed brace treatment. Subjects were labeled as "progressive" if their condition had progressed despite brace treatment and "non-progressive" otherwise. Wrapper-based feature selection selected two useful predictor variables from a list of 14 clinical measurements taken from the records. A logistic regression model was trained to classify patients as "progressive" or "non-progressive" using these two variables. The logistic regression model's simplicity and interpretability should facilitate its clinical acceptance. The model was tested on data from an additional 28 patients and found to be 75 % accurate. This accuracy is sufficient to make the predictions clinically useful. It can be used online: http://www.ece.ualberta.ca/~dchalmer/SimpleBracePredictor.html .

  16. Heated indoor swimming pools, infants, and the pathogenesis of adolescent idiopathic scoliosis: a neurogenic hypothesis

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    McMaster Marianne E

    2011-10-01

    Full Text Available Abstract Background In a case-control study a statistically significant association was recorded between the introduction of infants to heated indoor swimming pools and the development of adolescent idiopathic scoliosis (AIS. In this paper, a neurogenic hypothesis is formulated to explain how toxins produced by chlorine in such pools may act deleteriously on the infant's immature central nervous system, comprising brain and spinal cord, to produce the deformity of AIS. Presentation of the hypothesis Through vulnerability of the developing central nervous system to circulating toxins, and because of delayed epigenetic effects, the trunk deformity of AIS does not become evident until adolescence. In mature healthy swimmers using such pools, the circulating neurotoxins detected are chloroform, bromodichloromethane, dibromochloromethane, and bromoform. Cyanogen chloride and dichloroacetonitrile have also been detected. Testing the hypothesis In infants, the putative portals of entry to the blood could be dermal, oral, or respiratory; and entry of such circulating small molecules to the brain are via the blood-brain barrier, blood-cerebrospinal fluid barrier, and circumventricular organs. Barrier mechanisms of the developing brain differ from those of adult brain and have been linked to brain development. During the first 6 months of life cerebrospinal fluid contains higher concentrations of specific proteins relative to plasma, attributed to mechanisms continued from fetal brain development rather than immaturity. Implications of the hypothesis The hypothesis can be tested. If confirmed, there is potential to prevent some children from developing AIS.

  17. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    Science.gov (United States)

    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  18. Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis

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    Cuddihy, Laury; Danielsson, Aina J.; Cahill, Patrick J.; Samdani, Amer F.; Grewal, Harsh; Richmond, John M.; Mulcahey, M. J.; Gaughan, John P.; Antonacci, M. Darryl; Betz, Randal R.

    2015-01-01

    Purpose. We report a comparison study of vertebral body stapling (VBS) versus a matched bracing cohort for immature patients with moderate (25 to 44°) idiopathic scoliosis (IS). Methods. 42 of 49 consecutive patients (86%) with IS were treated with VBS and followed for a minimum of 2 years. They were compared to 121 braced patients meeting identical inclusion criteria. 52 patients (66 curves) were matched according to age at start of treatment (10.6 years versus 11.1 years, resp. [P = 0.07]) and gender. Results. For thoracic curves 25–34°, VBS had a success rate (defined as curve progression Risser 0-1) moderate IS (25–44°), in smaller thoracic curves (25–34°) VBS provided better results as a clinical trend as compared to bracing. VBS was found not to be effective for thoracic curves ≥35°. For lumbar curves measuring 25–34°, results appear to be similar for both VBS and bracing, at 80% success. PMID:26618169

  19. Standardization of dynamic RX for preoperative planning in adolescent idiopathic scoliosis

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    Everton Quadros Fiebig

    2014-09-01

    Full Text Available OBJECTIVE: To compare X-rays usually performed in supine with lateralization with those in lateral decubitus with fulcrum at the apex of the primary curve caused by cushion, in order to monitor the achievement of improvement patterns of correction in preestablished deformities for the preoperative surgical planning. METHODS: Comparison of radiographic studies in the preoperative supine with lateralization and lateral decubitus with cushion performing fulcrum at the apex of the major curve in patients with adolescent idiopathic scoliosis. RESULTS: Curves varied in AP between 76° e 40° and were corrected in supine with lateralization to the average of 21° observing that when carried out with fulcrum with cushion in lateral decubitus the curves were corrected to 15° on average with higher discrepancy in values among the most rigid curves. CONCLUSIONS: It was verified that on flexible curves the cushions did not produce satisfactory corrections in primary curves. In more rigid curves and in collaborative patients, greater effectiveness on the correction of deformity in main curves was obtained with cushions producing local fulcrum for a better preoperative planning on correction of deformities.

  20. Effect of upright position on tonsillar level in adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ryan K.L.; Leung, Joyce H.Y.; Chu, Winnie C.W. [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong, Shatin (China); Griffith, James F. [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong, Shatin (China); The Chinese University of Hong Kong, Prince of Wales Hospital, Faculty of Medicine, Shatin, Hong Kong, SAR (China); Lam, T.P.; Ng, Bobby K.W.; Cheng, Jack C.Y. [The Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Shatin (China)

    2015-08-15

    The aim of this study was to investigate the effect of an upright position on cerebellar tonsillar level in patients with adolescent idiopathic scoliosis (AIS). Twenty-five patients with clinically diagnosed AIS and 18 normal controls were examined in both supine and upright positions using 0.25T MRI. The position of the inferior cerebellar tonsil tip relative to a reference line connecting the basion to the opisthion (BO line) was measured in millimetres. None of the 18 normal control subjects had cerebellar tonsillar descent below the BO line in either supine or the upright position. Forty-eight percent of AIS patients had tonsillar descent in the upright position, compared to 28 % in the supine position. In the upright position, cerebellar tonsillar position was lower in AIS patients than in normal subjects (mean -0.7 ± 1.5 vs. +2.1 ± 1.7, p < 0.00001). AIS patients also had a large degree of tonsillar excursion between upright and supine positions compared to normal subjects (mean -1.9 ± 2.3 vs. -0.1 ± 0.2, p < 0.00001). When considering the theoretical likelihood that a low tonsillar position may affect spinal cord function, one should bear in mind that tonsillar descent in AIS is significantly greater in the upright position. (orig.)

  1. Evaluation of the Stress Level of Children with Idiopathic Scoliosis in relation to the Method of Treatment and Parameters of the Deformity

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    Justyna Leszczewska

    2012-01-01

    Full Text Available Stress level due to existing body deformity as well as to the treatment with a corrective brace is one of factors influencing the quality of life of children with idiopathic scoliosis undergoing non-surgical management. The purpose of the study was to evaluate the stress level among children suffering from idiopathic scoliosis in relation to the method of treatment and the parameters of the deformity. Seventy-three patients with idiopathic scoliosis participated in the study. Fifty-two children were treated by means of physiotherapy, while 21 patients were treated with both Cheneau corrective brace and physiotherapy. To assess the stress level related to the deformity itself and to the method of treatment with corrective brace, the two Bad Sobernheim Stress Questionnaires (BSSQs were applied, the BSSQ Deformity and the BSSQ Brace, respectively.

  2. [Treatment of severe scoliosis].

    Science.gov (United States)

    Helenius, Ilkka; Pajulo, Olli

    2015-01-01

    Untreated severe scoliosis results in a serious malposition of the back, restrictive lung disease and increases mortality compared with the normal population. Idiopathic scoliosis rarely reaches a severe degree. In the treatment of severe scoliosis, preoperative head traction of several weeks' duration has proven a safe and effective method of correcting the malposition, and will also make scoliosis surgery technically easier. Most cases of severe scoliosis can be treated with anterior pedicle screw instrumentation, and vertebrectomy is only seldom required.

  3. Long-term results after Boston brace treatment in adolescent idiopathic scoliosis

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    Steen Harald

    2009-08-01

    Full Text Available Abstract Background Few studies have evaluated long-term outcome after bracing using validated health related quality of life outcome measures. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS 12 years or more after treatment with the Boston brace. Methods 109 (80% of 135 patients (7 men with AIS treated with the Boston brace at a mean of 19.2 (range 12–28 years previously responded to long-term follow-up examination. All patients (n = 109 answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI (100-worst possible, General Function Score (GFS (100 – worst possible, EuroQol (EQ-5D (1 – best possible, EQ-VAS (100 – best possible and Scoliosis Research Society -22 (SRS – 22 (5 – best possible. Clinical and radiological examination was obtained in 86 patients. Results The magnitude of the primary prebrace major curve was in average 33.4° (range 20 – 52. At weaning and at the last follow-up the corresponding values were 28.3° (9–56 and 34.2° (8 – 87, respectively. The mean age at follow-up was 35 (27 – 46 years. Work status was: full time (80%, on sick-leave (3%, on rehabilitation (4%, disability pension (4%, homemaker (7%, students (2%, 7% had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81%. The mean (standard deviation ODI was 6.4 (9.8, GFS 5.4 (10.5, EQ-5D 0.84 (0.2, SRS-22: pain 4.2 (0.8, mental health 4.2 (0.7, self-image 3.9 (0.7, function 4.1 (0.6, satisfaction with treatment 3.7 (1.0. 28% had taken physiotherapy for back pain the last year and 12% had visited a doctor. Conclusion Long-term results were satisfactory in most patients with AIS treated with the Boston brace.

  4. Comparison of Harrington Rod and Cotrel-Dubousset Devices in Surgical Correction of Adolescent Idiopathic Scoliosis

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    Ameri

    2013-10-01

    Full Text Available Background Since the time of Paul Harrington numerous implants have been introduced for correction of scoliosis, but none are ideal. Newer devices are very expensive, and in our country some patients cannot afford them. Objectives The aim of this study was to compare the results of the Harrington rod (HR device and the newer Cotrel-Dubousset (CD device in treatment of adolescent idiopathic scoliosis (AIS. Materials and Methods A retrospective review assessed patients with AIS admitted for spinal curve correction treated with HR (n = 120 and CD devices (n = 138 between October 1988 to April 2001 at the Shafa Yahyaeian Hospital, Tehran, Iran. We extracted information from the patient’s file and radiographs before, after and two years post-operation. Results The mean age of patients was 16.7 ± 2.5 years. There was no statistically significant difference between the two groups regarding gender, age, curve before surgery, and percentage of flexibility. The mean curvature was 70 ± 20.7 in the HR and 64.81 ± 19.4 in the CD group before surgery (P = 0.09; and the mean curvature was 40 ± 16.3 and 26.58 ± 15.37 in HR and CD groups respectively after surgery (P = 0.156. The mean curvature was 47.2 ± 15.9 in HR and 31.2 ± 15.4 in CD groups at two years follow-up (P = 0.156. Conclusions Results of many studies have shown no significant impairment in long-term quality of life and function in patients treated with Harrington rods. According to previously performed studies and the current study, surgical correction with Harrington rods seem to be comparable with the newer more expensive CD device. Although there is no doubt that the preference is to use newer devices in view of some disadvantages of HR, but this does not preclude using it for patients that cannot afford the newer devices.

  5. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan

    OpenAIRE

    Sato, Tsuyoshi; Hirano, Toru; Ito, Takui; Morita, Osamu; Kikuchi, Ren; Endo, Naoto; Tanabe, Naohito

    2010-01-01

    There have been a few studies regarding detail of back pain in adolescents with idiopathic scoliosis (IS) as prevalence, location, and severity. The condition of back pain in adolescents with IS was clarified based on a cross-sectional study using a questionnaire survey, targeting a total of 43,630 pupils, including all elementary school pupils from the fourth to sixth grade (21,893 pupils) and all junior high pupils from the first to third year (21,737 pupils) in Niigata City (population of ...

  6. Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

    OpenAIRE

    Dariusz Czaprowski

    2014-01-01

    The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9–18 years, mean 13.8 ± 2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P = 0.02). The prevalence of GJH was significantly (P = 0.01) lower in IS girls aged 16–18 years in comparison with younger individuals. There was no differenc...

  7. Idiopathic giant cell myocarditis in childhood: A case report.

    Science.gov (United States)

    Pehlivan, Sultan; Akçan, Ramazan; Heybet, Eyup Ruşen; Cavlak, Mehmet; Pehlivan, Ali

    2016-03-01

    Idiopathic giant cell myocarditis is a rare entity of unknown origin, which causes sudden death in more than half of the affected patients. It is rarely seen in childhood, and might result in death due to heart failure and ventricular arrhythmias. Idiopathic giant cell myocarditis is mostly diagnosed at autopsy incidentally. Here we present a rare case of childhood idiopathic giant cell myocarditis. A 10-year old boy found dead in his bed in the morning. Interview with family members revealed death the boy was in good health conditions apart from being overweight. At autopsy, external examination was completely normal. Internal examination revealed normal findings; the heart was 297g and macroscopically normal. No traces of any toxic agents detected in complete toxicological analyses. Areas characterized with granulomatous lesions, lymphocytes, histiocytes, and multinucleated giant cells were observed in myocardium at histopathological examination. No necrosis was observed in granulomatous areas. Tuberculosis was negative in the PCR assays. There were no signs indicative of fungal infection, and clinical status of the case was not compatible with the sarcoidosis. In this respect death was attributed to idiopathic giant cell myocarditis.

  8. Model-based registration for assessment of spinal deformities in idiopathic scoliosis

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    Forsberg, Daniel; Lundström, Claes; Andersson, Mats; Knutsson, Hans

    2014-01-01

    Detailed analysis of spinal deformity is important within orthopaedic healthcare, in particular for assessment of idiopathic scoliosis. This paper addresses this challenge by proposing an image analysis method, capable of providing a full three-dimensional spine characterization. The proposed method is based on the registration of a highly detailed spine model to image data from computed tomography. The registration process provides an accurate segmentation of each individual vertebra and the ability to derive various measures describing the spinal deformity. The derived measures are estimated from landmarks attached to the spine model and transferred to the patient data according to the registration result. Evaluation of the method provides an average point-to-surface error of 0.9 mm ± 0.9 (comparing segmentations), and an average target registration error of 2.3 mm ± 1.7 (comparing landmarks). Comparing automatic and manual measurements of axial vertebral rotation provides a mean absolute difference of 2.5° ± 1.8, which is on a par with other computerized methods for assessing axial vertebral rotation. A significant advantage of our method, compared to other computerized methods for rotational measurements, is that it does not rely on vertebral symmetry for computing the rotational measures. The proposed method is fully automatic and computationally efficient, only requiring three to four minutes to process an entire image volume covering vertebrae L5 to T1. Given the use of landmarks, the method can be readily adapted to estimate other measures describing a spinal deformity by changing the set of employed landmarks. In addition, the method has the potential to be utilized for accurate segmentations of the vertebrae in routine computed tomography examinations, given the relatively low point-to-surface error.

  9. Surgical treatment of Lenke 5 adolescent idiopathic scoliosis: Comparison of anterior vs posterior approach

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    Abel, Mark F; Singla, Anuj; Feger, Mark A; Sauer, Lindsay D; Novicoff, Wendy

    2016-01-01

    AIM To compare the posterior vs anterior approaches for fusion of Lenke 5 adolescent idiopathic scoliosis curves, matched for curve magnitude and for the distal level of fixation (dLOF) standardized to the third lumbar vertebrae (L3). METHODS A prospectively collected multicenter database was used for this retrospective comparative study. Our dependent variables included sagittal and coronal radiographic measurements, number of fused vertebrae, estimated blood loss, length of hospitalization and SRS total and individual domain scores at the two-year follow-up. Subject demographics were similar for all group comparisons. Independent t-test was used to compare groups for all analyses at P < 0.01. RESULTS For all matched cases of Lenke 5 curves, a selective approach was used only 50% of the time in cases undergoing a posterior fusion. When comparing a posterior selective approach to an anterior selective approach, surgeons utilizing a posterior approach fused significantly more levels than surgeons using an anterior approach with no other significant differences in radiographic or SRS outcomes (Ant = 4.8 ± 1.0 levels vs post = 6.1 ± 1.0 levels, P < 0.0001). When the dLOF was standardized to L3, the anterior approached provided significantly greater lumbar Cobb percent correction than the posterior approach (Ant = 69.1% ± 12.6% vs post = 54.6% ± 16.4%, P = 0.004), with no other significant radiographic or SRS score differences between approaches. CONCLUSION Surgeons treating Lenke 5c curves with a posterior instrumentation and fusion vs an anterior approach include more motion segments, even with a selective fusion. When controlled for the distal level of fixation, the anterior approach provides greater correction of the thoracolumbar curve. PMID:27672568

  10. Spontaneus bilateral pedicle fracture 30 years after Harrington Instrumentation for idiopathic scoliosis: a case report

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    Obid Peter

    2012-01-01

    Full Text Available Abstract Introduction Spontaneous fractures of the spine are a common entity. They usually occur in older people with osteoporosis. This case is presented on account of its rarity. To the best of the authors' knowledge only one case of an osteoporotic pedicle fracture after Harrington Instrumentation has been described before. Case presentation We report the case of a 46-year-old Caucasian woman who underwent surgery due to idiopathic scoliosis with a Harrington Instrumentation (T4 to L3 30 years ago. During the operation she was infected with hepatitis C while receiving erythrocyte concentrates and has suffered from liver cirrhosis since then. She presented with a sudden pain in her lower back and paraesthesia in both her legs but no other neurological symptoms. A computed tomography scan showed a bilateral pedicle fracture of L3 and an additional compression fracture of L4. In the first session we performed a dorsal stabilization with massive intraoperative bleeding and a postoperative failure of liver synthesis. In a second session an additional ventral augmentation was done. After the second operation she developed a hepatorenal syndrome. Both operations left the patient in a very critical state which led to a prolonged stay in the intensive care and rehabilitation unit. At her 12-month follow-up visit, she was free of complaints. Conclusion The un-physiological load of the spine after Harrington Instrumentation can lead to osteoporosis due to inactivity even in younger patients. Although these implants are not used anymore one should keep this possibility in mind when dealing with patients who have received Harrington rods in surgical procedures.

  11. The prevalence of distal junctional kyphosis following posterior instrumentation and arthrodesis for adolescent idiopathic scoliosis.

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    Ameri, Ebrahim; Behtash, Hamid; Mobini, Bahram; Ghandhari, Hassan; Vahid Tari, Hossein; Khakinahad, Mohammad

    2011-01-01

    Distal junctional kyphosis (DJK) is a radiographic finding in patients that undergo spinal instrumentation and fusion, since there is an abrupt transition between fixed and mobile spinal segments.The true incidence of DJK is variable in literature and seems that has a multifactorial etiology. A consecutive series of 130 patients (mean age 15.6 years) with adolescent idiopathic scoliosis who underwent posterior spinal fusion and instrumentation were evaluated by analyzing coronal and sagittal angulation and balance measurements from standing radiographs obtained pre-operatively, within 6 weeks post-operation, at two years postoperative and at the latest follow-up. There was 35 male and 95 female. The mean time of follow-up was 36 months. The incidence of DJK at latest follow-up was 6.9% (9 patients). In DJK group, distal junctional angle from pre-operative of -12.5° lordosis (-30 to 0) reached to -5.5° (P=0.015) at 6 weeks postoperation and to -1.4° (-20 to 12°) (P=0.000) at 2 years follow-up,with mean of 12.1° kyphotic change (10-20°). In non DJK group, distal junctional angle from pre-operative angle of -7.5° reached -8.1° at 2 years follow-up (P=0.43). The mean age of DJK group at surgery was 17 years and for non-DJK group was 15.4 years (P=0.022). Distal junctional kyphosis was less common in this study than previous reports and stabilized after two years. The magnitude of coronal cobb angles or multiplicity of coronal curves had no effect in developing DJK that may be prevented by incorporation of the first lordotic disc into the fusion construct.

  12. The Prevalence of Distal Junctional Kyphosis Following Posterior Instrumentation and Arthrodesis for Adolescent Idiopathic Scoliosis

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    Ebrahim Ameri

    2011-06-01

    Full Text Available Distal junctional kyphosis (DJK is a radiographic finding in patients that undergo spinal instrumentation and fusion, since there is an abrupt transition between fixed and mobile spinal segments.The true incidence of DJK is variable in literature and seems that has a multifactorial etiology. A consecutive series of 130 patients (mean age 15.6 years with Adolescent Idiopathic Scoliosis who underwent posterior spinal fusion and instrumentation were evaluated by analyzing coronal and sagittal angulation and balance measurements from standing radiographs obtained pre-operatively, within 6 weeks post-operation, at two years postoperative and at the latest follow-up. There was 35 male and 95 female. The mean time of follow-up was 36 months. The incidence of DJK at latest follow-up was 6.9% (9 patients. In DJK group ,distal junctional angle from pre-operative of -12.5 ̊ lordosis (-30 to 0 reached to -5.5 ̊ (P=0.015 at 6 weeks postoperation and to -1.4 ̊ (-20 to 12 ̊ (P=0.000 at 2 years follow-up,with mean of 12.1 ̊ kyphotic change (10-20 ̊. In non DJK group, distal junctional angle from pre-operative angle of -7.5 ̊ reached -8.1 ̊ at 2 years follow-up (P=0.43. The mean age of DJK group at surgery was 17 years and for non-DJK group was 15.4 years (P=0.022. Distal junctional kyphosis was less common in this study than previous reports and stabilized after two years. The magnitude of coronal cobb angles or multiplicity of coronal curves had no effect in developing DJK that may be prevented by incorporation of the first lordotic disc into the fusion construct.

  13. Corrective Bracing for Severe Idiopathic Scoliosis in Adolescence: Influence of Brace on Trunk Morphology

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    Edyta Kinel

    2012-01-01

    Full Text Available Aim. The aim of the work was to study whether wearing a corrective brace by adolescent girls with severe idiopathic scoliosis can influence external shape of the trunk. Methods. Comparison of clinical deformity of two groups of girls matched for age and Cobb angle: group (1 of 23 girls, aged 14.9±1.3 years, Cobb angle 55.0°±6.8°, who refused surgical treatment and have been wearing Chêneau brace for more than 6 months, compared with group (2 of 22 girls, aged 14.1±1.8 years, Cobb angle 59.7°±14.6° never treated with corrective bracing. Clinical deformity was assessed with the Bunnell scoliometer (angle of trunk rotation ATR and surface topography (posterior trunk symmetry index POTSI and Hump Sum HS. Results. The ATR in the primary curvature was 11.9°±3.4° (5°–18° in group 1 versus 15.1°±5.6° (6°–25° in group 2 (P=0.027. The HS was 16.8°±3.8 versus 19.2°±4.6, respectively, P=0.07. The POTSI value did not differ between groups. Conclusion. Girls with Cobb angle above 45 degrees, who have been subjected to brace treatment, revealed smaller clinical deformity of their back comparing to nontreated girls having similar radiological curvatures.

  14. Assessment of spontaneous correction of lumbar curve after fusion of the main thoracic vertebrae in Lenke 1 adolescent idiopathic scoliosis

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    Danilo Mizusaki

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical and radiographic response of the lumbar curve after fusion of the main thoracic vertebrae, in patients with adolescent idiopathic scoliosis of Lenke type 1. METHODS: Forty-two patients with Lenke 1 adolescent idiopathic scoliosis who underwent operations via the posterior route with pedicle screws were prospectively evaluated. Clinical measurements (size of the hump and translation of the trunk in the coronal plane, by means of a plumb line and radiographic measurements (Cobb angle, distal level of arthrodesis, translation of the lumbar apical vertebral and Risser were made. The evaluations were performed preoperatively, immediately postoperatively and two years after surgery. RESULTS: The mean Cobb angle of the main thoracic curve was found to have been corrected by 68.9% and the lumbar curve by 57.1%. Eighty percent of the patients presented improved coronal trunk balance two years after surgery. In four patients, worsening of the plumb line measurements was observed, but there was no need for surgical intervention. Less satisfactory results were observed in patients with lumbar modifier B. CONCLUSIONS: In Lenke 1 patients, fusion of the thoracic curve alone provided spontaneous correction of the lumbar curve and compensation of the trunk. Less satisfactory results were observed in curves with lumbar modifier B, and this may be related to overcorrection of the main thoracic curve.

  15. Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50°.

    Science.gov (United States)

    Danielsson, Aina J

    2013-02-01

    The purpose of this lecture was to give an overview of the natural history of adolescent idiopathic scoliosis (AIS), in order to serve as guidance in the decision of performing surgery or not for the specific patient with AIS. A literature review was performed. Studies concerning long-term outcome in patients with adolescent idiopathic scoliosis that had received no treatment were used. Outcome in terms of curve size, pulmonary function, back function and quality or life/social life was compared. The literature review showed that single thoracic curves of 50°-75° progress 0.73°/year over a 40-year period. AIS do not result in increased mortality, but pulmonary symptoms may be associated with larger curves. Back pain is more frequent among patients with AIS. No study using modern quality of life questionnaires exists, but for social function, childbearing, and marriage no apparent disadvantageous effects were reported compared to the healthy population. The conclusion is that most individuals with AIS and moderate curve size around maturity function well and lead an acceptable life in terms of work and family. Some patients with larger curves have pulmonary problems, but not to the extent that this affects the life span. This needs to be taken into account when discussing surgery with the individual patient.

  16. Initial and treatment induced changes to muscle activation patterns in patients with adolescent idiopathic scoliosis compared to the frontal plane spinal configuration as measured with surface electromyography

    Institute of Scientific and Technical Information of China (English)

    Raymond Wiegand

    2005-01-01

    PURPOSE:The purpose of this study is to report paraspinal muscle activity patterns in adolescent idiopathic scoliosis (AIS)patients in comparison to the frontal plane spinal configuration and to report changes to the muscle activity resulting from a multi-factorial treatment program that includes chiropractic manipulation.

  17. 青少年特发性脊柱侧凸的选择性胸弯融合%Selective thoracic fusion for adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    仉建国; 孙武

    2010-01-01

    @@ 青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)手术治疗的目的是通过融合来阻止畸形的进一步加重,并在此基础上尽可能地矫正畸形,维持脊柱和躯干的平衡.

  18. Health-related quality of life in patients with adolescent idiopathic scoliosis after treatment: Short-term effects after brace or surgical treatment

    NARCIS (Netherlands)

    E.M. Bunge (Eveline); R.E. Juttmann (Rikard); M. de Kleuver (Marinus); F.C. van Biezen (Frans); H.J. de Koning (Harry); H.D. Been (Henk); L.N.J.E.M. Coene (Luc); H. Creemers (Huub); A.J. de Gruijter; A.A.J.M. Hazebroek-Kampschreur (Alice); P.H.J. Klop (Patrick); H.J.A. Kruls; P.J.M. van Loon (Piet); L.C.F. Luttmer; F. de Nies (Frank); J.E.H. Pruijs; L.W. van Rhijn (Lodewijk); M.P. Teeuwen (Marcel); P.A. Wiegersma (Auke)

    2007-01-01

    textabstractFor treatment of teenagers with progressive adolescent idiopathic scoliosis in an early stage, two options are generally considered: treatment with a brace or observation followed by surgery if necessary. Many doctors and patients prefer conservative treatment (i.e. brace treatment) to s

  19. Surgical Treatment of Adult Degenerative Scoliosis

    OpenAIRE

    Cho, Kyu-Jung; Kim, Young-tae; Shin, Sang-hyun; Suk, Se-Il

    2014-01-01

    The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what...

  20. Towards an understanding of the information and support needs of surgical adolescent idiopathic scoliosis patients: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Nyhof-Young Joyce

    2009-05-01

    Full Text Available Abstract Background Informed decision making for adolescents and families considering surgery for scoliosis requires essential information, including expected outcomes with or without treatment and the associated risks and benefits of treatment. Ideally families should also receive support in response to their individual concerns. The aim of this study was to identify health-specific needs for online information and support for patients with adolescent idiopathic scoliosis who have had or anticipate having spinal surgery. Methods Focus group methodology was chosen as the primary method of data collection to encourage shared understandings, as well as permit expression of specific, individual views. Participants were considered eligible to participate if they had either experienced or were anticipating surgery for adolescent idiopathic scoliosis within 12 months, were between the ages of 10 and 18 years of age, and were English-speaking. Results Two focus groups consisting of 8 adolescents (1 male, 7 female and subsequent individual interviews with 3 adolescents (1 male, 2 female yielded a range of participant concerns, in order of prominence: (1 recovery at home; (2 recovery in hospital; (3 post-surgical appearance; (4 emotional impact of surgery and coping; (5 intrusion of surgery and recovery of daily activities; (6 impact of surgery on school, peer relationships and other social interactions; (7 decision-making about surgery; (8 being in the operating room and; (9 future worries. Conclusion In conclusion, adolescents welcomed the possibility of an accessible, youth-focused website with comprehensive and accurate information that would include the opportunity for health professional-moderated, online peer support.

  1. Transient long thoracic nerve injury during posterior spinal fusion for adolescent idiopathic scoliosis: A report of two cases

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    Athanasios I Tsirikos

    2013-01-01

    Full Text Available We present the transient long thoracic nerve (LTN injury during instrumented posterior spinal arthrodesis for idiopathic scoliosis. The suspected mechanism of injury, postoperative course and final outcome is discussed. The LTN is susceptible to injury due to its long and relatively superficial course across the thoracic wall through direct trauma or tension. Radical mastectomies with resection of axillary lymph nodes, first rib resection to treat thoracic outlet syndrome and cardiac surgery can be complicated with LTN injury. LTN injury producing scapular winging has not been reported in association with spinal deformity surgery. We reviewed the medical notes and spinal radiographs of two adolescent patients with idiopathic scoliosis who underwent posterior spinal arthrodesis and developed LTN neuropraxia. Scoliosis surgery was uneventful and intraoperative spinal cord monitoring was stable throughout the procedure. Postoperative neurological examination was otherwise normal, but both patients developed winging of the scapula at 4 and 6 days after spinal arthrodesis, which did not affect shoulder function. Both patients made a good recovery and the scapular winging resolved spontaneously 8 and 11 months following surgery with no residual morbidity. We believe that this LTN was due to positioning of our patients with their head flexed, tilted and rotated toward the contralateral side while the arm was abducted and extended. The use of heavy retractors may have also applied compression or tension to the nerve in one of our patients contributing to the development of neuropraxia. This is an important consideration during spinal deformity surgery to prevent potentially permanent injury to the nerve, which can produce severe shoulder dysfunction and persistent pain.

  2. Methodology of evaluation of morphology of the spine and the trunk in idiopathic scoliosis and other spinal deformities - 6th SOSORT consensus paper

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    Maruyama Toru

    2009-11-01

    Full Text Available Abstract Background Comprehensive evaluation of the morphology of the spine and of the whole body is essential in order to correctly manage patients suffering from progressive idiopathic scoliosis. Although methodology of clinical and radiological examination is well described in manuals of orthopaedics, there is deficit of data which clinical and radiological parameters are considered in everyday practise. Recently, an increasing tendency to extend scoliosis examination beyond the measure of the Cobb angle can be observed, reflecting a more patient-oriented approach. Such evaluation often involves surface parameters, aesthetics, function and quality of life. Aim of the study To investigate current recommendations of experts on methodology of evaluation of the patient with spinal deformity, essentially idiopathic scoliosis. Methods Structured Delphi procedure for collecting and processing knowledge from a group of experts with a series of questionnaires and controlled opinion feedback was performed. Experience and opinions of the professionals - physicians and physiotherapists managing scoliosis patients - were studied. According to Delphi method a Meeting Questionnaire (MQ has been developed, resulting from a preliminary Pre-Meeting Questionnaire (PMQ which had been previously discussed and approved on line. The MQ was circulated among the SOSORT experts during Consensus Session on "Measurements" which took place at the Annual Meeting of the Society, totally 23 panellists being engaged. Clinical, radiological and surface topography parameters were checked for agreement. Results 90% agreement or more was reached in 35 items and superior than 75% agreement was reached in further 25 items. An evaluation form was proposed to be used by clinicians and researchers. Conclusion The consensus was reached on evaluation of the morphology of the patient with idiopathic scoliosis, comprising clinical, radiological and, to less extend, surface topography

  3. Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model

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    Wyatt Lawrence A

    2005-11-01

    Full Text Available Abstract Background Screening for adolescent idiopathic scoliosis (AIS is a commonly performed procedure for school children during the high risk years. The PRECEDE-PROCEDE (PP model is a health promotion planning model that has not been utilized for the clinical diagnosis of AIS. The purpose of this research is to study AIS in the school age population using the PP model and its relevance for community, school, and clinical health promotion. Methods MEDLINE was utilized to locate AIS data. Studies were screened for relevance and applicability under the auspices of the PP model. Where data was unavailable, expert opinion was utilized based on consensus. Results The social assessment of quality of life is limited with few studies approaching the long-term effects of AIS. Epidemiologically, AIS is the most common form of scoliosis and leading orthopedic problem in children. Behavioral/environmental studies focus on discovering etiologic relationships yet this data is confounded because AIS is not a behavioral. Illness and parenting health behaviors can be appreciated. The educational diagnosis is confounded because AIS is an orthopedic disorder and not behavioral. The administration/policy diagnosis is hindered in that scoliosis screening programs are not considered cost-effective. Policies are determined in some schools because 26 states mandate school scoliosis screening. There exists potential error with the Adam's test. The most widely used measure in the PP model, the Health Belief Model, has not been utilized in any AIS research. Conclusion The PP model is a useful tool for a comprehensive study of a particular health concern. This research showed where gaps in AIS research exist suggesting that there may be problems to the implementation of school screening. Until research disparities are filled, implementation of AIS screening by school, community, and clinical health promotion will be compromised. Lack of data and perceived importance by

  4. Treatment of Childhood Idiopathic Language Deterioration with Valproate.

    Science.gov (United States)

    Holmes, Gregory L.; Riviello, James J.

    2001-06-01

    Childhood idiopathic language deterioration is a rare condition in which children lose previously gained language skills. In some children this language deterioration occurs in association with behavioral seizures or EEG epileptiform activity. The effectiveness of antiepileptic drugs in this patient population is not known. Here we retrospectively reviewed records of 57 children with childhood idiopathic language deterioration associated with seizures or epileptiform activity on their EEG who received valproate for the purpose of treating their language impairment. In 22 of the children improvement in language skills was observed. In two children language returned to normal while in the other 20 the improvement was modest. Children who responded to valproate had an earlier age of onset of the aphasia than children who were nonresponders. Seizure type, EEG findings, developmental status, and presence or absence of a frequency-modulated auditory evoked potential were not related to response. This study demonstrates that valproate can be helpful in improving language function in some children with idiopathic language deterioration associated with seizures or epileptiform activity on the EEG.

  5. Ergoespirometria em indivíduos com escoliose idiopática Ergospirometry in individuals with idiopathic scoliosis

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    Maria Elaine Trevisan

    2010-06-01

    Full Text Available Escoliose idiopática é uma disfunção na coluna vertebral que tende a diminuir os diâmetros, a flexibilidade e a excursão da caixa torácica, com possíveis efeitos deletérios na função pulmonar. O objetivo deste estudo foi verificar se há relação entre o grau de curvatura escoliótica e a função pulmonar e capacidade de exercício em indivíduos com escoliose idiopática de grau leve e moderado. Dezessete indivíduos com escoliose idiopática leve e moderada e 19 controles foram submetidos a teste pulmonar em repouso e exercício em esteira. As médias das variáveis pulmonares em repouso encontraram-se dentro da normalidade nos dois grupos; as variáveis de exercício consumo de oxigênio de pico (p=0,81, tempo de exercício (p=0,68, freqüência cardíaca (p=0,39, ventilação minuto (p=0,82, produção de dióxido de carbono (p=0,95, quociente respiratório (p=0,09, equivalente ventilatório para o oxigênio (p=0,90, lactato sangüíneo (p=0,98 não mostraram diferença estatisticamente significante entre os grupos. Não foi possível estabelecer relação de causa e efeito entre o grau de escoliose, função pulmonar e capacidade aeróbia, sugerindo que a escoliose não implica necessariamente perdas funcionais, sendo o treinamento uma importante medida de prevenção.Idiopathic scoliosis is a disorder of the spine that tends to reduce rib cage diameter, flexibility, and excursion, which might affect pulmonary function. The purpose here was to assess whether there is a relationship between the degree of scoliosis and pulmonary function and exercise capacity in subjects with mild to moderate idiopathic scoliosis. Seventeen subjects with mild to moderate idiopathic scoliosis and 19 controls underwent lung test at rest and during exercise on a treadmill. Mean pulmonary variables at rest were within normal parameters in both groups; during exercise, oxygen uptake (p=0.81, exercise time (p=0.68, heart rate (p=0,39, minute

  6. Association of Body Composition with Curve Severity in Children and Adolescents with Idiopathic Scoliosis (IS

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    Edyta Matusik

    2016-01-01

    Full Text Available The link between scoliotic deformity and body composition assessed with bioimpedance (BIA has not been well researched. The objective of this study was to correlate the extent of scoliotic-curve severity with the anthropometrical status of patients with idiopathic scoliosis (IS based on standard anthropometric measurements and BIA. The study encompassed 279 IS patients (224 girls/55 boys, aged 14.21 ± 2.75 years. Scoliotic curve severity assessed by Cobb’s angle was categorized as moderate (10°–39° or severe (≥40°. Corrected height, weight, waist and hip circumferences were measured and body mass index (BMI, corrected height z-score, BMI Z-score, waist/height ratio (WHtR and waist/hip ratio (WHR were calculated for the entire group. Body composition parameters: fat mass (FAT, fat-free mass (FFM and predicted muscle mass (PMM were determined using a bioelectrical impedance analyzer. The mean Cobb angle was 19.96° ± 7.92° in the moderate group and 52.36° ± 12.54° in the severe group. The corrected body heights, body weights and BMIs were significantly higher in the severe IS group than in the moderate group (p < 0.05. Significantly higher FAT and lower FFM and PMM were observed in the severe IS group (p < 0.05. The corrected heights and weights were significantly higher in patients with severe IS and normal weight (p < 0.01. Normal and overweight patients with a severe IS had significantly higher adiposity levels assessed by FAT, FFM and PMM for normal and BMI, BMI z-score, WHtR, FAT and PMM for overweight, respectively. Overweight IS patients were significantly younger and taller than underweight and normal weight patients. The scoliotic curve severity is significantly related to the degree of adiposity in IS patients. BMI z-score, WHtR and BIA seem to be useful tools for determining baseline anthropometric characteristics of IS children.

  7. Transcranial motor evoked potential waveform changes in corrective fusion for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Kobayashi, Kazuyoshi; Imagama, Shiro; Ito, Zenya; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Nishida, Yoshihiro; Ishiguro, Naoki

    2017-01-01

    OBJECTIVE Corrective surgery for spinal deformities can lead to neurological complications. Several reports have described spinal cord monitoring in surgery for spinal deformity, but only a few have included patients younger than 20 years with adolescent idiopathic scoliosis (AIS). The goal of this study was to evaluate the characteristics of cases with intraoperative transcranial motor evoked potential (Tc-MEP) waveform deterioration during posterior corrective fusion for AIS. METHODS A prospective database was reviewed, comprising 68 patients with AIS who were treated with posterior corrective fusion in a prospective database. A total of 864 muscles in the lower extremities were chosen for monitoring, and acceptable baseline responses were obtained from 819 muscles (95%). Intraoperative Tc-MEP waveform deterioration was defined as a decrease in intraoperative amplitude of ≥ 70% of the control waveform. Age, Cobb angle, flexibility, operative time, estimated blood loss (EBL), intraoperative body temperature, blood pressure, number of levels fused, and correction rate were examined in patients with and without waveform deterioration. RESULTS The patients (3 males and 65 females) had an average age of 14.4 years (range 11-19 years). The mean Cobb angles before and after surgery were 52.9° and 11.9°, respectively, giving a correction rate of 77.4%. Fourteen patients (20%) exhibited an intraoperative waveform change, and these occurred during incision (14%), after screw fixation (7%), during the rotation maneuver (64%), during placement of the second rod after the rotation maneuver (7%), and after intervertebral compression (7%). Most waveform changes recovered after decreased correction or rest. No patient had a motor deficit postoperatively. In multivariate analysis, EBL (OR 1.001, p = 0.085) and number of levels fused (OR 1.535, p = 0.045) were associated with waveform deterioration. CONCLUSIONS Waveform deterioration commonly occurred during rotation maneuvers

  8. Assessment of the Quality of Movement for Patients with Adolescent Idiopathic Scoliosis

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    Dalibor Kiseljak

    2015-08-01

    Full Text Available Goal of the work is to verify if there exists a significant difference in the quality of movement measured via virtual reality (VR technology between two groups of patients diagnosed with adolescent idiopathic scoliosis (AIS. Grouping is made according to geographic regions; Group 1 is from Zagreb, Group 2 from Vukovar. Another goal of the work is to verify whether there is a significant improvement from initial to final measurements over a one year period in the results of all patients from both groups. Hypothesis: there is no significant difference in the quality of movement between two groups of patients, as obtained through VR tests. The second hypothesis is that there is no significant difference in the results of specific VR tests for AIS between initial and final measurements of all the examinee; respectively, the conventional therapy program in both groups doesn’t produce significant results in the direction of improvement. The sample: each group is comprised of 5 patients with AIS diagnosis, between the ages of 12–18, of both genders. The patients have a double scoliotic curve with Cobb value between 37 and 46 degrees, and are being treated with classical physiotherapeutic methods for AIS, at clinics in Zagreb and Vukovar. Methodology: VR tests for assessment of the quality of movement are a part of the System for Diagnosis and Control in Kinesiology (SYDACK constructed at the Faculty of Kinesiology, University of Zagreb, as described in the dissertation: VR in physiotherapy of patients with AIS (Filipović, 2011. SYDACK is an original Croatian product, containing 4 VR tests for evaluating the quality of movement: diagonal sliding to the right, diagonal sliding to the left, sliding and hip elevation. Results are analyzed via a t-test for small independent samples and a t-test for small dependent samples. In 93.75% cases there is no significant difference between results of the two groups, as obtained by all 4 VR tests. The analysis

  9. Multimodal intraoperative neuromonitoring in corrective surgery for adolescent idiopathic scoliosis: Evaluation of 354 consecutive cases

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    Kundnani Vishal

    2010-01-01

    Full Text Available Background : Multimodal intraoperative neuromonitoring is recommended during corrective spinal surgery, and has been widely used in surgery for spinal deformity with successful outcomes. Despite successful outcomes of corrective surgery due to increased safety of the patients with the usage of spinal cord monitoring in many large spine centers, this modality has not yet achieved widespread popularity. We report the analysis of prospectively collected intraoperative neurophysiological monitoring data of 354 consecutive patients undergoing corrective surgery for adolescent idiopathic scoliosis (AIS to establish the efficacy of multimodal neuromonitoring and to evaluate comparative sensitivity and specificity. Materials and Methods : The study group consisted of 354 (female = 309; male = 45 patients undergoing spinal deformity corrective surgery between 2004 and 2008. Patients were monitored using electrophysiological methods including somatosensory-evoked potentials and motor-evoked potentials simultaneously. Results : Mean age of patients was 13.6 years (±2.3 years. The operative procedures involved were instrumented fusion of the thoracic/lumbar/both curves, Baseline somatosensory-evoked potentials (SSEP and neurogenic motor-evoked potentials (NMEP were recorded successfully in all cases. Thirteen cases expressed significant alert to prompt reversal of intervention. All these 13 cases with significant alert had detectable NMEP alerts, whereas significant SSEP alert was detected in 8 cases. Two patients awoke with new neurological deficit (0.56% and had significant intraoperative SSEP + NMEP alerts. There were no false positives with SSEP (high specificity but 5 patients with false negatives with SSEP (38% reduced its sensitivity. There was no false negative with NMEP but 2 of 13 cases were false positive with NMEP (15%. The specificity of SSEP (100% is higher than NMEP (96%; however, the sensitivity of NMEP (100% is far better than SSEP (51

  10. The "X-Factor" index: a new parameter for the assessment of adolescent idiopathic scoliosis correction.

    Science.gov (United States)

    Sun, Yu Qing; Samartzis, Dino; Cheung, Kenneth M C; Wong, Yat Wa; Luk, Keith D K

    2011-01-01

    The correction rate (CR) and fulcrum bending correction index (FBCI) based on the fulcrum bending radiograph (FBR) were parameters introduced to measure the curve correcting ability; however, such parameters do not account for contributions by various, potential extraneous "X-Factors" (e.g. surgical technique, type and power of the instrumentation, anesthetic technique, etc.) involved in curve correction. As such, the purpose of the following study was to propose the concept of the "X-Factor Index" (XFI) as a new parameter for the assessment of the correcting ability of adolescent idiopathic scoliosis (AIS). A historical cohort radiographic analysis of the FBR in the setting of hook systems in AIS patients (Luk et al. in Spine 23:2303-2307, 1998) was performed to illustrate the concept of XFI. Thirty-five patients with AIS of the thoracic spine undergoing surgical correction were involved in the analysis. Plain posteroanterior (PA) plain radiographs were utilized and Cobb angles were obtained for each patient. Pre- and postoperative PA angles on standing radiograph and preoperative fulcrum bending angles were obtained for each patient. The fulcrum flexibility, curve CR, and FBCI were determined for all patients. The difference between the preoperative fulcrum bending angle and postoperative PA angle was defined as Angle(XF), which accounted for the correction contributed by "X-Factors". The XFI, designed to measure the curve correcting ability, was calculated by dividing Angle(XF) by the fulcrum flexibility. The XFI was compared with the curve CR and FBCI by re-evaluating the original data in the original paper (Luk et al. in Spine 23:2303-2307, 1998). The mean standing PA and FBR alignments of the main thoracic curve were 58.3° and 24.5°, respectively. The mean fulcrum flexibility was 58.8%. The mean postoperative standing PA alignment was 24.7°. The mean curve CR was 58.0% and the mean FBCI was 101.1%. The mean XFI was noted as 1.03%. The CR was significantly

  11. Body mass index in relation to truncal asymmetry of healthy adolescents, a physiopathogenetic concept in common with idiopathic scoliosis: summary of an electronic focus group debate of the IBSE

    OpenAIRE

    Grivas, Theodoros B.; Burwell, Geoffrey R; Dangerfield, Peter H

    2013-01-01

    There is no generally accepted scientific theory for the cause of adolescent idiopathic scoliosis (AIS). As part of its mission to widen understanding of scoliosis etiology, the International Federated Body on Scoliosis Etiology (IBSE).introduced the electronic focus group (EFG) as a means of increasing debate on knowledge of important topics. This has been designated as an on-line Delphi discussion. The text for this debate was written by Dr TB Grivas. It is based on published research from ...

  12. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    Directory of Open Access Journals (Sweden)

    Białek Marianna

    2011-11-01

    Full Text Available Abstract Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1 single structural thoracic, thoracolumbar or lumbar curves and (2 double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees, stable (+/- 5 degrees, and progressed (increase of Cobb angle of more than 5 degrees was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1 in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2 in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1 in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2 in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish.

  13. Comparative Kinetic Methods used for the Therapy of Idiopathic Scoliosis in Adolescents

    OpenAIRE

    Elena AMARICĂI

    2013-01-01

    Scoliosis is one of the most common axial deviations of the spine. Because of its incidence and the fact that, with the evolution of technology, adolescents spend increasingly more time sitting at desk, adopting positions often incorrect, this paper aims to study the evolution of adolescent patients diagnosed with scoliosis using different kinetic methods of treatment. Another objective is to highlight the most effective method of treatment in terms of overall rehabilitation period, the time ...

  14. Management of idiopathic nephrotic syndrome in childhood

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    Peco-Antić Amira

    2004-01-01

    Full Text Available The management of idiopathic nephrotic syndrome (INS in children includes immunosuppressive and symptomatic treatment. The response to corticosteroid therapy is the best prognostic marker of the disease. The majority of children with INS (about 85% are steroid-sensitive as they normalize proteinuria within 4 weeks of daily, oral prednisone administration. The most of steroid-sensitive patients (94% has minimal change of nephrotic syndrome, while the majority (80.5%-94.4% of those who are steroid-resistant has focal segmental glomerulosderosis or mesangioproliferative glomerulonephritis. Initial therapy of INS consists of 60 mg/m2/day prednisone daily for 4 weeks followed by 40 mg/m2 on alternate days for 4 weeks, thereafter decreasing alternate day therapy every month by 25% over the next 4 months. Thus, the overall duration of the initial cortico-steroids course is 6 months that may be significantly protective against the future development of frequent relapses. Approximately 30% of patients experience only one attack and are cured after the first course of therapy; 10-20% have only 3 or 4 steroid-responsive episodes before permanent cure; the remaining 40-50% of patients are frequent relapsers, or steroid-dependent. Standard relapse therapy consists of 60 mg/m2/ day prednisone until urine is protein free for at least 3 days, followed by 40 mg/m2 on alternate days for 4 weeks. The treatment of frequent-relapses and steroid-dependent INS includes several different regimens: maintenance (6 months alternate steroid therapy just above steroid threshold (0.1-0.5 mg/kg/ 48h, levamisole, alkylating agents (cyclophosphamide or chlorambucil or cyclosporine. The worse prognosis is expected in steroid-resistant patients who are the most difficult to treat. Renal biopsy should be performed in them. At present, there is no consensus on therapeutic regimen for steroid-resistant patients. The following immunosuppressive drugs have been used with varying

  15. The Differential Effects of Exercise,Brace and Combined Rehabilitation Treatment in Patients with Adolescent Idiopathic Scoliosis%The Differential Effects of Exercise, Brace and Combined Rehabilitation Treatment in Patients with Adolescent Idiopathic Scoliosis

    Institute of Scientific and Technical Information of China (English)

    DU Qing; ZHOU Xuan; LI Jianan; ZHAO Li; TAO Quan; CHEN Ting; CHEN Peijie

    2013-01-01

    Objective:To compare the effects of different conservative managements on patients with adolescent idiopathic scoliosis (AIS).Method:One hundred and four AIS patients were recruited for this study.The patients were divided into 3groups:exercise (E group),brace (B group) and combined rehabilitation treatment (brace treatment combined with exercise,CR group).Radiological parameter were used to assess AIS patients before and after treatment.The Chinese version of scoliosis research society-22(SRS-22) patient questionnaires were filled out by patients after treatment.The SRS-22 scores were compared among management groups.Result:The maximal Cobb angles were smaller in E group than in B group or CR group both before and after treatment.The maximal Cobb angles were significantly smaller after treatment than before treatment in B group and CR group.Function/activity was better in E group than in B group or CR group.Self-image/appearance and satisfaction with management were better in E group and CR group than in B group.There was no significant difference among treatment groups in pain and mental health.Conclusion:Both brace and combined rehabilitation treatment can reduce the spinal curve of AIS patients.Both exercise and combined rehabilitation treatment have positive influence on self-image/appearance and satisfaction with management.We support preference of combined rehabilitation treatment above brace treatment.

  16. The pendulum swings back to scoliosis screening: screening policies for early detection and treatment of idiopathic scoliosis - current concepts and recommendations

    OpenAIRE

    2013-01-01

    This editorial article initiates the school scoliosis screening thematic series of the Scoliosis journal. The various issues on screening policies are discussed; clinical and practical recommendations of setting up school screening programs are also described.

  17. The Sforzesco brace can replace cast in the correction of adolescent idiopathic scoliosis: A controlled prospective cohort study

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    Zaina Fabio

    2008-10-01

    Full Text Available Abstract Background The conservative treatment of adolescent idiopathic scoliosis (AIS has traditionally been divided into two phases–correction and stabilisation–and casts, even if less used today, can be considered the best standard in the correction phase. Till the present, however, no comparison between cast and brace efficacy has been proposed. Methods This is a prospective cohort study with a retrospective control group. The aim was to verify if it is possible to obtain with a specifically developed rigid brace results comparable to a cast. We considered fifty AIS patients who had refused surgery, aged 14.1 ± 1.5 years, with 46.7 ± 7.8° Cobb scoliosis. Thirty-two consecutive patients (with no drop-outs were prospectively followed up with the Sforzesco brace (SBG, and compared against a retrospective group of eighteen patients treated with the Risser cast (RCG. The treatment time (the total correction phase was 19 ± 3 months. Out-of-brace x-rays were compared, as well as clinical results. Results Compliance and hours of treatment were higher in the RCG while all the other parameters were not different. We observed a reduction of 6° Cobb and an important aesthetic gain in both groups (P Conclusion In the corrective phase of AIS treatment it is possible with a specific rigid brace (Sforzesco – SPoRT concept to obtain scoliosis correction similar to cast. Due to the human and social costs of casting, and worst sagittal profile results, Sforzesco brace should be the preferred method wherever possible.

  18. Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

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    Ahmad Jabir Rahyussalim

    2016-01-01

    Full Text Available Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity.

  19. Role of rod diameter in comparison between only screws versus hooks and screws in posterior instrumentation of thoracic curve in idiopathic scoliosis.

    Science.gov (United States)

    Lamartina, Claudio; Petruzzi, Maria; Macchia, Marcello; Stradiotti, Paola; Zerbi, Alberto

    2011-05-01

    Since the introduction of Cotrel-Dubousset instrumentation in 1984, the correction techniques in scoliosis surgery have changed from Harrington principles of concave distraction to segmental realignment to a variety of possibilities including the rod rotation manoeuvres, and to segmental approximation via cantilever methods. Additionally, pedicle screw utilization in lumbar curves enhanced correction and stabilization of various deformities, and various studies have strongly supported the clinical advantages of lumbar pedicle screws versus conventional hook instrumentation. Pedicle screw constructs have become increasingly popular in the treatment of patients with spinal deformity. When applied to adolescent idiopathic scoliosis patients, pedicle screw fixation has demonstrated increased corrective ability compared with traditional hook/hybrid instrumentation. In our study, we do a retrospective review of idiopathic scoliosis patients (King 2-Lenke 1 B/C) treated with a selective thoracic posterior fusion using an all-screw construct versus a hybrid (pedicle screws and hooks) construct and, compare the percentage of correction of the scoliotic curves obtained with screws alone and screws and hooks. Special attention was given to the rod diameter and correction technique. Our results show that the percentage of correction of idiopathic thoracic scoliosis is similar when treating the scoliosis with rods and screws alone or with rods, screws and hooks; therefore, we and the majority of authors in the literature do not consider the rod section. This can be an important parameter in the evaluation of the superiority of treatment with screws only or screws and hooks. In our study, even if not of statistical significance, the better thoracic curve correction obtained with the hybrid group should be ascribed to the fact that in this group mostly 6 mm rods were used.

  20. Posterior Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis Patients: a Comparison of All Pedicle Screws versus Hybrid Instrumentation

    Institute of Scientific and Technical Information of China (English)

    Bin Yu; Jian-guo Zhang; Gui-xing Qiu; Yi-peng Wang; Yu Zhao; Jian-xiong Shen; Hong Zhao; Xin-yu Yang

    2009-01-01

    Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions: Group A was hook-screw-rod (hybrid) internal fixation type, Group B was screw-rod (all pedicle screws) internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients (7 males, 41 females) were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A (P = 0.003). The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A (P = 0.003). The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted (both P > 0.05). The decompensation rate at final follow

  1. Pathogenesis of Adolescent Idiopathic Scoliosis%青少年特发性脊柱侧凸病因学研究进展

    Institute of Scientific and Technical Information of China (English)

    朱泽章

    2016-01-01

    青少年特发性脊柱侧凸( adolescent idiopathic scoliosis,AIS)是脊柱侧凸中最为常见的一种类型,目前病因尚不明确。文中针对AIS的病因学研究现状,从遗传学因素、生长发育、激素/代谢障碍以及神经系统异常等方面进行综述。%The etiology of adolescent idiopathic scoliosis ( AIS) ,the most common form of scoliosis, is still unclear.This article reviews the progress of etiology and related problems of AIS from the points of genetic factors, growing development, hormone metabolism and nervous dysfunction.

  2. Idiopathic and normal lateral lumbar curves: muscle effects interpreted by 12th rib length asymmetry with pathomechanic implications for lumbar idiopathic scoliosis

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    Theodoros B. Grivas

    2016-10-01

    Full Text Available Abstract Background The historical view of scoliosis as a primary rotation deformity led to debate about the pathomechanic role of paravertebral muscles; particularly multifidus, thought by some to be scoliogenic, counteracting, uncertain, or unimportant. Here, we address lateral lumbar curves (LLC and suggest a pathomechanic role for quadrates lumborum, (QL in the light of a new finding, namely of 12th rib bilateral length asymmetry associated with idiopathic and small non-scoliosis LLC. Methods Group 1: The postero-anterior spinal radiographs of 14 children (girls 9, boys 5 aged 9–18, median age 13 years, with right lumbar idiopathic scoliosis (IS and right LLC less that 10°, were studied. The mean Cobb angle was 12° (range 5–22°. Group 2: In 28 children (girls 17, boys 11 with straight spines, postero-anterior spinal radiographs were evaluated similarly to the children with the LLC, aged 8–17, median age 13 years. The ratio of the right/left 12th rib lengths and it’s reliability was calculated. The difference of the ratio between the two groups was tested; and the correlation between the ratio and the Cobb angle estimated. Statistical analysis was done using the SPSS package. Results The ratio’s reliability study showed intra-observer +/−0,036 and the inter-observer error +/−0,042 respectively in terms of 95 % confidence limit of the error of measurements. The 12th rib was longer on the side of the curve convexity in 12 children with LLC and equal in two patients with lumbar scoliosis. The 12th rib ratios of the children with lumbar curve were statistically significantly greater than in those with straight spines. The correlation of the 12th rib ratio with Cobb angle was statistically significant. The 12th thoracic vertebrae show no axial rotation (or minimal in the LLC and no rotation in the straight spine group. Conclusions It is not possible, at present, to determine whether the 12th convex rib lengthening is

  3. Imaging of painful scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Davies, Alun; Saifuddin, Asif [Royal National Orthopaedic Hospital Trust, Department of Radiology, London (United Kingdom)

    2009-03-15

    Scoliosis is defined as a lateral deviation of the spine from the normal plumb line. Commonly, there is a rotational component and deviation also in the sagittal plane (kyphosis or hyperlordosis). When scoliosis presents in adults, it is often painful. In contrast, back pain in a child is considered rare, and serious underlying pathology should be excluded, particularly since idiopathic scoliosis is typically painless. A painful scoliosis in a child or adolescent, especially if the patient has a left-sided curve, should be examined thoroughly. The aim of this review is to illustrate the causes of a painful scoliosis in children, adolescents and adults. (orig.)

  4. Idiopathic scoliosis: evaluation of loss of correction in postoperative follow-up

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    Liliane Faria Garcia

    2014-03-01

    Full Text Available OBJECTIVE: To evaluate the postoperative loss of scoliosis correction using third-generation instrumental, comparing the immediately postoperative period, and the last visit of the patients operated on from 2002 to 2010. METHOD: This was a cross-sectional study, conducted by analysis of medical records, in which 45 patients undergoing scoliosis correction were included. Variables were evaluated preoperatively, immediately postoperatively and in the last follow-up visit after surgery. Statistical analysis of data was performed in PASW program, with a significance level of 95%. RESULTS: Among the 45 patients studied, 88.9% were female and 82.8% were in the skeletally immature group. The mean pre-operative Cobb was 57°, the postoperative was 6.5° and at the last visit, it was 7.04°. There was no statistic difference between postoperative Cobb angle and that at the last examination (p = 0.176. CONCLUSION: There was no significant loss of scoliosis correction loss between the immediate postoperative and the final radiographic evaluation.

  5. Behavior and social competency in idiopathic and cryptogenic childhood epilepsy.

    Science.gov (United States)

    Berg, Anne T; Vickrey, Barbara G; Testa, Francine M; Levy, Susan R; Shinnar, Shlomo; DiMario, Francis

    2007-07-01

    Behavioral and related disorders are frequently reported in association with childhood epilepsy but the reasons for this are unclear. In a long-term prospective, community-based study of newly-diagnosed childhood epilepsy, behavioral assessments (Child Behavior Checklist) were performed in children 8 to 9 years after the initial diagnosis of epilepsy to determine the impact of remission and medication status on behavioral problems. Children with epilepsy were also compared with sibling controls. A total of 226 children (108 females, 118 males; mean age 13y 1mo [SD 2y 8mo], range 8-17y) with idiopathic or cryptogenic epilepsy were included in the analyses. One hundred and twenty-eight matched pairs were included in analyses of case-sibling differences. Lack of remission and current medication use were associated with worse behavioral problem and competency scores. Lack of remission generally had a greater effect than medication use, except for attention problems; medication status had the more deleterious effect (pChildren with epilepsy had significantly worse behavioral problems and competency scores relative to sibling controls. Even in paris in which the patient was seizure-free and off medication, significant case-sibling differences persisted for most scales (p=0.05 to p=0.001). Lack of remission and continued use of antiepileptic drugs have a negative influence on behavioral problems in children with epilepsy but do not fully explain the worse scores relative to siblings. This suggests an independent effect associated with the epilepsy itself.

  6. Idiopathic childhood occipital epilepsy of Gastaut: report of 12 patients.

    Science.gov (United States)

    Wakamoto, Hiroyuki; Nagao, Hideo; Fukuda, Mitsumasa; Watanabe, Shohei; Motoki, Takahiro; Ohmori, Hiromitsu; Ishii, Eiichi

    2011-03-01

    This study sought to present clinical and outcome data of patients with idiopathic childhood occipital epilepsy of Gastaut, to validate previously reported characteristics of this epilepsy. The study group was comprised of 12 affected children (three boys and nine girls), with a median age of onset at 10.3 years. Common ictal manifestations included elementary visual hallucinations (75.0%), blindness or blurring of vision (50.0%), headache (50.0%), and secondarily generalized tonic-clonic seizures (58.3%). Interictal electroencephalography revealed occipital spike-wave paroxysms reactive to eye closure and opening in all patients, accompanied by spike-wave activity in the extra-occipital areas in four (33.3%), and by generalized spike-wave discharges in two (16.7%). One patient exhibited the onset of occipital lobe seizures 1 year after manifesting absence epilepsy. Seizure remission occurred in 81.8% of cases, in half of which medication was discontinued by late adolescence. This study confirmed the previously delineated electroclinical features of epilepsy syndrome, with additional aspects including the frequent association of generalized tonic-clonic seizures and atypical evolution from childhood absence epilepsy.

  7. Evaluation of IRX Genes and Conserved Noncoding Elements in a Region on 5p13.3 Linked to Families with Familial Idiopathic Scoliosis and Kyphosis

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    Cristina M. Justice

    2016-06-01

    Full Text Available Because of genetic heterogeneity present in idiopathic scoliosis, we previously defined clinical subsets (a priori from a sample of families with idiopathic scoliosis to find genes involved with spinal curvature. Previous genome-wide linkage analysis of seven families with at least two individuals with kyphoscoliosis found linkage (P-value = 0.002 in a 3.5-Mb region on 5p13.3 containing only three known genes, IRX1, IRX2, and IRX4. In this study, the exons of IRX1, IRX2, and IRX4, the conserved noncoding elements in the region, and the exons of a nonprotein coding RNA, LOC285577, were sequenced. No functional sequence variants were identified. An intrafamilial test of association found several associated noncoding single nucleotide variants. The strongest association was with rs12517904 (P = 0.00004, located 6.5 kb downstream from IRX1. In one family, the genotypes of nine variants differed from the reference allele in all individuals with kyphoscoliosis, and two of three individuals with scoliosis, but did not differ from the reference allele in all other genotyped individuals. One of these variants, rs117273909, was located in a conserved noncoding region that functions as an enhancer in mice. To test whether the variant allele at rs117273909 had an effect on enhancer activity, zebrafish transgenesis was performed with overlapping fragments of 198 and 687 bp containing either the wild type or the variant allele. Our data suggests that this region acts as a regulatory element; however, its size and target gene(s need to be identified to determine its role in idiopathic scoliosis.

  8. Spontaneous regression of curve in immature idiopathic scoliosis - does spinal column play a role to balance? An observation with literature review

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    Modi Hitesh N

    2010-11-01

    Full Text Available Abstract Background Child with mild scoliosis is always a subject of interest for most orthopaedic surgeons regarding progression. Literature described Hueter-Volkmann theory regarding disc and vertebral wedging, and muscular imbalance for the progression of adolescent idiopathic scoliosis. However, many authors reported spontaneous resolution of curves also without any reason for that and the rate of resolution reported is almost 25%. Purpose of this study was to question the role of paraspinal muscle tuning/balancing mechanism, especially in patients with idiopathic scoliosis with early mild curve, for spontaneous regression or progression as well as changing pattern of curves. Methods An observational study of serial radiograms in 169 idiopathic scoliosis children (with minimum follow-up one year was carried. All children with Cobb angle Results Average age was 9.2 years at first visit and 10.11 years at final follow-up with an average follow-up of 21 months. 32.5% (55/169, 41.4% (70/169 and 26% (44/169 children exhibited regression, no change and progression in their curves, respectively. 46.1% of children (78/169 showed changing pattern of their curves during the follow-up visits before it settled down to final curve. Comparing final fate of curve with side of curve and number of curves it did not show any relationship (p > 0.05 in our study population. Conclusion Possible reason for changing patterns could be better explained by the tuning/balancing mechanism of spinal column that makes an effort to balance the spine and result into spontaneous regression or prevent further progression of curve. If this which we called as "tuning/balancing mechanism" fails, curve will ultimately progress.

  9. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

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    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  10. Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis – A cross sectional study in 150 patients

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    Kim Hak-Jun

    2008-08-01

    Full Text Available Abstract Background Hueter-Volkmann's law regarding growth modulation suggests that increased pressure on the end plate of bone retards the growth (Hueter and conversely, reduced pressure accelerates the growth (Volkmann. Literature described the same principle in Rat-tail model. Human spine and its deformity i.e. scoliosis has also same kind of pattern during the growth period which causes wedging in disc or vertebral body. Methods This cross sectional study in 150 patients of adolescent idiopathic scoliosis was done to evaluate vertebral body and disc wedging in scoliosis and to compare the extent of differential wedging of body and disc, in thoracic and lumbar area. We measured wedging of vertebral bodies and discs, along with two adjacent vertebrae and disc, above and below the apex and evaluated them according to severity of curve (curve 30° to find the relationship of vertebral body or disc wedging with scoliosis in thoracic and lumbar spine. We also compared the wedging and rotations of vertebrae. Results In both thoracic and lumbar curves, we found that greater the degree of scoliosis, greater the wedging in both disc and body and the degree of wedging was more at apex supporting the theory of growth retardation in stress concentration area. However, the degree of wedging in vertebral body is more than the disc in thoracic spine while the wedging was more in disc than body in lumbar spine. On comparing the wedging with the rotation, we did not find any significant relationship suggesting that it has no relation with rotation. Conclusion From our study, we can conclude that wedging in disc and body are increasing with progression on scoliosis and maximum at apex; however there is differential wedging of body and disc, in thoracic and lumbar area, that is vertebral body wedging is more profound in thoracic area while disc wedging is more profound in lumbar area which possibly form 'vicious cycle' by asymmetric loading to spine for the

  11. Health-related quality-of-life in adolescent idiopathic scoliosis patients 25 years after treatment

    DEFF Research Database (Denmark)

    Simony, A.; Christensen, Steen Bach; Carreon, L. Y.

    2015-01-01

    treated with Boston brace (Brace) or posterior spinal fusion (PSF) using Harrington- DDT instrumentation between 1983 and 1990 at Rigshospitalet Copenhagen, were invited to participate in a long-term evaluation study. A validated Danish version of the Scoliosis Research Society 22R (SRS22R) and Short Form.......6 %), 1 brace pt and 3 Harrington-DDT pt. SRS22R domain scores were within the range described as normal for the general population with no statistical difference between the groups except in the Satisfaction domain, where the PSF group had better scores than the braced group. The SF36 PCS and MCS scores...

  12. Effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with idiopathic scoliosis that is an operative indication

    Science.gov (United States)

    Kim, Kyoung-Don; Hwangbo, Pil-Neo

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with growing idiopathic scoliosis, an operative indication. [Subjects] Five idiopathic scoliosis patients with a Cobb’s angle of the thoracic vertebra of 40 degrees or higher and Risser sign stage 3 or higher. [Methods] The Schroth exercise was applied 3 times a week for 12 weeks. We measured the thoracic trunk inclination, Cobb’s angle, and vital capacity before and after the exercise program. [Results] The thoracic trunk rotation angle decreased from 11.86 ± 3.32° to 4.90 ± 1.91° on average, the thoracic Cobb’s angle decreased from 42.40 ± 7.86° to 26.0 ± 3.65° on average, and the vital capacity also increased from 2.83 ± 1.23° to 4.04° ± 1.67° on average. All these effects were significant. [Conclusion] The 12-week Schroth exercise caused significant effects in the thoracic trunk inclination, Cobb’s angle, and vital capacity. The conservative treatment method was found to be effective even at a 40 degree or higher Cobb’s angle. In the future, universal exercise approach methods and preventive training for the treatment of scoliosis should be developed further. PMID:27134385

  13. High risk of adrenal insufficiency in adults previously treated for idiopathic childhood onset growth hormone deficiency

    DEFF Research Database (Denmark)

    Lange, Martin; Feldt-Rasmussen, Ulla; Svendsen, Ole Lander;

    2003-01-01

    The aim was to reevaluate a group of adults treated for idiopathic childhood onset GH deficiency (GHD) after 18 yr without GH treatment. Twenty-six (11 females) patients participated. All but two had isolated GHD. Childhood diagnosis was established by insulin tolerance test (ITT). The patients w...

  14. Validation of the scale on Satisfaction of Adolescents with Postoperative pain management-idiopathic Scoliosis (SAP-S

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    Khadra C

    2017-01-01

    Full Text Available Christelle Khadra,1–3 Sylvie Le May,1,2 Ariane Ballard,1,2 Jean Théroux,1,4 Sylvie Charette,5 Edith Villeneuve,6,7 Stefan Parent,2,8,9 Argerie Tsimicalis,10,11 Jill MacLaren Chorney12,13 1Faculty of Nursing, Université de Montréal, 2CHU Sainte-Justine Research Centre, 3Montreal Chest Institute, McGill University Health Centre, Montreal, QC, Canada; 4School of Health Professions, Murdoch University, Perth, WA, Australia; 5Direction of Nursing, 6Department of Anesthesia, CHU Sainte-Justine, 7Department of Anesthesia, 8Department of Surgery, Faculty of Medicine, Université de Montréal, 9Orthopaedic Service, Department of Surgery, CHU Sainte-Justine, 10Ingram School of Nursing, McGill University, 11Shriners Hospitals for Children, Montreal, QC, 12Pediatric Complex Pain Team, IWK Health Centre, 13Department of Anesthesia, Pain Management, and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Background: Spinal fusion is a common orthopedic surgery in children and adolescents and is associated with high pain levels postoperatively. If the pain is not well managed, negative outcomes may ensue. To our knowledge, there is no measure in English that assesses patient’s satisfaction with postoperative pain management following idiopathic scoliosis surgery. The aim of the present study was to assess the psychometric properties of the satisfaction subscale of the English version of the Satisfaction of Adolescents with Postoperative pain management – idiopathic Scoliosis (SAP-S scale.Methods: Eighty-two participants aged 10–18 years, who had undergone spinal fusion surgery, fully completed the SAP-S scale at 10–14 days postdischarge. Construct validity was assessed through a principal component analysis using varimax rotation.Results: Principal component analysis indicated a three-factor structure of the 13-item satisfaction subscale of the SAP-S scale. Factors referred to satisfaction regarding current

  15. Prognostic Value of Bone Mineral Density on Curve Progression: A Longitudinal Cohort Study of 513 Girls with Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    YIP, Benjamin Hon Kei; YU, Fiona Wai Ping; WANG, Zhiwei; HUNG, Vivian Wing Yin; LAM, Tsz Ping; NG, Bobby Kin Wah; ZHU, Feng; CHENG, Jack Chun Yiu

    2016-01-01

    Osteopenia has been found to occur in about 30% of Adolescent Idiopathic Scoliosis (AIS) patients. This study aimed to investigate its prognostic value on the risk of curve progression to surgical threshold. Newly diagnosed AIS girls (N = 513) with Cobb angle 10°–40° were recruited with follow-up till maturity. Bilateral hips were assessed with dual-energy x-ray absorptiometry (DXA). Distal radius of a subgroup of 90 subjects was further assessed with high-resolution peripheral quantitative computed tomography (HR-pQCT). 55 patients progressed to surgical threshold or underwent spine surgery at the end of follow-up. Cox model with osteopenia status performed significantly better than the model without (p = 0.010). Osteopenic patients had significantly higher risk of surgery (HR2.25, p = 0.011), even after adjustment for menarche status, age and initial Cobb angle. The incremental predictive value of osteopenia was, however, not statistically significant. In the subgroup analysis, cortical bone density was identified as a better marker to improve the sensitivity of the prediction, but requires further larger study to validate this finding. These consistent results of bone density measured at different sites suggest a systemic effect, rather than local effect to the deformed spine, and support to the link of abnormal bone density to the etiopathogenesis in AIS patients. PMID:27991528

  16. Abnormal Skeletal Growth in Adolescent Idiopathic Scoliosis Is Associated with Abnormal Quantitative Expression of Melatonin Receptor, MT2

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    Alain Moreau

    2013-03-01

    Full Text Available The defect of the melatonin signaling pathway has been proposed to be one of the key etiopathogenic factors in adolescent idiopathic scoliosis (AIS. A previous report showed that melatonin receptor, MT2, was undetectable in some AIS girls. The present study aimed to investigate whether the abnormal MT2 expression in AIS is quantitative or qualitative. Cultured osteoblasts were obtained from 41 AIS girls and nine normal controls. Semi-quantification of protein expression by Western blot and mRNA expression by TaqMan real-time PCR for both MT1 and MT2 were performed. Anthropometric parameters were also compared and correlated with the protein expression and mRNA expression of the receptors. The results showed significantly lower protein and mRNA expression of MT2 in AIS girls compared with that in normal controls (p = 0.02 and p = 0.019, respectively. No differences were found in the expression of MT1. When dichotomizing the AIS girls according to their MT2 expression, the group with low expression was found to have a significantly longer arm span (p = 0.036. The results of this study showed for the first time a quantitative change of MT2 in AIS that was also correlated with abnormal arm span as part of abnormal systemic skeletal growth.

  17. Ultrastructure of Intervertebral Disc and Vertebra-Disc Junctions Zones as a Link in Etiopathogenesis of Idiopathic Scoliosis

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    Evalina L. Burger

    2014-01-01

    Full Text Available Background Context. There is no general accepted theory on the etiology of idiopathic scoliosis (IS. An important role of the vertebrae endplate physes (VEPh and intervertebral discs (IVD in spinal curve progression is acknowledged, but ultrastructural mechanisms are not well understood. Purpose. To analyze the current literature on ultrastructural characteristics of VEPh and IVD in the context of IS etiology. Study Design/Setting. A literature review. Results. There is strong evidence for multifactorial etiology of IS. Early wedging of vertebra bodies is likely due to laterally directed appositional bone growth at the concave side, caused by a combination of increased cell proliferation at the vertebrae endplate and altered mechanical properties of the outer annulus fibrosus of the adjacent IVD. Genetic defects in bending proteins necessary for IVD lamellar organization underlie altered mechanical properties. Asymmetrical ligaments, muscular stretch, and spine instability may also play roles in curve formation. Conclusions. Development of a reliable, cost effective method for identifying patients at high risk for curve progression is needed and could lead to a paradigm shift in treatment options. Unnecessary anxiety, bracing, and radiation could potentially be minimized and high risk patient could receive surgery earlier, rendering better outcomes with fewer fused segments needed to mitigate curve progression.

  18. Characteristics of lateral electrical surface stimulation (LESS) and its effect on the degree of spinal deformity in idiopathic scoliosis

    Science.gov (United States)

    Kowalski, Ireneusz M.; Palko, Tadeusz; Pasniczek, Roman; Szarek, Jozef

    2009-01-01

    Clinical studies were carried out in the period of 2003-2006 at the Provincial Children's Rehabilitation Hospital in Ameryka near Olsztyn (Poland). The study involved a group of children and youth exhibiting spinal deformity progression in idiopathic scoliosis (IS) of more than 5° per year according to the Cobb scale. Four hundred and fifty patients between 4 and 15 years of age were divided into three groups (n = 150). Group I and group II received 2-hour and 9-hour lateral electrical surface stimulation (LESS), respectively, whereas group III (control) was treated only with corrective exercises for 30 minutes twice a day. LESS was performed with the use of a battery-operated SCOL-2 stimulator manufactured by Elmech, Warsaw, Poland. The effectiveness of this method was confirmed in the treatment of spinal IS in children and youth, especially when the initial spinal deformity did not exceed 20° according to the Cobb scale. A short-duration electrostimulation (2 hours daily) was found to produce results similar to those obtained after overnight (9 h) electrostimulation. Moreover, the analysis of the Harrington prognostic index F confirms the positive effect of LESS in both groups of patients (2 h and 9 h of LESS).

  19. Unique local bone tissue characteristics in iliac crest bone biopsy from adolescent idiopathic scoliosis with severe spinal deformity

    Science.gov (United States)

    Wang, Zhiwei; Chen, Huanxiong; Yu, Y. Eric; Zhang, Jiajun; Cheuk, Ka-Yee; Ng, Bobby K. W.; Qiu, Yong; Guo, X. Edward; Cheng, Jack C. Y.; Lee, Wayne Y. W.

    2017-01-01

    Adolescent idiopathic scoliosis is a complex disease with unclear etiopathogenesis. Systemic and persistent low bone mineral density is an independent prognostic factor for curve progression. The fundamental question of how bone quality is affected in AIS remains controversy because there is lack of site-matched control for detailed analysis on bone-related parameters. In this case-control study, trabecular bone biopsies from iliac crest were collected intra-operatively from 28 severe AIS patients and 10 matched controls with similar skeletal and sexual maturity, anthropometry and femoral neck BMD Z-score to control confounding effects. In addition to static histomorphometry, micro-computed tomography (μCT) and real time-PCR (qPCR) analyses, individual trabecula segmentation (ITS)-based analysis, finite element analysis (FEA), energy dispersive X-ray spectroscopy (EDX) were conducted to provide advanced analysis of structural, mechanical and mineralization features. μCT and histomorphometry showed consistently reduced trabecular number and connectivity. ITS revealed predominant change in trabecular rods, and EDX confirmed less mineralization. The structural and mineralization abnormality led to slight reduction in apparent modulus, which could be attributed to differential down-regulation of Runx2, and up-regulation of Spp1 and TRAP. In conclusion, this is the first comprehensive study providing direct evidence of undefined unique pathological changes at different bone hierarchical levels in AIS. PMID:28054655

  20. Scoliosis Associated With Syringomyelia

    Directory of Open Access Journals (Sweden)

    Gh Fathi

    2007-01-01

    Full Text Available Introduction: The differential diagnosis of idiopathic and syringomyelia associated scoliosis is important because corrective surgery for scoliosis associated with syringomyelia prior to management of syringomyelia can be dangerous. There are important imaging indicators for diagnosis of syringomyelia associated with scoliosis. A few of these indicators have been assessed in our study. Methods: A retrospective descriptive study including 38 patients with both scoliosis and syringomyelia was performed at the Shafa Yahyaeian center. Standard scoliosis series radiographs and MRI of all patients were studied. The type of scoliosis, location and magnitude of deformity, kyphosis or lordosis in the sagittal plane, location and size of syrinx were assessed. Results: Thoracic kyphosis was present in 94.7% of patients. 37% of patients had scoliosis with convexity to left. Arnold –chiari malformation was present in 36% and cord tethering in 21% of patients. The locations of syrinx were as follows: 47.4%cervical, 44.6 thoracic, 2.7% lumbar and 5.3% were holocord. Conclusion: Kyphosis, abscence of lordosis in sagittal plane, progressive scoliosis and scoliosis with convexity to left are atypical findings and could be indicators of the presence of syringomyelia. If these indicators are present, a diagnosis of idiopathic scoliosis should be made with caution.

  1. SURGICAL CORRECTION OF SPINAL DEFORMITY IN IDIOPATHIC SCOLIOSIS: THE HISTORY AND CURRENT STATE (REVIEW

    Directory of Open Access Journals (Sweden)

    S. V. Vissarionov

    2013-01-01

    Full Text Available The article presents the historical and contemporary aspects of the state of the question correct scoliosis spine with dorsal and ventral spinal systems. The variants of spinal deformity correction method from Harrington to modern surgical techniques using both hook and metal screw. Detailed technological aspects of surgical interventions for the correction of spinal deformity using a variety of spinal structures. A comparative estimate of the correction of spinal deformity, the impact on the result of the initial mobility of the spine, level metallofiksatsii vertebral-motor segment, as well as the degree of true derotation vertebrae at the top of the curvature in a variety of surgical procedures. Describes the advantages and disadvantages of options for surgery.

  2. Genetic Evaluation for the Scoliosis Gene(s) in Patients with Neurofibromatosis 1 and Scoliosis

    Science.gov (United States)

    2015-10-01

    allow for early detection and intervention. Aim 2. Determine whether the genetic markers for curve progression in Adolescent Idiopathic Scoliosis...allow for early detection and intervention. Aim 2. Determine whether the genetic markers for curve progression in Adolescent Idiopathic Scoliosis...present an intriguing hypothesis that dystrophic scoliosis may be pre- determined based on a patient’s genetic composition. Validation of these

  3. Chinese Adaptation of the Bad Sobernheim Stress Questionnaire for Patients With Adolescent Idiopathic Scoliosis Under Brace Treatment.

    Science.gov (United States)

    Xu, Ximing; Wang, Fei; Yang, Mingyuan; Huang, Qikai; Chang, Yifan; Wei, Xianzhao; Bai, Yushu; Li, Ming

    2015-08-01

    Bad Sobernheim Stress Questionnaire (BSSQ)-Deformity and BSSQ-Brace are the most widely used instruments for evaluating stress levels in adolescent idiopathic scoliosis (AIS) patients under brace treatment, and good reliability and validity have been demonstrated across different cultures. Great stress has been found among many adolescents, becoming a major concern for professionals. However, no previous research has addressed the cultural adaptations and psychometric testing of BSSQ-Deformity and BSSQ-Brace in China or the stress levels in AIS patients. The purposes of our study were to evaluate the cross-cultural adaptation and validation of the BSSQ-Deformity and BSSQ-Brace and to investigate stress levels in Chinese (AIS) patients under brace treatment.The original (German) versions of BSSQ-Deformity and BSSQ-Brace were cross-culturally translated according to international guidelines. Psychometric properties such as reliability and construct validity were tested. Eighty-six AIS patients were included in our study, and 50 patients paid a second visit 3 to 7 days later to test reproducibility. Cronbach α and the intraclass coefficient were determined to assess internal consistency and reproducibility. Scoliosis Research Society patient questionnaire-22 (SRS-22) was applied to evaluate construct validity.The mean BSSQ-Deformity and BSSQ-Brace scores were 15.3 and 13.4 points, respectively. Severe stress was observed in 12% of patients due to brace treatment. Item analysis demonstrated that each item was scored under a normal distribution with no redundancy. Psychometric analysis revealed excellent internal consistency (Cronbach α = 0.85 and 0.80, respectively) and reproducibility (intraclass correlation coefficient = 0.85 and 0.90, respectively) for BSSQ-Deformity and BSSQ-Brace. The correlation coefficients of BSSQ-Deformity, BSSQ-Brace and SRS-22 were 0.48 and 0.63, respectively.In conclusion, BSSQ-Deformity and BSSQ-Brace have been successfully

  4. Results of Milwaukee and Boston Braces with or without Metal Marker Around Pads in Patients with Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Mohammad Saleh Ganjavian

    2011-09-01

    Full Text Available "nBracing is the non-operative treatment of choice for adolescent idiopathic scoliosis (AIS and careful application of pads on apical segment of curve is very important for correction. Control of pads` appropriate site in brace is not easy by clinical evaluation. Therefore, we decided to compare results of braces which for better control of pads by radiographs, metal marker inserted around pads with those without metal marker. We evaluated 215 consecutive cases (182 female, 33 male of AIS with 342 major curves from 1993 to 2003. Mean initial age was,13.2 ± 1.8 years (9-16 and mean duration of follow-up was, 16.1±16.4 months (0-114 that treated by 4 type of brace; 89 with type 1(Milwaukee with metal pads, 87 with type 2 (Milwaukee with simple pads, 17 with type 3 (Boston with metal pads and 22 with type 4(Boston with simple pads. Cobb angle recorded at 5 stages (initial, best, wean, stop and final follow-up. Mean initial Cobb was 36.2 ̊, at stop stage, 35.2̊ and reached 38̊ at final follow-up. Overall, 21.3% improved, 42.2% were the same and 36.5% failed. Failure for braces type 1 to 4 were, 40.5%, 34%, 38% and 24% at final follow-up. A total of 59 patients (27.4% underwent spinal fusion that for brace type 1 to 4 , was, 33, 21, 2 and 3 patients respectively. From 16 cases with initial Cobb of 50̊, at follow-up, 12 were ≥50̊ or had spinal fusion. Correction of lumbar (P=0.008 and main thoracic curves (P=0.002 was better by Boston than Milwaukee, however, In general difference between 4 types of braces was not significant and metal marker had no significant effect on results. Two important predictors of brace failure were, initial curve magnitude and brace type, but using metal marker around pads had no effect in results. It seems that bracing did not alter the natural history of scoliosis in early Risser stages with large magnitude of initial curves. Insertion of metal marker around pads is easy and cheap way that facilitate control of

  5. Anthropometric characteristics, high prevalence of undernutrition and weight loss: impact on outcomes in patients with adolescent idiopathic scoliosis after spinal fusion.

    LENUS (Irish Health Repository)

    Tarrant, Roslyn C

    2015-02-01

    Abnormal anthropometry including comparably lower weight and body mass index (BMI) in the adolescent idiopathic scoliosis (AIS) population is increasingly recognised, however, no study has examined postoperative weight loss or its clinical relevance in these relatively thin patients. This study aimed to assess perioperative nutritional status as well as clinically severe involuntary weight loss and its impact on outcomes in patients with AIS undergoing posterior spinal fusion (PSF). A further objective was to compare preoperative anthropometric measurements of the current AIS cohort with healthy controls.

  6. Inter-tester and intra-tester reliability of ultrasound imaging measurements of abdominal muscles in adolescents with and without idiopathic scoliosis: a case-controlled study.

    Science.gov (United States)

    Yang, Hoe S; Yoo, Ji W; Lee, Bo A; Choi, Chang K; You, Joshua H

    2014-01-01

    The present study established inter-tester and intra-tester reliabilities of ultrasound imaging and diagnostically differentiated muscle imbalances in lateral abdominal muscle sizes between normal adolescents and adolescents with idiopathic scoliosis (AIS). Fifteen adolescents with AIS were age- and gender-matched with 15 normal adolescents. There was no significant difference between bilateral abdominal muscles in normal adolescents, but there was a significant difference between bilateral abdominal muscles in adolescents with AIS (Pabdominal muscle thickness is: (1) highly reliable between and within the testers; and (2) capable of distinguishing between subjects with and without pathological muscle morphology due to AIS.

  7. Significance of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients

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    Kuroki Hiroshi

    2012-03-01

    Full Text Available Abstract Background Although most idiopathic scoliosis patients subject to conservative treatment in daily clinical practice, there have been no ideal methods to evaluate the spinal flexibility for the patients who are scheduled the brace treatment. The purpose of this study was to investigate the value of hanging total spine x-ray to estimate the indicative correction angle by brace wearing in idiopathic scoliosis patients. Methods One hundred seventy-six consecutive patients with idiopathic scoliosis who were newly prescribed the Osaka Medical College (OMC brace were studied. The study included 14 boys and 162 girls with a mean age of 13 years and 1 month. The type of curves consisted of 62 thoracic, 23 thoracolumbar, 22 lumbar, 42 double major, 14 double thoracic, and 13 triple curve pattern. We compared the Cobb angles on initial brace wearing (BA and in hanging position (HA. Of those, 108 patients who had main thoracic curves were selected and evaluated the corrective ability of OMC brace. These subjects were divided into three groups according to the relation between BA and HA (BA HA group, and then, maturity was compared among them. Results The average Cobb angle in upright position (UA of all cases was 31.0 ± 7.8°. The average BA and HA of all cases were 20.3 ± 9.5° and 21.1 ± 8.4°, respectively. The average chronological age was lowest in BA Conclusions The use of hanging total spine x-ray served as a useful tool to estimate the degree of correction possible curve within the OMC brace for main thoracic curve in idiopathic scoliosis. Maturity had some influence on the correlation between HA and BA. Namely, in immature patients, HA tended to be larger than BA. In contrast, in mature patients, HA had a tendency to be smaller than BA. With consideration for spinal flexibility based on maturity, in mature patients, larger BA than HA may be allowed. However, in immature patients, smaller BA than HA should be aimed.

  8. Pattern Of Scoliosis In Indian Population

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    Reddy P.D

    1987-01-01

    Full Text Available This paper analyses the scoliotic curves in 100 Indian patients who attended Scoliosis Clinic at the All India Institute of Medical Sciences, New Delhi, between January 1982 and December 1983. We found that Idiopathic scoliosis was the commonest and both sexes were equally affected. Majority of the curves were to the right side. The incidence of Infantile Idiopathic scoliosis was very insignificant. Congenital scoliosis was second commonest Incidence of paralytic scoliosis was much less in spite of poliomyelitis being common in India. We have presented a detailed analysis of various curved and also the role of muscle imbalance in the production and progression of scoliosis.

  9. Radiographic versus ultrasound evaluation of the Risser Grade in adolescent idiopathic scoliosis: a prospective study of 46 patients

    OpenAIRE

    Thaler, Martin; Kaufmann, Gerhard; Steingruber, Iris; Mayr, Eckart; Liebensteiner, Michael; Bach, Christian

    2008-01-01

    The determination of skeletal age is essential in the management of patients with scoliosis. One of the most frequently used techniques to determine skeletal maturity is the method described by Risser. However, repeated X-ray exposure in the follow-up examinations of scoliosis patients may increase the risk of cancer. We compared conventional radiological evaluation of the Risser grade with ultrasound evaluation. For scoliosis patients routine application of ultrasound in the follow-up examin...

  10. Real time noninvasive assessment of external trunk geometry during surgical correction of adolescent idiopathic scoliosis

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    Mac-Thiong Jean-Marc

    2009-02-01

    Full Text Available Abstract Background The correction of trunk deformity is crucial in scoliosis surgery, especially for the patient's self-image. However, direct visualization of external scoliotic trunk deformity during surgical correction is difficult due to the covering draping sheets. Methods An optoelectronic camera system with 10 passive markers is used to track the trunk geometry of 5 scoliotic patients during corrective surgery. The position of 10 anatomical landmarks and 5 trunk indices computed from the position of the passive markers are compared during and after instrumentation of the spine. Results Internal validation of the accuracy of tracking was evaluated at 0.41 +/- 0.05 mm RMS. Intra operative tracking during surgical maneuvers shows improvement of the shoulder balance during and after correction of the spine. Improvement of the overall patient balance is observed. At last, a minor increase of the spinal length can be noticed. Conclusion Tracking of the external geometry of the trunk during surgical correction is useful to monitor changes occurring under the sterile draping sheets. Moreover, this technique can used be used to reach the optimal configuration on the operating frame before proceeding to surgery. The current tracking technique was able to detect significant changes in trunk geometry caused by posterior instrumentation of the spine despite significant correction of the spinal curvature. It could therefore become relevant for computer-assisted guidance of surgical maneuvers when performing posterior instrumentation of the scoliotic spine, provide important insights during positioning of patients.

  11. A segmental radiological study of the spine and rib – cage in children with progressive Infantile Idiopathic Scoliosis

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    Vasiliadis Elias S

    2006-10-01

    Full Text Available Abstract Background The role of rib cage in the development of progressive infantile idiopathic scoliosis (IIS has not been studied previously. No report was found for rib growth in children with IIS. These findings caused us to undertake a segmental radiological study of the spine and rib-cage in children with progressive IIS. The aim of the present study is to present a new method for assessing the thoracic shape in scoliotics and in control subjects and to compare the findings between the two groups. Materials and methods In the posteroanterior (PA spinal radiographs of 24 patients with progressive IIS, with a mean age of 4.1 years old, the Thoracic Ratios (TRs (segmental convex and concave TRs, the Cobb angle, the segmental vertebral rotation and vertebral tilt were measured. In 233 subjects, with a mean age of 5.1 years old, who were used as a control group, the segmental left and right TRs and the total width of the chest (left plus right TRs were measured in PA chest radiographs. Statistical analysis included Mann-Whitney, Spearman correlation coefficient, multiple linear regression analysis and ANOVA. Results The comparison shows that the scoliotic thorax is significantly narrower than that of the controls at all spinal levels. The upper chest in IIS is funnel-shaped and the vertebral rotation at T4 early in management correlates significantly with the apical vertebral rotation at follow up. Conclusion The IIS thorax is narrower than that of the controls, the upper chest is funnel-shaped and there is a predictive value of vertebral rotation at the upper limit of the thoracic curve of IIS, which reflects, impaired rib control of spinal rotation possibly due to neuromuscular factors, which contribute also to the funnel-shaped chest.

  12. Association between common variants near LBX1 and adolescent idiopathic scoliosis replicated in the Chinese Han population.

    Directory of Open Access Journals (Sweden)

    Wenjie Gao

    Full Text Available BACKGROUND: Adolescent idiopathic scoliosis (AIS is one of the most common spinal deformities found in adolescent populations. Recently, a genome-wide association study (GWAS in a Japanese population indicated that three single nucleotide polymorphisms (SNPs, rs11190870, rs625039 and rs11598564, all located near the LBX1 gene, may be associated with AIS susceptibility [1]. This study suggests a novel AIS predisposition candidate gene and supports the hypothesis that somatosensory functional disorders could contribute to the pathogenesis of AIS. These findings warrant replication in other populations. METHODOLOGY/PRINCIPAL FINDINGS: First, we conducted a case-control study consisting of 953 Chinese Han individuals from southern China (513 patients and 440 healthy controls, and the three SNPs were all found to be associated with AIS predisposition. The ORs were observed as 1.49 (95% CI 1.23-1.80, P = 5.09E-5, 1.70 (95% CI 1.42-2.04, P = 1.17E-8 and 1.52 (95% CI 1.27-1.83, P = 5.54E-6 for rs625039, rs11190870 and rs11598564, respectively. Second, a case-only study including a subgroup of AIS patients (N = 234 was performed to determine the effects of these variants on the severity of the condition. However, we did not find any association between these variants and the severity of curvature. CONCLUSION: This study shows that the genetic variants near the LBX1 gene are associated with AIS susceptibility in Chinese Han population. It successfully replicates the results of the GWAS, which was performed in a Japanese population.

  13. Association of IL-6 and MMP-3 gene polymorphisms with susceptibility to adolescent idiopathic scoliosis: a meta-analysis

    Indian Academy of Sciences (India)

    JIAN ZHAO; MINGYUAN YANG; MING LI

    2016-09-01

    Recently, several institutions have investigated the associations of MMP-3-1171 5A/6A and IL-6-174-G/C gene polymorphisms with adolescent idiopathic scoliosis (AIS), while reports from different institutions are not consistent. Therefore, we,comprehensively and systematically performed this meta-analysis to detect whether the two gene polymorphisms are correlated with AIS. From January 1994 to October 2015, all case–control studies focussed on the relationship between the two a forementioned gene polymorphisms and the susceptibility to AIS were retrieved from bibliographic databases. A total of 16 articles were found, of which five consisted of 944 cases and 1177 controls, were finally included after being assessed by two reviewers. We calculated the pooled odds ratio (OR) with 95% confidence interval (95% CI) to assess the associations. The pooled data analyses were based on allele contrast, homozygote, heterozygote, dominant and recessive models. Overall, there was no significant association of IL-6-174-G/C gene polymorphism with AIS risk. Significant association was observedin homozygote model of MMP-3-1171-5A/6A gene polymorphism (5A5A versus 6A6A: OR= 1.69, 95% CI = 1.11–2.58,P =0.02). When stratified into Caucasian and Asian populations, positive association was found in Caucasian population(5A versus 6A: OR =1.43, 95% CI=1.11–1.84, P= 0.006; 5A5A versus 6A6A: OR = 1.90, 95% CI=1.13–3.19, P= 0.015); however, there was no significant association in Asian population. The present study concluded that 5A5A genotype of MMP-3-1171 5A/6A gene polymorphism was associated with AIS, especially in Caucasian population. However, no significant association was detected between IL-6-174-G/C gene polymorphism and AIS.

  14. The effect of backpack weight on the standing posture and balance of schoolgirls with adolescent idiopathic scoliosis and normal controls.

    Science.gov (United States)

    Chow, Daniel H K; Kwok, Monica L Y; Cheng, Jack C Y; Lao, Miko L M; Holmes, Andrew D; Au-Yang, Alexander; Yao, Fiona Y D; Wong, M S

    2006-10-01

    Concerns have been raised regarding the effect of carrying a backpack on adolescent posture and balance, but the effect of backpack loading combined with other factors affecting balance, such as adolescent idiopathic scoliosis (AIS), has not been determined. This study examines the effects of backpack load on the posture and balance of schoolgirls with AIS and normal controls. The standing posture of 26 schoolgirls with mild AIS (mean age 13, Cobb angle 10-25 degrees ) and 20 age-matched normal schoolgirls were recorded without a backpack and while carrying a standard dual-strap backpack loaded at 7.5%, 10%, 12.5% and 15% of the subject's bodyweight (BW). Kinematics of the pelvis, trunk and head were recorded using a motion analysis system and centre of pressure (COP) data were recorded using a force platform. Reliable COP data could only be derived for 13 of the subjects with AIS. Increasing backpack load causes a significantly increased flexion of the trunk in relation to the pelvis and extension of the head in relation to the trunk, as well as increased antero-posterior range of COP motion. While backpack load appears to affect balance predominantly in the antero-posterior direction, differences between groups were more evident in the medio-lateral direction, with AIS subjects showing poor balance in this direction. Overall, carrying a backpack causes similar sagittal plane changes in posture and balance in both normal and AIS groups. Load size or subject group did not influence balance, but the additive effect of backpack carrying and AIS on postural control alters the risk of fall in this population. Therefore, load limit recommendations based on normal subjects should not be applicable to subjects with AIS.

  15. The value of different Risser grading systems in determining growth maturity of girls with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Wang, Weijun; Zhen, Xin; Sun, Xu; Zhu, Zezhang; Zhu, Feng; Lam, T P; Cheng, Jack C Y; Qiu, Yong

    2012-01-01

    A grading system for ossification of the iliac apophysis (Risser sign) was developed for skeletal maturity assessment in the United States (US) then adopted with modifications in France (Fr) and other countries. Despite the same name, these systems have important differences. With the aim to analyzing the difference between US and Fr Risser grading systems in determining the growth maturity of girls with adolescent idiopathic scoliosis (AIS), Fifty-three AIS girls undergoing posterior spinal correction with autogenous bone graft were recruited. The Risser grades were recorded for the non-dominant side iliac crest apophysis according to the US and Fr grading systems. Growth activity was determined by standard histologic grades (HGs) on iliac crest cartilage. As a result, Kappa statistics showed poor agreement between two grading systems. The US system showed higher correlation with HGs compared to Fr system by Spearman correlation analysis. It was also found that growth cessation could be determined by Risser grade 5 of US system or Risser grade 4 of Fr system. Furthermore, by employing Receiver Operating Characteristic (ROC) curve analysis, it was found that the Risser grade 4-5 of US system with two years after menarche could be used in determining growth cessation with the highest sensitivity, specificity and accuracy. Hence it was concluded that the US Risser grading system was better in determining maturity of girls with AIS than Fr Risser grading system. By combining years since menarche, the accuracy of Risser grades in determining growth cessation could be enhanced, and the time of weaning from a brace could be advanced.

  16. Effects of Multilevel Facetectomy and Screw Density on Postoperative Changes in Spinal Rod Contour in Thoracic Adolescent Idiopathic Scoliosis Surgery

    Science.gov (United States)

    Kokabu, Terufumi; Sudo, Hideki; Abe, Yuichiro; Ito, Manabu; Ito, Yoichi M.; Iwasaki, Norimasa

    2016-01-01

    Flattening of the preimplantation rod contour in the sagittal plane influences thoracic kyphosis (TK) restoration in adolescent idiopathic scoliosis (AIS) surgery. The effects of multilevel facetectomy and screw density on postoperative changes in spinal rod contour have not been documented. This study aimed to evaluate the effects of multilevel facetectomy and screw density on changes in spinal rod contour from before implantation to after surgical correction of thoracic curves in patients with AIS prospectively. The concave and convex rod shapes from patients with thoracic AIS (n = 49) were traced prior to insertion. Postoperative sagittal rod shape was determined by computed tomography. The angle of intersection of the tangents to the rod end points was measured. Multiple stepwise linear regression analysis was used to identify variables independently predictive of change in rod contour (Δθ). Average Δθ at the concave and convex side were 13.6° ± 7.5° and 4.3° ± 4.8°, respectively. The Δθ at the concave side was significantly greater than that of the convex side (P Risser sign (P = 0.032), the preoperative main thoracic Cobb angle (P = 0.031), the preoperative TK angle (P = 0.012), and the number of facetectomy levels (P = 0.007). Furthermore, a Δθ at the concave side ≥14° significantly correlated with the postoperative TK angle (P = 0.003), the number of facetectomy levels (P = 0.021), and screw density at the concave side (P = 0.008). Rod deformation at the concave side suggests that corrective forces acting on that side are greater than on the convex side. Multilevel facetectomy and/or screw density at the concave side have positive effects on reducing the rod deformation that can lead to a loss of TK angle postoperatively. PMID:27564683

  17. Are adolescent idiopathic scoliosis and ankylosing spondylitis counter-opposing conditions? A hypothesis on biomechanical contributions predisposing to these spinal disorders.

    Science.gov (United States)

    Masi, A T; Dorsch, J L; Cholewicki, J

    2003-01-01

    Human spinal biomechanics are profoundly complex and not well understood, especially in terms of the dynamic spine function. Translation of biomechanics to disease is difficult, particularly since cause must be separated from effect. Primary dynamics predisposing to the onset of chronic spinal disorders, e.g., adolescent idiopathic scoliosis (AIS) or ankylosing spondylitis (AS), must clearly be differentiated from secondary alterations. This commentary addresses primary biomechanics that may predispose to these idiopathic diseases. A novel hypothesis is proposed, based upon inferences regarding their contrasting muscular dynamics. The hypothesis postulates opposing inherent muscle tonicity in AIS versus AS. Converse degrees of spinal stability may predispose to the respective curvature deformities of AIS and the enthesopathy lesions of AS. One condition is suspected to counter-oppose the other, within a polymorphic spectrum of spinal stability.

  18. Pineal gland hormone and idiopathic scoliosis: possible effect of melatonin on sleep-related postural mechanisms.

    Science.gov (United States)

    Pompeiano, O; Manzoni, D; Miele, F

    2002-04-01

    Experimental and clinical evidences indicate that endocrine mechanisms, particularly involving the pineal gland, exert a role in the development of postural deficits leading to the occurrence of idiopatic scoliosis (IS). In particular, experiments performed in bipedal animals have shown that removal of the pineal gland, which secretes melatonin (M), induced a scoliosis, and that in such preparations, administration of this hormone prevented the development of this deformity (cf. 131). It appears also that adolescents with IS showed a reduced level of serum M with respect to age-related control subjects. The possible mechanisms involved in the M regulation of the tonic contraction of the axial musculature have been discussed. It is known that the pineal gland is implicated in the control of circadian rhythms, including the sleep-waking cycle, and that during this cycle there are prominent changes in postural activity, which affect not only the limbs, but also the axial musculature. These changes are characterized by a decrease followed by a suppression of postural activity, which occur particularly during transition from wakefulness to synchronized sleep and, more prominently, to rapid eye movement (REM) sleep. Episodes of postural atonia may also occur during the cataplectic episodes, which are typical of narcolepsy. Cholinergic and/or cholinoceptive neurons located in the dorsal pontine reticular formation (pRF) and the related medullary inhibitory reticulospinal (RS) system, intervene in the suppression of posture during REM sleep, as well as during the cataplectic episodes which occur in narcolepsy. These structures are under the modulatory (inhibitory) influence of the dorsomedial and the dorsolateral pontine tegmentum, where serotoninergic raphe nuclei (RN) neurons and noradrenergic locus coeruleus (LC) neurons are located. We postulated that M may act not only on the circadian pacemaker, but also directly on the pontine tegmental structures involved in the

  19. Influences of combined therapies with traditional Chinese medicine on pulmonary function and surface average electromyogram ratio in adolescent idiopathic scoliosis patients

    Directory of Open Access Journals (Sweden)

    Jia-ping SHEN

    2016-09-01

    Full Text Available Objective  To evaluate the influences of traditional Chinese medicinal combined therapies on pulmonary function and surface average electromyogram (AEMG ratio in adolescent idiopathic scoliosis patients. Methods  One hundred and twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a Traditional Chinese Medicine (TCM group and a brace group. TCM group patients underwent i Navigation of the spinal balance (twice a day, 40min/ time, until to skeletal maturity; ii Balance manipulation (twice a week, 25min/time, lasted 12 months; iii Small needle-knife therapy (once a week, 10 times. The brace group patients were treated with a Milwaukee brace. The Cobb angle was measured after 12 and 24 months of treatment, pulmonary function was determined after 12 months of treatment, and AEMG ratio of the surface electromyogram was measured 6, 12, 18 and 24 months after treatment, and intergroup comparison was performed. Results  The Cobb angle significantly decreased in both groups 12 months after treatment (P0.05 in the TCM group and brace group, respectively, 12 months after treatment and 62.5% and 34.7% (P<0.05, respectively, 24 months aftertreatment. Pulmonary function was significantly improved 12 months after treatment in TCM group (P<0.05 but significantly decreased in brace group (P<0.05. The AEMG ratio was significantly reduced (P<0.01 and tended to remain at 1 after stopping treatment in TCM group, showed that the muscle imbalance existed on both sides of the scoliosis, but was adverse in brace group (P<0.05, showed that the muscle imbalance aggravated. No side effect of the therapeutic method was found. Conclusions  The spinal balance therapy based on traditional Chinese medicine theory has excellent therapeutic efficacy and safety, and can significantly ameliorate the imbalance existed on both sides of the scoliosis, improve lung function index, and have better compliance. The AEMG ratio is a

  20. Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2006-04-01

    Full Text Available Abstract Background Medicine is a scientific art: once science is not clear, choices are made according to individual and collective beliefs that should be better understood. This is particularly true in a field like adolescent idiopathic scoliosis, where currently does not exist definitive scientific evidence on the efficacy either of conservative or of surgical treatments. Aim of the study To verify the philosophical choices on the final outcome of a group of people believing and engaged in a conservative treatment of idiopathic scoliosis. Methods We performed a multifaceted study that included a bibliometric analysis, a questionnaire, and a careful Consensus reaching procedure between experts in the conservative treatment of scoliosis (SOSORT members. Results The Consensus reaching procedure has shown to be useful: answers changed in a statistically significant way, and 9 new outcome criteria were included. The most important final outcomes were considered Aesthetics (100%, Quality of life and Disability (more than 90%, while more than 80% of preferences went to Back Pain, Psychological well-being, Progression in adulthood, Breathing function, Scoliosis Cobb degrees (radiographic lateral flexion, Needs of further treatments in adulthood. Discussion In the literature prevail outcome criteria driven by the contingent treatment needs or the possibility to have measurement systems (even if it seems that usual clinical and radiographic methods are given much more importance than more complex Disability or Quality of Life instruments. SOSORT members give importance to a wide range of outcome criteria, in which clinical and radiographic issues have the lowest importance. Conclusion We treat our patients for what they need for their future (Breathing function, Needs of further treatments in adulthood, Progression in adulthood, and their present too (Aesthetics, Disability, Quality of life. Technical matters, such as rib hump or radiographic lateral

  1. Comparison of the curative effects of video assisted thoracoscopic anterior correction and small incision, thoracotomic anterior correction for idiopathic thoracic scoliosis

    Institute of Scientific and Technical Information of China (English)

    QIU Yong; WANG Bin; ZHU Feng

    2008-01-01

    Background The advantages of video assisted thoracoscopic anterior correction for scoliosis are minimal invasion and relatively short-time instrumentation; however the relatively steep learning curve cannot be ignored. Small incision, thoracotomic anterior correction for idiopathic thoracic scoliosis could be another choice because of less demanding technique. We compared the outcomes of these two techniques.Methods Forty-nine patients with idiopathic right thoracic scoliosis were randomly divided into two groups. Group A was 12 girls with mean age 14.9 years, mean Cobb angle 52° and Risser signs "+++" to "++++". Ten patients received video assisted thoracoscopic anterior correction with Eclipse rectification and two with Frontier instrumentation. Group B was 4 boys and 33 girls with mean age 14.1 years, mean Cobb angle of 56° and Risser signs "++" to "++++". These patients underwent small incision, thoracotomic anterior instrumentation. The operation time, blood loss, postoperative drainage, instrumented levels, curve correction and eady loss of correction of both groups were analyzed.Results Group A had average operation time of (390+82) minutes, intraoperative blood loss of (600+155) ml, instrumented level of 7.4+1.3, postoperative drainage of (500±160) ml, correction rate of (65±16)% and loss of correction during the 18-36 month followup of (8.6±2.9)%. Group B had average operative time of (220±80) minutes, intraoperative blood loss of (320±120) ml, instrumented level of 7.8±0.9, postoperative drainage of (210±90) ml, curve correction rate of (70±12)% and loss of correction during the 18-36-month followup of (4.6±3.9)%. The curve correction rates of the two groups were not statistically significant (P〉0.05). However, the operative time, blood loss, postoperative drainage, and early loss of correction showed statistical significance (P〈0.05).Conclusion Both video assisted thoracoscopic anterior correction and small incision thoracotomic anterior

  2. EVALUATION OF PROGNOSTIC FACTORS IN QUALITY OF LIFE OF PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS UNDERGOING SPINAL FUSION BY THE POSTERIOR APPROACH

    Directory of Open Access Journals (Sweden)

    FELIPE DE MORAES POMAR

    Full Text Available ABSTRACT Objective: To evaluate the prognostic factors in the treatment of patients diagnosed with adolescent idiopathic scoliosis undergoing spinal fusion by the posterior approach. Methods: The study included 48 patients with idiopathic adolescent scoliosis (43 females and 5 males who underwent spinal fusion by the posterior approach, with an average age at diagnosis of 12 years, and clinical signs of Risser between 3 and 4 at the time of surgery. Clinical and radiographic measurements were performed, the participants answered the SRS-30 questionnaire, and the analysis of the medical record data was performed in two occasions during the preoperative period and at the end of two years of follow-up. Results: All satisfaction measures showed statistically significant change after the procedure (p<0.05 with respect to the radiographic characteristics, except for the lumbar apical vertebral translation (p=0.540 and Cobb L1-L5 (p=0.225. Conclusion: In general, it was found that patients who received surgical treatment were more satisfied with their appearance than those who underwent conservative treatment.

  3. 支具治疗青少年特发性脊柱侧凸的研究现状及新进展%The new advances and research situation of brace treatment for adolescent idiopathic scoliosis.

    Institute of Scientific and Technical Information of China (English)

    施新革; 张永刚

    2013-01-01

      青少年特发性脊柱侧凸是引起青少年脊柱畸形最常见的原因,进展型的青少年特发性脊柱侧凸预后不良,若不及时干预治疗,最终需要外科手术矫正治疗。支具治疗是唯一证明有确切疗效的非手术治疗方法。本文就支具治疗青少年特发性脊柱侧凸的研究现状及新进展作一综述,以促进临床医师更好的应用支具治疗青少年特发性脊柱侧凸。%Adolescent idiopathic scoliosis is the common cause resulting in the spinal deformity of adolescent. The progressing ad-olescent idiopathic scoliosis have the poor prognosis and the patient ultimately requires surgical treatment without intervention in time. The brace treatment is proved the only effective treatment in non-surgical treatment. We reviewed the new literature of brace treatment for adolescent idiopathic scoliosis in order to promote the clinicians to treat the patients of adolescent idiopathic scoliosis with brace.

  4. Schroth Physiotherapeutic Scoliosis-Specific Exercises Added to the Standard of Care Lead to Better Cobb Angle Outcomes in Adolescents with Idiopathic Scoliosis – an Assessor and Statistician Blinded Randomized Controlled Trial

    Science.gov (United States)

    Parent, Eric C.; Khodayari Moez, Elham; Hedden, Douglas M.; Hill, Douglas L.; Moreau, Marc; Lou, Edmond; Watkins, Elise M.; Southon, Sarah C.

    2016-01-01

    Background The North American non-surgical standard of care for adolescent idiopathic scoliosis (AIS) includes observation and bracing, but not exercises. Schroth physiotherapeutic scoliosis-specific exercises (PSSE) showed promise in several studies of suboptimal methodology. The Scoliosis Research Society calls for rigorous studies supporting the role of exercises before including it as a treatment recommendation for scoliosis. Objectives To determine the effect of a six-month Schroth PSSE intervention added to standard of care (Experimental group) on the Cobb angle compared to standard of care alone (Control group) in patients with AIS. Methods Fifty patients with AIS aged 10–18 years, with curves of 10°-45° and Risser grade 0–5 were recruited from a single pediatric scoliosis clinic and randomized to the Experimental or Control group. Outcomes included the change in the Cobb angles of the Largest Curve and Sum of Curves from baseline to six months. The intervention consisted of a 30–45 minute daily home program and weekly supervised sessions. Intention-to-treat and per protocol linear mixed effects model analyses are reported. Results In the intention-to-treat analysis, after six months, the Schroth group had significantly smaller Largest Curve than controls (-3.5°, 95% CI -1.1° to -5.9°, p = 0.006). Likewise, the between-group difference in the square root of the Sum of Curves was -0.40°, (95% CI -0.03° to -0.8°, p = 0.046), suggesting that an average patient with 51.2° at baseline, will have a 49.3° Sum of Curves at six months in the Schroth group, and 55.1° in the control group with the difference between groups increasing with severity. Per protocol analyses produced similar, but larger differences: Largest Curve = -4.1° (95% CI -1.7° to -6.5°, p = 0.002) and Sum of Curves=−0.5° (95% CI -0.8 to 0.2, p = 0.006). Conclusion Schroth PSSE added to the standard of care were superior compared to standard of care alone for reducing the

  5. A Comparison of Patient-Reported Outcome Measures Following Different Treatment Approaches for Adolescents with Severe Idiopathic Scoliosis: A Systematic Review

    Science.gov (United States)

    Weiss, Hans-Rudolf; Chockalingam, Nachiappan; Kandasamy, Gokulakannan; Arnell, Tracey

    2016-01-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine which is usually not symptomatic and which can progress during growth and cause a surface deformity. In adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Although surgery is usually recommended for curvatures exceeding 40° to 50° to stop curvature progression, recent reviews have shed some light on the long-term complications of such surgery and to the lack of evidence for such complicated procedures within the scientific literature. Furthermore, a number of patients are very fearful of having surgery and refuse this option or live in countries where specialist scoliosis surgery is not available. Other patients may be unable to afford the cost of specialist scoliosis surgery. For these patients the only choice is an alternative non-surgical treatment option. To examine the impact of different management options in patients with severe AIS, with a focus on trunk balance, progression of scoliosis, cosmetic issues, quality of life, disability, psychological issues, back pain, and adverse effects, at both the short-term (a few months) and the long-term (over 20 years). We searched CENTRAL, MEDLINE, EMBASE, CINHAL and two other databases up to January 2016 with no language limitations. We also checked the reference lists of relevant articles and conducted an extensive hand search of the grey literature. We searched for randomised controlled trials as well as prospective and retrospective controlled trials comparing spinal fusion surgery with no treatment or conservative treatment in AIS patients with a Cobb angle greater than 40°. We did not identify any evidence of superiority of effectiveness of operative compared to nonoperative interventions for patients with severe AIS. Within the present literature there is no clear evidence to suggest that a specific type of treatment is superior to

  6. The clinical course of juvenile idiopathic arthritis-associated uveitis in childhood and puberty

    NARCIS (Netherlands)

    Hoeve, Maretta; Ayuso, Viera Kalinina; Schalij-Delfos, Nicoline E.; Los, Leonoor I.; Rothova, Aniki; de Boer, Joke H.

    2012-01-01

    Aim The long-term course of juvenile idiopathic arthritis (JIA)-associated uveitis is not known yet. This study investigates the course and activity of JIA-associated uveitis in childhood and puberty. Design Retrospective study of the clinical data of 62 JIA patients with uveitis. The main outcome m

  7. Uveitis in childhood : Complications and treatment with emphasis on juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Sijssens, K.M.

    2008-01-01

    The aim of this study was to gain more insight into the development of complications in childhood uveitis and to evaluate the treatment options for these mostly sight-threatening conditions with emphasis on juvenile idiopathic arthritis (JIA)-associated uveitis. The second aim was to investigate whi

  8. Application of 3D rapid prototyping technology in posterior corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Yang, Mingyuan; Li, Chao; Li, Yanming; Zhao, Yingchuan; Wei, Xianzhao; Zhang, Guoyou; Fan, Jianping; Ni, Haijian; Chen, Ziqiang; Bai, Yushu; Li, Ming

    2015-02-01

    A retrospective study to evaluate the effectiveness of 3-dimensional rapid prototyping (3DRP) technology in corrective surgery for Lenke 1 adolescent idiopathic scoliosis (AIS) patients. 3DRP technology has been widely used in medical field; however, no study has been performed on the effectiveness of 3DRP technology in corrective surgery for Lenke 1 AIS patients. Lenke 1 AIS patients who were preparing to undergo posterior corrective surgery from a single center between January 2010 and January 2012 were included in this analysis. Patients were divided into 2 groups. In group A, 3-dimensional (3D) printing technology was used to create subject-specific spine models in the preoperative planning process. Group B underwent posterior corrective surgery as usual (by free hand without image guidance). Perioperative and postoperative clinical outcomes were compared between 2 groups, including operation time, perioperative blood loss, transfusion volume, postoperative hemoglobin (Hb), postoperative complications, and length of hospital stay. Radiological outcomes were also compared, including the assessment of screw placement, postoperative Cobb angle, coronal balance, sagittal vertical axis, thoracic kyphosis, and lumbar lordosis. Subgroup was also performed according to the preoperative Cobb angle: mean Cobb angle 50°. Besides, economic evaluation was also compared between 2 groups. A total of 126 patients were included in this study (group A, 50 and group B, 76). Group A had significantly shorter operation time, significantly less blood loss and transfusion volume, and higher postoperative Hb (all, P 0.05). There was also no significant difference in misplacement of screws in total populations (16.90% vs 18.82%, P = 0.305), whereas a low misplacement rate of pedicle screws was observed in patients whose mean Cobb angle was >50° (9.15% vs 13.03%, P = 0.02). Besides, using 3DRP increased the economic burden of patients (157,000 ± 9948.85 Ren Min Bi

  9. Diagnostic accuracy of motor evoked potentials to detect neurological deficit during idiopathic scoliosis correction: a systematic review.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Crammond, Donald J; Loke, Yoon K; Cheng, Hannah L; Huang, Jessie; Balzer, Jeffrey R

    2017-03-01

    OBJECTIVE The goal of this study was to evaluate the efficacy of intraoperative transcranial motor evoked potential (TcMEP) monitoring in predicting an impending neurological deficit during corrective spinal surgery for patients with idiopathic scoliosis (IS). METHODS The authors searched the PubMed and Web of Science database for relevant lists of retrieved reports and/or experiments published from January 1950 through October 2014 for studies on TcMEP monitoring use during IS surgery. The primary analysis of this review fit the operating characteristic into a hierarchical summary receiver operating characteristic curve model to determine the efficacy of intraoperative TcMEP-predicted change. RESULTS Twelve studies, with a total of 2102 patients with IS were included. Analysis found an observed incidence of neurological deficits of 1.38% (29/2102) in the sample population. Of the patients who sustained a neurological deficit, 82.8% (24/29) also had irreversible TcMEP change, whereas 17.2% (5/29) did not. The pooled analysis using the bivariate model showed TcMEP change with sensitivity (mean 91% [95% CI 34%-100%]) and specificity (mean 96% [95% CI 92-98%]). The diagnostic odds ratio indicated that it is 250 times more likely to observe significant TcMEP changes in patients who experience a new-onset motor deficit immediately after IS correction surgery (95% CI 11-5767). TcMEP monitoring showed high discriminant ability with an area under the curve of 0.98. CONCLUSIONS A patient with a new neurological deficit resulting from IS surgery was 250 times more likely to have changes in TcMEPs than a patient without new deficit. The authors' findings from 2102 operations in patients with IS show that TcMEP monitoring is a highly sensitive and specific test for detecting new spinal cord injuries in patients undergoing corrective spinal surgery for IS. They could not assess the value of TcMEP monitoring as a therapeutic adjunct owing to the limited data available and their

  10. Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study.

    Directory of Open Access Journals (Sweden)

    Stefan Schmid

    Full Text Available Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated.Ten patients (Cobb angle: 44.4±17.7 degrees were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar/lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles.The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar/lumbar than thoracic curvature angles. It is suggested that spinal curvature

  11. Stability of the Scoliotic Spine: Effect of Scoliosis Braces.

    Science.gov (United States)

    Havey, Robert M; Gavin, Thomas M; Patwardhan, Avinash G

    2016-04-01

    Orthotic treatment (braces) for scoliosis is best understood in light of the natural history of idiopathic scoliosis and the mechanics of spine stability. Idiopathic scoliosis is a spinal deformity confronted often by spine surgeons. With prompt recognition, treatment can be effective.

  12. Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005

    Directory of Open Access Journals (Sweden)

    Grivas Theodoros B

    2006-05-01

    Full Text Available Abstract Background Based on a recognized need for research to examine the premise that nonsurgical approaches can be used effectively to treat signs and symptoms of scoliosis, a scientific society on scoliosis orthopaedic and rehabilitation treatment (SOSORT was established in Barcelona in 2004. SOSORT has a primary goal of implementing multidisciplinary research to develop quantitative, objective data to address the role of conservative therapies in the treatment of scoliosis. This international working group of clinicians and scientists specializing in treatment of scoliosis met in Milan, Italy in January 2005. Methods As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1 the aims of physical exercises; (2 standards of treatment; and (3 the impact of such treatment performed by specialists in the field. Results The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education.

  13. The CD-Hopf method in the surgical treatment of idiopathic scoliosis of the thoracolumbar or lumbar spine.

    Science.gov (United States)

    Głowacki, Maciej; Harasymczuk, Jerzy; Piontek, Tomasz; Strzyzewski, Wojciech

    2005-04-30

    Background. The aim of this paper is to assess the extent of correction of scoliosis after surgery from the anterior approach using the CD Hopf method. Material and methods. We analyzed 20 patients with idiopatic thoracolumbar or lumbar scoliosis (Cobb angle 53 +/- 8 degrees , lordosis angle 56.9 +/- 11.9 degrees , vertebral translation 5.5 +/- 0.9 cm). Results. After surgery with the CD Hopf method, the scoliosis angle was reduced to 21 +/- 8 degrees . The correction rate was 61.7 +/- 12.1 degrees , with spondylodesis limited to 4 vertebrae in 13 patients, and 3 vertebrae in 7 patients. The average lumbar lordosis after surgery was 50.8+/-7.9 degrees , and the average vertebral translation was 2.6 +/- 1.1 cm. In post-surgical follow-up examinations the scoliosis angle increased slightly, not exceeding 3 degrees . Conclusions. Surgical treatment of scoliosis using the CD Hopf technique through the anterior approach allows for major correction in the frontal plane, accompanied by moderate decrease of lumbar lordosis. This method also enables significant improvement of horizontalization of border scoliosis vertebrae despite the short extent of the instrumentation and spondylodesis.

  14. [Scoliosis: review of types, aetiology, diagnostics, and treatment 1

    NARCIS (Netherlands)

    Baat, P. de; Biezen, E.C. van; Baat, C. de

    2012-01-01

    A scoliosis is a flexible or rigid deformity of the spine in the frontal plane. There are several types of scoliosis, each with specific characteristics. The most prevalent types are idiopathic, congenital, and neuromuscular scoliosis and scoliosis in adults. The aetiology is varied and largely unde

  15. Imaging features of cervical spine curvature of idiopathic scoliosis%特发性脊柱侧弯颈椎曲度影像学特征分析

    Institute of Scientific and Technical Information of China (English)

    唐瑶; 邓俊才; 明星; 吴非

    2016-01-01

    Objective To analyze the imaging characteristics of cervical spine curvature of idiopathic scoliosis and to explore the relationship between cervical curvature and scoliosis angle size .Methods Frontal and lateral full-spine X-ray imaging of 93 pa-tients with idiopathic scoliosis were retrospectively analyzed .Cervical sagittal Cobb angle and cervical spine angle were measured on lat-eral view,and scoliosis Cobb angle was measured on the anteroposterior films .The differences between cervical Cobb angle and the cer-vical angle were compared and the correlation among cervical sagittal Cobb angle ,scoliosis Cobb angle ,and cervical spine angle was an-alyzed.Results In the 93 patients,the scoliosis Cobb angle was (27.9±16.9)°,cervical sagittal Cobb angle (-3.7±16.0)°and av-erage of cervical angle was (-2.0 ±16.6 ) °.The abnormalities of cervical Cobb angle accounted for 69.89%.The abnormalities of cer-vical angle accounted for 67.74%.There was a significant difference between cervical Cobb angle and the cervical angle ( t =-2.641 , P =0.010 ) .They were highly correlated ( r =0.935 ,P =0.000 ) .The correlations between cervical scoliosis Cobb angle and Cobb angle and between cervical scoliosis Cobb angle and cervical angle were weak ( r =0.246 ,P =0.018 and r =0.215 ,P =0.039 ,re-spectively).Conclusion The abnormalities of curvature in sagittal cervical of idiopathic scoliosis have a high proportion .There is no exactly correlation between the size of the curvature in sagittal cervical and the scoliosis curvature .%目的:探讨特发性脊柱侧弯患者颈椎曲度的特点及颈椎曲度与脊柱侧弯角度大小的关系。方法回顾性分析93例特发性脊柱侧弯患者全脊柱正侧位X射线片影像资料,在标准侧位片上测量颈椎矢状面Cobb角和颈椎夹角,在正位片上测量脊柱侧弯Cobb角。比较颈椎Cobb角和颈椎夹角的差异,分析脊柱侧弯Cobb角、颈椎Cobb角和颈椎夹角的相关性。结果93例特

  16. Splenectomy in children with idiopathic thrombocytopenic purpura : A prospective study of 134 children from the Intercontinental Childhood ITP Study Group

    NARCIS (Netherlands)

    Kuehne, Thomas; Blanchette, Victor; Buchanan, George R.; Ramenghi, Ugo; Donato, Hugo; Tamminga, Rienk Y. J.; Rischewski, Johannes; Berchtold, Willi; Imbach, Paul

    2007-01-01

    Background. Splenectomy is an effective procedure for children and adults with severe or refractory idiopathic thrombocytopenic purpura (ITP). Data regarding pediatric patients are limited. Procedure. Sixty-eight Intercontinental Childhood ITP Study Group (ICIS) investigators from 57 institutions in

  17. Computer algorithms and applications used to assist the evaluation and treatment of adolescent idiopathic scoliosis: a review of published articles 2000-2009.

    Science.gov (United States)

    Phan, Philippe; Mezghani, Neila; Aubin, Carl-Éric; de Guise, Jacques A; Labelle, Hubert

    2011-07-01

    Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity whose assessment and treatment present many challenges. Computer applications have been developed to assist clinicians. A literature review on computer applications used in AIS evaluation and treatment has been undertaken. The algorithms used, their accuracy and clinical usability were analyzed. Computer applications have been used to create new classifications for AIS based on 2D and 3D features, assess scoliosis severity or risk of progression and assist bracing and surgical treatment. It was found that classification accuracy could be improved using computer algorithms that AIS patient follow-up and screening could be done using surface topography thereby limiting radiation and that bracing and surgical treatment could be optimized using simulations. Yet few computer applications are routinely used in clinics. With the development of 3D imaging and databases, huge amounts of clinical and geometrical data need to be taken into consideration when researching and managing AIS. Computer applications based on advanced algorithms will be able to handle tasks that could otherwise not be done which can possibly improve AIS patients' management. Clinically oriented applications and evidence that they can improve current care will be required for their integration in the clinical setting.

  18. [Conservative treatment of idiopathic scoliosis with effective braces: early response to trunk asymmetry may avoid curvature progress].

    Science.gov (United States)

    Matussek, J; Dingeldey, E; Wagner, F; Rezai, G; Nahr, K

    2014-07-01

    Vertical posture of the growing child requires minute central nervous control mechanisms in order to maintain symmetry of the torso in its various activities. Scoliosis describes a constant deviation in the frontal, transverse and sagittal planes from the dynamic symmetry of the trunk. Early intervention with effective bracing, physiotherapy and sports can reverse curve progression during growth spurts, once these are identified in screening. Modern braces have a derotating and reducing effect (mirror effect) on asymmetric body volumes, thus influencing the growing torso and restoring lasting symmetry. Recent data support the use of braces to reverse progressing scoliosis.

  19. Does higher screw density improve radiographic and clinical outcomes in adolescent idiopathic scoliosis? A systematic review and pooled analysis.

    Science.gov (United States)

    Luo, Ming; Wang, Wengang; Shen, Mingkui; Luo, Xin; Xia, Lei

    2017-02-03

    OBJECTIVE The radiographic and clinical outcomes of low-density (LD) versus high-density (HD) screw constructs in patients with adolescent idiopathic scoliosis (AIS) treated with all-pedicle screw constructs are still controversial. A systematic review and pooled analysis were performed to compare radiographic, perioperative, and quality-of-life (QOL) outcomes and complications in patients with moderate AIS treated with LD or HD screw constructs. METHODS The MEDLINE, Embase, and Web of Science databases were searched for English-language articles addressing LD versus HD screw constructs in AIS patients treated with all-pedicle screw constructs. The division of LD and HD groups was based on relative screw density and screw techniques. This systematic analysis strictly followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and all articles included in the analysis met the criteria specified in the guidelines. Two reviewers independently assessed the quality of the studies using the Newcastle-Ottawa Scale. Date on radiographic, perioperative, and QOL outcomes and complications were extracted from the included studies. RESULTS Twelve studies, involving a total of 827 patients (480 treated with LD constructs, 347 with HD), were analyzed-1 randomized controlled trial, 1 quasi-randomized controlled trial, and 10 retrospective studies. The patients' age at surgery, preoperative Cobb angle of the major curve, amount of thoracic kyphosis, and major curve flexibility were reasonably distributed, and no statistically significant differences were found. Regarding the outcomes at most recent follow-up, there were no significant differences in the Cobb angle of the major curve (mean difference 0.96°, 95% CI -0.06° to 1.98°, p = 0.06, I(2) = 1%), major curve correction (mean difference -0.72%, 95% CI -2.96% to 1.52%, p = 0.53, I(2) = 0%), thoracic kyphosis (mean difference -1.67°, 95% CI -4.59° to 1.25°, p = 0.26, I(2) = 79

  20. Health-related quality-of-life in adolescent idiopathic scoliosis patients 25 years after treatment

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Carreon, Leah Y

    2015-01-01

    ) using Harrington- DDT instrumentation between 1983 and 1990 at Rigshospitalet Copenhagen, were invited to participate in a long-term evaluation study. A validated Danish version of the Scoliosis Research Society 22R (SRS22R) and Short Form-36 (SF36v1) were administrated to the patients two weeks before...

  1. Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    ... About SRS العَرَبِية 中文 فارسی français deutsche Ελληνικά Italiano 日本語 한국어 português español Türkçe Member Login Become ... SRS Türkçe español português 한국어 日本語 Ελληνικά deutsche Italiano français فارسی 中文 العَرَبِية Patients and Families Find ...

  2. 广州市中小学生特发性脊柱侧弯患病率的调查%An Investigation on the Prevalence Rate of Idiopathic Scoliosis for Primary and Secondary School Students in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    余升华; 胡汉生; 范震波; 邱勤业; 李远辉

    2014-01-01

    Objective To investigate the prevalence rate of idiopathic scoliosis (IS) of primary and secondary school students in Guangzhou district. Methods From March 2012 to June 2014, the survey of idiopathic scoliosis was taken in 29 532 cases of primary and secondary school students in Guangzhou. Results 240 (0.81%) cases with idiopathic scoliosis were detected, with 104 cases of male and 136 cases of female;The prevalence rate of male was significantly lower than that of female (P 0.05). Conclusions The prevalence rate of idiopathic scoliosis in primary and secondary school students is 0.81%in Guangzhou. Female has higher prevalence rate than male, especially in the junior middle school, which suggests special monitoring.%目的:研究广东省广州市中小学生特发性脊柱侧凸患病率情况,以指导临床治疗和预防。方法2012年3月至2014年6月对广州市29532名中小学生进行特发性脊柱侧凸普查。结果检出特发性脊柱侧凸240例(患病率0.81豫),其中男104例、女136例,男性患病率显著低于女性(孕0.05)。结论广州市青少年特发性脊柱侧凸患病率为0.81豫,女性患病率显著高于男性,进入初中后尤为明显,应重点进行监测。

  3. Juvenile idiopathic scoliosis treated with posterior arthrodesis and segmental pedicle screw instrumentation before the age of 9 years: a 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Musaoğlu Resul

    2009-01-01

    Full Text Available Abstract Study design Retrospective study. Objective To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up. Summary of background data Progression of spinal deformity after posterior instrumentation and fusion in immature patients has been reported by several authors. Segmental pedicle screw fixation has been shown to be effective in controlling both coronal and sagittal plane deformities. However, there is no long term study of fusion with segmental pedicle screw fixation in these group of patients. Methods Seven patients with juvenile idiopathic scoliosis treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 7.4 years (range 5–9 years at the time of the operation. All the patients were followed up 5 years or more (range 5–8 years and were all Risser V at the most recent follow up. Three dimensional reconstruction of the radiographs was obtained and 3DStudio Max software was used for combining, evaluating and modifying the technical data derived from both 2d and 3d scan data. Results The preoperative thoracic curve of 56 ± 15° was corrected to 24 ± 17° (57% correction at the latest follow-up. The lumbar curve of 43 ± 14° was corrected to 23 ± 6° (46% correction at the latest follow-up. The preoperative thoracic kyphosis of 37 ± 13° and the lumbar lordosis of 33 ± 13° were changed to 27 ± 13° and 42 ± 21°, respectively at the latest follow-up. None of the patients showed coronal decompensation at the latest follow-up. Four patients had no evidence of crankshaft phenomenon. In two patients slight increase in Cobb angle at the instrumented segments with a significant increase in AVR suggesting crankshaft phenomenon was seen. One patient had a curve increase in both instrumented and non instrumented segments due to incorrect strategy. Conclusion In juvenile idiopathic curves of

  4. How to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS: a SPoRT brace treatment according to SOSORT management criteria

    Directory of Open Access Journals (Sweden)

    Fusco Claudia

    2009-09-01

    Full Text Available Abstract Background Aesthetics is a main goal of both conservative and surgical treatments in adolescent idiopathic scoliosis (AIS. Previously, we developed and validated a clinical scale - the Aesthetic Index (AI--in order to measure aesthetic impairment and changes during treatment. Aim To verify the efficacy of bracing on aesthetics in AIS. Study Design Prospective Cohort Study. Population Thirty-four consecutive patients, age 13.2 ± 3.7, initial Cobb Angle 32 ± 12°, ATR 10 ± 4° Bunnel, 11 males. Methods Patients with AI scores of at least 5/6 were included. Each of them had a brace prescription (18 to 23 hours per day, according to the SPoRT concept. AI was measured again after six months and at the end of treatment, and then the pre- and post-treatment scores compared. The Wilcoxon test was performed. Results Twenty-nine patients out of the 34 included completed the treatment and had six-month and final results; four patients were lost during the treatment, and one was fused. At baseline, median AI was 6 (95% IC 5-6 but the score decreased to 3 (95% IC 0-5; p Conclusion Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria. This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical. The use of a more sensitive tool like TRACE could more easily detect the clinical changes; nevertheless, AI proved sensible enough that its use in everyday clinical practice can be suggested.

  5. The influence of elastic orthotic belt on sagittal profile in adolescent idiopathic thoracic scoliosis: a comparative radiographic study with Milwaukee brace

    Directory of Open Access Journals (Sweden)

    Qian Bangping

    2010-09-01

    Full Text Available Abstract Background The effectiveness of bracing on preventing curve progression in coronal plane for mild and moderate adolescent idiopathic scoliosis (AIS patients has been confirmed by previous radiographic researches. However, a hypokyphotic effect on the sagittal plane has been reported by a few studies. A relatively increasing number of AIS patients were noticed to wear a new kind of elastic orthotic belt for the treatments of scoliosis without doctors' instructions. We postulate the correcting mechanism of this new appliance may cause flattening of the spine. To our knowledge, no study has investigated the effects of this new orthosis on the sagittal profile of AIS patients. The aim of this study was to evaluate and compare the effects of elastic orthotic belt and Milwaukee brace on the sagittal alignment in AIS patients. Methods Twenty-eight female AIS patients with mild or moderate thoracic curves were included in this study. Standing full-length lateral radiographs were obtained in three conditions: natural standing posture without any treatment, with elastic orthotic belt and with Milwaukee brace. Thoracic kyphosis (TK, lumber lordosis (LL and pelvic incidence (PI were measured and compared between the above three conditions. Results Both elastic orthotic belt and Milwaukee brace can lead to significant decrease of TK, however, the decrease of TK after wearing elastic orthotic belt is significantly larger than that after wearing Milwaukee brace. Compared with no treatment, LL was found to be significantly smaller after wearing Milwaukee brace, however, such significant decrease was not noted after wearing elastic orthotic belt. No significant changes were observed for the PI between 3 conditions. Conclusions The elastic orthotic belt could lead to more severe thoracic hypokyphosis when compared with Milwaukee brace. This belt may not be a suitable conservative method for the treatment of mild and moderate AIS patients.

  6. Sagittal Balance in Adolescent Idiopathic Scoliosis: A Radiographic Study of Spinopelvic Compensation After Selective Posterior Fusion of Thoracolumbar/Lumbar (Lenke 5C) Curves.

    Science.gov (United States)

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-11-01

    The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have an LL

  7. The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Danielsson, A.J.; Nachemson, A.L. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Orthopaedics; Cederlund, C.G.; Ekholm, S. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Diagnostic Radiology

    2001-03-01

    To determine the long-term outcome after fusion for adolescent idiopathic scoliosis in terms of degenerative disc findings diagnosed using MR imaging and to elucidate the clinical consequences. Material and methods: Thirty-two patients with adolescent idiopathic scoliosis, who had undergone spinal fusion using Harrington rods to the lower lumbar spine with one or two unfused discs below the fusion, were re-examined 25 years after the fusion. The re-examinations included validated questionnaires, clinical examination, full standing frontal and lateral radiographs and MR examination of the lower lumbar region. Curve size and degenerative findings on MR images were evaluated by two unbiased radiologists, blinded to the clinical findings. A matched control group of 32 persons without scoliosis was subjected to the same examinations. Results and conclusion: There were significantly more degenerative disc changes (p<0.0001), disc height reduction (p=0.0010) and end-plate changes (p<0.0001 for both upper and lower end-plates) in the lowest unfused disc in the patient group compared with the control group. The MR findings in the lowest unfused disc, but not the one above, in the patient group correlated to lumbar pain intensity as well as to the diminished lumbar lordosis.

  8. XbaI and PvuII polymorphisms of estrogen receptor 1 gene in females with idiopathic scoliosis: no association with occurrence or clinical form.

    Directory of Open Access Journals (Sweden)

    Piotr Janusz

    Full Text Available INTRODUCTION: XbaI single nucleotide polymorphism (SNP (A/G rs934099 in estrogen receptor 1 gene (ESR1 was described to be associated with curve severity in Japanese idiopathic scoliosis (IS patients and in Chinese patients with both curve severity and predisposition to IS. PvuII SNP (C/T rs2234693 of ESR1 was described to be associated with the occurrence of IS in the Chinese population; however, two replication studies did not confirm the findings. The ESR1 SNPs have never been studied in Caucasian IS patients. METHODS: Case-control study. 287 females with IS underwent clinical, radiological and genetic examinations. The patients were divided into three groups according to curve progression velocity: non-progressive IS, slowly progressive IS (progression <1° per month, and rapidly progressive IS (progression ≥1° per month. The radiological maximum Cobb angle was measured and surgery rate established. A control group consisted of 182 healthy females. RESULTS: All results followed Hardy-Weinberg equilibrium. In the case-control study, genotype frequency in the patients did not differ for the XbaI (AA = 33.5%, AG = 49.1%, GG = 17.4%, nor for the PvuII (TT = 26.8%, TC = 50.2%, CC = 23.0% comparing to controls (AA = 33.5%, AG = 50.5%, GG = 15.9% and (TT = 23.1%, TC = 51.1%, CC = 25.8%, respectively, p = 0.3685, p = 0.6046. The haplotype frequency for the patients (AT = 47.1%, GC = 39.2%, AC = 8.9%, GT = 2.8% did not differ from the controls (AT = 44.8%, GC = 37.4%, AC = 14.0%, GT = 3.8%, p = 0.0645. No difference was found either in XbaI (p = 0.8671 or PvuII (p = 0.3601 allele distribution between the patients and the controls. In the case study, there was no significant difference in genotype frequency for the non-progressive, slowly progressive, and rapidly progressive scoliosis. No difference was found in genotype or haplotype distribution for

  9. Quantitative ultrasound for predicting curve progression in adolescent idiopathic scoliosis: a prospective cohort study of 294 cases followed-up beyond skeletal maturity.

    Science.gov (United States)

    Lam, Tsz Ping; Hung, Vivian Wing Yin; Yeung, Hiu Yan; Chu, Winnie Chiu Wing; Ng, Bobby Kin Wah; Lee, Kwong Man; Qin, Ling; Cheng, Jack Chun Yiu

    2013-03-01

    Adolescent idiopathic scoliosis (AIS) is prevalent among adolescents and can carry significant morbidities. We evaluated the use of quantitative ultrasound (QUS) for predicting curve progression in patients with AIS. We recruited 294 girls with AIS at a mean age of 13.4 years, and they were prospectively followed beyond skeletal maturity for curve progression. We recorded 3 calcaneal QUS measurements at baseline, namely broadband ultrasound attenuation (BUA), velocity of sound (VOS), and stiffness index (SI). Logistic regression analysis indicated that SI, age, menarchal status, and Cobb angle were significant prognostic factors to be included in the final prediction model. The adjusted odds ratio of curve progression for Z-score of SI≦0 was 2.00 (95% CI: 1.08-3.71). The area under the ROC curve was 0.831 (95% CI: 0.785-0.877). The results of this study indicate that SI was an independent and significant prognostic factor for AIS and could be considered in addition to other prognostic factors when estimating the risk for curve progression and planning treatment for patients with AIS.

  10. 青少年特发性脊柱侧凸与手术分型%Adolescent idiopathic scoliosis and its operative classification

    Institute of Scientific and Technical Information of China (English)

    邱贵兴

    2008-01-01

    脊柱侧凸是指脊柱的一个或数个节段向侧方弯曲并伴有椎体旋转的三维脊柱畸形,国际脊柱侧凸研究学会(Scoliosis Research Society,SRS)对脊柱侧凸有明确定义青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是指10岁以上儿童至发育成熟前的一种脊柱侧凸,占青少年人口的2%~3%,占整个脊柱侧凸发病率的80%。AIS是发生于冠状面侧凸、矢状面后凸/前凸及水平面椎体旋转的复杂三维畸形,由于脊柱侧凸、扭曲,胸廓变形,

  11. IDIOPATHIC THORACO SCOLIOSIS TREATMENT USING A COMBINATION OF DOCUMENTATION BASED CARE (DBC BACK ACTIVE RECONDITIONING PROGRAMME AND SCHROTH METHODS: A PROSPECTIVE CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ganesan Kathiresan

    2013-10-01

    Full Text Available reconditioning programme and Schroth methods to lessen the curvature allied with idiopathic Thoracicscoliosis.ResearchDesign: Sampling-An 18 years old female, single case study,Setting-DBC Kuching Active rehabilitationcentre, Malaysia.Duration of the study-20 weeks,Outcome measures-A base line and follow-up outcomemeasures includes Borg pain scale, Functional Rating Index, Balance test, and Radiographic analysis.Interventions-Document Based Care (DBC Back active reconditioning programme and Schroth methodsConclusion-The combination of the Document Based Care (DBC Back active reconditioning programme andSchroth methods seemed to be effective at reducing a Thoracic dextroscoliosis by about 14° (50% andLumbarLevoscoliosis by about 7° (25%, Short form (SF-36 showed improvement inQuality of life,balance time on theBalance board improved to 52 seconds and Borg pain scale rated 8/10 at the onset of care, dropped to a 1/10after 20 weeks, in this single case study. The positive outcomes of this practice validate a policyof offeringconservative treatment as an alternative to Thoracic scoliosis patients, including those for whom surgery isdiscussed

  12. Prevalence of adolescent idiopathic scoliosis in Zhenjiang%镇江市青少年特发性脊柱侧凸的患病率调查

    Institute of Scientific and Technical Information of China (English)

    柯荣军; 曹兴兵; 黄永辉; 刘方刚; 陈燕; 吕飞

    2015-01-01

    Objective To investigate the prevalence of adolescent idiopathic scoliosis(AIS) in Zhenjiang ,China .Methods A total of 15667 adolescents aged from 12 to 18 years old in Zhenjiang received physical examination for screening AIS ,of whom the adolescents with positive or suspiciously positive results were reviewed by professional spine surgeons and examined by spinal X-ray film . Results Taking Cobb′s angle>10 degrees as a standard ,161 patients with AIS were confirmed with the prevalence of 1.03% and major age of 13-16 years old .The prevalence of AIS in female was higher than that in male(74.5% vs .25.5% )(P10度为标准 ,共检出AIS患者161例 ,患病率为1.03% ,主要集中在13-16岁.女性青少年AIS患病率高于男性(74.5% vs .25.5% )(P<0 .01) ,并随着角度增大 ,女性所占比例逐渐增加.结论 镇江市女性青少年AIS患病率高于男性 ,女性更易进展为大角度.普查中早期发现 ,对A IS诊治具有重要意义.

  13. Movement intervention recovers the Cobb angle of adolescent idiopathic scoliosis%运动干预青少年脊柱侧弯Cobb角的变化*★

    Institute of Scientific and Technical Information of China (English)

    杨宁; 徐盼

    2013-01-01

      背景:青少年脊柱侧弯康复目前有许多方法,但针对患者的病症,以功能能力为目标运动疗法报道不多。目的:观察分析运动干预对青少年脊柱侧弯Cobb角恢复的疗效。方法:对1例15岁青少年脊柱侧弯患者做干预前拍摄X射线片,测量Cobb角度,确定弯屈的位置,根据弯曲位置确定相关肌肉,设计出功能动作,进行针对练习和运动模式练习。运动干预包括:①左腿跨侧栏练习。②左腿侧够橡皮筋练习(左手拉下高于头的皮筋,在橡皮筋弹性回落时及时用脚踝勾住。要求左侧腰部肌肉要及时收缩)。③舞蹈的扒杆动作练习(左侧):擦地练习、划圈练习、小踢腿练习和蹲练习。④左侧侧压腿练习(拉伸右侧肌肉)。⑤直臂侧下拉皮带(双侧的背阔肌)。⑥俯卧沙袋提拉。⑦左侧单臂悬垂练习。⑧垫上运动:前、后滚翻,肩肘倒立起。⑨腹肌练习(正、侧转)。⑩教了4套韵律体操组合。所有的练习都在音乐控制下完成。共干预约50次,1-1.5 h/次,时间为两个半月。再次拍摄X射线片观察Cobb角的改变,观察干预前后患侧神经肌肉功能的进步情况。结果与结论:通过两个半月,约50次(每次1.0-1.5 h)训练,使患者的Cobb角34°回到28°,专科医生建议可不用戴支具。说明运动干预对青少年脊柱侧弯Cobb角恢复效果显著。%BACKGROUND: Various methods are involved for the treatment of adolescent idiopathic scoliosis; however, reports concerning independent function-mediated training are rare. OBJECTIVE: To explore the effect of movement intervention on the recovery of Cobb angle of patients with adolescent idiopathic scoliosis. METHODS: One 15-year-old patient with adolescent idiopathic scoliosis was asked to take X-ray film before movement intervention to measure the Cobb angle and define the location. The related muscles were determined according to the

  14. High risk of adrenal insufficiency in adults previously treated for idiopathic childhood onset growth hormone deficiency

    DEFF Research Database (Denmark)

    Lange, Martin; Feldt-Rasmussen, Ulla; Svendsen, Ole Lander;

    2003-01-01

    The aim was to reevaluate a group of adults treated for idiopathic childhood onset GH deficiency (GHD) after 18 yr without GH treatment. Twenty-six (11 females) patients participated. All but two had isolated GHD. Childhood diagnosis was established by insulin tolerance test (ITT). The patients...... were retested with an ITT to evaluate adult GH status. In five patients, an arginine and a synacthen test were performed instead of an ITT. Eleven of 25 patients had a subnormal cortisol response to ITT or synacthen. Ten patients had a GH peak less than 3.0 microg/liter (0.5. +/- 0.5 microg....../liter), whereas 16 patients displayed a normal GH response (12.3 +/- 10.6 microg/liter) after ITT. IGF-I values were decreased in the patients with a pathological retest as well as in patients with a normal GH response compared with controls (P

  15. Perception of vertical and horizontal orientation in children with scoliosis

    NARCIS (Netherlands)

    Cheung, John; Sluiter, Wim J.; Veldhuizen, Albert G.; Cool, Jan C.; Van Horn, Jim R.

    2002-01-01

    To determine whether the perception of body posture is altered in idiopathic scoliosis, a simple neurophysiologic experiment through laser line projection was conducted to test this hypothesis in three groups of individuals: 89 children with idiopathic scoliosis (IS), 50 children with congenital sco

  16. Perception of vertical and horizontal orientation in children with scoliosis

    NARCIS (Netherlands)

    Cheung, J; Sluiter, WJ; Veldhuizen, AG; Cool, JC; Van Horn, [No Value

    2002-01-01

    To determine whether the perception of body posture is altered in idiopathic scoliosis, a simple neurophysiologic experiment through laser line projection was conducted to test this hypothesis in three groups of individuals: 89 children with idiopathic scoliosis (IS). 50 children with congenital sco

  17. Anterior correction of idiopathic scoliosis using the KASS-Dual rod system%应用KASS系统前路矫正治疗特发性脊柱侧凸

    Institute of Scientific and Technical Information of China (English)

    Kiyoshi Kaneda; Yasuhiro Shono

    2006-01-01

    [ Objective] To analyze the clinical results of scoliosis patients treated by anterior correction surgery using the KASS (Kaneda Anterior Scoliosis System: the dual rod system). [ Method] Total 123 idiopathic scoliosis patients were treated. The patients' curve patterns by King classification were as follows:Thoracic scoliosis [ type Ⅱ (n = 13), Ⅲ (n = 18 ) , and Ⅳ (n = 16) ,total (n =47) and thoracolumbar or lumbar (TL/L) curve (n = 76)]. In all patients, anterior correction surgery within the range of the major curve was performed. The average follow-up period was 7 years 7 months (2 ~ 13 years 6 months).[ Result] Fusion was attained in all patients. Correction rates of the major curve scoliosis were 68% in thoracic scoliosis and 81%in TL/L scoliosis. In sagittal alignment, all patients restored nearly physiologic thoracic kyphosis and lumbar lordosis. Correction rates of horizontal tilt of the lowermost end vertebra were 78% in thoracic scoliosis and 83% in TL/L scoliosis. Correction rates of the apical vertebral rotation were 59% in thoracic scoliosis and 70% in TL/L scoliosis. No neurovascular and implant related complications were observed. [ Conclusion ] KASS allows excellent 3-D correction of the scoliosis and rigid enough stability to maintain the correction with a shorter fusion.%[目的] 探讨应用KASS系统前路矫正治疗特发性脊柱侧凸的临床效果.[方法] 应用KASS系统治疗总123例病例.根据King分型法可分为:胸椎侧凸47例(其中Ⅱ型13例,Ⅲ型18例,Ⅳ型16例),胸腰椎或腰椎侧凸76例.所有病例中均对主要侧凸部位行前路矫形手术,平均随访7年7个月(2年~13年6个月).[结果] 所有病例均获骨性融合,胸椎生理性后凸和腰椎生理性前凸基本正常.胸椎侧凸部位矫正率为68%,胸腰椎或腰椎侧凸矫正率为81%.胸椎最底椎水平倾斜改善率分别为78%和83%,顶椎旋转矫正率分别为59%和70%.无神经血管及内置

  18. Strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction for the treatment of severe adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-qi; YIN Xin-hua; LI Feng; GAO Qi-le; GE Lei; WU Jian-huang; LIU Jin-yang; GUO Chao-feng; LIU Shao-hua; LU Shi-jin; LI Jin-song

    2012-01-01

    Background Many investigators advocate anterior release combined with halo-femoral traction and posterior fusion when treating stiff thoracic curves in patient with adolescent idiopathic scoliosis (AIS).But the anterior operations often induce severe complications.Some surgeons choose posterior-only surgery with halo-femoral traction,posterior wide release and correction.But to the best of our knowledge,there are only rare prospective studies on these posterior-only surgeries for AIS patients who have a rigid curve more than 80° and flexibility less than 35%.@@Methods Sixty-four AIS patients were recruited from September 2006 to June 2009.All patients had rigid curves and underwent spinal correction.They were randomly divided into group A (combined anteroposterior surgery) and group B (posterior-only surgery).Images and scoliosis research society-22 questionnaire (SRS-22) scores were performed praand post-operation and during follow-up visits.The operation time,blood loss,hospital days,and hospital charges were compared between the two groups.@@Results These patients were followed for an average of 37.5 months (range,24-65 months).No serious complications were observed.There were no significant differences between the two groups in gender,age,preoperative radiographic data,or preoperative SRS-22 score.The average operation time,blood loss,hospital days and hospital charges in group B were less than those in group A.The SRS-22 score in group B was better than in group A at post-operation and at final follow-up.@@Conclusions In AIS with a rigid curve more than 80° and flexibility less than 35%,strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction can provide better SRS-22 scores,comparable curve correction,shorter operation time,less blood loss,shorter hospital stays and lower charges when compared to combined anterior and posterior surgery.

  19. The sagital balance in idiopatic and neuromuscular scoliosis

    OpenAIRE

    Borges,Paulo Alvim; Ocampos, Guilherme Pereira; Mancuso Filho,José Antonio; Letaif,Olavo Biraghi; Marcon, Raphael Martus; Cristante, Alexandre Fogaça

    2014-01-01

    OBJECTIVES: To describe and compare the distribution of spinopelvic parameters (SPP) in a Brazilian population with idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS), and evaluate the association between pelvic incidence (PI) and lumbar lordosis (LL). METHOD: Medical records investigation was performed. Sagital balance angles were measured in patients with neuromuscular and idiopathic scoliosis. RESULTS: IS sample means (in degrees): PI 55.55; Sacral Slope (SS) 45.35; Pelvic Tilt (P...

  20. Proposal for a Candidate Core Set of Fitness and Strength Tests for Patients with Childhood or Adult Idiopathic Inflammatory Myopathies

    NARCIS (Netherlands)

    van der Stap, Djamilla K D; Rider, Lisa G; Alexanderson, Helene; Huber, Adam M; Gualano, Bruno; Gordon, Patrick; van der Net, Janjaap; Mathiesen, Pernille; Johnson, Liam G; Ernste, Floranne C; Feldman, Brian M; Houghton, Kristin M; Singh-Grewal, Davinder; Kutzbach, Abraham Garcia; Munters, Li Alemo; Takken, Tim

    2016-01-01

    OBJECTIVE: Currently there are no evidence-based recommendations regarding fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies (IIM). This hinders clinicians and researchers in choosing the appropriate fitness- or muscle strength-related outcome measure

  1. Current trends in genetic etiology research of adolescent idiopathic scoliosis%重视青少年特发性脊柱侧凸病因机制中的基因学研究

    Institute of Scientific and Technical Information of China (English)

    邱勇

    2010-01-01

    @@ 青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是发生于青春期发育前后的最常见的脊柱畸形,其病因不明.目前其病因学研究主要包括遗传学机制、激素的作用、结缔组织异常、生长不对称及生物力学作用等,但并无统一的病因学解释.

  2. The association of rs1149048 polymorphism in matrilin-1(MATN1) gene with adolescent idiopathic scoliosis susceptibility: a meta-analysis.

    Science.gov (United States)

    Zhang, Hongqi; Zhao, Shushan; Zhao, Zijin; Tang, Lanhua; Guo, Qiang; Liu, Shaohua; Chen, Lizhang

    2014-01-01

    Several previous studies have evaluated the association between rs1149048 polymorphism in the matrilin-1 gene (MATN1) and the risk of adolescent idiopathic scoliosis (AIS). However the results of those studies were inconsistent. We conducted this meta-analysis to assess whether rs1149048 polymorphism was involved in the risk of AIS and evaluated the associations in different ethnicities. Electronic databases, such as: PubMed, EMBASE, WANFANG databases in any languages up to Dec 2012 were searched to assess the association between rs1149048 polymorphism and AIS. Meta-analysis was performed by STATA 12.0 software to estimate the pooled odds ratio (OR) and the 95 % confidence interval (CI). Finally four papers including five studies which involved 1436 AIS patients and 1,879 controls were identified for this meta-analysis. The results showed that G allele of the rs1149048 was significantly associated with increased AIS risk [OR = 1.13, 95 % CI (1.02-1.25), P = 0.023]. As for genotype (GG vs. GA + AA), homozygous GG genotype was also found to be a risk factor of developing AIS. The subgroup meta-analysis results showed G allele and GG genotype were significantly associated with AIS in Asian group but not in Caucasian group. Neither Egger's test nor Begg's test found evidence of publication bias in current study (P > 0.05). In summary, this meta-analysis found an overall significant association of rs1149048 polymorphism with risk of AIS, especially in Asian population. The relationship between rs1149048 polymorphism and AIS in other ethnic population is needed to be investigated.

  3. A retrospective study to reveal factors associated with postoperative shoulder imbalance in patients with adolescent idiopathic scoliosis with double thoracic curve.

    Science.gov (United States)

    Lee, Choon Sung; Hwang, Chang Ju; Lim, Eic Ju; Lee, Dong-Ho; Cho, Jae Hwan

    2016-12-01

    OBJECTIVE Postoperative shoulder imbalance (PSI) is a critical consideration after corrective surgery for a double thoracic curve (Lenke Type 2); however, the radiographic factors related to PSI remain unclear. The purpose of this study was to identify the radiographic factors related to PSI after corrective surgery for adolescent idiopathic scoliosis (AIS) in patients with a double thoracic curve. METHODS This study included 80 patients with Lenke Type 2 AIS who underwent corrective surgery. Patients were grouped according to the presence [PSI(+)] or absence [PSI(-)] of shoulder imbalance at the final follow-up examination (differences of 20, 15, and 10 mm were used). Various radiographic parameters, including the Cobb angle of the proximal and middle thoracic curves (PTC and MTC), radiographic shoulder height (RSH), clavicle angle, T-1 tilt, trunk shift, and proximal and distal wedge angles (PWA and DWA), were assessed before and after surgery and compared between groups. RESULTS Overall, postoperative RSH decreased with time in the PSI(-) group but not in the PSI(+) group. Statistical analyses revealed that the preoperative Risser grade (p = 0.048), postoperative PWA (p = 0.028), and postoperative PTC/MTC ratio (p = 0.011) correlated with PSI. Presence of the adding-on phenomenon was also correlated with PSI, although this result was not statistically significant (p = 0.089). CONCLUSIONS Postoperative shoulder imbalance is common after corrective surgery for Lenke Type 2 AIS and correlates with a higher Risser grade, a larger postoperative PWA, and a higher postoperative PTC/MTC ratio. Presence of the distal adding-on phenomenon is associated with an increased PSI trend, although this result was not statistically significant. However, preoperative factors other than the Risser grade that affect the development of PSI were not identified by the study. Additional studies are required to reveal the risk factors for the development of PSI.

  4. Administration of tranexamic acid to patients undergoing surgery for adolescent idiopathic scoliosis evokes pain and increases the infusion rate of remifentanil during the surgery

    Science.gov (United States)

    Ohashi, Nobuko; Ohashi, Masayuki; Endo, Naoto; Kohno, Tatsuro

    2017-01-01

    Background We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Methods Data were collected from patients with AIS who underwent posterior spinal fusion surgery from January 2008 to December 2015. All surgical procedures were performed under total intravenous anesthesia with propofol and remifentanil, by the same team of orthopedic surgeons and anesthesiologists at a single institution. Patients in the TXA group were administered TXA (loading and maintenance doses, 1000 mg and 100 mg/h) whereas those in the control group were not. Our primary outcome was the infusion rate of the intraoperative opioid analgesic remifentanil. Results The final analysis was based on data collected from 33 and 30 patients in the control and TXA groups, respectively. No differences were observed in the demographic data or the hemodynamic parameters between the two groups of patients. In the TXA group, the durations of surgery and anesthesia were shorter, intravascular fluid volume and total blood loss were lower, and the doses of fentanyl and ketamine administered were higher than they were in the control group (P pain during the surgery. PMID:28282425

  5. Comparative Analysis of Interval, Skipped, and Key-vertebral Pedicle Screw Strategies for Correction in Patients With Lenke Type 1 Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Wang, Fei; Xu, Xi-Ming; Lu, Yanghu; Wei, Xian-Zhao; Zhu, Xiao-Dong; Li, Ming

    2016-03-01

    Pedicle screw constructs have become the mainstay for surgical correction in patients with spinal deformities. To reduce or avoid the risk of pedicle screw-based complications and to decrease the costs associated with pedicle screw instrumentation, some authors have introduced interval, skipped, and key-vertebral pedicle screw strategies for correction. However, there have been no comparisons of outcomes among these 3 pedicle screw-placement strategies.The aim of this study was to compare the correlative clinical outcomes of posterior correction and fusion with pedicle screw fixation using these 3 surgical strategies.Fifty-six consecutive patients with Lenke type 1 adolescent idiopathic scoliosis were included in this study. Twenty patients were treated with the interval pedicle screw strategy (IPSS), 20 with the skipped pedicle screw strategy (SPSS), and 16 with the key-vertebral pedicle screw strategy (KVPSS). Coronal and sagittal radiographs were analyzed before surgery, at 1 week after surgery, and at the last follow-up after surgery.There were no significant differences among the 3 groups regarding preoperative radiographic parameters. No significant difference was found between the IPSS and SPSS groups in correction of the main thoracic curve (70.8% vs 70.0%; P = 0.524). However, there were statistically significant differences between the IPSS and KVPSS groups (70.8% vs 64.9%) and between the SPSS and KVPSS groups (70.0% vs 64.9%) in correction of the main thoracic curve (P SPSS group was significantly higher than those in the IPSS (P SPSS and KVPSS groups (P SPSS, it can achieve a satisfactory clinical outcome and is more cost-effective.

  6. Update on evaluation and treatment of scoliosis.

    Science.gov (United States)

    El-Hawary, Ron; Chukwunyerenwa, Chukwudi

    2014-12-01

    Scoliosis is a spinal deformity that can be seen in children of all ages. It is most commonly seen as an adolescent idiopathic condition. Progressive scoliosis between 25° and 45° before skeletal and physiologic maturity can be treated with a brace, whereas progressive scoliosis greater than 50° should be treated surgically. For children younger than 10 years, it is important to not only prevent scoliosis from worsening but to also maintain the growth of the spine and chest wall through the use of growth-friendly surgical techniques. Spinal fusion and instrumentation surgery is generally reserved for adolescent patients.

  7. Imaging in scoliosis: What, why and how?

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N.; Eisenstein, S.M

    2002-07-01

    Scoliosis may be a spinal manifestation of underlying disease and although most cases of scoliosis are idiopathic, imaging plays a very important role in determining the underlying aetiology and in monitoring the changes of the deformity that take place with growth. As a clinical problem scoliosis may present directly to the radiology department through a primary healthcare referral, or it may be referred from the paediatric, orthopaedic, spinal and neurosurgical hospital services. Growth affects all types of scoliosis irrespective of cause. There are no reliable predetermined algorithmic steps in the management of scoliosis, and treatment decisions require the inclusion of multiple extrinsic (e.g age, menarche) and intrinsic (curve magnitude, vertebral anomaly) factors. It is important to remember that most of what is known about curve behaviour and its progression applies to idiopathic scoliosis, and it is inappropriate to apply these criteria to the other specific types of scoliosis. It is imperative that radiation techniques are used judiciously to minimize the radiation burden. Although magnetic resonance imaging (MRI) has had a significant impact in the understanding of the scoliotic deformity, it is still evolving and it may well eventually play a very important role in uncovering the underlying aetiology of 'idiopathic' scoliosis. Cassar-Pullicino, V.N. and Eisenstein, S.M. (2002)

  8. Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools

    OpenAIRE

    Berdishevsky, Hagit; Lebel, Victoria Ashley; Bettany-Saltikov, Josette; Rigo, Manuel; Lebel, Andrea; Hennes, Axel; Romano, Michele; Białek, Marianna; M’hango, Andrzej; Betts, Tony; de Mauroy, Jean Claude; Durmala, Jacek

    2016-01-01

    In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called “wait and see” approach that far too many doctors use when evaluating children’s scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scol...

  9. Scoliosis (image)

    Science.gov (United States)

    Abnormal curvature in the spine is known as scoliosis, and generally begins just at the onset of ... growth. Most junior high schools routinely screen for scoliosis because, if caught early, progressive spine curvature can ...

  10. Study of the pressures applied by a Chêneau brace for correction of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Pham, V M; Houilliez, A; Schill, A; Carpentier, A; Herbaux, B; Thevenon, A

    2008-09-01

    We performed a study on 32 idiopathic scoliotic patients (30 females, 2 males) treated with a Chêneau brace. Eighteen patients had a single right thoracic curve and 14 had a single right thoracolumbar curve. We used the TekScan system (ClinSeat Type 5315 Sensor, TekScan, Boston MA, USA) to measure pressures at the skin-brace interface, assess the effect of strap tension and analyze the variation of these pressures with position and activity. The TekScan device enabled identification of the pressure areas corresponding to the brace's three loading points. The pressure under the main pad had a greater mean value than the pressure under the two counter-pads. Tightening the straps led to a significant increase in the pressures, whatever the position studied or the curve pattern. Compared with the standing (reference) position, we observed significantly higher pressures during maximal inspiration (p TekScan system does not provide direct information on the correction of spinal curvature, it appears to be a useful tool in the treatment of scoliotic patients. Strap adjustment clearly influences the applied pressures - particularly those on the rib cage. During activity, there is a natural tendency to decrease the pressure; this justifies efforts to maintain strap tensions in general and during day wear in particular.

  11. The Superiority of Intraoperative O-arm Navigation-assisted Surgery in Instrumenting Extremely Small Thoracic Pedicles of Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Liu, Zhen; Jin, Mengran; Qiu, Yong; Yan, Huang; Han, Xiao; Zhu, Zezhang

    2016-01-01

    Abstract To investigate the accuracy of O-arm navigation-assisted screw insertion in extremely small thoracic pedicles and to compare it with free-hand pedicle screw insertion in adolescent idiopathic scoliosis (AIS). A total of 344 pedicle screws were inserted in apical region (defined as 2 vertebrae above and below the apex each) of 46 AIS patients (age range 13–18 years) with O-arm navigation and 712 screws were inserted in 92 AIS patients (age range 11–17 years) with free-hand technique. According to the narrowest diameter orthogonal to the long axis of the pedicle on a trajectory entering the vertebral body on preoperative computed tomography, the pedicles were classified into large (>3 mm) and small (≤3 mm) subgroups. Furthermore, a subset of extremely small pedicles (≤2 mm in the narrowest diameter) was specifically discussed. Screw accuracy was categorized as grade 0: no perforation, grade 1: perforation by less than 2 mm, grade 2: perforation by 2 to 4 mm, grade 3: perforation over 4 mm. In the O-arm group, the mean thoracic pedicle diameters were 2.23 mm (range 0.7–2.9 mm) and 3.48 mm (3.1–7.1 mm) for small and large pedicles, respectively. In the free-hand group, the small and large thoracic pedicle diameters were 2.42 mm (range 0.6–2.9 mm) and 3.75 mm (3.1–6.9 mm), respectively. The overall accuracies of screw insertion in large and small thoracic pedicles (grade 0, 1) were significantly higher in O-arm group (large: 93.8%, 210/224, small: 91.7%, 110/120) than those of free-hand group (large: 84.9%, 353/416, small: 78.4%, 232/296) (P < 0.05). Importantly, the overall accuracy of screw placement in extremely small pedicles was significantly higher in the O-arm group (84.3%, 48/57) compared with 62.7% (79/126) in free-hand group (P < 0.05), and the incidence of medial perforation was significantly lower in O-arm group (11.1%, 1/9) compared with 17.0% (8/47) in free-hand group (P < 0.05). The O

  12. Validade da fotogrametria computadorizada na detecção de escoliose idiopática adolescente Validity of computed photogrammetry for detecting idiopathic scoliosis in adolescents

    Directory of Open Access Journals (Sweden)

    MB Döhnert

    2008-08-01

    Full Text Available INTRODUÇÃO: A escoliose idiopática adolescente (EIA é uma alteração tridimensional da coluna vertebral. Sua etiologia é desconhecida e seu início ocorre no início da puberdade, tendo sua progressão associada ao estirão de crescimento. A análise angular de movimento e postura corporal através da imagem estática, conhecida como fotogrametria, permite ao fisioterapeuta quantificar e qualificar sua avaliação da postura/movimento corporal. OBJETIVO: Este estudo foi realizado para avaliar a sensibilidade deste instrumento na detecção da EIA no exame escolar. MÉTODOS: Estudo transversal de base escolar sobre alunos de 5ª a 8ª série do ensino fundamental das redes pública e particular de Pelotas. Foram realizados coleta de imagem digital e exame radiográfico em postura antero-posterior e perfil. A sensibilidade e especificidade da fotogrametria foram verificadas utilizando três e dois graus de margem para desnivelamento da superfície corporal. RESULTADOS: Duzentos e vinte e quatro alunos realizaram o exame de fotogrametria na escola e o exame radiológico padrão. A prevalência de EIA foi de 4,5% (n=10, sendo oito meninas e dois meninos, com média de 13,3º Cobb; média de 1,1 para rotação vertebral (Nash-Moe; 29,5º Cobb para cifose dorsal; 3,6º para ângulo íleo-lombar; e sinal de Risser em 1,6. Para trêsº, a sensibilidade foi de 21,4% e a especificidade de 90,7%. Utilizando dois graus, a sensibilidade foi de 50% e a especificidade de 61,2%. CONCLUSÕES: Com base nestes resultados, verificou-se que a fotogrametria computadorizada não pode ser realizada como screening para detecção de escoliose de grau leve nas escolas.INTRODUCTION: Adolescent idiopathic scoliosis (AIS is a three-dimensional abnormality of the spine, of unknown etiology. It starts at the beginning of puberty and its progression is associated with the growth spurt. Analysis of angular movement and body posture through the static imaging method known

  13. Functional Investigation of a Non-coding Variant Associated with Adolescent Idiopathic Scoliosis in Zebrafish: Elevated Expression of the Ladybird Homeobox Gene Causes Body Axis Deformation.

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    Long Guo

    2016-01-01

    Full Text Available Previously, we identified an adolescent idiopathic scoliosis susceptibility locus near human ladybird homeobox 1 (LBX1 and FLJ41350 by a genome-wide association study. Here, we characterized the associated non-coding variant and investigated the function of these genes. A chromosome conformation capture assay revealed that the genome region with the most significantly associated single nucleotide polymorphism (rs11190870 physically interacted with the promoter region of LBX1-FLJ41350. The promoter in the direction of LBX1, combined with a 590-bp region including rs11190870, had higher transcriptional activity with the risk allele than that with the non-risk allele in HEK 293T cells. The ubiquitous overexpression of human LBX1 or either of the zebrafish lbx genes (lbx1a, lbx1b, and lbx2, but not FLJ41350, in zebrafish embryos caused body curvature followed by death prior to vertebral column formation. Such body axis deformation was not observed in transcription activator-like effector nucleases mediated knockout zebrafish of lbx1b or lbx2. Mosaic expression of lbx1b driven by the GATA2 minimal promoter and the lbx1b enhancer in zebrafish significantly alleviated the embryonic lethal phenotype to allow observation of the later onset of the spinal curvature with or without vertebral malformation. Deformation of the embryonic body axis by lbx1b overexpression was associated with defects in convergent extension, which is a component of the main axis-elongation machinery in gastrulating embryos. In embryos overexpressing lbx1b, wnt5b, a ligand of the non-canonical Wnt/planar cell polarity (PCP pathway, was significantly downregulated. Injection of mRNA for wnt5b or RhoA, a key downstream effector of Wnt/PCP signaling, rescued the defective convergent extension phenotype and attenuated the lbx1b-induced curvature of the body axis. Thus, our study presents a novel pathological feature of LBX1 and its zebrafish homologs in body axis deformation at

  14. Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis

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    Santiago Tomas Bosio

    2016-02-01

    Full Text Available Objective:  To evaluate variations in cerebellar tonsil position after posterior spinal fusion (PSF in neurologically intact patients with adolescent idiopathic scoliosis (AIS.  Methods: We retrospective evaluated 40 patients with AIS and no neurological symptoms that underwent PSF. Anteroposterior and sagittal standing radiographs, and sagittal hindbrain MRI were performed in all patients before and after spinal surgery.  The level of the cerebellar tonsil relative to the magnum foramen was measured according to the method described by Aboulezz (J Comput Assist Tomogr 1985. We evaluate variations in cerebellar tonsil position in relation to spinal correction and spinal elongation after PSF. Results: Mean preoperative magnitude of the curve was 53,15° (SD 10,46° and thoracic kyphosis was 35,42º (SD 12,38°. Mean postoperative values were 7,45º (SD 7,33°  and 27,87º (SD 9,03°, respectively. This represents 86% correction in the coronal plane (p<0.00001 and 25% of kyphosis variation (p<0.00001. The average length of the spine in the coronal plane was 44,5 cm (SD 5,25 cm in preoperative x-rays and 48,27 cm (SD 4,40 cm in postoperative x-rays (p<0.00001.  The average length in the sagittal plane was 50,87 cm (SD 4,47 cm in preoperative x-rays and 55,13cm (SD 3,27 cm in postoperative x-rays (p<0.00001. There was no significant difference in the position of the Cerebellar Tonsil before and after spinal correction (p=0,6042. In 10 (25% of the 40 patients, we observed caudal displacement in cerebellar tonsil position after PSF. Average displacement in these patients was 1,22 mm (range 0.1-2.3 mm. In 21 patients we did not observe any variation and in 2 a cephalic displacement was measured. Conclusions:  In most AIS patients, position of the cerebellar tonsil does not change with PSF. We were not able to find any correlation between curve correction or spine elongation and variations in cerebellar tonsillar position.

  15. The experience of brace treatment in children/adolescents with scoliosis

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    Zafiri Vassiliki

    2006-05-01

    Full Text Available Abstract Background Idiopathic scoliosis is a chronic illness with several different braces used for its treatment. Brace treatment during childhood/adolescence can produce stress. There are studies supporting that it can decrease body-image perception while other studies support that it has no such effect. The purpose of this study was to explore the experience of brace treatment in children/adolescents with scoliosis. The aim was to investigate which feelings are created by the bracing experience in children/adolescents with scoliosis and what are the children/adolescents' with scoliosis opinions of the support provided to them by health-care professionals and by their families. Methods We conducted interviews with the help of a semi-structured interview guide in order to address the topic of the experience of brace treatment. A convenient sample of twelve children and adolescents with scoliosis was selected from patients attending follow-up appointments at the Outpatient Scoliosis Clinics of two Greek hospitals. The data was analysed using the method of content analysis. Results Patients in the sample were 10–16 years old and they were mainly females (71%. Almost all of the participants reported having to deal with stress, denial, fear, anger, and shame. They were satisfied with the information they received regarding their condition and therapy. However, the information was not accompanied by support from the health care professionals. They reported that they were receiving support mainly from their families, friends, and classmates. Conclusion The present study is contributing to the development of a better understanding of significant issues related to the experience of bracing therapy. It is clear that scoliosis children/adolescents have to be provided with support during the long period of bracing. It is apparent that those children/adolescents have unmet needs for care and health professionals and policy makers should try to find a

  16. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  17. The utility of superficial abdominal reflex in the initial diagnosis of scoliosis: a retrospective review of clinical characteristics of scoliosis with syringomyelia

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    Fujimori Takahito

    2010-08-01

    Full Text Available Abstract Background With increasing use of magnetic resonance imaging (MRI, underlying syringomyelia is increasingly found in patients with presumed idiopathic scoliosis. To determine the indications for MRI in the differential diagnosis of scoliosis, several clinical characteristics of syringomyelia have been reported. Neurological signs, particularly abnormal superficial abdominal reflex (SAR, are important in establishing the initial diagnosis of scoliosis. However, the prevalence of abnormal SAR in patients with scoliosis and the sensitivity of this sign in predicting syringomyelia are not well known. We aimed to determine the diagnostic utility of SAR and other characteristics of syringomyelia in patients with scoliosis. Methods We reviewed the medical records of 93 patients with scoliosis, 90 of whom underwent corrective surgery. All patients underwent MRI to determine the presence of syringomyelia. Mean age at surgery was 12.5 years. Abnormal SAR was defined as unilateral or bilateral absence or hyporeflexia of SAR. We calculated indices of diagnostic utility of abnormal SAR for non-idiopathic scoliosis and for syringomyelia. Abnormal SAR, left thoracic curve pattern, gender, and curve flexibility were compared between scoliosis with syringomyelia and idiopathic scoliosis. Logistic regression analysis was performed with the existence of syringomyelia as the dependent variable and curve flexibility as the independent variable. Results Abnormal SAR was observed in 20 patients (prevalence 22%. All 6 patients with myopathic scoliosis displayed bilateral absence of SAR. The sensitivity of abnormal SAR for non-idiopathic scoliosis was 38%, with 96% specificity, 90% PPV (positive predictive value, and 60% NPV (negative predictive value. Syringomyelia was identified in 9 of the 93 patients (9.7%; 8 of these had abnormal SAR. The sensitivity of abnormal SAR for syringomyelia in presumed idiopathic scoliosis was 89%, with 95% specificity, 80% PPV

  18. Improving the measurement of health-related quality of life in adolescent with idiopathic scoliosis: the SRS-7, a Rasch-developed short form of the SRS-22 questionnaire.

    Science.gov (United States)

    Caronni, Antonio; Zaina, Fabio; Negrini, Stefano

    2014-04-01

    Scoliosis Research Society-22 (SRS-22) questionnaire was developed to evaluate health-related quality of life (HRQL) in adolescent idiopathic scoliosis (AIS) patients. Rasch analysis (RA) is a statistical procedure which turns questionnaire ordinal scores into interval measures. Measures from Rasch-compatible questionnaires can be used, similar to body temperature or blood pressure, to quantify disease severity progression and treatment efficacy. Purpose of the current work is to present Rasch analysis (RA) of the SRS-22 questionnaire and to develop an SRS-22 Rasch-approved short form. 300 SRS-22 were randomly collected from 2447 consecutive IS adolescents at their first evaluation (229 females; 13.9 ± 1.9 years; 26.9 ± 14.7 Cobb°) in a scoliosis outpatient clinic. RA showed both disordered thresholds and overall misfit of the SRS-22. Sixteen items were re-scored and two misfitting items (6 and 14) removed to obtain a Rasch-compatible questionnaire. Participants HRQL measured too high with the rearranged questionnaire, indicating a severe SRS-22 ceiling effect. RA also highlighted SRS-22 multidimensionality, with pain/function not merging with self-image/mental health items. Item 3 showed differential item functioning (DIF) for both curve and hump amplitude. A 7-item questionnaire (SRS-7) was prepared by selecting single items from the original SRS-22. SRS-7 showed fit to the model, unidimensionality and no DIF. Compared with the SRS-22, the short form scale shows better targeting of the participants' population. RA shows that SRS-22 has poor clinimetric properties; moreover, when used with AIS at first evaluation, SRS-22 is affected by a severe ceiling effect. SRS-7, an SRS-22 7-item short form questionnaire, provides an HRQL interval measure better tailored to these participants.

  19. Prevalence of Idiopathic Scoliosis in Primary School Children in Beitang District, Wuxi, Jiangsu, China%无锡市北塘区小学生特发性脊柱侧凸患病率调查

    Institute of Scientific and Technical Information of China (English)

    郑瑜; 吴晓珺; 孙宁; 杨艳; 王涛; Jan D.Reinhardt; 党英杰

    2016-01-01

    Objective To investigate the epidemiology of idiopathic scoliosis in China based on a representative sample of primary school children from Beitang district, Wuxi, Jiangsu, China. Methods All 11,024 primary school pupils from 11 schools aged 6-13 years were enrolled. A scoliometer was applied to initially screen for idiopathic scoliosis. Those angle of trunk rotation above 4° was invited to a clinical visit. Definite diagnosis was made based on a Cobb angle of 10° or above by X-ray. Inverse probability weights were used to adjust for non-attendance of the physical examination. Results 282 children (2.6%) were screened positive and 128 of them accepted clinical pro-gram. 11 children were diagnosed as idiopathic scoliosis, suggesting a prevalence rate of around 0.22%in primary school children in Wuxi. Adjusted for non-response estimated prevalence was slightly lower at 0.21%. Prevalence was higher in girls than in boys. The highest preva-lence was found in girls aged 12-13 years. None confirmed case was found in children younger than 10 years old. Conclusion A relatively low overall prevalence of idiopathic scoliosis was found in primary school children of Beitang district, Wuxi. It is suggested to focus on chil-dren aged 10-13 years, while the screening for the 6-9 years olds could be slightly postponed.%目的 调查无锡市北塘区小学生特发性脊柱侧凸患病率.方法 2014年3~6月对江苏省无锡市北塘区全部11所小学11,024名6~13岁小学生进行特发性脊柱侧凸调查.调查工作分为学校筛查和医院确诊两个部分.学校筛查包括躯干对称性检查、脊柱前屈试验和脊背倾斜角测量;脊背倾斜角>4°者接受全脊柱X片,Cobb角>10°者排除其他原因后确诊.采用基于逆概率权重的倾向指数模型进行患病率校正.结果 学校筛查阶段,脊柱倾斜角>4°小学生282名(2.6%),其中128名接受免费全面体格检查和全脊柱摄片,共11名被确诊为特发性脊柱侧凸.小学

  20. Spinal Fusion for Scoliosis in Rett Syndrome With an Emphasis on Respiratory Failure and Opioid Usage.

    Science.gov (United States)

    Rumbak, Dania M; Mowrey, Wenzhu; W Schwartz, Skai; Sarwahi, Vishal; Djukic, Aleksandra; Killinger, James S; Katyal, Chhavi

    2016-02-01

    Our objective was to characterize our experience with 8 patients with Rett syndrome undergoing scoliosis surgery in regard to rates of respiratory failure and rates of ventilator-acquired pneumonia in comparison to patients with neurologic scoliosis and adolescent idiopathic scoliosis. This study was a retrospective chart review of patients undergoing scoliosis surgery at a tertiary children's hospital. Patients were divided into 3 groups: (1) adolescent idiopathic scoliosis, (2) neurologic scoliosis, and (3) Rett syndrome. There were 133 patients with adolescent idiopathic scoliosis, 48 patients with neurologic scoliosis, and 8 patients with Rett syndrome. We found that patients with Rett syndrome undergoing scoliosis surgery have higher rates of respiratory failure and longer ventilation times in the postoperative period when compared with both adolescent idiopathic scoliosis and neurologic scoliosis patients. There is insufficient evidence to suggest a difference in the incidence of ventilator-acquired pneumonia between the Rett syndrome and the neurologic scoliosis group. We believe our findings are the first in the literature to show a statistically significant difference between these 3 groups in regard to incidence of respiratory failure.

  1. CLINICAL AND ELECTROENCEPHALOGRAPHIC CHARACTERISTICS OF IDIOPATHIC CHILDHOOD FOCAL EPILEPSY WITH CENTROTEMPORAL SPIKES

    Directory of Open Access Journals (Sweden)

    K. Yu. Mukhin

    2015-01-01

    Full Text Available Idiopathic childhood focal epilepsy with centrotemporal spikes, which is more known as rolandic epilepsy (RE, is age- and localization-related epilepsy with childhood onset, which is characterized mainly by short-lasting hemifacial and oropharyngeal seizures generally occurring when awakening or falling asleep, by the normal neurological status of patients, by specific electroencephalographic changes and complete arrest of seizures during therapy or when achieving puberty.RE is the most common epilepsy in childhood. Its prevalence is 21 per 100,000 healthy children. It is characterized by an onset that is clearly related to age. In 85 % of cases, RE occurs at 4–10 years of age with its peak at about 9 years. The clinical manifestations of this form of epilepsy are several types of seizures, such as oropharyngolaryngeal, hemifacial, faciobrachial, secondarily generalized convulsive, unilateral seizures with the possible development of short duration Todd’s paresis. Other types of seizures (absence, atonic, and myoclonic ones are uncharacteristic of RE. They may occur occasionally on aggravation resulting from the use of carbamazepine or oxcarbazepine or permanently on transformation into pseudo-Lennox syndrome. According to the definition, focal neurological symptoms and behavioral and intellectual disorders are absent in patients with RE. However, there have been recent observations suggesting that speech, cognitive, and behavioral disorders may occur (at the same time rarely in children with RE. Magnetic resonance imaging (MRI fails to reveal the abnormality in the vast majority of cases. The described MRI changes in nearly 10 % of the patients with RE are an incidental finding and irrelevant to the course of the disease. Valproate in small doses is a first-choice drug; if it is inefficient, levetiracetam, topiramate, or a combination of valproate and ethosuximide are administered. Sulthiame (ospolot as monotherapy is used in Germany

  2. [Scoliosis secondary to tuberculous spondylitis: A case report and discussion of diagnosis].

    Science.gov (United States)

    Bouillot, L; Kayayan, H; Goiset, E

    2015-12-01

    Idiopathic scoliosis is the most common form of spinal deformity in adolescence. However, secondary causes of scoliosis should always be considered so as to provide appropriate treatment and avoid complications. Additional explorations, such as MRI, are required in the presence of atypical signs. We report a case of spinal tuberculosis, or Pott's disease, misdiagnosed as idiopathic scoliosis, and then present a discussion to help identify the warning signs during the evaluation of scoliosis that might indicate secondary scoliosis and suggest when to perform further radiologic exploration.

  3. 三亚市青少年脊柱侧凸畸形患病率调查%Epidemiology of adolescent idiopathic scoliosis in Sanya

    Institute of Scientific and Technical Information of China (English)

    马建国; 刘强; 陈政伟; 林明卓; 高志明

    2015-01-01

    目的:了解三亚市中小学生特发型脊柱侧凸畸形(AIS)的患病情况。方法采用横断面研究方法,随机抽查三亚市城乡10所中学10~16岁中学生6952名,其中男生3750名,女生3202名。首先通过观察体检者的肩部和肩胛骨的对称性以及Adams试验筛选出疑似患者。对于AIS疑似患者,进一步采用全脊柱正侧位X射线摄片来明确脊柱侧凸诊断。结果6952名中小学生中共检筛出AIS疑似患者375名(男性191名,女性184名),其中358名疑似患者接受进一步检查,最终明确AIS患者88名(1.27%),男性42名(0.60%),女性46名(0.66%),男、女比率为1:0.91,但二者患病率比较差异无统计学意义(χ2=1.39,P>0.05)。结论三亚市公立学校中小学生AIS患病率为1.27%,男女患病率相当。%Objective To investigate the prevalence of adolescent idiopathic scoliosis (AIS) in elementary and junior middle school students in public schools in Sanya, China. Methods In a cross-sectional study, 6 952 stu-dents (3 750 males and 3 202 females) aged from 10 to 16 years old were randomly selected from 10 public schools. We evaluated the symmetry of the shoulders, the scapulae, and the Adams test. In suspected cases, students were re-ferred to panoramic radiographs of the spine. Results A total of 6 952 students participated in the study, of which 375 were suspected of AIS (191 males and 184 females). Then 358 of the suspected students took radiographs, and 88 were diagnosed with AIS (42 males and 46 females), with the prevalence of 1.27%. Thus, the prevalence rate of male student was 1.12%, and that of the female was 1.44%. The ratio between the male and female was 1:1.29. The chi-square test suggested that there was no significant statistical difference in prevalence between the genders (χ2=1.39, P>0.05). Conclusion The prevalence rate of AIS in the public schools of Sanya is 1.27%. And the prevalence rate between the male and the female has no

  4. Clinical Research Progress of Adolescent Idiopathic Scoliosis%青少年脊柱侧弯的临床诊治进展

    Institute of Scientific and Technical Information of China (English)

    赵平; 田青

    2011-01-01

    Adolescent Idiopathic Scoliosis (AIS) is one of diseases most difficult to be dealt with medically. Apart from the physiological suffering to the patient, AIS gives enormous financial pressure upon the involved family and state governments of many countries, which earned a reputation as one of the toughest problems in medical field. The paper reviews the recent clinical studies about AIS and found that results of the modern researches are full of clinical paradox. The ambiguities or arguing about what we have done to AIS in the past arouses many debates in the field. The paper also put up some new ideas in treating AIS patient based on the author's clinical experiences, which makes full use of compensation power inside spinal column for maintaining self-balance. It changes the principle of the therapy from correcting the deformation of spine to assisting the compensating power inside the spine for self-balance system instead. It also put more weight on changing the attitude toward AIS children in order not to depress them psychologically, which make them psychologically "diseased" all of their life. Chinese philosophy will play an important role in author's idea of treating AIS patients, which bases mostly on the nature rule of "Yin-Yang" self-balance and compensation system naturally existed inside spinal column. The reviews provide strong supports for that new idea of therapeutic principle will be practically significant in dealing with the patients suffering from AIS.%青少年特发性脊柱侧弯(AIS)既对患儿及家庭所造成的痛苦,也对患者家庭和国家财政都造成沉重的经济负担,引发各国及各级政府的高度关注.但是,随着对AIS了解的深入,质疑和犹豫也逐渐产生.本文回顾当前关于AIS的临床和基础研究结果,发现其中许多研究结论都充满了临床悖论.本文还通过总结作者单位的临床经验,提出的AIS诊治新原则.该原则利用脊柱对于AIS的充

  5. [How to treat an idiopatic scoliosis].

    Science.gov (United States)

    Korbelář, Petr

    2016-01-01

    Scoliosis is a three-dimensional deformity of the spine. In its most common form idiopathic scoliosis (70 to 80 % of cases), the causes are unknown. It is defined as a curve of at least 10°, measured on a standing radiograph using the Cobb technique. A severe form of scoliosis is more commonly found in females. Typically scoliosis does not cause any health problems during growth (except for extreme cases). Patients are generally treated in an attempt to halt the progressive nature of the deformity. We present a treatment of different kind of curves.By the end of growth, the risk of health and social problems in adulthood increases significantly. Problems include reduced quality of life, disability, pain, increased cosmetic deformity, functional limitations, sometimes pulmonary problems, and progression during adulthood. It is necessary to start with the treatment ASAP, because the management of scoliosis includes the prevention of secondary problems associated with the deformity.

  6. Adolescent Scoliosis Screening in Nara City Schools: A 23-Year Retrospective Cross-Sectional Study

    OpenAIRE

    Yamamoto, Satoshi; Shigematsu, Hideki; Kadono, Fumihiko; Tanaka, Yukihiro; Tatematsu, Masataka; Okuda, Akinori; Iwata, Eiichiro; Koizumi, Munehisa; Tanaka, Yasuhito

    2015-01-01

    Study Design Retrospective cross-sectional study. Purpose To determine the prevalence of idiopathic scoliosis, define the distribution of the curve magnitude, evaluate the accuracy of Moiré topography as a screening tool, and investigate the cost-effectiveness of our screening system. Overview of Literature Early detection of idiopathic scoliosis provides the opportunity for conservative treatment before the deformity is noticeable. We believe that scoliosis screening in schools is useful for...

  7. Adolescent Scoliosis Screening in Nara City Schools: A 23-Year Retrospective Cross-Sectional Study.

    OpenAIRE

    YAMAMOTO, Satoshi; Shigematsu, Hideki; Kadono, Fumihiko; Tanaka, Yukihiro; Tatematsu, Masataka; Okuda, Akinori; Iwata, Eiichiro; Koizumi, Munehisa; Tanaka, Yasuhito

    2015-01-01

    STUDY DESIGN: Retrospective cross-sectional study. PURPOSE: To determine the prevalence of idiopathic scoliosis, define the distribution of the curve magnitude, evaluate the accuracy of Moiré topography as a screening tool, and investigate the cost-effectiveness of our screening system. OVERVIEW OF LITERATURE: Early detection of idiopathic scoliosis provides the opportunity for conservative treatment before the deformity is noticeable. We believe that scoliosis screening in schools is useful ...

  8. Clinical effect of continuous corrective force delivery in the non-operative treatment of idiopathic scoliosis : a prospective cohort study of the triaC-brace

    NARCIS (Netherlands)

    Bulthuis, Gerben J.; Veldhuizen, Albert G.; Nijenbanning, Gert

    2008-01-01

    A prospective cohort study of skeletally immature idiopathic scoliotic patients treated with the TriaC brace. To determine if the TriaC brace is effective in preventing curve progression in immature adolescent idiopathic scoliotic patients with a very high risk of curve progression based on reported

  9. Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes

    Directory of Open Access Journals (Sweden)

    McPhee Ian

    2007-02-01

    Full Text Available Abstract Study design and aim This was a longitudinal chart review of a diverse group (cohort of patients undergoing HGH (Human Growth Hormone treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis. Methods and cohort 185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle of scoliosis were recorded. Results Four (3.6% of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population and scoliosis progression was not prospectively observed. 13 (28.8% of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48% of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis. Conclusion In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four. An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.

  10. 支具治疗对青少年特发性脊柱侧凸近期肺功能的影响%Recent influence of brace - treatment on lung function with adolescence idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    陶有平; 吴继功; 马华松; 邹德威; 陈志明; 谭荣; 张乐乐; 白克文; 姬勇

    2011-01-01

    [目的]比较青少年特发性脊柱侧凸患者支具治疗前与末次随访肺功能的变化,探讨支具治疗对患者近期肺功能的影响.[方法]对2009年2月~2010年10月在本院接受规范支具治疗的40例青少年特发性脊柱侧凸患者;其中男性4人,女性36人;初诊时年龄10 ~14岁,平均12.2岁,骨骼发育Risser征0~Ⅱ度,平均1.1度;观察支具治疗前、末次随访时主侧凸冠状Cobb角以及肺功能等指标的变化.[结果]随访时间为6~17个月,平均8个月;支具治疗前主侧凸冠状Cobb角(28.41±6.45)°,末次随访时主侧凸冠状Cobb角(16.21±10.22)°,平均矫正率为43.56%,两者差异有显著性意义(P<0.05);支具治疗前、末次随访时肺功能指标VC(肺活量)、FEV1(第1 s时间肺活量)、MVV(最大通气量)实测值及占预计值百分率进行比较,结果有显著性差异(P<0.05).随访期间患者脊柱侧凸的进展均得到有效控制,患者无明显呼吸困难及活动功能障碍等并发症.[结论]支具治疗对青少年特发性脊柱侧凸有矫正效果;但是对患者近期肺功能可能有消极影响,患者在佩戴支具期间需要加强对肺功能的锻炼.%[Objective] To evaluate the lung function changes during brace -treatment with adolescent idiopathic scolio-sis, and to analyze the recent influence of brace - treatment on lung function with adolescence idiopathic scoliosis. [Methods] Forty cases with adolescence idiopathic scoliosis were treated with brace from Feb 2009 to Oct 2010. Four were male and 36 were female with mean age of 12. 2 years (from 10 to 14) . The Risser grade were 0-2 degree, average 1.1. The clinical and radiological date including Cobbs angle of major curve, average preliminary corrective rate and lung function measurements were recorded. [Results] Follow-up period ranged from 6 to 17 months (mean 8 months) . The brace could obviously prevent the curve progression. The Cobb angle of major curve reduced

  11. Efficacy analysis for adolescent idiopathic scoliosis treated with Milwaukee or Boston orthosis%Milwaukee和Boston支具治疗青少年特发性脊柱侧凸的疗效分析

    Institute of Scientific and Technical Information of China (English)

    张宏其; 黄术; 盛斌; 高琪乐; 王昱翔; 郭超峰; 唐明星

    2011-01-01

    目的 评估Milwaukee和Boston支具不同佩戴方式对于治疗青少年脊柱侧凸疗效.方法 回顾总结2004年2月至2009年3月间对85例骨骼发育未成熟的青少年特发性脊柱侧凸患儿的诊治.支具治疗的57例患儿,分别接受颈胸腰骶支具( CTLSO) -Milwaukee支具(28例)和胸腰骶矫形支具(TLSO) -Boston支具(29例)并辅以体操矫正.其中30例规律佩戴,每天21 ~23 h;27例间断佩戴,每天6 ~ 15 h;另28例未佩戴相应支具.每3~6个月定期观察患儿Cobb角和Risser征,复查时均摄佩带和卸下支具站立位全脊柱正侧位X线片及外观大体像.结果 73例获得2~5年的临床随访,时间(26.3±33.7)个月.Milwaukee支具组:规律佩戴支具类有效率达91.67%(11/12),间断佩戴支具类有效率达56.25%(9/16),未佩戴支具类有效率为20%(4/20).经比较Milwaukee支具规律类优于支具间断类和无支具类(P<0.05).Boston支具组:规律佩戴支具类有效率达88.89%(16/18),间断佩戴支具类有效率达54.55%(6/11),未佩戴支具类有效率为25%(2/8).经比较Boston支具规律类优于支具间断类和无支具类(P<0.05).文中支具和患儿选择不同,因此未对两种支具临床疗效对比.结论 两种支具均应坚持正确规律的佩戴,两种支具组规律类疗效优于各支具组间断类和无支具类,对于符合支具治疗指征的AIS患儿疗效确切.%Objective To evaluate the efficacy about the different wearing manner with Milwaukee and Boston for the treatment of adolescent idiopathic scoliosis (AIS).Methods Retrospectively summarization and analysis was performed in 85 adolescent patients with idiopathic scoliosis who were treated from February 2004 to March 2009.The skeletal growth of them had not completed.There were 57 cases who received brace treatment.In them,28 were treated with (CTLSO) Milwaukee brace,and the rest were treated with (TLSO) Boston brace and orthopedic gymnastics.The 30 cases wear

  12. Role of rod diameter in comparison between only screws versus hooks and screws in posterior instrumentation of thoracic curve in idiopathic scoliosis

    OpenAIRE

    Lamartina, Claudio; Petruzzi, Maria; Macchia, Marcello; Stradiotti, Paola; Zerbi, Alberto

    2011-01-01

    Since the introduction of Cotrel–Dubousset instrumentation in 1984, the correction techniques in scoliosis surgery have changed from Harrington principles of concave distraction to segmental realignment to a variety of possibilities including the rod rotation manoeuvres, and to segmental approximation via cantilever methods. Additionally, pedicle screw utilization in lumbar curves enhanced correction and stabilization of various deformities, and various studies have strongly supported the cli...

  13. [Scoliosis: review of types, aetiology, diagnostics, and treatment 1].

    Science.gov (United States)

    de Baat, P; van Biezen, E C; de Baat, C

    2012-10-01

    A scoliosis is a flexible or rigid deformity of the spine in the frontal plane. There are several types of scoliosis, each with specific characteristics. The most prevalent types are idiopathic, congenital, and neuromuscular scoliosis and scoliosis in adults. The aetiology is varied and largely undetermined. Essential components of diagnostics are patient history, physical examination, and radiographs. Treatment options are a conservative approach involving observation and follow-up, a conservative approach involving non-surgical treatment, and surgical treatment. Usually, idiopathic scoliosis causes no or only few complaints at a young age. Up to 35% of patients have a certain degree of back pain. The choice of a certain treatment is determined by the likelihood of progression of the spine deformity. The objective of brace treatment is preventing progression of the deformity. Important objectives of surgical treatment are preventing progression of the deformity and correcting the deformity with correction or preservation of physical equilibrium.

  14. Intraspinal anomalies in scoliosis: An MRI analysis of 177 consecutive scoliosis patients

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2010-01-01

    Full Text Available Background : The association of intraspinal neural anomalies with scoliosis is known for more than six decades. However, there are no studies documenting the incidence of association of intraspinal anomalies in scoliotic patients in the Indian population. The guide lines to obtain an magnetic resonance imaging (MRI scan to rule out neuro-axial abnormalities in presumed adolescent idiopathic scoliosis are also not clear. We conducted a prospective study (a to document and analyze the incidence and types of intraspinal anomalies in different types of scoliosis in Indian patients. (b to identify clinico-radiological ′indicators′ that best predict the findings of neuro-axial abnormalities in patients with presumed adolescent idiopathic scoliosis, which will alert the physician to the possible presence of intraspinal anomalies and optimize the use of MRI in this sub group of patients. Materials and Methods : The data from 177 consecutive scoliotic patients aged less than 21 years were analyzed. Patients were categorized into three groups; Group A - congenital scoliosis (n=60, group B -presumed idiopathic scoliosis (n=94 and group C - scoliosis secondary to neurofibromatosis, neuromuscular and connective tissue disorders (n=23. The presence and type of anomaly in the MRI was correlated to patient symptoms, clinical signs and curve characteristics. Results : The incidence of intraspinal anomalies in congenital scoliosis was 35% (21/60, with tethered cord due to filum terminale being the commonest anomaly (10/21. Patients with multiple vertebral anomalies had the highest incidence (48% of neural anomalies and isolated hemi vertebrae had none. In presumed ′idiopathic′ scoliosis patients the incidence was higher (16% than previously reported. Arnold Chiari-I malformation (AC-I with syringomyelia was the most common neural anomaly (9/15 and the incidence was higher in the presence of neurological findings (100%, apical kyphosis (66.6% and early

  15. Lowest instrumented vertebra selection for Lenke 5C scoliosis

    DEFF Research Database (Denmark)

    Wang, Yu; Bünger, Cody Eric; Zhang, Yanqun;

    2013-01-01

    STUDY DESIGN: A radiographical follow-up and analysis. OBJECTIVE: To investigate the postoperative curve change in Lenke 5C scoliosis, and to discuss how to select lowest instrumented vertebra (LIV). SUMMARY OF BACKGROUND DATA: 5C curves are relatively rare in adolescent idiopathic scoliosis......, and few studies have focused on this type of adolescent idiopathic scoliosis. Such questions as "How does the curve change over time in the postoperative period?" "Is LIV selection correlated with final correction and balance?" and "How should we select LIV for Lenke 5C curves?" need to be answered....... METHODS: We reviewed all the adolescent idiopathic scoliosis cases surgically treated in an institution from 2002 through 2008. Inclusion criteria were as follows: (1) patients with Lenke 5C curves who were treated with selective lumbar fusion; (2) minimum 2-year radiographical follow-up.All image data...

  16. Aspectos genéticos da escoliose idiopática do adolescente Aspectos genéticos de la escoliosis idiopática del adolescente Genetic aspects of the adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Marcelo Wajchenberg

    2012-09-01

    Full Text Available A escoliose idiopática do adolescente é uma doença frequente e sua etiologia permanece obscura. Várias hipóteses foram formuladas, entre elas a possibilidade da transmissão genética. Estudos na literatura procuraram analisar a prevalência da doença em determinadas populações, as possíveis formas de transmissão, a localização dos genes responsáveis e as variações de determinados genes (polimorfismos que podem influenciar o desenvolvimento da deformidade. O objetivo deste artigo é revisar e atualizar os conceitos sobre a influência genética na etiologia da escoliose idiopática do adolescente.La escoliosis idiopática del adolescente es una enfermedad frecuente y su etiología continúa siendo obscura. Varias hipótesis fueron elaboradas, entre ellas, la posibilidad de la transmisión genética. Los estudios en la literatura procuraron analizar la prevalencia de la enfermedad en determinadas poblaciones, las posibles formas de transmisión, la localización de los genes responsables y las variaciones de genes específicos (polimorfismos que pueden influenciar en el desarrollo de la deformidad. El objetivo de este artículo es revisar y actualizar los conceptos sobre la influencia genética en la etiología de la escoliosis idiopática del adolescente.The adolescent idiopathic scoliosis is a common disease and its etiology remains unclear. Several hypotheses have been devised, including the possibility of genetic transmission. Studies in the literature have examined the prevalence of the disease in certain populations, the possible modes of transmission, the location of genes and variations of certain genes (polymorphisms that may influence the development of the deformity. This article intends to review and update the concepts of genetic influence in the etiology of adolescent idiopathic scoliosis.

  17. Soft braces in the treatment of Adolescent Idiopathic Scoliosis (AIS – Review of the literature and description of a new approach

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2012-05-01

    Full Text Available Abstract Background The use of soft braces to treat scoliosis has been described by Fischer as early as 1876. With the help of elastic straps, as the authors suggested, a corrective movement for individual curve patterns should be maintained in order to inhibit curve progression. Today this concept has been revived besides soft 3 point pressure systems. Some shortcomings have been revealed in literature in comparison with hard braces, however the concept of improving quality of life of a patient while under brace treatment should furtherly be considered as valuable. Purpose of this review is to gather the body of evidence existent for the use of soft braces and to present recent developments. Method A review of literature as available on Pub Med was performed using the key words ‘scoliosis’ and ‘soft brace’ at first. The search was expanded using ‘scoliosis’ and the known trademarks (1 ‘scoliosis’ and ‘SpineCor’, (2 ‘scoliosis’ and ‘TriaC’, (3 ‘scoliosis’ and ‘St. Etienne brace’, (4 ‘scoliosis’ and ‘Olympe’. The papers considered for inclusion were new technical descriptions, preliminary results, cohort studies and controlled studies. Results When searching for the terms ‘scoliosis’ and ‘SpineCor’: 20 papers have been found, most of them investigating a soft brace, for ‘scoliosis’ and ‘TriaC’: 7 papers displayed, for ‘scoliosis’ and ‘St. Etienne brace’: one paper displayed but not meeting the topic and for ‘scoliosis’ and ‘Olympe’: No paper displayed. Four papers found on the SpineCor™ were of prospective controlled or prospective randomized design. These papers partly presented contradictory results. Two papers were on soft Boston braces used in patients with neuromuscular scoliosis. Discussion There is a small but consistent body of evidence for the use of soft braces in the treatment of scoliosis. Contradictory results have been published for samples treated during

  18. Osteoporosis in unstable adult scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Velis, K.P.; Healey, J.H.; Schneider, R.

    1988-12-01

    New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

  19. Cerebral glucose metabolic abnormality in patients with congenital scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Nam, H. Y.; Seo, G. T.; Lee, J. S.; Kim, S. C.; Kim, I. J.; Kim, Y. K.; Jeon, S. M. [Pusan National University Hospital, Pusan (Korea, Republic of)

    2007-07-01

    A possible association between congenital scoliosis and low mental status has been recognized, but there are no reports describing the mental status or cerebral metabolism in patients with congenital scoliosis in detail. We investigated the mental status using a mini-mental status exam as well as the cerebral glucose metabolism using F-18 fluorodeoxyglucose brain positron emission tomography in 12 patients with congenital scoliosis and compared them with those of 14 age-matched patients with adolescent idiopathic scoliosis. The mean mini-mental status exam score in the congenital scoliosis group was significantly lower than that in the adolescent idiopathic scoliosis group. Group analysis found that various brain areas of patients with congenital scoliosis showed glucose hypometabolisms in the left prefrontal cortex (Brodmann area 10), right orbitofrontal cortex (Brodmann area 11), left dorsolateral prefrontal cortex (Brodmann area 9), left anterior cingulate gyrus (Brodmann area 24) and pulvinar of the left thalamus. From this study, we could find the metabolic abnormalities of brain in patients with congenital scoliosis and suggest the possible role of voxel-based analysis of brain fluorodeoxyglucose positron emission tomography.

  20. 特发性脊柱侧凸相关基因研究进展%Research advances in the genetics of adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    赵栋; 邱贵兴

    2009-01-01

    目前,多数学者认为特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)可能是一种多基因遗传疾病。大量文献报道了AIS的可疑相关致病基因,但如何选择合理方法进一步筛选或确定致病基因仍需进一步研究。

  1. Progress of gait analysis in adolescent idiopathic scoliosis%步态分析在青少年特发性脊柱侧凸中的应用进展

    Institute of Scientific and Technical Information of China (English)

    王彦辉; 陈学明; 于振山; 孔超

    2016-01-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine,which not only affects spinal anatomy,mobility and trunk symmetry,but also leads to the changes of human locomotion through pelvic.During the past 30 years,though great progress has been made in the treatment of AIS,the pathogeny of AIS is still uncertain.Most scholars believe that many factors contribute to the pathogeny of AIS,however,some studies have shown that poor posture during walking and poor manage of balance could lead to the progress of scoliosis.Gait is a behaviour characteristic during walking,and normal gait is the result of nervous system,musculoskeletal system,proprioception and vision.Any disease of the system above may cause abnormal gait.Gait analysis can spot the key links and impact factors of abnormal gait by observing and measuring the testers' walking,reflect the abnormal gait objectively and quantitatively,and provide reference opinions for the recovery and treatment of patients.At present,gait analysis has been mostly applied in hemiplegia,cerebral palsy and knee osteoarthritis.In recent years,gait analysis has been increasingly used in AIS patients.There have been many researches about the kinematics and kinetics of gait analysis in adolsecent idiopathic scoliosis abroad and some positive results have been reported..But in China,it's still in the initial stage.We reviewed the published papers about gait analysis in AIS patients,and summarized the kinematics,kinetics and different means of intervention on gait in AIS patients.We hope it will provide references for our researches.%青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是一种复杂的脊柱三维畸形,不仅影响脊柱的形态、运动及躯干平衡,理论上也会通过骨盆影响患者的步态.在过去的30余年中,AIS虽然在治疗方面取得了较大进展,但病因至今仍未阐明.虽然目前大多数学者认为AIS的发病机制是多因素综合作用的

  2. Effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises based on SOSORT management criteria: results according to the SRS criteria for bracing studies - SOSORT Award 2009 Winner

    Directory of Open Access Journals (Sweden)

    Fusco Claudia

    2009-09-01

    Full Text Available Abstract Background The SRS criteria give the methodological reference framework for the presentation of bracing results, while the SOSORT criteria give the clinical reference framework for an appropriate bracing treatment. The two have not been combined in a study until now. Our aim was to verify the efficacy of a complete, conservative treatment of Adolescent Idiopathic Scoliosis (AISaccording to the best methodological and management criteria defined in the literature. Methods Study Design. Retrospective study. Population. We included all AIS patients respecting the SRS inclusion criteria (age 10 years or older; Risser test 0-2; Cobb degrees 25-40°; no prior treatment; less than one year post-menarchal who had reached the end of treatment since our institute database start in 2003. Thus we had 44 females and four males, with an age of 12.8 ± 1.6 at the commencement of the study. Methods. According to individual needs, two patients have been treated with Risser casts followed by Lyon brace, 40 with Lyon or SPoRT braces (14 for 23 hours per day, 23 for 21 h/d, and seven for 18 h/d at start, and two with exercises only (1 male, 1 female: these were excluded from further analysis. Outcome criteria. SRS (unchanged; worsened 6° or more; over 45° at the end of treatment; surgically treated; two years' follow-up; clinical (ATR, Aesthetic Index, plumbline distances; radiographic (Cobb degrees; and ISICO (optimal; minimal. Statistics. Paired ANOVA and t-test, Tukey-Kramer and chi-square test. Results Median reported compliance during the 4.2 ± 1.4 treatment years was 90% (range 5-106%. No patient progressed beyond 45°, nor was any patient fused, and this remained true at the two-year follow-up for the 85% that reached it. Only two patients (4% worsened, both with single thoracic curve, 25-30° Cobb and Risser 0 at the start. We found statistically significant reductions of the scoliosis curvatures (-7.1°: thoracic (-7.3°, thoracolumbar (-8.4

  3. Dynamic magnetic resonance imaging in assessing lung function in adolescent idiopathic scoliosis: a pilot study of comparison before and after posterior spinal fusion

    Directory of Open Access Journals (Sweden)

    Lam Wynnie WM

    2007-11-01

    Full Text Available Abstract Background Restrictive impairment is the commonest reported pulmonary deficit in AIS, which improves following surgical operation. However, exact mechanism of how improvement is brought about is unknown. Dynamic fast breath-hold (BH-MR imaging is a recent advance which provides direct quantitative visual assessment of pulmonary function. By using above technique, change in lung volume, chest wall and diaphragmatic motion in AIS patients before and six months after posterior spinal fusion surgery were measured. Methods 16 patients with severe right-sided predominant thoracic scoliosis (standing Cobb's angle 50° -82°, mean 60° received posterior spinal fusion without thoracoplasty were recruited into this study. BH-MR sequences were used to obtain coronal images of the whole chest during full inspiration and expiration. The following measurements were assessed: (1 inspiratory, expiratory and change in lung volume; (2 change in anteroposterior (AP and transverse (TS diameter of the chest wall at two levels: carina and apex (3 change in diaphragmatic heights. The changes in parameters before and after operation were compared using Wilcoxon signed ranks test. Patients were also asked to score their breathing effort before and after operation using a scale of 1–9 with ascending order of effort. The degree of spinal surgical correction at three planes was also assessed by reformatted MR images and correction rate of Cobb's angle was calculated. Results The individual or total inspiratory and expiratory volume showed slight but insignificant increase after operation. There was significantly increase in bilateral TS chest wall movement at carina level and increase in bilateral diaphragmatic movements between inspiration and expiration. The AP chest wall movements, however, did not significantly change. The median breathing effort after operation was lower than that before operation (p There was significant reduction in coronal Cobb's angle

  4. Análise quantitativa do tratamento da escoliose idiopática com o método klapp por meio da biofotogrametria computadorizada Quantitative photogrammetric analysis of the klapp method for treating idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Denise H. Iunes

    2010-04-01

    Full Text Available INTRODUÇÃO: Poucos trabalhos comprovam a eficácia das técnicas fisioterapêuticas para o tratamento da escoliose. OBJETIVO: Analisar a eficácia do Método Klapp no tratamento das escolioses por meio do estudo quantitativo pela biofotogrametria computadorizada. MÉTODOS: Dezesseis indivíduos com média de idade de 15±2,61 anos, portadores de escoliose idiopática, foram tratados com o método Klapp. Para análise dos resultados do tratamento, todos foram fotografados antes e após o tratamento, seguindo uma padronização fotográfica. Todas as fotografias foram analisadas quantitativamente por um mesmo experimentador, utilizando o software ALCimagem 2000. A análise estatística foi realizada, utilizando-se a o teste-t pareado com nível de significância de 5%. RESULTADOS: Os resultados apontam para a melhora após o tratamento dos ângulos agromioclaviculares (AC-p=0,00 e esternoclavicular (EC-p=0,01, que avaliam a simetria dos ombros, e para o ângulo que avalia o triângulo de Tales esquerdo, (ΔTe-p=0,02. Em termos de flexibilidade, houve melhora dos ângulos tibiotársicos (ATT-p=0,01 e coxofemoral (CF-p=0,00. Não houve modificações das curvaturas vertebrais e nem melhora no posicionamento da cabeça, apenas na curvatura lombar, avaliada pelo ângulo lordose lombar (LL-p=0,00, sofreu modificação com o tratamento. CONCLUSÃO: O método Klapp foi uma técnica terapêutica eficaz para tratar as assimetrias de tronco e a flexibilidade. Não foi eficaz para assimetrias da pelve, modificações da posição da cabeça, da lordose cervical e cifose torácica.INTRODUCTION: Few studies have proved that physical therapy techniques are efficient in the treatment of scoliosis. OBJECTIVE: To analyze the efficiency of the Klapp method for the treatment of scoliosis, through a quantitative analysis using computerized biophotogrammetry. METHODS: Sixteen participants of a mean age of 15±2.61 yrs. with idiopathic scoliosis were treated using

  5. Quality of life for Chinese patients with adolescent idiopathic scoliosis: evaluation of the Chinese version of the Scoliosis Research Society's outcomes instrument 22%中文版SRS-22问卷评估青少年特发性脊柱侧凸患者生活质量的研究

    Institute of Scientific and Technical Information of China (English)

    周璇; 陶泉; 杨晓颜; 张树新; 陆体江; 潘晨辉; 杜青; 赵黎; 励建安; 张自明; 杨军林; 陈秋; 李海; 沈品泉

    2011-01-01

    Objective To evaluate the health-related quality of life ( HRQL) of patients with adolescent idiopathic scoliosis ( AIS) before treatment. Methods Sixty-two female patients with AIS were evaluated using the Chinese version of Scoliosis Research Society's outcomes instrument 22 ( SRS-22) HRQL questionnaire before treatment. The patients were categorized into thFee groups: a mild deformity group with a major curve Cobb angle less than 30° ( n =14),a moderate deformity group with Cobb angles of 30° to 50° ( n =42), and a severe deformity group with Cobb angles more than 50° ( n =6). Results The severe deformity group scored lowest in the self-image domain.There was,however,no significant difference in the functional activity,pain or mental health domain scores between the three groups. Conclusions The Chinese version of the SRS-22 HRQL questionnaire can be used to assess the HRQL of Chinese AIS patients.AIS patients with a major curve Cobb angle more than 50° have relatively low self-image scores.%目的 研究未经治疗的青少年特发性脊柱侧凸( AIS)患者的健康相关的生活质量.方法 对62例未经治疗的女性AIS患者采用中文版脊柱侧凸研究学会患者问卷表(SRS-22)进行问卷评估.根据Cobb角大小分为轻度脊柱侧凸组14例(Cobb角<30°)、中度脊柱侧凸组42例(Cobb角30°~50°)、重度脊柱侧凸组6例(Cobb角>50°).结果 重度脊柱侧凸组自我形象维度得分均低于轻度脊柱侧凸组和中度脊柱侧凸组,差异有统计学意义(P<0.05).3组功能活动、疼痛、心理健康三个维度的得分差异均无统计学意义(P>0.05).结论 中文版SRS-22问卷可提供AIS患者与健康相关的生活质量信息.Cobb角>50°的AIS患者自我形象维度得分较低.

  6. Analysis of spinopelvic sagittal alignment in adult patients with idiopathic scoliosis%成人特发性脊柱侧凸患者脊柱-骨盆矢状位平衡分析

    Institute of Scientific and Technical Information of China (English)

    李危石; 陈仲强; Kirkham B Wood

    2011-01-01

    Objective:To analyze the spinopelvic sagittal alignment in adult patients with idiopathic scoliosis according to curve types.Method:The sagittal spinopelvie parameters and scoliosis curves types were analyzed retrospectively in standing radiographs of 83 adult patients(mean age 43.0 years) with adult idiopathic scoliosis,these parameters included cobb angle of primary scoliosis,thoracic kyphosis (TK),thoracolumbar junction kyphosis(TLJ),lumbar lordosis(LL),pelvic incidence(PI),sacrum slope(SS),pelvic tilt(PT) and sagittal vertical axis (SVA).According to SRS classification,the patients were divided into two groups,thoracic curve and lumbar curve. All spinopelvic parameters between two groups were compared. The correlations between parameters as well as these parameters with age were analyzed. Result:The average age of 39 patients with thoracic curve was 40.9,while that for 44 patients with lumbar curve was 45.8.No age-related difference was noted between two groups. Also no difference for all spinopelvic parameters except SVA was noted.The SVA in patients with lumbar curve was significantly greater than that with thoracic curve (P<0.05).For patients less than 40 years old,all spinopelvic parameters between two groups showed no difference,while for patients older than 40 years old,SVA and PT in lumbar curve group were significant greater than those in thoracic curve group (P<0.05). In thoracic curve group,9 patients had SVA more than±50mm. Among them 7 patients were negative imbalance. In lumbar curve group, 12 patients had SVA more than±50mm,and 8 patients of them were positive im balance. In both two groups,there were significant correlations between LL and TK,LL and SS,PI and SS,PI and PT,SVA and LL,SVA and SS,SVA and PT,age and SVA,and age and PT.PI showed significant correlaion with LL in patients with thoracic curve while no correlation with LL in patients with lumbar curve. Unlike thoracic curve group,no relationship between PI and LL in lumbar curve

  7. To What Extent Can Adolescent Scoliosis Be Improved in Four Weeks?

    OpenAIRE

    Mehmet Ağırman; İlknur Saral; Ali Akın Uğraş

    2016-01-01

    Scoliosis is a condition that leads to severe disability and an impaired cosmetic appearance in adolescence. This article presents x-ray images of a patient with adolescent idiopathic scoliosis (AIS) in whom the pain and posture improved dramatically over four weeks, emphasizing the importance of physical therapy. A 13-year-old male was admitted because of posture deformity and mild back and lower back pain. He was being followed with the diagnosis of scoliosis for two ye...

  8. 特发性脊柱侧弯后路矫形植骨融合内固定围术期护理%Perioperative nursing on posterior fusion and fixation for idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    夏同霞; 袁发孝; 杨晓群; 周芬; 谢文婷; 李媛媛

    2011-01-01

    Objective To probe into the perioperative nursing method during osterior fusion and fmation for idiopathic scoliosis. Methods The study involved 31 patients with idiopathic scoliosis treated with posterior correction nails and selective spinal fusion with hook-rod system fixation.The severe patients were treated with extensive posterior release or anterior correction and fusion posterior to release.Before the operation,the patients were administrated with mental nursing,lung function exercise,self-elongation exercise,wake-up pilot training,self-image appraisement and bed and life skills exercise.After the operation,an observation was done on the change of nervous system,propor turning the body over best clinostatism,drainage tube care,respiratory passage care,functional exercise instruction and discharge instruction. Results The operation was accomplished successfully in all the patients,which showed that the body height was increased 2-15 cm.There found no complications including loosening or breakage of the nails or sticks,nervous system injury,incisional wound infection or press~e sore. Conclusion Preoperative sufficient preparation and fine postoperative nursing are important guarantee to successful operation and fast rehabilitation.%目的 探讨脊柱侧弯后路矫形植骨融合内固定术围术期的护理方法.方法 对31例特发性脊柱侧弯患者采用后路矫形钉、钩棒系统内固定选择性脊柱融合术,对于重度患者采用广泛后路松解或前路松解后矫形融合治疗;术前给予心理护理、肺功能训练、自我伸长训练、唤醒试验训练、自我形象鉴定、床上生活能力训练;术后密切观察神经系统变化,正确搬运和翻身,给予最佳卧位,加强引流管护理、呼吸道护理、功能锻炼指导和出院指导.结果 31例患者均顺利完成手术.术后身高增加2~15 cm.本组未发生螺钉及棒的松动、断裂及神经系统损伤、切口感染,压疮等.结论 术前充

  9. Effect of Exercise on I° Adolescent Idiopathic Scoliosis%运动疗法治疗Ⅰ°青少年型特发性脊柱侧凸的效果①

    Institute of Scientific and Technical Information of China (English)

    贺星; 蔡艺芳; 谭恒; 林绍炳; 林丽莎

    2013-01-01

      目的观察运动疗法治疗Ⅰ°青少年型特发性脊柱侧凸(AIS)的疗效。方法70例Ⅰ° AIS 患者,32例未经康复治疗,自行姿势矫正0.5年以上为对照组,38例经本院运动疗法治疗0.5年为治疗组。比较治疗前后全脊柱站立位正侧位片。结果治疗后治疗组 Cobb 角、脊柱旋转程度、代偿性均较治疗前明显改善(P0.05)。结论运动疗法治疗Ⅰ° AIS 安全有效,自行姿势矫正无效。%Objective To investigate the effect of exercise therapy on I° adolescent idiopathic scoliosis (AIS). Methods 70 cases with I° AIS were included. 32 patients correcting posture themselves for 0.5 year or above were as control group, and the other 38 cases who accept-ed exercise therapy for 0.5 year were as treatment group. Their X-ray of spine before and after treatment were compared. Results The Cobb's angle, rotation of the spine, and compensatory improved after treatment in the treatment group (P<0.01), but no significant improve-ment was obsereved in the control group after 0.5 year. Conclusion Exercise therapy is safe and effective on I° AIS.

  10. The influencing factors of curve flexibility in adolescent idiopathic scoliosis%青少年特发性脊柱侧凸患者脊柱柔韧性的影响因素

    Institute of Scientific and Technical Information of China (English)

    刘文军; 邱勇; 孙旭; 刘臻; 束昊; 王信华; 孙超

    2009-01-01

    目的:探讨青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者脊柱柔韧性的可能影响因素.方法:选取2006年12月~2008年4月在我院脊柱外科手术治疗的204例AIS患者,男性36例,女性168例,平均年龄15.0岁;平均Cobb角50.1°;平均Risser征3.4度;主弯跨度平均6.8个椎体;主弯顶椎旋转度平均2.0度.摄站立位全脊柱正侧位及仰卧左右侧屈位X线片,计算主弯柔韧性.采用相关分析研究各临床指标与主弯柔韧性的相关性.结果:女性AIS患者的脊柱柔韧性明显高于男性(P0.05).女性AIS患者中的年龄及主弯Cobb角(站立位与侧屈位)均与脊柱柔韧性显著负相关(P0.05).结论:女性AIS患者脊住柔韧性受年龄、月经初潮至手术时间、主弯Cobb角(站立位与侧屈位)、弯型及顶椎旋转度等因素影响;男性AIS患者的脊柱侧凸柔韧性主要受主弯Cobb角及弯型影响.

  11. Estimating the effectiveness of screening for scoliosis : A case-control study

    NARCIS (Netherlands)

    Bunge, Eveline M.; Juttmann, Rikard E.; van Biezen, Frans C.; Creemers, Huub; Hazebroek-Kampschreur, Alice A. J. M.; Luttmer, Bert C. F.; Wiegersma, P. Auke; de Koning, Harry J.

    2008-01-01

    OBJECTIVE. The aim of this study was to test the hypothesis that screening for scoliosis is effective in reducing the need for surgical treatment. METHODS. The study was a case-control study. A total of 125 consecutive patients who were treated surgically for idiopathic scoliosis between January 200

  12. A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

    Science.gov (United States)

    Ucpunar, Hanifi; Sevencan, Ahmet; Balioglu, Mehmet Bulent; Albayrak, Akif; Polat, Veli

    2016-01-01

    Study Design Retrospective study. Purpose To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. Overview of Literature Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. Methods Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. Results We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). Conclusions We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups. PMID:27114761

  13. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    Science.gov (United States)

    Maghbool, Maryam; Maghbool, Masood; Shahriari, Mehdi; Karimi, Mehran

    2009-06-08

    Idiopathic thrombocytopenic purpura (ITP) is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori) infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years). A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150×10(9)/L) or partial (platelet count between 50 and 150×10(9)/L). We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  14. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    Directory of Open Access Journals (Sweden)

    Maryam Maghbool

    2009-07-01

    Full Text Available Idiopathic thrombocytopenic purpura (ITP is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years. A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150x109/L or partial (platelet count between 50 and 150x109/L. We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  15. Congenital scoliosis: an up-to-date.

    Science.gov (United States)

    Burnei, G; Gavriliu, S; Vlad, C; Georgescu, I; Ghita, R A; Dughilă, C; Japie, E M; Onilă, A

    2015-01-01

    Congenital scoliosis represents a spinal malformation due to defects of formation, segmentation or mixed ones. It is characterized by a longitudinal and rotational imbalance. 54 patients were analyzed and 39 out of them were operated by various approaches with anterior and posterior instrumentations during 2000 and 2012. The impossibility to appoint some patients encountered in the daily practice into the known classifications, allowed us to purpose two categories of congenital scoliosis related to the predominance of spinal deviances in the coronal and transversal views. No certain etiology of congenital scoliosis has been identified until today. The susceptibility of some polygenic defects is obvious due to the presence of a sum of defects associated to most of the congenital scoliosis cases and the rarity of the presence of a unique defect. The diagnosis requires a thorough clinical and imaging examination in order to establish an individualized therapeutic strategy. The treatment of congenital scoliosis is different from the adolescent idiopathic one. Therapeutic criteria are significantly different. It is essential to assess the difference in growth of the concavity related to the convexity when choosing a particular procedure. The magnitude of the curve and the progressive rate are fundamental issues to the surgeon.

  16. 特发性脊柱侧弯后路钉棒置入内固定:谁是影响效果的因素?%Posterior screw-rod fixation for idiopathic scoliosis:factors affecting the results

    Institute of Scientific and Technical Information of China (English)

    毕中普; 夏磊; 徐静磊; 周亚旗; 柯广水; 桑亮

    2014-01-01

    背景:特发性脊柱侧弯在脊柱侧弯中最常见,有时还伴有神经、内分泌系统以及营养代谢的异常,但保守治疗效果欠佳,通常需要进行手术治疗。畸形矫正是一个极其复杂的过程,对特发性脊柱侧弯治疗、转归等进行深入研究意义巨大,但目前缺少相近研究。  目的:观察后路钉棒内固定置入治疗特发性脊柱侧弯的矫正效果,探讨影响其效果的相关因素。  方法:回顾性分析近4年80例接受后路钉棒内固定置入治疗的特发性脊柱侧弯患者的病例资料,记录研究患者年龄、性别、病程、治疗前后X射线平片测量的冠状面Cobb's角、躯干偏移度等观察指标,并进行统计学分析。  结果与结论:单因素分析显示患者性别和患者病程均与内固定后矫正效果无明显相关(P>0.05);而患者年龄分布、侧凸的位置、侧凸的柔韧性均与内固定疗效相关(P OBJECTIVE:To observe the correction effect of posterior screw-rod fixation for idiopathic scoliosis, and explore the relevant factors influencing its effectiveness. METHODS:We retrospectively analyzed 80 cases receiving pedicle screw fixation in the treatment of idiopathic scoliosis in the latest four years. Age, gender, disease duration, preoperative and postoperative X-ray measurement of coronal Cobb’s angle, and trunk deviation were recorded, and statistical y analyzed. RESULTS AND CONCLUSION:Univariate analysis showed that gender and disease duration were not significantly correlated with postoperative correction results (P>0.05). However, the age distribution of patients, the location of scoliosis, and scoliosis flexibility were associated with curative effects of internal fixation (P<0.05). Posterior screw-rod fixation for idiopathic scoliosis can achieve significant effects. The patient’s age, location and flexibility of scoliosis have a significant effect on the effects of fixation. The

  17. 特发性脊柱侧凸椎旁肌组织中神经型及诱导型一氧化氮合酶表达的研究%Expressions of neuronal and inducible nitric oxide synthase in paraspinal muscles of idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    赵宇; 邱贵兴

    2004-01-01

    背景:特发性脊柱侧凸病因不清楚,目前关于其病因及发病机制存在诸多争论.椎旁肌在脊柱侧凸中作用已经成为研究热点.目的:比较特发性脊柱侧凸胸椎椎旁肌肉中神经型一氧化氮合酶和诱导型一氧化氮合酶表达与定位.设计:以诊断为依据设立对照的实验研究.地点与对象:北京协和医院骨科收治胸椎侧凸畸形患者10例,其中男8例,女2例;平均年龄14岁.胸腰椎爆裂骨折患者2例做对照.干预:手术中,于T6~T11椎体水平的侧弯顶椎水平取双侧椎旁肌,部分组织甲醛固定,行苏木精-伊红(HE)染色;其余组织冰冻,进行免疫组织化学及Western印迹杂交.主要观察指标:脊柱侧凸患者及正常椎旁肌组织中神经型一氧化氮合酶和诱导型一氧化氮合酶的表达情况.?结果:脊柱侧凸患者脊柱凸侧椎旁肌组织与凹侧椎旁肌组织和正常对照相比,神经型一氧化氮合酶的表达明显下调,诱导型一氧化氮合酶的表达也有所下调,但诱导型一氧化氮合酶表达总量较低.Western印迹检测得到同样的结果.结论:脊柱侧凸患者双侧椎旁肌神经型一氧化氮合酶蛋白表达不均衡,可能与特发性脊柱侧凸发生存在密切关系,诱导型一氧化氮合酶可能在特发性脊柱侧凸的发生中不发挥作用.%BACKGROUND: There are many conflicting theories on the etiology and pathogenesis of idiopathic scoliosis. The effect of paraspinal muscles in adolescent idiopathic scoliosis has become a hot topic in the researches.OBJECTIVE: To compare the expression and localization of neuronal nitric oxide synthase(nNOS) and inducible nitric oxide synthase(iNOS) of the thoracic spinal musculature on convex side with those on the concave side in the idiopathic scoliosis.DESIGN: A randomized controlled trial based on the diagnosis.SETTING and PARTICIPANTS: Ten patients with thoracic spinal scoliosis admitted by the Department of Orthopaedic Surgery

  18. Densidade mineral óssea estimada pelo Osteorisk em pacientes com escoliose idiopática do adolescente Bone mineral density estimated by Osteorisk in patients with adolescent idiopathic scoliosis

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    Thiago Cardoso Maia

    2012-12-01

    Full Text Available OBJETIVO: Considera-se a prevalência de osteoporose em portadores de Escoliose Idiopática do Adolescente (EIA maior do que na população adolescente em geral.Uma alternativa à radiologia para caracterização da densidade mineral óssea pode ser através de índices correlativos, como o Osteorisk, de fácil acesso e baixo custo, que auxilia o médico na solicitação da Densitometria Óssea. Por considerarmos que a osteoporose pode interferir na evolução e no tratamento da EIA fomos motivados a realizar este estudo. Nosso objetivo foi avaliar subjetivamente a densidade mineral óssea através do índice Osteorisk em pacientes portadores de EIA. MÉTODOS: Foram avaliados pacientes saudáveis, (grupo controle, n=30 e pacientes com EIA (n=30, dos quais obtivemos idade, peso e altura, sendo estabelecido o Osteorisk. Feito teste t de Student não-pareado, com pOBJECTIVE: The prevalence of osteoporosis in patients with Adolescent Idiopathic Scoliosis (AIS is believed to be higher than in the general adolescent population. An alternative to radiology for the characterization of bone mineral density may be through correlative indexes like the Osteorisk index, which is easy to access and low in cost, and which helps the doctor in the request for Bone Densitometry. Our belief that osteoporosis can affect the evolution and treatment of AIS was what motivated us to conduct this study. Our objective was to subjectively evaluate bone mineral density by the Osteorisk index in patients with AIS. METHODS: Healthy patients (control group, n=30 and patients with AIS (n = 30 were evaluated, documenting age, weight and height, and establishing the Osteorisk. The unpaired Student t test was performed, with a level of significance of p <0.05. RESULTS: The mean Osteorisk found for the patients with AIS was 6.38 ± 2.2 while in the control group, it was 8.27 ± 2.14, which represents a low risk of developing osteoporosis in both groups. Comparing these means

  19. Selection of Fusion Levels Using the Fulcrum Bending Radiograph for the Management of Adolescent Idiopathic Scoliosis Patients with Alternate Level Pedicle Screw Strategy: Clinical Decision-making and Outcomes.

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    Dino Samartzis

    Full Text Available Selecting fusion levels based on the Luk et al criteria for operative management of thoracic adolescent idiopathic scoliosis (AIS with hook and hybrid systems yields acceptable curve correction and balance parameters; however, it is unknown whether utilizing a purely pedicle screw strategy is effective. Utilizing the fulcrum bending radiographic (FBR to assess curve flexibility to select fusion levels, the following study assessed the efficacy of pedicle screw fixation with alternate level screw strategy (ALSS for thoracic AIS.A retrospective study with prospective radiographic data collection/analyses (preoperative, postoperative 1-week and minimum 2-year follow-up of 28 operative thoracic AIS patients undergoing ALSS was performed. Standing coronal/sagittal and FBR Cobb angles, FBR flexibility, fulcrum bending correction index (FBCI, trunkal shift, radiographic shoulder height (RSH, and list were assessed on x-rays. Fusion level selection was based on the Luk et al criteria and compared to conventional techniques.In the primary curve, the mean preoperative and postoperative 1 week and last follow-up standing coronal Cobb angles were 59.9, 17.2 and 20.0 degrees, respectively. Eighteen patients (64.3% had distal levels saved (mean: 1.6 levels in comparison to conventional techniques. Mean immediate and last follow-up FBCIs were 122.6% and 115.0%, respectively. Sagittal alignment did not statistically differ between any assessment intervals (p>0.05. A decrease in trunkal shift was noted from preoperative to last follow-up (p = 0.003. No statistically significant difference from preoperative to last follow-up was noted in RSH and list (p>0.05. No "add-on" of other vertebra or decompensation was noted and all patients achieved fusion.This is the first report to note that using the FBR for decision-making in selecting fusion levels in thoracic AIS patients undergoing management with pedicle screw constructs (e.g. ALSS is a cost-effective strategy

  20. 青少年特发性脊柱侧凸脊柱前后柱骨骺软骨细胞的增殖和凋亡%Cell viability between anterior and posterior spinal growth plate in adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    朱锋; 邱勇; 孟魁; 郑振耀

    2004-01-01

    目的通过对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,简称AIS)脊柱前后柱次发性生长骨骺的增殖和凋亡研究,发现AIS患者青春期脊柱前后柱生长活跃度的差异.方法AIS组患者17例(男性4例,女性13例),平均年龄13.6岁(10~17岁),均有累及胸段的脊柱侧弯,术前Cobb角65°~115°,平均89.3°,Risser分级0~3.取材部位为顶椎区终板软骨和棘突次发性生长骨骺.HE染色,光镜下观察生长板软骨细胞层结构变化.免疫组化增殖采用细胞增殖核抗原(PCNA)指数,凋亡采用原位末端标记法(TUNEL)指数,采用PCAN/TUNEL作为生长活跃度的指标.结果 AIS前柱(终板软骨)细胞增殖活跃,增生骨巢密集且厚度较大;后柱软骨增生程度一般,增殖层内骨巢散在分布呈团状,骨巢厚度较前柱低.前后柱骨骺软骨静止区、增殖区以及肥大区均有PCNA和TUNEL阳性细胞,PCNA指数前后柱大于后柱(P0.05).结论特发性脊柱侧凸患者青春期脊柱前后柱软骨细胞生长活性存在明显差异.

  1. Analysis of bone mineral density in adolescent idiopathic scoliosis girls with a small curve magnitude%低角度青少年特发性脊柱侧凸女性患者的骨密度分析

    Institute of Scientific and Technical Information of China (English)

    孙旭; 邱勇; 朱锋; 李卫国; 邱旭升; 夏才伟; 刘臻; 朱泽章; 王斌; 俞杨; 钱邦平

    2007-01-01

    目的 分析低角度青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)女性患者的骨密度(BMD)和骨矿含量(BMC),探讨其与年龄、生长发育、人体测量学和侧凸角度等的相关性.方法 研究对象为218例Cobb角15~40°的女性AIS患者.运用双能X线骨密度吸收仪测定非优势侧股骨颈和腰椎的BMC/BMD.探讨这两个部位的BMC/BMD与患者的年龄、生长发育、人体测量学和侧凸角度等的相关性.结果 所有患者的年龄平均为(13.4±1.4)岁,Cobb角平均为(28.3±6.2)°.股骨颈BMD平均为(0.827±0.103)g/cm2,腰椎BMD平均为(0.887±0.124)g/cm2,显著低于同龄健康女性儿童;股骨颈BMC平均为(3.49±0.56)g,腰椎BMC平均为(29.78±7.37)g.患者的BMC/BMD与Cobb角无显著相关,而与体重、身高、Risser征、月经状况、BMI和年龄显著相关.逐步回归分析显示,体重和年龄是影响患者BMD的主要因素.结论 低角度女性AIS患者存在全身性的骨量减低,且与Cobb角无显著相关,而与生长发育和人体测量学相关指标显著相关.这提示AIS患者的骨量减低与生长发育和低体重有关.

  2. Pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy

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    Moulton Alan

    2009-10-01

    Full Text Available Abstract Anthropometric data from three groups of adolescent girls - preoperative adolescent idiopathic scoliosis (AIS, screened for scoliosis and normals were analysed by comparing skeletal data between higher and lower body mass index subsets. Unexpected findings for each of skeletal maturation, asymmetries and overgrowth are not explained by prevailing theories of AIS pathogenesis. A speculative pathogenetic theory for girls is formulated after surveying evidence including: (1 the thoracospinal concept for right thoracic AIS in girls; (2 the new neuroskeletal biology relating the sympathetic nervous system to bone formation/resorption and bone growth; (3 white adipose tissue storing triglycerides and the adiposity hormone leptin which functions as satiety hormone and sentinel of energy balance to the hypothalamus for long-term adiposity; and (4 central leptin resistance in obesity and possibly in healthy females. The new theory states that AIS in girls results from developmental disharmony expressed in spine and trunk between autonomic and somatic nervous systems. The autonomic component of this double neuro-osseous theory for AIS pathogenesis in girls involves selectively increased sensitivity of the hypothalamus to circulating leptin (genetically-determined up-regulation possibly involving inhibitory or sensitizing intracellular molecules, such as SOC3, PTP-1B and SH2B1 respectively, with asymmetry as an adverse response (hormesis; this asymmetry is routed bilaterally via the sympathetic nervous system to the growing axial skeleton where it may initiate the scoliosis deformity (leptin-hypothalamic-sympathetic nervous system concept = LHS concept. In some younger preoperative AIS girls, the hypothalamic up-regulation to circulating leptin also involves the somatotropic (growth hormone/IGF axis which exaggerates the sympathetically-induced asymmetric skeletal effects and contributes to curve progression, a concept with therapeutic

  3. Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea

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    Camille Orion

    2016-07-01

    Full Text Available Idiopathic facial aseptic granuloma (IFAG is a rare, benign pediatric dermatological lesion that occurs in children between 8 months and 13 years of age. The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood. Here we describe a case of IFAG in a 13-year-old boy who showed a dramatic response to oral doxycycline and topical metronidazole, which supports the hypothesis that IFAG may belong to the spectrum of rosacea.

  4. First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies

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    Faruk Incecik

    2015-01-01

    Full Text Available Background: The early and late benign occipital epilepsies of childhood (BOEC are described as two discrete electro-clinical syndromes, eponymously known as Panayiotopoulos and Gastaut syndromes. The purpose of this study was to identify predictors of failure to respond to the initial antiepileptic drug (AED. Materials and Methods: A total of 42 children with BOEC were enrolled. Predictive factors were analyzed by survival methods. Results: Among the 42, 25 patients (59.5% were boys and 17 (40.5% were girls and the mean age at the seizure onset was 7.46 ± 2.65 years (4-14 years. Of the 42 patients, 34 (81.0% were treated relatively successfully with the first AED treatment, and 8 (19.0% were not responded initial AED treatment. There was no correlation between response to initial AED treatment and sex, consanguinity, epilepsy history of family, age of seizure onset, frequency of seizures, history of status epilepticus, duration of starting first treatment, findings on electroencephalogram. However, history of febrile seizure and type of BOEC were significantly associated with failure risk. Conclusions: Factors predicting failure to respond to the AED were history of febrile seizure and type of BOEC in children with BOEC.

  5. 青少年特发性脊柱侧凸患者存在异常的脊柱骨盆生长发育模式%Abnormal growth of spine in patients with adolescent idiopathic thoracic scoliosis

    Institute of Scientific and Technical Information of China (English)

    鲍虹达; 刘臻; 邱勇; 朱锋; 朱泽章; 张文

    2014-01-01

    Objective To investigate if the growth patterns of the spine and pelvis are consistent in adolescent idiopathic scoliosis (AIS) patients with single thoracic curves.Methods Forty-eight thoracic adolescent idiopathic scoliosis (T-AIS) female patients and 48 heahhy age-matched adolescents were recruited consecutively between December 2011 and October 2012.Radiographic parameters including height of spine (HOS),length of spine (LOS),height of thoracic spine (HOT),length of thoracic spine (LOT),height of pelvis(HOP),width of pelvis (WOP) and width of thorax (WOT) were measured on the longcassete posteroanterior standing radiographs.In addition,ratios including HOS/HOP,LOS/HOP,HOT/HOP,LOT/HOP,LOS/LOT,WOT/WOP were also calculated.Independent t-test was performed to compare the radiographic parameters and ratios between the two groups.Results Compared to the agematched healthy adolescents,T-AIS patients had a significantly higher LOS and LOT (t =-2.364 and -1.495,P=0.020 and 0.043) and smaller HOS and HOT (t =2.060 and 3.359,P =0.042 and 0.001).Yet,all of HOP,WOP and WOT showed no significant difference between T-AIS patients and healthy adolescents.Similarly,LOS/HOP and LOT/HOP were significantly higher in T-AIS patients as may be expected with an average LOS/HOP of 2.26 ±0.14 in normal controls.In addition,LOS/LOT in normal controls had a trend of increase with age which was different from the stable LOS/LOT in T-AIS patients,indicating an increased growth of thoracic vertebra compared to lumbar vertebra.Conclusions Compared to the age-matched healthy adolescents,T-AIS patients have an abnormal growth characteristics with longer spine.The growth of pelvis and thorax show no significant differences between T-AIS patients and healthy adolescents.%目的 比较单胸弯青少年特发性脊柱侧凸(T-AIS)患者与同龄健康青少年脊柱骨盆生长发育模式情况.方法 研究对象包括2011年12月至2012年10月就诊的48例女性T-AIS患者(T-AIS组)和48例

  6. Three-dimensional finite element simulation of surgical correction for Lenke 2 type adolescent idiopathic scoliosis%Lenke2型特发性脊柱侧凸三维矫形手术的有限元模拟

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    刘祥胜; 吴冰; 魏显招; 吴大江; 杨宗德; 易红蕾; 王传锋; 董有海; 李明

    2012-01-01

    Objective To simulate different anterior and posterior correction strategies using finite element model of Lenke 2 type adolescent idiopathic scoliosis(AlS), in an effort to seek the optimal surgical protocol. Methods The finite element model of Lenke 2 type AIS was established and used to simulate five surgical strategies. The effectiveness and shoulder balance parameters were compared among different surgical approaches. Results The coronary proximal thoracic(PT) Cobb angle and corrective rates of the five surgical strategies were 21. 5(44. 8%), 26.5(32. 1%), 28. 1(27.9%), 34. 1(12.5%), and 32(17. 9%). The corrective rates for the main thoracic curves were not significantly different among the five strategies, and the physiological sagittal configuration was maintained. Postoperative radiographic shoulder balance parameters were increased for all five surgical protocols. Except for strategy A(posterior fusion from T2 to T11 ), other four strategy achieved the following outcomes! coracoid height difference>9 mm, elavical angle>2. 5° and clavicular tilt angle difference>4. 5° . Conclusion Simulation of posterior correction and fusion to T2 including both thoracic curve can achieve excellent three-dimensional shoulder imbalance slight to moderate degrees.%目的 利用建立的Lenke 2型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)三维有限元模型,分别仿真模拟前路、后路手术矫形操作,探讨其最佳手术方案.方法 建立Lenke 2型AIS的有限元模型,分别模拟前路和后路共5种不同的矫形方案,比较不同手术方案的矫形效果和双肩平衡参数的变化.结果 5种不同矫形方案有限元模拟术后的上胸弯冠状面Cobb角和矫形率分别为:21.5(44.8%)、26.5(32.1%)、28.1(27.9%)、34.1(12.5%)、32(17.9%),各矫形方案的主胸弯矫正率无明显差别.胸椎矢状面生理后凸得以维持.5种矫形方案术后各双肩平衡影像学参数较术前有所升高,除方

  7. 脊椎共面排列矫形技术治疗特发性脊柱侧凸的初步疗效%Preliminary outcome of three-dimensional correction for idiopathic scoliosis by vertebral coplanar alignment

    Institute of Scientific and Technical Information of China (English)

    修鹏; 宋跃明; 刘浩; 刘立岷; 龚全; 李涛; 曾建成

    2011-01-01

    Objective:To evaluate the preliminary outcome of vertebral coplanar alignment (VCA) for the management of idiopathic scoliosis (IS).Method:20 patients with IS undergoing one-stage posterior pedicle screw fixation,VCA correction and allograft fusion were included in this study.There were 15females and 5 males with the mean age of 15.3 years (range,11 to 21 years ).According to Lenke classification system,there were 14 type 1 and 6 type 2.The mean Cobb angle of the main curve was 67.5°(range,50° to 86°) and the mean thoracic kyphosis was 25.7°(range,5° to 55°).After correction,the Cobb angle of the main curve and thoracic kyphosis were evaluated.The rib hump(RH),apical vertebral body rib ratio(AVB-R),apical rib spread difference(ARSD) and rotational angle to sacrum(RAsac) were measured to assess the correction of rotational deformity.Result:All patients underwent this surgical protocol successfully without major complications.The average operation time was 164min (range,115 to 196min),and the mean blood loss was 680ml (range,400 to 800ml).The mean residual Cobb angle of main curve was 20.6°(range,12° to 27°) and the corrective rate was 70.1% with the corrective rate of RH,AVB-R,ARSD and RAsac of 56.3%,29.8%,74.3% and 54.1% respectively. The mean postoperative kyphosis was 21.8°(range,17° to 27°) and the thoracic kyphosis recovered to normal in all patients with no hypokyphosis noted. All patients were followed up for an average of 9 months (range,3 to 12 months).No decompensation and loss of correction was noted. Conclusion:VCA correc tion can manage coronal misalignment, recover thoracic alignment and rotational deformity of IS effectively.%目的:评估脊椎共面排列(vertebral coplanar alignment,VCA)矫形技术治疗特发性脊柱侧凸(idiopathic scoliosis,IS)的初步疗效.方法:2010年1月~9月采用VCA技术治疗IS患者20例,男5例,女15例,年龄11~21岁,平均15.3岁;Lenke 1型14例,2型6例;术前主弯Cobb角50°~86

  8. 女性青少年特发性脊柱侧凸支具治疗效果和影响因素评估%Bracing treatment for girls with adolescent idiopathic scoliosis: clinical outcomes and predictive factors

    Institute of Scientific and Technical Information of China (English)

    孙旭; 毛赛虎; 王斌; 邱勇; 朱泽章; 朱锋; 俞杨; 钱邦平; 马薇薇; 刘臻

    2011-01-01

    Objective To analyze the outcomes of bracing treatment for girls with adolescent idiopathic scoliosis (AIS), and to investigate the predictive factors of the protocol. Methods This study included 142 girls with AIS who finished standardized bracing treatment from July 2003 to July 2009. These patients had a mean age of 13.1±1.5 years, a mean main curve of 29.6°±5.4°, and a mean Risser grade of 2.0±1.5 before bracing treatment. Curve progression was defined that Cobb angle was greater than 6° compared to bracing initiation or was aggravated to more than 45° (indicative for surgery). The outcomes of bracing treatment were assessed based on the ratio of curves of progression or indicative for surgery. Chi-square and Logistic regression Analyses were performed to investigate the predictive factors of bracing treatment. Results The duration of bracing treatment averaged 2.5±1.0 years. Twenty-seven girls with curve progression (19%)and 115 girls (81%) with non-progression were found. Final curve which was greater than 45° was found in 18 girls (13%) who need a correction surgery, the remaining 124 girls (87%) had completed bracing treatment and avoided surgery. Chi-square analyses revealed that curve progression were more common in younger girls with lower Risser grade, with initial larger Cobb angle and with a main thoracic curve pattern.Logistic regression analyses found that premenarchal status and a main thoracic curve pattern were the independent risk factors of curve progression despite bracing. While initial Cobb angle which was greater than 30° was the additional independent risk factor of progression requiring surgery. Conclusion Bracing treatment could effectively prevent curve progression in most girls with AIS. The degree of growth maturity, the pattern and grade of curve are the influencing factor for bracing treatment.%目的 评估女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者支具治

  9. RESTORATION OF THORACIC KYPHOSIS WITH MULTILEVEL Ponte OSTEOTOMIES IN THORACIC IDIOPATHIC SCOLIOSIS SURGERY%特发性脊柱侧凸多节段Ponte截骨术对恢复胸椎后凸的疗效

    Institute of Scientific and Technical Information of China (English)

    张国莹; 张永刚; 张雪松; 王征; 毛克亚; 王岩

    2012-01-01

    Objective To investigate the effectiveness of multilevel Ponte osteotomies on maintenance and restoration of thoracic kyphosis in idiopathic scoliosis (IS) surgery. Methods Between March 2008 and February 2010, 42 patients with thoracic IS (Lenke type 1 curves) were corrected with posterior pedicle screw system. Multilevel Ponte osteostomies for posterior release was performed in 17 cases (group A), and the 3 segments near the apical vertebrae were selected as the osteotomy site; simple posterior soft tissue release was given in 25 cases (group B). There was no significant difference in sex, age, disease duration, lesion segments, coronary Cobb angle, thoracic kyphosis, Risser index, and bending flexibility between 2 groups (P > 0.05). The anteroposterior and lateral standing radiographs of the spine were taken to compare the effectiveness between 2 groups. Results Operation was successfully completed in all patients. The operation time and blood loss in group A were significantly greater than those in group B (P 0.05). Group A was significantly better than group B in the thoracic kyphotic angle and angle changes at 1 week and 2 years after operation (P < 0.05). Conclusion The posterior approach surgery with multilevel Ponte osteotomies can restore the thoracic kyphosis in IS, but it has no effect on coronal correction in Lenke type 1 curves.%目的 探讨在特发性脊柱侧凸(idiopathic scoliosis,IS)后路矫形手术中,多节段Ponte截骨术对保持和恢复胸椎后凸的作用.方法 回顾分析2008年3月- 2010年2月收治的42例采用脊柱后路椎弓根钉棒系统矫治的Lenke 1型IS患者,按照术中脊柱后方结构松解方式不同分为A、B两组.A组17例采用多节段Ponte截骨术,截骨部位均选择在胸弯顶椎附近连续3个节段;B组25例采用单纯软组织松解术.两组患者性别、年龄、病程、病变累及节段、冠状面Cobb角、胸椎后凸角、Risser指数及侧方弯曲像柔韧度比较

  10. 特发性胸椎侧凸选择性融合术后远端叠加现象%Distal adding-on phenomenon after selective fusion for idiopathic thoracic scoliosis

    Institute of Scientific and Technical Information of China (English)

    孙旭; 邱勇; 孙超; 朱泽章; 王斌; 徐磊磊; 丁旗; 钱邦平; 俞杨

    2013-01-01

    目的:探讨主胸弯型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)单次前或后路胸弯融合术后远端叠加现象的发生率,并对其影响因素进行分析.方法:回顾性分析110例行单次前或后路主胸弯融合术的主胸弯型(Lenke 1A型)AIS患者.其中男20例,女90例;年龄10~18岁,平均14.2±2.0岁;主胸弯Cobb角40°~80°,平均为48.2°±7.8°.所有患者在术前、术后及术后随访时均摄站立位全脊柱正侧位X线片.测量侧凸Cobb角,记录患者的年龄、Risser征、Y软骨形态、手术方式、稳定椎及融合节段,统计术后远端叠加现象的发生率,分析其影响因素.结果:随访时间为12~46个月,平均21±5个月.术后Cobb角平均为16.7°±6.1°,末次随访时Cobb角平均为22.0°±8.5°.共有19例出现远端叠加现象,发生率为17.3%.与非叠加组相比,叠加组患者的Risser征较低(2.1±1.4∶3.1±1.3,P=0.002),月经来潮后时间较短(11.2±14.2:21.9±18.9个月,P=0.002),代偿性腰弯柔软度较高[(97.0±9.1)%∶(90.5±15.5)%,P=0.017],远端融合椎(LIV)的位置约高出0.8个椎体.关于叠加现象发生率,低Risser征患者高于高Risser征患者,Y软骨开放组高于Y软骨闭合组,月经初潮未至和来潮小于1年组高于月经来潮大于1年组,腰弯高柔软度组高于低柔软度组,LIV高位置组[相对于稳定椎(SV)]高于低位置组.经过Logistic回归分析,LIV-SV≤-2 、Y软骨开放和腰弯高柔软度是术后发生远端叠加现象的三个独立的危险因素.结论:部分主胸弯型AIS患者前或后路矫形术后可发生远端叠加现象.LIV的选择、患者的生长发育成熟度和代偿性腰弯的柔软度是影响远端叠加现象的重要因素.%Objectives: To investigate the prevalence of distal adding-on phenomenon after selective fusion in adolescent idiopathic scoliosis(AIS) patients having a main thoracic curve, and to determine its risk factors. Methods: This

  11. Early-onset scoliosis: current treatment.

    Science.gov (United States)

    Cunin, V

    2015-02-01

    Early-onset scoliosis, which appears before the age of 10, can be due to congenital vertebral anomalies, neuromuscular diseases, scoliosis-associated syndromes, or idiopathic causes. It can have serious consequences for lung development and significantly reduce the life expectancy compared to adolescent scoliosis. Extended posterior fusion must be avoided to prevent the crankshaft phenomenon, uneven growth of the trunk and especially restrictive lung disease. Conservative (non-surgical) treatment is used first. If this fails, fusionless surgery can be performed to delay the final fusion procedure until the patient is older. The gold standard delaying surgical treatment is the implantation of growing rods as described by Moe and colleagues in the mid-1980s. These rods, which are lengthened during short surgical procedures at regular intervals, curb the scoliosis progression until the patient reaches an age where fusion can be performed. Knowledge of this technique and its complications has led to several mechanical improvements being made, namely use of rods that can be distracted magnetically on an outpatient basis, without the need for anesthesia. Devices based on the same principle have been designed that preferentially attach to the ribs to specifically address chest wall and spine dysplasia. The second category of surgical devices consists of rods used to guide spinal growth that do not require repeated surgical procedures. The third type of fusionless surgical treatment involves slowing the growth of the scoliosis convexity to help reduce the Cobb angle. The indications are constantly changing. Improvements in surgical techniques and greater surgeon experience may help to reduce the number of complications and make this lengthy treatment acceptable to patients and their family. Long-term effects of surgery on the Cobb angle have not been compared to those involving conservative "delaying" treatments. Because the latter has fewer complications associated with

  12. Horizontal gaze palsy with progressive scoliosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Bomfim, Rodrigo C.; Tavora, Daniel G.F.; Nakayama, Mauro; Gama, Romulo L. [Sarah Network of Rehabilitation Hospitals, Department of Radiology, Ceara (Brazil)

    2009-02-15

    Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare congenital disorder characterized by absence of conjugate horizontal eye movements and progressive scoliosis developing in childhood and adolescence. We present a child with clinical and neuroimaging findings typical of HGPPS. CT and MRI of the brain demonstrated pons hypoplasia, absence of the facial colliculi, butterfly configuration of the medulla and a deep midline pontine cleft. We briefly discuss the imaging aspects of this rare entity in light of the current literature. (orig.)

  13. Postoperative coronal plane imbalance and model construction for adolescent idiopathic scoliosis%青少年特发性脊柱侧凸植入物内固定后冠状面失平衡及模型构建

    Institute of Scientific and Technical Information of China (English)

    李世昊; 邓强; 荀传辉; 盛伟斌

    2014-01-01

    BACKGROUND:Adolescent idiopathic scoliosis is a common disease that can affect physical appearance of adolescents in the clinic at present. However, there are lacks of studies on coronal plane imbalance after fixation using Logistic regression equation at present. OBJECTIVE:To investigate the reasons for coronal plane imbalance after fixation in patients with Lenke type II adolescent idiopathic scoliosis. METHODS:141 cases of Lenke type II adolescent idiopathic scoliosis admitted by Department of Spinal Surgery of the First Affiliated Hospital of Xinjiang Medical University in China from January 2001 to November 2012 were chosen as subjects. Multivariate single factor and multiple-factor Logistic regression were performed. Risk factors for the coronal plane imbalance after fixation in adolescent idiopathic scoliosis patients were screened, and predictive models were established. RESULTS AND CONCLUSION:Coronal plane imbalance occurred in 30 of the 141 patients, accounting for 21.28%. For Lenke type II adolescent idiopathic scoliosis patients, preoperative apical vertebral Nash-More rotation level 3-4, Risser grade 4-5, major curve correction rate/flexibility>1, lower thoracic Cobb angle>70° were vulnerable to postoperative coronal plane imbalance. Multivariate logistic regression showed that vertebral rotation, Risser grade, major curve correction rate/flexibility, lower thoracic Cobb angle were independent risk factors for postoperative coronal plane imbalance in Lenke type II adolescent idiopathic scoliosis patients. The predictive model was Y=1/[1+exp(-1.182X 1+1.228X 2+1.671X 3-0.71X 4+0.407)].%背景:青少年特发性脊柱侧凸是目前临床上影响青少年身体外观的常见病,但通过 Logistic 回归方程来分析固定后冠状面失平衡目前尚缺乏报道。  目的:探讨Lenke Ⅱ型青少年特发性脊柱侧凸患者固定后冠状面失平衡的原因。  方法:对新疆医科大学第一附属医院脊柱外科2001年1

  14. Risser征对特发性脊柱侧凸患者生长潜能评估的组织学研究%Assessment of the residual spine growth potential in idiopathic scoliosis by Risser sign and histological grading

    Institute of Scientific and Technical Information of China (English)

    王守丰; 邱勇; 朱泽章; 朱锋; 马兆龙; 夏才伟

    2008-01-01

    Objective To investigate the correlation between histological grade (HG) of vertebral growth plates and Risser grade in the female idiopathic scoliosis(IS)patients;and to identify whether Risser grading is a reliable indicator for accurate evaluation of the spinal residual growth potential.Methods Thirtynine samples of vertebral growth plates obtained during operation from 15 females IS patients,all female,aged 15.1(12.4-18.0),underwent HE staining and light microscopy to determine the values of HG.Xray photography of pelvis was conducted before operation to identify the Risser sign.The correlation of Risser grade with pubertal status was analyzed.Results All the vertebral growth plates of the IS patients with the Risser grade of 0 showed growth activity.The vertebral growth plates showed HG Ⅱ activity in 6 of the 16 IS patients with the Risser grade of 4.All the vertebral growth plates showed no growth activity in the 3 IS patients with the Risser grade of 5.There was a negative correlation between the HG and Risser grade in all 39 patients(r=-0.645,P=0.000).The HG of the patients with the Risser grade of 4 was negatively correlated with the menarchal status(time between menarche and operation)(r=-0.710,P=0.002).The residual growth potential of spinal growth plates of the patients with the Risser grades of 2-5 was significantly lower than of the patients with the Risser grades of 0-1(P=0.020).Conclusion Risser sign may be a reliable indicator for predicting the spinal residual growth potential in IS patients,but it should be correlated with menarchal status and chronological ages.%目的 探讨Risser征对特发性脊柱侧凸(IS)患者的脊柱生长潜能的相关性.方法 对39例IS患者椎体生长板组织学分级(HGs)、Risser分级、患者月经状况和社会学年龄进行相关性分析.结果 Risser 0级时,所有患者椎体生长板具有生长活性.6例Risser 4级的患者椎体生长板组织学表现为Ⅱ度生长活性.Risser 5级时,所

  15. 性别对青少年特发性脊柱侧凸患者支具治疗效果的影响%Sex-related effect of bracing treatment for adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    孙旭; 邱勇; 王斌; 俞杨; 朱泽章; 钱邦平; 朱锋; 马薇薇

    2010-01-01

    目的:比较男、女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者支具治疗的效果,探讨性别因素对支具治疗效果的影响.方法:2003年7月~2009年7月在我院完成支具治疗的男性AIS患者19例(A组),初诊时平均年龄14.0±2.0岁.平均主弯Cobb角28.8°±5.7°,初始Boston支具治疗6例,Milwaukee支具治疗13例;随机抽取同时期完成支具治疗的女性AIS患者57例(B组),初诊时平均年龄13.0±1.4岁,平均主弯Cobb角29.4°±6.1°,初始Boston支具治疗17例,Milwaukee支具治疗40例.定义末次随访时Cobb角大于初诊6°或治疗期间建议行矫形手术者为侧凸进展.结果:两组初诊时Risser征(P=0.786)、Cobb角(P=0.790)、弯型分布(P=0.350)和应用支具类型分布(P=0.350)等无显著性差异.A组和B组平均支具治疗时长分别为2.1±0.7年和2.5±0.9年,平均依从性分别为84.4%±7.6%和87.1%±5.7%.A组患者中发生侧凸进展8例(42%),其中需手术治疗者6例(32%);B组中侧凸进展12例(21%),其中需手术治疗者10例(18%).男性患者侧凸进展比例高于女性,但统计学差异不明显(P=0.071).两组中,生长发育状态低下、侧凸Cobb角大及主胸弯型患者侧凸进展比例高.结论:支具治疗可有效控制多数AIS患者的侧凸进展,女性患者支具治疗效果可能好于男性患者.

  16. 脊柱侧凸顶椎椎体及附件旋转角测量及其临床意义%Axial rotation evaluation of different parts of apical vertebrae in idiopathic scoliosis and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    黄紫房; 杨军林; 谢红波; 李佛保; 王丽琴; 谢超凡

    2012-01-01

    [目的]评估特发性脊柱侧凸患者术前椎体、椎板、棘突旋转角及椎体相对棘突偏移的距离,为指导术中轴状面去旋转及冠状面侧凸矫形提供影像学基础.[方法]选取本院脊柱外科2008年1月~2010年1月收治的30例特发性脊柱侧凸患者,男11例,女19例;平均年龄17.0岁,Cobb角51.9°,术前皆行平卧位顶椎区域CT平扫.测量顶椎椎体、椎板及棘突的旋转角度,然后将椎体、椎板及棘突的旋转角度利用SPSS13.0进行三组定量资料的两两比较,分析三者间的旋转角差异.同时测量椎体相对椎板的偏移距离,计算出其平均值.[结果]顶椎旋转角:椎体平均为17.3°±8.67°,椎板平均为17.6°±11.14°,棘突平均为11.3°±10.51°.经统计分析椎体、椎板与棘突间的旋转角差异具有统计学意义(P=0.017,P=0.013),而椎体与椎板间的旋转角度无明显统计学差异(P =0.906).椎体相对椎板偏移的距离平均为(0.19 ±0.12) cm.[结论]测量脊柱侧凸患者术前CT顶椎椎体、椎板及棘突的旋转度和椎体相对棘突的偏移距离,对术中指导脊柱侧凸的轴状面和冠状面矫形具有一定临床意义.%[Objective] To compare rotational angle versus vertebral body, laminar and spinal processes, and measure the distance between vertebral axis and spinal process axis. [ Methods ] A restrospective study was performed on 30 patients with idiopathic scoliosis (11 boys, 19 girls) , with mean age of 17.0 years (range 10-29 years) . Mean Cobb angle of coronal curve before operation was 51. 9°. All patients took CT scaning of apical region before operation was done from January 2008 to January 2010. According to different parts of the apical vertebrae, rotational angel was divided into three groups; vertebral column group, laminar group and spinal process group. [ Results] The average rotation angle was 17. 3° ± 8. 67°for apical vertebral column group, 17. 6° ±11. 14°for laminar group, and 11. 3

  17. 青少年特发性脊柱侧凸术后远端节段楔形变危险因素分析%Analysis of risk factors leading to postoperative subjacent disc wedging in adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    赵颖川; 魏显招; 马辉; 李明

    2012-01-01

    目的 分析与青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者术后长期随访时融合区下方邻近节段楔形变相关的术后即刻影像学参数,指导手术治疗.方法 2003年3月~2006年1月连续收治的64名诊断为Lenke Ⅰ型或Ⅱ型的AIS患者纳入分析,所有患者采用后路全椎弓根螺钉系统手术治疗.术前、术后2周及术后末次随访(≥术后2年)时记录各项影像学数据,主要包括冠状面指标、矢状面指标、肩平衡指标及融合区平衡指标.分析这些指标与术后末次随访时融合区下方邻近节段成角及楔形变的相关性.结果 融合区下方椎间隙成角术前为4.59°±4.75°,术后2周为1.46°±2.82°,末次随访时为2.81°±6.43°.末次随访时的融合区下方椎间隙成角与术后即刻椎间隙成角、矢状面平衡以及融合下终椎偏移相关(r2 = 0.743 3,P<0.01).末次随访时的融合下终椎倾斜与术后即刻的下终椎成角、远端末融合节段前凸、下终椎偏移以及冠状面平衡相关(r2 =0.887 9,P<0.01).结论应用全椎弓螺钉系统矫形时,当脊柱侧凸矫形术后融合区下方邻近的椎间隙成角、下终椎倾斜或偏移时,极易发生术后远期的邻近节段倾斜或椎间隙楔形变.术前完善的手术策略制定、术中保持融合下终椎水平对于防止术后下方邻近节段退变相当重要.%Objective To analyze which radiographic parameter immediately after posterior spinal fusion for adolescent idi opathic scoliosis ( AIS ) correlates with subjacent disc wedging after long-term follow-up. Methods Sixty-four consecutive patients with AIS of Lenke I or II underwent posterior pedicle screw fixation from 2003 to 2006. Radiologic parameters including coronal, sagittal, shoulder and fusion balance were recorded preoperatively, 2 weeks postoperatively and at the final follow-up ( minimum 2 years ). Specific correlation of these parameters to disc wedging and lowest

  18. Instabilidade hemodinâmica grave durante o uso de isoflurano em paciente portador de escoliose idiopática: relato de caso Severe hemodynamic instability during the use of isoflurane in a patient with idiopathic scoliosis: case report

    Directory of Open Access Journals (Sweden)

    Adriano Bechara de Souza Hobaika

    2007-04-01

    ámica grave causada por isoflurano en pacientes previamente saludables. Anafilaxia, taquicardia supraventricular con repercusión hemodinámica y sensibilidad cardiaca aumentada al isoflurano son discutidas como posibles causas de la inestabilidad hemodinámica. Actualmente, existen evidencias de que el isoflurano pude interferir en el sistema de acoplamiento y desacoplamiento de la contratilidad miocárdica a través de la reducción del Ca2+ citosólico y/o deprimiendo la función de las proteínas contráctiles. Los mecanismos moleculares fundamentales de este proceso deben ser elucidados todavía. El relato sugiere que la administración del isoflurano fue la causa de las alteraciones hemodinámicas presentadas por el paciente y que este, probablemente, presentó una sensibilidad cardiovascular no común al fármaco.BACKGROUND AND OBJECTIVES: Isoflurane is considered a safe inhalational anesthetic. It has a low level of biotransformation, and low hepatic and renal toxicity. In clinical concentrations, it has minimal negative inotropic effect, causes a small reduction in systemic vascular resistance, and, rarely, can cause cardiac arrhythmias. The objective of this report was to present a case of severe hemodynamic instability in a patient with idiopathic scoliosis. CASE REPORT: Male patient, 13 years old, ASA physical status I, with no prior history of allergy to medications, scheduled for surgical repair of idiopathic scoliosis. After anesthetic induction with fentanyl, midazolam, propofol, and atracurium, 1% isoflurane with 100% oxygen was initiated for anesthesia maintenance. After five minutes, the patient presented severe hypotension (MAP = 26 mmHg associated with sinus tachycardia (HR = 166 bpm that did not respond to the administration of vasopressors and fluids. Lung and heart auscultation, pulse oxymetry, capnography, nasopharyngeal temperature, and arterial blood gases did not change. The patient was treated for anaphylaxis and the surgery was cancelled. The

  19. Scoliosis and dental occlusion: a review of the literature

    Directory of Open Access Journals (Sweden)

    Tecco Simona

    2011-07-01

    Full Text Available Abstract Background Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports. Objectives The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis Search strategy All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010. Selection criteria All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis. Data collection and analysis Data were extracted without blinding to the authors, age of patients or type of occlusion. Main results Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions

  20. Treatment planning in severe scoliosis: the role of MRI

    Energy Technology Data Exchange (ETDEWEB)

    Freund, M. [Dept. of Clinical Radiology, Univ. of Muenster (Germany); Dept. of Neuroradiology, Univ. of Heidelberg Medical School (Germany); Haehnel, S.; Sartor, K. [Dept. of Neuroradiology, Univ. of Heidelberg Medical School (Germany); Thomsen, M. [Dept. of Orthopaedic Surgery, University of Heidelberg, Medical School (Germany)

    2001-06-01

    The use of magnetic resonance imaging (MRI) in the preoperative investigation of children with idiopathic scoliosis is controversial. Syringomyelia and other intraspinal lesions may be risk factors for neurological injury during surgical correction. Our purpose was to investigate whether pathology of the neuraxis is associated with scoliosis and to detect lesions which may threaten neurological sequelae during distraction and instrumented correction. We obtained T1- and T2-weighted images of 40 children (28 girls, 12 boys), mean age 12.7 years with severe idiopathic scoliosis (Cobb angle 50-70 ) obtained in coronal, sagittal and axial planes from the posterior cranial fossa to the sacrum, and these were assessed by two neuroradiologists and an orthopaedic surgeon prior to further treatment planning. Abnormalities of the neuraxis were found in 24 patients (60 %); five (12 %) had two or more lesions. No abnormalities of the neuraxis were found in 16 patients (40 %). There were 15 patients (38 %) with intraspinal abnormalities who deteriorated clinically and nine (22 %) who showed no clinical changes. We transferred 16 patients (40 %) from the orthopaedic to the neurosurgical department for further assessment. Our results suggest that one should investigate the neuraxis with MRI before contemplating orthopaedic surgical correction of severe idiopathic scoliosis, because the findings may lead to a change of procedure. (orig.)

  1. Nonsurgical Management of Early-onset Scoliosis.

    Science.gov (United States)

    Thorsness, Robert J; Faust, John R; Behrend, Caleb J; Sanders, James O

    2015-09-01

    Early-onset scoliosis is potentially fatal if left untreated. Although surgical management with growing instrumentation may be necessary, this is not a panacea and is associated with high complication rates. Recent evidence has demonstrated that nonsurgical treatment can be an effective early management strategy in delaying or even precluding the need for surgery, especially surgery with growing instrumentation. The goal of both nonsurgical and surgical management is to control or correct the spinal curve to allow appropriate pulmonary development while delaying definitive fusion until an appropriate skeletal age. Although more commonly used to delay surgery, serial cast correction using the Cotrel and Morel elongation-derotation-flexion technique may result in complete correction in patients with infantile idiopathic scoliosis and smaller curve magnitudes.

  2. Experiences of young diagnosed with idiopathic scoliosis

    OpenAIRE

    Bonilla Carrasco, Maria Isabel; Solano Ruiz, Maria Carmen

    2016-01-01

    Justificación: Durante la adolescencia y la juventud acontecen cambios psicológicos y fisiológicos que forman parte del desarrollo normal de la persona. La irrupción de la escoliosis en esta edad influye en la vivencia de la autopercepción corporal. Objetivo: Conocer cómo una deformidad corporal influye en la estabilidad emocional de las jóvenes diagnosticadas de escoliosis. Diseño: Metodología cualitativa fenomenológicas situada en la hermenéutica. Método: Se utilizó una en...

  3. An analysis of vertebral axial rotation in adolescent idiopathic scoliosis based on EOSTM%基于 EOSTM 的青少年特发性脊柱侧凸椎体轴面旋转分析

    Institute of Scientific and Technical Information of China (English)

    秦乐; 严福华; 杜联军; 师小凤

    2016-01-01

    目的:利用 EOS 影像系统分析青少年特发性脊柱侧凸( adolescent idiopathic scoliosis,AIS )患者的椎体轴面旋转角度与冠状面、矢状面和骨盆畸形间的关系。方法选择2015年9月至2016年2月,在我院拍摄的 EOS 脊柱全长 X 线片的 AIS 患者,共有49例纳入研究,使用 sterEOS 软件对脊柱全长 X 线片进行三维模型重建。根据主弯所在位置,获得冠状面 Cobb’s 角,轴面顶点椎体旋转、上椎旋转、末椎旋转、上椎椎体间轴面旋转和末椎椎体间轴面旋转角度,矢状面 T4~12后凸角和骨盆参数骨盆入射角、骨盆倾斜角。对各轴面旋转角度与冠状面 Cobb’s 角以及骨盆参数进行 Pearson 相关性分析。将胸主弯、胸腰段主弯和腰主弯的顶点椎体旋转角度分别与胸椎矢状面后凸角进行相关性分析。结果顶点椎体轴面旋转与 Cobb’s 角有较好的相关性(r=0.792,P<0.001),上椎旋转、末椎旋转、上椎椎体间轴面旋转和末椎椎体间轴面旋转分别与 Cobb’s 角有轻、中度的相关性(r=0.419,P=0.003;r=0.320,P=0.025;r=0.366,P<0.01;r=0.345,P=0.015)。除顶点椎体轴面旋转与骨盆倾斜角有轻度相关性外(r=0.330,P<0.021),其余脊柱轴面与骨盆参数均无明显相关性。主胸椎侧凸组、胸腰段侧凸组和腰椎侧凸组顶点椎体旋转角度与 T4~12后凸角均无明显相关性。结论椎体轴面旋转角度与脊柱冠状面 Cobb’s 角之间存在密切的联系,但可能与胸椎后凸角和骨盆畸形并无明显关系。%Objective To evaluate the axial vertebral rotation for their relations with the coronal and sagittal spine as well as pelvic deformity by EOS imaging system.Methods From September 2015 to February 2016, 49 patients with adolescent idiopathic scoliosis subjected to EOS X-ray examinations were enrolled in this study, followed by sterEOS 3 D reconstructions

  4. Prevalência de escoliose idiopática e variáveis associadas em escolares do ensino fundamental de escolas municipais de Cuiabá, MT, 2002 Prevalence of idiopathic scoliosis and associated variables in schoolchildren of elementary public schools in Cuiabá, state of Mato Grosso, 2002

    Directory of Open Access Journals (Sweden)

    Alcebíades do Espírito Santo

    2011-06-01

    Full Text Available OBJETIVO: Estimar a prevalência de escoliose idiopática e variáveis associadas em escolares do ensino público fundamental. MÉTODOS: Estudo de corte transversal em duas fases, sendo a primeira nas salas de aula, com teste de Adams. Os que apresentaram Adams positivo foram convidados para a segunda fase, que constou de entrevista para fatores associados e exames para escoliose. Aqueles com teste confirmado nessa fase foram radiografados para escoliose e outras alterações. Para cálculo de prevalência utilizou-se, como ponto de corte, curvas > 5 e > 10 graus Cobb. RESULTADOS: Na primeira fase contaram-se 382 escolares com teste Adams positivo; destes, 210 compareceram para a segunda fase, sendo 142 com o teste confirmado. Comparando-se as variáveis idade, sexo e cor da pele, pelo teste de Qui-quadrado, do grupo das perdas (n = 172 com aqueles que atenderam ao convite (n = 210, não observamos diferenças com significância estatística, permitindo a validade para a amostra estudada (n = 3.105. A prevalência estimada de escoliose foi de 5,3% para curvas > 5 graus Cobb, e de 2,2% para curvas > 10 graus Cobb. Curva torácica foi observada em 44,8%, Risser grau 1 em 97,4% e 13,2% de rotação vertebral grau I. Observou-se significância estatística (p OBJECTIVE: To estimate the prevalence of idiopathic scoliosis and its associated factors in schoolchildren of elementary public schools. METHODS: Cross sectional two-phase study, the first of which in classrooms. Those considered Adams positive were invited for the second phase, which consisted of an interview for associated factors and a scoliosis exam. Those with a confirmed test in the second phase were submitted to x-rays for scoliosis and other factors. To estimate the prevalence, curves with > 5 and > 10 Cobb degrees were used as cut off. RESULTS: In the first phase, 382 students were counted as Adams positive; of these 210 came for the second phase, 142 of which with a confirmed test

  5. Video-Assisted Thoracoscopic Surgery for Correction of Adolescent Idiopatic Scoliosis: Comparison of 4.5 mm versus 5.5 mm Rod Constructs

    OpenAIRE

    Kim, Hak Sun; Park, Jin Oh; Nanda, Ankur; Kho, Phillip Anthony; Kim, Jin Young; Lee, Hwan Mo; Moon, Seong Hwan; Ha, Jung Won; Ahn, Eun Kyoung; Shin, Dong Eun; Kim, Sung Jun; Moon, Eun Su

    2010-01-01

    Purpose The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS). Materials and Methods Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis....

  6. Correlation and comparison of Risser sign versus bone age determination (TW3) between children with and without scoliosis in Korean population

    OpenAIRE

    Yang Jae-Hyuk; Suh Seung; Modi Chetna H; Modi Hitesh N; Hong Jae-Young

    2009-01-01

    Abstract Background Most studies comparing the Risser staging for skeletal maturity are representing the American or European standards which are not always applicable to Asian population who have relatively less height and body mass. There is no article available that compares the Risser sign and bone age correlation between patients with idiopathic scoliosis and patients without scoliosis. Materials and methods To analyze and compare the skeletal age with the Risser sign between scoliosis a...

  7. Animal models of scoliosis.

    Science.gov (United States)

    Bobyn, Justin D; Little, David G; Gray, Randolph; Schindeler, Aaron

    2015-04-01

    Multiple techniques designed to induce scoliotic deformity have been applied across many animal species. We have undertaken a review of the literature regarding experimental models of scoliosis in animals to discuss their utility in comprehending disease aetiology and treatment. Models of scoliosis in animals can be broadly divided into quadrupedal and bipedal experiments. Quadrupedal models, in the absence of axial gravitation force, depend upon development of a mechanical asymmetry along the spine to initiate a scoliotic deformity. Bipedal models more accurately mimic human posture and consequently are subject to similar forces due to gravity, which have been long appreciated to be a contributing factor to the development of scoliosis. Many effective models of scoliosis in smaller animals have not been successfully translated to primates and humans. Though these models may not clarify the aetiology of human scoliosis, by providing a reliable and reproducible deformity in the spine they are a useful means with which to test interventions designed to correct and prevent deformity.

  8. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Vishal Sarwahi

    2015-01-01

    Full Text Available Minimally invasive surgery (MIS has been described in the treatment of adolescent idiopathic scoliosis (AIS and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

  9. Effect of melatonin and calmodulin on idiopathic scoliosis model%褪黑素、钙调蛋白在脊柱侧凸模型中的相互作用

    Institute of Scientific and Technical Information of China (English)

    吴俊哲; 柯庆峰; 吴文华; 何立江; 王江波; 黄隆; 戴章生; 林朝晖

    2015-01-01

    Objective To explore influence of continuous illumination, luzindole and calmodulin antagonist, on success rate and Cobb angle of making animal model of bipedal rat scoliosis.Methods Make 32 one-month female rats, who were just weaned, into bipedal rats and randomly divided them into 4 groups.Group A: luzindole by intraperitoneal injection + continuous illumination, Group B: luzindole by intraperitoneal injection, Group C: luzindole by intraperitoneal injection + calmodulin antagonist TMX by drinking and Group D: equivalent normal saline by intraperitoneal injection as blank control.Take X-ray films on weeks 8 and 16 and count scoliosis model incidence and different scoliosis degree of different groups of rats.Results (1) On week 8, scoliosis occurs in part of rats in groups A and B, with incidence of 75.0% and 12.5% respectively.Scoliosis degrees of group A are between 10.8° and 16.8°, with an average of 12.4°, and average scoliosis of group B is 19.4°.The scoliosis incidences of both groups are with statistically significant differences (P < 0.05).Either group C or D has no scoliosis, with incidence of 0;(2) On week 16, scoliosis incidences of groups A and B are 57.0% and 62.5% respectively, and degrees of which are between 10.1° and 17.9° for group A and between 18.0° and 30.3° for group B, with an average of 14.3° and 25.2° respectively.Scoliosis incidences of groups A and B are of no significant difference (P > 0.05).No scoliosis occurs in either group C or group D, with incidence of 0, while incidences of groups B and C as well as groups B and D are of significant differences (P < 0.05).Conclusion (1) By intraperitoneal injection of luzindole to bipedal rats, scoliosis rat models could be successfully made, the incidence of scoliosis is associated with the loss of effect of melatonin;(2) Under light, the occurrence of scoliosis may be increased in early period, but it is reversible;(3) Light conditions can not increase the incidence

  10. The role of initial bone mineral status in predicting the early outcome of brace treatment in girls with adolescent idiopathic scoliosis%初诊骨密度对女性青少年特发性脊柱侧凸患者早期支具治疗效果的预测价值

    Institute of Scientific and Technical Information of China (English)

    孙旭; 朱泽章; 邱勇; 王斌; 李卫国; 朱锋; 俞杨; 钱邦平; 马薇薇

    2008-01-01

    Objective To investigate whether initial bone mineral status acts as a predictor factor in evaluating the early outcome of brace treatment in adolescent idiopathic scoliosis (AIS) girls. Methods Seventy-sevengirls with AIS, aged 10-15 years old, were included in this study. A standardized bracing protocol was performed in these girls, and the early outcomes of brace treatment were evaluated at over-1-year follow-up. Girls with a progressed scoliosis and those with a non-progressed scoliosis were identified.The associations between the outcome and the indices before bracing, including age, menstrual status,Risser grade, bone mineral density (BMD) status, curve magnitude and curve pattern were assessed using univariate analysis. A multiple Logistic stepwise regression was used to determine the risk factors in curve progression in AIS girls treated with brace treatment. Results There were 16 girls (21%) with a progressed scoliosis and 61 girls (79%) with a non-progressed scoliosis, respectively. In the girls with a progressed scoliosis, higher ratios of subjects were found with premenarchal status ( X2>= 9. 628, P =0. 004), lower Risser grade ( X2> = 4. 565, P = 0.037 ), main thoracic scoliosis ( X2> = 4. 009, P = 0. 045 ), a larger curve (X2> = 1. 685 ,P = 0.194), as well as osteopenia (X2>= 3. 828, P = 0. 050), as compared with those with a non- progressed scoliosis. During brace treatment, besides premenarchal status, a larger Cobb angle, and a main thoracic scoliosis, osteopenia ( OR = 5. 362, P = 0. 022) was identified as the risk factor in curve progression in AIS girls, as revealed by the multiple Logistic regression analysis. Conclusions Osteopenia might be an independent risk factor in the curve progression during brace treatment. The analysis of initial BMD status before bracing may help to predict the outcome of brace treatment.%目的 探讨青少年特发性脊柱侧凸女性患者初诊时骨密度对短期支具治疗期间侧凸畸

  11. Postoperative Trunk Shift in Lenke 1C Scoliosis

    DEFF Research Database (Denmark)

    Wang, Yu; Bünger, Cody Eric; Wu, Chunsen;

    2012-01-01

    STUDY DESIGN: A risk factor analysis study. OBJECTIVE: To identify the causative factors for postoperative trunk shift in Lenke 1C scoliosis and investigate how to prevent it. SUMMARY OF BACKGROUND DATA: When selective thoracic fusion is performed, postoperative trunk shift is a significant problem...... in the management of Lenke 1C scoliosis. It is often accompanied by unsatisfactory clinical outcomes and a risk of reoperation. METHODS: We reviewed all the patients with adolescent idiopathic scoliosis (AIS) surgically treated in our institution from 2002 through 2008. Inclusion criteria were as follows: (1......) patients with Lenke 1C curves who were treated with selective thoracic fusion using posterior pedicle screw-only constructs; (2) the lowest instrumented vertebra (LIV) ending at L1 level or above; and (3) 2-year radiographical follow-up. Eighteen radiographical parameters were chosen as potential risk...

  12. 青少年特发性脊柱侧凸患者FBN3基因多态性研究%FBN3 gene polymorphisms in adolescent idiopathic scoliosis patients

    Institute of Scientific and Technical Information of China (English)

    曹兴兵; 邱勇; 邱旭升; 朱泽章; 陈志军; 陈海鸥; 陈文俊

    2008-01-01

    目的 探讨FBN3基因多态性与青少年特发性脊柱侧凸(AIS)发生发展以及AIS患者异常生长模式之间的关联性.方法 本研究包括273例AIS患者及287名正常青少年.采用PCR-RFLP的方法 对FBN3基因外显子区域的4个多态性位点进行基因分型.结果 rs35277492位点AIS患者组和对照组均只出现CC一种基因型.FBN3基因多态性位点rs35579498、rs12608849、rs7257948基因型及等位基因分布AIS组与正常对照组比较没有明显差异.在AIS组内,rs7257948位点校正身高≥160 cm2组AIS患者CC基因型要明显多于160 cm2组(P=0.01).rs35579498位点,月经初潮年龄≥12岁的AIS女性患者T等位基因型表现活跃(P=0.015),CT基因型明显高于初潮年龄<12岁患者(P=0.042).3个位点不同基因型所对应的最大Cobb角、臂长以及BMI差异均无统计学意义.结论 FBN3基因rs35277492、ra35579498、rs12608849、rs7257948位点多态性与AIS的发病及侧凸严重程度无明显相关性.FBN3 rs35579498位点在AIS组中T等位基因表达相对活跃(P=0.051),可能影响月经来潮,在一定程度上影响AIS的发病及侧凸的进展,而rs7257948位点可能影响AIS患者的身高.%Objective To investigate the association of FBN3 gene polymorphism with abnormal growth pattern in adolescent idiopathic scoliosis (AIS) patients. Methods Blood samples were obtained from 273 AIS patients, aged (14. 6 ± 2. 1) (10-18), and 287 healthy age-matched females adolescents. The anthropometric parameters of the AIS group, including age, body height, weight, arm span, Cobb angle, time of menarche, and Risser's sign were recorded. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect the FBN3 gene distribution. Results The genotype and allele frequency distribution were comparable between the AIS and normal control groups. There was no association with curve severity, arm span, BMI in patients with AIS. In the rs7257948

  13. Sagittal spinopelvic alignment in various curve patterns in adolescent idiopathic scoliosis%不同弯型青少年特发性脊柱侧凸患者脊柱-骨盆矢状面参数研究

    Institute of Scientific and Technical Information of China (English)

    胡宗杉; 朱泽章; 邱勇; 刘臻; 王斌; 俞杨; 钱邦平; 朱锋; 孙旭

    2015-01-01

    目的:探讨不同弯型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者脊柱-骨盆矢状面平衡情况.方法:回顾性分析2013年9月~2014年12月我科收治的161例AIS患者,其中男34例,女127例,年龄12~17岁(14.6±2.1岁).在术前站立位全脊柱正侧位X线片上测量主弯Cobb角、颈椎角(cervical sagittal alignment,CSA)、胸椎后凸角(thoracic kyphosis,TK)、腰椎前凸角(lumbar lordosis,LL)、骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、骶骨倾斜角(sacrum slope,SS)以及C7铅垂线与S1后上缘的水平距离(sagittal vertical axis,SVA).根据不同弯型将AIS患者分为单胸弯组、双胸弯组和腰弯组,比较3组间脊柱-骨盆矢状位参数的差异,采用Pearson相关性分析对各参数间的相关性进行分析.结果:单胸弯组61例,其中男13例,女48例,主弯Cobb角为51.2°±8.7°;双胸弯组40例,其中男7例,女33例,主弯Cobb角为53.7°±5.2°;腰弯组60例,男14例,女46例,主弯Cobb角为48.9°±4.8°.3组患者年龄及性别分布均无统计学差异(P>0.05).3组间Cobb角大小的差异无统计学意义(P>0.05).单胸弯组的CSA、TK均显著小于双胸弯和腰弯组(P<0.05),但后两组间的差异无统计学意义(P>0.05),余各项矢状面参数3组间无统计学差异(P>0.05).在3组患者中,CSA与TK均呈显著性正相关(单胸弯组r=0.73,P<0.05;双胸弯组r=0.29,P<0.05;腰弯组r=0.60,P<0.05),但与LL及骨盆参数(PI、SS、PT)无显著相关性(P>0.05).双胸弯组TK与LL呈正相关性(r=0.40,P<0.05),而在另外两组则无相关性(P>0.05).结论:单胸弯型AIS患者较双胸弯型和腰弯型患者具有更小的颈椎前凸,3种弯型AIS患者的颈椎前凸均与TK呈正相关.单胸弯型患者的TK较另外两种弯型患者更小.双胸弯型患者的TK与LL密切相关,而单胸弯型与腰弯型患者的TK与LL无关.

  14. 青少年特发性脊柱侧凸腰腹部肌群表面肌电信号特征研究%Lumbo-abdominal muscle activity while standing in adolescents with idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    杜青; 周璇; 励建安; 赵黎; 杨晓颜; 陈楠; 张树新; 梁菊萍; 吴超

    2013-01-01

    目的 研究青少年特发性脊柱侧凸(AIS)患者不同站立位腰腹部肌群表面肌电信号特征.方法 选取33例AIS患者作为AIS组,15例健康青少年作为健康对照组,采用FlexComp Infiniti十通道表面肌电分析系统测试腰腹部肌群的表面肌电信号.所有研究对象分别站立在稳定平面和软垫上、去除和不去除视觉听觉干扰时进行测试.比较2组研究对象腰腹部肌群激活率.结果 站立在稳定平面和软垫上、去除和不去除视觉听觉干扰时,AIS组凹侧顶椎水平椎旁肌激活率分别为4.91% MVIC、5.22% MVIC、5.51%MVIC、6.01% MVIC,AIS组凸侧顶椎水平椎旁肌激活分别为6.45% MVIC、7.69% MVIC、8.31% MVIC、8.77% MVIC,AIS组凹侧顶椎水平椎旁肌激活均小于凸侧(P<0.01).AIS组凸侧顶椎水平椎旁肌在稳定静止站立位的激活率小于去除视觉和听觉干扰、不稳定的站立位(P<0.05).结论 AIS患者双侧顶椎水平椎旁肌激活率不对称;在去除视觉和听觉干扰的不稳定站立位下,AIS患者凸侧顶椎水平椎旁肌更易激活.%Objective To characterize the lumbo-abdominal muscles activities of adolescent idiopathic scoliosis (AIS) patients in different standing postures by using surface electromyography (sEMG).Methods A total of 33 AIS patients and 15 healthy subjects were recruited.The sEMG signals from the lumbo-abdominal muscles of the healthy subjects and AIS patients were measured with the FlexComp Infiniti apparatus.The sEMG signals were recorded in different standing postures with and without visual and auditory input.The activation of the lumbo-abdominal muscles was compared between healthy subjects and AIS patients.Results In different standing posture with and without visual and auditory information input,the activation rate of the concave side of the apex level paraspinal muscle was 4.91% MVIC,5.22% MVIC,5.51% MVIC,6.01% MVIC,and the activation rate of the convex side of

  15. The influence of thoracic kyphosis on sagittal balance of the lumbosacral spine in thoracic idiopathic scoliosis patients%特发性胸椎侧凸患者的胸椎后凸状态对腰骶椎矢状面形态的影响

    Institute of Scientific and Technical Information of China (English)

    邱勇; 殷刚; 曹兴兵; 王斌; 朱锋; 孙旭

    2008-01-01

    目的 探讨特发性胸椎侧凸患者的胸椎矢状面形态对腰骶椎矢状面形态的影响. 方法 研究对象包括胸弯犁青少年特发性脊柱侧凸(AIS)患者55例.所有研究对象均摄站立位脊柱全长正位片,并在上肢抱胸体位下摄站立位脊柱全长侧位片.按胸椎后凸(TK)的测量值分为:第一组TK<10°和第二组10°≤TK≤40°,测量的参数指标包括:腰椎前凸(LL)、上腰椎前凸、下腰椎前凸、骶骨后上缘与C,铅垂线的距离、骨盆倾斜角(PT)、骶骨倾斜角(SS)、骨盆投射角(PI).将第一组及第二组就参数的测量结果进行t检验比较(P<0.05),并对相关参数指标进行相关分析(P<0.01). 结果 第一组的LL和上腰椎前凸小于第二组的LL和上腰椎前凸,且具有统计学意义(P<0.05).胸弯型MS患者相邻节段的脊柱在矢状位形态上存在相关性,其中TK与LL、上腰椎前凸存在明显的线性相关.PT、SS及PI也存在明显的线性相关. 结论 胸弯型AIS患者的胸椎矢状面形态对患者的腰椎前凸有明显影响,并通过上腰椎对整个腰椎产生影响,在对主弯为胸椎的脊柱侧凸在进行选择性胸椎融合时必须考虑这种相互影响.%Objectives To evaluate the influence of thoracic kyphosis to sagittal alignment and balance of the lumbesacral vertebrae in thoracic adolescent idiopathic scoliosis patients. Methods Standing posteroanterior and lateral x-rays of a cohort of 55 patients with thoracic adolescent idiopathic scoliosis were obtained. The patients were classified according to their thoracic kyphosis, the first group TK < 10° and the second group 10°≤TK≤40°. The following parameters were measured: lumbar lordosis (LL) , upper and lower arc of lumbar lordosis, sagittal vertical axis, sacral slope ( SS), pelvic incidence ( PI ), pelvic tilt (PT). Sagittal plane parameters were analyzed using t-test between two groups, with significance set at P < 0. 05. Linear correlations between

  16. Analysis of burdens and influencing factors of the primary caregivers of patients with idiopathic scoliosis%特发性脊柱侧弯住院患者主要照顾者负荷及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    柴丽娜; 郭锦丽

    2016-01-01

    Objective To understand the situation in terms of burden of caregivers of the idiopathic scoliosis patients during hospitalization. Methods Totally 60 patients and their caregivers were investigated with Caregivers Bur-den Inventory ( CBI) , Self-Rating Anxiety Scale ( SAS) and general situation questionnaire. Results The total bur-den score of 60 primary caregivers ranged from 24 to 65 points, with an average score of (35. 46±11. 54). And 53. 3%of the caregivers were in a state of anxiety. Multiple linear regression analysis showed that caregivers' monthly income, daily time for caring, assistance of others and anxiety were the main factors for caregivers' burden. Conclusion Primary caregivers of patients with idiopathic scoliosis during hospitalization all shared a certain burden, so the medical staffs should give caregivers adequate love and help while taking care of the patients, in order to release their burdens.%目的:了解特发性脊柱侧弯患者在住院期间主要照顾者照顾负荷的现状,探讨照顾负荷的影响因素。方法采用一般情况问卷、照顾负荷问卷和焦虑自评量表对60例特发性脊柱侧弯患者及其主要照顾者进行调查。结果60名主要照顾者负荷总分为24~65分,平均(35.46±11.54)分,且60名照顾者中有53.3%处于焦虑状态;多元线性逐步回归分析显示,照顾者月收入、每天照顾时间、是否有他人协助以及照顾者焦虑情况是照顾者照顾负荷的主要影响因素。结论特发性脊柱侧弯患者在住院期间其主要照顾者均存在着一定的负荷,医护人员在护理患者的同时应该给予照顾者一定的爱护与帮助,以减轻其照顾负荷。

  17. Treatment of adolescent idiopathic scoliosis by high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation%优值牵引、中药熏蒸联合整脊手法治疗青少年特发性腰椎侧凸

    Institute of Scientific and Technical Information of China (English)

    张梦雨; 鲍铁周; 宋永伟; 李洋

    2016-01-01

    Objective: To observe the clinical effect of high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation in the treatment of adolescent idiopathic scoliosis. Method: 48 patients with adolescent idiopathic scoliosis between February 2013 and March 2015 from were treated with high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation. The VAS score, ODI score and Cobb change were compared before and after treatment. Result: After the treatment, the VAS score, ODI score and Cobb angle were decreased, and the difference between the three indicators were statistically significant(P<0.01). Conclusion: The treatment of AIS with high-qualitive traction and Chinese medicine fumigation combined with chiropractic manipulation can effectively improve the functional activity of patients, reduce the pain of patients with the advantages of simple operation, less injury and high safety.%目的:观察优值牵引、中药熏蒸联合整脊手法治疗青少年特发性腰椎侧凸的临床疗效。方法:2013年2月—2015年3月采用优值牵引、中药熏蒸联合整脊手法治疗青少年特发性脊柱侧弯患者48例,对比治疗前后患者VAS疼痛评分、ODI评分及Cobb角的变化。结果:疗程结束后患者的VAS疼痛评分、ODI评分及Cobb角均减小,且三项指标治疗前后差异具有统计学意义(P<0.01)。结论:优值牵引、中药熏蒸联合整脊手法治疗 AIS,可有效地改善患者功能活动,减轻患者疼痛,具有操作简便、无创安全等特点。

  18. Scoliosis Research Society

    Science.gov (United States)

    Back To Top Scoliosis Research Society Close Menu Member Login Become a Member Home Find a Specialist | Calendar Contact | Donate Patients and Families Professionals About SRS العَرَبِية ...

  19. Scoliosis in Children and Adolescents

    Science.gov (United States)

    ... Questions and Answers about Scoliosis in Children and Adolescents This publication defines scoliosis and provides information about ... it is diagnosed and treated in children and adolescents. You may be interested in contacting one or ...

  20. Scoliosis bracing and exercise for pain management in adults—a case report

    Science.gov (United States)

    Weiss, Hans-Rudolf; Moramarco, Kathryn; Moramarco, Marc

    2016-01-01

    [Purpose] For adult patients with late-onset idiopathic scoliosis, cosmetic concerns and pain are the main reasons for seeking treatment at a physician’s office. The purpose of this paper was to describe the mid-term effect of physical rehabilitation and part-time bracing on an adult scoliosis patient who had been suffering from chronic low back pain for fourteen years. [Subject and Methods] Case description: A 37-year-old female patient with late-onset idiopathic scoliosis presented in the office of the first author in January 2014. She reported having chronic pain (low back pain) since the age of 23 and reported daily pain at a level of 5–7 on average on a Visual Analogue Scale of 0 to 10. She received a short scoliosis-specific Schroth exercise program and was also fitted with a Gensingen brace for part-time wear. [Results] At a 16 month follow-up, the patient no longer suffered from daily low back pain (with heavy lifting only) and was fully active. Additionally, her lumbar Cobb angle and angle of trunk rotation improved. [Conclusion] Patients with late-onset idiopathic scoliosis and pain may benefit from a pattern-specific conservative treatment approach. In this population, surgical intervention should be regarded as the last resort, since there are many long-term unknowns with surgery. PMID:27630444

  1. Screening for Scoliosis: Different Countries' Perspectives and Evidence-Based Health Care

    Science.gov (United States)

    Plaszewski, Maciej; Nowobilski, Roman; Kowalski, Pawel; Cieslinski, Maciej

    2012-01-01

    Idiopathic scoliosis affects 2-3% of adolescents. Large, progressing deformities, mostly present in girls, may lead to pulmonary complications, pain symptoms, the feeling of social isolation, and even mental disorders. The correlation of screening programs with surgery rate reduction and the clinical effectiveness of bracing remain a matter of…

  2. Influence of implant rod curvature on sagittal correction of scoliosis deformity

    DEFF Research Database (Denmark)

    Salmingo, Remel A.; Tadano, Shigeru; Abe, Yuichiro;

    2014-01-01

    BACKGROUND CONTEXT: Deformation of in vivo–implanted rods could alter the scoliosis sagittal correction. To our knowledge, no previous authors have investigated the influence of implanted-rod deformation on the sagittal deformity correction during scoliosis surgery. PURPOSE: To analyze the changes...... of the implant rod’s angle of curvature during surgery and establish its influence on sagittal correction of scoliosis deformity. STUDY DESIGN: A retrospective analysis of the preoperative and postoperative implant rod geometry and angle of curvature was conducted. PATIENT SAMPLE: Twenty adolescent idiopathic...... scoliosis patients underwent surgery. Average age at the time of operation was 14 years. OUTCOME MEASURES: The preoperative and postoperative implant rod angle of curvature expressed in degrees was obtained for each patient. METHODS: Two implant rods were attached to the concave and convex side...

  3. Postoperative spinal alignment remodeling in Lenke 1C scoliosis treated with selective thoracic fusion

    DEFF Research Database (Denmark)

    Wang, Yu; Bünger, Cody; Zhang, Yanqun;

    2012-01-01

    and how spinal alignment remodeling affects spinal balance. METHODS: All adolescent idiopathic scoliosis (AIS) cases surgically treated in our institution between 2002 and 2008 were reviewed. Inclusion criteria were as follows: Lenke 1C scoliosis patients treated with posterior pedicle screw...... after surgery. Although some patients regained spinal balance through postoperative spinal alignment remodeling, 11 patients remained imbalanced at 2-year follow-up. CONCLUSIONS: Selective thoracic fusion is prone to cause leftward spinal imbalance in Lenke 1C scoliosis patients. Postoperative spinal...... alignment remodeling can facilitate recovery of spinal balance in some patients. Postoperative spinal imbalance in Lenke 1C scoliosis patients could be prevented by selecting stable vertebra or the vertebrae above as LIV, checking the balance condition during surgery, or considering ratio criteria when...

  4. The management of scoliosis in children with cerebral palsy: a review

    Science.gov (United States)

    Gardner, Adrian

    2016-01-01

    Children who suffer with cerebral palsy (CP) have a significant chance of developing scoliosis during their early years and adolescence. The behavior of this scoliosis is closely associated with the severity of the CP disability and unlike idiopathic scoliosis, it continues to progress beyond skeletal maturity. Conservative measures may slow the progression of the curve, however, surgery remains the only definitive management option. Advances in surgical technique over the last 50 years have provided methods to effectively treat the deformity while also reducing complication rates. The increased risk of surgical complications with these complex patients make decisions about treatment challenging, however with careful pre-operative optimization and post-operative care, surgery can offer a significant improvement in quality of life. This review discusses the development of scoliosis in CP patient, evaluates conservative and surgical treatment options and assesses post-operative outcome. PMID:28097247

  5. [Costoplasty in scoliosis surgery].

    Science.gov (United States)

    González López, J L; Riquelme García, O; Soleto Martín, F J; Villa García, A; Vázquez Estévez, J

    2006-04-01

    The rib hump is a protrusion of the apicals ribs of the convex side of the toracic scoliosis and it is due to the torsional deformity that appears in scoliosis. It originates a great cosmetic deformity that although improves with the correction of the scoliosis, it appears again by the costal elasticity. For this reason, in cases of important deformity it is necessary to associate a costoplasty for its definitive improvement. 10 cases of Idiopatic Scoliosis with 75.5 degrees of average and rib hump of 22.1 degrees were analysed. A resection of apicals ribs without stabilization in the same surgical act were done; the correction of the curve was 34.6 degrees (55%) and of the hump 8.1 degrees (64%); there were no important complications and the postoperative evolution was normal. The average follow up was 21,9 months, only in 1 case a slight deterioration of the hump was detected, although in all the cases the ribs recovered. In conclusion, costoplasty breaks the vertebro-bicosto-esternal ring. For that reason it is effective for the improvement of the costal hump without adding morbidity to the correction of the scoliosis.

  6. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools.

    Science.gov (United States)

    Berdishevsky, Hagit; Lebel, Victoria Ashley; Bettany-Saltikov, Josette; Rigo, Manuel; Lebel, Andrea; Hennes, Axel; Romano, Michele; Białek, Marianna; M'hango, Andrzej; Betts, Tony; de Mauroy, Jean Claude; Durmala, Jacek

    2016-01-01

    In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called "wait and see" approach that far too many doctors use when evaluating children's scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient's preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also

  7. Surgical treatment of scoliosis: a review of techniques currently applied

    Directory of Open Access Journals (Sweden)

    Maruyama Toru

    2008-04-01

    Full Text Available Abstract In this review, basic knowledge and recent innovation of surgical treatment for scoliosis will be described. Surgical treatment for scoliosis is indicated, in general, for the curve exceeding 45 or 50 degrees by the Cobb's method on the ground that: 1 Curves larger than 50 degrees progress even after skeletal maturity. 2 Curves of greater magnitude cause loss of pulmonary function, and much larger curves cause respiratory failure. 3 Larger the curve progress, more difficult to treat with surgery. Posterior fusion with instrumentation has been a standard of the surgical treatment for scoliosis. In modern instrumentation systems, more anchors are used to connect the rod and the spine, resulting in better correction and less frequent implant failures. Segmental pedicle screw constructs or hybrid constructs using pedicle screws, hooks, and wires are the trend of today. Anterior instrumentation surgery had been a choice of treatment for the thoracolumbar and lumbar scoliosis because better correction can be obtained with shorter fusion levels. Recently, superiority of anterior surgery for the thoracolumbar and lumbar scoliosis has been lost. Initial enthusiasm for anterior instrumentation for the thoracic curve using video assisted thoracoscopic surgery technique has faded out. Various attempts are being made with use of fusionless surgery. To control growth, epiphysiodesis on the convex side of the deformity with or without instrumentation is a technique to provide gradual progressive correction and to arrest the deterioration of the curves. To avoid fusion for skeletally immature children with spinal cord injury or myelodysplasia, vertebral wedge ostetomies are performed for the treatment of progressive paralytic scoliosis. For right thoracic curve with idiopathic scoliosis, multiple vertebral wedge osteotomies without fusion are performed. To provide correction and maintain it during the growing years while allowing spinal growth for

  8. Scoliosis and bronchial obstruction.

    Science.gov (United States)

    Qiabi, Mehdi; Chagnon, Karine; Beaupré, Alain; Hercun, Julian; Rakovich, George

    2015-01-01

    Severe scoliosis may have a significant effect on respiratory function. The effect is most often restrictive due to severe anatomical distortion of the chest, leading to reduced lung volumes, limited diaphragmatic excursion and chest wall muscle inefficiency. Bronchial compression by the deformed spine may also occur but is more unusual. Management options include a conservative approach using bracing and physiotherapy in mild cases, as well as surgical correction of the scoliosis in more severe cases. Bronchial stenting has also been used successfully as an alternative to surgical correction, and in cases in which spinal surgery was either unsuccessful or not feasible. The authors present a case involving a 52-year-old woman who exhibited symptomatic compression of the bronchus intermedius by severe residual scoliosis despite previous corrective surgery. She was treated with an indwelling bronchial stent.

  9. Scoliosis and Bronchial Obstruction

    Directory of Open Access Journals (Sweden)

    Mehdi Qiabi

    2015-01-01

    Full Text Available Severe scoliosis may have a significant effect on respiratory function. The effect is most often restrictive due to severe anatomical distortion of the chest, leading to reduced lung volumes, limited diaphragmatic excursion and chest wall muscle inefficiency. Bronchial compression by the deformed spine may also occur but is more unusual. Management options include a conservative approach using bracing and physiotherapy in mild cases, as well as surgical correction of the scoliosis in more severe cases. Bronchial stenting has also been used successfully as an alternative to surgical correction, and in cases in which spinal surgery was either unsuccessful or not feasible. The authors present a case involving a 52-year-old woman who exhibited symptomatic compression of the bronchus intermedius by severe residual scoliosis despite previous corrective surgery. She was treated with an indwelling bronchial stent.

  10. Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Damasio, Maria Beatrice [G. Gaslini Institute, Department of Diagnostic Imaging, Genoa (Italy); Malattia, Clara [G. Gaslini Institute, Department of Pediatrics 2, Genoa (Italy); Martini, Alberto [University of Genova, Department of Pediatrics, Genoa (Italy); Toma, Paolo [Bambin Gesu Pediatric Hospital, Rome (Italy)

    2010-06-15

    Juvenile idiopathic arthritis (JIA) represents a group of heterogeneous diseases characterized by a chronic inflammatory process primarily targeting the synovial membrane. A persistent synovitis is associated with an increased risk of osteocartilaginous damage. With the advent of effective structure-modifying treatment for JIA, it may be possible to significantly reduce or even completely prevent structural damage and associated functional disability. The trend towards early suppression of inflammation, in order to prevent erosive disease, shifts the emphasis away from conventional radiographic detectable structural damage to the slightest traces of early joint damage, and drives the need for alternative imaging techniques more sensitive in detecting early signs of disease activity and damage. In this regard MRI and US are playing an increasing role in the evaluation of arthritic joints. This article will review the key aspects of the current status and recent important advances of imaging techniques available to investigate the child with rheumatic disease, briefly discussing conventional radiography, and particularly focusing on MRI and US. In this era of advancing imaging technology, knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with JIA. (orig.)

  11. Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB: assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

    Directory of Open Access Journals (Sweden)

    Perisano Carlo

    2009-09-01

    Full Text Available Abstract Background The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect. The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS Committee on Bracing and Nonoperative Management Standardisation Criteria. Methods Fifty adolescent females (mean age 11.8 ± 0.5 years with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 ± 44.5 months. Antero-posterior radiographs were used to estimate the curve magnitude (CM and the torsion of the apical vertebra (TA at 5 time points: beginning of treatment (t1, one year after the beginning of treatment (t2, intermediate time between t1 and t4 (t3, end of weaning (t4, 2-year minimum follow-up from t4 (t5. Three situations were distinguished: curve correction, curve stabilisation and curve progression. The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests. Results CM mean value was 29,30 ± 5,16 SD at t1 and 14,67 ± 7,65 SD at t5. TA was 12.70 ± 6,14 SD at t1 and 8,95 ± 5,82 at t5. The variation between measures of Cobb and Perdriolle degrees at t1,2,3,4,5 and between CM t5-t1 and TA t5-t1 were significantly different. Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients. Conclusion The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

  12. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, A.; Aderbauer, J.; Segerer, H. [St. Hedwig Hospital, Regensburg (Germany). Dept. of Pediatrics; Marienhagen, J.; Bock, E.; Eilles, C. [Univ. Hospital, Regensburg (Germany). Dept. of Nuclear Medicine

    1999-05-01

    A 9 1/2-year-old girl suffered from intermitting tremor and jitteriness of her left hand and oral muscles every 4 to 6 weeks with long lasting episodes. Clinically myoclonias and dystonic positioning of the left arm, hand and facial muscles were seen. No evidence of trauma, infection or inborn errors of metabolism was found. Successful therapy with carbamazepine was initiated while L-DOPA failed. An ictal 99m-Tc-HMPAO-SPECT showed severe asymmetry with focal hyperperfusion of the contralateral right thalamus and basal ganglia as well as of the bifrontal cortex, whereas no anatomical lesions were found by MRI. In contrast, an interictally performed 99m-Tc-HMPAO SPECT showed hypoperfusion or the right thalamus and normalisation of the frontal perfusion under medical treatment. These 99m-Tc-HMPAO-SPECT findings may provide new insights into the localisation and pathophysiological pathways of idiopathic childhood dystonia. (orig.) [Deutsch] Ein 9 1/2jaehriges Maedchen litt an rezidivierenden, langdauernden Schueben von Tremor und Zittern der linken Hand und der perioralen Muskulatur links. Klinisch fanden sich eine dystone Haltung des linken Armes und unerschoepfliche Myoklonien des Armes, der Hand und der Gesichtsmuskulatur links. Trauma, Infektion oder ein Stoffwechseldefekt als Ursache lagen nicht vor. Ein Therapieversuch mit L-DOPA war erfolglos. Unter Gabe von Carbamazepin wurde Beschwerdefreiheit bleibend erreicht. Ein iktuales 99m-Tc-HMPAO-SPECT zeigte eine fokale Hyperperfusion des rechtsseitigen Thalamus und der Basalganglien, sowie des bifrontalen Kortex. Ein interiktuales 99m-Tc-HMPAOSPECT ergab dann eine deutliche Hypoperfusion des rechtseitigen Thalamus bei normalisierter Perfusion des bifrontalen Kortex. Eine kranielle Magnetresonanztomographie (MRI) ergab einen unauffaelligen Befund. Der Vergleich der iktualen und interiktualen Perfusionsverhaeltnisse weist auf neue pathophysiologische Zusammenhaenge bei idiopathischer kindlicher Dystonie hin. (orig.)

  13. The Impact of Gender on the Quality of Life in Patients with Adolescent Idiopathic Scoliosis (A IS) Treated with Brace%不同性别对青少年特发性脊柱侧凸患者支具治疗生存质量评价的影响

    Institute of Scientific and Technical Information of China (English)

    周惠清; 张建新; 林思舜; 柳明忠; 林松庆

    2012-01-01

    目的:检测男女性别不同对青少年特发性脊柱侧凸(AIS)患者支具治疗生存质量评价的影响.方法:将87例支具治疗AIS患者分为2组,男性41例,女性46例,平均随访时间2.5年.2组患者在年龄、随访时间、支具治疗类型、主弯所在节段、以及支具治疗前、治疗后cobb角和Risser征等比较差异无统计学意义(P>0.05),87例患者均填写脊柱侧凸研究会患者问卷-22(SRS-22)量表,比较2组间量表单个维度和单个条目得分的差别.结果:女性治疗满意度维度得分高于男性(P<0.05),女性自我形象/外观维度得分也高于男性(P<0.05);其中自我形象/外观维度的条目4、6、10,以及治疗满意度维度的条目22的得分比较差异有统计学意义(P<0.05);但2组功能/活动度、疼痛和精神健康维度的得分比较差异无统计学意义(P>0.05).结论:性别不同会影响AIS患者支具治疗生存质量的评测结果,评测患者生存质量时需考虑此因素影响.%Objective: To observe the impact of gender on the quality of life in patients with adolescent idiopathic scoliosis (AIS) treated with brace. Methods:87 patients (male 41 cases, female 46) with AIS treated with brace were divided into two groups. The mean follow-up time was 2. 5 years. There was no significant difference (P>0. 05) in age, follow-up time, the type of brace treatment, the main curved located segments, and the Cobb's angle before and after brace treatment and Risser sign in two groups. The questionnaires -22 (SRS-22) scales were filled in for all 87 patients, the scores of dimensions and single items were compared between the two groups. Results: The scores of therapeutic satisfaction in women were higher than that in men (P0. 05) in self-image / appearance of the dimension entries 4,6,10 and the score of therapeutic satisfaction in 22 entries (P0. 05) in function, activity, pain and scores of mental health dimensions in the two group. Conclusions

  14. The preliminary study of the efficiency of using cervical vertebral maturation in the evaluation of growth level of female adolescent idiopathic scoliosis%颈椎骨成熟度用于女性青少年特发性脊柱侧凸患者骨骼生长发育评价的初步研究

    Institute of Scientific and Technical Information of China (English)

    张涤清; 陈自强; 李明

    2011-01-01

    Objectives To investigate the reliability of cervical vertebral maturation(CVM)and to verify the possibility in the growth evaluation of female adolescent idiopathic scoliosis patients as a helpful supplementary to the Risser sign. Methods Coronal and lateral full-length spine X-ray film and left handwrist radiographs of 77 female adolescent patients with idiopathic scoliosis were selected from January 2010 to Octorber 2010. The interval period between lateral length of the spine and left hand-wrist radiographs did not exceed 3 months. The CVM was assessed by a method developed by Baccetti and co-workers, whereas handwrist maturation was assessed by Fishman's method. The results were analyzed by Spearman correlation with patients Risser sign, chronological age, and menarche period. Results There were strong correlations between CVM and SMI or Risser sign(r =0. 862 and 0. 762,P <0. 01). While in 26 patients whose Risser sign were 0- Ⅰ , the correlation between CVM and SMI was more pronounced(r = 0. 761, P < 0. 01),compared with the correlation between Risser sign and SMI(r = 0. 641, P < 0. 01). Conclusions CVM is a valid indicator of skeletal growth evaluation and can be used as a helpful supplementary to Risser sign.%目的 通过对颈椎骨成熟度(CVM)、Fishman骨成熟度指标(SMT)及Risser征之间的相关性进行研究,探讨CVM作为Risser征的补充指标应用于对女性青少年特发性脊柱侧凸患者骨骼生长发育评价的可行性.方法 选取2010年1月至10月77例女性青少年特发性脊柱侧凸患者,行脊柱全长正侧位X线片及左手正位X线片检查,拍摄时间间隔不超过3个月.以CVM分期对颈椎C2~C4进行分期,Fishman提出的SMI分期评估骨龄.所得结果均与患者Risser征及实际年龄、月经初潮时间作Spearman相关性分析.结果 CVM分期与SMI分期、Risser征均呈明显相关(r=0.862和0.762,P<0.01).Risser征与SMI分期间有相关性(r=0.801,P<0.01).在26例Risser征0

  15. Association study of CALM2 gene polymorphisms with susceptibility to adolescent idiopathic scoliosis%CALM2基因多态性与青少年特发性脊柱侧凸遗传易感性的关联性研究

    Institute of Scientific and Technical Information of China (English)

    周熹; 邱贵兴; 吴志宏; 原所茂; 费琦; 刘正

    2011-01-01

    Objective To identify the relationship between CALM2 gene and adolescent idiopathic scoliosis (AIS). Methods A hospital-based case-control design was applied in this study. A total of 107 patients diagnosed with adolescent idiopathic scoliosis admitted in Peking Union Medical College ( PUMC) hospital and 107 controls were enrolled in this study. Genomic DNA was extracted from peripheral blood leukocytes of each subject. Based on genotype data from the international HapMap project, single nucleotide polymorphisms (SNPs) in calmodulin 2 ( CALM2) gene were initially chosen. Genotyping of all selected SNPs was done by VeraCode GoldenGate Genotyping Assay SNPstream technolofy. Haplotype frequencies were estimated and difference in haplotype distributions between cases and controls were assessed. Results SNP Allele-AIS; the allele frequency distributions of rsl0153674 was statistically different between case group and control group (P =0.003). The genotypes distributions of rsl0153674 and rsl027478 were statistically different between PUMC I AIS group and control group (P =0.038, 0. 006 respectively). Conclusion Genetic variants of CALM2 gene are associated with AIS and may play an important role in the development of AIS. The development of PUMC I AIS might be related to genotype polymorphisms of rsl0153674 and rsl027478.%目的 探讨钙调蛋白2基因(CALM2基因)与青少年特发性脊柱侧凸遗传易感性的相关性.方法 采集北京协和医院骨科确诊的汉族青少年特发性脊柱侧凸患者107例,对照组107例,病例组按照PUMC分型进行分组.采外周血试剂盒提取DNA.根据国际人类基因组单倍体型图计划提供的基因型数据,选取CALM2基因的SNPs位点,应用VeraCode GoldenGate Genotyping Assay基因芯片进行SNPs基因型鉴定.用关联分析法探索CALM2基因与患者发病及临床表型之间的关系.结果 CALM2的rs10153674等位基因在病例组和对照组中的分布频率统

  16. Imaging study of the wedging changes of vertebral bodies and intervertebral disks in Adolescent idiopathic scoliosis%青少年特发性脊柱侧凸患者的椎体及椎间盘楔形变的影像学研究

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 邱贵兴; 王以朋; 吴志宏; 仉建国; 刘勇

    2008-01-01

    目的 观察进展型青少年特发性脊柱侧凸支具治疗前及手术治疗前椎体和椎间盘楔形角的变化,并探讨椎体和椎间盘楔形变与侧凸之间的相关性.方法 对2001年6月至2003年8月间37例青少年特发性脊柱侧凸患者支具治疗前和手术治疗前影像学上椎体和椎问盘的楔形变及侧弯的角度进行测量,本组男6例,女31例,年龄11~18岁,平均14.9岁.根据PUMC分型:PUMC la 8例,PUMC I b 3例,PUMC I c 5例,PUMC Ⅱ bl 12例,PUMCⅡ b2 3例,PUMC Ⅱ cl 3例,PUMC Ⅱ e3 l例,PUMC Ⅱ dl 2例.结果 发育成熟(Risser征Ⅳ~V)及月经初潮2年以上的患儿支具治疗前后的椎体、椎问盘楔形角与侧凸Cobb角的相关程度较低(r=0.17),而发育不成熟的患儿(Risser征0~Ⅲ,月经未来潮)支具治疗前后的椎体、椎间盘楔形角与侧凸Cobb角的相关程度较高(r=O.69).随着侧凸的进展,椎体和椎间盘的楔形角明显增加,椎体和椎间盘的楔形变同侧凸的进展明显相关,并与侧凸的程度呈正相关.结论 在侧凸的发生和进展过程中椎体和椎间盘出现明显的楔形变,并随着侧凸的加重而变得更加明显,表明椎体软骨终板的不对称生长可能是导致椎体楔形变的关键因素.%Objective To observe the wedging changes of vertebral bodies and intervertebral disks in progress Adolescent idiopathic scoliosis patients before conservative treatment with braces and operation,and define the correlation between vertebral bodies and intervertebral disks wedging change with scoliosis curve.Methods Thirty-seven consecutive patients with Adolescent idiopathic scoliosis were included in this study from June 2001 to Augest 2003.There are 3l females and 6 males.with the average age of 14.9years.According PUMC grading system,there were I a for 8 cases,I b for 3 cases,I C for 5 cases,Ⅱ bl for 12 cases.Ⅱb2 for 3 cases,Ⅱ C1 for 3 ases,Ⅱc3 for 1 ease,Ⅱdl for 2 cases.The wedging changes of vertebral

  17. Scoliosis Screening in Schools.

    Science.gov (United States)

    New York State Education Dept., Albany. Div. of Pupil Personnel Services.

    The booklet outlines New York state school policy and procedures for screening students for scoliosis, lateral curvature of the spine. It is explained that screening is designed to discover spinal deformities early enough to prevent surgery. Planning aspects, including organizing a planning team for the school district, are discussed. Among…

  18. 青少年特发性脊柱侧凸不同弯型患者椎体和椎间盘楔形变的差异及临床意义%Contributions of vertebral and disc wedging to the Cobb angle in adolescent idiopathic scoliosis with different curve pattern:radiographic discrepancy and clinical significance

    Institute of Scientific and Technical Information of China (English)

    丁旗; 邱勇; 孙旭; 王斌; 毛赛虎; 季明亮

    2011-01-01

    Objective;To investigate the difference of contribution to the Cobb angle between vertebral and disc wedging in adolescent idiopathic scoliosis(AIS) with different curve pattern and its clinical significance. Method:Form January 2007 to June 2009,110 AIS patients were divided into three groups according to their curve patterns,which included 39 patients with a major thoracic curve (group A),33 with a thoracolumbar curve (group B) and 38 with major lumbar curve (group C). According to the Cobb angle (0.05).The wedging angle and wedging percentage of vertebrae were significantly higher than those of discs in group A (21.9°±5.6° vs 13.7°±5.9°,and 62.3% vs 37.7% ,P<0.001),however the reverse results in group B and C (24.1°±9.2° vs 10.4°±3.8°,69.0% vs 31.0%,P<0.001;and 25.1°±7.2° vs 7.7°±2.4°,76.6% vs 23.4%,/?<0.001).The wedging angle of vertebra and discs in patients with Cobb angle ^40° was significantly higher than that in patients with Cobb angle <40°(P<0.001).Along with the increase of Cobb angle,vertebral wedging still played a major role in contribution to Cobb angle in group A,while disc wedging accounted for the main part in group B and C.Additionally,the wedging angle of apical vertebrae was linearly correlated with the Cobb angle in each group (P<0.001).Conclusion:Various vertebral and disc wedging exist in adolescent idiopathic scoliosis regardless of the curve patterns.The vertebral wedging contribute more to the Cobb angle in major thoracic curve than discs,while disc wedging contribute more to the Cobb angle in thoracolumbar and lumbar curves,which indicate different biomechanical pathogenesis among varied curve types.%比较不同弯型、不同Cobb角的青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者椎体和椎间盘楔形变及其对整体Cobb角构成的差异,探讨其临床意义.方法:2007年1月~2009年6月对收治的110例单弯型AIS患者按弯型分组,其中主胸弯39例(A组),胸腰弯33

  19. Surgical treatment of rigid adolescent thoracic idiopathic scoliosis with posterior all pedicle screw constructs: comparison of Ponte osteotomy versus Smith-Petersen osteotomy%Ponte截骨与SPO截骨联合后路全椎弓根螺钉系统矫正僵硬性青少年特发性胸椎侧凸的疗效比较

    Institute of Scientific and Technical Information of China (English)

    刘祥胜; 朱晓东; 白玉树; 吴大江; 吴冰; 易红蕾; 李明; 王达义

    2012-01-01

    [目的]对Ponte截骨与Smith - Petersen截骨(SPO截骨)治疗僵硬性青少年特发性胸椎侧凸的临床疗效及影像学结果进行回顾性比较.[方法] 2007年5月~2009年3间收治的单纯后路全椎弓根螺钉系统矫正僵硬性青少年特发性胸椎侧凸的手术病例58例,其中36例行SPO截骨,22例行Ponte截骨.通过影像学检查对两组的手术效果和躯干平衡情况进行分析,末次随访时用中文版SRS - 22量表进行患者的健康生存质量评价.[结果]两组患者的性别比例、手术时年龄、Risser征、融合节段数、置钉密度、术前冠状面胸主弯Cobb角无显著性意义(P>0.05).Ponte截骨组的术后3个月冠状面胸主弯Cobb角矫正率明显大于SPO截骨组,分别为67.1%和56% (P<0.05).末次随访时两组矫正率得到很好的维持,分别为61%和50.5% (P<0.05).两组的术前、术后腰椎代偿性次弯Cobb角无显著性差异.两组的术前胸椎后凸 Cobb角分别为20.6±8.5°和22.3±10.5°,术后3个月胸椎后凸角SPO截骨组比术前平均增加1.2°,Ponte截骨组比术前平均丢失1.4°,末次随访SPO截骨组胸椎后凸角比术前平均增加1.9°,Ponte截骨组比术前平均丢失2.9°,两组间比较无显著性差异(P>0.05).两组的次要并发症无显著性差异(P>0.05),两组均未发生主要并发症.[结论]多节段Ponte截骨能提高僵硬性青少年特发性胸椎侧凸冠状面胸主弯Cobb角的手术矫正率,并不增加并发症的发生率,而且能提供更多的局部自体植骨量、增加植骨融合面积.%[Objective] To compare the clinical and radiological outcomes between Ponte osteotomy and Smith - Petersen osteotomy ( SPO) for the surgical treatment of rigid adolescent thoracic idiopathic scoliosis with posterior all pedicle screw constructs. [Methods] From May 2007 to March 2009, 58 patients with rigid adolescent thoracic idiopathic scoliosis were treated by posterior segmental pedicle screw

  20. The influence of the Risser sign on the post-operative sagittal profile of idiopathic thoracic scoliosis patients treated with the anterior instrumentation%不同Risser征的胸弯青少年特发性脊柱侧凸前路矫形术后矢状面重建

    Institute of Scientific and Technical Information of China (English)

    钱邦平; 邱勇; 曹兴兵; 王斌; 俞杨; 朱泽章

    2011-01-01

    Objective To analyze the influence of the Risser sign on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after anterior spinal fusion.Methods Between June 2002 and November 2006,43 adolescent idiopathic scoliosis(AIS)patients(Lenke 1)undergone anterior correction with a minimum 2 years follow-up were included in this study.The patients were divided into three groups according to the Risser sign:group A(Risser 0),group B(Risser 1-3),and group C(Risser 4-5).The preoperative,postoperative and follow-up sagittal profile were evaluated by the following radiological parameters measured on the lateral radiograph,including the thoracic kyphosis,the lumbar lordosis,the thoracolumbar junction kyphosis,the distal junctional kyphosis,and the sagittal vertical axis.Results In group A,the thoracolumbar junction kyphosis significantly changed from-1.7° preoperative to 6.6° at the final follow-up,with an average increase of 8.3°.Similarly,in group B,the thoracolumbar junction kyphosis changed from -7.3° before surgery to 0.6° at the final follow-up,with an average variation of 7.9°.No obvious change of the thoracolumbar junction kyphosis was observed in group C.At the final follow-up,the average thoracic kyphosis in three groups was 21.2°,18.4° and 14.7°,respectively.No significance of the variation of the thoracic kyphosis was observed in the three groups,however,in group A and B,the thoracic kyphosis showed an ascending trend during the follow-up without significant statistical difference,in addition; the ratio of the thoracic kyphosis increased in group A was higher compared with group B and C.Conclusion For AIS patients with low Risser sign,the increased thoracic kyphosis,and the thoracolumbar junction kyphosis may be ascribed to the decompensation of thoracolumbar region caused by the reconstruction of sagittal alignment due to the continued growth of posterior elements of the thoracic spine.%目的 探讨不同Risser征的胸弯青

  1. Comparison of conventional full spine radiographs and fluoroscopic scanning method in young patients with idiopathic scoliosis; Vergleich von konventioneller Wirbelsaeulenganzaufnahme und fluoroskopischer Scan-Methode bei jungen Patienten mit idiopathischer Skoliose

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, J.; Kottke, R.; Claussen, C. [Abt. fuer Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Kluba, T.; Niemeyer, T.; Hahnfeldt, T. [Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Tuebingen (Germany); Vonthein, R. [Inst. fuer Medizinische Biometrie, Universitaetsklinikum Tuebingen (Germany); Kamm, K.F. [Philips Medizin Systeme GmbH, Hamburg (Germany)

    2005-08-01

    Purpose: evaluation of low-dose full spine radiographs using fluoroscopic images for the assessment of the Cobb angle measurement in patients with scoliosis. Material and methods: twenty-one consecutive patients (aged 10-27 years, mean age 14 years) with a conventional full spine examination (film speed class 800) underwent a follow-up exam using digital pulsed fluoroscopy (Multi Diagnost 4, Philips Medical Systems, Eindhoven, The Netherlands). The mean follow-up was 9 months. During a synchronized scan with a C-arm speed of 4 cm/sec fluoroscopic images were stored with a pulsed frequency of 3 images per second. The single images were merged and reconstructed to one image with the software easy spine (Philips medical Systems, Eindhoven, The Netherlands). The corresponding dose-area product values (DAP) of both methods were compared. Three independent observers assessed Cobb angles and image quality for each technique. Results: the mean DAP values for conventional imaging was 94.9 cGy x cm{sup 2} and for fluoroscopy 7.8 cGy x cm{sup 2}, respectively. A significant dose reduction of 91.8% (CI 91% to 95%) was calculated. The average absolute angle difference between the observers was found to be 2.7 for conventional imaging and 2.4 for the fluoroscopic method. Interobserver standard deviati