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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

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica

    2012-01-01

    Full Text Available 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 diagnostics of idiopathic scoliosis. The management of idiopathic scoliosis can be conservative or operative. The main forms of conservative management are: therapy exercises, electrical stimulation and spinal orthosis. The primary aim of scoliosis management is to stop curvature progression. The improvement of pulmonary function (vital capacity and treatment of pain are also of major importance. The guidelines for Conservative Management of Scoliosis. The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment gave the guidelines for conservative management of scoliosis. Conservative management of scoliosis includes: a Lyonaise, Side-Shift, Dobosiewicz, Schroth and other kinesitherapy methods, b scoliosis intensive rehabilitation which appears to be effective with respect to many signs and symptoms of scoliosis and with respect to impeding curvature progression and c brace treatment, which has been found to be effective in preventing curvature progression and thus in altering the natural history of idiopathic scoliosis. Conclusion. The International Society has given the standards for kinesitherapy, intensive rehabilitation and spinal orthosis in clinical practice and clinical investigations. Surgical procedures can improve curves in the frontal plane, but have important limitations in maintaining fixation and achieving correction in other planes.

  3. Idiopathic scoliosis.

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    Jens Ivar Brox

    1989-01-01

    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...

  4. Idiopathic Scoliosis

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    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.

  5. Adolescent Idiopathic Scoliosis

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    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

  6. Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Choudhry, Muhammad Naghman; Ahmad, Zafar; Verma, Rajat

    2016-01-01

    Background: Scoliosis refers to deviation of spine greater than 10 degrees in the coronal plane. Idiopathic Scoliosis is the most common spinal deformity that develops in otherwise healthy children. The sub types of scoliosis are based on the age of the child at presentation. Adolescent idiopathic scoliosis (AIS) by definition occurs in children over the age of 10 years until skeletal maturity. Objective: The objective of this review is to outline the features of AIS to allow the physician to recognise this condition and commence early treatment, thereby optimizing patient outcome. Method: A thorough literature search was performed using available databases, including Pubmed and Embase, to cover important research published covering AIS. Conclusion: AIS results in higher incidence of back pain and discontent with body image. Curves greater than 50 degrees in thoracic region and greater than 30 degrees in lumbar region progress at a rate of 0.5 to 1 degree per year into adulthood. Curves greater than 60 degrees can lead to pulmonary functional deficit. Therefore once the disease is recognized, effective treatment should be instituted to address the deformity and prevention of its long-term sequelae. PMID:27347243

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

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    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.

  8. 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...

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

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    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.

  10. Pulmonary function in children with idiopathic scoliosis

    OpenAIRE

    Tsiligiannis Theofanis; Grivas Theodoros

    2012-01-01

    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 ...

  11. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children

    OpenAIRE

    Huh, Seokwon; Eun, Lucy Yougmin; Kim, Nam Kyun; Jung, Jo Won; Choi, Jae Young; Kim, Hak Sun

    2015-01-01

    Purpose Idiopathic scoliosis is a structural lateral curvature of the spine of unknown etiology. The relationship between degree of spine curvature and cardiopulmonary function has not yet been investigated. The purpose of this study was to determine the association between scoliosis and cardiopulmonary characteristics. Methods Ninety children who underwent preoperative pulmonary or cardiac evaluation at a single spine institution over 41 months were included. They were divided into the thora...

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

    OpenAIRE

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

    2015-01-01

    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 pro...

  13. 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

  14. Nonsurgical Management of Adolescent Idiopathic Scoliosis.

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    Gomez, Jaime A; Hresko, M Timothy; Glotzbecker, Michael P

    2016-08-01

    Pediatric patient visits for spinal deformity are common. Most of these visits are for nonsurgical management of scoliosis, with approximately 600,000 visits for adolescent idiopathic scoliosis (AIS) annually. Appropriate management of scoliotic curves that do not meet surgical indication parameters is essential. Renewed enthusiasm for nonsurgical management of AIS (eg, bracing, physical therapy) exists in part because of the results of the Bracing in Adolescent Idiopathic Scoliosis Trial, which is the only randomized controlled trial available on the use of bracing for AIS. Bracing is appropriate for idiopathic curves between 20° and 40°, with successful control of these curves reported in >70% of patients. Patient adherence to the prescribed duration of wear is essential to maximize the effectiveness of the brace. The choice of brace type must be individualized according to the deformity and the patient's personality as well as the practice setting and brace availability. PMID:27388720

  15. 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.

  16. 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.

  17. 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....

  18. Dobosiewicz method physiotherapy for idiopathic scoliosis.

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    Dobosiewicz, Krystyna; Durmala, Jacek; Kotwicki, Tomasz

    2008-01-01

    The method developed since 1979, comprises active 3-dimensional auto-correction, concerning the primary curve mobilization towards the correction of the curvature, with special emphasis on the kyphotization of the thoracic spine, carried on in closed kinematic chains, and developed on a symmetrically positioned pelvis and shoulder girdle, followed by active stabilization of the corrected position, and endured as postural habit. The positions for exercising and the movements involved are described in details. Small, moderate and important curves can be managed with DoboMed, however the effectiveness of the therapy depends on the curve flexibility and patient's compliance. DoboMed has been used as a single therapy or together with bracing, as well as preparation for scoliosis surgery. The published results demonstrated that the DoboMed has a positive influence on inhibition of the curve progression in idiopathic scoliosis, the improvement of respiratory functions, assessed by the spirometric values, and the general exercise efficiency evaluated using ergospirometry. PMID:18401093

  19. Adolescent idiopathic scoliosis and back pain.

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    Balagué, Federico; Pellisé, Ferran

    2016-01-01

    This broad narrative review addresses the relationship between adolescent idiopathic scoliosis (AIS) and back pain. AIS can be responsible for low back pain, particularly major cases. However, a linear relationship between back pain and the magnitude of the deformity cannot be expected for any individual patient. A large number of juvenile patients can remain pain-free. The long-term prognosis is rather benign for many cases and thus a tailored approach to the individual patient seems mandatory. The level of evidence available does not allow stringent recommendations for any of the disorders included in this review. PMID:27648474

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

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    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.

  1. Adult idiopathic scoliosis: the tethered spine.

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    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.

  2. 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.

  3. 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. PMID:24411157

  4. Sagittal Balance in Adolescent Idiopathic Scoliosis

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

    2015-01-01

    Abstract 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

  5. 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

  6. The natural history of adolescent idiopathic scoliosis

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    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.

  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......, but it seems like patients treated with Providence braces are more likely to experience back pain than healthy adolescents and surgically treated scoliosis patients....

  8. 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.

  9. 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...... of monozygotic and dizygotic pairs was significantly different (P scoliosis in 1 twin whose other twin has scoliosis is smaller than believed up until now....

  10. 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.

  11. 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...

  12. 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 ...

  13. 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

  14. 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

  15. Bone density determination using I125 densitometry with idiopathic scoliosis

    International Nuclear Information System (INIS)

    Based on the assumption that radiographs from patients with idiopathic scoliosis show osteoporotic changes in the curved area, investigation with I125-densitometry were made, and specifically with measurement points at the ulna and the calcaneus. A difference in the bone density between patients with scoliosis and normal controls could not be proven. The mineral-salt content of the scoliosis patients lay on the average 6.5 to 9.3% lower than the normal controls. No relation could be found between the degree of curvature of the scoliosis and the peripheral bone density, from which it can be concluded that no generalized mineral-salt deficiency exists. Radiographs show only local changes (photo densitometry, computed tomography). (TRV)

  16. The 10 key steps for radiographic analysis of adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Highlights: • Adolescent idiopathic scoliosis is a significant cause of morbidity amongst young people. • Despite this, there is a lack of clarity regarding its radiographic assessment. • We suggest ten steps which will facilitate the radiographic analysis of scoliosis

  17. 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.

  18. MRI evaluation of multifidus muscles in adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Background. The role of the multifidus muscles in the initiation and progression of curve in adolescent idiopathic scoliosis is not fully understood and controversy exists as to the side of the abnormality. Objective. To evaluate on MRI the multifidus muscles at the apex of the major curve in adolescent idiopathic scoliosis to ascertain if the multifidus muscles on the convex or concave side are abnormal and the relationship to curve severity. Materials and methods. Forty-six patients with adolescent idiopathic scoliosis, separated into two groups, were studied using a 1.5-T MR scanner with the synergy spine coil, employing a modified STIR (short tau inversion recovery) axial sequence obtained at the apex of the major scoliotic curve. Results. No hyperintense signal change was demonstrated in the convex side multifidus muscles in any patient. In group I, 16 of 18 patients with severe or rapidly progressive curve showed increase in signal intensity in the multifidus muscle on the concave side of the apex of the curve. In group II, of the 15 patients with mild curve (Cobb angle 10-30 ), 4 had increased signal intensity in the multifidus muscle on the concave side; of the 13 with more severe curve (Cobb angle greater than 30 ), 10 had increase in multifidus signal intensity on the concave side. Conclusions. The concave-side multifidus muscle at the apex of a scoliotic curve was morphologically abnormal. A significant association between abnormal signal change and curve severity was also established. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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...

  1. 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

  2. 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

  3. Knowledge about idiopathic scoliosis among students of physiotherapy.

    Science.gov (United States)

    Ciazynski, D; Czernicki, K; Durmala, J

    2008-01-01

    The aim of the study was to determine the level of basic knowledge about idiopathic scoliosis (IS) among students of physiotherapy. The study included 37 students of Medical University of Silesia (17F and 20M aged 22-25, mean 22.6), attending the 3(rd) year of a 1(st) degree of physiotherapy. All students had credits in kinesiotherapy, including methods of conservative treatment of IS. Students were examined using a questionnaire, comprising general knowledge of IS, questions related to sagittal plane correction, influence of various physical activities on IS and known methods of conservative treatment. 81 students considered IS as 3-D deformity. 62.2% of those questioned would diagnose IS when the Cobb angle reaches 10 degrees . All students agreed that the aetiology of IS remains unknown. 54.1% considered forcible extensory exercises of back as favourable in IS. Questioned students mostly preferred swimming (94.6%), yoga (73.0%) and martial arts (32.4%) as beneficial to IS. The methods of conservative treatment which were known best were: Lehnert-Schroth-Weiss (94.6%), Klapp (91.9%), Majoch (89.2%) and Dobosiewicz (78.4%). The conclusions indicate that the average level of knowledge of idiopathic scoliosis among students of physiotherapy is unsatisfactory, despite the education programme including the SOSORT guidelines. Education in the field of scoliosis should be comprehensive and meet contemporary guidelines and standards. PMID:18810037

  4. 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

    2014-01-01

    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. PMID:25066033

  5. 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.

  6. 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.

  7. 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. PMID:27615585

  8. 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.

  9. 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.

  10. Postural Rehabilitation for Adolescent Idiopathic Scoliosis during Growth

    Science.gov (United States)

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

    2016-01-01

    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. PMID:27340540

  11. 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. PMID:25440198

  12. 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. PMID:27340540

  13. 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

  14. Adolescent idiopathic scoliosis in athletes: is there a connection?

    Science.gov (United States)

    Kenanidis, Eustathios I; Potoupnis, Michael E; Papavasiliou, Kyriakos A; Sayegh, Fares E; Kapetanos, George A

    2010-06-01

    The potential relationship between adolescent idiopathic scoliosis (AIS) and sports is rather vague. Sports have often been considered to be a causative factor of, or a treatment option for the former, particularly among adolescent athletes who are engaged in certain athletic activities. The highly repetitive nature of sports, amenorrhea, exercise-related exerted stress on the immature spine of professional adolescent athletes, and the joint laxity that may coexist during adolescence, have also been associated with an increased incidence of AIS. The purpose of this article is to discuss the potential connection between sports and AIS by reviewing the existing literature. PMID:20631476

  15. [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. PMID:27013625

  16. [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.

  17. 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.

  18. 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

    2015-08-01

    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. PMID:26274967

  19. 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

    2015-08-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

  2. Current concepts and controversies on adolescent idiopathic scoliosis: Part II

    Directory of Open Access Journals (Sweden)

    Alok Sud

    2013-01-01

    Full Text Available A new era in the surgical treatment of adolescent idiopathic scoliosis (AIS opened with the introduction of pedicle screw instrumentation, which provides 3-column vertebral fixation and allows major deformity correction on the coronal, sagittal, and axial planes. A steep learning curve can be expected for spinal surgeons to become familiar with pedicle screw placement and correction techniques. Potential complications including injury to adjacent neural, vascular, and visceral structures can occur due to screw misplacement or pull-out during correction maneuvers. These major complications are better recognized as pedicle screw techniques become more popular and may result in serious morbidity and mortality. Extensive laboratory and clinical training is mandatory before pedicle screw techniques in scoliosis surgery are put to practice. Wider application, especially in developing countries, is limited by the high cost of implants. Refined correction techniques are currently developed and these utilize a lesser number of pedicle anchors which are strategically positioned to allow optimum deformity correction while reducing the neurological risk, surgical time, and blood loss, as well as instrumentation cost. Such techniques can be particularly attractive at a time when cost has major implications on provision of health care as they can make scoliosis treatment available to a wider population of patients. Pedicle screw techniques are currently considered the gold standard for scoliosis correction due to their documented superior biomechanical properties and ability to produce improved clinical outcomes as reflected by health-related quality-of-life questionnaires. Ongoing research promises further advances with the future of AIS treatment incorporating genetic counseling and possibly fusionless techniques.

  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. PMID:27117993

  5. 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

    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...... samples from 100 surgically treated idiopathic scoliosis patients. Novel or rare missense, nonsense, or splice site variants were selected for individual genotyping in the 1,739 cases and 1,812 controls. In addition, the 5'UTR, noncoding exon and promoter regions of LBX1, not covered by exome sequencing......, were Sanger sequenced in the 100 pooled samples. RESULTS: Of the four candidate genes, an intergenic variant, rs11190870, downstream of the LBX1 gene, showed a highly significant association to idiopathic scoliosis in 1,739 cases and 1,812 controls (p=7.0×10(-18)). We identified 20 novel variants...

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

    OpenAIRE

    Man Gene Chi Wai; Wang William Wei Jun; Yim Annie Po Yee; Wong Jack Ho; Ng Tzi Bun; Lam Tsz Ping; Lee Simon Kwong Man; Ng Bobby Kin Wah; Wang Chi Chiu; Qiu Yong; Cheng Jack Chun Yiu

    2014-01-01

    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 melato...

  7. The Vestibular-Evoked Postural Response of Adolescents with Idiopathic Scoliosis Is Altered

    OpenAIRE

    Jean-Philippe Pialasse; Martin Descarreaux; Pierre Mercier; Jean Blouin; Martin Simoneau

    2015-01-01

    Adolescent idiopathic scoliosis is a multifactorial disorder including neurological factors. A dysfunction of the sensorimotor networks processing vestibular information could be related to spine deformation. This study investigates whether feed-forward vestibulomotor control or sensory reweighting mechanisms are impaired in adolescent scoliosis patients. Vestibular evoked postural responses were obtained using galvanic vestibular stimulation while participants stood with their eyes closed an...

  8. Pulmonary function after less invasive anterior instrumentation and fusion for idiopathic thoracic scoliosis

    OpenAIRE

    Huitema, Geertje C; Jansen, Rob C; Dompeling, Edward; Willems, Paul; Punt, Ilona; Lodewijk W van Rhijn

    2013-01-01

    Purpose Standard thoracotomy for anterior instrumentation and fusion of the thoracic spine in idiopathic scoliosis may have detrimental effects on pulmonary function. In this study we describe a less invasive anterior surgical technique and show the pre- and postoperative pulmonary function with a minimum follow-up of 2 years. Methods Twenty patients with Lenke type 1 adolescent thoracic idiopathic scoliosis were treated with anterior spinal fusion and instrumentation. The mean preoperative C...

  9. Comparison of Apical Axial Derotation between Adolescent Idiopathic and Neuromuscular Scoliosis with Pedicle Screw Instrumentation

    OpenAIRE

    Modi, Hitesh N.; Suh, Seung-Woo; Srinivasalu, S.; Mehta, Satyen; Yang, Jae-Hyuk

    2008-01-01

    Study Design A retrospective study. Purpose To compare outcomes of apical derotation with pedicle screws in idiopathic and neuromuscular scoliosis (NMS). Overview of Literature No information about apical derotation in NMS with pedicle screws is available. Methods We performed deformity correcting surgery using pedicle screw constructs on 12 adolescent idiopathic scoliosis (AIS) patients (mean age 14.1 years) and 16 NMS patients (mean age 16.5 years). Preoperative, postoperative, and final fo...

  10. Electromyography of the paravertebral muscles in idiopathic scoliosis. Measurements of amplitude and spectral changes under load.

    Science.gov (United States)

    Zetterberg, C; Björk, R; Ortengren, R; Andersson, G B

    1984-06-01

    The myoelectric activity of the paraspinal muscles was recorded in girls with idiopathic scoliosis and in healthy controls. The muscles of the back were loaded isometrically and the signals recorded at the T8 and L3 levels were analysed as regards amplitude and frequency. A comparatively higher signal amplitude was found on the convex side of the scoliosis curve. This was found to be due to a lower amplitude on the concave side when the scoliosis group was compared to the controls. The amplitude difference was correlated to the degree of scoliosis. A shift in the myoelectric spectrum toward lower frequencies occurred during the loading period. There were no differences in this respect between the sides of the scoliosis, nor were there differences between the scoliosis patients and the controls. Secondary adaptation to the higher load demand by the muscles on the convex side in scoliosis is the most probable explanation for our observations. PMID:6741480

  11. Adolescent idiopathic scoliosis: Retrospective analysis of 235 surgically treated cases

    Directory of Open Access Journals (Sweden)

    Unnikrishnan Ranjith

    2010-01-01

    Full Text Available Background : The surgical treatment of adolescent idiopathic scoliosis (AIS has taken great strides in the last two decades. There have been no long term reported studies on AIS from India with documented long term followup. In this study we review a single surgical team′s series of 235 surgically treated cases of AIS with a follow-up from two to six years. Materials and Methods : Pre operative charts, radiographs and MRI scans for 235 patients were collected for this study. The patients were grouped into three groups where anterior correction and fusion (n=47, posterior correction and fusion (n=123 and combined anterior release and posterior instrumentation (n=65 was performed. Each group was divided into two subgroups based on the surgical approach and instrumentation strategy (all screw construct or hybrid construct used. Patients were followed up for coronal and saggital plane corrections, apical vertebral translation (AVT, trunk balance and back pain. The percentage of correction was calculated in each group as well as sub groups. Results : The incidence of MRI detected intraspinal anomaly in this series is 5.9% with 3.4% of them requiring neurosurgical procedure along with scoliosis correction. Average coronal major curve correction was 66% in the all screw group and 58.5% in the hybrid group. The coronal plane correction was better when the all screw constructs were employed. Also, the AVT and trunk balance was better with the all screw constructs. The anterior corrections resulted in better correction of the AVT and trunk balance as compared to the posterior correction. There were eight (3.4% complications in this series. The coronal and saggital plane correction paralleled the published international standards. Conclusion : The coronal plane correction was better when all screw constructs were employed. Use of all pedicle screw systems obviated the need for costoplasty in most cases. The increased incidence of intraspinal anomaly may

  12. 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.

  13. 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.

  14. Changes in Pulmonary Functional Parameters after Surgical Treatment of Idiopathic Scoliosis

    OpenAIRE

    Smiljanić, Iva; Kovač, Vladimir; Čimić, Mislav

    2009-01-01

    There is a controversy in results about influence of surgery on pulmonary function in idiopathic scoliosis. The aim of the study was to study pulmonary function in severe thoracic idiopathic scoliosis and to detect changes in pulmonary function after the three-dimensional anterior surgical correction in severe thoracic scoliosis. 91 patients at the age of 16±5.1yrs underwent surgery in order to make a correction of scoliotic deformity. All the curves were greater than 70° (86±5.1). Group I co...

  15. 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

  16. 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.

  17. 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

  18. Mechanism of right thoracic adolescent idiopathic scoliosis at risk for progression; a unifying pathway of development by normal growth and imbalance

    DEFF Research Database (Denmark)

    Wong, Christian

    2015-01-01

    Adolescent idiopathic scoliosis is regarded as a multifactorial disease and none of the many suggested causal etiologies have yet prevailed. I will suggest that adolescent idiopathic scoliosis has one common denominator, namely that initial curve development is mediated through one common normal...... of adolescent idiopathic scoliosis should address this physiological pathway and the overall treatment strategy is early intervention with strengthening of thoracic rotational stability for small curve adolescent idiopathic scoliosis....

  19. 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. PMID:26406054

  20. 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.

  1. 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...

  2. 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.

  3. AKAP2 identified as a novel gene mutated in a Chinese family with adolescent idiopathic scoliosis

    Science.gov (United States)

    Li, Wei; Li, YaWei; Zhang, Lusi; Guo, Hui; Tian, Di; Li, Ying; Peng, Yu; Zheng, Yu; Dai, Yuliang; Xia, Kun; Lan, Xinqiang; Wang, Bing; Hu, Zhengmao

    2016-01-01

    Background Adolescent idiopathic scoliosis exhibits high heritability and is one of the most common spinal deformities found in adolescent populations. However, little is known about the disease-causing genes in families with adolescent idiopathic scoliosis exhibiting Mendelian inheritance. Objective The aim of this study was to identify the causative gene in a family with adolescent idiopathic scoliosis. Methods Whole-exome sequencing was performed on this family to identify the candidate gene. Sanger sequencing was conducted to validate the candidate mutations and familial segregation. Real-time QPCR was used to measure the expression level of the possible causative gene. Results We identified the mutation c.2645A>C (p.E882A) within the AKAP2 gene, which cosegregated with the adolescent idiopathic scoliosis phenotypes. AKAP2 is located in a previously reported linkage locus (IS4) on chromosome 9q31.2–q34.2 and has been implicated in skeletal development. The mutation was absent in dbSNP144, ESP6500 and 503 ethnicity-matched controls. Real-time QPCR revealed that the mRNA expression level in the patients was increased significantly compared with the family controls (p<0.0001). Conclusions AKAP2 was therefore implicated as a novel gene mutated in a Chinese family with adolescent idiopathic scoliosis. Further studies should be conducted to validate the results from the perspective of both the genetics and pathogenesis of this disease. PMID:26989089

  4. The Vestibular-Evoked Postural Response of Adolescents with Idiopathic Scoliosis Is Altered.

    Science.gov (United States)

    Pialasse, Jean-Philippe; Descarreaux, Martin; Mercier, Pierre; Blouin, Jean; Simoneau, Martin

    2015-01-01

    Adolescent idiopathic scoliosis is a multifactorial disorder including neurological factors. A dysfunction of the sensorimotor networks processing vestibular information could be related to spine deformation. This study investigates whether feed-forward vestibulomotor control or sensory reweighting mechanisms are impaired in adolescent scoliosis patients. Vestibular evoked postural responses were obtained using galvanic vestibular stimulation while participants stood with their eyes closed and head facing forward. Lateral forces under each foot and lateral displacement of the upper body of adolescents with mild (n = 20) or severe (n = 16) spine deformation were compared to those of healthy control adolescents (n = 16). Adolescent idiopathic scoliosis patients demonstrated greater lateral displacement and net lateral forces than controls both during and immediately after vestibular stimulation. Altered sensory reweighting of vestibular and proprioceptive information changed balance control of AIS patients during and after vestibular stimulation. Therefore, scoliosis onset could be related to abnormal sensory reweighting, leading to altered sensorimotor processes. PMID:26580068

  5. The Vestibular-Evoked Postural Response of Adolescents with Idiopathic Scoliosis Is Altered.

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Pialasse

    Full Text Available Adolescent idiopathic scoliosis is a multifactorial disorder including neurological factors. A dysfunction of the sensorimotor networks processing vestibular information could be related to spine deformation. This study investigates whether feed-forward vestibulomotor control or sensory reweighting mechanisms are impaired in adolescent scoliosis patients. Vestibular evoked postural responses were obtained using galvanic vestibular stimulation while participants stood with their eyes closed and head facing forward. Lateral forces under each foot and lateral displacement of the upper body of adolescents with mild (n = 20 or severe (n = 16 spine deformation were compared to those of healthy control adolescents (n = 16. Adolescent idiopathic scoliosis patients demonstrated greater lateral displacement and net lateral forces than controls both during and immediately after vestibular stimulation. Altered sensory reweighting of vestibular and proprioceptive information changed balance control of AIS patients during and after vestibular stimulation. Therefore, scoliosis onset could be related to abnormal sensory reweighting, leading to altered sensorimotor processes.

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

    OpenAIRE

    Weiss Hans-Rudolf

    2007-01-01

    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. ...

  7. Sagittal Plane Analysis of Adolescent Idiopathic Scoliosis after VATS (Video-Assisted Thoracoscopic Surgery) Anterior Instrumentations

    OpenAIRE

    Kim, Hak-Sun; Lee, Chong-Suh; Jeon, Byoung-Ho; Park, Jin-Oh

    2007-01-01

    Radiographic sagittal plane analysis of VATS (video-assisted thoracoscopic surgery) anterior instrumentation for adolescent idiopathic scoliosis. This is retrospective study. To report, in details about effects of VATS anterior instrumentation on the sagittal plane. Evaluations of the surgical outcome of scoliosis have primarily studied in coronal plane correction, functional, and cosmetic aspects. Sagittal balance, as well as coronal balance, is important in functional spine. Recently, scoli...

  8. Active treatment for idiopathic adolescent scoliosis (ACTIvATeS): a feasibility study.

    OpenAIRE

    Williams, MA; Heine, PJ; Williamson, EM; Toye, F; Dritsaki, M; Petrou, S; Crossman, R; Lall, R; Barker, KL; Fairbank, J; Harding, I.; Gardner, A.; Slowther, AM; Coulson, N; Lamb, SE

    2015-01-01

    The feasibility of conducting a definitive randomised controlled trial (RCT) evaluating the clinical effectiveness and cost-effectiveness of scoliosis-specific exercises (SSEs) for adolescent idiopathic scoliosis (AIS) is uncertain.The aim of this study was to assess the feasibility of conducting a large, multicentre trial of SSE treatment for patients with AIS, in comparison with standard care, and to refine elements of the study design. The objectives were to (1) update a systematic review ...

  9. Evidence based postoperative physiotherapy management of adolescent idiopathic scoliosis - a literature review

    OpenAIRE

    Ahola, Janette

    2015-01-01

    The purpose of this thesis was to gather evidence-based and up-to-date studies about Adolescent Idiopathic Scoliosis (AIS) and its’ post-operative physiotherapy management. The thesis was made for Satakunta Central Hospital (Satakunnan keskussairaala). The need for such topic came from the physiotherapists working at the paediatric outpatient clinic. They wanted to have concrete updated information of post-operative physiotherapy management for scoliosis surgery patients. The theoretical ...

  10. 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

    Introduction: The purpose of this study was to evaluate the long term clinical outcomes using validated measures of health-related qualityof- life (HRQOL), 25 years after termination of scoliosis treatment, in a cohort of Adolescent Idiopathic Scoliosis Patients. Method: 219 consecutive patients...... 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...

  11. 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.

  12. 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, i...

  13. 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

  14. 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

  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. 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

  17. 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.…

  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. 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...... 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...... pairs where at least one twin self-reported having scoliosis were invited to a clinical and radiological examination. Zygosity was established by genetic testing. RESULTS: 182 individuals (33.2%) of the original cohort agreed to participate, 128 of whom had scoliosis by self-report. There were 91 twin...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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...

  2. 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…

  3. 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.

  4. 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

  5. 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.

  6. Non-surgical interventions for adolescents with idiopathic scoliosis: an overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Maciej Płaszewski

    Full Text Available BACKGROUND: Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. OBJECTIVES: Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. DESIGN: Systematic overview of systematic reviews. METHODS: Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute's hierarchies were applied to analyze the levels of evidence from included reviews. RESULTS: From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. CONCLUSIONS: Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis

  7. Screening for adolescent idiopathic scoliosis: an information statement by the scoliosis research society international task force

    OpenAIRE

    Labelle, Hubert; Richards, Stephens B; de Kleuver, Marinus; Grivas, Theodoros B; Luk, Keith D. K.; Wong, Hee Kit; Thometz, John; Beauséjour, Marie; Turgeon, Isabelle; Fong, Daniel Y.T.

    2013-01-01

    Background Routine screening of scoliosis is a controversial subject and screening efforts vary greatly around the world. Methods Consensus was sought among an international group of experts (seven spine surgeons and one clinical epidemiologist) using a modified Delphi approach. The consensus achieved was based on careful analysis of a recent critical review of the literature on scoliosis screening, performed using a conceptual framework of analysis focusing on five main dimensions: technical...

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

    OpenAIRE

    Hyun, Seung-Jae; Kim, Woong-Beom; Park, Young-Seop; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J.

    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...

  9. SSEP analysis in surgery of idiopathic scoliosis: the influence of spine deformity and surgical approach

    OpenAIRE

    Hausmann, Oliver; Min, Kan; Böni, Thomas; Erni, Thomas; Dietz, Volker; Curt, Armin

    2002-01-01

    The study was conducted to assess the possible impact of spine deformity in patients with idiopathic scoliosis (IS) on tibial nerve somatosensory evoked potentials (t-SSEPs) and the influence of spine correction upon postoperative SSEP recordings. In 61 consecutive patients undergoing 64 spinal instrumentations, 129 pre- and postoperative SSEPs were analyzed. The degree of spine deformity was assessed by the pre-operative Cobb angle of the major scoliotic curve. In a control group, reference ...

  10. 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.

  11. Bioelectric Activity in the Suprachiasmatic Nucleus—Pineal Gland System in Children with Adolescent Idiopathic Scoliosis

    OpenAIRE

    Dmitry Yu Pinchuk; Bekshaev, Sergey S.; Bumakova, Svetlana A.; Dudin, Mikhail G.; Pinchuk, Olga D.

    2012-01-01

    The purpose of this work is to identify a role of the pineal gland/suprachiasmatic nucleus system in adolescent idiopathic scoliosis (AIS) aetiology and pathogenesis. To analyze electroencephalograms of 292 children with AIS and in 46 healthy subjects, a processing method was used to assess three-dimensional coordinates of electric equivalent dipole sources (EEDSs) within the brain. Amounts of EEDSs in the pineal gland and suprachiasmatic nucleus (SCN) area were assessed in different age grou...

  12. Pulmonary function before and after anterior spinal surgery in adult idiopathic scoliosis.

    OpenAIRE

    Wong, C. A.; Cole, A. A.; L. Watson; Webb, J K; Johnston, I. D.; Kinnear, W. J.

    1996-01-01

    BACKGROUND: Little is known about the long term effects of anterior spinal surgery on pulmonary function in adult patients with idiopathic scoliosis. A study was therefore undertaken of pulmonary function before and after anterior spinal surgery in this group of patients. METHODS: Fourteen patients (12 women) of mean age 26.5 years (range 17-50, 10 > or = 20 years) were studied. All 14 patients underwent thoracotomy and anterior arthrodesis, and five also underwent posterior arthrodesis. Scol...

  13. The Brazilian version of the SRS-22r questionnaire for idiopathic scoliosis

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    Paula M. F. Camarini

    2013-10-01

    Full Text Available BACKGROUND: The SRS-22r questionnaire is a well-accepted instrument used to measure health-related quality of life in patients with idiopathic scoliosis. No validated tool exists in Brazil for idiopathic scoliosis, and the use of the SRS-22r in non-English Laguage contries requires its transcultural adaptation. OBJECTIVE: The objective of this study was to culturally adapt the translated Brazilian version of the SRS-22r questionnaire and to determine its reliability using statistical tests for internal consistency and test-retest reliability. METHOD: The transcultural adaptation process was carried out according to the recommendations of the American Academy of Orthopedic Surgeons. The pre-final version was administered to 44 patients with idiopathic scoliosis. The mean age of the participants was 18.93 years and the mean curve magnitude was 54.6°. A subgroup of 30 volunteers completed the questionnaire a second time one week later to determine the scale's reproducibility. Internal consistency was determined using Cronbach's alpha coefficient, and the test-retest reliability was determined using the Intraclass Correlation Coefficient (ICC. RESULTS: No floor effects were observed using the Brazilian version of the SRS-22r. Ceiling effects were observed in the Pain and Satisfaction with Management domains. The internal consistency values were very good for 3 domains and good for 2 domains. The ICC values were excellent for all domains. CONCLUSIONS: The high values of internal consistency and ICC reproducibility suggest that this version of the questionnaire can be used in Brazilian patients with idiopathic scoliosis.

  14. Functional variants of POC5 identified in patients with idiopathic scoliosis

    OpenAIRE

    Patten, Shunmoogum A.; Margaritte-Jeannin, Patricia; Bernard, Jean-Claude; Alix, Eudeline; Labalme, Audrey; Besson, Alicia; Girard, Simon L.; Fendri, Khaled; Fraisse, Nicolas; Biot, Bernard; Poizat, Coline; Campan-Fournier, Amandine; Abelin-Genevois, Kariman; Cunin, Vincent; Zaouter, Charlotte

    2015-01-01

    Idiopathic scoliosis (IS) is a spine deformity that affects approximately 3% of the population. The underlying causes of IS are not well understood, although there is clear evidence that there is a genetic component to the disease. Genetic mapping studies suggest high genetic heterogeneity, but no IS disease-causing gene has yet been identified. Here, genetic linkage analyses combined with exome sequencing identified a rare missense variant (p.A446T) in the centriolar protein gene POC5 that c...

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

    OpenAIRE

    McMaster Marianne E

    2011-01-01

    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 hy...

  16. [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. PMID:22019528

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Idiopathic arterial calcification in childhood

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    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.)

  3. 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). PMID:25780381

  4. 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

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

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    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.

  6. 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...

  7. 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%...

  8. 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

  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. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. SpineCor treatment for Juvenile Idiopathic Scoliosis: SOSORT award 2010 winner

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    Circo Alin B

    2010-11-01

    Full Text Available Introduction Juvenile idiopathic scoliosis is a condition used to describe patients who are least 4 years of age but younger than 10 when the deformity is first identified. In these patients, the condition is usually progressive and those that are diagnosed at five years or younger have a high chance of progression to a large curve, with additional pulmonary and cardiac complications. The main form of conservative treatment for juvenile scoliosis is the use of a bracing system. This prospective interventional study was conducted to evaluate the effectiveness of the Dynamic SpineCor orthosis for juvenile idiopathic scoliosis as well as to evaluate the stability of the spine after the weaning point. Material and Methods For this study, 150 juvenile patients were treated by the SpineCor orthosis between 1993 and 2009. Of these, 67 patients had a definite outcome and 83 are still actively being treated. To determine the effectiveness of the brace the OUTCOME criteria recommended by the SRS was used. Results The results from our study showed that of the 67 patients with a definite outcome, 32.9% corrected their Cobb angle by at least 5° and 10.5% had a stabilization of their Cobb angle. Within the patients with a definite outcome, 37.3% of patients where recommended for surgery before authorized end of treatment. For this group of patients, surgery was postponed. Looking at the stability of the curves 2 years after the end of the treatment, we found 12.5% of the patients continued their correction without the brace being used and 71.4% remained stable. Discussion From our study we can clearly see that the effectiveness of the SpineCor orthosis in obtaining and maintaining the neuromuscular integration of the corrective movement can be achieved effectively for juvenile patients. Over 75% of all patients that finished the treatment had remained stable with a few continuing to correct their Cobb angle after the use of the SpineCor orthosis was

  18. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence

    Science.gov (United States)

    Byun, Sunghak; Han, Dongwook

    2016-01-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis. PMID:27190435

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

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    Galina Viktorovna Piatakova

    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.

  20. 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.

  1. Posterior spinal instrumented fusion for idiopathic scoliosis in patients with multisystemic neurodegenerative disorder: a report of two cases.

    Science.gov (United States)

    Loh, K W; Chan, C Yw; Chiu, C K; Bin Hasan, M S; Kwan, M K

    2016-08-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke (MELAS) syndrome is a progressive multisystemic neurodegenerative disorder. MELAS syndrome impairs oxidative phosphorylation and predisposes patients to lactic acidosis, particularly under metabolic stress. We report 2 siblings with MELAS-associated idiopathic scoliosis who underwent posterior spinal instrumented fusion with measures taken to minimise anaesthetic and surgical stress, blood loss, and operating time. PMID:27574278

  2. [Idiopathic headache in childhood and adolescence].

    Science.gov (United States)

    Karwautz, A; Wöber-Bingöl, C; Wöber, C

    1993-12-01

    This review of the literature covers classification, epidemiology and clinical aspects of idiopathic headache in childhood and adolescence. In addition, pathogenetic models taking into account the complex involvement of organic, psychological and psychosocial factors are critically reviewed. A general pathogenetic model of migraine may be characterized by a given predisposition, various co-factors which enhance the tendency, and finally, trigger mechanisms which induce an attack. No generally accepted model exists for tension-type headache. In assessing the importance of various factors thought to be related to idiopathic headache, it is necessary to differentiate between causal relation, unspecific association, and coincidence. The aim of this review is to present potential factors influencing headache in childhood and adolescence and to discuss these factors critically with regard to their etiopathogenetic importance. Organic factors seem to be most important in migraine, whereas psychological and (psycho)social factors may influence any type of headache. Briefly, migraine in childhood and adolescence seems to be definitively associated with vegetative dysfunction, abdominal symptoms and hormonal factors and possibly with allergic reactions, whereas a relation to epilepsy can be excluded. There is absolutely no evidence for a typical personality of migraine patients. Various psychic reactions, however, are important in all types of headache. Depression and anxiety in young headache patients seem to be related generally to pain, but not specifically to headache. However, school problems, learning disabilities and stress coping behaviour seem to be related directly to recurrent headache. Additionally, there is evidence that the prevalence of headache is associated with low economic status. PMID:8114976

  3. Scoliosis

    Science.gov (United States)

    ... Saunders; 2014:chap 12. Thomas MA, Therattil M. Scoliosis and kyphosis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation . 3rd ed. Philadelphia, ...

  4. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

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    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

  5. 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

    BACKGROUND: Since 1962 to the mid eighties the Harrington Rod instrumentation was the Golden standard for surgical treatment of Adolescent Idiopathic Scoliosis (AIS). The Boston braces were introduced in the 1970´s and are still used as a conservative treatment, for curves less than 40°. Very few......) 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...

  6. A meta-analysis identifies adolescent idiopathic scoliosis association with LBX1 locus in multiple ethnic groups

    DEFF Research Database (Denmark)

    Londono, Douglas; Kou, Ikuyo; Johnson, Todd A;

    2014-01-01

    BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common rotational deformity of the spine that presents in children worldwide, yet its etiology is poorly understood. Recent genome-wide association studies (GWAS) have identified a few candidate risk loci. One locus near the chromosome 10q24...... the International Consortium for Scoliosis Genetics (ICSG). METHODS: Here, we report the first ICSG study, a meta-analysis of the LBX1 locus in six Asian and three non-Asian cohorts. RESULTS: We find significant evidence for association of this locus with AIS susceptibility in all nine cohorts. Results for seven...

  7. 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.

  8. Impact of Increasing Age on Outcomes of Spinal Fusion in Adult Idiopathic Scoliosis

    Science.gov (United States)

    Verla, Terence; Adogwa, Owoicho; Toche, Ulysses; Farber, S. Harrison; Petraglia, Frank; Murphy, Kelly R.; Thomas, Steven; Fatemi, Parastou; Gottfried, Oren; Bagley, Carlos A.; Lad, Shivanand P.

    2016-01-01

    Objective To investigate the role of advancing age on postoperative complications and revision surgery after fusion for scoliosis. Methods A retrospective, cohort study was performed using the Thomson Reuters MarketScan database, examining patients with adult scoliosis who underwent spinal fusion from 2000 to 2009. Primary outcomes included infection, hemorrhage and pulmonary embolism (PE) within 90 days of surgery, and refusion. The effect of increasing age was estimated using the odds ratio (OR) of complications in a multivariate logistic regression analysis, and a Cox proportional hazard model estimated the hazard ratio of refusion. Results A total of 8432 patients were included in this study. Overall, the average age was 53.3 years, with 26.90% males and 39% with a Charlson Comorbidity Score of ≥1. Most patients had commercial insurance (66.81%), with 26.03% and 7.16% covered by Medicare and Medicaid, respectively. Increasing age (per 5-year increment) was a significant predictor of hemorrhagic complication (OR, 1.06; confidence interval [CI], 1.01–1.11; P = 0.0196), PE (OR, 1.09; CI, 1.03–1.16; P = 0.0031), infection (OR, 1.04; CI, 1.01–1.07; P = 0.0053), and refusion (hazard ratio, 1.07; CI, 1.02–1.13; P = 0.0103). Conclusions In this study, age was associated with increased risk of hemorrhage, PE, infection, and refusion. With the aging population, the role of patient age on postoperative healing and outcomes deserves deeper investigation after repair of adult idiopathic scoliosis. PMID:26546999

  9. 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

  10. 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.

  11. Vertebral derotation in adolescent idiopathic scoliosis causes hypokyphosis of the thoracic spine

    Directory of Open Access Journals (Sweden)

    Watanabe Kota

    2012-06-01

    Full Text Available Abstract Background The purpose of this study was to test the hypothesis that direct vertebral derotation by pedicle screws (PS causes hypokyphosis of the thoracic spine in adolescent idiopathic scoliosis (AIS patients, using computer simulation. Methods Twenty AIS patients with Lenke type 1 or 2 who underwent posterior correction surgeries using PS were included in this study. Simulated corrections of each patient’s scoliosis, as determined by the preoperative CT scan data, were performed on segmented 3D models of the whole spine. Two types of simulated extreme correction were performed: 1 complete coronal correction only (C method and 2 complete coronal correction with complete derotation of vertebral bodies (C + D method. The kyphosis angle (T5-T12 and vertebral rotation angle at the apex were measured before and after the simulated corrections. Results The mean kyphosis angle after the C + D method was significantly smaller than that after the C method (2.7 ± 10.0° vs. 15.0 ± 7.1°, p  Conclusions In the 3D simulation study, kyphosis was reduced after complete correction of the coronal and rotational deformity, but it was maintained after the coronal-only correction. These results proved the hypothesis that the vertebral derotation obtained by PS causes hypokyphosis of the thoracic spine.

  12. 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.

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

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    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.

  14. 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

  15. 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

  16. Scoliosis

    Science.gov (United States)

    ... special doctor called an orthopedist (say: or-tho-PEE-dist), or orthopedic surgeon, who knows a lot about bones and how to treat scoliosis. The orthopedist will probably start by figuring out how severe your spine's curve is. To do this, an orthopedist ...

  17. 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

  18. 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

  19. A COMPARISON OF PULMONARY FUNCTIONS DURING PRE AND POST-OPERATIVE PERIODS IN IDIOPATHIC SCOLIOSIS TREATED BY EMPLOYING HARRINGTON RODS

    OpenAIRE

    Domanic, Unsal; Hamzaoglu, Azmi; Temocin, Bahattin O.; Akalin, Yilmaz; Taser, Omer

    2004-01-01

    Attempts have been made to examine and evaluate the preoperative and postoperative pulmonary functions of 25 idiopathic cases of scoliosis who were oparated by utilizing Harington rods and whose late follow-ups were made in the Department of Orthopaedics in the Medical School of the İstanbul University. Furthermore, results have been compared and a discussion has been carried out about the effects of surgical treatment with Harrington rods on pulmonary functions.

  20. The immediate effect of a Boston brace on lung volumes and pulmonary compliance in mild adolescent idiopathic scoliosis

    OpenAIRE

    Katsaris, G.; Loukos, A.; Valavanis, J.; Vassiliou, M.; Behrakis, P. K.

    1999-01-01

    Idiopathic scoliosis (IS) is known to result in lung volume and pulmonary compliance reduction. Boston brace treatment of IS is an additional factor causing restrictive respiratory syndrome due to external chest wall compression. Nevertheless, the immediate effect of Boston bracing on the pulmonary compliance of scoliotic patients has not been studied systematically. Spirometric and plethysmographic lung volumes, static lung compliance (CST(L)) and specific lung compliance (CST(L)/functional ...

  1. Postoperative Disc Wedging in Adolescent Idiopathic Thoracolumbar/Lumbar Scoliosis: a Comparison of Anterior and Posterior Approaches

    Institute of Scientific and Technical Information of China (English)

    Bin Yu; Yi-peng Wang; Gui-xing Qiu; Jian-guo Zhang; Jian-xiong Shen; Yu Zhao; Shu-gang Li; Qi-yi Li

    2010-01-01

    Objective To evaluate the different influences of anterior and posterior correction and fusion ap-proaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis.Methods The retrospective study was conducted with the medical records and radiographs of ado-lescent idiopathic thoracolumbar/lumbar scoliosis patients that underwent anterior (group A) or posterior (group B) correction and fusion surgery from December 1998 to May 2008. The correction of the main curve and changes of the disc wedging were analyzed.Results Fifty-three patients were included, 26 in group A and 27 in group B. The mean coronal Cobb angles of the main curve in group A and group B were significantly corrected after surgery (P0.05). The difference between disc wedging at final follow-up and that after surgery was significant in group A (P0.05). Between the two groups, group A had larger disc angles after operation and at final follow-up (P<0.05), and a greater loss of disc angle (P<0.05).Conclusion For adolescent idiopathic thoracolumbar/lumbar scoliosis, posterior approach using all pedicle screws might produce a better result in terms of disc wedging compared with anterior approach.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Effectiveness of the SpineCor brace based on the new standardized criteria proposed by the scoliosis research society for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Coillard, Christine; Vachon, Valerie; Circo, Alin B; Beauséjour, Marie; Rivard, Charles H

    2007-06-01

    The purpose of this prospective observational study was to evaluate the effectiveness of the Dynamic SpineCor brace for adolescent idiopathic scoliosis in accordance with the standardized criteria proposed by the Scoliosis Research Society Committee on Bracing and Nonoperative Management. They proposed these guidelines to make the comparison among studies more valid and reliable. From 1993 to 2006, 493 patients were treated using the SpineCor brace. Two hundred forty-nine patients met the criteria for inclusion, and 79 patients were still actively being treated. Overall, 170 patients have a definitive outcome. All girls were premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness included (1) percentage of patients who have 5 degrees or less curve progression, and percentage of patients who have 6 degrees or more progression; (2) percentage of patients who have been recommended/undergone surgery before skeletal maturity; (3) percentage of patients with curves exceeding 45 degrees at maturity (end of treatment); and (4) Two-year follow-up beyond maturity to determine the percentage of patients who subsequently underwent surgery. Successful treatment (correction, >5 degrees, or stabilization, +/-5 degrees) was achieved in 101 (59.4%) of the 170 patients from the time of the fitting of the SpineCor brace to the point in which it was discontinued. Thirty-nine immature patients (22.9%) required surgical fusion while receiving treatment. Two (1.2%) of 170 patients had curves exceeding 45 degrees at maturity. One mature patient (2.1%) required surgery within 2 years of follow-up beyond skeletal maturity. The conclusion drawn from these findings is that the SpineCor brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, positive outcomes are maintained after 2 years because 45 (95.7%) of 47 patients stabilized or corrected their end of bracing Cobb angle up to 2 years after bracing. Therapeutic study-investigating the

  7. Anterior Overgrowth in Primary Curves, Compensatory Curves and Junctional Segments in Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    van Stralen, Marijn; Chu, Winnie C. W.; Lam, Tsz-Ping; Ng, Bobby K. W.; Vincken, Koen L.; Cheng, Jack C. Y.; Castelein, René M.

    2016-01-01

    Introduction Although much attention has been given to the global three-dimensional aspect of adolescent idiopathic scoliosis (AIS), the accurate three-dimensional morphology of the primary and compensatory curves, as well as the intervening junctional segments, in the scoliotic spine has not been described before. Methods A unique series of 77 AIS patients with high-resolution CT scans of the spine, acquired for surgical planning purposes, were included and compared to 22 healthy controls. Non-idiopathic curves were excluded. Endplate segmentation and local longitudinal axis in endplate plane enabled semi-automatic geometric analysis of the complete three-dimensional morphology of the spine, taking inter-vertebral rotation, intra-vertebral torsion and coronal and sagittal tilt into account. Intraclass correlation coefficients for interobserver reliability were 0.98–1.00. Coronal deviation, axial rotation and the exact length discrepancies in the reconstructed sagittal plane, as defined per vertebra and disc, were analyzed for each primary and compensatory curve as well as for the junctional segments in-between. Results The anterior-posterior difference of spinal length, based on “true” anterior and posterior points on endplates, was +3.8% for thoracic and +9.4% for (thoraco)lumbar curves, while the junctional segments were almost straight. This differed significantly from control group thoracic kyphosis (-4.1%; Plumbar lordosis (+7.8%; Plumbar curves). Conclusions Excess anterior length of the spine in AIS has been described as a generalized growth disturbance, causing relative anterior spinal overgrowth. This study is the first to demonstrate that this anterior overgrowth is not a generalized phenomenon. It is confined to the primary as well as the compensatory curves, the junctional zones do not exhibit this growth discrepancy, however, they are straight. PMID:27467745

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

    Directory of Open Access Journals (Sweden)

    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

  9. 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 . PMID:26002592

  10. Time-to-contact and multiscale entropy identify differences in postural control in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Gruber, Allison H; Busa, Michael A; Gorton Iii, George E; Van Emmerik, Richard E A; Masso, Peter D; Hamill, Joseph

    2011-05-01

    Previous reports on changes in postural control in adolescent idiopathic scoliosis (AIS) compared to healthy controls have been inconsistent. This may suggest center of pressure (COP) sway parameters are not sufficient for determining the ability to maintain quiet upright stance indicating more complex measures may be needed to examine postural control in AIS. The purpose of this investigation was to compare postural control between AIS of different severity levels and healthy controls using time-to-contact (TtC), the complexity index of multiscale entropy (C(r)), and COP sway parameters. Thirty-six AIS patients were classified as pre-bracing or pre-operative and compared to 10 healthy control subjects. Overall, the AIS patients showed significantly greater COP sway in mediolateral direction, but deficits with respect to the anteroposterior direction were only systematically identified with the time-to-contact and entropy measures. The multiscale entropy (C(r)) results indicate that those with AIS utilize a different control strategy from healthy controls in the mediolateral direction that is more constrained, less complex and less adaptable. AIS severity further reduced this adaptability in the anteroposterior direction. These results indicate it is necessary to examine both planes of motion when investigating postural control in AIS. Additionally, the application of the measures used to assess the nature of the postural control changes in AIS should also be considered. PMID:21478018

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

    Directory of Open Access Journals (Sweden)

    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.

  12. A neglected point in surgical treatment of adolescent idiopathic scoliosis: Variations in the number of vertebrae.

    Science.gov (United States)

    Hu, Zongshan; Zhang, Zhen; Zhao, Zhihui; Zhu, Zezhang; Liu, Zhen; Qiu, Yong

    2016-08-01

    Inaccurate identification of vertebral levels is the main cause of wrong-site spine surgery which is performed by nearly half of the spine surgeons. Unusual anatomy and failure to verify the surgical level on radiographs have been commonly reported. We aimed at investigating the variations in vertebral number in adolescent idiopathic scoliosis (AIS) patients and thus to raise awareness of the possibility for wrong-level spinal surgery and to make a comparison with normal adolescents. A cohort of 657 AIS patients and 248 normal adolescents, presented to our center from June 2008 to February 2013, who met the inclusion criteria, were recruited. Radiographs were reviewed to identify the number of thoracic or lumbar vertebrae and the presence of a lumbosacral transitional vertebra. In the AIS group, 70 (10.6%) patients had variations in the number of thoracic and/or lumbar vertebrae. Remarkably, the prevalence of variations in male subjects was significantly higher than that in female subjects (P  0.05). Therefore, we concluded that variations in the number of thoracic-lumbar vertebrae were found in up to10.6% of AIS patients. Identification of variations in the number of vertebrae is crucial to serve to decrease the risk of wrong-level surgery. PMID:27559975

  13. 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. PMID:27293961

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Functional variants of POC5 identified in patients with idiopathic scoliosis

    Science.gov (United States)

    Patten, Shunmoogum A.; Margaritte-Jeannin, Patricia; Bernard, Jean-Claude; Alix, Eudeline; Labalme, Audrey; Besson, Alicia; Girard, Simon L.; Fendri, Khaled; Fraisse, Nicolas; Biot, Bernard; Poizat, Coline; Campan-Fournier, Amandine; Abelin-Genevois, Kariman; Cunin, Vincent; Zaouter, Charlotte; Liao, Meijiang; Lamy, Raphaelle; Lesca, Gaetan; Menassa, Rita; Marcaillou, Charles; Letexier, Melanie; Sanlaville, Damien; Berard, Jerome; Rouleau, Guy A.; Clerget-Darpoux, Françoise; Drapeau, Pierre; Moldovan, Florina; Edery, Patrick

    2015-01-01

    Idiopathic scoliosis (IS) is a spine deformity that affects approximately 3% of the population. The underlying causes of IS are not well understood, although there is clear evidence that there is a genetic component to the disease. Genetic mapping studies suggest high genetic heterogeneity, but no IS disease-causing gene has yet been identified. Here, genetic linkage analyses combined with exome sequencing identified a rare missense variant (p.A446T) in the centriolar protein gene POC5 that cosegregated with the disease in a large family with multiple members affected with IS. Subsequently, the p.A446T variant was found in an additional set of families with IS and in an additional 3 cases of IS. Moreover, POC5 variant p.A455P was present and linked to IS in one family and another rare POC5 variant (p.A429V) was identified in an additional 5 cases of IS. In a zebrafish model, expression of any of the 3 human IS-associated POC5 variant mRNAs resulted in spine deformity, without affecting other skeletal structures. Together, these findings indicate that mutations in the POC5 gene contribute to the occurrence of IS. PMID:25642776

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

    Science.gov (United States)

    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.

  17. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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...

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

    OpenAIRE

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

    2011-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Normal Leptin Expression, Lower Adipogenic Ability, Decreased Leptin Receptor and Hyposensitivity to Leptin in Adolescent Idiopathic Scoliosis

    OpenAIRE

    Guoyan Liang; Wenjie Gao; Anjing Liang; Wei Ye; Yan Peng; Liangming Zhang; Swarkar Sharma; Peiqiang Su; Dongsheng Huang

    2012-01-01

    Leptin has been suggested to play a role in the etiology of Adolescent Idiopathic Scoliosis (AIS), however, the leptin levels in AIS girls are still a discrepancy, and no in vitro study of leptin in AIS is reported. We took a series of case-control studies, trying to understand whether Leptin gene polymorphisms are involved in the etiology of the AIS or the change in leptin level is a secondary event, to assess the level of leptin receptor, and to evaluate the differences of response to lepti...

  4. Is Circumferential Minimally Invasive Surgery Effective in the Treatment of Moderate Adult Idiopathic Scoliosis?

    OpenAIRE

    Anand, Neel; Baron, Eli M.; Khandehroo, Babak

    2014-01-01

    Background Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis. Questions/purposes We describe the effects of circumferential minimally invasive ...

  5. Experience with an online prospective database on adolescent idiopathic scoliosis: development and implementation.

    Science.gov (United States)

    Arlet, Vincent; Shilt, Jeffrey; Bersusky, Ernesto; Abel, Mark; Ouellet, Jean Albert; Evans, Davis; Menon, K V; Kandziora, Frank; Shen, Frank; Lamartina, Claudio; Adams, Marc; Reddi, Vasantha

    2008-11-01

    Considerable variability exists in the surgical treatment and outcomes of adolescent idiopathic scoliosis (AIS). This is due to the lack of evidence-based treatment guidelines and outcome measures. Although clinical trials have been extolled as the highest form of evidence for evaluating treatment efficacy, the disadvantage of cost, time, lack of feasibility, and ethical considerations indicate a need for a new paradigm for evidence based research in this spinal deformity. High quality clinical databases offer an alternative approach for evidence-based research in medicine. So, we developed and established Scolisoft, an international, multidimensional and relational database designed to be a repository of surgical cases for AIS, and an active vehicle for standardized surgical information in a format that would permit qualitative and quantitative research and analysis. Here, we describe and discuss the utility of Scolisoft as a new paradigm for evidence-based research on AIS. Scolisoft was developed using dot.net platform and SQL server from Microsoft. All data is deidentified to protect patient privacy. Scolisoft can be accessed at (www.scolisoft.org). Collection of high quality data on surgical cases of AIS is a priority and processes continue to improve the database quality. The database currently has 67 registered users from 21 countries. To date, Scolisoft has 200 detailed surgical cases with pre, post, and follow up data. Scolisoft provides a structured process and practical information for surgeons to benchmark their treatment methods against other like treatments. Scolisoft is multifaceted and its use extends to education of health care providers in training, patients, ability to mine important data to stimulate research and quality improvement initiatives of healthcare organizations. PMID:18830720

  6. Leptin Receptor Metabolism Disorder in Primary Chondrocytes from Adolescent Idiopathic Scoliosis Girls.

    Science.gov (United States)

    Wang, Yun-Jia; Yu, Hong-Gui; Zhou, Zhen-Hai; Guo, Qiang; Wang, Long-Jie; Zhang, Hong-Qi

    2016-01-01

    To investigate the underlying mechanisms of low metabolic activity of primary chondrocytes obtained from girls with adolescent idiopathic scoliosis (AIS); AIS is a spine-deforming disease that often occurs in girls. AIS is associated with a lower bone mass than that of healthy individuals and osteopenia. Leptin was shown to play an important role in bone growth. It can also regulate the function of chondrocytes. Changes in leptin and Ob-R levels in AIS patients have been reported in several studies. The underlying mechanisms between the dysfunction of peripheral leptin signaling and abnormal chondrocytes remain unclear; The following parameters were evaluated in AIS patients and the control groups: total serum leptin levels; Ob-R expression in the plasma membrane of primary chondrocytes; JAK2 and STAT3 phosphorylation status. Then, we inhibited the lysosome and proteasome and knocked down clathrin heavy chain (CHC) expression in primary chondrocytes isolated from girls with AIS and evaluated Ob-R expression. We investigated the effects of leptin combined with a lysosome inhibitor or CHC knockdown in primary chondrocytes obtained from AIS patients; Compared with the controls, AIS patients showed similar total serum leptin levels, reduced JAK2 and STAT3 phosphorylation, and decreased cartilage matrix synthesis in the facet joint. Lower metabolic activity and lower membrane expression of Ob-R were observed in primary chondrocytes from the AIS group than in the controls. Lysosome inhibition increased the total Ob-R content but had no effect on the membrane expression of Ob-R or leptin's effects on AIS primary chondrocytes. CHC knockdown upregulated the membrane Ob-R levels and enhanced leptin's effects on AIS primary chondrocytes; The underlying mechanism of chondrocytes that are hyposensitive to leptin in some girls with AIS is low plasma membrane Ob-R expression that results from an imbalance between the rate of receptor endocytosis and the insertion of newly

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  11. 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. PMID:24432057

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

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

    Science.gov (United States)

    Tsirikos, Athanasios I; Al-Hourani, Khalid

    2013-11-01

    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. PMID:24379470

  18. 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

  19. 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

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

    Science.gov (United States)

    Matusik, Edyta; Durmala, Jacek; Matusik, Pawel

    2016-01-01

    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. PMID:26828519

  1. 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

  2. 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.

  3. 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

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    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.

  4. 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.

  5. 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.

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

    Science.gov (United States)

    Rahyussalim, Ahmad Jabir; Saleh, Ifran; Purnaning, Dyah; Kurniawati, Tri

    2016-01-01

    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. PMID:27064801

  7. 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.

  8. Experiments with a novel content-based image retrieval software: can we eliminate classification systems in adolescent idiopathic scoliosis?

    Science.gov (United States)

    Menon, K Venugopal; Kumar, Dinesh; Thomas, Tessamma

    2014-02-01

    Study Design Preliminary evaluation of new tool. Objective To ascertain whether the newly developed content-based image retrieval (CBIR) software can be used successfully to retrieve images of similar cases of adolescent idiopathic scoliosis (AIS) from a database to help plan treatment without adhering to a classification scheme. Methods Sixty-two operated cases of AIS were entered into the newly developed CBIR database. Five new cases of different curve patterns were used as query images. The images were fed into the CBIR database that retrieved similar images from the existing cases. These were analyzed by a senior surgeon for conformity to the query image. Results Within the limits of variability set for the query system, all the resultant images conformed to the query image. One case had no similar match in the series. The other four retrieved several images that were matching with the query. No matching case was left out in the series. The postoperative images were then analyzed to check for surgical strategies. Broad guidelines for treatment could be derived from the results. More precise query settings, inclusion of bending films, and a larger database will enhance accurate retrieval and better decision making. Conclusion The CBIR system is an effective tool for accurate documentation and retrieval of scoliosis images. Broad guidelines for surgical strategies can be made from the postoperative images of the existing cases without adhering to any classification scheme. PMID:24494177

  9. 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

  10. Body Image and Quality-of-Life in Untreated Versus Brace-Treated Females With Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Schwieger, Traci; Campo, Shelly; Weinstein, Stuart L.; Dolan, Lori A.; Ashida, Sato; Steuber, Keli R.

    2016-01-01

    Study Design. The Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) included skeletally immature high-risk patients with adolescent idiopathic scoliosis (AIS) with moderate curve sizes (20°– 40°). BrAIST was a multicenter, controlled trial using both randomized and preference treatment arms into either an observation group or a brace treatment group. Objective. The aim of this study was to analyze and compare body image and quality-of-life (QOL) in female AIS patients who were observed or treated with a brace. Summary of Background Data. Brace treatment is an effective means for controlling progressive scoliosis and preventing the need for surgery, but there is no consensus regarding the effect of brace treatment on body image or on QOL in adolescents with AIS. Methods. Data from female BrAIST patients in the randomized (n = 132) or preference (n = 187) arms and were observed (n = 120) or brace treated (n = 199) were analyzed. Patients completed the Spinal Appearance Questionnaire (SAQ) and the Pediatric Quality of Life Inventory (PedsQOL) 4.0 Generic Scales at baseline and 6 month follow-up visits up to 2 years. Items on the SAQ measured three body image constructs (self, ideal, and overall). The PedsQOL measured health, activities, feelings, social factors, and school. Results. . In general, there were no significant differences within or between study arms or treatments regarding body image or QOL through 2 years of follow-up. Poorer body image was significantly correlated with poorer QOL during the first 2 years of follow-up regardless of study arm or treatment. Patients who crossed-over to a different treatment and patients with largest Cobb angles ≥ 40 degrees had significantly poorer body image, in particular self-body image, compared with those that did not. Conclusion. This study does not support findings from previous research indicating that wearing a brace has a negative impact on or is negatively impacted by body image or

  11. 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

  12. Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS?

    Directory of Open Access Journals (Sweden)

    Weiss Hans-Rudolf

    2007-12-01

    Full Text Available Abstract Historically, the treatment options for AIS, the most common form of scoliosis are; exercises; in-patient rehabilitation; braces and surgery. While there is evidence in the form of prospective controlled studies that Scoliosis Intensive Rehabilitation (SIR and braces can alter the natural history of the condition, there is no prospective controlled study comparing the natural history with surgical treatment. One aim of the Scoliosis Society (SOSORT should be; to help develop a body of research regarding the outcomes of conservative and operative treatment as well, and to highlight the problems of treatment indications in patients with AIS and other spinal deformities. Another aim is to help to improve the safety of patients who have surgery. By producing evidence-based information that can be used to develop guidelines that could aid both professionals and patients in making decisions about surgical and conservative options. Although 'Scoliosis' is the official journal of the SOSORT and is the main forum for experts in the field of conservative management of patients with spinal deformities, there needs to be more wide spread attempt to develop a fuller body of evidence focussing on spine surgery as well.

  13. 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.

  14. Expression of Estrogen Receptor Coactivator Proline-, Glutamic Acid- and Leucine-Rich Protein 1 within Paraspinal Muscles in Adolescents with Idiopathic Scoliosis

    Science.gov (United States)

    Skibinska, Izabela; Tomaszewski, Marek; Andrusiewicz, Miroslaw; Urbaniak, Paulina; Czarnecka-Klos, Roza; Shadi, Milud; Kotwicki, Tomasz; Kotwicka, Malgorzata

    2016-01-01

    Purpose The aim of this study was to detect and assess the estrogen receptor (ESR) coactivator PELP1 expression within human paraspinal skeletal muscles in patients suffering from idiopathic scoliosis. Methods During surgical correction of scoliosis the muscle biopsies harvested in 29 females. Presence of PELP1, ESR1 and ESR2 genes transcripts was studied using RT-qPCR technique while immunohistochemistry and western blot methods were used to detect the PEPL1 protein presence. Results PELP1 expression in deep paraspinal muscles revealed higher than in superficial back muscles (p = 0.005). Positive immunohistochemical staining for PELP1 was observed in the nuclei of the paraspinal muscle cells. Western blot revealed PELP1 protein in all samples. No significant difference in PELP1 expression between the convex and the concave scoliosis side (p>0.05) was found. In deep paraspinal back muscles, a significant correlation between the PELP1 expression level on the concave side and the Cobb angle (r = 0.4; p<0.05) was noted as well as between the PELP1 and ESR1 expression level (r = 0.7; p<0.05) while no correlation between PELP1 and ESR2 expression level was found. Conclusion To our knowledge, three techniques for the first time demonstrated the presence of the PELP1 in paraspinal muscles of patients with idiopathic scoliosis. The PELP1 potential regulatory impact on back muscle function is to be further investigated. PMID:27045366

  15. 青少年特发性脊柱侧凸术后疗效的评估%Postoperative evaluation of adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    李明; 胡佳; 王传锋

    2009-01-01

    @@ 青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是指一组青少年起病、不明病因的脊柱侧向弯曲大于10°伴有椎体旋转的三维脊柱畸形,发病率较高,严重危害青少年的身心健康.

  16. 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.)

  17. Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients

    Science.gov (United States)

    Johari, Joehaimey; Sharifudin, Mohd Ariff; Rahman, Azriani Ab; Omar, Ahmad Sabri; Abdullah, Ahmad Tajudin; Nor, Sobri; Lam, Weii Cheak; Yusof, Mohd Imran

    2016-01-01

    INTRODUCTION This retrospective review aimed to examine the relationship between preoperative pulmonary function and the Cobb angle, location of apical vertebrae and age in adolescent idiopathic scoliosis (AIS). To our knowledge, there have been no detailed analyses of preoperative pulmonary function in relation to these three factors in AIS. METHODS A total of 38 patients with thoracic or thoracolumbar scoliosis were included. Curvature of spinal deformity was measured using the Cobb method. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used to evaluate preoperative pulmonary function. Statistical methods were used to analyse the relationship between preoperative pulmonary function and the factors that may contribute to poor pulmonary function. RESULTS The mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1–L3 than at T6–T8 or T9–T12 (p = 0.006). CONCLUSION Lung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients. PMID:26831315

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

    Science.gov (United States)

    Justice, Cristina M.; Bishop, Kevin; Carrington, Blake; Mullikin, Jim C.; Swindle, Kandice; Marosy, Beth; Sood, Raman; Miller, Nancy H.; Wilson, Alexander F.

    2016-01-01

    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. PMID:27172222

  19. A Comparison of Cobb Angle: Standing Versus Supine Images of Late-Onset Idiopathic Scoliosis

    Science.gov (United States)

    Vavruch, Ludvig; Tropp, Hans

    2016-01-01

    Summary Background Scoliosis is traditionally evaluated by measuring the Cobb angle in radiograph images taken while the patient is standing. However, low-dose computed tomography (CT) images, which are taken while the patient is in a supine position, provide new opportunities to evaluate scoliosis. Few studies have investigated how the patient’s position, standing or supine, affects measurements. The purpose of this study was to compare the Cobb angle in images from patients while standing versus supine. Material/Methods A total of 128 consecutive patients (97 females and 21 males; mean age 15.5 [11–26] years) with late-onset scoliosis requiring corrective surgery were enrolled. One observer evaluated the type of curve (Lenke classification) and measured the Cobb angle in whole-spine radiography (standing) and scout images from low-dose CT (supine) were taken on the same day. Results For all primary curves, the mean Cobb angle was 59° (SD 12°) while standing and 48° (SD 12°) while in the supine position, with a mean difference of 11° (SD 5°). The correlation between primary standing and supine images had an r value of 0.899 (95% CI 0.860–0.928) and an intra-class correlation coefficient value of 0.969. The correlation between the difference in standing and supine images from primary and secondary curves had an r value of 0.340 (95% CI 0.177–0.484). Conclusions We found a strong correlation between the Cobb angle in images obtained while the patient was standing versus supine for primary and secondary curves. This study is only applicable for patients with severe curves requiring surgical treatment. It enables additional studies based on low-dose CT. PMID:27354881

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

    Directory of Open Access Journals (Sweden)

    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

  1. Infection after anterior spinal fusion for idiopathic scoliosis using the Cotrel-Dubousset-Hopf system: A clinical case series of three patients

    Science.gov (United States)

    Willems, Paul C.; Punt, Ilona M.; van Rhijn, Lodewijk W.; van Ooij, André

    2016-01-01

    Background Three patients with late-onset infection after multilevel instrumented anterior spinal fusion for idiopathic scoliosis, using the Cotrel-Dubousset-Hopf (CDH) system, are presented. The CDH-system is an anterior instrumentation with high biomechanical stability and rigidity, ensuring a stable primary fixation. Unlike after posterior spinal fusion, infection after anterior spinal fusion (ASF) for idiopathic scoliosis has rarely been reported. Methods The files of three patients who developed an infection after ASF for scoliosis using the CDH-system, were reviewed. The clinical presentation and diagnostic and therapeutic options are discussed. Results All three patients had a late-onset infection of the CDH-system, which was difficult to diagnose because of nonspecific symptoms. Radiographs and technetium bone scan appeared to be of low value. When an abscess was present, this could accurately be diagnosed with MRI or CT imaging. Operative treatment with implant removal and antibiotic therapy was successful in all cases. Conclusion Late onset infections after ASF using the CDH-system presented with few and nonspecific symptoms. The clinical presentation was mainly characterized by vague abdominal- or back-pain after an interval of normal postoperative recovery, moderately raised infection parameters and inconclusive findings with imaging modalities. As treatment, implant removal, debridement and parenteral antibiotics are recommended. It should be noted though that implant removal poses serious risks for vascular and visceral structures. PMID:26913222

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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).

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. 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.

  8. Comparison of Functional Outcome and Quality of Life in Patients With Idiopathic Scoliosis Treated by Spinal Fusion

    Science.gov (United States)

    Fan, Hengwei; Wang, Qifei; Huang, Zifang; Sui, Wenyuan; Yang, Jingfan; Deng, Yaolong; Yang, Junlin

    2016-01-01

    Abstract Longer spinal fusions have been shown to result in improved deformity correction; however, loss of normal flexibility in the fusion area should not be ignored. Current consensus was to achieve a shorter fusion in primary surgery, with the goal of preserving as much of the distal motion segment as possible. However, the correlation between the length of fusion and functional outcome remains controversial. To the best of our knowledge, a previous study has demonstrated the function outcomes and the differences in HRQoL with specific fusion levels. In this cross-sectional study, 172 patients (mean age, 17.8 y) with idiopathic scoliosis treated by spinal fusion (mean time since surgery, 29.7 mo) were included to measure lumbar spine mobility and quality of life using validated outcome instruments in the study population. Patients were assigned to 5 groups according to the lower instrumented vertebra (LIV) level: group A (fusion above L2) 26 patients; group B (fusion to L2) 21 patients; group C (fusion to L3) 46 patients; group D (fusion to L4) 53 patients; and group E (fusion to L5) 26 patients. At each follow-up, patients were asked to complete the Scoliosis Research Society 22 (SRS-22) Questionnaire. Lumbar mobility was assessed using a dual digital inclinometer. Average spinal range of motion (ROM) was 41.4 degrees (SD, 20.7), forward flexion was 29.2 degrees (SD, 15.0), and backward extension was 12.2 degrees (SD, 9.5). The total spinal range of motion and forward flexion dropped noticeably as the LIV got more distal. Statistically significant between-group differences (1-way ANOVA) were found for ROM (P < 0.001), forward flexion (P < 0.001), or backward extension (P < 0.001). The motion segments preserved significantly correlated with ROM (r = 0.76, P < 0.001), ROMF (r = 0.76, P < 0.001), and ROME (r = 0.39, P < 0.001). However, no significant between-group differences was found for each domain of SRS-22 questionnaire

  9. 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.

  10. 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...

  11. Abnormal osteogenic and chondrogenic differentiation of human mesenchymal stem cells from patients with adolescent idiopathic scoliosis in response to melatonin

    Science.gov (United States)

    Chen, Chong; Xu, Caixia; Zhou, Taifeng; Gao, Bo; Zhou, Hang; Chen, Changhua; Zhang, Changli; Huang, Dongsheng; Su, Peiqiang

    2016-01-01

    Abnormalities of membranous and endochondral ossification in patients with adolescent idiopathic scoliosis (AIS) remain incompletely understood. To investigate abnormalities in the melatonin signaling pathway and cellular response to melatonin in AIS, a case-control study of osteogenic and chondrogenic differentiation was performed using human mesenchymal stem cells (hMSCs). AIS was diagnosed by physical and radiographic examination. hMSCs were isolated from the bone marrow of patients with AIS and control subjects (n=12 each), and purified by density gradient centrifugation. The expression levels of melatonin receptors (MTs) 1 and 2 were detected by western blotting. Osteogenic and chondrogenic differentiation was induced by culturing hMSCs in osteogenic and chondrogenic media containing vehicle or 50 nM melatonin. Alkaline phosphatase (ALP) activity assays, quantitative glycosaminoglycan (GAG) analysis, and reverse transcription-quantitative polymerase chain reaction analysis were performed. Compared with controls, MT2 demonstrated low expression in the AIS group. Melatonin increased ALP activity, GAG synthesis and upregulated the expression of genes involved in osteogenic and chondrogenic differentiation including, ALP, osteopontin, osteocalcin, runt-related transcription factor 2, collagen type II, collagen type X, aggrecan and sex-determining region Y-box 9 in the normal control hMSCs, but did not affect the AIS groups. Thus, AIS hMSCs exhibit abnormal cellular responses to melatonin during osteogenic and chondrogenic differentiation, which may be associated with abnormal membranous and endochondral ossification, and skeletal growth. These results indicate a potential modulating role of melatonin via the MT2 receptor on abnormal osteogenic and chondrogenic differentiaation in patients with AIS. PMID:27314307

  12. Spot14/Spot14R expression may be involved in MSC adipogenic differentiation in patients with adolescent idiopathic scoliosis

    Science.gov (United States)

    WANG, QIFEI; YANG, JUNLIN; LIN, XIANG; HUANG, ZIFANG; XIE, CHAOFAN; FAN, HENGWEI

    2016-01-01

    The aim of the present study was to evaluate the different expression levels of thyroid hormone responsive (THRSP; Spot14)/S14 related, Mig12 (S14R) during bone marrow mesenchymal stem cell (BM-MSC) adipogenesis in adolescent idiopathic scoliosis (AIS) patients. MSCs were retrospectively isolated from AIS patients and controls, and adipogenic differentiation was induced. Total RNA was extracted for Affymetrix 3′-IVT expression profiling microarrays and compared with the results from healthy controls. The results were confirmed by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) validation and the protein expression levels of Spot14 and its paralogous gene S14R by western blotting and immunohistochemistry. A total of 300 significantly altered mRNAs were detected (111 upregulated and 189 downregulated) and confirmed by RT-qPCR. The mRNA expression levels of seven genes, including Spot14, were altered by >2-fold in AIS patients. Spot14/S14R was selected for further investigation. The results of the western blotting demonstrated that mRNA and protein expression levels of Spot14/S14R were significantly higher in AIS patients than the controls (P<0.05). Immunohistochemistry demonstrated Spot14 was expressed in 85% (17/20 cases) in adipose tissue samples from AIS patients and 23.1% (3/13 cases) of adipose tissue samples from controls. The positive ratio of Spot14 in adipose tissue samples from AIS was significantly higher than the controls (P<0.001). The results of the present study indicated that Spot14/S14R were differently expressed in MSC adipogenesis in AIS patients, and they may be important in the abnormal adipogenic differentiation in AIS. PMID:27082501

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

    Science.gov (United States)

    Zhao, Jian; Yang, Mingyuan; Li, Ming

    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 aforementioned 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 observed in 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. PMID:27659327

  14. Factors favoring regain of the lost vertical spinal height through posterior spinal fusion in adolescent idiopathic scoliosis

    Science.gov (United States)

    Shi, Benlong; Mao, Saihu; Xu, Leilei; Sun, Xu; Liu, Zhen; Zhu, Zezhang; Lam, Tsz Ping; Cheng, Jack CY; Ng, Bobby; Qiu, Yong

    2016-01-01

    Height gain is a common beneficial consequence following correction surgery in adolescent idiopathic scoliosis (AIS), yet little is known concerning factors favoring regain of the lost vertical spinal height (SH) through posterior spinal fusion. A consecutive series of AIS patients from February 2013 to August 2015 were reviewed. Surgical changes in SH (ΔSH), as well as the multiple coronal and sagittal deformity parameters were measured and correlated. Factors associated with ΔSH were identified through Pearson correlation analysis and multivariate regression analysis. A total of 172 single curve and 104 double curve patients were reviewed. The ΔSH averaged 2.5 ± 0.9 cm in single curve group and 2.9 ± 1.0 cm in double curve group. The multivariate regression analysis revealed the following pre-operative variables contributed significantly to ΔSH: pre-op Cobb angle, pre-op TK (single curve group only), pre-op GK (double curve group only) and pre-op LL (double curve group only) (p < 0.05). Thus change in height (in cm) = 0.044 × (pre-op Cobb angle) + 0.012 × (pre-op TK) (Single curve, adjusted R2 = 0.549) or 0.923 + 0.021 × (pre-op Cobb angle1) + 0.028 × (pre-op Cobb angle2) + 0.015 × (pre-op GK)-0.012 × (pre-op LL) (Double curve, adjusted R2 = 0.563). Severer pre-operative coronal Cobb angle and greater sagittal curves were beneficial factors favoring more contribution to the surgical lengthening effect in vertical spinal height in AIS. PMID:27373798

  15. 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 < 0.0001) and significantly correlated with 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

  16. 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.

  17. 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 < 0.0001) and significantly correlated with 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

  18. 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.

  19. 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.

  20. A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

    OpenAIRE

    Bozcali, Evin; 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 co...

  1. Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide.

    Science.gov (United States)

    Kafer, E R

    1975-06-01

    The aims were to examine the effects of scoliosis (angle), and age on lung volumes, elastic properties of the respiratory system, and the ventilatory response to CO2. The mean age of the 55 patients was 25.4 plus or minus SEM 2.5 yr, and the mean angle was 80 plus or minus SEM 4.2. The mean plus or minus SEM percent predicted lung volumes were vital capacity (VC), 60.5 plus or minus 2.7; total lung capacity (TLC), 70,2 plus or minus 2.6; functional residual capacity (frc), 79.3 plus or minus 3.2; and residual volume (RV), 99.7 plus or minus 5.2. The correlation coefficients between the angle of scoliosis and each of the following were significant: TLC (-0.548), percent predicted TLC (-0.547), VC (-0.485), percent predicted VC (-0.523), FRC (-0.533), percent predicted FRC (-0.338), RV (-0.438), and percent predicted RV (-0.318). The mean compliance of the total respiratory system (Crs) was 0.049 litter/cm H2O plus or minus SEM 0.004, and the mean compliance of the chest wall (Ccw) was 0.080 liter/cm H2O plus or minus SEM 0.012. The Crs and Ccw were inversely proportional to the angle (r-0.620 and -0.721) and directly proportional to the height and the weight. The mean deltaV/deltaPco2 was 1.32 liter/min per mm Hg (SEM 0.171), and the mean deltaVt/deltaPco2 was 28.9 ml/mm Hg (SEM 3.64). The correlation coefficients between deltaV/deltaPco2 and the following were height, 0.499; VC, 0.792; TLC, 0.632; AND Crs, 0.520; and between the deltaTt/deltaPco2 and the following were height, 0.500; VC, 0.878; TLC, 0.802; and Crs, 0.590. We conclude that body size and the deformity were the determinants of the lung volumes and the mechanical properties of the respiratory system, and that these variables were the major factors in both the magnitude and pattern of the ventilatory response to CO2. The correlations between age and the mechanical properties of the respiratory sytem, deltaV/deltaPco2, and deltaVt/deltaPco2, were not significant, but the correlation coefficients between

  2. 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

  3. 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

  4. Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire

    Directory of Open Access Journals (Sweden)

    Yu Ching-Hsiao

    2012-02-01

    Full Text Available Abstract Background In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS. Methods Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years. The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop, postoperative (PO and final follow-up (FFU period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed. Results The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p p = 0.12 FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%. The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25. Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p Conclusion Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.

  5. 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.

  6. 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

  7. Comparison of effectiveness of Halo-femoral traction after anterior spinal release in severe idiopathic and congenital scoliosis: a retrospective study

    Directory of Open Access Journals (Sweden)

    Zhu Zezhang

    2007-11-01

    Full Text Available Abstract Background Halo-femoral traction could gradually improve the coronal and sagittal deformity and restore the trunk balance through the elongation of the spine. The purpose of this retrospective study was to assess the effectiveness of Halo-femoral traction after anterior spinal release in the management of severe idiopathic and congenital scoliosis. Methods Sixty patients with severe and rigid curve treated with anterior spinal release, Halo-femoral traction, and second stage posterior spinal fusion were recruited for this retrospective study. Idiopathic Scoliosis (IS group was 30 patients (23 females and 7 males with mean age of 15.5 years. The average coronal Cobb angle was 91.6° and the mean global thoracic kyphosis was 50.6°. The curve type of these patients were 2 with Lenke 1AN, 4 with Lenke 1A+, 1 with Lenke 1BN, 10 with Lenke 1CN, 3 with Lenke 1C+, 3 with Lenke 3CN, 3 with Lenke 3C+, and 4 with Lenke 5C+. Congenital Scoliosis (CS group included 30 patients (20 females and 10 males with average age of 15.2 years. The average coronal Cobb angle of the main curve before operation was 95.7° and the average thoracic kyphosis was 70.2°. All patients had a minimum 12-month follow-up radiograph (range 12–72 months, mean 38 months. Results The average traction time was 23 days and the average traction weight was 16 kg. Four patients experienced brachial plexus palsy and complete nerve functional restoration was achieved at two months follow-up. For the IS group, the post-operative mean Cobb angle of major curve averaged 40.1° with correction rate of 57.5%. For the CS group, the post-operative mean Cobb angle was 56.5° with average correction rate of 45.2%. The difference in curve magnitude between the IS and CS patients after posterior correction was statistically significant (t = 4.15, p Conclusion Halo-femoral traction was a safe, well-tolerated and effective method for the treatment of severe and rigid scoliosis patients. The

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Changes of concave and convex rib-vertebral angle, angle difference and angle ratio in patients with right thoracic adolescent idiopathic scoliosis.

    Science.gov (United States)

    Canavese, Federico; Turcot, Katia; Holveck, Jerôme; Farhoumand, Agnés Dahl; Kaelin, André

    2011-01-01

    The aim of this study is to describe the radiological changes in rib-vertebral angles (RVAs), rib-vertebral angle differences (RVADs), and rib-vertebral angle ratios (RVARas) in patients with untreated right thoracic adolescent idiopathic scoliosis and to compare with the normal subjects. The concave and convex RVA from T1 to T12, the RVADs and the RVARas were measured on AP digital radiographs of 44 female patients with right convex idiopathic scoliosis and 14 normal females. Patients were divided into three groups: normal subjects (group 1), scoliotic patients with Cobb's angle equal or <30° (group 2) and scoliotic patients with Cobb's angle over 30° (group 3). Overall values (mean ± SD) of the RVAs on the concave side were 90.5° ± 17° in group 1, 90.3° ± 15.8° in group 2 and 88.8° ± 15.4° in group 3. On the convex side, values were 90.0° ± 17.3° in group 1, 86.3° ± 13.7° in group 2 and 80.7° ± 14.4° in group 3. Overall values (mean ± SD) of the RVADs at all levels were 0.5° ± 0.7° in group 1, 4.0° ± 4.8° in group 2 and 8.0° ± 4.0° in group 3. The RVARa values (mean ± SD) at all levels was 1.008° ± 0.012° in group 1, 1.041° ± 0.061° in group 2 and 1.102° ± 0.151° in group 3. RVAD and RVARa values in the scoliotic segment were greater in patients with untreated scoliosis over 30° than in patients with an untreated deformity of <30° or normal subjects. A significant effect between groups was observed for the RVA, RVAD and RVARa variables. Measurement of RVA, RVAD and RVARa should not only be performed at and around the apex of a thoracic spinal deformity, but also extended to the whole thoracic spine. PMID:20811755

  13. Idiopathic fibrosing pancreatitis: a rare cause of chronic obstructive jaundice in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Seong; Kim, Hyun Sook; Kim, Hack Hee; Kim, Ok Hwa; Kim, Choon Yul; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1992-01-15

    We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.

  14. 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

  15. Infantile 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 ...

  16. 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 ...

  17. 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

    2007-01-01

    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…

  18. 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.

  19. 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

    2016-01-01

    Abstract 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 < 0.001 for both). Additionally, there were no significant differences among the 3 strategies for sagittal parameters at the immediate postoperative and last postoperative follow-up periods, though there were significant differences in the Cobb angle between the preoperative and immediate postoperative periods among the 3 groups, but not between the immediate postoperative and last follow-up periods. The amount of hospital charges in the SPSS group was significantly

  20. 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

    International Nuclear Information System (INIS)

    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

  1. 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.

  2. 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

  3. Identification of candidate diagnostic biomarkers for adolescent idiopathic scoliosis using UPLC/QTOF-MS analysis: a first report of lipid metabolism profiles

    Science.gov (United States)

    Sun, Zhi-jian; Jia, Hong-mei; Qiu, Gui-xing; Zhou, Chao; Guo, Shigong; Zhang, Jian-guo; Shen, Jian-xiong; Zhao, Yu; Zou, Zhong-mei

    2016-01-01

    Adolescent idiopathic scoliosis (AIS) is a complex spine deformity, affecting approximately 1–3% adolescents. Earlier diagnosis could increase the likelihood of successful conservative treatment and hence reduce the need for surgical intervention. We conducted a serum metabonomic study to explore the potential biomarkers of AIS for early diagnosis. Serum metabolic profiles were firstly explored between 30 AIS patients and 31 healthy controls by ultra high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Then, the candidate metabolites were validated in an independent cohort including 31 AIS patients and 44 controls. The results showed that metabolic profiles of AIS patients generally deviated from healthy controls in both the discovery set and replication set. Seven differential metabolites were identified as candidate diagnostic biomarkers, including PC(20:4), 2-hexenoylcarnitine, beta-D-glucopyranuronicacid, DG(38:9), MG(20:3), LysoPC(18:2) and LysoPC(16:0). These candidate metabolites indicated disrupted lipid metabolism in AIS, including glycerophospholipid, glycerolipid and fatty acid metabolism. Elevated expressions of adipose triglyceride lipase and hormone sensitive lipase in adipose tissue further corroborated our findings of increased lipid metabolism in AIS. Our findings suggest that differential metabolites discovered in AIS could be used as potential diagnostic biomarkers and that lipid metabolism plays a role in the pathogenesis of AIS. PMID:26928931

  4. 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,

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. Scoliosis - resources

    Science.gov (United States)

    Resources - scoliosis ... The following organizations are good resources for information on scoliosis : American Academy of Orthopedic Surgeons -- orthoinfo.aaos.org/topic.cfm?topic=A00626 National Institute of Arthritis and ...

  13. 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 ...

  14. 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)

  15. 微量元素硒与特发性脊柱侧弯相关性研究%Research in the Correlation between Trace Element Se and Idiopathic Scoliosis

    Institute of Scientific and Technical Information of China (English)

    柴耀凤; 赵胜; 郭锦丽

    2014-01-01

    Objective:To explore the correlation between trace element Se and idiopathic scoliosis and provide the basis for idiopathic scoliosis' etiology. Method:90 patients with idiopathic scoliosis were examined and divided into three subgroups according to the Cobb angle:35 mild cases,30 moderate cases and 25 severe cases. 30 healthy adolescents of the same gender,age were recruited from high incidence areas. Fluorescence method was adopted to determine the selenium concentration in the whole blood,researched the correlation between selenium and idiopathic scoliosis by a case-control study. Result:Selenium concentration in the case group was(34.56±15.54)µg/L,and was lower than(63.53±19.08) µg/L in the control group,the difference was significantly(P0.05). The correlation coefficient between selenium concentration and Cobb Angle was 0.671. Conclusion:Selenium concentration in scoliotic patients decreaseds,and with the severity of idiopathic scoliosis progressing,selenium deficiency become increasingly prominent. The changes of selenium concentration were not accidental,there is probably a correlation between them.%目的:探讨微量元素硒与特发性脊柱侧弯的相关性,为特发性脊柱侧弯的病因学研究提供依据。方法:选取山西医科大学第二医院90例青少年特发性脊柱侧弯患者为病例组,Cobb角20°~85°,根据Cobb角的大小将患者分为三组:轻度组35例,中度组30例,重度组25例;以高发区同性别、同年龄段体检正常的青少年为对照组,共30例。采用荧光法测定血硒含量,病例对照研究分析硒含量与特发性脊柱侧弯的相关性。结果:病例组硒含量为(34.56±15.54)µg/L,明显低于对照组的(63.53±19.08)µg/L(P0.05);特发性脊柱侧弯患者血硒含量值与Cobb角相关系数为0.671(P<0.01)。结论:特发性脊柱侧弯患者血硒含量降低,且随着侧弯程度加重,硒缺乏表现更突出,微量元素硒

  16. 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

  17. 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

  18. 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

    Science.gov (United States)

    Guo, Long; Yamashita, Hiroshi; Kou, Ikuyo; Takimoto, Aki; Meguro-Horike, Makiko; Horike, Shin-ichi; Sakuma, Tetsushi; Miura, Shigenori; Adachi, Taiji; Yamamoto, Takashi; Ikegawa, Shiro; Hiraki, Yuji; Shukunami, Chisa

    2016-01-01

    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 various stages of

  19. The experience of brace treatment in children/adolescents with scoliosis

    Directory of Open Access Journals (Sweden)

    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

  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. 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.

  2. 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

  3. [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.

  4. Establishing a three-dimensional finite element model of PUMCIId1 adolescent idiopathic scoliosis%PUMCⅡd1型青少年特发性脊柱侧凸三维有限元模型的建立

    Institute of Scientific and Technical Information of China (English)

    黄盛佳; 霍洪军; 杨学军; 邢文华; 辛大奇; 李峰

    2014-01-01

    背景:建立高质量的有限元模型是进行生物力学分析研究的重要基础,完整的青少年特发性脊柱侧凸三维有限元模型报道甚少。目的:建立PUMCⅡd1型青少年特发性脊柱侧凸三维有限元模型,为特发性脊柱侧凸的生物力学分析提供有效的数字化平台。方法:采集1例14岁PUMCⅡd1型特发性脊柱侧凸女性志愿者从T 1至骶尾骨的CT 断层图像,将CT数据导入Mimics 16.0医学三维重建软件中,建立包括胸廓结构的完整脊柱侧凸三维几何模型。再将几何模型以点云格式导入Geomagic Studio 11.0软件中,对三维模型进行光滑、打磨、去噪等一系列图像处理,生成特发性脊柱侧凸三维有限元模型。最后导入ANSYS 14.0有限元分析软件中添加韧带、设置单元类型和定义材料属性,生成完整的特发性脊柱侧凸三维有限元模型。结果与结论:成功建立了完整的PUMCⅡd1型特发性脊柱侧凸三维有限元模型,包括四面体单元522887个和杆单元730个,共计523617个单元,159008个节点。试验建立了外形逼真的PUMCⅡd1型特发性脊柱侧凸三维有限元模型,为进一步的生物力学分析提供了可靠的数字化模型。%BACKGROUND:Establishment of high-quality finite element model is an important basis of biomechanical analysis. The reports on three-dimensional finite element model of complete adolescent idiopathic scoliosis are less. OBJECTIVE:To set up three-dimensional finite element model of PUMCIId1 adolescent idiopathic scoliosis for building ideal digitization platform for further biomechanical study. METHODS:A 14-year-old female patient with PUMCIId1 adolescent idiopathic scoliosis was included as volunteer for the current study. CT images obtained from CT transverse scanning from T 1 to sacrococcyx were imported into Mimics 16.0 software to form qualified three-dimensional geometric model, including thoracic cage, which was

  5. The influence of personalized plantar sustentation in postural straightening of the patient with idiopathic structural scoliosis tipe I – comparative study of two cases

    OpenAIRE

    Vlădăreanu Liliana

    2009-01-01

    It is known that type I scoliosis often benefits from physical therapy treatment, the patients being able to diminish the Cobb angle by use of physical exercises. It is also known that the most important part of the treatment is static and dynamic postural realignment. This is also the most difficult part for the patient as he or she has to “rewrite” their own movement and gait patterns. In this study we have compared the evolution of two female 12 years old cases of type I scoliosis. One of ...

  6. 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.

  7. 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

  8. Pediatric scoliosis

    OpenAIRE

    Mo, Fred; Cunningham, Matthew E.

    2011-01-01

    Pediatric scoliosis is a relatively uncommon condition typically first noticed due to altered stature or by routine spine screenings by a school nurse or pediatrician. The formal diagnosis is made with spine radiographs, with coronal curvature measurement of 10° or greater. Treatment may consist of serial observation, bracing until skeletal maturity, or surgery for correction and fusion/stabilization of severe or progressive deformity. Overall success for non-operative management of scoliosis...

  9. Effects and influencing factors of posterior orthopedic surgery on adolescent idiopathic scoliosis%青少年特发性脊柱侧凸的脊柱后路矫形及其影响因素

    Institute of Scientific and Technical Information of China (English)

    唐云德

    2015-01-01

    背景:后路矫形是治疗青少年特发性脊柱侧凸较为有效的方法,但目前关于青少年特发性脊柱侧凸患者后路矫形后脊柱高度的矫正程度及其影响因素鲜见报道。  目的:分析后路矫形对青少年特发性脊柱侧凸患者的脊柱矫形效果及其影响因素。  方法:回顾性分析青少年特发性脊柱侧凸患者346例的病历资料,其中单弯组203例,双弯组143例。测量患者矫形前后脊柱侧弯 Cobb 角和脊柱高度,采用逐步筛选回归法分析探讨性别、年龄、体质量、治疗前脊柱高度、治疗后脊柱高度、治疗前Cobb角、Cobb角矫正值、Cobb角矫正率、融合节段数、脊柱单弯或双弯、Lenke分型与矫形后脊柱高度增加值的关系。  结果与结论:单弯组和双弯组患者矫形后的Cobb角均显著小于矫形前(P<0.05),脊柱高度显著高于矫形前(P<0.05),随着矫形前Cobb角的增加Cobb角减少值(∆Cobb)和脊柱高度增加值(∆SH)均显著增加(P<0.05)。多元线性回归分析结果显示Cobb角矫正值、治疗前Cobb角、治疗后脊柱高度、Lenke分型、脊柱单弯或双弯、年龄对治疗后脊柱高度增加值(∆SH)有显著性影响(P<0.01),其中Cobb角矫正值是最大的影响因素。提示后路矫形对青少年特发性脊柱侧凸有显著的脊柱矫形效果,影响治疗后脊柱高度增加值的影响因素包括Cobb角矫正值、治疗前Cobb角、治疗后脊柱高度、Lenke分型、脊柱单弯或双弯、年龄。%BACKGROUND:Posterior orthopedic surgery is the more effective treatment of adolescent idiopathic scoliosis. However, there is rare study on the correction extent of spinal height and influential factors after posterior orthopedic surgery in patients with adolescent idiopathic scoliosis. OBJECTIVE:To explore the effect and influencing factors of posterior orthopedic surgery on adolescent idiopathic scoliosis. METHODS:Data of 346

  10. 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...

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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。

  16. Three-dimensional finite element analysis of adolescent idiopathic scoliosis correction by different correction methods%不同矫形力矫正特发性脊柱侧凸的三维有限元分析

    Institute of Scientific and Technical Information of China (English)

    盛林; 汪学松; 吴志宏; 翟吉良; 李书纲

    2009-01-01

    CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P < 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P< 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction> concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression > simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression > concave distraction and convex compression simultaneously = concave distraction prior to convex compression

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 轻中度青少年特发性脊柱侧凸患者肺功能研究%A study on pulmonary function in patients with mild-to-moderate adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    杜青; 周璇; 陈楠; 杨晓颜; 梁菊萍; 孙锟

    2016-01-01

    目的:研究轻中度青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者肺功能特征.方法:选取68例AIS患者作为AIS组,20例健康青少年作为正常对照组,采用肺功能仪测定研究对象用力肺活量(FVC)、FVC预计值(FVC pred)、FVC占预计值百分数(FVC pred%)、第1秒用力呼气量(FEV1)、FEV1预计值(FEV1 pred)、FEV1占预计值百分数(FEV1 pred%)、FEV1占FVC百分数(FEV1/FVC%).结果:AIS组FEV1 pred%、FEV1/FVC%分别为(85.60± 11.60)、(88.40±6.84),对照组分别为(93.20±9.39)、(91.00±3.13),AIS组FEV1 pred%、FEV 1/FVC%均低于正常对照组,差异有显著性意义.不同侧凸类型、不同性别AIS患者FVC pred%、FEV1 pred%、FEV1/FVC%差异无显著性意义.患者年龄与FVC、FVC pred、FEV1、FEV1 pred正相关,患者Cobb角与肺功能指标无关.结论:轻、中度AIS患者存在肺功能障碍,患者肺功能与年龄正相关,与侧凸类型、性别、Cobb角没有相关性.

  3. 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.

  4. 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

  5. Way of Life as Emphasizing Factors in the Progression of Idiophatic Scoliosis in Adolescence Era

    OpenAIRE

    Muminagic, Sahib; Bisanovic, Senaida; Mehic, Sanra; Sivic, Suad

    2012-01-01

    Introduction: Idiopathic scoliosis is a significant health problem which occurs in 2%–4% school kids in adolescent age. Reasons of occurrence are not quite clear, there are many theories, but probably it is multifactor disease. Among the theories that are mentioned some of them included environmental and behavioral factors. Aim: Research the impact of some environmental and behavioral factor on development and progression of idiopathic scoliosis in school kids. Methodology: Research was condu...

  6. Construction of Lenke3 type adult idiopathic scoliosis finite element model and thoracic screw guide target 3D model%Lenke3型成人特发性脊柱侧凸有限元模型及胸椎钉道导靶3D模型的建立

    Institute of Scientific and Technical Information of China (English)

    辛大奇; 霍洪军; 胡侦明; 杨学军; 邢文华; 赵岩; 汉迪; 李剑锋

    2015-01-01

    BACKGROUND:Studies have shown that posterior orthopedic internal fixation and anterior orthopedic internal fixation al can get good clinical outcomes for treatment of adult idiopathic scoliosis, however, it has not been reported on what kind of methods could achieve a better clinical outcome for treatment of Lenke3 type adult idiopathic scoliosis, have less risk of pedicle screws breakage and more reliable long-term efficacy. OBJECTIVE:To establish the Lenke 3 type adult idiopathic scoliosis finite element model and thoracic screw guide target 3D model using finite element analysis software, so as to provide scientific basis for biomechanical analysis and scientific pedicle screw implantation. METHODS:The CT scan image from T 1 to sacrum of one 28 years old volunteer with Lenke 3 type adult idiopathic scoliosis was imported into Mimics 16.0 software by Dicom form. Integral idiopathic scoliosis three dimensional model was established by geometry clear technology. Nail guide target of thoracic vertebra was established on vertebral model by design module in Mimics 16.0 software. The point cloud form of three dimensional model was imported into Geomagic Studio 11.0 software. Series of image processing of model were conducted. At last, three dimensional model was imported into ANSYS 14.0 finite element analysis software in order to build finite element model with biological properties. RESULTS AND CONCLUSION:Complete Lenke 3 type adult idiopathic scoliosis three dimensional finite element model was established successful y. It concluded 440 975 tetrahedron units and 580 bar units, total y 441 555 units and 1 077 318 nodes. Total y 12 nail guide target models of thoracic vertebra were established, including 4 682 tetrahedron units and 7 390 nodes. Lenke 3 type adult idiopathic scoliosis three dimensional finite element model and nail guide target of thoracic vertebral model with a realistic appearance were established successful y in this experiment. These results

  7. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    OpenAIRE

    Maryam Maghbool; Masood Maghbool; Mehdi Shahriari; Mehran Karimi

    2009-01-01

    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...

  8. An experimental study of correction of idiopathic-type scoliosis by staple%半骨骺加压钉矫治特发性脊柱侧凸的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    郑国权; 张永刚; 王岩; 张雪松; 张如意; 张巍

    2009-01-01

    anterior spinal epiphysis were performed simultaneously. Dorsoventral and lateral plain radiographs were taken preoperatively and postoperatively. Serial X-ray postoperatively were performed every 4 weeks to measure the Cobb angle of the spine and to observe the condition of the insert. The observing time is about 8 weeks. Results Radiography showed that 12 goats had created scoliosis model successfully. Control group (n=6): Series X-ray show that the change of the Cobb angle was not obviously. The initial curves after the procedures measured an average of 40.8°(28°-56°), the average Cobb angle was 42.5°(30°-58°) after 8 weeks, no statistics difference are found (P0.05). Treatment group (n=6): no complication such as pedicel screw break, instrument loosen, dislocation, injury of blood vessel, nerve injury and organ injury of thoracic cavity etc, were found during the observing period. The initial curves after the procedures measured an average of 44.5°(36°-57°), to some degree, the Cobb angle decreased and the average was 42.5°(30°-58°) after 8 weeks. There are statistics difference between the initial and final curves (P<0.05). Conclusion As a means of mechanical modulation, stapling can be manipulate conveniently and safely, and can modulate the spinal growth of the animal model successfully, predicted that it may be a new selection for idiopathic-type scoliosis in growing children.

  9. 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.

  10. 特发性脊柱侧弯与褪黑素的相关性%Correlation between idiopathic scoliosis and melatonin

    Institute of Scientific and Technical Information of China (English)

    张善勇; 杨小玉; 殷照阳

    2006-01-01

    目的:根据近年来出现新的脊柱侧弯动物模型的研究近况,探讨松果体切除以及褪黑素在侧弯形成中作用的研究进展.资料来源:应用计算机检索PubMed 1959-01/2006-03相关脊柱侧弯方面的文献,检索词"scoliosis,pinealectomy,melatonin",并限定文献语言种类为English.应用计算机检索中国期刊全国数据库2000-01/2006-03相关脊柱侧弯方面的文献,检索词"脊柱侧弯,褪黑素",语言种类为中文.资料选择:对资料进行初审,选取包括脊柱侧弯的相关文献,开始查找全文.纳入标准:文献所述内容涉及褪黑素相关脊柱侧弯的动物实验研究,排除标准:综述和重复研究.资料提炼:共检索到褪黑素相关脊柱侧弯动物实验的文献61篇,30篇文献符合纳入标准.资料综合:①松果体切除引发的侧弯与人类特发性脊柱侧弯的相似性:同样有着以右弯为主的特点.②从松果体切除后的小鸡以及大马哈鱼椎体和间盘组织学改变、系列双足鼠实验研究、血清素和5-羟色氨酸对侧弯的治疗作用、血清素在姿势和平衡中的作用这四个方面可以得出一个简单的假设:褪黑素减低造成椎体和间盘结构改变和血清素不足造成的姿势平衡障碍,二者联合在二足动物直立行走状态下将引发侧弯.结论:松果体切除是否造成其他激素或神经递质分泌方面的改变,还没有完全测定.但随着对于褪黑素进一步研究,脊柱侧弯发病机制或许会越来越明朗.

  11. 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 ... a Member Find a Specialist Calendar Contact Donate Scoliosis Research Society Dedicated to the optimal care of ...

  12. Idiopathic Infantile Arterial Calcification: A Rare Cause of Sudden Unexpected Death in Childhood

    Directory of Open Access Journals (Sweden)

    Susana Guimarães

    2010-01-01

    Full Text Available Unexpected child death investigation is a difficult area of forensic practice in view of the wide range of possible genetic, congenital, and acquired natural and nonnatural causes. Idiopathic infantile arterial calcification (IIAC is a rare autosomic recessive disease usually diagnosed postmortem. Inactivating mutations of the ENPP1 gene were described in 80% of the cases with IIAC. We report a case of a 5-year-old girl submitted to a forensic autopsy due to sudden death and possible medical negligence/parents child abuse. Major alterations found (intimal proliferation and deposition of calcium hydroxyapatite around the internal elastic lamina and media of arteries; acute myocardial infarct, stenotic and calcified coronary artery; perivascular and interstitial myocardial fibrosis; and subendocardial fibroelastosis were diagnostic of IIAC. We reviewed IIAC cases published in the English literature and highlight the importance of adequate autopsy evaluation in cases of sudden child death.

  13. Use of sodium chromate Cr51 in diagnosing childhood idiopathic pulmonary hemosiderosis

    International Nuclear Information System (INIS)

    The diagnosis of idiopathic pulmonary hemosiderosis (IPH) may be elusive. A 6-year-old boy had microcytic hypochromic anemia and a hemolytic component. Hemosiderin-laden macrophages were not found in the gastric aspirate. He had no pulmonary signs or symptoms. Extensive hematologic and roentgenologic investigations failed to reveal the cause of the anemia. Quantitative serial scintigraphic scanning showed significant (35%) pulmonary sequestration of autologous erythrocytes labeled with sodium chromate Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy spece Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy specimen confirmed the diagnosis of IPH. A diagnosis of IPH should be considered when children have iron deficiency anemia and pulmonary signs or symptoms. Organ sequestration studies may be helpful in equivocal cases

  14. 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

  15. 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

  16. 青少年特发性脊柱侧凸患者的骨强度特征研究%Study of bone strength in patients with adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    周璇; 杜青; 陈佩杰; 励建安; 赵黎; 陈楠; 张树新; 梁菊萍

    2015-01-01

    目的 探讨青少年特发性脊柱侧凸(AIS)患者的骨强度特征.方法 选取68例AIS患者作为AIS组,20例健康青少年作为正常对照组,采用超声骨强度仪测定研究对象桡骨远端的声速(SOS)、Z值、百分位.结果 AIS组SOS、Z值、百分位均低于正常对照组,差异有统计学意义(P<0.05).不同类型、不同性别AIS患者的SOS、Z值、百分位之间比较,差异无统计学意义(P>0.05).AIS患者的年龄与SOS呈正相关,其最大Cobb角与SOS之间无明显相关性.结论 AIS患者存在骨质强度偏低现象,其骨质强度与年龄呈正相关,与侧凸类型、性别之间无明显相关性.%Objective To investigate the bone strength of adolescent idiopathic scoliosis (AIS) patients.Methods A total of 68 AIS patients and 20 healthy subjects were recruited.Speed of sound (SOS),Z-score and percentile of distal radius of normal subjects and AIS patients were measured using the quantitative ultrasound.Results Compared with normal controls,AIS had significantly lower average SOS,Z value and percentile.No significant difference was found among different curve patterns and gender of AIS patients.There was a positive correlation between SOS and age in AIS patients.However,there was no correlation between SOS and maximal Cobb angle in AIS patients.Conclusions AIS patients have lower bone strength generally.The bone strength has a positive correlation with the age,but no correlation with the curve pattern and gender in AIS patients.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. Anatomical characteristics of thoracic vertebrae for safe pedicle screw placement:comparison between normal adolescents and adolescent idiopathic scoliosis patients%胸椎安全置入椎弓根螺钉的解剖特点:正常发育与特发性脊柱侧凸青少年比较

    Institute of Scientific and Technical Information of China (English)

    崔冠宇; 田伟; 刘波; 何达; 孙宇庆; 赵经纬; 程晓光

    2015-01-01

    BACKGROUND:Pedicle screw is the major instrumentation of surgery in thoracic spine. However, there have been few reports about pedicle morphology relevant to screw insertion tracts, and few reports comparing the normal adolescents and adolescent idiopathic scoliosis patients. OBJECTIVE:To compare the morphologic characteristics of the thoracic pedicle with regard to safe thoracic pedicle screw placement in normal adolescents and adolescent idiopathic scoliosis patients. METHODS: Thoracic pedicles of thirty-five normal adolescents and thirty-five adolescent idiopathic scoliosis patients were measured with three-dimensional reconstruction CT images. Measured parameters include (1) critical distance: the shortest distance from an entry point to the ventral cortex of the lamina. (2) Safe distance: the distance from the entry point to the tangent of the spinal canal at the medial wal of the pedicle. (3) Pedicle screw length. (4) Pedicle width. (5) Pedicle transverse angle. The dangerous area was defined as the distance between the critical distance and the safe distance. RESULTS AND CONCLUSION: The mean critical distance was (9.2±1.0) mm for the normal adolescents, and (9.4±1.2) mm for the adolescent idiopathic scoliosis patients. Safe distances were significantly less in normal adolescents (14.7±0.8) mm than that of the adolescent idiopathic scoliosis group (15.4±1.4) mm (P < 0.001). The dangerous area was (5.4±0.7) mm for the normal adolescents, which was significantly less than that of the adolescent idiopathic scoliosis patients (6.0±1.0) mm (P < 0.001). Pedicle screw length was (36.6±4.1) mm for the normal adolescents and (37.1±5.3) mm for the adolescent idiopathic scoliosis patients. Pedicle width was (5.8±1.2) mm for the normal adolescents and (5.7±1.7) mm for the adolescent idiopathic scoliosis patients. No significant difference in critical distance, pedicle screw length and pedicle width was found between the two groups (P=0.382, 0.135, 0

  19. 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...... of MT: TL/L Cobb angle) - 3.9 (preoperative LIV-LEV difference). The model R2 = 0.55. CONCLUSION: Both LIV selection and ratio of MT: TL/L curve were found to be highly correlated with the onset of postoperative trunk shift in Lenke 1C scoliosis. Amount of correction obtained by surgery, however, did...

  20. 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

    2009-01-01

    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. PMID:21589818

  1. 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.

  2. Radiografias em inclinação lateral como fator preditivo da correção cirúrgica na escoliose idiopática do adolescente Bending radiographs as a predictive factor in surgical correction of adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Alberto Ofenhejm Gotfryd

    2011-10-01

    Full Text Available OBJETIVO: Avaliar a utilização de radiografias com inclinação lateral ativa em decúbito dorsal como fator preditivo da correção cirúrgica da curva torácica principal em pacientes com escoliose idiopática do adolescente (EIA. MÉTODOS: Foram avaliados, clínica e radiograficamente, 20 pacientes portadores de EIA tipo Lenke 1A e 1B operados por via posterior, utilizando nas montagens apenas parafusos pediculares. A flexibilidade das curvas foi calculada através de radiografias em inclinação lateral supina ativa. Os valores obtidos no pré-operatório para a curva torácica principal foram incluídos em uma equação matemática proposta por Cheung et al com a finalidade de predizer o resultado angular esperado após a correção cirúrgica. Após isto, foi realizado estudo estatístico de significância entre o valor predito e o real pós-operatório. RESULTADOS: Houve significância estatística para todos os casos estudados em relação ao valor predito pré-operatoriamente e os achados radiográficos do pós-operatório imediato (p OBJECTIVE: To evaluate the use of x-rays in dorsal decubitus, as a predictive factor for surgical correction of the main thoracic curve using pedicle screws, on patients with idiopathic adolescent scoliosis. METHOD: Twenty patients with idiopathic adolescent scoliosis of Lenke types 1A and 1B who were operated using a technique only involving pedicle screws by means of the posterior route were evaluated clinically and radiographically. The curve flexibility was calculated by means of active supine lateral oblique radiographs. The postoperative values for the main thoracic curve were included in a mathematical equation proposed by Cheung et al., with the aim of predicting the expected angular result from the surgical correction. The difference between the expected and actual postoperative results was then investigated regarding its statistical significance. RESULTS: There was statistical significance for

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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

  4. 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

  5. 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

    Directory of Open Access Journals (Sweden)

    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.

  6. Application of bone morphogenetic protein 2 loaded nano-hydroxyapatite artificial bone in the correction and fusion of adult idiopathic scoliosis%骨形态发生蛋白2纳米人工骨在成人特发性脊柱畸形矫正融合中的应用

    Institute of Scientific and Technical Information of China (English)

    胡文; 黄旗凯; 苏佳灿; 李明

    2012-01-01

    背景:复合骨形态发生蛋白2 纳米人工骨具有独特的生物特性,模仿天然骨的成分及结构特征,可为细胞提供与天然骨相类似的微环境.目的:观察复合骨形态发生蛋白2 纳米人工骨与同种异体骨植骨在成人特发性脊柱畸形矫正融合的临床效果.方法:回顾分析69 例成人特发性脊柱侧弯患者资料,分别采用复合骨形态发生蛋白2 纳米人工骨移植36 例,同种异体骨移植33 例,植骨后第3,6 个月拍摄脊柱全长正侧位片,观察植骨融合情况.结果与结论:69 例患者畸形明显矫正,3,6 个月的影像学观测两组均可见骨小梁生长.植骨后6 个月,复合骨形态发生蛋白2 纳米人工骨组明显融合33 例,同种异体骨组26 例.复合骨形态发生蛋白2 纳米人工骨组早期融合率高于同种异体骨组(P < 0.05).提示成人特发性脊柱侧凸后路矫形手术中,复合骨形态发生蛋白2 纳米人工骨是比较理想的骨移植材料,在融合效果方面优于同种异体骨.%BACKGROUND: Bone morphogenetic protein 2 (BMP-2) loaded nano-hydroxyapatite artificial bone has unique biological properties that can imitate the component and structure of natural bone. It can provide cells a microenvironment which is similar to that of natural bone. OBJECTIVE: To investigate the clinical effects of BMP-2 loaded nano-hydroxyapatite artificial bone and allogeneic bone grafting on the correction and fusion of adult idiopathic scoliosis. METHODS: A retrospective review of 69 patients with adult idiopathic scoliosis was performed. These patients were randomly divided into two groups: group A and group B. In group A, 36 patients were received BMP-2 loaded nano-hydroxyapatite artificial bone; in group B, 33 patients were received allogeneic bone grafting. The anterioposterior and lateral full spinal films were taken at 3 and 6 months after operation, and the spinal fusion status in the two groups were observed and compared. RESULTS

  7. 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.)

  8. 特发性脊柱侧凸椎旁肌组织Bcl-2蛋白表达及细胞凋亡的研究%Apoptosis and expression of Bcl-2 in the paraspinal muscles of idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    赵宇; 邱贵兴

    2004-01-01

    BACKGROUND: The etiology of idiopathic scoliosis is still uncertain. The paraspinal muscles have been implicated by several investigators as a possible causative factor in the production and progression of adolescent idiopathic scoliosis. Therefore, the role of the spinal musculature in the pathogenesis of scoliosis has been the subject of much investigation.OBJECTIVE: This study focused on the expressive difference among Bcl-2,Caspase-3 and bcl-x of the thoracic spinal musculature on convex side with those on the concave side in the scoliosis patients in order to explore the possible mechanism which paraspinal muscles play on scoliosis from the view of molecular biology.DESIGN:A randomized case-control study was conducted.SETTING and PARTICIPANTS: This research was completed in Department of Orthopaedics of Peking Union Hospital. Two patients with bursting fracture of thoracic vertebra and lumbar were selected as control group. The research group was composed by 10 patients which including 2 males and 8 females with scoliosis of thoracic vertebra, aged from 12 to 17 years old,mean age was 14. 3. The average Cobb angel was 57.7°(ranged from 45°~85°).INTERVENTION: Paraspinal muscles were taken from both sides during surgery from the apex of the curve between the 6th and 11th thoracic vertebral levels. Part of the tissue was fixed in formalin and stained with hematoxylin and eosin; the remaining tissue was snap frozen and processed for immunohistochemistry and Western blotting.muscles.RESULTS: The expression of Bcl-2 in convex side of paraspinal muscles was reduced. There was no difference between scoliosis patients and control group on cell apoptosis because it could be seen in both groups. Compared with concave side of scoliosis and control group, the muscle fibers were much thinner in convex side.CONCLUSION: The asymmetry of paraspinal muscles caused by anomaly of nerve and muscles may be the important factor which leads to the development of idiopathic

  9. First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

  11. 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

  12. Relationship between Cobb's angle of idiopathic scoliosis and multivariable rotation deformity of top vertebrae%特发性脊柱侧凸Cobb's角与顶椎多变量旋转畸形的相关性

    Institute of Scientific and Technical Information of China (English)

    杜欣; 陈立民; 肖艳秋

    2004-01-01

    BACKGROUND: Idiopathic scoliosis(IS) is a kind of three-dimensional deformity. At present, little is known about the outward appearance and the inherent law of the deformity.OBJECTIVE: To investigate the inherent law between Cobb' s angle of IS and multivariable rotation deformity of top vertebrae.DESIGN: A non-randomized controlled retrospective study was conducted.SETTING and PARTICIPANTS: The study was completed in the Department of Orthopaedics, the Second Affiliated hospital of Harbin Universify. The subjects were patients with IS, 21 males and 16 females, aged 9-32years old.METHODS: Cobb' s angles were measured by anteroposterior X-ray examination of spines. Rotation angles of top vertebral(Aaro method) and angles between axis lines of bilateral top vertebral pedicles and axis lines of top vertebral bodies were measured by CT scan.MAIN OUTCOME MEASURES: Cobb' s angles measured by anteroposterior X-ray examination; rotation angles of top vertebrae and angles between axis lines of bilateral vertebral pedicles and axis lines of vertebral bodies measnred by CT scan.RESULTS: Within 38°-124°, when Cobb' s angles increased 1°, the rotation angles of top vertebrae would increase 0.39°. Angles between axis lines of bilateral top vertebral pedicles and axis lines of top vertebral bodies were (4.72 +6.02)° and (14.22 +6.52)° respectively.CONCLUSION: There are obvious inner link and linear relationship between Cobb' s angles of IS and rotation of top vertebrae. There is significant difference in axis angles between lateral top vertebral pedicles and top vertebral bodies.%背景:特发性脊柱侧凸是一种三维畸形,目前对其外观表现与畸变的内在规律所知甚少.目的:探讨特发性脊柱侧凸Cobb's角与顶椎多变量旋转畸形之间的内在规律.设计:采用非随机对照的回顾性研究.地点和对象:研究地点为哈尔滨医科大学附属第二医院骨科,研究对象为特发性脊柱侧凸患者37例,男21例,女16

  13. 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

  14. 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

  15. 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.)

  16. 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.

  17. 夜用式脊柱侧凸矫形器治疗脊柱单侧弯的临床疗效观察%Effectiveness of night-time bending brace in the treatment of adolescent single-curve idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    陈东; 武继祥; 黄丹

    2014-01-01

    目的:探讨分析夜用式脊柱侧凸矫形器对青少年特发性脊柱单侧弯的疗效。方法:脊柱单侧凸患者40例,分为观察组22例和对照组18例。观察组在睡觉时佩戴夜用式脊柱侧凸矫形器8~10h ,对照组佩戴传统色努式脊柱侧凸矫形器≥20h。观察2组患者治疗前后的Cobb角,顶椎偏离中线距离(AVT)、躯干位移(TS)和肺活量(VC)的改善。结果:治疗3个月后,2组患者的Cobb角度、AVT及TS距离均明显低于治疗前(P<0.01),且观察组更低于对照组(P<0.01);2组治疗后VC含量均明显高于治疗前,且观察组更高于对照组(P<0.01)。结论:夜用式脊柱侧凸矫形器适合青少年C型侧凸治疗,其矫正效果明显优于传统的脊柱侧凸矫形器,值得临床推广应用。%Objective :To analyze the effectiveness of night-time bending brace in the treatment of adolescent single-curve idiopathic scoliosis .Method:Forty patients with single-curve scoliosis were divided into observation group (n=22) and control group (n=18) .The patients in the observation group wore night-time bending brace for 8-10 h when sleeping ,and those in the control group wore traditional scoliosis brace for more than 20 h .The Cobb's angle , apex vertebral trunking distance from the center line (AVT) ,trunk swing (TS) ,spinal flexibility and vital capacity (VC) were comapred between two groups .Results :After treatment ,the cobb's angle ,AVT and TS in both two groups were significantly reduced as compared with those before treatment (P<0 .01) ,and those indexes were even significantly lower in the observation group than in the control group (P<0 .01) .After treatment ,VC in both two groups was increased as compared with that before treatment ,and the index was significantly higher in the observa-tion group than in the control group (P<0 .01) .Conclusion :Night-time bending brace is suitable for the treatment of adolescent

  18. Adolescent idiopathic scoliosis and melatonin: a survey on scoliosis in 8 198 adolescents from over 10 middle and primary schools in Haikou City%青少年脊柱侧凸畸形与褪黑素:海口市10余所城乡中小学8198名青少年普查结果分析

    Institute of Scientific and Technical Information of China (English)

    张寿; 金旭红; 梁宁; 邢势; 林尤仁; 王伟

    2005-01-01

    背景:对于褪黑素是否与特发性脊柱侧凸(AIS)的发病机制有关,目前国内外学者研究结果尚无统一认识.目的:探讨青少年脊柱侧凸发病机制与褪黑素的关系及作用.设计:两检筛选法普查及非随机化同期对照研究.单位:海口市人民医院骨二科.对象:实验在海口市人民医院骨二科完成.调查海府地区10余所城乡中小学8 198名7~16岁在校学生,其中男4 423名,女3 775名.方法:选择普查中被诊断为AIS患儿42名,随机抽取50名正常人做对照,用放免法进行褪黑素测定与统计学处理.主要观察指标:两组调查者血清褪黑素含量.结果:青春前期10岁前年龄段AIS男女初始组褪黑素含量均低于青春期组及正常组,尤以女性为显,具有高度统计学意义.结论:血清中褪黑素与脊柱侧凸的发病机制有关.%BACKGROUD: It is not consistent on whether melatonin correlates with the adolescent idiopathic scoliosis(AIS) demonstrated by the domestic and foreign scholars.OBJECTIVE: To study the pathogenesis of AIS and its correlation with melatonin.DESIGN: A nonrandomized age-matched controlled study screened with two tests.SETTING: The Second Department of Orthopaedics, Haikou People' s Hospital.PARTICIPANTS: The experiment was completed in the Second Department of Orthopaedics, Haikou People' s Hospital. Totally 8 198 in-school students.from over 10 schools of towns in Haifu District, 4 423 males and 3 775 females, aged 7 to 16 years were surveyed.METHODS: Forty-two adolescents who have been diagnosed with AIS were selected and 50 healthy age-matched adolescents were selected as controls. Melatonin was assayed with the radioimmunology and the data were processed statistically.MAIN OUTCOME MEASURES: The levels of serum melatonin in the two groups.RESULTS: The serum melatonin of the preadolescents below 10 years old in AIS group, especially of females, was less than that of adolescents in the control group, with significant

  19. Genetics Home Reference: adolescent idiopathic scoliosis

    Science.gov (United States)

    ... of the condition include a tilt or unevenness (asymmetry) in the shoulders, hips, or waist, or having ... 3 percent of children in the U.S. Related Information What information about a genetic condition can statistics ...

  20. 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.

  1. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Science.gov (United States)

    Sarwahi, Vishal; Amaral, Terry; Wendolowski, Stephen; Gecelter, Rachel; Gambassi, Melanie; Plakas, Christos; Liao, Benita; Kalantre, Sarika; Katyal, Chhavi

    2015-01-01

    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. PMID:26649305

  2. 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.

  3. 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

  4. 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

  5. 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

  6. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    International Nuclear Information System (INIS)

    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.)

  7. 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。

  8. 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。

  9. Scoliosis in Mitochondrial Myopathy

    OpenAIRE

    Li, Zheng; Shen, Jianxiong; Liang, Jinqian

    2015-01-01

    Abstract The mitochondrial myopathies include a diverse group of disorders characterized by morphological abnormalities of muscle mitochondria. Little is reported about spinal deformity associated with this syndrome. This study presents a case of scoliosis occurring in the setting of mitochondrial myopathies and explores the possible mechanisms between the 2 diseases. A previously unreported scoliosis in mitochondrial myopathies is described. The patient was a 16-year-old Chinese adolescent b...

  10. Radiological case: congenital scoliosis

    OpenAIRE

    Macedo, F.

    2010-01-01

    ABSTRACT We present a case of a two month old infant with clinical suspicion of congenital torticollis because of lateral flexion of the head and neck since birth. There was no response to physiotherapy and the neck ultrasound was normal. An x-ray of the cervical and dorsal spine showed congenital scoliosis with failure of formation in certain vertebras. The diagnosis of congenital scoliosis must be considered in cases of abnormal tilting of the head and neck.

  11. Scoliosis and bronchial obstruction

    OpenAIRE

    Mehdi Qiabi; Karine Chagnon; Alain Beaupré; Julian Hercun; George Rakovich

    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 sev...

  12. 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

  13. Relative shortening and functional tethering of spinal cord in adolescent scoliosis – Result of asynchronous neuro-osseous growth, summary of an electronic focus group debate of the IBSE

    OpenAIRE

    Burwell R Geoffrey; Cheng Jack CY; Guo Xia; Lee Kwong-man; Tze-ping Lam; Ng Bobby KW; Lam Wynnie MW; Chu Winnie CW; Dangerfield Peter H; Jaspan Tim

    2008-01-01

    Abstract There is no generally accepted scientific theory for the causes 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 Statement for this debate was written by Dr WCW Chu and colleagues who examine ...

  14. 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…

  15. 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...

  16. 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...

  17. Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton.

    Science.gov (United States)

    Schiess, Regula; Boeni, Thomas; Rühli, Frank; Haeusler, Martin

    2014-02-01

    Owing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding the skeletal biology of Homo erectus. Nevertheless, since the reported asymmetries and distortions of Nariokotome boy's axial skeleton suggest adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as a reference for H. erectus. Recently, however, the presence of skeletal dysplasia has been refuted. Here, we present a morphological and morphometric reanalysis of the assertion of idiopathic scoliosis. We demonstrate that unarticulated vertebral columns of non-scoliotic and scoliotic individuals can be distinguished based on the lateral deviation of the spinous process, lateral and sagittal wedging, vertebral body torsion, pedicle thickness asymmetry, and asymmetry of superior and inferior articular facet areas. A principal component analysis of the overall asymmetry of all seven vertebral shape variables groups KNM-WT 15000 within non-scoliotic modern humans. There is, however, an anomaly of vertebrae T1-T2 that is compatible with a short left convex curve at the uppermost thoracic region, possibly due to injury or local growth dysbalance. Asymmetries of the facet joints L3-L5 suggest a local right convex curve in the lower lumbar region that probably resulted from juvenile traumatic disc herniation. This pattern is incompatible with adolescent idiopathic scoliosis or other types of scoliosis, including congenital, neuromuscular or syndromic scoliosis. It is, however, consistent with a recent reanalysis of the rib cage that did not reveal any asymmetry. Except for these possibly trauma-related anomalies, the Nariokotome boy fossil therefore seems to belong to a normal H. erectus youth without evidence for adolescent idiopathic scoliosis or other severe pathologies of the axial skeleton. PMID:24491377

  18. 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.

  19. 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

  20. 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

  1. Evaluation of quality of life of non-operational idiopathic scoliosis patients with ICF items: a preliminary study%非手术治疗特发性脊柱侧凸生存质量《国际功能、残疾和健康分类》类目组合制定初步研究

    Institute of Scientific and Technical Information of China (English)

    吴超; 杜青; 周璇; 杨晓颜; 陈楠; 徐彬; 于虹; 梁菊萍

    2016-01-01

    目的:通过将中文版脊柱侧凸研究会患者问卷表(The Scoliosis Research Society-22 Questionnaire,SRS-22)与《国际功能、残疾和健康分类》中相关类目匹配,旨在实现SRS-22问卷跨语言、跨学科的交流,为特发性脊柱侧凸(idiopathic scoliosis,IS)患者生存质量(QOL)评定提供通用的、标准化无语言局限的评定方法.方法:将脊柱侧凸研究会患者问卷SRS-22的内容与ICF中相关类目进行匹配,获得ICF类目组合,运用获得的ICF类目组合、SRS-22问卷,分别对41例非手术治疗IS患者进行评定;初测2周后,随机对其中20例患者进行ICF类目组合重测.结果:SRS-22问卷与ICF类目匹配一致性Kappa=0.87 (P<0.01);SRS-22问卷与IS患者QOL的ICF类目组合临床评定结果相关性r=0.838(P<0.01);ICF类目组合各维度重测信度均大于0.75.结论:ICF类目组合能全面体现SRS-22问卷内容,且具有良好的信度与效度,与SRS-22问卷评定结果高度相关,可运用于临床非手术治疗IS患者QOL的评定.

  2. Life-threatening hypersplenism due to idiopathic portal hypertension in early childhood: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Duck Christina

    2010-10-01

    Full Text Available Abstract Background Idiopathic portal hypertension (IPH is a disorder of unknown etiology and is characterized clinically by portal hypertension, splenomegaly, and hypersplenism accompanied by pancytopenia. This study evaluates the pathogenic concept of the disease by a systematic review of the literature and illustrates novel pathologic and laboratory findings. Case Presentation We report the first case of uncontrolled splenic hyperperfusion and enlargement with subsequent hypersplenism leading to life-threatening complications of IPH in infancy and emergent splenectomy. Conclusions Our results suggest that splenic NO and VCAM-1, rather than ET-1, have a significant impact on the development of IPH, even at a very early stage of disease. The success of surgical interventions targeting the splenic hyperperfusion suggests that the primary defect in the regulation of splenic blood flow seems to be crucial for the development of IPH. Thus, beside other treatment options splenectomy needs to be considered as a prime therapeutic option for IPH.

  3. What Is Scoliosis?

    Science.gov (United States)

    ... stay in the body and help keep the spine straight after surgery. Can Exercise Help? Exercise programs have not been ... how different treatments can help to straighten the spine or keep curves from ... of surgery and of untreated scoliosis. For More Information About ...

  4. 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…

  5. 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.

  6. 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

  7. Vitamin D receptor gene TaqI and Apal polymorphisms and steroid responsiveness in childhood idiopathic nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Al-Eisa AA

    2016-08-01

    Full Text Available Amal A Al-Eisa, Mohammad Z Haider Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait Background: Vitamin D activity is controlled by vitamin D receptors (VDRs, which are affected by different genetic polymorphisms, including TaqI and Apal restriction fragment length polymorphisms (RFLPs, which have been reported to be associated with several diseases. The aim of this study was to determine the frequency and the association of VDR gene polymorphisms with idiopathic nephrotic syndrome (INS and steroid responsiveness in Kuwaiti children. Subjects and methods: Genotypes of the VDR TaqI gene polymorphism and the Apal gene polymorphism were analyzed using polymerase chain reaction-RFLP in 78 INS patients and 56 matched controls. Results: A total of 78 INS (62 steroid sensitive [SS] and 16 steroid resistant [SR] patients with a mean age of 6.5±3.1 years were studied. Male:female ratio was 2:1. The TT genotype of VDR–TaqI polymorphism was detected in 41% of the INS patients compared to 42% of the controls (P=0.816. The heterozygous TC genotype was detected in 33% of INS patients compared to 46% of the controls (P=0.462. The CC genotype was detected in 25.6% of INS patients and 21% of the controls (P=0.719. The C-allele frequency, in its homozygous and heterozygous forms, was 71% in INS patients compared to 63% in the controls (P=0.342. Similarly, no significant difference was detected in terms of VDR–Apal polymorphism in INS patients compared to the controls for all the three genotypes (P=0.76, P=0.207, and P=0.364, respectively, for GG, GT, and TT genotypes. The T-allele frequency, in its homozygous and heterozygous forms, was 89% in INS patients compared to 93% in the controls (P=0.076. No significant difference was found in any of the allele frequencies between SS and SR subgroups when compared with each other or when compared to the controls. Conclusion: Our data do not support the use of VDR–TaqI or

  8. 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.)

  9. 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 deviation of 2.9 was lower than the 5.3 for conventional images. Image quality was better in the conventional images. Conclusion: using the scanning method, we could achieve a mean reduction of the radiation dose of 92%, while the accuracy of the Cobb angle measurements was comparable for both techniques despite of reduced image quality of digital fluoroscopy. (orig.)

  10. Scoliosis curve type classification using kernel machine from 3D trunk image

    Science.gov (United States)

    Adankon, Mathias M.; Dansereau, Jean; Parent, Stefan; Labelle, Hubert; Cheriet, Farida

    2012-03-01

    Adolescent idiopathic scoliosis (AIS) is a deformity of the spine manifested by asymmetry and deformities of the external surface of the trunk. Classification of scoliosis deformities according to curve type is used to plan management of scoliosis patients. Currently, scoliosis curve type is determined based on X-ray exam. However, cumulative exposure to X-rays radiation significantly increases the risk for certain cancer. In this paper, we propose a robust system that can classify the scoliosis curve type from non invasive acquisition of 3D trunk surface of the patients. The 3D image of the trunk is divided into patches and local geometric descriptors characterizing the surface of the back are computed from each patch and forming the features. We perform the reduction of the dimensionality by using Principal Component Analysis and 53 components were retained. In this work a multi-class classifier is built with Least-squares support vector machine (LS-SVM) which is a kernel classifier. For this study, a new kernel was designed in order to achieve a robust classifier in comparison with polynomial and Gaussian kernel. The proposed system was validated using data of 103 patients with different scoliosis curve types diagnosed and classified by an orthopedic surgeon from the X-ray images. The average rate of successful classification was 93.3% with a better rate of prediction for the major thoracic and lumbar/thoracolumbar types.

  11. Scoliosis and anaesthetic considerations

    OpenAIRE

    Kulkarni, Anand H; M Ambareesha

    2007-01-01

    Scoliosis may be of varied etiology and tends to cause a restrictive ventilatory defect, along with ventilation-perfusion mismatch and hypoxemia. There is also cardiovascular involvement in the form of raised right heart pressures, mitral valve prolapse or congenital heart disease. Thus a careful pre-anaesthetic evaluation and optimization should be done. Intraoperatively temperature and fluid balance, positioning, spinal cord integrity testing and blood conservation techniques are to be kept...

  12. Degenerative Scoliosis: A Review

    OpenAIRE

    Kotwal, Suhel; Pumberger, Matthias; Hughes, Alex; Girardi, Federico

    2011-01-01

    Degenerative lumbar scoliosis is a coronal deviation of the spine that is prevalent in the elderly population. Although the etiology is unclear, it is associated with progressive and asymmetric degeneration of the disc, facet joints, and other structural spinal elements typically leading to neural element compression. Clinical presentation varies and is frequently associated with axial back pain and neurogenic claudication. Indications for treatment include pain, neurogenic symptoms, and prog...

  13. 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.)

  14. Proposal for a candidate core-set of fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies

    Science.gov (United States)

    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

    2015-01-01

    OBJECTIVES Currently there are no evidence-based recommendations regarding which fitness and strength tests to use 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 measures for these patients. Through a Delphi survey, we aimed to identify a candidate core-set of fitness and strength tests for children and adults with IIM. METHODS Fifteen experts participated in a Delphi survey that consisted of five stages to achieve a consensus. Using an extensive search of published literature and through the expertise of the experts, a candidate core-set based on expert opinion and clinimetric properties was developed. Members of the International Myositis Assessment and Clinical Studies Group (IMACS) were invited to review this candidate core-set during the final stage, which led to a final candidate core-set. RESULTS A core-set of fitness- and strength-related outcome measures was identified for children and adults with IIM. For both children and adults, different tests were identified and selected for maximal aerobic fitness, submaximal aerobic fitness, anaerobic fitness, muscle strength tests and muscle function tests. CONCLUSIONS The core-set of fitness and strength-related outcome measures provided by this expert consensus process will assist practitioners and researchers in deciding which tests to use in IIM patients. This will improve the uniformity of fitness and strength tests across studies, thereby facilitating the comparison of study results and therapeutic exercise program outcomes among patients with IIM. PMID:26568594

  15. Hardware complications in scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bagchi, Kaushik; Mohaideen, Ahamed [Department of Orthopaedic Surgery and Musculoskeletal Services, Maimonides Medical Center, Brooklyn, NY (United States); Thomson, Jeffrey D. [Connecticut Children' s Medical Center, Department of Orthopaedics, Hartford, CT (United States); Foley, Christopher L. [Department of Radiology, Connecticut Children' s Medical Center, Hartford, Connecticut (United States)

    2002-07-01

    Background: Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide. As part of the evolution of scoliosis surgery, newer implants have resulted in improved outcomes with respect to deformity correction, reliability of fixation, and paucity of complications. Each technique and implant has its own set of unique complications, and the surgeon must appreciate these when planning surgery. Materials and methods: Various surgical techniques and types of instrumentation typically used in scoliosis surgery are briefly discussed. Though scoliosis surgery is associated with a wide variety of complications, only those that directly involve the hardware are discussed. The current literature is reviewed and several illustrative cases of patients treated for scoliosis at the Connecticut Children's Medical Center and the Newington Children's Hospital in Connecticut are briefly presented. Conclusion: Spine surgeons and radiologists should be familiar with the different types of instrumentation in the treatment of scoliosis. Furthermore, they should recognize the clinical and roentgenographic signs of hardware failure as part of prompt and effective treatment of such complications. (orig.)

  16. Vitamin D receptor gene TaqI and Apal polymorphisms and steroid responsiveness in childhood idiopathic nephrotic syndrome

    Science.gov (United States)

    Al-Eisa, Amal A; Haider, Mohammad Z

    2016-01-01

    Background Vitamin D activity is controlled by vitamin D receptors (VDRs), which are affected by different genetic polymorphisms, including TaqI and Apal restriction fragment length polymorphisms (RFLPs), which have been reported to be associated with several diseases. The aim of this study was to determine the frequency and the association of VDR gene polymorphisms with idiopathic nephrotic syndrome (INS) and steroid responsiveness in Kuwaiti children. Subjects and methods Genotypes of the VDR TaqI gene polymorphism and the Apal gene polymorphism were analyzed using polymerase chain reaction-RFLP in 78 INS patients and 56 matched controls. Results A total of 78 INS (62 steroid sensitive [SS] and 16 steroid resistant [SR]) patients with a mean age of 6.5±3.1 years were studied. Male:female ratio was 2:1. The TT genotype of VDR–TaqI polymorphism was detected in 41% of the INS patients compared to 42% of the controls (P=0.816). The heterozygous TC genotype was detected in 33% of INS patients compared to 46% of the controls (P=0.462). The CC genotype was detected in 25.6% of INS patients and 21% of the controls (P=0.719). The C-allele frequency, in its homozygous and heterozygous forms, was 71% in INS patients compared to 63% in the controls (P=0.342). Similarly, no significant difference was detected in terms of VDR–Apal polymorphism in INS patients compared to the controls for all the three genotypes (P=0.76, P=0.207, and P=0.364, respectively, for GG, GT, and TT genotypes). The T-allele frequency, in its homozygous and heterozygous forms, was 89% in INS patients compared to 93% in the controls (P=0.076). No significant difference was found in any of the allele frequencies between SS and SR subgroups when compared with each other or when compared to the controls. Conclusion Our data do not support the use of VDR–TaqI or –Apal gene polymorphisms as genetic markers of INS nor do they predict steroid responsiveness in children with the disease.

  17. Reliability and validity of the adapted Dutch version of the revised Scoliosis Research Society 22-item questionnaire

    NARCIS (Netherlands)

    T.P.C. Schlösser; A. Stadhouder; J.J.P. Schimmel; A.M. Lehr; G.J.M.G. van der Heijden; R.M. Castelein

    2014-01-01

    Background context As in other fields of medicine, there is an increasing interest among orthopedic surgeons to measure health-related quality of life in adolescent idiopathic scoliosis patients and to evaluate the burden of disease and the effectiveness of different treatment strategies. The develo

  18. Auxílio da tomografia computadorizada no planejamento pré-operatório de pacientes portadores de escoliose idiopática do adolescente Auxilio de la tomografía computarizada en el plan preoperatorio de pacientes portadores de escoliosis idiopática del adolescente Computed tomography aid in preoperative planning of patients with adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Rodrigo Rezende

    2010-03-01

    á libre de riesgos y complicaciones, necesitando de una mayor curva de aprendizaje por el médico cirujano, así como también de un adecuado plan preoperatorio. Hasta el momento, no hay en la literatura un relato sobre la utilización de la tomografía computarizada en el auxilio quirúrgico de los pacientes con escoliosis. Según lo expuesto, proponemos, en el presente estudio, describir una técnica para el plan preoperatorio con el auxilio de la tomografía computarizada para la fijación de la columna en pacientes con escoliosis idiopática del adolescente, especificando la angulación y el diámetro de los pedículos vertebrales, lo que podrá auxiliar al médico cirujano en el momento de la fijación.The adolescent idiopathic scoliosis is a diagnosed disease in the beginning of puberty, with unknown etiology, characterized by lateral deviation of the spine (above 10°, which is related to vertebral rotation. The form of surgical treatment by spinal fixation with pedicle screws showed better results when compared to other fastening systems, but there are still technical difficulties at the time of passage and the choice of pedicle screws because of vertebral pedicles angle and diameter. Despite its advantages, this technique presents risks and complications, requiring a greater learning curve for the surgeon, as well as an adequate preoperative planning. So far, there is no literature report about the use of computed tomography as an aid to surgical planning of patients with scoliosis. In this light, the present study aims to describe a preoperative planning technique with the aid of computed tomography for spinal fixation in patients with Adolescent Idiopathic Scoliosis, specifying the angle and diameter of the vertebral pedicles, which may help the surgeon in the fixation.

  19. Scoliosis may be the first symptom of the tethered spinal cord

    Science.gov (United States)

    Barutçuoğlu, Mustafa; Selçuki, Mehmet; Umur, Ahmet Sukru; Mete, Mesut; Gurgen, Seren Gulsen; Selcuki, Deniz

    2016-01-01

    Background: Tethered cord syndrome (TCS) is a progressive clinical entity that arises from abnormal spinal cord tension. Scoliosis may be a unique symptom in TCS. The aim of this study is to investigate prognosis after releasing the filum terminale in scoliosis due to TCS with/without findings in magnetic resonance imaging (MRI) and to draw attention to the importance of somatosensorial evoked potentials (SSEP) on the differential diagnosis of idiopathic scoliosis versus scoliosis due to TCS with normal appearance of filum terminale and conus medullaris. Materials and Methods: Eleven female and seven male patients with progressive scoliosis were included in the study. They were evaluated radiologically, SSEP and urodynamical studies. Preoperative and postoperative anteroposterior full spine X-rays were obtained for measuring the Cobb's angle. MRI was performed in all cases for probable additional spinal abnormalities. All patients underwent filum terminale sectioning through a L5 hemilaminectomy. The resected filum terminale were subjected to histopathological examination. Results: The mean Cobb angle was 31.6° (range 18°–45°). Eight patients (44.45%) had a normal appearance of filum terminale and normal level conus medullaris in MRI, but conduction delay and/or block was seen on SSEP. In the histopathological examination of filum terminale dense collagen fibers, hyaline degeneration and loss of elastic fibers were observed. Postoperatively none of the patients showed worsening of the Cobb angle. Three patients showed improvement of scoliosis. Conclusion: In TCS presented with scoliosis, untethering must be performed prior to the corrective spinal surgery. Absence of MRI findings does not definitely exclude TCS. SSEP is an important additional guidance in the diagnosis of TCS. After untethering, a followup period of 6 months is essential to show it untethering helps in stopping the progress of the scoliotic curve. In spite of non progression (curve stopped

  20. VIDEO-ASSISTED THORACOSCOPIC CORRECTION AND FUSION OF SCOLIOSIS

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To evaluate the operative technique and preliminary results of video-assisted thoracoscopic anterior correction and fusion of scoliosis.Methods Eleven cases underwent thoracoscopic anterior correction and fusion of scoliosis from March 2003 to April 2005 in our hospital were reviewed. They were all females with an average age of 13.1 years old. Of which, 9cases were idiopathic scoliosis, 1 case was congenital scoliosis, and 1 case was Marfan syndrome scoliosis. The coronal Cobb angle and apical vertebral translation before and after surgery as well as at final follow-up were measured. The operation time, blood loss during operation, and peri-operative complications were recorded.Results The mean operation time was 6. 4 hours, mean instrumented vertebrae were 6. 4 segments, and mean blood loss during operation was 364 mL. The coronal Cobb angles of the thoracic curve before and after surgery were 45.5° and 15.4° respectively, with an average correction rate of 65.4%. The lumbar curve was corrected from 28.4°to 11.8°, with an average simultaneous correction rate of 57.2%. All of the patients were followed up regularly with an average time of 21.4 months. At the final follow-up, the coronal Cobb angles of the thoracic and lumbar curves were 19. 0° and 20. 1°, with a 3.6° and 8. 3° loss of correction, respectively. The apical vertebral translation was improved from 32.3 mm to 10. 5 mm for the thoracic curve, and from 13. 1 mm to 8.2 mm for the lumbar curve. There were 6cases with peri-operative complications, including 1 case of thoracic effusion, 1 case of chylothorax, 1 case of locking plug loosing, 2 cases of aggravation of the unfused lumbar curve ( 1 case also with thoracolumbar kyphosis), and 1 case with a screw tip causing a contour deformity of the aorta. And 4 of them underwent revision surgery.Conclnsions Video- assisted thoracoscopic anterior correction and fusion of scoliosis has good correction capability, less intraoperative bleeding

  1. Correlation and comparison of Risser sign versus bone age determination (TW3 between children with and without scoliosis in Korean population

    Directory of Open Access Journals (Sweden)

    Yang Jae-Hyuk

    2009-09-01

    Full Text Available 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 and non-scoliosis group, a cross-sectional study was done in 418 scoliosis (untreated, bracing or surgically and 256 non-scoliosis children of Korean origin. Relationship was found in both groups using Pearson correlation test. Results In scoliosis group, Pearson correlation exhibited significant correlation (p 2 = 0.791 for girls, 0.787 for boys and Risser sign and TW3 age (r2 = 0.718 for girls, 0.785 for boys. Non-scoliosis group also showed significant relationship (p 2 = 0.893 for girls, 0.879 for boys and Risser sign and TW3 age (r2 = 0.913 for girls, 0.895 for boys. Similarly, comparing Cobb angles of each patient according to their Risser staging, exhibited that if scoliosis remains untreated Cobb angle will increase with the increase in their Risser staging (r2 = 0.363 for girls, 0.443 for boys; p Conclusion Our results showed that chronological age is equally as reliable as skeletal age method to compare with Risser sign, and therefore, we do not mean to imply that only the Risser sign compared with skeletal age should be considered in the decision making in idiopathic as well as non-scoliosis patients of Korean ethnicity. Concomitant indicators such as menarchal period, secondary sex characteristics, and recent growth pattern will likely reinforce our data comparing Risser sign with skeletal age in decision making.

  2. A preliminary study of the cost-effect evaluation on rehabilitation in patients with adolescent idiopathic scoliosis%青少年特发性脊柱侧凸康复治疗卫生经济学初步研究

    Institute of Scientific and Technical Information of China (English)

    杜青; 励建安; 周璇; 王欢; 赵黎; 陈珽; 陈楠; 张树新; 陆体江

    2013-01-01

    Objective:To evaluate the expense of rehabilitation in patients with adolescent idiopathic scoliosis (AIS) through the cost-effect analysis.Method:Twenty-four subjects were divided into two groups according to their management:the rehabilitation group received exercise,manipulation and brace; the operation group received surgery.All the subjects were assessed with Chinese version of Scoliosis Research Society-22 (SRS-22) health-related quality-of-life (HRQL) questionnaire before and after treatment.At the end of the 6th month,the cost was investigated.Result:At the end of the 6th month,self-image/appearance and mental health for the rehabilitation group were better than before treatment,and self-image/appearance and satisfaction with management were better for the rehabilitation group than for the operation group.The self-image scores were improved 1 point,the total direct medical costs of the rehabilitation group and the operation group were (¥) 14561.07 and (¥)74776.44 respectively.Conclusion:Rehabilitation is an economical and effective medical strategy for AIS patients.%目的:对青少年特发性脊柱侧凸患者康复治疗进行成本-效果分析.方法:24例青少年特发性脊柱侧凸患者分为康复治疗组和手术治疗组.康复治疗组12例,采取运动疗法、关节松动、支具治疗;手术治疗组12例,采取手术治疗.治疗前后均应用中文版脊柱侧凸研究学会患者问卷(SRS-22)进行生存质量调查,并在治疗6个月后进行费用调查.结果:治疗6个月后,康复治疗组患者SRS-22问卷自我形象、心理健康维度得分高于治疗前,康复治疗组患者自我形象、对治疗的满意程度维度得分高于手术治疗组(P<0.05).康复治疗组自我形象维度得分每增加1分所需要的总直接医疗费用为人民币14561.07元,手术治疗组每增加1分所需要的总直接医疗费用为人民币74776.44元.结论:康复治疗是青少年特发性脊柱侧凸经济有效的治疗方案.

  3. Idiopathic anaphylaxis.

    Science.gov (United States)

    Greenberger, Paul A

    2007-05-01

    Idiopathic anaphylaxis is a prednisone-responsive condition without external cause, but it can coexist with food-, medication-, or exercise-induced anaphylaxis. Mast cell activation may occur at night or after foods that have been eaten with impunity many times previously. Idiopathic anaphylaxis can be classified into frequent (if there are six or more episodes per year or two episodes in the last 2 months) or infrequent (if episodes occur less often). Idiopathic anaphylaxis-generalized consists of urticaria or angioedema associated with severe respiratory distress, syncope or hypotension, and gastrointestinal symptoms. Idiopathic anaphylaxis-angioedema consists of massive tongue enlargement or severe pharyngeal or laryngeal swelling with urticaria or peripheral angioedema. The differential diagnosis of idiopathic anaphylaxis is reviewed, and treatment approaches are presented. PMID:17493503

  4. Scoliosis and tibiotarsal deformities in broiler chickens.

    Science.gov (United States)

    Droual, R; Bickford, A A; Farver, T B

    1991-01-01

    The incidence and degree of scoliosis were investigated in broiler chickens with and without intertarsal deformities associated with slipped gastrocnemius tendons. In both groups, the incidence of scoliosis was similar and there was a significant tendency for scoliosis to be convex on the right side. However, scoliosis was significantly greater in birds with intertarsal deformities, and in a significant proportion of these the joint with a slipped tendon was on the convex side of scoliosis. In birds with deformities, inequalities between right and left tibiotarsi were significantly greater, and tibiotarsi with greater length, narrower condyles and trochleae, and shallower trochlear grooves were significantly more often on the convex side of scoliosis. Significant positive correlations were found between scoliosis and rotational and bending deformities of the distal tibiotarsus on the convex side of scoliosis. These findings suggest a cause-and-effect relationship between scoliosis and tibiotarsal deformities associated with slipped tendons. PMID:2029256

  5. 青少年特发性脊柱侧弯症患者椎旁肌表面肌电信号测试方法选择与比较%A comparison of surface electromyographic signals recorded from the paraspinal muscles of adolescents with idiopathic scoliosis during three loading tests

    Institute of Scientific and Technical Information of China (English)

    王楚怀; 许轶; 梁崎; 阮经文; 赖建洋

    2009-01-01

    目的 采用多种方法对青少年特发性脊柱侧弯症(AIS)患者椎旁肌表面肌电活动进行检测.筛选可用于评价椎旁肌功能的检测方法.方法 共选取AIS患者25例,所有入选患者均给予BST、抬物动作及半桥动作检测,采用芬兰ME6000型表面肌电仪记录患者凸、凹侧椎旁肌表面肌电信号指标,包括平均肌电值(AEMG)及频谱面积(SPA)等,分析各检测方法所得结果间有无差异.结果 本研究AIS患者经上述3种方法检测后,发现各检测手段所获凸侧及凹侧AEMG、SPA数据间差异均无统计学意义(P>0.05).结论 BST、抬物动作及半桥动作试验均可作为检测AIS患者椎旁肌表面肌电活动的有效方法.%Objective Using surface electromyography (sEMG) techniques to investigate the patterns of frequency domain indexes of sEMC signals recorded from adolescent idiopathic scoliosis (AIS) patients' paraspinal muscles. Methods Twenty-five AIS patients were enrolled. All the patients undertook the Biering Sorensen test ( BST) ,the object-lifting test and a semi-bridge test, the ME3000P sEMG instrument was applied to record the electric activities of paraspinal muscles (convex/concave) of all subjects, and the time domain indexes such as averaged EMG(AEMG)and spectrum area(SPA) were analyzed, values in three tests were compared with one way ANOVA. Results The differences of AEMGs and SPAs on both convex and concave sides among the three tests showed no statistical significances (P = 0. 10,0.23, 0. 24 and 0. 45, respectively). Conclusions Any of the Biering Sorensen test( BST) , the object-lifting test or the semi-bridge test can be used to test the electric activities of paraspinal muscles (convex/concave) of AIS patients.

  6. Clinical Observation on the Treatment of Childhood Refractory Idiopathic Thrombocytopenic Purpura with Dihuang Zhixue Capsule(地黄止血胶囊)

    Institute of Scientific and Technical Information of China (English)

    LIU Qing-chi; WU Wei-hai; WU Da-yong; FENG Xin-wang; MA Ya-hui; LI Jian-ying; PANG Yu-hui; SONG Shu-hua

    2008-01-01

    Objective:To observe the clinical effect of Dihuang Zhixue Capsule(地黄止血胶囊,DZC,a Chinese preparation for cooling blood and dispelling toxic substances) in the treatment of childhood refractory idiopathic thrombocytopenic purpura(RITP),with cyclosporin A(CsA)used as the control.Methods:Fody-one children of RITP were randomized into the treated group and the control group.The 21 patients in the treated group were orally given 2 to 3 DZC capsules each time,thrice a day and the 20 in the control group were given 3 mg/kg CsA per day,with 3 months as one therapeutic course.The therapeutic efficacy,platelet count and adverse reaction in the two groups were compared at the end of the course.Results:(1)In the treated group,1 (4.8%)patient was evaluated as cured,3(14.3%)as markedly effective,5(23.8%)as effective,5(23.8%)as improved,7(33.3%)as ineffective,with the total effective rate being 66.7%:while in the control group,the corresponding numbers were 0,2(10.0%),2(10.0%),3(15.0%),13(65.0%)and 35.0%,respectively,showing statistical significance in difference between the total effective rates of the two groups(X2=4.11,P=0.0426).(2)As compared with the baseline,the platelet count increased in both groups after 2 months'treatment(P<0.05).After 3 months'treatment,the platelet count was higher in the treated group than in the control group(P<0.05).(3)The improvement of hemorrhage in the treated group after 8 weeks'treatment was better than that in the control group (P<0.05).(4)No apparent adverse reaction was observed in fhe treated group,while in the control group,hirsutism was shown in 15 cases;gingival hyperplasia in 10;digestive reaction in 5,liver function impairment in 5.hypedension in 2 and renal impairment in 2.Conclusion:The therapeutic efficacy of DZC is better than that of CsA.and DZC shows good compliance but brings no obvious adverse reaction.

  7. Rare causes of scoliosis and spine deformity: experience and particular features

    OpenAIRE

    Pliarchopoulou Fani M; Pyrovolou Nikolaos E; Mandellos Georgios C; Chouliaras Vasilios T; Payatakes Alexandros H; Soultanis Konstantinos C; Soucacos Panayotis N

    2007-01-01

    Abstract Background Spine deformity can be idiopathic (more than 80% of cases), neuromuscular, congenital or neurofibromatosis-related. However, there are many disorders that may also be involved. We present our experience treating patients with scoliosis or other spine deformities related to rare clinical entities. Methods A retrospective study of the records of a school-screening study in North-West Greece was performed, covering a 10-year period (1992–2002). The records were searched for p...

  8. Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

    OpenAIRE

    Schiess, Regula; Böni, Thomas; Rühli, Frank J.; Häusler, Martin

    2014-01-01

    Owing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding skeletal biology of Homo erectus. Nevertheless, since Latimer and Ohman (2001, Axial dysplasia in Homo erectus. J Hum Evol 40:A12) reported on asymmetries and distortions of Nariokotome boy’s axial skeleton suggesting adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as reference for Homo e...

  9. To What Extent Can Adolescent Scoliosis Be Improved in Four Weeks?

    Directory of Open Access Journals (Sweden)

    Mehmet Ağırman

    2016-03-01

    Full Text Available 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 years and specific exercises were proposed for scoliosis. On physical examination, we observed paravertebral muscle spasm and significant asymmetry of the thoracolumbar region. Neurological examination and laboratory tests were normal. X-ray showed arcuate thoracolumbar scoliosis (cobb angle: 24° with a leftward convexity. Electrical stimulation was applied to the convex and concave sides for 30 minutes, five times a week for four weeks and an exercise program was performed under the supervision of a therapist. The stimulation amplitude was the maximum stimulation intensity with which the patient was comfortable. Analgesic and myorelaxant drugs were not required, and no brace was used. After the treatment, significant improvements were observed in the patient’s posture and radiography (cobb angle: 10°. This work demonstrates that well-planned physical therapy is a rapid and effective option for treating AIS.

  10. 顶椎置钉与否对Lenke 1型青少年特发性脊柱侧凸矫形效果的影响%Effect of apical pedicle screw placement on the surgical correction of Lenke 1 adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    郑欣; 王渭君; 钱邦平; 江华; 王斌; 朱泽章; 俞扬; 邱勇

    2012-01-01

    Objectives: To investigate the effect of apical pedicle screw instrumentation on the correction of thoracic adolescent idiopathic scoliosis(AIS). Methods: From June 2009 to January 2010, 69 Lenke 1 type AIS patients treated with exclusive pedicle screw instrumentation were reviewed. The mean age at the time of surgery was 15.0 years old(range, 12-20 years), and the Cobb angle was 53.7° on average (range, 50°-70°). According to whether pedicle screws were inserted in the apical vertebrae, all cases were divided into two groups: group A (without apical instrumentation, 35 cases) and group B (instrumented with screws, 34 cases). The preoperative chronological age, sex, the Cobb angle of the major curve, and rotation degree of the apex were compared between two groups. The implant density, postoperative Cobb angle, the correction rate in Cobb angle, and derotation degree of the apical vertebra were also recorded and compared between two groups. While in group B, misplacement of the apical screws was calculated on CT scans. Results: There was no statistical difference with respect to the chronological age, gender distribution, the preoperative Cobb angle, curve flexibility and rotation degree of the apex between the two groups. No case suffered from coronal or sagittal imbalance postoperatively. The loss of correction was also not significant in both groups. The implant density averaged 63.4% in group A and 65.3% in group B. The fusion levels were 11.3 in group A and 11.6 in group B. The correction rate in Cobb angle was 73.9% in group A and 72.6% in group B. There was no statistical difference in terms of implant density, number of fused vertebrae or the Cobb angle correction rate between the two groups. However, as for the derotation degree of the apical vertebrae, group A had a significantly lower degree(18.4%) than group B(34.8%)(P<0.05). In the 41 pedicle screws instrumented in the apical vertebrae in group B, 5(12.2%) were identified as misplacement

  11. 应用脊椎操纵器顶椎双侧去旋转技术治疗特发性脊柱侧凸的早期疗效%Preliminary outcome of three-dimensional correction on idiopathic scoliosis by bilateral apical vertebral derotation by vertebral column manipulation

    Institute of Scientific and Technical Information of China (English)

    孙麟; 宋跃明; 刘立岷; 周春光; 安永刚; 龚全; 孔清泉

    2012-01-01

    目的 评估应用脊椎操纵器(vertebral column manipulation,VCM)顶椎双侧去旋转技术治疗特发性脊柱侧凸(idiopathic scoliosis,IS)的早期疗效.方法 2011年2~9月使用VCM去旋转技术治疗IS患者17例(VCM组),其中男6例,女11例,平均年龄14.3岁;Lenke 1型10例,2型7例;术前主弯Cobb角平均57.5°.2010年7月~2011年2月采用旋棒技术治疗IS患者18例(旋棒组),男6例,女12例,年龄平均14.5岁;Lenke 1型10例,2型8例;术前主弯Cobb角平均58.1°.手术采用后路椎弓根螺钉固定、VCM矫形或旋棒技术矫形以及同种异体骨植骨融合.以主弯Cobb角矫正率、胸椎后凸角、腰椎前凸角及顶椎椎体旋转角(rotation angle sagittal,RAsag)矫正率评价矫形情况.结果 所有患者成功完成手术,无严重并发症发生.VCM组Cobb角矫正率为(85.3±7.2)%,旋棒组为(79.4±11.4)%,差异无统计学意义(P>0.05).矫形后胸椎后凸角及腰椎前凸角2组之间差别无统计学意义(P>0.05).VCM组顶椎RAsag矫正率为(61.4±12.9)%,旋棒组为(26.1±20.6)%,差异有统计学意义(P<0.05).VCM组随访8.7个月,旋棒组13.4个月,随访期间未见明显的失代偿和矫形度数丢失(P>0.05).结论 VCM顶椎双侧去旋转技术是一种有效的IS矫形方法,三维矫形效果满意,去旋转矫形方面矫形效果明显.%Objective To evaluate the preliminary outcome of bilateral apical vertebral derotation by vertebral column manipulation ( VCM ) for the management of idiopathic scoliosis( IS ). Methods A total of 35 patients with IS undergoing posterior pedicle screw fixation,bilateral apical vertebral derotation by VCM or freehand derotation technique correction ,and allograft fusion were included in this study. Of all patients, 17 IS cases ( 6 males and 11 females ) were included in the VCM group from February to September 2011 with an average age of 14.3 years old. IS presented with Lenke type 1 ( n = 10 ), 2 ( n = 7 ). The average Cobb' s angle of

  12. THREE-DIMENSIONAL CORRECTION OF SCOLIOSIS USING TSRH INSTRUMENTATION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective. To evaluate the results of TSRH instrumentation in the correction of coronal, sagittal and rotational deformity of scoliosis. Methods. From January 1998 to December 1999, thirty-two consecutive patients (6 males, 26 females) with scoliosis underwent anterior or posterior spinal instrumentation and fusion using TSRH instrumentation. Of these cases, 21 were idiopathic scoliosis and 11 were congenital scoliosis. The average age at surgery was 16.4 years (range, 11~ 45 years). The mean Cobb angle at surgery was 71 .2 (range, 44 ~ 125 ) in the coronal plane, and 49.2 ( range, 16 ~ 67 ) in the sagittal plane. Rotational deformity (Nash -Moe) ranged from I to III degree. Preoperative apical translation averaged 4.8 cm (range, 3~ 9 cm). Results. The average follow-up duration was 13.3 months (range, 10 ~ 24 months).At the final follow-up, the mean Cobb angle in the coronal plane was 26. 6 (range, 10 ~ 73 ),with a 63.8% of improvement. Sagittal alignment was well maintained with a mean Cobb angle of 28 ( range, 10 ~ 45 ). The average correction of rotation of the apical vertebra was I degree. The average apical translation was 1.6 cm (range, 0.5~ 5.0 cm) representing a correction rate of 66,7% . Complication was noted in two cases with an incidence of 3.1 % , one case had superficial infection and the other one had lower hook dislocation.There was no neurologic deficit and pseudoarthrodesis in this series. Conclusion. TSRH instrumentation is an effective and convenient three-dimensional correction system with a lower rate of complication, which can not only correct the coronal and rotational deformity, but maintain the sagittal alignment as well.

  13. ANTERIOR SPINAL FUSION WITH TSRH INSTRUMENTATION FOR SCOLIOSIS

    Institute of Scientific and Technical Information of China (English)

    沈建雄; 邱贵兴; 翁习生; 赵宏; 金今; 王以朋; 叶启彬; 林进

    2003-01-01

    Objective.To introduce a new spinal internal fixation system,Texas Scottish Rite Hospital(TSRH),and to investigate its early clinical outcomes. Methods. The preliminary clinical outcomes of 15 patients with thoracolumbar or lumbar scoliosis treated by anterior spinal fusion with TSRH instrumentation were studied retrospectively. Fourteen patients were diag-nosed as idiopathic scoliosis and 1 as neuromuscular scoliosis. Results. Preoperatively,the Cobb's angle on the coronal plane was 55.8°(range 35°~78°),and 14°postoperatively,with an average correction of 74.8 %. The average unfused thoracical curve was 35.9 ° preoperatively(range 26°~51°)and 21.8°(10°~42° )postoperatively,with 40% correction. The sagittal curve of lumbar was kept physiologically,preoperative 27.9°and postoperative 25.7°respectively. The trunk shift was 13.4 mm(5~28mm)preoperatively and 3.5 mm(0~7 mm)postoperatively. The averaged apic vertebra derivation was 47.8 mm(21~69 mm)before operation and 10.8 mm(3~20 mm)after operation. The distance of C7 to center sacrum vertical line(CSVL)was 19.5 mm(16~42)preoperatively and 11.3 mm(0~32 mm)postoperatively. The apical vertebra rotation was 3 degree in 15 patients preoperatively,and were improved to normal in 10 patients,1 degree in 4 patients,and 2 degree in 1 patients postoperatively. None had neurological injury and infection. Only 1 patient complained a cool feeling in the low extremity of concave side,and the symptom vanished at 3-month followed up.Conclusion. If used appropriately,TSRH anterior spinal system is a good treatment for low thoracic or thoracic lumbar scoliosis.

  14. THREE-DIMENSIONAL CORRECTION OF SCOLIOSIS USING TSRH INSTRUMENTATION

    Institute of Scientific and Technical Information of China (English)

    翁习生; 仉建国; 邱贵兴; 沈建雄; 赵宏; 金今; 王以朋; 田野; 林进

    2001-01-01

    Objective. To evaluate the results of TSRH instrumentation in the correction of coronal, sagittal and rotational deformity of scoliosis. Methods. From January 1998 to December 1999, thirty-two consecutive patients (6 males, 26 females) with scoliosis underwent anterior or posterior spinal instrumentation and fusion using TSRH instrumentation. Of these cases, 21 were idiopathic scoliosis and 11 were congenital scoliosis. The average age at surgery was 16.4 years(range, 11-45 years). The mean Cobb angle at surgery was 71 . 2°(range, 44°- 125°) in the coronal plane, and 49. 20( range, 16°- 67°) in the sagittal plane. Rotational deformity (Nash - Moe) ranged from Ⅰ to Ⅲ degree. Preopera-tive apical translation averaged 4. 8 cm (range, 3 - 9 cm). Results. The average follow-up duration was 13.3 months (range, 10- 24 months). At the final follow-up,the mean Cobb angle in the coronal plane was 26. 6°(range, 10°- 73°), with a 63.8% of improvement. Sagit-tal alignment was well maintained with a mean Cobb angle of 28*( range, 10°- 45°). The average correction of rotation of the apical vertebra was I degree. The average apical translation was 1.6 cm (range, 0. 5 -5.0 cm)representing a correction rate of 66, 7%. Complication was noted in two cases with an incidence of 3.1%, one case had superficial infection and the other one had lower hook dislocation. There was no neurolagic deficit and pseudoarthrodesis in this series. Concluaion. TSRH inslrumentation is an elective and convenient three-dimensional correction system with alower rate of complication, which can not only correct the coronal and rotational deformity, but maintain the sagittal alignment as well.

  15. Research progress in scoliosis for adolescent%青少年脊柱侧弯的研究进展

    Institute of Scientific and Technical Information of China (English)

    余升华; 尹得龙; 杨展翔

    2014-01-01

    Scoliosis types include functional scoliosis and structural scoliosis in that idiopathic scoliosis account for about 70-80% of all and are the most common structural clinically. Domestic and abroad research shows that prevalence rate of adolescent idiopathic scoliosis (AIS) is about 0.5%-3%, and it is believed the percent would rise with the pupillary study burden to raise in the present Chinese education. The key of prognosis of scoliosis is early detection , early intervention. The most effective way for early discovery of AIS should be census. Because the development of scoliosis often occurred in the period of rapid growth, in which AIS is easy to be corrected.%脊柱侧弯类型包括功能性脊柱侧弯及结构性脊柱侧弯。特发性脊柱侧弯属结构性脊柱侧弯,约占全部脊柱侧弯80%左右,是临床中最常见的结构性脊柱侧弯。青少年特发性脊柱侧弯(AIS)影响了约0.5%~3%的学生,由于中国的教育发展,中小学生的学习压力不断增加,相信AIS发病率可能进一步升高。脊柱侧弯的预后关键在于早期发现,早期干预。早期发现的最有效途径应该是普查,且早期畸形不明显亦无脊柱结构的变化,易于矫正。

  16. [Degenerative adult scoliosis].

    Science.gov (United States)

    García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

    2015-01-01

    Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

  17. Effects of Schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis

    OpenAIRE

    Kim, Gichul; Hwangbo, Pil-Neo

    2016-01-01

    [Purpose] The purpose of this study was to compare the effect of Schroth and Pilates exercises on the Cobb angle and body weight distribution of patients with idiopathic scoliosis. [Subjects] Twenty-four scoliosis patients with a Cobb angle of ≥20° were divided into the Schroth exercise group (SEG, n = 12) and the Pilates exercise group (PEG, n = 12). [Methods] The SEG and PEG performed Schroth and Pilates exercises, respectively, three times a week for 12 weeks. The Cobb angle was measured i...

  18. Congenital Scoliosis (Mini-review).

    Science.gov (United States)

    Weiss, Hans-Rudolf; Moramarco, Marc

    2016-01-01

    Congenital scoliosis is a lateral deformity of the spine with a disturbance of the sagittal profile caused by malformations of vertebra and ribs. Typically, early surgical intervention is the suggested treatment (before three-years-old) for young patients with congenital scoliosis. While a previous study was conducted in 2011 to investigate long-term studies supporting the necessity for this recommendation and no evidence was found, this current review, is an updated search for evidence published from 2011 through March 2015. This also failed to find any prospective or randomized controlled studies to support the hypothesis that spinal fusion surgery in patients with congenital scoliosis should be considered as evidence-based treatment. Contradictory results exist on the safety of hemivertebra resection and segmental fusion using pedicle screw fixation. When using the VEPTR (vertical expandable prosthetic titanium rib) device, studies show a high rate of complications exist. It is difficult to predict the final outcome for patients with congenital scoliosis. However, it is possible that many patients with congenital scoliosis may be able to avoid spinal surgery with the application of advanced bracing technology. Therefore, it is only prudent to advocate for conservative management first before spinal surgery is considered.

  19. Sensory reweighting is altered in adolescent patients with scoliosis: Evidence from a neuromechanical model.

    Science.gov (United States)

    Pialasse, Jean-Philippe; Descarreaux, Martin; Mercier, Pierre; Simoneau, Martin

    2015-10-01

    Idiopathic scoliosis is the most frequent spinal deformity in adolescence. While its aetiology remains unclear, impairments in balance control suggest a dysfunction of the sensorimotor control mechanisms. The objective of this paper is to evaluate the ability of patients with idiopathic scoliosis to reweigh sensory information. Using a neuromechanical model, the relative sensory weighting of vestibular and proprioceptive information was assessed. Sixteen healthy adolescents and respectively 20 and 16 adolescents with mild or severe scoliosis were recruited. Binaural bipolar galvanic vestibular stimulation was delivered to elicit postural movement along the coronal plane. The kinematics of the upper body, using normalized horizontal displacement of the 7th cervical vertebra, was recorded 1s before, 2s during, and 1s following vestibular stimulation. The neuromechanical model included active feedback mechanisms that generated corrective torque from the vestibular and proprioceptive error signals. The model successfully predicted the normalized horizontal displacement of the 7th cervical vertebra. All groups showed similar balance control before vestibular stimulation; however, the amplitude (i.e., peak horizontal displacement) of the body sway during and immediately following vestibular stimulation was approximately 3 times larger in patients compared to control adolescents. The outcome of the model revealed that patients assigned a larger weight to vestibular information compared to controls; vestibular weight was 6.03% for controls, whereas it was 13.09% and 13.26% for the mild and severe scoliosis groups, respectively. These results suggest that despite the amplitude of spine deformation, the sensory reweighting mechanism is altered similarly in adolescent patients with scoliosis. PMID:26371828

  20. Idiopathic short stature

    Directory of Open Access Journals (Sweden)

    Vlaški Jovan

    2013-01-01

    Full Text Available Growth is a complex process and the basic characteristic of child- hood growth monitoring provides insight into the physiological and pathological events in the body. Statistically, the short stature means departure from the values of height for age and sex (in a particular environment, which is below -2 standard deviation score, or less than -2 standard deviation, i.e. below the third percentile. Advances in molecular genetics have contributed to the improvement of diagnostics in endocrinology. Analysis of patients’ genotypes should not be performed before taking a classical history, detailed clinical examination and appropriate tests. In patients with idiopathic short stature specific causes are excluded, such as growth hormone deficiency, Turner syndrome, short stature due to low birth weight, intrauterine growth retardation, small for gestational age, dysmorphology syndromes and chronic childhood diseases. The exclusion of abovementioned conditions leaves a large number of children with short stature whose etiology includes patients with genetic short stature or familial short stature and those who are low in relation to genetic potential, and who could also have some unrecognized endocrine defect. Idiopathic short stature represents a short stature of unknown cause of heterogeneous etiology, and is characterized by a normal response of growth hormone during stimulation tests (>10 ng/ml or 20 mJ/l, without other disorders, of normal body mass and length at birth. In idiopathic short stature standard deviation score rates <-2.25 (-2 to -3 or <1.2 percentile. These are also criteria for the initiation of growth hormone therapy. In children with short stature there is also the presence of psychological and social suffering. Goals of treatment with growth hormone involve achieving normal height and normal growth rate during childhood.

  1. 青少年特发性脊柱侧弯症患者椎旁肌表面肌电信号时域指标变化规律%The patterns of time domain indexes of surface electromyographic signals of adolescent idiopathic scoliosis patients' paraspinal muscles

    Institute of Scientific and Technical Information of China (English)

    梁崎; 许轶; 王楚怀; 赖建洋; 林科宇

    2009-01-01

    Objective: Using surface electromyographic (sEMG) techniques to investigate the patterns of time domain indexes of surface electromyographic signals of adolescent idiopathic scoliosis (AIS) patients' paraspinal muscles. Method: Twenty-five AIS patients were enrolled, included 7 males and 18 females, aged 11 to 21 years. Forteen healthy adolescents, included 4 males and 10 females, aged 12 to 19 years, were set as control. Adolescents in both groups undertook the Biering Sorensen test (BST), the object-lifting test and semi-bridge test. A ME3000P sEMG instrument was applied to record the electromyographic activities of paraspinal muscles (convex /concave) of all subjects, and the time domain indexes: averaged EMG parameters (AEMG) and spectrum area (SPA) were analyzed. Result: The differences of AEMGs and SPAs between the convex side and the concave side of paraspinal muscles at the zone of apex vertebrae of AIS patients were of statistic significance (AEMGs: convex side 106.76± 47.73μV/s vs concave side 67.93±26.11μV/s, SPAs: convex side 11.01±8.81m~2 vs concave side 4.38±3.14 m~2, both P<0.01). The AEMGs of healthy controls' paraspinal muscles on both sides showed no significant difference. Conclusion: Electromyographic activities of paraspinal muscles (convex /concave) at the zone of apex vertebrae of AIS patients are asymmetric. sEMG can be one of the objective examinations used to evaluate the differences of electromyographic activities of paraspinal muscles(convex /concave) of AIS patients, and may have a promising value in clinical practice.%目的:采用表面肌电图(sEMG)检测技术对青少年特发性脊柱侧弯症(AIS)患者脊柱旁凸、凹侧椎旁肌肌电活动时域指标变化规律进行初步探讨.方法:AIS患者25例,男7例,女18例,年龄11-21岁;正常对照组少年14例,男4例,女10例,年龄12-19岁;两组受试者均执行BST实验、抬物实验,采用ME6000型表面肌电仪记录受试者双侧椎旁肌表面肌电信

  2. 青少年特发性脊柱侧凸患者小脑扁桃体位置与异常体感诱发电位的相关性分析%Study of relationship between position of the cerebellar tonsil and abnormal somatosenory evoked potentials in adolescent idiopathic scoliosis

    Institute of Scientific and Technical Information of China (English)

    陈志军; 邱勇; 孙旭; 马薇薇

    2009-01-01

    Objective To investigate the abnormality of position of the cerebellar tonsil and somatosensory evoked potentials (SEP) in adolescent idiopathic scoliosis (AIS), and to explore its clinical significance. Methods Sagittal magnetic resonance imaging (MBI) of hindbrain and posterior tibial nerve SEP (PTN-SEP) were performed on 171 young operative treated AIS patients. The PTN-SEP obtained from 45 age-matched healthy control individuals were considered as standard values. Tonsillar ectopia (TE) was defined as any inferior displacement of the tonsils. Absence of SEP waveforms, prolongation of peek latency or asymmetrical peek latency were defined as pathological change. The incidence of TE and pathological SEP was determined in all AIS patients. The association of TE and abnormal SEP for AIS patients was also assessed. Results The incidence of TE and abnormal SEP in AIS patients was 36.8% (63/171) and 36.3% (62/171), respectively. It was shown the frequency of TE and abnormal SEP were not significantly different among AIS patients with different curve severity. Statistical analysis failed to show a correlation between TE and abnormal SEP. Conclusions TE and disorder of somatosensory pathways do exist in a subgroup of AIS patients. However, there is not a significant association between TE and abnormal somatosensory function. It is suggested that TE and disorder of somatosensory function might contributes to different etiopathogenesis of AIS.%目的 探讨青少年特发性脊柱侧凸(AIS)患者小脑扁桃体位置与异常体感诱发电位(SEP)的相关性,分析其在AIS临床诊治中的意义.方法 对171例AIS患者行MRI扫描和胫后神经SEP检查;并以45名年龄匹配的健康青少年的胫后神经SEP作为正常值参考对照.在MRI图像上测量AIS患者的小脑扁桃体位置.小脑扁桃体位置低于枕骨大孔前后缘骨皮质的最低点之间的连线定义为小脑扁桃体异位.SEP波形消失、峰潜伏期延长及峰潜伏期不对

  3. 生姜热敷脐部缓解青少年特发性脊柱侧弯术后腹胀的效果%Effect of Postoperative Distension Ease Use the Umbilicus Therapy of Ginger Thermal Diffusion for Adolescent Idiopathic Scoliosis

    Institute of Scientific and Technical Information of China (English)

    许鑫; 施晓君; 胡晓晔; 胡三莲; 陈博昌

    2015-01-01

    Objective To observe the clinical curative effect of postoperative distension ease use the umbilicus therapy of ginger thermal diffusion for adolescent idiopathic scoliosis.Methods By convenience sampling,78 cases of patients were randomly divided into two groups.The ginger group(n = 40)cut ginger into bits and filled in umbilicus after operation,apply 30 min use hot water bagafter fixation with abdominal massage.The zusanli group in 38 cases,bilateral zusanli acupoint massage after operation 2 times a day with abdominal massage.The incidence of abdominal distension,level of abdominal distension,first exhausting time,recovering time of enterokinesia and the exhausting time after first food intake in 6 hours after surgery were compared between two groups.Results Two groups showed different level of abdominal distension in 96 hours after surgery,and the incidence rate was different at each time points.The incidence of abdominal distension in giger group was significantly lower than zu-sanli group(P <0.001).The level of abdominal distension in ginger group was lower than zusanli group(P <0.01), The recovering time of enterokinesia and the exhausting time in ginger group were ahead in zusanli group(P <0.05).There was no statistical significance between exhausting time after first food intake in 6 hours after surgery between two groups(P =0.571).Conclusion The incidence rate of abdominal distension after scoliosis surgery is high,in early time.The effect umbilicus therapy of ginger thermal diffusion is better than zusanli massage.%目的:观察生姜热敷脐部缓解青少年特发性脊柱侧弯术后腹胀的临床效果。方法便利选取2011年8月至2013年5月在上海交通大学附属第六人民医院小儿骨科行脊柱侧弯矫形术的患儿78例,采用区组随机化法分为两组。生姜组(40例)术后用生姜切成碎末填充脐部,局部固定后用热水袋热敷其上30 min,并配合腹部按摩;足三里组(38例)术

  4. Púrpura trombocitopênica idiopática e linfoma não-Hodgkin de células T na infância Idiopathic thrombocytopenic purpura and T-cell non-Hodgkin's lymphoma in childhood

    Directory of Open Access Journals (Sweden)

    Alessandra C. Borges

    2006-03-01

    Full Text Available Os linfomas representam 10% de todos os tumores malignos da infância e, destes, os linfomas não-Hodgkin são os mais freqüentes. Crianças com doenças auto-imunes apresentam maior probabilidade de desenvolver doenças linfoproliferativas, podendo ocorrer antes, durante ou após o aparecimento da neoplasia. A associação de púrpura trombocitopênica idiopática e linfomas é infreqüente (3%, principalmente na faixa etária pediátrica. Duas teorias tentam explicar a origem desta associação. Na primeira, a trombocitopenia seria decorrente da produção de auto-anticorpos antiplaquetas pelo clone tumoral. Na segunda, a PTI seria resultado de um estímulo antigênico persistente, secundário a uma desordem na proliferação linfóide. O objetivo do presente trabalho foi relatar a associação infreqüente na infância entre púrpura trombo-citopênica idiopática e linfoma não-Hodgkin de células T.Lymphomas represent 10% of all malignant tumors in childhood and from these non-Hodgkin's lymphomas are the most frequent. Children who have autoimmune diseases have a higher probability of developing lymphoproliferative diseases, which can happen before, during or after the appearance of the neoplasia. The association between idiopathic thrombocytopenic purpura and lymphomas is not common (3% especially in children. Two theories try to explain the origin of this association. In the first one, the thrombocytopenia would be a result of an autoantibody anti-blood platelet production by the tumoral clone. In the second one, the idiopathic thrombocytopenic purpura would be a result of a persistent antigenic stimulus subordinate to a disorder in the lymphoid proliferation. The aim of this work is to report the unusual association between idiopathic thrombocytopenic purpura and T-cell non-Hodgkin's lymphoma in childhood.

  5. Early-onset or rapidly progressive scoliosis in children: check the eyes!

    Science.gov (United States)

    Kurian, M; Megevand, C; De Haller, R; Merlini, L; Boex, C; Truffert, A; Kaelin, A; Burglen, L; Korff, C M

    2013-11-01

    Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare autosomal recessive disorder characterized by the absence of conjugate horizontal eye movements, and progressive scoliosis developing in childhood and adolescence, caused by mutations in the ROBO3 gene which has an important role in axonal guidance and neuronal migration. We describe two female children aged 12 years and 18 months, with progressive scoliosis, in whom the neurological examination showed absent conjugate horizontal eye movements, but preserved vertical gaze and convergence. Cerebral Magnetic resonance imaging findings included pontine hypoplasia, absent facial colliculi, butterfly configuration of the medulla and a deep midline pontine cleft, while Diffusion tensor imaging (DTI) maps showed the absence of decussating ponto-cerebellar fibers and superior cerebellar peduncles. Somatosensory and motor evoked potential studies demonstrated ipsilateral sensory and motor responses. The diagnosis was confirmed by the identification of bi-allelic mutations in the ROBO3 gene. PMID:23810770

  6. Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report

    Directory of Open Access Journals (Sweden)

    Pinto Fernando Campos Gomes

    2002-01-01

    Full Text Available Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what has already been reported in literature, we consider that scoliosis associated with disc herniation in young patients is most likely to be only an anthalgic position, not indicative of further structural changes.

  7. Scoliosis treatment using spinal manipulation and the Pettibon Weighting System™: a summary of 3 atypical presentations

    Directory of Open Access Journals (Sweden)

    Joy Timothy

    2006-01-01

    Full Text Available Abstract Background Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25–30° range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis. Case presentation Patient presentation, examination, intervention and outcomes are detailed for each case. The types of scoliosis presented here are left thoracic, idiopathic scoliosis after Harrington rod instrumentation, and a left thoracic scoliosis secondary to Scheuermann's Kyphosis. Each case carries its own clinical significance, in relation to clinical presentation. The first patient presented for chiropractic treatment with a 35° thoracic dextroscoliosis 18 years following Harrington Rod instrumentation and fusion. The second patient presented with a 22° thoracic levoscoliosis and concomitant Scheuermann's Disease. Finally, the third case summarizes the treatment of a patient with a primary 37° idiopathic thoracic levoscoliosis. Each patient was treated with a novel active rehabilitation program for varying lengths of time, including spinal manipulation and a patented external head and body weighting system. Following a course of treatment, consisting of clinic and home care treatments, post-treatment radiographs and examinations were conducted. Improvement in symptoms and daily function was obtained in all 3 cases. Concerning Cobb angle measurements, there was an apparent reduction in Cobb angle of 13°, 8°, and 16° over a maximum of 12 weeks of treatment. Conclusion Although mild to moderate reductions in Cobb angle measurements were achieved in these cases, these improvements may not be related to the symptomatic and functional improvements. The lack of a control also includes the possibility of a placebo effect. However, this study adds to the growing body of literature investigating methods by which

  8. [Adolescent scoliosis : From deformity to treatment].

    Science.gov (United States)

    Schulze, A; Schrading, S; Betsch, M; Quack, V; Tingart, M

    2015-11-01

    Scoliosis affects up to 6 % of the population. The resulting spine deformity, the increasing risk of back pain, cosmetic aspects, pulmonary disorders if the Cobb angle is > 80°, and the progress of the deformity to > 50° after the end of growth indicate non-operative or operative therapy. In daily clinical practice, the classifications of scoliosis allow the therapy to be adapted. Classifications consider deformity, topography of the scoliosis, and the age at diagnosis. This publication gives an overview of the relevant and most common classifications in the treatment of adolescent scoliosis. For evaluation, the deformity measurement on the coronary radiographic projection of the total spine (Cobb angle) is relevant to therapy. The classification of topography, form, and the sagittal profile of the deformity of the spine are useful for preoperative planning of the fusion level. Classifications that take into account the age at the time of the diagnosis of scoliosis differentiate among early onset scoliosis (younger than 10 years of age), adolescent scoliosis (up to the end of growth), and adult scoliosis. Early onset scoliosis is subdivided by age and etiology. Therapy is derived from the classification of clinical and radiological findings. Classifications that take into account clinical and radiological parameters are essential components of modern scoliosis therapy.

  9. CLINICAL APPLICATION OF THE TRAFIX INSTRUMENTATION IN CORRECTING SCOLIOSIS

    Institute of Scientific and Technical Information of China (English)

    王以朋; 叶启彬; 邱贵兴; 张嘉

    2002-01-01

    Objective.To evaluate the results of the TRAFIX instrumentation in correcting scoliosis. Methods.Since October 1997,47 patients with scoliosis received spinal fixation with the TRAFIX instrumentation at the Peking Union Medical College Hospital.The average age was 14.3 years (range 10 to 38 years).There were 27 idiopathic cases,16 congenital cases,2 cases with Marfan syndrome and 2 with neurofibromatosis.Twelve of the 47 patients underwent anterior release,while 4 patients received the revision approach.The average follow up time was 26 months (13~38 months). Results.The measurements of primary coronal deformity before and after surgery were 74° (50°~115° ) and 38.7° (11°~95° ),respectively.The average curve correction was 54% .The average number of fused segments was 12.5 (7~17) vertebrae.The distance between the center of apex and the C7 plumb line was 56.8 mm before surgery (25~107mm) and 31 mm after surgery (10~87mm). Conclusion.The TRAFIX instrumentation provides three dimensional correction with refinement,convenience and reliable fixation.

  10. Development of a non-fusion scoliosis correction device : numerical modelling of scoliosis correction

    NARCIS (Netherlands)

    Meijer, Gerarda Johanna Maria

    2011-01-01

    Scoliosis is a three-dimensional deformity of the spine and trunk, comprising of a lateral deviation and an axial rotation. Severe scoliosis is mostly seen in girls and is often detected during adolescence. Without treatment, scoliosis progression can lead to a life-threatening situation because the

  11. 椎弓根螺钉内固定材料置入并植骨融合后路矫正治疗重度僵硬性青少年特发性脊柱侧凸20例%Posterior correction using pedicle screw fixation combined with bone grafting and fusion for treatment of severe and rigid adolescent idiopathic scoliosis in 20 cases

    Institute of Scientific and Technical Information of China (English)

    臧危平; 刘祖德; 李展春; 冯宇; 张磊

    2008-01-01

    主弯平均Cobb角从术前的82°(75o~ 92o)矫正到31°(22°~37°),平均矫正率为62%.③双肩高度差及住院时间:术后脊柱侧位片均显示患者胸腰椎基本恢复正常后凸及前凸,平均双肩高度差为7.5 mm(0~11 mm),患者住院日为8~11 d, 平均9 d.④随访结果:所有患者均获术后4年随访,所有侧凸主弯矫正角度未发生丢失,固定节段全部融合,无断钉、断棒发生.结论:单纯后路椎弓根螺钉内固定材料置入并植骨融合术能有效治疗主弯在75o~92o,柔韧性≥ 20%的重度僵硬性青少年特发性脊柱侧凸.%BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82

  12. Scoliosis in patients with Prader Willi Syndrome – comparisons of conservative and surgical treatment

    Science.gov (United States)

    Weiss, Hans-Rudolf; Goodall, Deborah

    2009-01-01

    demonstrate that scoliosis in this entity plays only a minor role and surgery is unnecessary when high quality conservative management exists. There is lack of the long follow-up studies in post-surgical cases in patients with PWS and scoliosis. The rate of complications of spinal fusion in patients with PWS and scoliosis is very high and the death rates have been found to be higher than in patients with Adolescent Idiopathic Scoliosis (AIS). The long-term side-effects of the intervention are detrimental, so that the risk-benefit ratio favours the conservative approaches over spinal fusion surgery. PMID:19419581

  13. Scoliosis in patients with Prader Willi Syndrome – comparisons of conservative and surgical treatment

    Directory of Open Access Journals (Sweden)

    Goodall Deborah

    2009-05-01

    results of our retrospective study of nine patients demonstrate that scoliosis in this entity plays only a minor role and surgery is unnecessary when high quality conservative management exists. Conclusion There is lack of the long follow-up studies in post-surgical cases in patients with PWS and scoliosis. The rate of complications of spinal fusion in patients with PWS and scoliosis is very high and the death rates have been found to be higher than in patients with Adolescent Idiopathic Scoliosis (AIS. The long-term side-effects of the intervention are detrimental, so that the risk-benefit ratio favours the conservative approaches over spinal fusion surgery.

  14. Surgical strategy of one stage surgery of anterior release combined with posterior correction in treatment of severe scoliosis

    Institute of Scientific and Technical Information of China (English)

    LI Ming; LIU Yang; ZHU Xiao-dong; ZHAO Xin-gang; BAI Yu-shu; NI Chun-hong; SHI Zhi-cai; HOU Tie-sheng

    2005-01-01

    Objective: Severe scoliosis refers to scoliosis with serious and stiff curve. It always combins with trunk imbalance in coronal and sagittal contour. Besides complex pathological changes, cardiopulmonary deficits and other concomitant diseases increase treatmental difficulties. So the treatment of severe scoliosis is always a great challenge to spine surgeon.Methods:Thirty-six patients with severe scoliosis received one stage posterior correction followed by anterior release during July 1997 to January 2003, including 9 males and 27 females. Mean age was 17.2 years. Of them, 33 was idiopathic scoliosis and 3 was neurofibromatosis scoliosis( Cobb angle: 85-116 degree); 20 cases were abnormal in sagital plane. Three-dimensional devised instrumentation were applied such as CD, CD-Horizon, TSRH or Isola in posterior procedure followed by anterior release during the same anesthesia. 31 cases of this group received thoracic plasty.Results: The correction in the frontal plane achieved an average of 48.5%. In the sagittal plane, the pathological shape of the spine was reduced and distinctly ameliorated. 80.6% of the patients maintained or achieved balance of sagittal plane. There were no complications of severe neurological deficit, hook displacement, rod broken, and deep infection at follow-up. One case occurred traumatic pleurisy after operation and another appeared pseudarthrosis 2 years later. One case demonstrated imbalance 11 months after operation. One patient was presented loss of correction more than 10 degree at one year follow-up and 5.2 degree in average.Conclusion:The study indicates that the one stage posterior correction combined with anterior release in treatment of severe scoliosis can achieve satisfactory correction. Appropriate choice of cases, preoperational detailed assessment and application of SEP and wake-up test during operation can possibly reduce severe complication. The long-term outcomes still need further observation.

  15. Evaluation of supine fulcrum pressurized radiograph for predicting spinal flexibility in adolescent idiopathic scoliosis%仰卧支点加压侧屈位片评估青少年特发性脊柱侧凸脊柱柔韧性的价值

    Institute of Scientific and Technical Information of China (English)

    秦民益; 朱斌; 胡安宁; 束昊; 王钟; 辛小燕; 曾启龙; 田传帅

    2010-01-01

    目的 探讨仰卧支点加压侧屈位片评估青少年特发性脊柱侧凸(AIS)患者脊柱柔韧性的价值.方法 (1)实验研究:在同侧2个支点A-B与对侧1个支点C之间放置塑杆作压力测试,支点C位于支点A-B的中点时对塑杆加压,测量支点C加压后塑杆A侧端投影的移位数;A-C距离加倍时重复前一次的加压试验.分析加长力距对降低压力强度产生的影响.(2)临床研究:45例(男16例,女29例)AIS患儿术前检查包括全脊柱站立位正位X线平片、支点侧屈位和卧位侧屈位片,测量脊柱侧凸Cobb角,并计算带结构性弯曲的主弯柔韧性.结果 (1)支点A-C距离为25 cm,在支点C加压,压力定量刻度数分别在测量尺的1和2格时,塑杆投影移位分别为5 cm和10 cm;支点A-C距离为50 cm,在支点C加压,压力定量刻度数分别在测量尺的1和2格时,塑杆投影移位分别为8 cm和15 cm;加压支点间距越长,使塑杆投影移位的力越小.(2)45例患儿的卧位侧屈位与支点加压侧屈位片比较:男性组Cobb角分别为28.6°±4.4°、16.70°±4.6°,柔韧性分别为47.6%±8.1%、69.4%±8.5%;女性组Cobb角分别为24.5°±2.7°、12.6°±2.4°,柔韧性分别为53.4%±5.2%、76.0%±4.7%,差异均有统计学意义(P值均<0.01),且AIS患儿的脊柱主弯的柔韧性女性高于男性.结论 仰卧位支点加压技术可弥补仰卧侧屈位片主动矫形力的不足,是一种简便、安全、能准确地评价侧凸脊柱柔韧性的方法.%Objective To examine supine fulcrum pressurized radiograph to predict spinal flexibility in adolescent idiopathic scoliosis (AIS). Methods 1. Empirical study: put two points (A and B) on one side of the plastic stick and one point on the other side ( C), pressurize on the plastic stick when point C is in the middle of A and B, and then measure the projection shifting of point A. Repeat the pressure test when the distance between A and C doubled. Analyze the effect of increasing distance on

  16. Primary application of the simplified Chinese version of spinal appearance questionnaire in appearance evaluation of adolescent idiopathic scoliosis%中文版脊柱外观问卷在青少年特发性脊柱侧凸患者外观评价中的初步运用

    Institute of Scientific and Technical Information of China (English)

    魏显招; 陈家瑜; 王传锋; 张国有; 吴冰; 刘祥胜; 张伟; 陈自强; 李明

    2011-01-01

    Objective To develop a simplified Chinese version of spinal appearance questionnaire (SAQ) and assess its reliability and validity among patients with adolescent idiopathic scoliosis ( AIS). Methods The SAQ was translated and cross-culturally adapted into simplified Chinese according the international guideline. A total of 95 AIS patients were recruited to finish the simplified Chinese SAQ and SRS-22. In order to assess the test-retest reliability, 50 AIS patients were randomly selected to re-complete the SAQ at a time interval of 7 d. Internal consistency coefficient (ICC) was calculated and the Bland-Altman plot was made. Convergent validity was assessed by Pearson correlation analysis between the simplified Chinese SAQ with the simplified Chinese SRS-22 appearance domain, and discriminant validity by analyzing the relationship between simplified Chinese SAQ scores and the severity of deformity and different scheduled treatments. Results Internal consistency for the SAQ was satisfactory with intra-domain correlation coefficients ranging 0.521-0.792 (P < 0.01). The test-retest reliability for the SAQ was excellent with intra-class correlation coefficient being 0. 965 and good Bland-Altman agreement. Convergent validity test demonstrated a moderate correlation between the overall SAQ and SRS-22 appearance domain with r = - 0. 326 (P < 0.01). Correlation between the overall SAQ and the major Cobb' s angle was significant with r = 0. 779 (P < 0.01). Discriminant validity was confirmed by significant differences of SAQ total scores among the 3 subgroups categorized by the major Cobb's angle (P<0.001) and among patients who required exercise, bracing, or surgery (P<0.01). Conclusion Our simplified Chinese SAQ has satisfactory reliability and validity in evaluating spinal deformity appearance in Chinese AIS.%目的 建立简体中文版脊柱外观问卷(spinal appearance questionnaire,SAQ)并测验其用于评价青少年特发性脊柱侧凸患者

  17. Computer-assisted preoperative calculation of the orthopaedic rod length for patients with adolescent idiopathic scoliosis%计算机辅助术前预测青少年特发性脊柱侧凸内置物的长度

    Institute of Scientific and Technical Information of China (English)

    周忠杰; 刘立岷; 宋跃明

    2011-01-01

    BACKGROUND: Surgeons usually need to estimate the rod length according to the feature of the deformity and the length of the rod model made before the correction. But such estimation is not precise.OBJECTIVE: To calculate preoperatively the length of the rod for patients with adolescent idiopathic scoliosis (AIS) using computer and to evaluate the validity and accuracy of this method.METHODS: The spinal spiral CT of the patients with AIS was manipulated by the MIMICS software to reconstruct a three-dimensional model of all the vertebrae needing to be corrected. The vertebrae's positions were adjusted to mimic the orthopaedic result of the operation, and the length of the orthopaedic rod can be calculated using short straight line by the software's measuring tool. Seven patients were selected. The length of the orthopedic rod was calculated by MIMICS software and traditional method, anterior and posterior position X-ray of vertebral column were done postoperatively to measure the ideal length of the orthopaedic rod to evaluate the accuracy of the method.RESULTS AND CONCLUSION: For validity evaluation, the interobserver variability was (2.492±2.089) mm, and r=0.986,P=0.000 for the intra observer variability. The rod length measured by the software was (4.23±3.84) mm longer than the ideal length, while the length measured by the traditional method was (9.32±5.23) mm longer. The P value was 0.021, and the difference was statistically significant. The method of calculating preoperatively the length of the orthopaedic rod for patients with AIS using MIMICS software has good validity and reproducibility; this method also has good accuracy, which can be put into practical use.%背景:青少年特发性脊柱侧凸常需要根据患者脊柱畸形的特点和棒模板的长度对棒长进行估计,但这种方法并不精确.目的:计算机辅助术前预测青少年特发性脊柱侧凸矫形棒的长度,并评价该法的可重复性及准确性.方法:将青少年

  18. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  19. A survey on adolescent scoliosis in Guangzhou%广州市青少年脊柱侧凸患病率调查

    Institute of Scientific and Technical Information of China (English)

    黄南祺; 郭峘杉; 刘进; 黄广鑫; 杨夏慧; 陈静; 苏培强

    2011-01-01

    目的 了解广州市青少年脊柱侧凸的患病率.方法 2007年11月至2009年7月对广州市30 142名在校学生进行脊柱侧凸普查.首先由普查体检医生在学校对学生进行初步体格检查,阳性或可疑阳性者再由骨科医生复查;对骨科医生检查阳性或可疑阳性者行X线摄片检查.结果 共检出脊柱侧凸患者211例(Cobb角≥10°),患病率为0.70%.其中特发性脊柱侧凸192例(91.00%),先天性脊柱侧凸19例(9.00%).女生180例,男生31例,女生患病率显著高于男生(x2=112.332,P<0.001).结论 广州市中小学生脊柱侧凸的患病率为0.70%,女生患病率明显高于男性.对青少年进行脊柱侧凸普查可以早期发现、及时矫治,对防治脊柱侧凸具有积极意义.%Objective To investigate the prevalence of adolescent scoliosis in Guangzhou for development of effective prevention and treatment program to the disease. Methods From November2007 to July 2009, 30 142 students between 7 to 20 years old in primary and junior middle schools received physical check-up for detection of scoliosis through physical and radiographic examination.Results 211 cases were diagnosed as scoliosis (Cobb angle≥10°) , with the prevalence rate as 0.70%. 192 patients with idiopathic scoliosis (IS) were detected, accounting for 91.00%. There were 19 cases of congenital scoliosis, accounting for 9.00%. Sex ratio of scoliosis was 180/31. The prevalence of scoliosis was significantly lower in boys than that in girls (x2= 112.332, P<0.001 ).Conclusion The crude prevalence of adolescent scoliosis was 0.70% in Guangzhou with majority of idiopathic scoliosis. Investigation on scoliosis among school-age population seemed to be important for the purposes of early diagnosis, selection of effective prevention and treatment.

  20. Método de Cobb na escoliose idiopática do adolescente: avaliação dos ângulos obtidos com goniômetros articulados e fixos Método de Cobb en la escoliosis idiopática del adolescente: evaluación de los ángulos obtenidos con goniómetros articulados y fijos Cobb method in adolescent idiopathic scoliosis-angle: evaluation with articulated and fixed goniometers

    Directory of Open Access Journals (Sweden)

    Ana Laura Loyola Munhoz da Cunha

    2009-06-01

    ómetro articulado y con el fijo en 16 de las 17 curvas evaluadas en la presente muestra. Las diferencias observadas entre los goniómetros en la curva M parecen no estar relacionadas al equipamiento utilizado.OBJECTIVE: to determine the variance of Cobb angle measurements in adolescent idiopathic scoliosis with two types of goniometer: a fixed and an articulated one, both were previously calibrated. METHODS: eight digital radiographs of patients with adolescent idiopathic scoliosis, with severe primary curve (over 30 degrees were selected. Each one of the eight scoliosis images selected was processed 26 times and printed in a radiographic film, adding up 228 images. A total of 17 curves, primary and secondary, were measured by six orthopedic surgeons experienced in spine surgery. Each examiner received a pencil, eight scoliosis images and the same goniometer. The six orthopedists measured each curve in six different occasions, three times with the articulated and three with the fixed goniometer. The cranial and caudal vertebras to be measured were pre-established, so the choose of wrong levels could be avoided. The statistic analysis was done with "parametric tests" to determine the variance of the measures between different goniometer and the same examiner. RESULTS: among the 17 evaluated (A a Q, only the curve M showed a statistically significant difference between the angles measured by the two goniometers (mean of 33,3+9,1 degrees with the articulated and (27,9+4,2 degrees with the fixed one p=0,009. CONCLUSION: No significant differences were found between values obtained with goniometer articulated with the goniometer fixed in 16 of the 17 curves evaluated in this sample. The differences observed between the goniometer on the curve "M" does not appear to be related to the equipment used.

  1. Scoliosis in patients with aortic coarctation and patent ductus arteriosus: does standard posterolateral thoracotomy play a role in the development of the lateral curve of the spine?

    Science.gov (United States)

    Roclawski, Marek; Sabiniewicz, Robert; Potaz, Piotr; Smoczynski, Andrzej; Pankowski, Rafal; Mazurek, Tomasz; Daibo, Bawo

    2009-10-01

    The aim of this study was to determine the influence of lateral thoracotomy on the development of scoliosis in subjects undergoing repair of coarctation of the aorta (CoA) and patent ductus arteriosus (PDA). A group of 133 patients with CoA and PDA was evaluated. Forty-five patients with CoA and 38 with PDA underwent surgery using standard posterolateral thoracotomy (operative group), whereas 12 patients with CoA and 31 with PDA were treated using balloon dilatation and stent or coil implantation (nonoperative group). A spinal examination, together with the evaluation of chest and spinal roentgenograms, was conducted. Among the operated patients, 62% of those with CoA and 55% of those with PDA had clinical scoliosis. In the nonoperated patients, scoliosis was present in only 25% of those with CoA and 16% of those with PDA. Scoliosis ranged between 10 degrees and 42 degrees . In 89% of the operated patients with CoA and 76% of those with PDA the curve was thoracic; in 46% of the CoA group and 57% of the PDA group the curve was left-sided. All curves were right-sided in nonoperated subjects. Scoliosis in the operated group was higher in male than in female subjects (63% vs. 60% in CoA and 86% vs. 37% in PDA). The prevalence of scoliosis after standard posterolateral thoracotomy was significantly higher than after nonsurgical treatment methods in the CoA and PDA groups as well as in the general population. The rate of single thoracic and the rate of left-sided thoracic curves in patients after thoracotomy is higher than in nonoperated patients or in those with idiopathic scoliosis. The rate of scoliosis after thoracotomy is higher in male than female patients, especially after thoracotomy for PDA. PMID:19597861

  2. Superior oblique tendon (Brown’s syndrome as the presenting finding in childhood onset HLA-B27-related enthesitis and juvenile idiopathic oligoarticular arthritis

    Directory of Open Access Journals (Sweden)

    C. Pham

    2014-11-01

    Full Text Available We report two patients who presented with Brown’s syndrome. The first is a 7-year-old boy who at the time of his diagnosis was also found to have enthesitis and HLA-B27 positivity. The second patient was diagnosed with bilateral Brown’s syndrome at 13 months of age. At age 7 she developed a persistent oligoarticular arthritis and unilateral anterior iritis consistent with the oligoarticular Juvenile Idiopatic Arthritis (JIA phenotype. These cases highlight ophthalmologic findings and diagnostic considerations with respect to Brown’s syndrome and associated childhood onset rheumatologic disease.

  3. A new method of MR total spine imaging for showing the brace effect in scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Schmitz, A.; Kandyba, J.; Koenig, R.; Jaeger, U.E.; Gieseke, J.; Schmitt, O. [Univ. of Bonn (Germany)

    2001-07-01

    Bracing is a method of early, nonsurgical treatment for scoliosis, but a hypokyphotic effect on the thoracic spine is reported. We developed a magnetic resonance tomography (MR) procedure presenting an image of the whole spine in the coronal and sagittal planes (MR total spine imaging), and studied the brace effect, using this technique. We examined 26 female patients with idiopathic scoliosis treated with a Cheneau brace (mean age, 13.2 years; mean duration of brace treatment at the time of investigation, 1.5 years). The MR examinations were performed with the patient in the supine position with and without the brace in direct sequence. As measured on the coronal MR images, the thoracic curve was corrected, on average, from 29 deg to 22 deg (mean correction, 24%). There was a slight reduction in the sagittal Cobb angle measured between T4 and T12 (mean sagittal Cobb angle without brace, 14 deg ; with brace, 12 deg), which was still a significant change. MR total spine imaging could be a useful tool for studying the brace effect in scoliosis in two planes. Using this technique, we found reduced sagittal Cobb angles for the thoracic kyphosis with brace. Because there is no radiation exposure, the MR procedure has a potential use in the monitoring of brace treatment. (author)

  4. Introduction to the "Scoliosis" Journal Brace Technology Thematic Series: increasing existing knowledge and promoting future developments

    Directory of Open Access Journals (Sweden)

    Grivas Theodoros B

    2010-01-01

    Full Text Available Abstract Bracing is the main non-surgical intervention in the treatment of idiopathic scoliosis during growth, in hyperkyphosis (and Scheuermann disease and occasionally for spondylolisthesis; it can be used in adult scoliosis, in the elderly when pathological curves lead to a forward leaning posture or in adults after traumatic injuries. Bracing can be defined as the application of external corrective forces to the trunk; rigid supports or elastic bands can be used and braces can be custom-made or prefabricated. The state of research in the field of conservative treatment is insufficient and while it can be stated that there is some evidence to support bracing, we must also acknowledge that today we do not have a common and generally accepted knowledge base, and that instead, individual expertise still prevails, giving rise to different schools of thought on brace construction and principles of correction. The only way to improve the knowledge and understanding of brace type and brace function is to establish a single and comprehensive source of information about bracing. This is what the Scoliosis Journal is going to do through the "Brace Technology" Thematic Series, where technical papers coming from the different schools will be published.

  5. Late presentation of superior mesenteric artery syndrome following scoliosis surgery: a case report

    Directory of Open Access Journals (Sweden)

    Tsirikos Athanasios I

    2008-01-01

    Full Text Available Abstract Introduction Obstruction of the third part of the duodenum by the superior mesenteric artery (SMA can occur following surgical correction of scoliosis. The condition most commonly occurs in significantly underweight patients with severe deformities during the first few days to a week following spinal surgery. Case presentation We present the atypical case of a patient with normal body habitus and a 50° adolescent idiopathic thoracolumbar scoliosis who underwent anterior spinal arthrodesis with instrumentation and developed SMA syndrome due to progressive weight loss several weeks postoperatively. The condition manifested with recurrent vomiting, abdominal distension, marked dehydration, and severe electrolyte disorder. Prolonged nasogastric decompression and nasojejunal feeding resulted in resolution of the symptoms with no recurrence at follow-up. The spinal instrumentation was retained and a solid spinal fusion was achieved with good spinal balance in both the coronal and sagittal planes. Conclusion SMA syndrome can occur much later than previously reported and with potentially life-threatening symptoms following scoliosis correction. Early recognition of the condition and institution of appropriate conservative measures is critical to prevent the development of severe complications including the risk of death.

  6. Gastaut type idiopathic occipital epilepsy

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    I. V. Volkov

    2015-01-01

    Full Text Available Idiopathic occipital epilepsy is a rare epileptic syndrome. Its incidence in a Novosibirsk cohort of patients with idiopathic focal epilepsy is 0.9%. Objective: to present a clinical description of new cases of Gastaut syndrome, the types of its course, and treatment options in these patients. Patients and methods. The study covers 17 cases of Gastaut type idiopathic occipital epilepsy in 13 women and 4 men aged 11–53 years. Results. Among 17 cases we present 4 family cases with the disease. Three generations in 2 families were observed to have epilepsy, including Gastaut syndrome concurrent with childhood absence epilepsy. The adolescent onset of the disease was seen in most cases. Its main symptoms were focal visual seizures (100%, focal sensory seizures (58.9%, cephalalgia (47.1%, speech disorders (41.2%, and secondarily generalized convulsive seizures (35.3%. According to the frequency of seizures, the investigators identified 5 types of the course: single focal seizures, rare focal seizures with or without convulsions, frequent focal seizures with or without convulsions. The identity of the course of epilepsy was found in familial cases. 76.5% of the patients had a good quality of life: 41.2% of them were untreated while 35.3% were treated; no seizures were noted. 

  7. Idiopathic sclerosing orbital inflammation

    NARCIS (Netherlands)

    J.D. Hsuan; D. Selva; A.A. McNab; T.J. Sullivan; P. Saeed; B.A. O'Donnell

    2006-01-01

    Objective: To perform a multicenter review of the clinical features and treatment of 31 patients with idiopathic sclerosing orbital inflammation. Methods: We included all patients with histologically confirmed idiopathic sclerosing orbital inflammation from 5 regional orbital centers. We reviewed th

  8. Tratamento cirúrgico da escoliose idiopática do adolescente utilizando parafusos pediculares: análise dos resultados clínicos e radiográficos Tratamiento quirúrgico de la escoliosis idiopática del adolescente utilizando tornillos pediculares: análisis de los resultados clínicos y radiográficos Surgical treatment of adolescent idiopathic scoliosis using pedicle screws: analysis of clinical and radiographic results

    Directory of Open Access Journals (Sweden)

    Alberto Ofenhejm Gotfryd

    2011-01-01

    artrodesis por vía posterior, utilizando solamente tornillos pediculares, y correlacionar el resultado radiográfico con los valores obtenidos a través del cuestionario SRS-24. Métodos: Fueron evaluados 25 pacientes portadores de escoliosis idiopáticas del adolescente, sometidos a artrodesis de la columna por vía posterior. El seguimiento promedio fue de 23,7 meses, con variación entre 12 y 35. Analizamos criterios radiográficos referentes a la corrección de las deformidades y aplicamos el cuestionario SRS-24, específico para la patología en cuestión, estandarizada por la Scoliosis Research Society. Resultados: La muestra fue compuesta por 92% de pacientes del sexo femenino y el promedio de edad fue 14,2 años. El promedio del índice de Cobb en la radiografía anteroposterior preoperatoria fue de 24,4 grados para la curva torácica proximal, 54,9 grados para torácica principal y 38,5 grados para la curva lumbar. Los valores angulares promedio en el postoperatorio fueron 11 grados, 16,7 grados y 12,2 grados respectivamente, con un porcentaje de corrección promedio de la curva torácica principal de 69,9%. El valor promedio final del cuestionario SRS-24 fue de 98,1 puntos. Dos de los pacientes presentaron complicaciones en el postoperatorio, sin embargo ninguna del tipo neurológico. Conclusión: La técnica se mostró eficaz para el tratamiento quirúrgico de la EIA, proporcionando un alto porcentual de corrección de las deformidades, con un bajo riesgo de complicaciones y resultado clínico satisfactorio. No hubo asociación estadísticamente significativa entre el porcentaje de corrección de la curva (torácica o lumbar principal o su valor postoperatorio para el valor final del cuestionario SRS-24 ni con los dominios "satisfacción" y "autoimagen postoperatoria".Objective: To evaluate clinically and radiographically patients with adolescent idiopathic scoliosis (AIS submitted to posterior arthrodesis using pedicle screws-only constructs and correlate image

  9. Developmental abnormality and the juvenile idopathic scoliosis%生长发育异常和青少年特发性脊柱侧凸

    Institute of Scientific and Technical Information of China (English)

    朱锋; 邱勇

    2003-01-01

    @@ 青少年特发性脊柱侧弯(Adolescent Idiopathic Scoliosis,以下简称AIS)是以脊柱在冠状面上的侧凸、矢状面上的胸椎后凸减少甚至前凸和脊椎在水平面上的旋转为特征的三维畸形,它是最常见的青少年脊柱畸形之一.

  10. The role of tumor necrosis factor-alpha -308 G/A and transforming growth factor-beta 1 -915 G/C polymorphisms in childhood idiopathic thrombocytopenic purpura

    Directory of Open Access Journals (Sweden)

    Emel Okulu

    2011-09-01

    Full Text Available Objective: To increase our understanding of the etiology of idiopathic thrombocytopenic purpura (ITP some cytokine gene polymorphisms were analyzed for susceptibility to the disease. The aim of this study was to investigate the role of tumor necrosis factor-alpha (TNF-α -308 G/A and transforming growth factor-beta 1 (TGF-β1 –915 G/C polymorphisms in the development and clinical progression of childhood ITP.Materials and Methods: In all, 50 pediatric patients with ITP (25 with acute ITP and 25 with chronic ITP and 48 healthy controls were investigated via LightCycler® PCR analysis for TNF-α -308 G/A and TGF-β1 -915 G/C polymorphisms.Results: The frequency of TNF-α -308 G/A polymorphism was 20%, 16%, and 22.9% in the acute ITP patients, chronic ITP patients, and controls, respectively (p>0.05. The frequency of TGF-β1 -915 G/C polymorphism was 16%, 8%, and 8.3% in the acute ITP patients, chronic ITP patients, and controls, respectively (p>0.05. The risk of developing ITP and clinical progression were not associated with TNF-α -308 G/A (OR: 0.738, 95% CI: 0.275-1.981, and OR: 0.762, 95% CI: 0.179-3.249 or TGF-β1 -915 G/C (OR: 1.5, 95% CI: 0.396-5.685, and OR: 0.457, 95% CI: 0.076-2.755 polymorphisms. Conclusion: The frequency of TNF-α -308 G/A and TGF-β1 -915 G/C polymorphisms did not differ between pediatric ITP patients and healthy controls, and these polymorphisms were not associated with susceptibility to the development and clinical progression of the disease.

  11. Atherosclerosis in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2012-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE or rheumatoid arthritis (RA. There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA. Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.

  12. Scoliosis and the impact in neuromuscular disease.

    Science.gov (United States)

    Mayer, Oscar Henry

    2015-01-01

    Scoliosis can alter respiratory mechanics by changing the orientation of the muscles and joints of the respiratory system and in severe forms can put a patient at risk of severe respiratory morbidity or respiratory failure. However, perhaps the most important factor in determining the pulmonary morbidity in scoliosis is the balance between the "load" or altered respiratory mechanics and the "pump" or the respiratory muscle strength. Therefore, scoliosis in patients with neuromuscular disease will both lead to increased "load" and a weakened "pump", an exceptionally unfortunate combination. While progressive neuromuscular disease by its nature does not respond favorably to attempts to improve respiratory muscle strength, the natural approach of early proactive management of the "load" and in the case of scoliosis a variety of different strategies have been tried with variable short term and long term results. Figuring this out requires both an understanding of the underlying pathophysiology of a particular neuromuscular condition and the available options for and timing of surgical intervention.

  13. Scoliosis in Herlyn–Werner–Wunderlich Syndrome

    OpenAIRE

    Li, Zheng; Yu, Xin; Shen, Jianxiong; Liang, Jinqian

    2014-01-01

    Abstract Herlyn–Werner–Wunderlich syndrome (HWWS) is a congenital Müllerian duct anomaly characterized by uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Little is reported about spinal deformity associated with this syndrome. This study presents a case of scoliosis occurring in the setting of HWWS and explores the possible association between the 2 diseases. A previously unreported scoliosis in HWWS is described. The patient is a 12-year-old Chinese female with scol...

  14. Rubinstein-Taybi syndrome with scoliosis

    OpenAIRE

    Miyasaka Kazuyoshi; Tsuji Taichi; Kawakami Noriaki; Tatara Yasunori; Ohara Tetsuya; Nohara Ayato

    2011-01-01

    Abstract Study Design Case report. Objective The authors present the case of a 14-year-old boy with Rubinstein-Taybi syndrome (RSTS) presenting scoliosis. Summary of Background Data There have been no reports on surgery for RSTS presenting scoliosis. Methods The patient was referred to our hospital for evaluation of a progressive spinal curvature. A standing anteroposterior spine radiograph at presentation to our hospital revealed an 84-degree right thoracic curve from T6 to T12, along with a...

  15. Pelvic fixation for neuromuscular scoliosis deformity correction

    OpenAIRE

    Dayer, Romain; Ouellet, Jean Albert; Saran, Neil

    2012-01-01

    Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgica...

  16. Duchenne muscular dystrophy: the management of scoliosis

    Science.gov (United States)

    Gardner, Adrian C.; Roper, Helen P.; Chikermane, Ashish A.; Tatman, Andrew J.

    2016-01-01

    This study summaries the current management of scoliosis in patients with Duchenne Muscular Dystrophy. A literature review of Medline was performed and the collected articles critically appraised. This literature is discussed to give an overview of the current management of scoliosis within Duchenne Muscular Dystrophy. Importantly, improvements in respiratory care, the use of steroids and improving surgical techniques have allowed patients to maintain quality of life and improved life expectancy in this patient group.

  17. Acupucture in the treatment of scoliosis – a single blind controlled pilot study

    Directory of Open Access Journals (Sweden)

    Jahnke Anja

    2008-01-01

    Full Text Available Abstract Background Today, acupuncture therapy is commonly used for pain control throughout the world, although the putative mechanisms are still unclear. A Pub Med search for the key words "Acupuncture" and "Scoliosis" reveals 3 papers only, not containing any results of studies designed for the treatment of scoliosis with the help of acupuncture. Because of this lack of trials especially designed for the treatment of scoliosis this pilot study has been performed. Methods 24 girls undergoing in-patient rehabilitation, 14 – 16 years of age (at average 15,1 years, SD 0,74 with the diagnosis of an Adolescent Idiopathic Scoliosis (AIS have agreed to take part in this controlled single blind crossover study. Average Cobb angle was 33 degrees (SD 9,2 ranging from 16 to 49 degrees. 10 of the girls had a thoracic, one a lumbar, 7 a double major and 6 a thoracolumbar curve pattern. The patients have been scanned with the Formetric® surface topography measurement system before and after lying on the left side [L], before and after sham acupuncture [S] and before and after real acupuncture [R]. Results For the whole group of patients no significant changes have been found during lying, sham acupuncture or real acupuncture. There were no differences between the patient groups with different curve pattern. In the explorative subgroup analysis of Patients with curvatures from 16 to 35 degrees, however significant changes in surface rotation have been found after R intervention as well as a strong differences in lateral deviation while in the L or S intervention no real changes have been achieved. Conclusion One session with real (verum acupuncture seems to have an influence on the deformity of scoliosis patients with no more than 35 degrees. The findings during verum acupuncture clearly are different to sham acupuncture or just lying, while in the whole group of patients also including patients with curvatures of more than 35 degrees no obvious changes

  18. Scoliosis short-term rehabilitation (SSTR according to 'Best Practice' standards - are the results repeatable?

    Directory of Open Access Journals (Sweden)

    Borysov Maksym

    2012-01-01

    Full Text Available Abstract Claims have been made in a pilot study that a new form of short-term rehabilitation according to 'Best Practice' standards would change signs and symptoms of patients with scoliosis in the short-term. Aim of this study is to repeat the study published 2010 with a larger sample of patients using the same protocol. Both authors have undergone training in this special approach to scoliosis rehabilitation in 2010. Materials and methods 34 patients with Adolescent Idiopathic Scoliosis (AIS, 32 girls and 2 boys, average age 13.7 years and an average Cobb angle of 28.7 degrees (21-43 degrees underwent Scoliosis Short-Term Rehabilitation (SSTR of seven days. Two days with an intensity of 3 × 90 min sessions/day, and five days with an intensity of 2 × 60 min sessions/day. Angle of trunk rotation (ATR was measured before and after the time of treatment as well as the active correctability of the ATR after the programme as it has been done in the pilot investigation. Additionally to that, we also recorded the changes in Vital Capacity (VC before and after the programme. Results ATR was reduced significantly from 11,5 degrees to 8,4 degrees, the active correctability as measured with the Scoliometer (TM was also reduced significantly from the ATR after treatment 8,9 degrees to 6,5 degrees in the patients with thoracic curves. VC improved significantly (P Discussion The results achieved in the pilot investigation published previously are repeatable. The deformity of the trunk can be reduced significantly after SSTR. During the pilot study VC was not investigated. In our study VC improved significantly. Therefore, also shorter rehabilitation times with an appropriate programme seem to be able to change signs and symptoms of a patient with scoliosis. Like the out-patient Schroth programme as described in a study from Turkey, the SSTR provides benefits leading to an improvement of the condition. Conclusion Out-patient rehabilitation following the

  19. Surgical Treatment of Scoliosis in Patients with Charcot-Marie-Tooth Disease

    Institute of Scientific and Technical Information of China (English)

    Farzad Omidi Kashani; Ibrahim Ghayem Hasankhani; Mahdi Banaii

    2009-01-01

    Objective: Apparently, scoliosis occurs in approximately one-third of patients with Charcot-Marie-Tooth disease. Little is known about the response of these curves to treatment. The purpose of this study was to evaluate the results of spinal surgery in these peculiar patients. Methods: We retrospectively evaluated the results of spinal surgery in eight patients who had scoliosis due to clinically and electrophysiologically proven Charcot-Marie-Tooth disease. Radiographs were reviewed. The location and direction of the curve pattern, the age at the time of surgery, type of surgery, number of levels fused, instrumentations used, intra or postoperative complications, and results and need for reoperation were recorded. Results: Eight patients associated with Charcot-Marie-Tooth disease who underwent scoliotic surgery were identified. The average age and curve at the time of surgery were 21.1 years and 56.4° respectively. 62.5% of the curves had left thoracic component and more than one third was associated with thoracic hyperkyphosis. Long posterior spinal fusion was performed most often, with an average of 11.5 spinal segments fused. Instrumentation was used in all posterior fusions. At an average of 39 months (range, 24 to 72 months) postoperatively, the fusion appeared to be solid in all patients. Conclusion: Scoliosis in patients with Charcot-Marie-Tooth disease differs from that in patients with idiopathic scoliosis in regarding to the etiology and the prevalence of thoracic hyperkyphosis, but the surgical management appears to be similar. Spondylodesis does not appear to be associated with a high rate of complications.

  20. 小儿脊柱侧弯并发剃刀背畸形的矫治%Treatment of rib prominence scoliosis in children

    Institute of Scientific and Technical Information of China (English)

    孙琳; 于凤章; 潘少川; 张学军; 李承鑫; 马军; 赵华

    2001-01-01

    目的 矫正脊柱侧弯患儿的肋骨剃刀背畸形。方法 在实行后路脊柱侧弯矫形及脊柱融合术时,采用凸侧多节短段肋骨切除术同时矫治剃刀背及术后佩带矫形石膏或支具背心,更为有利。结果 1997年9月至1999年6月共有49例脊柱侧弯患儿施行剃刀背矫形术,未发生气胸、胸膜破裂等并发症,有3例患儿遗有残余剃刀背,其余患儿矫形效果均满意。结论 多节短段肋骨切除术是一种简便有效、安全的方法。在矫形剃刀背的同时,还可提供脊柱融合的植骨材料,免去髂骨取骨。%Objective In order to correct the rib prominence scoliosis inchildren .Methods From 1997 to 1999, 49 children with congenital scoliosis(27), idiopathic scoliosis(15), neurofibromatosis with scoliosis(6) and Marfan's syndrome with scoliosis(1) were treated. Rib resection was performed during the posterior spinal fusion on scoliosis, the spinal orthosis was applied postoperatively. Results No pneumothorax was happened postoperatively . All cases got satisfactory cosmetic appearance except 3 had residual rib prominence. Conclusions Multiple short segment costectomy is a safe and effective technique for the rib deformity in children with scoliosis. The resected ribs could provide the bone grafting for spinal fusion.

  1. Idiopathic portal hypertension

    International Nuclear Information System (INIS)

    To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

  2. Neuropatía idiopática do plexo lombossacro em criança: relato de caso Idiopathic lumbosacral plexus neuropathy in childhood: case report

    Directory of Open Access Journals (Sweden)

    Isac Bruck

    1996-12-01

    Full Text Available Os autores relatam um caso de plexopatia lombossacra em criança e em que a extensa investigação, incluindo ressonância nuclear magnética normal, biópsia muscular compatível com desinervação inicial e eletromiografia normal, afastou condições associadas. O paciente apresentava dor intensa, fraqueza e atrofia do membro inferior esquerdo, reflexo aquileu ausente e reflexo patelar diminuído à esquerda. Parestesia no membro envolvido acompanhava o quadro. O tratamento realizado foi dexametasona por um mês e morfina intratecal durante três meses. A evolução foi favorável, apresentando, após um ano, atrofia discreta do membro acometido e leve paresia do músculo iliopsoas esquerdo.We describe a lumbosacral plexus neuropathy case in childhood in which detailed investigation, including eletromyography and magnetic resonance imaging, was normal. Muscle biopsy showed mild denervation. No underlyng condition was detected. The patient presented with pain, weakness and light atrophy in left lower limb, reduced reflex at the ankle, loss of the quadriceps reflex and paresthesy in involved limb. Recovery after one year was almost complete, with persistent slight weakness and atrophy.

  3. Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

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    Adobor Raphael

    2012-10-01

    Full Text Available Abstract Background Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed. Methods Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988. Results We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86% girls and 108 (14% boys. Mean age at detection was 14.6 (7–19 years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°. About 40% had a major curve >40°. Seventy-one percent were detected by patients

  4. Idiopathic chronic eosinophilic pneumonia

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    Cordier Jean-François

    2006-04-01

    Full Text Available Abstract Idiopathic chronic eosinophilic pneumonia (ICEP is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than lymphocyte counts in the bronchoalveolar lavage. ICEP is a rare disorder of unknown cause. Its exact prevalence remains unknown. ICEP may affect every age group but is rare in childhood. It is twice as frequent in women as in men. One third to one half of the ICEP patients have a history of asthma. The mainstay of treatment of ICEP is systemic corticosteroids. Response to oral corticosteroid therapy is dramatic and has led to the consideration of corticosteroid challenge as a diagnostic test for ICEP. Nevertheless, relapses or development of severe asthma are frequent when tapering or withdrawing treatment. Long-term oral corticosteroid therapy is necessary in up to half of the patients.

  5. The joints in juvenile idiopathic arthritis

    OpenAIRE

    Ording Muller, Lil-Sofie; Humphries, Paul; Rosendahl, Karen

    2015-01-01

    Abstract Juvenile idiopathic arthritis is the most common rheumatic entity in childhood. Imaging has become an important supplement to the clinical assessment of children with JIA. Radiographs still play an important role in the workup, and long-term follow-up in children with JIA, but are not sensitive to findings in the early disease stage. Both ultrasound and MRI are more sensitive to inflammatory changes than clinical assessment alone. However, the differentiation between normal findings ...

  6. Genetics Home Reference: horizontal gaze palsy with progressive scoliosis

    Science.gov (United States)

    ... palsy and progressive scoliosis with mutations in ROBO3. Neurology. 2005 Apr 12;64(7):1196-203. Citation ... with progressive scoliosis maps to chromosome 11q23-25. Neurology. 2002 Aug 13;59(3):432-5. Citation ...

  7. IDIOPATHIC SC OLIOSIS. /LECTURE, PART I. «PARADOXES»/

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    Михаил Георгиевич Дудин

    2014-03-01

    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.

  8. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... Asked Questions Español Condiciones Chinese Conditions Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) En Español Read in Chinese What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that ...

  9. NK细胞在儿童免疫性血小板减少症发病和治疗中的意义%Significance of NK cell in the pathogenesis and treatment of childhood idiopathic thrombocytopenia

    Institute of Scientific and Technical Information of China (English)

    范秋霞; 王春美; 盛光耀

    2014-01-01

    目的:探讨自然杀伤细胞(NK细胞)在儿童免疫性血小板减少症(ITP)的发病和治疗中的意义。方法采用流式细胞仪分别检测62例新诊断ITP患儿、43例持续性ITP患儿、21例慢性ITP患儿和51例对照组儿童外周血NK细胞百分比;并观察单独使用标准剂量静脉注射用人免疫球蛋白(IVIG)对NK细胞百分比正常及减少的新诊断的ITP患儿的疗效。结果新诊断ITP患儿、持续性ITP、慢性ITP患儿NK细胞百分比均较正常对照组儿童显著降低(P<0.05),但三组ITP患儿NK细胞百分比差异无显著性(P !0.05);NK细胞百分比正常的新诊断ITP患儿单独使用IVIG有效率为92.86%(26/28),NK细胞百分比降低的新诊断ITP患儿单独使用IVIG有效率仅为14.70%(5/34)。结论 NK细胞表达变化与ITP发病存在一定关系,同时NK细胞百分比正常的新诊断ITP患儿可首选IVIG治疗。%Objective To explore the significance of natural killer cell(NK)in the pathogenesis and treatment of childhood idiopathic thrombocytopenia(ITP).Methods Peripheral NK cell percentage was teseted by flow cytometry in 62 children with newly diagnosed ITP,43 children with persistent ITP,2 1 children with chronic ITP and 5 1 controls.All the newly diagnosed ITP children were treated with standard dose of intravenous immunoglobulin (IVIG ). Then whether IVIG has a proven impact on the newly diagnosed ITP patients with normal or lower NK cells was observe.Results The percentage of NK cells in children with newly diagnosed ITP,persistent ITP and chronic ITP was all significantly decreased compared with the control group(P0.05 ).The efficiency of standard dose of IVIG in newly diagnosed ITP children with normal NK cells and abnormal NK cells was 92.86%(26/28)and 14.70%(5/34)separately.Conclusions NK cell may play role in the pathogenesis of childhood ITP,and standard dose of IVIG is the first choice to treat newly diagnosed ITP

  10. Gastaut型特发性儿童枕叶癫痫的临床及脑电图分析%Clinical analysis and electroencephalograghy features in idiopathic childhood occipital epilepsy of gastaut.

    Institute of Scientific and Technical Information of China (English)

    文家伦; 廖建湘; 陈彦; 陈黎

    2011-01-01

    Objective To investigate the clinical, electroencephalograghy (EEG) features and prognosis in children with idiopathic occipital epilepsy of Gastaut (COE-G). Methods A retrospective review was conducted of 13 children patients who were diagnosed as idiopathic occipital epilepsy of gastaut (COE-G). All of them were treated with antiepileptic drugs according to the seizure typies. The prognosis were reviewed. The clinical feature and EEG were analysed. Results In total, 13 children (6 boys and 7 girls) with idiopathic childhood occipital epilepsy of gastaut were enrolled in this study. The median age at seizure onset was 8.7 years. The ictal clinical manifestations involve frequent diurnal visual seizures in all patients, elementary visual hallucinations in nine (69.2%), blindness or blurring of vision in seven (53.8%), headache in five (38.5%), and secondarily generalized tonic-clonic seizures in three (23.1%). Frequent deviation of eyes and head were common, 1 patient had seizures at night also. Interictal EEG showed high-amplitude spikes, spike and wave discharge on the unilateral or bilateral occipital regions which had often been induced by eyes closed, inhibited by eyes open. Posterior temporal spikes occured in 4 cases (30.1%), brief generalized discharges of spike-wave in 1 case (7.7%). Ictal EEG showed continuing low-amplitude sharp wave rhythm originated from one hemisphere of the occipital or posterior temporal lobe, with its amplitude increasing gradually and spread to the former head of the same hemisphere or lateral head of the contralateral hemisphere during progress. 11 cases (84.6%) had seizure free, in half of whom the medication was terminated in late adolescence. Most of them was treated monotherapy, some required combination therapy, 2 cases had poor response to multiple antiepileptic drugs, and 1 case had mild cognitive impairment. Conclusion COE-G had relatively late onset, characterized by prominent diurnal visual seizures, more

  11. PATTERN OF INHERITANCE OF IDIOPATHIC HYPERCALCIURIA IN TWO FAMILIES

    Directory of Open Access Journals (Sweden)

    A. Nickavar

    2006-09-01

    Full Text Available Idiopathic hypercalciuria is a leading cause of frequency-dysuria syndrome in childhood. Different modes of inheritance have been suggested in this disease. This article presents the occurrence of idiopathic hypercalciuria in all children of two families. In the first family, a 5.5 year old girl with a history of renal stones and dysuria due to hypercalciuria, had two involved brothers and one sister. In the second family, hypercalciuria and medullary nephrocalcinosis were detected in two siblings who were admitted for polyuria and dysuria. Idiopathic type of hypercalciuria was diagnosed in these two families by normal laboratory exams and exclusion of other causes of normocalcemic hypercalciuria. According to the involvement of all offsprings (both sexes in these two families, it is suggested that idiopathic hypercalciuria is an autosomal dominant disease with complete penetration.

  12. Brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis

    Institute of Scientific and Technical Information of China (English)

    QIAN Bang-ping; QIU Yong; WANG Bin; YU Yang; ZHU Ze-zhang

    2007-01-01

    Objective: To explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.Methods: A total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy.The average Cobb angle was 110° (range, 90°-135°).Diagnoses were made as idiopathic scoliosis in 1 case,congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously,neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.Results: Traction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.Conclusions: The clinical features of brachial plexus palsy caused by halo traction include median nerve paresis,ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e. , damage of Cs and

  13. Exercise testing and fitness training in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Singh-Grewal, D.

    2010-01-01

    Juvenile Idiopathic Arthritis is the commonest rheumatic disease of childhood affecting 1:1000 children under the age of 16 years. Children with JIA have long been sidelined from physical activity due to active disease or irrational concerns that activity may in some way worsen disease. Children wit

  14. 脊柱侧弯影像检查的临床评价%Clinical value of the imaging study for spine scoliosis

    Institute of Scientific and Technical Information of China (English)

    彭雪华; 何玲; 朱铭; 蔡金华

    2009-01-01

    Objective: To discuss the values of different imagings in the morbidity of the structural scoliosis and guidance for the clinical course. Methods: A total of 155 cases of spine scoliosis underwent X radiography. Of them, 69 cases also underwent with computed tomography (CT) and Magnetic resonance imaging (MRI), 40 cases with CT, and 20 cases with heart ultrasound. Cases underwent CT further underwent the cured multiplanar reconstruction (CMPR) and volume reconstruction (VR). Results: A total of 81 cases are idiopathic scoliosis (IS) (52.3%, 15 cases with congenital heart diseases), 60 cases are congenital spine scoliosis (38.7%, 5 cases with congenital heart diseases),and others are 14 cases (9.0%). Conclusion: At present, X-radiography XT and MRI imaging are the most frequently used examining methods for spine scoliosis. Each of them has its own advantages and disadvantages. The selection of them should be according to the clinical conditions, which plays an important in the search for the causes of the spine scoliosis and comprehensive assessment in pre-operation or post-operation.%目的:讨论不同影像方法对结构性脊柱侧弯发病情况及其指导临床诊治价值.方法:对155例脊柱侧弯者,均行X线片检查,其中69例行计算机体层成像(Computed tomography,CT)和磁共振成像(Magneticl resonance imaging,MRI)检查,40例行CT检查,20例行心脏超声,CT检查者均行多层面曲面重建(Cured multiplanar reconstruction,CMPR)及容积重组技术(Volume reconstruction,VR).结果:特发性脊柱侧弯(Idiopathic scoliosis,IS)81例(52.3%,15例合并先天性心脏病).先天性脊柱侧弯60例(38.7%,5例合并先天性心脏病).其它类14例(9.0%).结论:X线、CT及MRI是目前脊柱侧弯最常用的影像检查方法,各有其优缺点,应根据临床实际情况合理选择,对脊柱侧弯病因查找及术前术后的综合评估起重要作用.

  15. Effects of Schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis.

    Science.gov (United States)

    Kim, Gichul; HwangBo, Pil-Neo

    2016-03-01

    [Purpose] The purpose of this study was to compare the effect of Schroth and Pilates exercises on the Cobb angle and body weight distribution of patients with idiopathic scoliosis. [Subjects] Twenty-four scoliosis patients with a Cobb angle of ≥20° were divided into the Schroth exercise group (SEG, n = 12) and the Pilates exercise group (PEG, n = 12). [Methods] The SEG and PEG performed Schroth and Pilates exercises, respectively, three times a week for 12 weeks. The Cobb angle was measured in the standing position with a radiography apparatus, and weight load was measured with Gait View Pro 1.0. [Results] In the intragroup comparison, both groups showed significant changes in the Cobb angle. For weight distribution, the SEG showed significant differences in the total weight between the concave and convex sides, but the PEG did not show significant differences. Furthermore, in the intragroup comparison, the SEG showed significant differences in the changes in the Cobb angle and weight distribution compared with the PEG. [Conclusion] Both Schroth and Pilates exercises were effective in changing the Cobb angle and weight distribution of scoliosis patients; however, the intergroup comparison showed that the Schroth exercise was more effective than the Pilates exercise. PMID:27134403

  16. Effects of Schroth and Pilates exercises on the Cobb angle and weight distribution of patients with scoliosis

    Science.gov (United States)

    Kim, Gichul; HwangBo, Pil-neo

    2016-01-01

    [Purpose] The purpose of this study was to compare the effect of Schroth and Pilates exercises on the Cobb angle and body weight distribution of patients with idiopathic scoliosis. [Subjects] Twenty-four scoliosis patients with a Cobb angle of ≥20° were divided into the Schroth exercise group (SEG, n = 12) and the Pilates exercise group (PEG, n = 12). [Methods] The SEG and PEG performed Schroth and Pilates exercises, respectively, three times a week for 12 weeks. The Cobb angle was measured in the standing position with a radiography apparatus, and weight load was measured with Gait View Pro 1.0. [Results] In the intragroup comparison, both groups showed significant changes in the Cobb angle. For weight distribution, the SEG showed significant differences in the total weight between the concave and convex sides, but the PEG did not show significant differences. Furthermore, in the intragroup comparison, the SEG showed significant differences in the changes in the Cobb angle and weight distribution compared with the PEG. [Conclusion] Both Schroth and Pilates exercises were effective in changing the Cobb angle and weight distribution of scoliosis patients; however, the intergroup comparison showed that the Schroth exercise was more effective than the Pilates exercise. PMID:27134403

  17. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas;

    2013-01-01

    PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: PubMed and Em......PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: Pub......Med and Embase databases were searched for studies reporting the outcomes and complications of NMS surgery, published from 1997 to May 2011. We focused on NMS as defined by the Scoliosis Research Society's classification. We measured the pooled estimate of the overall complication rates (PR) using a random....... In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2+ to 2-; the subsequent recommendations are level C. CONCLUSION: NMS patients have diverse and high complication rates after scoliosis surgery. High PRs...

  18. Reliability and validity of the adapted Greek version of scoliosis research society – 22 (SRS-22 questionnaire

    Directory of Open Access Journals (Sweden)

    Christodoulou Evangelos A

    2009-07-01

    Full Text Available Abstract Background The SRS-22 is a valid instrument for the assessment of the health related quality of life of patients with Idiopathic scoliosis. The SRS-22 questionnaire was developed in USA and has been widely used in the English speaking countries. Recently it has been translated and validated in many other languages. The purpose of this study is to evaluate the reliability and validity of the adapted Greek version of the refined Scoliosis Research Society-22 Questionnaire. Methods Following the steps of cross – cultural adaptation the adapted Greek version of the SRS-22 questionnaire and a validated Greek version of the SF-36 questionnaire were mailed to 68 patients treated surgically for Idiopathic Scoliosis. 51 out of the 68 patients returned the 1st set of questionnaires, while a second set was emailed to 30 randomly selected patients of the first time responders. 20 out of the 30 patients returned the 2nd set. The mean age at the time of operation was16,2 years and the mean age at the time of evaluation was 21,2 years. Descriptive statistics for content analysis were calculated. Reliability assessment was determined by estimating Cronbach's α and intraclass correlation coefficient (ICC respectively. Concurrent validity was evaluated by comparing SRS-22 domains with relevant domains in the SF-36 questionnaire using Pearson's Correlation Coefficient (r. Results The calculated Cronbach's α of internal consistency for three of the corresponding domains (pain 0.85; mental health 0.87; self image 0.83 were very satisfactory and for two domains (function/activity 0.72 and satisfaction 0.67 were good. The ICC of all domains of SRS-22 questionnaire was high (ICC>0.70, demonstrating very satisfactory or excellent test/retest reproducibility. Considering concurrent validity all correlations were found to be statistically significant at the 0.01 level among related domains and generally demonstrated high correlation coefficient. Conclusion

  19. Use of tranexamic acid for controlling bleeding in thoracolumbar scoliosis surgery with posterior instrumentation

    Directory of Open Access Journals (Sweden)

    Vinícius Magno da Rocha

    2015-04-01

    Full Text Available OBJECTIVE: Scoliosis surgery involves major blood loss and frequently requires blood transfusion. The cost and risks involved in using allogeneic blood have motivated investigation of methods capable of reducing patients' bleeding during operations. One of these methods is to use antifibrinolytic drugs, and tranexamic acid is among these. The aim of this study was to assess the use of this drug for controlling bleeding in surgery to treat idiopathic scoliosis.METHODS: This was a retrospective study in which the medical files of 40 patients who underwent thoracolumbar arthrodesis by means of a posterior route were analyzed. Of these cases, 21 used tranexamic acid and were placed in the test group. The others were placed in the control group. The mean volumes of bleeding during and after the operation and the need for blood transfusion were compared between the two groups.RESULTS: The group that used tranexamic acid had significantly less bleeding during the operation than the control group. There was no significant difference between the groups regarding postoperative bleeding and the need for blood transfusion.CONCLUSIONS: Tranexamic acid was effective in reducing bleeding during the operation, as demonstrated in other studies. The correlation between its use and the reduction in the need for blood transfusion is multifactorial and could not be established in this study. We believe that tranexamic acid may be a useful resource and that it deserves greater attention in randomized double-blind prospective series, with proper control over variables that directly influence blood loss.

  20. Transient Monoplegia as a Result of Unilateral Femoral Artery Ischemia Detected by Multimodal Intraoperative Neuromonitoring in Posterior Scoliosis Surgery

    Science.gov (United States)

    Pankowski, Rafal; Roclawski, Marek; Dziegiel, Krzysztof; Ceynowa, Marcin; Mikulicz, Marcin; Mazurek, Tomasz; Kloc, Wojciech

    2016-01-01

    Abstract This is to report a case of 16-year-old girl with transient right lower limb monoplegia as a result of femoral artery ischemia detected by multimodal intraoperative spinal cord neuromonitoring (MISNM) during posterior correction surgery of adolescent idiopathic scoliosis. A patient with a marfanoid body habitus and LENKE IA type scoliosis with the right thoracic curve of 48° of Cobb angle was admitted for posterior spinal fusion from Th6 to L2. After selective pedicle screws instrumentation and corrective maneuvers motor evoked potentials (MEP) began to decrease with no concomitant changes in somato-sensory evoked potentials recordings. The instrumentation was released first partially than completely with rod removal but the patient demonstrated constantly increasing serious neurological motor deficit of the whole right lower limb. Every technical cause of the MEP changes was eliminated and during the wake-up test the right foot was found to be pale and cold with no popliteal and dorsalis pedis pulses palpable. The patient was repositioned and the pelvic pad was placed more cranially. Instantly, the pulse and color returned to the patient's foot. Following MEP recordings showed gradual return of motor function up to the baseline at the end of the surgery, whereas somato-sensory evoked potentials were within normal range through the whole procedure. This case emphasizes the importance of the proper pelvic pad positioning during the complex spine surgeries performed in prone position of the patient. A few cases of neurological complications have been described which were the result of vascular occlusion after prolonged pressure in the inguinal area during posterior scoliosis surgery when the patient was in prone position. If incorrectly interpreted, they would have a significant impact on the course of scoliosis surgery. PMID:26871822

  1. Review of idiopathic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Recent advances in understanding of pancreatitis and advances in technology have uncovered the veils of idiopathic pancreatitis to a point where a thorough history and judicious use of diagnostic techniques elucidate the cause in over 80% of cases. This review examines the multitude of etiologies of what were once labeled idiopathic pancreatitis and provides the current evidence on each. This review begins with a background review of the current epidemiology of idiopathic pancreatitis prior to discussion of various etiologies. Etiologies of medications, infections, toxins,autoimmune disorders, vascular causes, and anatomic and functional causes are explored in detail. We conclude with management of true idiopathic pancreatitis and a summary of the various etiologic agents. Throughout this review, areas of controversies are highlighted.

  2. Idiopathic Pulmonary Fibrosis

    Science.gov (United States)

    ... Explore Idiopathic Pulmonary Fibrosis What Is... How the Lungs Work Other Names Causes Signs & Symptoms Diagnosis Treatments Living With Clinical Trials Links Related Topics How the Lungs Work Lung Transplant Pulmonary Hypertension Pulmonary Rehabilitation Respiratory Failure ...

  3. Juvenile idiopathic arthritis

    Science.gov (United States)

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It is thought to be an autoimmune illness . This means the body attacks ...

  4. Juvenile idiopathic arthritis: the paediatric perspective

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, Alison [Birmingham Children' s Hospital, Department of Adolescent Rheumatology, Birmingham (United Kingdom); McDonagh, Janet E. [Birmingham Children' s Hospital, Institute of Child Health, Birmingham (United Kingdom)

    2006-08-15

    Paediatric rheumatology is a relatively new specialty that has developed rapidly over the last 30 years. There have been major advances, which have included improvements in the classification and management of juvenile idiopathic arthritis (JIA). The former has led to enhanced international collaboration with disease registries, multicentre research and the development of new therapeutic agents. This has resulted in improved disease control and remission induction in many. There is, however, still significant morbidity associated with JIA during childhood, adolescence and adulthood, and challenges for the future include early identification of those with a poorer prognosis, appropriate administration of safe therapies and optimizing outcomes as young people move through adolescence into adulthood. (orig.)

  5. Juvenile idiopathic arthritis: a clinical overview

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J

    2000-02-01

    The chronic arthritides in childhood remain a poorly understood group of conditions. Their classification has been a source of much confusion over the years with differences in terminology between Europe and North America. A significant step forward in paediatric rheumatology has been the recent development of an internationally agreed classification system which uses the overall term juvenile idiopathic arthritis (JIA). The various subtypes of JIA and their clinical features are described, together with an overview of their differential diagnosis, complications and outcomes. An outline of current management strategies is given and potential future developments highlighted.

  6. Idiopathic Gingival Hyperplasia

    OpenAIRE

    Cekmez, Ferhat; Pirgon, Ozgur; Tanju, Ilhan Asya

    2009-01-01

    Gingival hyperplasia is a rare condition but it is important for cosmetic and mechanic reasons and because of its potential as an indicator of systemic disease. Gingival fibromatosis may exist as an isolated abnormality or as part of a syndrome. In this article a case that was diagnosed clinically and histologically as idiopathic gingival fibromatosis is presented. Patient with gingival hyperplasia should be examined to exclude other reasons to determine the idiopathic gingival fibromatosis o...

  7. Asymmetries of the shoulder and pelvic girdles in girls with scoliosis and scoliotic posture

    Directory of Open Access Journals (Sweden)

    Jacek Wilczyński

    2013-08-01

    Full Text Available Aim of the research: To evaluate the asymmetries of the shoulder and pelvic girdles in girls aged 7–18 with scoliosis and scoliotic posture. Material and methods: The children were enrolled at the Międzyszkolny Ośrodek Gimnastyki Korekcyjnej i Kompensacyjnej (Interschool Corrective and Compensatory Gymnastics Centre in Starachowice. The research was carried out in June 2011. 3D digital photogrammetry using the moiré effect was adopted in the research. Depending on the conformity of the variables’ distributions with the normal distribution, and the values of skewness and kurtosis, parametric or non-parametric tests were adopted. The variables were verified in terms of normal distribution with the Shapiro-Wilk test. A screening analysis of the parameters of physiological curvatures of the spine in age groups was also carried out. The relation between the frequency and type of disorders in the frontal plane and age was determined using the χ 2 test. Value of p ≤ 0.05 was assumed as the level of significance. Results: Based on the size of the angle of the curvature of the spine the following were singled out scoliotic posture (1–9° and idiopathic scoliosis (≥ 10°. There were 21 (75% children with the scoliotic posture and 7 (25% with idiopathic scoliosis. The frequency and type of disorders in the frontal plane does not depend on the age of the examined. Asymmetry of the shoulders and shoulder blades was found in all of the examined. The left shoulder along with the left shoulder blade were raised more often. The right side of the pelvis was lowered in most of the examined. Posterior rotation of the left hip bone occurred more often. Conclusions: The values of WBM, WBK and WBC asymmetry coefficients confirm the asymmetry of the shoulder and hip girdles. Analysis of variance did not show any significant relations of asymmetry of the shoulder and hip girdles and the age of the examined.

  8. The therapeutic effects of Cheneau orthosis with different pressure areas on adolescent idiopathic scoliosis%舍努式矫形器压力面积对青少年特发性脊柱侧凸疗效的影响

    Institute of Scientific and Technical Information of China (English)

    李丹; 王楚怀; 赖建洋; 许轶

    2008-01-01

    目的 通过比较2组特发性脊柱侧凸患者穿戴不同压力面积舍努式矫形器后的疗效,以期为临床设计、制作舍努式矫形器提供参考资料.方法 选取T6以下椎体为顶椎的特发性脊柱侧凸青少年患者30例,将其随机分为A,B两组,分别穿戴跨度为3个椎体面积和5~6个椎体面积作为压力区域的舍努式矫形器,并测量装配前、后科布氏(Cobb)角和顶椎旋转角度以及穿戴矫形器后的疼痛指数.结果 A组患者Cobb角的矫正率为17%,B组患者Cobb角的矫正率为29%,组间差异具有统计学意义(P0.05);A组患者疼痛指数为5.00,B组为2.07,组间差异具有统计学意义(P0.05). Pain index was 5.00 in group A, and 2.07 in group B, which was statistically different (P<0.05). Conclusions Increasing pressure points' areas of Cheneau orthosis properly can improve more effectively the lateral curvature angle of the patients with adolescent idiopathic seoliosis.

  9. Scoliosis in cystic fibrosis - an appraisal

    International Nuclear Information System (INIS)

    An unusually high prevalence (10%) of scoliosis is described in a series of 151 patients aged four years and older with cystic fibrosis. The scolioses were of the late onset (juvenile and adolescent) type, being typically thoracic with the curve convex to the right, although there was no significant preference for either sex. No direct relationship was found between the spinal curvature and the severity or distribution of the lung disease, although the worse scolioses tended to occur in patients with relatively severe pulmonary involvement. There was no evidence of metabolic bone disease as a predisposing cause. Some indication of a familial tendency towards scoliosis was apparent, and a genetic or constitutional basis is postulated with an unknown precipitating factor. (orig.)

  10. Richard's back: death, scoliosis and myth making.

    Science.gov (United States)

    Lund, Mary Ann

    2015-12-01

    The body of a mediaeval monarch was always under scrutiny, and Richard III's was no exception. In death, however, his body became subject to new forms of examination and interpretation: stripped naked after the battle of Bosworth, his corpse was carried to Leicester and exhibited before being buried. In 2012, it was rediscovered. The revelation that Richard suffered from scoliosis prompts this article to re-evaluate the historical sources about Richard's physique and his posthumous reputation. This article argues that Richard's death and his myth as 'crookback' are inextricably linked and traces attitudes to spinal curvature in the early modern period. It also considers how Shakespeare represented Richard as deformed, and aspects of performance history which suggest physical vulnerability. It then considers Richard's scoliosis from the perspective of medical history, reviewing classical accounts of scoliosis and arguing that Richard was probably treated with a mixture of axial traction and pressure. It demonstrates from the evidence of Richard's medical household that he was well placed to receive hands-on therapies and considers in particular the role of his physician and surgeon, William Hobbes. Finally, it shows how the case of Richard III demonstrates the close relationship between politics and medicine in the period and the contorted process of historical myth making.

  11. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  12. Clinical presentation and surgical treatment of scoliosis in Marfan syndrome

    Institute of Scientific and Technical Information of China (English)

    LI Qi-yi; QIU Gui-xing; WANG Yi-peng; ZHANG Jian-guo; SHEN Jian-xiong; WENG Xi-sheng; Wang Ting; LEE Chia-I; YU Sheng-ji

    2005-01-01

    @@ Marfan syndrome (MFS) as an autosomal dominant connective tissue disease is characterized by ocular,cardiovascular,and skeletal deformities including scoliosis.1,2 A group of 12 patients with Marfan syndrome associated with scoliosis were surgically treated at our hospital from January 1990 to January 2004.

  13. Development of Scoliosis Research Society outcomes instrument%脊柱侧凸研究会患者问卷表的研究进展

    Institute of Scientific and Technical Information of China (English)

    周惠清; 林思舜; 张建新; 柳明忠; 林松庆; 苏再发

    2009-01-01

    @@ 脊柱侧凸患者生活质量的评价已越来越受到众多临床专家的关注和重视,临床中随着三维矫形理论和内固定器械的发展,青少年特发性脊柱侧凸(adolescent idiopathic scoliosis, AIS)的治疗取得了长足的进步.对于AIS治疗效果的评价既往主要是基于放射学检查结果.

  14. Application of Image Processing Technique in Scoliosis Detection%图像处理技术在脊柱侧弯检查中的应用

    Institute of Scientific and Technical Information of China (English)

    吕东辉; 顼超静; 孙九爱

    2012-01-01

    脊柱侧弯是指脊柱偏离其中心线的畸形生长,是一种常发生在青少年人群中的特发性疾病.本文通过对现有的脊柱侧弯检查方法的分析,指出了利用图像处理技术对青少年脊柱侧弯检测的优越性.主要介绍了两类脊柱侧弯检测的图像处理方法:一类为提取莫尔图像的非对称特征,将其与Cobb角相联系进行检测;另一类为利用不同的光学成像方法对人体背部进行三维重建,然后根据提取的三维特征对脊柱侧弯进行检测.两类方法的相似点在于都涉及到人体背部的对称性的判别问题.最后,对图像处理技术在脊柱侧弯方面的进一步应用做了展望.%Scoliosis,the abnormal lateral curvature of the spine,is an idiopathic disease often suffered by teenagers. Normally medical doctors use X-rays to measure the Cobb angle,and then assess the severity of scoliosis with it. In this paper,we point out the superiorities of image processing technique through analyzing the existing methods in the diagnosis of scoliosis. Two kinds of image processing technique are mainly introduced for scoliosis detection. The moire stripe images show an asymmetric deformation pattern between the left-hand side and the right-hand side of human back,and these associate with Cobb angle to detect scoliosis. In order to check scoliosis through accurate three-dimensional surface features of human back,we in the second technique use different optical imaging methods to reconstruct the three-dimensional surface model of the patient's back,and extract the characteristics of the reconstructive human back to diagnose the disease. Both approaches tried to describe symmetry discrimination of human back and correlated it with the Cobb angles. Finally,we look forward to the future development in the application of image processing technique for scoliosis detection.

  15. Resultados imediatos da correção cirúrgica de escoliose idiopática do adolescente por via posterior com instrumentação após liberação anterior por videotoracoscopia Resultados inmediatos de la corrección quirúrgica de escoliosis idiopática del adolescente por vía posterior con instrumentación después de liberación anterior por videotoracoscopia Short term results of surgical correction of adolescents' idiopathic scoliosis by posterior approach instrumentation following videothoracoscopic anterior release

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2009-12-01

    videotoracoscopia y después la vía posterior para corrección y fijación con instrumental de Hartshill, en un mismo tiempo quirúrgico. RESULTADOS: todos los procedimientos fueron completados con suceso con videotoracoscopia, sin necesidad de conversión para toracotomía. El promedio de edad de los pacientes fue de 15.7 años (12 a 21 años. En relación a los días de internación, se obtuvo un tiempo promedio de permanencia de 9.45 días (5 a 26 días. El promedio entre los valores angulares fue, en el pre operatorio, de 66.25º Cobb (48º a 92º Cobb, y en el postoperatorio fue de 31.2º Cobb (15º a 45º Cobb. Como complicaciones, cuatro pacientes tenían neuralgia intercostal (20% y había un caso de atelectasia (5%. CONCLUSIONES: la disectomía por videotoracoscopia es un método efectivo y seguro para tornar flexibles las curvas escolióticas rígidas. Sin embargo, se trata de un procedimiento técnicamente difícil, que requiere entrenamiento arduo y prolongado, con curva de aprendizaje extensa.OBJECTIVE: to describe the initial results of anterior videothoracoscopic release followed by posterior instrumentation for surgical correction of adolescent idiopathic scoliosis. METHODS: twenty patients were selected, between August 1989 and May 2001, with stiff, King III, right thoracic adolescent idiopathic scoliosis. They underwent anterior videothoracoscopic release followed by posterior correction and fixation with Hartshill instrumentation, performed in a single surgical stage. RESULTS: all procedures were successfully completed with videothoracoscopy, without need to convert to thoracotomy. The average age was 15.7 years (12 to 21 years. Concerning the length of hospital stay, there was a mean of 9.45 days (5 to 26 days. The preoperative Cobb angle average was 66.25º (48º to 92º, and the mean postoperative Cobb angle was 31.2º (15º to 45º. As complications, there were four patients with intercostal neuralgia (20% and one with atelectasis (5%. CONCLUSIONS: the

  16. Associations between body mass and the outcome of surgery for scoliosis in Chinese adults.

    Directory of Open Access Journals (Sweden)

    Ziqiang Chen

    Full Text Available BACKGROUND: In this study we intended to prove that being overweight has an unfavorable impact on the surgical treatment outcome of adult idiopathic scoliosis (AdIS. METHODS: This is a retrospective study on the surgical treatment of seventy-one more than 30 years old (58 females and 13 males; mean age 42.9±12.2 idiopathic scoliotic patients with a minimum follow up of at least 2 years. The patients were divided into an overweight group (BMI≥23 and a non-overweight group (BMI<23. Preoperative, postoperative first erect and final follow-up radiographic measures, perioperative data, the Oswestry disability index (ODI, and the visual analog scale (VAS were reviewed and compared. FINDINGS: In the overweight group, no significant differences in radiographic measures, perioperative data, preoperative comorbidities, or postoperative complications, except for the more frequent concomitance of preoperative thoracic kyphosis 37.9±7.7 vs. 26.5±11.8 (P = 0.000 and thoracolumbar kyphosis 14.9±10.1 overweighted group vs. 6.5±9.9 non-overweighted group respectively (P = 0.002 were found. A higher morbidity of hypertension 36.8% vs. 9.6% (P = 0.004 was also observed in the overweight group. Postoperative ODI and VAS improved significantly in both groups compared to pre-operative values. The postoperative ODI of the overweight group (19.6±12.4 was significantly higher than that of the non-overweight group (12.4±7.9 (P = 0.022. CONCLUSIONS: Overweight adult idiopathic scoliotic patients had more frequent concomitance of preoperative thoracic kyphosis and thoracolumbar kyphosis and more serious postoperative pain. However, BMI did not affect the outcomes of surgical correction for coronal and sagittal scoliotic deformity and their postoperative complication rates were not significantly affected.

  17. The long-term outcome of patients treated operatively and non-operatively for scoliosis deformity secondary to spina bifida.

    Science.gov (United States)

    Khoshbin, A; Vivas, L; Law, P W; Stephens, D; Davis, A M; Howard, A; Jarvis, J G; Wright, J G

    2014-09-01

    The purpose of this study was to evaluate the long-term outcome of adults with spina bifida cystica (SBC) who had been treated either operatively or non-operatively for scoliosis during childhood. We reviewed 45 patients with a SBC scoliosis (Cobb angle ≥ 50º) who had been treated at one of two children's hospitals between 1991 and 2007. Of these, 34 (75.6%) had been treated operatively and 11 (24.4%) non-operatively. After a mean follow-up of 14.1 years (standard deviation (sd) 4.3) clinical, radiological and health-related quality of life (HRQOL) outcomes were evaluated using the Spina Bifida Spine Questionnaire (SBSQ) and the 36-Item Short Form Health Survey (SF-36). Although patients in the two groups were demographically similar, those who had undergone surgery had a larger mean Cobb angle (88.0º (sd 20.5; 50.0 to 122.0) ; : versus 65.7º (sd 22.0; 51.0 to 115.0); p scoliosis corrects coronal deformity and stops progression of the curve but has no clear effect on HRQOL.

  18. Tocilizumab in the treatment of systemic juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Murakami M

    2012-07-01

    Full Text Available Miho Murakami,1 Minako Tomiita,2,3 Norihiro Nishimoto11Laboratory of Immune Regulation, Wakayama Medical University, Wakayama, 2Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, 3Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, JapanAbstract: Systemic juvenile idiopathic arthritis is one of the common rheumatic diseases in childhood and characterized by spiking fever, evanescent skin rash, lymphadenopathy, hepatosplenomegaly, and serositis, in addition to arthritis. Children with systemic juvenile idiopathic arthritis often show growth retardation and developmental abnormality, as well as macrophage activation syndrome, a life-threatening complication. Overproduction of interleukin-6 is pathologically responsible for the systemic inflammatory manifestations and abnormal laboratory results with systemic juvenile idiopathic arthritis. Thus, tocilizumab, a humanized antihuman interleukin-6 receptor antibody, has been developed as a therapeutic agent for the disease. A series of clinical studies have demonstrated the excellent efficacy and safety of tocilizumab for patients with active disease. Tocilizumab was approved for systemic juvenile idiopathic arthritis in Japan in 2008 and in the European Union and the United States in 2011.Keywords: systemic juvenile idiopathic arthritis, tocilizumab, antihuman interleukin-6 receptor antibody, biologics

  19. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

    Juvenile idiopathic arthritis is a heterogeneous group of diseases characterised by arthritis of unknown origin with onset before age of 16 years. Pivotal studies in the past 5 years have led to substantial progress in various areas, ranging from disease classification to new treatments. Gene expres

  20. Association of human parvovirus B19 infection and childhood idiopathic thrombocy-topenic purpura: a meta analysis of Chinese literatures%人微小病毒B19感染与儿童特发性血小板减少性紫癜关系的meta分析

    Institute of Scientific and Technical Information of China (English)

    张耀东; 胡群; 刘双又; 刘爱国; 王冠玲; 熊昊; 孙燕

    2009-01-01

    Objective To study the relationship between human parvovirus B19 infection and childhood idiopathic thrombocytopenic purpura ( FTP) by the principle of evidence based medicine. Methods Papers related to the relationship between human parvovirus B19 infection and childhood ITP published between 1994 and 2008 were retrieved electronically from the Chinese Journals Full-text Database and the Wanfang Data. These relevant papers on case-control trials were statistically studied by meta analysis. Results Eight papers that met the inclusion criteria were included for this meta analysis. Five hundred and sixteen cases of childhood ITP and 246 healthy controls were enrolled. The meta analysis showed that the incidence of human parvovirus B19 infection in the ITP group was significantly higher than that in the control group ( OR = 13. 71, 95% CI = 7. 07-26. 59, Z = 7. 75, P < 0. 01). Conclusions Human parvovirus B19 infection is closely associated with childhood ITP.%目的 综合分析人微小病毒B19感染与儿童特发性血小板减少性紫癜(ITp)的关系.方法 计算机检索中国期刊全文数据库、万方数据库,检索时间从1994~2008年,纳入人微小病毒B19感染与儿童ITP关系的病例对照研究,对文献数据进行meta分析.结果 共纳入8个研究,其中病例组516例,对照组246例.meta分析显示人微小病毒B19感染在病例组的表达高于对照组(OR=13.71,95% CI=7.07~26.59,Z=7.75,P<0.01).结论 人微小病毒B19感染与儿童ITP的发病有密切相关性.

  1. COMPARISON OF COBB ANGLE MEASUREMENT IN SCOLIOSIS BY RESIDENTS AND SPINE EXPERTS

    Directory of Open Access Journals (Sweden)

    Rafael Ritter

    2016-03-01

    Full Text Available ABSTRACT Objective: The adolescent idiopathic scoliosis (AIS is a spine deformity that occurs in both the coronal plane and the sagittal plane of patients between 10 and 17 years. The Cobb method is the most widely used to determine the angular value of scoliosis and it is defined as the "gold standard". The goal is to verify the reproducibility of the measured angles between orthopedic residents and spinal pathologies specialists, comparing the variability of the angles measured by professionals with greater and lesser experience. Method: A total of 10 radiographs of patients diagnosed with AIS were assessed. Radiographs were handed over to 7 orthopedists specialized in spine and 14 orthopedic residents. The measurement of the angles for each of the examiners was described using means and standard deviations and intraclass correlations were calculated, as well as the measure of repeatability, and Bland-Altman plots were designed with the results of the measurements of each group of examiners, according to experience, to assess the agreement/reproducibility of Cobb angle measurements. Results: Each examiner obtained a resulting average of 10 cases summation. In order to assess trends in variability of the measurements of the angles of each group graphs were plotted based on the arithmetic mean of each of the 10 cases by the total number of participants in the group versus the standard deviation in each case. Conclusion: There was a poor correlation (ICC=0.4 in the measurement of Cobb in both groups, demonstrating difficulties in the method, which cannot be overcome by the expertise.

  2. Estimation of the stress related to conservative scoliosis therapy: an analysis based on BSSQ questionnaires

    Directory of Open Access Journals (Sweden)

    Szulc Andrzej

    2007-01-01

    Full Text Available Abstract Background Adolescent girls treated with a brace for scoliosis are submitted to prolonged stress related to both the disease and the therapy. Currently proposed quality of life questionnaires are focused on the outcome of therapy. Bad Sobernheim Stress Questionnaire (BSSQ enables monitoring of patients being under treatment with a brace or exercises. The aim of the study was to assess the stress level in conservatively managed scoliotic girls using BSSQ. Materials and methods 111 girls, aged 14,2 ± 2,2 years, mean Cobb angle of the primary curve 42,8° ± 17,0° and mean Bunnell angle of 11,4° ± 4,5° were examined with two versions of BSSQ (Deformity and Brace. The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. Results The BSSQ Deformity revealed the median of 17 points in patients managed with exercises (from 4 to 24 points, 18 in patients managed with a brace (from 8 to 24 points and 12 in patients before surgery (from 3 to 21 points. Braced patients who completed both questionnaires (n = 50 revealed significantly higher score with BSSQ Deformity (median = 18 comparing to BSSQ Brace (median = 9. There was a correlation between the total score of BSSQ Deformity and the Cobb angle (r = -0,34, Bunnell primary curve rotation (r = -0,34 and Bunnell sum of rotation (r = -0,33 but not with the age of patients. Conclusion Scoliotic adolescents managed with exercises and brace suffered little stress from the deformity. The brace increased the level of stress over the stress induced by the deformity. The stress level correlated with clinical deformity (Bunnell angle, radiological deformity (Cobb angle and the type of treatment (exercises, bracing, surgery. Bad Sobernheim Stress Questionnaires are simple and helpful in the management of girls treated conservatively for idiopathic scoliosis.

  3. Idiopathic focal epilepsies: the "lost tribe".

    Science.gov (United States)

    Pal, Deb K; Ferrie, Colin; Addis, Laura; Akiyama, Tomoyuki; Capovilla, Giuseppe; Caraballo, Roberto; de Saint-Martin, Anne; Fejerman, Natalio; Guerrini, Renzo; Hamandi, Khalid; Helbig, Ingo; Ioannides, Andreas A; Kobayashi, Katsuhiro; Lal, Dennis; Lesca, Gaetan; Muhle, Hiltrud; Neubauer, Bernd A; Pisano, Tiziana; Rudolf, Gabrielle; Seegmuller, Caroline; Shibata, Takashi; Smith, Anna; Striano, Pasquale; Strug, Lisa J; Szepetowski, Pierre; Valeta, Thalia; Yoshinaga, Harumi; Koutroumanidis, Michalis

    2016-09-01

    The term idiopathic focal epilepsies of childhood (IFE) is not formally recognised by the ILAE in its 2010 revision (Berg et al., 2010), nor are its members and boundaries precisely delineated. The IFEs are amongst the most commonly encountered epilepsy syndromes affecting children. They are fascinating disorders that hold many "treats" for both clinicians and researchers. For example, the IFEs pose many of the most interesting questions central to epileptology: how are functional brain networks involved in the manifestation of epilepsy? What are the shared mechanisms of comorbidity between epilepsy and neurodevelopmental disorders? How do focal EEG discharges impact cognitive functioning? What explains the age-related expression of these syndromes? Why are EEG discharges and seizures so tightly locked to slow-wave sleep? In the last few decades, the clinical symptomatology and the respective courses of many IFEs have been described, although they are still not widely appreciated beyond the specialist community. Most neurologists would recognise the core syndromes of IFE to comprise: benign epilepsy of childhood with centro-temporal spikes or Rolandic epilepsy (BECTS/RE); Panayiotopoulos syndrome; and the idiopathic occipital epilepsies (Gastaut and photosensitive types). The Landau-Kleffner syndrome and the related (idiopathic) epilepsy with continuous spikes and waves in sleep (CSWS or ESES) are also often included, both as a consequence of the shared morphology of the interictal discharges and their potential evolution from core syndromes, for example, CSWS from BECTS. Atypical benign focal epilepsy of childhood also has shared electro-clinical features warranting inclusion. In addition, a number of less well-defined syndromes of IFE have been proposed, including benign childhood seizures with affective symptoms, benign childhood epilepsy with parietal spikes, benign childhood seizures with frontal or midline spikes, and benign focal seizures of adolescence. The

  4. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  5. Idiopathic focal epilepsies: the "lost tribe".

    Science.gov (United States)

    Pal, Deb K; Ferrie, Colin; Addis, Laura; Akiyama, Tomoyuki; Capovilla, Giuseppe; Caraballo, Roberto; de Saint-Martin, Anne; Fejerman, Natalio; Guerrini, Renzo; Hamandi, Khalid; Helbig, Ingo; Ioannides, Andreas A; Kobayashi, Katsuhiro; Lal, Dennis; Lesca, Gaetan; Muhle, Hiltrud; Neubauer, Bernd A; Pisano, Tiziana; Rudolf, Gabrielle; Seegmuller, Caroline; Shibata, Takashi; Smith, Anna; Striano, Pasquale; Strug, Lisa J; Szepetowski, Pierre; Valeta, Thalia; Yoshinaga, Harumi; Koutroumanidis, Michalis

    2016-09-01

    The term idiopathic focal epilepsies of childhood (IFE) is not formally recognised by the ILAE in its 2010 revision (Berg et al., 2010), nor are its members and boundaries precisely delineated. The IFEs are amongst the most commonly encountered epilepsy syndromes affecting children. They are fascinating disorders that hold many "treats" for both clinicians and researchers. For example, the IFEs pose many of the most interesting questions central to epileptology: how are functional brain networks involved in the manifestation of epilepsy? What are the shared mechanisms of comorbidity between epilepsy and neurodevelopmental disorders? How do focal EEG discharges impact cognitive functioning? What explains the age-related expression of these syndromes? Why are EEG discharges and seizures so tightly locked to slow-wave sleep? In the last few decades, the clinical symptomatology and the respective courses of many IFEs have been described, although they are still not widely appreciated beyond the specialist community. Most neurologists would recognise the core syndromes of IFE to comprise: benign epilepsy of childhood with centro-temporal spikes or