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Sample records for scoliosis ais treated

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    , is comparable to modern equipment. This is to our knowledge the first study to report increased rates of endometrial cancers in a cohort of AIS patients, and future attention is needed to reduce the radiation dose distributed to the AIS patients both pre-operatively and during surgery.......PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence....... RESULTS: From the original cohort of 215 consecutive AIS patients, radiation information was available in 211 of the patients, and medical charts were available in 209 AIS patients. 170 (83 %) of the 205 AIS patients participated in the follow-up study with questionnaires. The calculated mean total...

  2. Anterior or posterior surgery for right thoracic adolescent idiopathic scoliosis (AIS)? A prospective cohorts' comparison using radiologic and functional outcomes.

    Science.gov (United States)

    Rushton, Paul R P; Grevitt, Michael P; Sell, Philip J

    2015-04-01

    Prospective cohort study. Prospectively compare patient-reported as well as clinical and radiologic outcomes after anterior or posterior surgery for right thoracic adolescent idiopathic scoliosis (AIS) in a single center by the same surgeons. Anterior and posterior spinal instrumentation and arthrodesis are both well-established treatments of thoracic AIS. The majority of studies comparing the 2 approaches have focused on radiographic outcomes. There remains a paucity of prospectively gathered patient-reported outcomes comparing surgical approaches. Forty-two consecutive patients with right thoracic AIS were treated in a single center by one of 2 surgeons with either anterior (n=18) or posterior (n=24) approaches and followed up for over 2 years. Radiographic, clinical, and patient-reported outcomes of the Modified Scoliosis Research Society Outcome Instrument were gathered and analyzed by an independent surgeon. Patients reported significant improvements in all areas of the Modified Scoliosis Research Society Outcome Instrument, especially pain and self-image domains. There were no significant differences in the degree of improvement in any domains between the groups. Posterior and anterior surgery corrected rib hump by 53% and 61%, respectively (P=0.4). The Main thoracic curve Cobb angle was corrected from 69 to 26 degrees (62%) by posterior surgery and 61 to 23 degrees (64%) by anterior surgery (P=0.6). Posterior surgery significantly reduced kyphosis and lumbosacral lordosis. Anterior surgery had no overall affect of sagittal alignment but seemed able to correct those hypokyphotic preoperatively. Complications differed and were largely approach-related--intrathoracic in anterior and wound-related in posterior surgery. Patients with right thoracic AIS of differing curve types but otherwise similar preoperatively demonstrated that anterior and posterior surgery are largely equivalent. Patient-reported outcomes are improved similarly by either approach. Both offer

  3. Do adolescent idiopathic scoliosis (AIS neglect proprioceptive information in sensory integration of postural control?

    Directory of Open Access Journals (Sweden)

    Christine Assaiante

    Full Text Available INTRODUCTION: It has been reported that AIS rely much more on ankle proprioception to control the amplitude of the balance control commands as compared to age-matched healthy adolescents. Our hypothesis was that AIS do not neglect proprioceptive information to control posture probably because of their vestibular deficits. We investigated the proprioceptive contribution to postural control in AIS which expresses spinal deformity during a crucial transitional period of ontogenesis. METHODS: 10 adolescents with idiopathic scoliosis (AIS with moderate spinal deformity (10° 35° and 10 control adolescents (CA had to maintain vertical stance while very slow oscillations in the frontal plane (below the detection threshold of the semicircular canal system were applied to the support with the eyes open and closed. Postural orientation and segmental stabilisation were analysed at head, shoulder, trunk and pelvis levels. RESULTS: Scoliosis did not affect vertical orientation control and segmental stabilization strategies. Vision improves postural control in both CA and AIS, which seem more dependent on visual cues than adults. CONCLUSIONS: AIS as CA were unable to control efficiently their postural orientation on the basis of the proprioceptive cues, the only sensory information available in the EC situation, whereas in the same condition healthy young adults present no difficulty to achieve the postural control. This suggests that AIS as CA transitory neglect proprioceptive information to control their posture. These results and previous studies suggest the existence of different afferent pathways for proprioceptive information subserving different parts in sensory integration of postural control. We conclude that the static proprioceptive system is not affected by the idiopathic scoliosis, while the dynamic proprioceptive system would be mainly affected.

  4. The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review.

    Science.gov (United States)

    Weiss, H-R; Goodall, D

    2008-06-01

    Traditionally, the treatment options for adolescent idiopathic scoliosis (AIS), the most common form of scoliosis, are exercises; in-patient rehabilitation; braces and surgery. The outcomes of treatments are usually compared with the natural history or observation (non-intervention). The aim of this paper was to provide a synopsis of all treatment options in the light of evidence based practice (EBP). A systematic review was carried out using the most encompassing databases available. Literature has been searched for the outcome parameter ''rate of progression'' and only prospective controlled studies that have considered the treatment versus the natural history have been included. The search strategy included the following terms: ''adolescent idiopathic scoliosis''; ''idiopathic scoliosis''; ''natural history''; ''observation''; ''physiotherapy''; ''physical therapy''; ''rehabilitation''; ''bracing''; ''orthotics'' and ''surgery''. Prospective short-term studies have been found to support outpatient physiotherapy. One prospective controlled study was found to support scoliosis in-patient rehabilitation (SIR). One prospective multi-centre study, a long-term prospective controlled study and a meta-analysis have been found to support bracing. No controlled study, neither short, mid nor long-term, was found to reveal any substantial evidence to support surgery as a treatment for this condition. There is some evidence supporting the conservative treatment for AIS. No substantial evidence has been found in terms of prospective controlled studies to support surgical intervention. In light of the unknown long-term effects of surgery, a randomised controlled trial (RCT) seems necessary. Due to the presence of evidence to support conservative treatments, a plan to compose a RCT for conservative treatment options seems unethical. But it is also important to conclude that the evidence for conservative treatments is weak in number and length.

  5. Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci

    2014-06-01

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

  6. HRQoL assessment by SRS-30 for Chinese patients with surgery for Adolescent Idiopathic Scoliosis (AIS).

    Science.gov (United States)

    Ng, Bobby Kin Wah; Chau, Wai-Wang; Hui, Chak-Na; Cheng, Po-Yin; Wong, Chau-Yuet; Wang, Bin; Cheng, Jack Chun Yiu; Lam, Tsz Ping

    2015-01-01

    Health-related quality of life (HRQoL) outcome questionnaire, Scoliosis Research Society (SRS)-30, had been well received since its establishment in 2003. Literatures from Asia on the use of SRS-30 mainly focused on the translation process and validation process, but not on measuring outcomes, particularly in the Chinese community. We carried out a prospective cohort study to evaluate the HRQoL of Chinese AIS adolescents with severe scoliosis after surgery. One hundred and four Chinese AIS patients with severe scoliosis undergoing posterior spinal fusion between 2009 and 2013 were recruited in this study. They completed SRS-30 questions before surgery, before hospital discharge, and at follow-up. Mean scores and percentages of individual scores in different domains, and composite scores in terms of subtotal and total scores were calculated referring to the scoring system. Gender-specific and period-specific descriptive analyses were described. Correlation of mean domain scores at the three time points were explored to look for any time-specific relationship. Linear regression analysis looking for potential risk factors on domain scores at different time points by gender were also carried out. Mean age was 16.28 at surgery, and 83.6% were female. Significant correlations between pre-op scores and scores after surgery were observed in function/activity domain (p=0.05) in males, and pain (p=0.04) and satisfaction with management (p=0.04) domains in females. No gender difference in all 5 domain scores at the 3 time points was found. Pre-op maximum Cobb angle and corrected angle were found to be risk factors on self-image, as well as satisfaction with management, in male and female patients. This is the first report on the evaluation of the clinical HRQoL outcomes of Chinese AIS patients with severe scoliosis after surgery. Medical professionals should pay attention to take care of the difference in personal perceptions of feelings between boys and girls. Special care

  7. Scoliosis

    International Nuclear Information System (INIS)

    Rowe, L.J.; Yochum, T.R.

    1987-01-01

    The term ''scoliosis'' is usually credited to Hippocrates. Its derivation is from the Greek word ''skolios'', meaning twisted or crooked. Within the disciplines of orthopedics and radiology scoliosis describes any lateral deviation of the spine from the midsagitttal plane. A review of the past and present literature available on this subject reveals a voluminous amount of information and sophisticated research. This chapter is not an encyclopedic compilation of this data but represents a presentation of the fundamental concepts, principles, and knowledge, particularly in relation to the role, evaluation, and clinical application of the radiological examination

  8. 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

    2016-02-01

    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. 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. 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. 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. . 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. 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 QOL. 2.

  9. Congenital scoliosis - presentation of three severe cases treated conservatively.

    Science.gov (United States)

    Weiss, H-R

    2008-01-01

    In view of the very limited data about conservative treatment of patients with congenital scoliosis (CS) available, early surgery is suggested already in mild cases with formation failures in the first three years of life. It is common sense that patients with failures of segmentation will not benefit from conservative treatment at all and the same applies to failures of formation with curves of >50 degrees in infancy. Two patients with rib synostosis denied surgery before entering the pubertal growth spurt. These patients have been treated conservatively with braces and Scoliosis In-Patient Rehabilitation (SIR) and now are beyond the pubertal growth spurt. One patient with a formation failure and a curve of >50 degrees lumbar has been treated with the help of braces and physiotherapy from 1.6 years on and is still under treatment now at the age of 15 years. Severe decompensation was prevented in the two patients with failure of segmentation, however a severe thoracic deformity is evident with underdeveloped lung function and severe restrictive ventilation disorder. The patient with failure of formation is well developed, now without cosmetic or physical complaints although his curve progressed at the end of the growth spurt due to final mal-compliance. Failures of segmentation should be advised to have surgery before entering the pubertal growth spurt. In case they deny, conservative treatment can at least in part be beneficial. For patients with failures of formation conservative treatment should be suggested in the first place because long-term outcomes of early surgery beyond pubertal growth spurt are not yet revealed.

  10. Ai

    African Journals Online (AJOL)

    :=g=~!Ai~~~~~g~~ ~~~~~~. Jim Taylor, Rob O'Donoghue and Alistair Clacherty. INTRODUCTION. The Department of Environment Affairs, in cooperation with ...

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

    Science.gov (United States)

    Lebel, Andrea; Lebel, Victoria Ashley

    2016-01-01

    . The patient in this case presentation was successfully treated with Schroth physiotherapy. Long-term comprehensive Schroth physiotherapy, to help correct and maintain proper posture in all aspects of daily living, should be part of scoliosis management for adult scoliosis patients in Canada to stop and reverse curve progression and to improve overall quality of life.

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

    Directory of Open Access Journals (Sweden)

    Andrea Lebel

    2016-10-01

    of PSSE, is shown to be effective in this case presentation. The patient in this case presentation was successfully treated with Schroth physiotherapy. Long-term comprehensive Schroth physiotherapy, to help correct and maintain proper posture in all aspects of daily living, should be part of scoliosis management for adult scoliosis patients in Canada to stop and reverse curve progression and to improve overall quality of life.

  13. 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.

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

    NARCIS (Netherlands)

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

    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

  15. Adolescent idiopathic scoliosis (AIS, environment, exposome and epigenetics: a molecular perspective of postnatal normal spinal growth and the etiopathogenesis of AIS with consideration of a network approach and possible implications for medical therapy

    Directory of Open Access Journals (Sweden)

    Burwell R Geoffrey

    2011-12-01

    Full Text Available Abstract Genetic factors are believed to play an important role in the etiology of adolescent idiopathic scoliosis (AIS. Discordant findings for monozygotic (MZ twins with AIS show that environmental factors including different intrauterine environments are important in etiology, but what these environmental factors may be is unknown. Recent evidence for common chronic non-communicable diseases suggests epigenetic differences may underlie MZ twin discordance, and be the link between environmental factors and phenotypic differences. DNA methylation is one important epigenetic mechanism operating at the interface between genome and environment to regulate phenotypic plasticity with a complex regulation across the genome during the first decade of life. The word exposome refers to the totality of environmental exposures from conception onwards, comprising factors in external and internal environments. The word exposome is used here also in relation to physiologic and etiopathogenetic factors that affect normal spinal growth and may induce the deformity of AIS. In normal postnatal spinal growth we propose a new term and concept, physiologic growth-plate exposome for the normal processes particularly of the internal environments that may have epigenetic effects on growth plates of vertebrae. In AIS, we propose a new term and concept pathophysiologic scoliogenic exposome for the abnormal processes in molecular pathways particularly of the internal environment currently expressed as etiopathogenetic hypotheses; these are suggested to have deforming effects on the growth plates of vertebrae at cell, tissue, structure and/or organ levels that are considered to be epigenetic. New research is required for chromatin modifications including DNA methylation in AIS subjects and vertebral growth plates excised at surgery. In addition, consideration is needed for a possible network approach to etiopathogenesis by constructing AIS diseasomes. These approaches may

  16. Three solutions to a single problem: alternative casting frames for treating infantile idiopathic scoliosis.

    Science.gov (United States)

    Halanski, Matthew A; Harper, Benjamin L; Cassidy, Jeffry A; Crawford, Haemish A

    2013-07-01

    This is a technique article discussing 3 alternative frames for casting children with infantile scoliosis. To provide surgeons with alternatives to expensive specialized casting tables to allow local treatment of these children utilizing readily available materials present at most institutions. Casting for infantile scoliosis has become more popular as reports have shown promising results with this technique without the morbidity and complications associated with more invasive procedures. However, without a specialized casting table, treating these patients has been limited to a few centers throughout the country often causing patients to travel large distances to receive care. Three different alternatives to commercially available casting frames are presented. Requirements, setup, and techniques are discussed. Each surgeon has had success with each of these frames. These provide adequate support and traction while allowing enough access to the trunk to apply a well-molded cast. Cotrel/Metha casting for infantile scoliosis can be accomplished without a specialized table using commonly available equipment.

  17. Selection of fusion levels in idiopathic adolescent scoliosis treated by Harrington-DDT instrumentation

    DEFF Research Database (Denmark)

    Andersen, G R; Andersen, M O; Christensen, S B

    1995-01-01

    Clinical records and radiographs of 106 patients treated by Harrington-dorsal transverse traction (DDT) instrumentation for idiopathic adolescent thoracolumbar scoliosis were reviewed. Our strategy was to fuse from one vertebra above the measured curve to two vertebrae below the curve, but to avoid...

  18. Chitin Oligosaccharide (COS) Reduces Antibiotics Dose and Prevents Antibiotics-Caused Side Effects in Adolescent Idiopathic Scoliosis (AIS) Patients with Spinal Fusion Surgery.

    Science.gov (United States)

    Qu, Yang; Xu, Jinyu; Zhou, Haohan; Dong, Rongpeng; Kang, Mingyang; Zhao, Jianwu

    2017-03-14

    Antibiotics are always considered for surgical site infection (SSI) in adolescent idiopathic scoliosis (AIS) surgery. However, the use of antibiotics often causes the antibiotic resistance of pathogens and side effects. Thus, it is necessary to explore natural products as drug candidates. Chitin Oligosaccharide (COS) has anti-inflammation and anti-bacteria functions. The effects of COS on surgical infection in AIS surgery were investigated. A total of 312 AIS patients were evenly and randomly assigned into control group (CG, each patient took one-gram alternative Azithromycin/Erythromycin/Cloxacillin/Aztreonam/Ceftazidime or combined daily), experiment group (EG, each patient took 20 mg COS and half-dose antibiotics daily), and placebo group (PG, each patient took 20 mg placebo and half-dose antibiotics daily). The average follow-up was one month, and infection severity and side effects were analyzed. The effects of COS on isolated pathogens were analyzed. SSI rates were 2%, 3% and 8% for spine wounds and 1%, 2% and 7% for iliac wound in CG, EG and PG ( p antibiotics ( p antibiotics dose and antibiotics-caused side effects in AIS patients with spinal fusion surgery by improving antioxidant and anti-inflammatory activities. COS should be developed as potential adjuvant for antibiotics therapies.

  19. Chitin Oligosaccharide (COS Reduces Antibiotics Dose and Prevents Antibiotics-Caused Side Effects in Adolescent Idiopathic Scoliosis (AIS Patients with Spinal Fusion Surgery

    Directory of Open Access Journals (Sweden)

    Yang Qu

    2017-03-01

    Full Text Available Antibiotics are always considered for surgical site infection (SSI in adolescent idiopathic scoliosis (AIS surgery. However, the use of antibiotics often causes the antibiotic resistance of pathogens and side effects. Thus, it is necessary to explore natural products as drug candidates. Chitin Oligosaccharide (COS has anti-inflammation and anti-bacteria functions. The effects of COS on surgical infection in AIS surgery were investigated. A total of 312 AIS patients were evenly and randomly assigned into control group (CG, each patient took one-gram alternative Azithromycin/Erythromycin/Cloxacillin/Aztreonam/Ceftazidime or combined daily, experiment group (EG, each patient took 20 mg COS and half-dose antibiotics daily, and placebo group (PG, each patient took 20 mg placebo and half-dose antibiotics daily. The average follow-up was one month, and infection severity and side effects were analyzed. The effects of COS on isolated pathogens were analyzed. SSI rates were 2%, 3% and 8% for spine wounds and 1%, 2% and 7% for iliac wound in CG, EG and PG (p < 0.05, respectively. COS reduces the side effects caused by antibiotics (p < 0.05. COS improved biochemical indexes and reduced the levels of interleukin (IL-6 and tumor necrosis factor (TNF alpha. COS reduced the antibiotics dose and antibiotics-caused side effects in AIS patients with spinal fusion surgery by improving antioxidant and anti-inflammatory activities. COS should be developed as potential adjuvant for antibiotics therapies.

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

    OpenAIRE

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

    2005-01-01

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

  1. Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system.

    Science.gov (United States)

    Ilharreborde, Brice; Sebag, Guy; Skalli, Wafa; Mazda, Keyvan

    2013-11-01

    Computed tomography can be used for three-dimensional (3D) evaluation of adolescent idiopathic scoliosis (AIS) patients, but at the expense of high radiation exposure, and with the limitation of being performed in the supine position. These drawbacks can now be avoided with low-dose stereoradiography, even in routine clinical use. The purpose of this study was to determine the 3D postoperative correction of AIS patients treated by posteromedial translation. Forty-nine consecutive patients operated for AIS (Lenke 1-4) using posteromedial translation were included. Corrections were evaluated preoperatively, postoperatively and after at least 2 years using the EOS imaging system. 3D angles were measured in the plane of maximum deformity. Mean number of levels fused and operative time were 13.5 ± 1 and 215 ± 25 min, respectively. Main thoracic, proximal thoracic, and lumbar curves corrections averaged 64.4 ± 18, 31 ± 10 and 69 ± 20 %, respectively. Mean T4-T12 kyphosis increased 18.8° ± 9° in the subgroup of hypokyphotic patients. Mean apical vertebral rotation reduction was 48.3 ± 20 %. Trunk height gain averaged 27.8 ± 14 mm. There was no pseudarthrosis or significant loss of correction in any plane during follow-up. Two patients (4 %) developed asymptomatic proximal junctional kyphosis, despite having normal thoracic kyphosis. Their sagittal balance was shifted posteriorly by 36 and 47 mm, respectively, by the operation, but revision surgery was not performed. Low-dose stereoradiography provided 3D reconstructions of the fused and unfused spine in routine clinical use. Postoperative 3D analysis showed that posteromedial translation enhanced sagittal balance correction, without sacrificing frontal or axial correction of the deformity.

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

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

    2013-09-01

    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. The study design was comprised of three questionnaire assessments, with the second and the third evaluation taking place 6 and 12 months after the beginning of the study, respectively. Thirty-six females treated conservatively were asked to fill in the TAPS, SRS-22 and BSSQ forms. In regards to TAPS, the results differed between the 1st and the 2nd assessment in Figure 2 only (p = 0.013). The difference between the 1st and the 3rd evaluation concerned Figure 3 and the total score (p = 0.011 and p = 0.005, respectively). The SRS-22 and BSSQ results of study participants did not differ significantly between the 1st and the 2nd, between the 2nd and the 3rd and between the 1st and the 3rd evaluations. The study indicated that the assessment of girls with AIS concerning body function and mental health did not deteriorate in the course of orthosis treatment. Furthermore, they showed improvement in perceptions particularly in regards to trunk shape. We pointed out that the negative perceptions of mental health, self-image and low level of activity held by females with AIS coexisted with severe emotional distress. Moreover, factors that improved functioning or subjective physical appearance ratings in particular, such as level of activity, were indicated.

  3. 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.

  4. Scoliosis surgery - child

    Science.gov (United States)

    ... from getting worse. But, when they no longer work, the child's health care provider will recommend surgery. There are several reasons to treat scoliosis: Appearance is a major concern. Scoliosis often causes back pain. If the curve is severe enough, ...

  5. 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

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

    OpenAIRE

    Andrea Lebel; Victoria Ashley Lebel

    2016-01-01

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

  7. Long-term outcomes of anterior spinal fusion for treating thoracic adolescent idiopathic scoliosis curves: average 15-year follow-up analysis.

    Science.gov (United States)

    Sudo, Hideki; Ito, Manabu; Kaneda, Kiyoshi; Shono, Yasuhiro; Takahata, Masahiko; Abumi, Kuniyoshi

    2013-05-01

    Retrospective review. To assess the long-term outcomes of anterior spinal fusion (ASF) for treating thoracic adolescent idiopathic scoliosis (AIS). Although ASF is reported to provide good coronal and sagittal correction of the main thoracic (MT) AIS curves, the long-term outcomes of ASF is unknown. A consecutive series of 25 patients with Lenke 1 MT AIS were included. Outcome measures comprised radiographical measurements, pulmonary function, and Scoliosis Research Society outcome instrument (SRS-30) scores (preoperative SRS-30 scores were not documented). Postoperative surgical revisions and complications were recorded. Twenty-five patients were followed-up for 12 to 18 years (average, 15.2 yr). The average MT Cobb angle correction rate and the correction loss at the final follow-up were 56.7% and 9.2°, respectively. The average preoperative instrumented level of kyphosis was 8.3°, which significantly improved to 18.6° (P = 0.0003) at the final follow-up. The average percent-predicted forced vital capacity and forced expiratory volume in 1 second were significantly decreased during long-term follow-up measurements (73% and 69%; P = 0.0004 and 0.0016, respectively). However, no patient had complaints related to pulmonary function. The average total SRS-30 score was 4.0. Implant breakage was not observed. All patients, except 1 who required revision surgery, demonstrated solid fusion. Late instrumentation-related bronchial problems were observed in 1 patient who required implant removal and bronchial tube repair, 13 years after the initial surgery. Overall radiographical findings and patient outcome measures of ASF for Lenke 1 MT AIS were satisfactory at an average follow-up of 15 years. ASF provides significant sagittal correction of the main thoracic curve with long-term maintenance of sagittal profiles. Percent-predicted values of forced vital capacity and forced expiratory volume in 1 second were decreased in this cohort; however, no patient had complaints

  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. Treat a new and efficient match algorithm for AI production system

    CERN Document Server

    Miranker, Daniel P

    1988-01-01

    TREAT: A New and Efficient Match Algorithm for AI Production Systems describes the architecture and software systems embodying the DADO machine, a parallel tree-structured computer designed to provide significant performance improvements over serial computers of comparable hardware complexity in the execution of large expert systems implemented in production system form.This book focuses on TREAT as a match algorithm for executing production systems that is presented and comparatively analyzed with the RETE match algorithm. TREAT, originally designed specifically for the DADO machine architect

  10. Male-female differences in Scoliosis Research Society-30 scores in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Roberts, David W; Savage, Jason W; Schwartz, Daniel G; Carreon, Leah Y; Sucato, Daniel J; Sanders, James O; Richards, Benjamin Stephens; Lenke, Lawrence G; Emans, John B; Parent, Stefan; Sarwark, John F

    2011-01-01

    Longitudinal cohort study. To compare functional outcomes between male and female patients before and after surgery for adolescent idiopathic scoliosis (AIS). There is no clear consensus in the existing literature with respect to sex differences in functional outcomes in the surgical treatment of AIS. A prospective, consecutive, multicenter database of patients who underwent surgical correction for adolescent idiopathic scoliosis was analyzed retrospectively. All patients completed Scoliosis Research Society-30 (SRS-30) questionnaires before and 2 years after surgery. Patients with previous spine surgery were excluded. Data were collected for sex, age, Risser grade, previous bracing history, maximum preoperative Cobb angle, curve correction at 2 years, and SRS-30 domain scores. Paired sample t tests were used to compare preoperative and postoperative scores within each sex. Independent sample t tests were used to compare scores between sexes. A P value of Self-image/appearance had the greatest relative improvement. Males had better self-image/appearance scores preoperatively, better pain scores at 2 years, and better mental health and total scores both preoperatively and at 2 years. Both males and females were similarly satisfied with surgery. Males treated with surgery for AIS report better preoperative self-image, less postoperative pain, and better mental health than females. These differences may be clinically significant. For both males and females, the most beneficial effect of surgery is improved self-image/appearance. Overall, the benefits of surgery for AIS are similar for both sexes.

  11. Sagittal alignment of the cervical spine in adolescent idiopathic scoliosis treated by posteromedial translation.

    Science.gov (United States)

    Ilharreborde, Brice; Vidal, Christophe; Skalli, Wafa; Mazda, Keyvan

    2013-02-01

    To analyze postoperative changes in the cervical sagittal alignment (CSA) of patients with AIS treated by posteromedial translation. 49 patients with thoracic AIS underwent posterior arthrodesis with hybrid constructs, combining lumbar pedicle screws and thoracic universal clamps. Posteromedial translation was the main correction technique used. 3D radiological parameters were measured from low-dose biplanar radiographs. CSA was assessed using the C2C6 angle, and the central hip vertical axis (CHVA) was used as a reference axis to evaluate patients' balance. Preoperatively, 58 % of patients had thoracic hypokyphosis, and 79 % had a kyphotic CSA. Significant correlation was found (r = 0.45, P = 0.01) between thoracic hypokyphosis and cervical kyphosis. Increase in T4-T12 thoracic kyphosis (average 14.5° ± 10°) was associated with significant decrease in cervical kyphosis in the early postoperative period. The CSA further improved spontaneously during follow-up by 7.6° (P < 0.0001). Significant positive correlation (r = 0.32, P = 0.03) was found between thoracic and cervical improvements. At latest follow-up, 94 % of the patients were normokyphotic and 67 % had a CSA in the physiological range. Sagittal balance of the thoracolumbar spine was not significantly modified postoperatively. However, the procedure significantly changed the position of C2 in regard to the CHVA (C2-CHVA), which reflects headposition (P = 0.012). At last follow-up, the patients sagittal imbalance was not significantly different from the preoperative imbalance (P = 0.34). Thoracic hypokyphosis and cervical hypolordosis, observed in AIS, can be improved postoperatively, when the posteromedial translation technique is used for correction. The cervical spine remains adaptable in most patients, but the proportion of patients with physiological cervical lordosis at final follow-up remained low (24.5 %).

  12. Scoliosis Research Society members attitudes towards physical therapy and physiotherapeutic scoliosis specific exercises for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Marti, Cindy L; Glassman, Steven D; Knott, Patrick T; Carreon, Leah Y; Hresko, Michael T

    2015-01-01

    Attitudes regarding non-operative treatment for adolescent idiopathic scoliosis (AIS) may be changing with the publication of BRAiST. Physiotherapeutic Scoliosis Specific Exercises (PSSE) are used to treat AIS, but high-quality evidence is limited. The purpose of this study is to assess the attitudes of members of the Scoliosis Research Society towards PSSE. A survey was sent to all SRS members with questions on use of Physical Therapy (PT) and PSSE for AIS. The majority of the 263 respondents were from North America (175, 67 %), followed by Asia (37, 14 %) and Europe (36, 14 %). The majority of respondents (166, 63 %) prescribed neither PT nor PSSE, 28 (11 %) prescribed both PT and PSSE, 39 (15 %) prescribe PT only and 30 (11 %) prescribe PSSE only. PT was prescribed by 67 respondents, as an adjunct to bracing (39) and in small curves (32); with goals to improve aesthetics (27) and post-operative outcomes (25). Of the 196 who do not prescribe PT, the main reasons were lack of evidence (149) and the perception that PT had no value (112). PSSE was prescribed by 58 respondents. The most common indication was as an adjunct to bracing (49) or small curves (41); with goals to improve aesthetics (36), prevent curve progression (35) and improve quality of life (31). Of the respondents who do not prescribe PSSE, the main reasons were lack of supporting research (149), a perception that PSSE had no value (108), and lack of access (63). Most respondents state that evidence of efficacy may increase the role of PSSE, with 85 % (223 of 263) favoring funding PSSE studies by the SRS. The results show that 22 % of the respondents use PSSE for AIS, skepticism remains regarding the benefit of PSSE for AIS. Support for SRS funded research suggests belief that there is potential benefit from PSSE and the best way to assess that potential is through evidence development.

  13. Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis

    DEFF Research Database (Denmark)

    Wang, Yu; Bünger, Cody; Zhang, Yanqun

    2012-01-01

    PURPOSE: The aim of this study was to investigate whether or not post-op curve behaviour differs due to different choices of lowest instrumented vertebra (LIV) with reference to lumbar apical vertebra (LAV) in Lenke 3C and 6C scoliosis. METHODS: We reviewed all the AIS cases surgically treated...... it can yield similar correction while preserving more lumbar mobility and growth potential....

  14. Flexibility Predicts Curve Progression in Providence Nighttime Bracing of Patients With Adolescent Idiopathic Scoliosis

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Hallager, Dennis Winge; Gehrchen, Poul Martin

    2016-01-01

    for adolescent idiopathic ccoliosis (AIS) have been inconsistent and further research is needed. The association between flexibility, as determined by pretreatment SLBR, and curve progression has not previously been examined. METHODS: All patients treated with the PB from 2006 to 2011 who met Scoliosis Research...

  15. Exercise tolerance and selected motor skills in young females with idiopathic scoliosis treated with different physiotherapeutic methods.

    Science.gov (United States)

    Fabian, Krzysztof Marek; Rożek-Piechura, Krystyna

    2014-01-01

    Scoliosis is a disorder that leads to dysfunction of a number of systems in the body, especially in young females. Physical capacity is one of the most important elements of good health as well as ofbiological development. Adolescence is a time when physical capacity develops intensively, and the condition of the respiratory system is one of many factors that have an impact on the level of physical capacity. This paper aims to evaluate a short-term application of two methods of physiotherapy and their influence on the level of exercise tolerance in young females suffering from idiopathic scoliosis. The study involved a group of 49 young females aged 14-15 years diagnosed with (2040°) thoracic and lumbar scoliosis who were in-patients at the rehabilitation ward of the Regional Paediatric Rehabilitation Hospital in Jastrzębie Zdrój. The group was divided into two subgroups depending on the method of rehabilitation employed: the first subgroup received asymmetric breathing exercise therapy by Dobosiewicz and the second subgroup practised symmetric remedial exercises. Cobb's angle, the degree of skeletal maturity, i.e. the Risser sign and the degree trunk rotation of the apex of the curvature by means of Raimondi's coefficient were determined once in an x-ray image. Basic somatic features, maximal voluntary ventilation (MVV parameter), selected motor skills and exercise tolerance were assessed on two occasions (before beginning and after completion of the rehabilitation treatment). 1. Young females suffering from (20-40°) thoracic and lumbar scoliosis demonstrate respiratory dysfunction, as shown by decreased maximal voluntary ventilation (MVV) in the two subgroups in the present study. Exercises according to Dobosiewicz's method brought about a significantly higher degree of improvement in this parameter. 2. The physiotherapeutic regimen administered to the young girls with scoliosis significantly improved their strength motor skills and exercise tolerance. A

  16. [Scoliosis: the bent spine].

    Science.gov (United States)

    Radl, R; Maafe, M; Ziegler, S

    2011-05-01

    Scoliosis, a permanent abnormal curvature of the spine to the side, is divided into four forms: idiopathic (infantile, juvenile and adolescent, accounting for 80% of cases), neurogenic, congenital and adult scoliosis. Most patients with adolescent idiopathic scoliosis initially have mainly cosmetic problems. However, neurogenic, congenital and adult scoliosis can lead to severe clinical symptoms. The leading symptom is back pain caused by secondary changes. In recent years the Lenke classification has been proven to be a reliable tool for disease classification. Non-progressive scoliosis is usually treated conservatively. In the case of Cobb angles of greater than 50°, surgical therapy is recommended in patients presenting before adulthood. Technical improvements in implants and the optimisation of surgical methods have set a trend in the direction of surgical therapy.

  17. An inquiry into chiropractors' intention to treat adolescent idiopathic scoliosis: a telephone survey.

    Science.gov (United States)

    Feise, R J

    2001-01-01

    The primary aim of this study was to (1) determine the clinical management approach of practicing chiropractors with regard to patients with adolescent idiopathic scoliosis and (2) measure the response rate of a telephone survey. A survey instrument was developed and pretested, and a case-specific clinical vignette was generated for a hypothetical typical 12-year-old girl with adolescent idiopathic scoliosis. The instrument addressed 3 domains: the specific management of idiopathic scoliosis, elements guiding the general selection of treatment recommendations, and demographics of respondents. The sample frame consisted of 62,000 US chiropractors, of whom 165 were randomly selected for the survey sample. Interviews were conducted by telephone through use of the tested survey instrument. The response rate was 69% (114/165). Of the 51 nonrespondents, 15 did not have a listed business telephone number and 24 were not in active practice. The response rate of those who met the inclusion criteria (practicing chiropractor with a listed telephone number) was 90% (114/126). The gender, chiropractic college, and years in practice of respondents in this survey were similar to those of respondents in 3 other national surveys. In general, the respondents would provide 6 months of "intensive" chiropractic therapy, then follow the patient for 4 years (near skeletal maturity). Eighty-two percent of respondents named diversified technique as their primary adjustive treatment, 87% would use exercise, and 30% would use electric muscle stimulation as an adjunct to manual therapy. Most surveyed chiropractors would use similar methods (frequency and length of treatment, manipulation technique, and exercise) in the treatment of patients with adolescent idiopathic scoliosis. A high response rate to a national survey can be achieved through use of telephone contact.

  18. Use of Postural Reconstruction® physiotherapy to treat an adolescent with asymmetric bilateral genu varum and idiopathic scoliosis.

    Science.gov (United States)

    Destieux, C; Gaudreault, N; Isner-Horobeti, M E; Vautravers, P

    2013-05-01

    To document the effect of Postural Reconstruction® physiotherapy on two postural disorders commonly observed in adolescents: genu varum and idiopathic scoliosis. A case report on a 16-year-old boy suffering from knee pain and presenting with bilateral genu varum and mild scoliosis. At the initial evaluation (T0), the intercondylar space was 7 cm and the Cobb angles for the right lumbar curve and left thoracic curve were 18° and 13°, respectively. The boy was treated with Postural Reconstruction(®), a neuromuscular physiotherapy intervention using facilitation/inhibition techniques. The outcomes used to quantify the effect of 6 months (T1), 12 months (T2) and 26 months (T3) of treatment were pain levels, the intercondylar space, the lumbar gibbosity and the lumbar and thoracic Cobb angles. The knee pain disappeared rapidly. At T3, the intercondylar space had decreased by 4 cm, the lumbar gibbosity angle had decreased by 2° and the lumbar and thoracic Cobb angles had decreased by 8° and 7°, respectively. This non-invasive physiotherapy intervention appears to have considerable promise for the long-term correction of postural disorders. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. 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....

  20. Adult Scoliosis

    Science.gov (United States)

    ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ...

  1. Health related quality of life and perception of deformity in patients with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Çolak, Tuğba Kuru; Akgül, Turgut; Çolak, Ilker; Dereli, Elif Elçin; Chodza, Mehmet; Dikici, Fatih

    2017-01-01

    Quality of life and cosmethic appearance have gained importance as outcomes in AIS treatment. Improving aesthetic appearance and quality of life are defined as the primary aims of scoliosis treatment by health professionals. Studies that assess and compare the different treatment results in the field of quality of life and cosmethics are some what limited. A cross-sectional study was designed to compare quality of life and deformity perception in patients with adolescent idiopathic scoliosis (AIS) received conservative (exercise or exercise + brace) or surgical treatment. A total of 68 (58 females) patients aged 10-18 years with AIS received conservative (exercise or exercise+brace) or surgical treatment were invited to participate in the study. Quality of life (Scoliosis Research Society-23 (SRS-23)) and perception of deformity (Walter Reed Visual Assessment (WRVAS)) were assessed. Conservatively treated patients had significantly superior scores in function domain of SRS-23 than surgically treated patients (exercise/surgery, exercise+brace/surgery; p= 0.009, 0.004). Otherwise, surgically treated patients had significantly superior scores in self-image (p= 0.000, 0.000), and satisfaction with management (p= 0.001, 0.006) domains of SRS-23, and WRVAS (p= 0.000, 0.000) than conservative groups. In addition to radiographic assessments, quality of life, aesthetic perception, functionality, satisfaction with management, psycho-social status should carefully be taken into consideration by health professionals in the teratment of AIS.

  2. 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.

  3. Adolescent Idiopathic Scoliosis: A 71 Cases Study Ascertaining that Straightening Is Possible, and a New Etiological Hypothesis.

    Science.gov (United States)

    Polak, Jan

    2013-12-01

    Seventy-one children (23 boys and 48 girls, aged 6 to 18 year-old) with adolescent idiopathic scoliosis (AIS) between 11° and 62°, without braces, have been treated manually, only at the level of the neck. To ascertain that non-surgical straightening of AIS is possible (without brace). So far no disease modifying treatment for AIS existed. Braces can only slow down worsening (and this can only be achieved if they are worn 23 hours a day). Surgery is not without important risks. All patients have been treated exclusively with a manual therapy called Brachy-Myotherapy. This method treats spasmed (contractured) muscles by placing them in a shortening position according to a specific protocol. An average straightening of 8° of AIS was observed, with a maximum of 25°. 94% of cases improved, 67 out of 71. The worst prognosis was, the better results. The more advanced AIS was, the better the results. A simple and reliable treatment of AIS is possible. AIS seems to be a compensation mechanism of the body, with the aim of keeping the ears, and thus the labyrinths, at a horizontal level for correct equilibrium. When lasting post-traumatic neck muscle contractures causing a permanent side-bending of the skull have been treated, this compensation mechanism becomes irrelevant and scoliosis tends to subside.

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

    OpenAIRE

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

    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...

  5. 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....

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

    Directory of Open Access Journals (Sweden)

    Yi-Lin Yang

    2017-01-01

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

  7. Chest cage angle difference and rotation of main thoracic curve are independent risk factors of postoperative shoulder imbalance in surgically treated patients with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Yagi, Mitsuru; Takemitsu, Masakazu; Machida, Masafumi

    2013-09-01

    Retrospective case series of surgically treated adolescent patients with scoliosis. To assess the prevalence and independent risk factors for postoperative shoulder imbalance in surgically treated adolescent patients with idiopathic scoliosis. Despite recent reports that have identified risk factors for postoperative shoulder imbalance, the relative risks remain unclear. A retrospective review of 85 consecutive patients treated with thoracic fusion with a minimum 2-year follow-up (mean, 3.1 yr) was conducted to investigate the patient radiographical measurements and demographics. Shoulder height difference (SHD) was measured as the graded height difference of the soft tissue shadows. A SHD more than 2 cm indicated an unbalanced shoulder. Patient demographics and radiographical data were studied to determine risk factors for postoperative SHD. The potential risk factors included age, sex, Risser sign, Cobb angle, flexibility, and apical vertebral rotation (AVR) of the main curve, upper-instrumented vertebra level, SHD, and clavicle chest cage angle difference (CCAD). Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for postoperative shoulder imbalance. Of the 85 patients, 21 patients presented postoperative shoulder imbalance. The univariate analysis indicated age, Risser sign, Cobb angle of the main curve, AVR of the main curve, and CCAD as risk factors, but the multivariate logistic regression analysis showed that only AVR of the main curve and CCAD were independent risk factors for postoperative shoulder imbalance (AVR, P = 0.04, odds ratio (OR): 3.54; CCAD, P = 0.01, OR: 5.10). Postoperative shoulder imbalance was observed in 25% of the surgically treated adolescent patients. The CCAD and AVR of the main thoracic curve were independent risk factors for postoperative shoulder imbalance in surgically treated patients with adolescent idiopathic scoliosis. The significant correlation between CCAD and

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

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2006-04-01

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

  9. Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Jens Ivar Brox

    2014-07-01

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

  10. Prediction of Curve Correction Using Alternate Level Pedicle Screw Placement in Patients With Adolescent Idiopathic Scoliosis (AIS) Lenke 1 and 2 Using Supine Side Bending (SB) and Fulcrum Bending (FB) Radiograph.

    Science.gov (United States)

    Kwan, Mun Keong; Zeyada, Hassan E; Chan, Chris Yin Wei

    2015-10-15

    Prospective cohort study. To compare side bending (SB) and fulcrum bending (FB) radiographs in patients with adolescent idiopathic scoliosis (AIS) and effect of magnitude and AR curves on curve correctability. The prediction of correction using side bending flexibility (SBF) and fulcrum bending flexibility (FBF) in alternate level pedicle screw (PS) configuration and effect of curve magnitude and AR curves are not well understood. 100 AIS Lenke 1 and 2 were recruited. Curve magnitude was stratified to G1 (41°-60°), G2 (61°-80°), G3 (>80°). The main thoracic (MT) curves were subclassified to AR curves [Miyanji F, Pawelek JB, Van Valin SE, et al. Is the lumbar modifier useful in surgical decision making? Defining two distinct Lenke 1A curve patterns. Spine 2008;33:2545-51]. Preoperatively SBF and FBF were determined whereas postoperative parameters were correction rate (CR), fulcrum bending correction index (FBCI), and side bending correction index (SBCI). Correlation test were carried out between SBF, FBF versus CR for the cohort. There were 38 (G1), 42 (G2), and 20 (G3) patients. 34% were AR curves. SBF for G1, G2, and G3 were 61.3 ± 14.4, 59.2 ± 16.2 and 43.1 ± 13.1% (P = 0.000) whereas FBF for G1, G2, and G3 were 71.1 ± 16.5, 58.3 ± 18.1 and 52.7 ± 17.1% (P = 0.000). The CR was G1 (74.5 ± 11.5%), G2 (69.2 ± 12.7%), and G3 (70.2 ± 8.6%). FBCI was 1.11 ± 0.3 (G1), 1.28 ± 0.4 (G2) and 1.48 ± 0.6 for G3. SBCI was 1.26 ± 0.2 (G1), 1.50 ± 0.5 (G2), and 1.72 ± 0.4 for G3. There was strong correlation for SBF and FBF versus CR for G1 and G2. For G3, a very strong correlation was established between SBF (r = 0.846, r = 0.716) and FBF versus CR (r = 0.700, r = 0.540). AR curves demonstrated higher SBF and FBF. CR remains almost constant in G1, G2, and G3. SBCI and FBCI increase significantly in G1, G2, and G3. Correlation between SBF and FBF and CR was strong for G1, G2, and very strong for G3. AR curves showed better correctability with SB and FB films.

  11. Minimally invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis: a comparison with standard open approach spinal instrumentation.

    Science.gov (United States)

    Zhu, Weiguo; Sun, Weixiang; Xu, Leilei; Sun, Xu; Liu, Zhen; Qiu, Yong; Zhu, Zezhang

    2017-04-01

    OBJECTIVE Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS. METHODS The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014. Levels of fusion, density of implants, operation time, and estimated blood loss (EBL) were recorded. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. The accuracy of pedicle screw placement was assessed according to postoperative axial CT images in both groups. The 22-item Scoliosis Research Society questionnaire (SRS-22) results and complications were collected during follow-up. RESULTS The authors retrospectively reviewed the records of 45 patients with Lenke Type 5C AIS, 15 who underwent posterior MISS under O-arm navigation and 30 who underwent posterior spinal fusion (PSF). The 2 treatment groups were matched in terms of baseline characteristics. Comparison of radiographic parameters revealed no obvious difference between the 2 groups immediately after surgery or at the final follow-up; however, the MISS patients had significantly less EBL (p self-image using the SRS-22 showed significantly higher scores in the MISS group (p = 0.013 and 0.046, respectively) than in the PSF group. Postoperative CT showed high accuracy in pedicle placement in both groups. No deep wound infection, pseudarthrosis, additional surgery, implant failure, or neurological complications were recorded in either group. CONCLUSIONS Minimally invasive scoliosis surgery is an effective and safe

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

    Science.gov (United States)

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

    2006-07-01

    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 investigated with at least 2 years follow-up at the time of receiving a posted self-administered questionnaire. Forty-four patients were treated with Boston brace (B) only, 41 patients had surgery (S), and 33 patients were treated both with brace and surgery (BS). The Cobb angles of the three treatment groups did not differ significantly after completed treatment. The outcome in terms of the total SRS 24 score was not significantly different among the three groups. B patients had a significantly better general (not treatment related) self-image and higher general activity level than the total group of surgically treated patients, while surgically treated patients scored significantly better in post-treatment self-image and satisfaction. Comparing B with BS we found a significantly higher general activity level in B patients, while the BS group had significantly higher satisfaction. There were no significant differences between BS and S patients in any of the domain scores. All treatment groups scored "fair or better" in all domain scores of the SRS 24 questionnaire, except in post-treatment function, where all groups scored worse than "fair". Improvement of appearance by means of surgical correction increases mean scores for post-treatment self-image and post-treatment satisfaction. Double-treatment by brace and surgery does not appear to jeopardize a good final outcome.

  13. Prospective study of 158 adult scoliosis treated by a bivalve polyethylene overlapping brace and reviewed at least 5 years after brace fitting

    Directory of Open Access Journals (Sweden)

    Jean Claude de Mauroy

    2016-10-01

    Full Text Available Abstract Background The conservative orthopaedic treatment of adult scoliosis is very disappointing. In a series of 144 patients; only 25 % (33 cases were monitored at 2 years of treatment. (Papadopoulos 2013. Thereby the literature typically focuses on a small number of patients, which limits the usefulness and relevance of its results. The brace effect on pain has been systematically described, but there is no publication on the effect of treatment on the Cobb angle and main clinical parameters. Methods From a prospective database started in 1998, we selected all 158 consecutive patients effectively treated conservatively with the Lyon management treatment and controlled five years after brace fitting. Lyon management includes a lordosing bivalve polyethylene overlapping brace in association with specific physiotherapy. The brace can either be short with anterior support under the chest or long with sterno-clavicular support when there is a high thoracic kyphosis. Results 1. For the rate of scoliosis controlled after 5 years, the follow-up was 24 % of the 661 patients accepting the treatment. Pain is almost the main reason for the medical consultation, generally correlating with an increase of the scoliotic angulation. 2. The descriptive data can be superimposed on general group with age (m=56 years, SD=13 but initial Cobb angulation is significantly higher (m=40°, SD=17. Ratio Female/Male=0.91. Generally, the scoliosis is stabilized at (m=39.74 °, SD=19.40, 8 years after the beginning of the treatment. 38 improvements of more than 5°= 24 %; 88 stable = 56 %; 32 worsening of more than 5° = 20 % The rib hump is improved of by 3 mm, (modelling effect of the brace. The occipital axis is improved by more than 6 mm. But the T1 plumb line distance is worsening by 7 mm (most braces are short without sterno-clavicular support. Conclusions For the first time, the number of records and follow up after 8 years allows to study the

  14. Comparison of in-and outpatients protocols for providence night time only bracing in AIS patients -- compliance and satisfaction

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid Tj; Tropp, Hans; Pedersen, Niels W

    2013-01-01

    BACKGROUND: Skeletally immature patients diagnosed with adolescent idiopathic scoliosis (AIS) and a Cobb angle above 25degrees is usually treated with a brace. Standard protocols in many centers include hospitalisation for a few days for the purpose of brace adaptation and fitting. The aim...... of this study is to compare compliance and satisfaction in hospitalization and out patient clinic protocols, at the initiation phase of brace treatment.Materials and methodsTwenty-four consecutive patients with AIS were initiated with the Providence night time only brace at our department between October 2008...

  15. Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Common Questions & Glossary Resources ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Juvenile Idiopathic Scoliosis Diagnosed ...

  16. Lumbar Scoliosis Combined Lumbar Spinal Stenosis and Herniation Diagnosed Patient Was Treated with “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy

    Directory of Open Access Journals (Sweden)

    Binbin Wu

    2017-01-01

    Full Text Available The objective was to report a case of a 63-year-old man with a history of low back pain (LBP and left leg pain for 2 years, and the symptom became more serious in the past 5 months. The patient was diagnosed with lumbar scoliosis combined with lumbar spinal stenosis (LSS and lumbar disc herniation (LDH at the level of L4-5 that was confirmed using Computerized Topography and Magnetic Resonance Imaging. The surgical team preformed a novel technique, “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD, which led to substantial, long-term success in reduction of pain intensity and disability. After removing the osteophyte mass posterior to the thecal sac at L4-5, the working channel direction was changed to the gap between posterior longitudinal ligament and thecal sac, and we also removed the herniation and osteophyte at L3-4 with “U” route PELD. The patient’s symptoms were improved immediately after the surgical intervention; low back pain intensity decreased from preoperative 9 to postoperative 2 on a visual analog scale (VAS recorded at 1 month postoperatively. The success of the intervention suggests that “U” route PELD may be a feasible alternative to treat lumbar scoliosis with LSS and LDH patients.

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

    NARCIS (Netherlands)

    Veldhuizen, AG; Webb, PJ

    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

  18. 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 w...

  19. Surgical treatment of double thoracic adolescent idiopathic scoliosis with a rigid proximal thoracic curve.

    Science.gov (United States)

    Sudo, Hideki; Abe, Yuichiro; Abumi, Kuniyoshi; Iwasaki, Norimasa; Ito, Manabu

    2016-02-01

    There is limited consensus on the optimal surgical strategy for double thoracic adolescent idiopathic scoliosis (AIS). Recent studies have reported that pedicle screw constructs to maximize scoliosis correction cause further thoracic spine lordosis. The objective of this study was to apply a new surgical technique for double thoracic AIS with rigid proximal thoracic (PT) curves and assess its clinical outcomes. Twenty one consecutive patients with Lenke 2 AIS and a rigid PT curve (Cobb angle ≥30º on side-bending radiographs, flexibility ≤30 %) treated with the simultaneous double-rod rotation technique (SDRRT) were included. In this technique, a temporary rod is placed at the concave side of the PT curve. Then, distraction force is applied to correct the PT curve, which reforms a sigmoid double thoracic curve into an approximate single thoracic curve. As a result, the PT curve is typically converted from an apex left to an apex right curve before applying the correction rod for PT and main thoracic curve. All patients were followed for at least 2 years (average 2.7 years). The average main thoracic and PT Cobb angle correction rate at the final follow-up was 74.7 and 58.0 %, respectively. The average preoperative T5-T12 thoracic kyphosis was 9.3°, which improved significantly to 19.0° (p corrected using SDRRT for Lenke 2 AIS with a rigid PT curve.

  20. Radiological Outcomes in Adolescent Idiopathic Scoliosis Patients More Than 22 Years After Treatment

    DEFF Research Database (Denmark)

    Simony, Ane; Christensen, Steen Bach; Carreon, Leah Y

    2015-01-01

    STUDY DESIGN: Longitudinal cohort. OBJECTIVES: To evaluate the long-term radiologic outcomes in adolescent idiopathic scoliosis (AIS) patients more than 22 years after treatment. SUMMARY OF BACKGROUND DATA: Although treatment for AIS is prophylactic and is aimed at preventing curve progression......, very few studies report long-term outcomes of treatment. METHODS: AIS patients treated with Boston brace or posterior spinal fusion (PSF) with Harrington-dorso-transverse traction (DTT) instrumentation from 1983 to 1990 were requested to return to clinic. Subsequently, 36-inch standing radiographs were...... obtained after patient consent. Cobb angles were compared with pretreatment and immediate posttreatment radiographs. Any evidence of adjacent-level disease or local kyphosis was also noted. RESULTS: One hundred fifty-nine (78%) of 219 patients were available for follow-up, 66 braced and 93 surgical...

  1. Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis.

    Science.gov (United States)

    Misterska, Ewa; Głowacki, Jakub; Głowacki, Maciej; Okręt, Adam

    2018-01-01

    We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group's SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group's results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had a

  2. Exercises for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Romano, Michele; Minozzi, Silvia; Bettany-Saltikov, Josette; Zaina, Fabio; Chockalingam, Nachiappan; Kotwicki, Tomasz; Maier-Hennes, Axel; Negrini, Stefano

    2012-08-15

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine . While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of scoliosis-specific exercises (SSE) to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial. To evaluate the efficacy of SSE in adolescent patients with AIS. The following databases (up to 30 March 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SportDiscus (from January 1975), PsycInfo (from January 1887), PEDro (from January 1929). We screened reference lists of articles and also conducted an extensive handsearch of grey literature. Randomised controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises. Two review authors independently selected studies, assessed risk of bias and extracted data. Two studies (154 participants) were included. There is low quality evidence from one randomised controlled study that exercises as an adjunctive to other conservative treatments increase the efficacy of these treatments (thoracic curve reduced: mean difference (MD) 9.00, (95% confidence interval (CI) 5.47 to 12.53); lumbar curve reduced:MD 8.00, (95% CI 5.08 to 10.92)). There is very low quality evidence from a prospective controlled cohort study that scoliosis-specific exercises structured within an exercise programme can reduce brace prescription (risk ratio (RR) 0.24, (95% CI 0.06 to1.04) as compared to usual physiotherapy (many different kinds of general exercises according to the preferences of the single therapists within different facilities

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

    Directory of Open Access Journals (Sweden)

    Goodall Deborah

    2009-05-01

    Full Text Available Abstract In children with Prader Willi syndrome (PWS, besides growth hormone (GH therapy, control of the food environment and regular exercise, surgical treatment of scoliosis deformities seems the treatment of choice, even though the risks of spinal surgery in this specific population is very high. Therefore the question arises as to whether the risks of spinal surgery outweigh the benefits in a condition, which bears significant risks per se. The purpose of this systematic review of the Pub Med literature was to find mid or long-term results of spinal fusion surgery in patients with PWS, and to present the conservative treatment in a case study of nine patients with this condition. Methods Types of studies included; all kinds of studies; retrospective and prospective ones, which reported upon the outcome of scoliosis surgery in patients with PWS. Types of participants included: patients with scoliosis and PWS. Type of intervention: surgery. Search strategy for identification of the studies; Pub Med; limited to English language and bibliographies of all reviewed articles. Nine patients with PWS from our data-base treated conservatively have been found, being 19 years or over at the time this study has been performed. The results of conservative management are described and related to the natural history and treatment results found in the Pub Med review. Results From 2210 titles displayed in the Pub Med database with the key word being "Prader Willi syndrome", 5 different papers were displayed at the date of the search containing some information on the outcome of surgery and none appeared to contain a mid or long-term follow-up. The PWS patients treated conservatively from our series all stayed below 70° and some of which improved. Discussion If the curve of scoliosis patients with PWS can be kept within certain limits (usually below 70 degrees conservatively, this treatment seems to have fewer complications than surgical treatments. The

  4. Trunk imbalance in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Fortin, Carole; Grunstein, Erin; Labelle, Hubert; Parent, Stefan; Ehrmann Feldman, Debbie

    2016-06-01

    Trunk imbalance (ie, frontal trunk shift measured with a plumb line from C7 to S1) is part of the clinical evaluation in adolescent idiopathic scoliosis (AIS), but its prevalence and relationship with scoliosis, back pain, and health-related factors are not well documented. The principal objectives are to document trunk imbalance prevalence and to explore the association between trunk imbalance and the following factors: Cobb angle, type of scoliosis, back pain, function, mental health, and self-image. The secondary objective is to determine back pain prevalence and the relationship between back pain and each of the following: Cobb angle, function, mental health, and self-image. This is a cross-sectional study in a scoliosis clinic of a tertiary university hospital center. The sample includes youth with AIS (N=55). The outcome measures were trunk imbalance prevalence and magnitude, and back pain prevalence and intensity using the Numeric Pain Rating Scale (NPRS) and the Scoliosis Research Society-22 (SRS-22) pain score, and the function, self-image, and mental health domains of the SRS-22. Trunk imbalance and back pain were assessed in 55 patients with AIS (Cobb angle: 10-60°). Patients completed the SRS-22 questionnaire and the NPRS. Correlations were done between trunk imbalance and scoliosis (Cobb angle, type of scoliosis), back pain (NPRS and SRS-22 pain score), and health-related factors using Pearson correlation coefficients (r) and logistic regression models. Trunk imbalance prevalence is 85% and back pain prevalence is 73%. We found fair to moderate significant positive correlation between trunk imbalance and Cobb angle (r=0.32-0.66, pself-image, or type of scoliosis. Lower self-reported pain significantly correlated with lower Cobb angles (r=0.29, p=.03), higher function (r=0.55, p=.000), higher self-image (r=0.44, p=.001), and better mental health (r=0.48, p=.000). There was a trend for trunk imbalance to be related with lower pain in logistic regression

  5. Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

    Sui, Wen-yuan; Ye, Fang; Yang, Jun-lin

    2016-04-27

    Adolescent idiopathic scoliosis (AIS) surgery usually require prolonged operative times with extensive soft tissue dissection and significant perioperative blood loss, and allogeneic blood products are frequently needed. Methods to reduce the requirement for transfusion would have a beneficial effect on these patients. Although many previous studies have revealed the efficacy of tranexamic acid (TXA) in spinal surgery, there is still a lack of agreement concerning the reduction of both blood loss and transfusion requirements of large dose tranexamic acid (TXA) in surgery for adolescent idiopathic scoliosis (AIS). The objective of this study was to elevate the efficacy and safety of a large dose tranexamic acid (TXA) in reducing transfusion requirements of allogeneic blood products in adolescent idiopathic scoliosis (AIS) surgery using a retrospective study designed with historical control group. One hundred thirty seven consecutive AIS patients who underwent surgery treatment with posterior spinal pedicle systems from August 2011 to March 2015 in our scoliosis center were retrospectively reviewed. Patients were divided into two groups, the TXA group and the historical recruited no TXA group (NTXA). Preoperative demographics, radiographic parameters, operative parameters, estimated blood loss (EBL), total irrigation fluid, number of patients requiring blood transfusion, mean drop of Hb (Pre-op Hb-Post-op Hb), haematocrit pre and post-surgery, mean volume of blood transfusion, hospitalization time, and adverse effect were recorded and compared. All the patients were successfully treated with satisfied clinical and radiographic outcomes. There were 71 patients in the TXA group and 66 patients in the NTXA group. The preoperative demographics were homogeneity between two groups (P > 0.05). There were no significant difference in average operative time between two groups (209 min vs 215 min, p >0.05). Number of patients in the TXA group showed a significant decrease in

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

    International Nuclear Information System (INIS)

    Chu, Winnie C.W.; Rasalkar, Darshana D.; Cheng, Jack C.Y.

    2011-01-01

    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.)

  7. 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.)

  8. AIS authentication

    CERN Multimedia

    2006-01-01

    Users are invited to use the NICE password for AIS authentication. As announced in CNL June-August 2006 (see http://www.cerncourier.com/articles/cnl/3/6/14/1) it is possible to use the NICE username and password to log on to AIS. The procedure is now fully operational and users can themselves reset the AIS password such that the NICE password will be used for authentication required by AIS applications. We strongly recommend CERN users who have a NICE account (this is the case of most users) to do this, with the objective to reduce the number of passwords they need to remember. This can be achieved very easily, directly from the Change Password option on the AIS login (https://aislogin.cern.ch/). Users should just select the '[Change Password]' option displayed at the bottom of the page, provide the 'Old Password' and then click on the button 'Use Nice password' followed by 'Submit'. Change Password option on the AIS login windowSetting the AIS password - Use Nice Password It should be noted that the proce...

  9. Characterization and Predictive Value of Segmental Curve Flexibility in Adolescent Idiopathic Scoliosis Patients

    DEFF Research Database (Denmark)

    Yao, Guanfeng; Cheung, Jason P Y; Shigematsu, Hideki

    2017-01-01

    STUDY DESIGN: A prospective radiographic analysis of adolescent idiopathic scoliosis (AIS) patients managed with alternate-level pedicle screw fixation was performed. OBJECTIVE: The objective of this study was to characterize segmental curve flexibility and to determine its predictive value...

  10. Upright, prone, and supine spinal morphology and alignment in adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Brink, Rob C; Colo, Dino; Schlösser, Tom P C; Vincken, Koen L; van Stralen, Marijn; Hui, Steve C N; Shi, Lin; Chu, Winnie C W; Cheng, Jack C Y; Castelein, RM

    2017-01-01

    BACKGROUND: Patients with adolescent idiopathic scoliosis (AIS) are usually investigated by serial imaging studies during the course of treatment, some imaging involves ionizing radiation, and the radiation doses are cumulative. Few studies have addressed the correlation of spinal deformity captured

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

    Directory of Open Access Journals (Sweden)

    Sanja Schreiber

    Full Text Available The North American non-surgical standard of care for adolescent idiopathic scoliosis (AIS includes observation and bracing, but not exercises. Schroth physiotherapeutic scoliosis-specific exercises (PSSE showed promise in several studies of suboptimal methodology. The Scoliosis Research Society calls for rigorous studies supporting the role of exercises before including it as a treatment recommendation for scoliosis.To determine the effect of a six-month Schroth PSSE intervention added to standard of care (Experimental group on the Cobb angle compared to standard of care alone (Control group in patients with AIS.Fifty patients with AIS aged 10-18 years, with curves of 10°-45° and Risser grade 0-5 were recruited from a single pediatric scoliosis clinic and randomized to the Experimental or Control group. Outcomes included the change in the Cobb angles of the Largest Curve and Sum of Curves from baseline to six months. The intervention consisted of a 30-45 minute daily home program and weekly supervised sessions. Intention-to-treat and per protocol linear mixed effects model analyses are reported.In the intention-to-treat analysis, after six months, the Schroth group had significantly smaller Largest Curve than controls (-3.5°, 95% CI -1.1° to -5.9°, p = 0.006. Likewise, the between-group difference in the square root of the Sum of Curves was -0.40°, (95% CI -0.03° to -0.8°, p = 0.046, suggesting that an average patient with 51.2° at baseline, will have a 49.3° Sum of Curves at six months in the Schroth group, and 55.1° in the control group with the difference between groups increasing with severity. Per protocol analyses produced similar, but larger differences: Largest Curve = -4.1° (95% CI -1.7° to -6.5°, p = 0.002 and [Formula: see text] (95% CI -0.8 to 0.2, p = 0.006.Schroth PSSE added to the standard of care were superior compared to standard of care alone for reducing the curve severity in patients with AIS.NCT01610908.

  12. Prevalence of postoperative pain in adolescent idiopathic scoliosis and the association with preoperative pain.

    Science.gov (United States)

    Bastrom, Tracey P; Marks, Michelle C; Yaszay, Burt; Newton, Peter O

    2013-10-01

    Review of a prospective database registry of surgical patients with adolescent idiopathic scoliosis (AIS). The purpose of this study was to examine the prevalence of postoperative pain and its impact on patient-reported postoperative outcomes using the Scoliosis Research Society (SRS)-22 outcomes questionnaire. Although reportedly rare, postoperative pain can be a devastating situation for the patient with AIS. Most recent studies examining outcomes in AIS surgical treatment use the SRS Pain domain score to assess pain in this population. A prospectively enrolled multicenter database was queried. Patients with minimum 2-year follow-up and 2-year SRS scores were included. Postoperative pain after the acute phase of recovery when reported by the patient to the treating surgeon/clinical team in follow-up is recorded as a complication in the database. Patients included in this series were grouped as either reporting pain or not to the surgeon/clinical team postoperatively. Pre- and postoperative SRS scores were then compared between these 2 groups using analysis of variance (P imaging). These 41 patients had significantly decreased 2-year SRS scores in the domains of Pain, Self-image, Mental health, and Total score (P 0.05). Unexplained pain after the 6-month postoperative period occurred in 7% of the cohort. The results indicate that patients reporting pain to their surgeons/clinical team postoperatively have lower pain scores on a subjective outcome instrument thus further validating the SRS-22 outcome tool. This reported pain seems to be associated with decreases in other SRS-22 domains. Interestingly, these patients also have lower preoperative pain scores than those without postoperative pain. Study into causes of pain in AIS and whether preoperative education and expectations targeted at this population would positively impact outcomes is warranted, especially because on average patients after AIS surgery have less pain. 3.

  13. Pediatric spine imaging post scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Alsharief, Alaa N. [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada); The Hospital for Sick Children, University of Toronto, Department of Diagnostic Imaging, Toronto (Canada); King Saud University, Department of Medical Imaging, King Abdul-Aziz Medical City, King Khaled National Guard Hospital-Western Region, Jeddah (Saudi Arabia); El-Hawary, Ron [Dalhousie University, Orthopedic Surgery Department, IWK Children' s Health Center, Halifax, NS (Canada); Schmit, Pierre [IWK Children' s Health Center, Dalhousie University, Diagnostic Imaging Department, Halifax, NS (Canada)

    2018-01-15

    Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

  14. Pediatric spine imaging post scoliosis surgery

    International Nuclear Information System (INIS)

    Alsharief, Alaa N.; El-Hawary, Ron; Schmit, Pierre

    2018-01-01

    Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible. To that end, the authors in this paper discuss postoperative imaging findings of Harrington rods, Luque rods, Luque-Galveston implants and segmental spinal fusion systems. Regarding early onset scoliosis, the guiding principles used for adolescent idiopathic scoliosis do not apply to a growing spine because they would impede lung development. As a result, other devices have been developed to correct the curve and to allow spinal growth. These include spine-based growing rods, vertically expandable prosthetic titanium rods (requiring repetitive surgeries) and magnetically controlled growing rods (with a magnetic locking/unlocking system). Other more recent systems are Shilla and thoracoscopic anterior vertebral body tethering, which allow guided growth of the spine without repetitive interventions. In this paper, we review the radiologic appearances of different orthopedic implants and techniques used to treat adolescent idiopathic scoliosis and early onset scoliosis. Moreover, we present the imaging findings of the most frequent postoperative complications. (orig.)

  15. [Clinical application of three-dimensional O-arm navigation system in treating patients with dystrophic scoliosis secondary to neurofibromatosis type Ⅰ].

    Science.gov (United States)

    Liu, Z; Qiu, Y; Li, Y; Zhao, Z H; Wang, B; Zhu, F; Yu, Y; Sun, X; Zhu, Z Z

    2017-03-01

    Objective: To investigate the clinical outcomes and the accuracy of O-arm-navigation system assisted pedicle screw insertion in dystrophic scoliosis secondary to neurofibromatosis type Ⅰ(NF-1). Methods: A retrospective study was conducted in 41 patients with dystrophic NF-1-associated thoracic scoliosis who were surgically treated at Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between June 2012 and October 2014 with more than 18 months follow-up. The patients were then divided into two groups: 18 patients were under the assistance of O-arm-navigation-based pedicle screw insertion (O-arm group) and the remaining 23 patients' pedicle screws insertion were conducted by free-hand (free-hand group). The X-ray and CT were analyzed to investigate the correction rate and safety of pedicle insertion. t -test was used to analyze measurement data and χ(2) test was used to analyze accuracy of screw insertion between the two groups. Results: The mean coronal Cobb angle was 63.2°±8.7° in the O-arm group and 66.9°±7.4° in the free-hand group ( P >0.05), which was then corrected into 23.1°±6.8° and 30.2°±7.6°( t =2.231, P =0.031) after surgery respectively.Operation time was (265.0±70.3)minutes and estimated blood loss was (1 024±465)ml in the O-arm group. Operation time and estimated blood loss was (243.0±49.6)minutes and (1 228±521)ml respectively in the free-hand group, which had no significant difference between the two groups. However, the implant density was higher in the O-arm group than that in the free-hand group ((64.1±10.8)% vs .(44.3±15.3)%)( t =4.652, P =0.000). The O-arm group comprised 122 screws, of which 72.9% were excellent, 22.1% were good and 4.9% were bad. The free-hand group comprised 136 screws and 48.5% of them were excellent, 33.8% were good and 17.6% were bad.Accuracy of pedicle screw insertion was higher in the O-arm group than that in the free-hand group(χ(2

  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. Imaging of painful scoliosis

    International Nuclear Information System (INIS)

    Davies, Alun; Saifuddin, Asif

    2009-01-01

    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.)

  18. Locomotor skills and balance strategies in adolescents idiopathic scoliosis.

    Science.gov (United States)

    Mallau, Sophie; Bollini, Gérard; Jouve, Jean-Luc; Assaiante, Christine

    2007-01-01

    Locomotor balance control assessment was performed to study the effect of idiopathic scoliosis on head-trunk coordination in 17 patients with adolescent idiopathic scoliosis (AIS) and 16 control subjects. The aim of this study was to explore the functional effects of structural spinal deformations like idiopathic scoliosis on the balance strategies used during locomotion. Up to now, the repercussion of the idiopathic scoliosis on head-trunk coordination and balance strategies during locomotion is relatively unknown. Seventeen patients with AIS (mean age 14 years 3 months, 10 degrees 30 degrees) and 16 control subjects (mean age 14 years 1 month) were tested during various locomotor tasks: walking on the ground, walking on a line, and walking on a beam. Balance control was examined in terms of rotation about the vertical axis (yaw) and on a frontal plane (roll). Kinematics of foot, pelvis, trunk, shoulder, and head rotations were measured with an automatic optical TV image processor in order to calculate angular dispersions and segmental stabilizations. Decreasing the walking speed is the main adaptive strategy used in response to balance problems in control subjects as well as patients with AIS. However, patients with AIS performed walking tasks more slowly than normal subjects (around 15%). Moreover, the pelvic stabilization is preserved, despite the structural changes affecting the spine. Lastly, the biomechanical defect resulting from idiopathic scoliosis mainly affects the yaw head stabilization during locomotion. Patients with AIS show substantial similarities with control subjects in adaptive strategies relative to locomotor velocity as well as balance control based on segmental stabilization. In contrast, the loss of the yaw head stabilization strategies, mainly based on the use of vestibular information, probably reflects the presence of vestibular deficits in the patients with AIS.

  19. Scoliosis Associated With Syringomyelia

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    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.

  20. 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.

  1. Clinically orientated classification incorporating shoulder balance for the surgical treatment of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Elsebaie, H B; Dannawi, Z; Altaf, F; Zaidan, A; Al Mukhtar, M; Shaw, M J; Gibson, A; Noordeen, H

    2016-02-01

    The achievement of shoulder balance is an important measure of successful scoliosis surgery. No previously described classification system has taken shoulder balance into account. We propose a simple classification system for AIS based on two components which include the curve type and shoulder level. Altogether, three curve types have been defined according to the size and location of the curves, each curve pattern is subdivided into type A or B depending on the shoulder level. This classification was tested for interobserver reproducibility and intraobserver reliability. A retrospective analysis of the radiographs of 232 consecutive cases of AIS patients treated surgically between 2005 and 2009 was also performed. Three major types and six subtypes were identified. Type I accounted for 30 %, type II 28 % and type III 42 %. The retrospective analysis showed three patients developed a decompensation that required extension of the fusion. One case developed worsening of shoulder balance requiring further surgery. This classification was tested for interobserver and intraobserver reliability. The mean kappa coefficients for interobserver reproducibility ranged from 0.89 to 0.952, while the mean kappa value for intraobserver reliability was 0.964 indicating a good-to-excellent reliability. The treatment algorithm guides the spinal surgeon to achieve optimal curve correction and postoperative shoulder balance whilst fusing the smallest number of spinal segments. The high interobserver reproducibility and intraobserver reliability makes it an invaluable tool to describe scoliosis curves in everyday clinical practice.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  3. Progression of spinal deformity in wheelchair-dependent patients with Duchenne muscular dystrophy who are not treated with steroids: coronal plane (scoliosis) and sagittal plane (kyphosis, lordosis) deformity.

    Science.gov (United States)

    Shapiro, F; Zurakowski, D; Bui, T; Darras, B T

    2014-01-01

    We determined the frequency, rate and extent of development of scoliosis (coronal plane deformity) in wheelchair-dependent patients with Duchenne muscular dystrophy (DMD) who were not receiving steroid treatment. We also assessed kyphosis and lordosis (sagittal plane deformity). The extent of scoliosis was assessed on sitting anteroposterior (AP) spinal radiographs in 88 consecutive non-ambulatory patients with DMD. Radiographs were studied from the time the patients became wheelchair-dependent until the time of spinal fusion, or the latest assessment if surgery was not undertaken. Progression was estimated using a longitudinal mixed-model regression analysis to handle repeated measurements. Scoliosis ≥ 10° occurred in 85 of 88 patients (97%), ≥ 20° in 78 of 88 (89%) and ≥ 30° in 66 of 88 patients (75%). The fitted longitudinal model revealed that time in a wheelchair was a highly significant predictor of the magnitude of the curve, independent of the age of the patient (p lordosis (16 (27%) abnormal and seven (11%) normal). This study provides a baseline to assess the effects of steroids and other forms of treatment on the natural history of scoliosis in patients with DMD, and an approach to assessing spinal deformity in the coronal and sagittal planes in wheelchair-dependent patients with other neuromuscular disorders.

  4. Surgical treatment of Lenke 1 thoracic adolescent idiopathic scoliosis with maintenance of kyphosis using the simultaneous double-rod rotation technique.

    Science.gov (United States)

    Sudo, Hideki; Ito, Manabu; Abe, Yuichiro; Abumi, Kuniyoshi; Takahata, Masahiko; Nagahama, Ken; Hiratsuka, Shigeto; Kuroki, Kei; Iwasaki, Norimasa

    2014-06-15

    Retrospective analysis of a prospectively collected, consecutive, nonrandomized series of patients. To assess the surgical outcomes of the simultaneous double-rod rotation technique for treating Lenke 1 thoracic adolescent idiopathic scoliosis (AIS). With the increasing popularity of segmental pedicle screw spinal reconstruction for treating AIS, concerns regarding the limited ability to correct hypokyphosis have also increased. A consecutive series of 32 patients with Lenke 1 main thoracic AIS treated with the simultaneous double-rod rotation technique at our institution was included. Outcome measures included patient demographics, radiographical measurements, and Scoliosis Research Society questionnaire scores. All 32 patients were followed up for a minimum of 2 years (average, 3.6 yr). The average main thoracic Cobb angle correction rate and the correction loss at the final follow-up were 67.8% and 3.3°, respectively. The average preoperative thoracic kyphosis (T5-T12) was 11.9°, which improved significantly to 20.5° (P correction of the main thoracic curve while maintaining sagittal profiles and correcting coronal and axial deformities. 4.

  5. 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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Study design Retrospective cross-sectional study. Objectives To analyze the referral pattern of patients with adolescent idiopathic scoliosis (AIS) in a tertiary hospital in a nationalized health care system without school screening and to compare curve magnitude on referral with results reported...... scoliosis screening. Our tertiary institution receives referrals for evaluation of AIS from general practitioners (GPs) and other hospitals or private specialists. Method A review was conducted on all patients diagnosed with AIS between 2010 and 2015. Data collection included age, gender, menarchal status...

  7. Culture and ethnicity influence outcomes of the Scoliosis Research Society Instrument in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Morse, Lee Jae; Kawakami, Noriaki; Lenke, Lawrence G; Sucato, Daniel J; Sanders, James O; Diab, Mohammad

    2012-05-20

    Retrospective comparative study. To report preoperative differences in the Scoliosis Research Society Outcomes Instrument (SRS-30) between multiple US ethnicities and native Japanese and Korean children with adolescent idiopathic scoliosis (AIS). The SRS-24 was developed in a US cohort with AIS. Comparative studies using the SRS-24 between US and Japanese patients showed differences, suggesting that culture might affect functional outcome. Preoperative SRS-30 outcomes were collected from 1853 children with AIS from 6 different ethnic groups: US white (1234), black (213), Hispanic (78), and Asian (29), as well as native Japanese (192) and Koreans (107). Analysis of covariance of 4 SRS-30 domains (pain, appearance, activity, and mental) was compared between groups adjusting for differences in age, sex, major curve magnitude, and body mass index. Pairwise comparisons of the 4 SRS-30 domains were adjusted for multiple comparisons, using Bonferroni correction. A P value of less than 0.05 was considered significant. Significant differences between ethnicities were found in all domains (P Culture and ethnicity influence SRS-30 outcomes in AIS. Whites reported more pain than Japanese and Koreans. Japanese and Koreans had the lowest appearance scores. Koreans additionally were distinguished by the lowest activity, mental, and total scores. These cultural and ethnic differences must be taken into account when counseling patients with AIS and studying functional outcomes.

  8. 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.

  9. Sagittal balance in scoliosis associated with Marfan syndrome: a stereoradiographic three-dimensional analysis.

    Science.gov (United States)

    Glard, Yann; Pomero, Vincent; Collignon, Patrick; Skalli, Wafa; Jouve, Jean-Luc; Bollini, Gérard

    2008-03-01

    Marfan syndrome (MFS) is a genetic disease often marked by the presence of scoliosis. There is no three-dimensional analysis of the deformity in the literature. Our aim was to determine what kind of sagittal balance defines scoliosis associated with MFS, namely a flexion deformity, as it is in scoliosis associated with Chiari I or an extension deformity, as in adolescent idiopathic scoliosis (AIS). To address this issue, we compared the presence or absence of a thoracic scoliosis with the presence or absence of a segment in extension in the thoracic spine. In our series, 30 patients diagnosed with Marfan syndrome were prospectively included. In each patient, personalized three-dimensional reconstruction from T1 to L5 of the spine was made using stereoradiography. The patients were first separated based on the presence or absence of thoracic scoliosis, in order to compare this with the presence or absence of a segment in extension in the thoracic spine. They were then classified into two groups based on the presence or absence of the segment in extension (meaning containing negative values of inter-vertebral sagittal rotation) in the thoracic spine. Among scoliotic patients with a thoracic scoliosis (17 cases), there were 13 (76.5% cases) with a segment in extension in the thoracic spine and 4 with no segment in extension. Our results showed that scoliosis associated with MFS is somehow original, demonstrating a sagittal balance in extension (as AIS) in about 80% of thoracic curves, but without this characteristic feature in about 20%.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis.

    Directory of Open Access Journals (Sweden)

    Ewa Misterska

    Full Text Available We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30 after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22 and Spinal Appearance Questionnaire (SAQ. Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace. The study group's SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002, among the remaining subscales the study group's results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016, function/activity (p<0.001 and the total score (p<0.001. The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  13. 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...

  14. Scoliosis in Steinert syndrome: a case report.

    Science.gov (United States)

    Themistocleous, George S; Sapkas, George S; Papagelopoulos, Panayiotis J; Stilianessi, Eugenia V; Papadopoulos, Elias Ch; Apostolou, Constantinos D

    2005-01-01

    Steinert syndrome is described as an autosomal dominant condition characterized by progressive muscular wasting, myotonia, musculoskeletal manifestations and rare spinal defects. Little is reported about spinal deformity associated with this syndrome. We present a patient with Steinert syndrome complicated by scoliosis. In the literature on muscular dystrophy, other than Duchenne, little mention is given to the problem of scoliosis in general and its treatment in particular. A case report of a patient with Steinert syndrome associated with thoracic scoliosis and hypokyphosis is presented. A 17-year-old boy presented with King type II right thoracic scoliosis (T5-T11, Cobb angle of 40 degrees) and hypokyphosis--10 degrees. He was treated with posterior stabilization and instrumentation at level T3-L2 with a postoperative correction of the scoliotic curve to 20 degrees. Histopathologic examination of the muscles confirmed the diagnosis of Steinert myotonic dystrophy. At 30-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. Scoliosis in Steinert syndrome shares the characteristic of an arthrogrypotic neuromuscular curve and demands the extensive soft tissue release for optimal surgical correction. Intraoperative observations included profound tissue bleeding, abnormally tough soft tissues and a difficult recovery from anaesthesia.

  15. [Therapeutic algorithm of idiopathic scoliosis in children].

    Science.gov (United States)

    Ciortan, Ionica; Goţia, D G

    2008-01-01

    Acquired deformations of spinal cord (scoliosis, kyphosis, lordosis) represent a frequent pathology in child; their treatment is complex, with variable results which depend on various parameters. Mild scoliosis, with an angle less than 30 degrees, is treated with physiotherapy and regular follow-up. If the angle is higher than 30 degrees, the orthopedic corset is required; the angle over 45 degrees impose surgically correction. The indications of every therapeutic method depend on many factors, the main target of the treatment is to prevent the aggravation of the curvature; concerning the surgery, the goal is to obtain a correction as normal as possible of the spinal axis.

  16. Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Smania, Nicola; Picelli, Alessandro; Romano, Michele; Negrini, Stefano

    2008-01-01

    Knowledge on mechanisms of neurophysiological control of trunk movement and posture could help in the development of rehabilitation programs and brace treatment in adolescent idiopathic scoliosis (AIS). Reviewing up-to-date research on neurophysiology of movement and posture control with the aim of providing basis for new researches in the field of AIS rehabilitation and background understanding for clinicians engaged in management of AIS. Review of literature. We considered several neurophysiological issues relevant for AIS rehabilitation, namely, the peculiar organization of patterns of trunk muscle recruitment, the structure of the neural hardware subserving axial and arm muscle control, and the relevance of cognitive systems allowing mapping of spatial coordinates and building of body schema. We made clear the reason why trunk control is generally carried out by means of very fast, feedforward or feedback driven patterns of muscle activation which are deeply rooted in our neural control system and very difficult to modify by training. We hypothesized that augmented sensory feedback and strength exercises could be an important stage in a rehabilitation program aimed at hindering, or possibly reversing, scoliosis progression. In this context we considered bracing not only as a corrective biomechanical device but also as a tool for continuous sensory stimulation that could help awareness of body misalignment. Future research aimed at developing strategies of trunk postural control learning is essential in the rehabilitation of adolescent idiopathic scoliosis.

  17. 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.

  18. Detorsion night-time bracing for the treatment of early onset idiopathic scoliosis.

    Science.gov (United States)

    Moreau, S; Lonjon, G; Mazda, K; Ilharreborde, B

    2014-12-01

    Management for early onset scoliosis has recently changed, with the development of new surgical procedures. However, multiple surgeries are often required and high complication rates are still reported. Conservative management remains an alternative, serial casting achieving excellent results in young children. Better compliance and improvement over natural history have been reported with night-time bracing in adolescent idiopathic scoliosis (AIS), but this treatment has never been reported in early onset idiopathic scoliosis (EIOS). All patients treated for progressive EOIS by detorsion night-time bracing (DNB), and meeting the Scoliosis Research Society (SRS) criteria for brace studies were reviewed. Recommendations were given to wear the DNB 8h/night and no restriction was given regarding sports activities. Radiological parameters were compared between referral and latest follow-up. Based on the SRS criteria defined for AIS, a similar classification was used as follows to analyze the course of the curves: success group: patients with a progression of 5° or less; unsuccess group (progression or failure): patients with a progression>5°, patients with curves exceeding 45° at maturity, or who have had recommendation for/undergone surgery, or patients who changed orthopaedic treatment, or who were lost to follow-up. Thirty-three patients were included (21 girls and 12 boys), with a median Cobb angle of 31° (Q1-Q3: 22-40). Age at brace initiation averaged 50months (Q1-Q3: 25-60). Median follow-up was 102-months (Q1-Q3: 63-125). Fifteen patients (45.5%) had reached skeletal maturity at last follow-up. The success rate was 67% (22 patients), with a median Cobb angle reduction of 15° (P<0.001). Four patients stopped DNB due to an important regression. Eleven patients were in the unsuccessful group (33%). Only one had surgery. All patients remained balanced in the frontal plane and normokyphotic. Initial curve magnitude and age at brace initiation appeared to be

  19. Adolescent Idiopathic Scoliosis Surgery by a Neurosurgeon: Learning Curve for Neurosurgeons.

    Science.gov (United States)

    Hyun, Seung-Jae; Han, Sanghyun; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Yongjung J; Rhim, Seung-Chul; Kim, Hyun-Jib

    2018-02-01

    To determine a neurosurgeon's learning curve of surgical treatment for adolescent idiopathic scoliosis (AIS) patients. This study is a retrospective analysis. Forty-six patients were treated by a single neurosurgeon between 2011 and 2017 using posterior segmental instrumentation and fusion. According to the time period, the former and latter 23 patients were divided into group 1 and group 2, respectively. Patients' demographic data, curve magnitude, number of levels treated, amount of correction achieved, radiographic/clinical outcomes, and complications were compared between the groups. The majority were females (34 vs. 12) with average ages of 15.0 versus 15.6, respectively. The mean follow-up period was 24.6 months. The average number of fusion levels was similar with 10.3 and 11.5 vertebral bodies in groups 1 and 2, respectively. The average Cobb angle of major curvature was 59.8° and 58.5° in groups 1 and 2, respectively. There observed significant reductions of operative time (324.4 vs. 224.7 minutes, P = 0.007) and estimated blood loss (648.3 vs. 438.0 mL, P = 0.027) in group 2. The correction rate of the major structural curve was greater in group 2 (70.7% vs. 81.0%, P = 0.001). There was no case of neurologic deficit, infection, and revision for screw malposition. One patient of group 1 underwent fusion extension surgery for shoulder asymmetry. Radiographic and clinical outcomes of AIS patients treated by a neurosurgeon were acceptable. AIS surgery may be performed with an acceptable rate of complications after about 20 surgeries. With acquisition of surgical experiences, neurosurgeons could perform deformity surgery for AIS effectively and safely. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Converting Scoliosis Research Society-24 to Scoliosis Research Society-22r in a Surgical-Range, Medical/Interventional Adolescent Idiopathic Scoliosis Patient Cohort.

    Science.gov (United States)

    Chen, Antonia F; Bi, Wenzhu; Singhabahu, Dilrukshika; Londino, Joanne; Hohl, Justin; Ward, Maeve; Ward, W Timothy

    2013-03-01

    Prospective questionnaire administration study. To assess the ability to translate total and domain scores from Scoliosis Research Society (SRS)-24 to SRS-22r in a surgical-range, medical/interventional adolescent idiopathic scoliosis (AIS) patient population. Conversion of SRS-24 to SRS-22r is demonstrated in an operative cohort of patients with AIS, but not in a medical/interventional patient population. We simultaneously administered SRS-24 and SRS-22r questionnaires to 75 surgical-range, medical/interventional AIS patients and compared them. We performed analysis by regression modeling to produce conversion equations from SRS-24 to SRS-22r. The total SRS-24 score for these medical/interventional AIS patients was 92.5 ± 9.45 (mean, 3.9 ± 0.39), and the total SRS-22r score was 93.5 ± 9.63 (mean, 4.3 ± 0.44). The correlation between these 2 groups was fair (R 2 = 0.77) and improved to good when mental health or recall questions were removed. The correlation was also fair for total pain domains (R 2 = 0.73). However, there was poor correlation for general self-image (R 2 = 0.6) and unacceptable for post-treatment self-image (R 2 = 0.01), general function (R 2 = 0.52), activity function (R 2 = 0.56), and satisfaction (R 2 = 0.53). Compared with a published population of operative AIS patients, R 2 values for total SRS-24 scores, pain, general self-image, activity function, and satisfaction were similar (p > .05). The R 2 values for general function and combined general and activity function were significantly different between the operative and medical/interventional cohorts. Scoliosis Research Society-24 can be converted to SRS-22r scores with fair accuracy in the surgical-range, medical/interventional AIS patient population for total score, and total pain domains. The SRS-24 translates unacceptably to the SRS-22r in self-image, function, and satisfaction domains. The SRS-24 to SRS-22r conversion equations are similar to operative AIS patients, except for the

  1. Family history and its association to curve size and treatment in 1,463 patients with idiopathic scoliosis.

    Science.gov (United States)

    Grauers, Anna; Danielsson, Aina; Karlsson, Magnus; Ohlin, Acke; Gerdhem, Paul

    2013-11-01

    To study family history in relation to curve severity, gender, age at diagnosis and treatment in idiopathic scoliosis. A self-assessment questionnaire on family history of scoliosis was administered to 1,463 untreated, brace or surgically treated idiopathic scoliosis patients. Out of the 1,463 patients, 51 % had one or more relatives with scoliosis. There was no significant difference between females and males, nor between juvenile and adolescent study participants in this respect (p = 0.939 and 0.110, respectively). There was a significant difference in maximum curve size between patients with one or more relatives with scoliosis (median 35°, interquartile range 25) and patients without any relative with scoliosis (median 32°, interquartile range 23) (p = 0.022). When stratifying patients according to treatment (observation, brace treatment or surgery), we found that it was more common to have a relative with scoliosis among the treated patients (p = 0.011). The OR for being treated was 1.32 (95% CI 1.06-1.64) when the patient had a relative with scoliosis, compared to not having. Larger curve sizes were found in patients with a family history of scoliosis than in the ones without. No relation between family history and gender or between family history and age at onset of idiopathic scoliosis was found. Although the presence of a family history of scoliosis may not be a strong prognostic risk factor, it indicates that these patients are at higher risk of developing a more severe curve.

  2. Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis?

    OpenAIRE

    Cheshire, James; Gardner, Adrian; Berryman, Fiona; Pynsent, Paul

    2017-01-01

    Background Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS. The aim of this study was to exami...

  3. 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

  4. THE EFFECT OF CORRECTIVE SURGERY OF SCOLIOSIS ON CERVICAL LORDOTIC AXIS

    OpenAIRE

    CALADO, ALDO; SANTOS, JULIANO RODRIGUES DOS; BAPTISTA, JOSE ALEXANDRE CUNHA; BRACONI, ANTONIO CARLOS MONTEIRO; HENRIQUES, GUILHERME GALITO; ROZINDO, DANUSA DE MELO; LEAL, JEFFERSON SOARES

    2017-01-01

    ABSTRACT Objectives: To quantify the changes in cervical sagittal alignment of patients with adolescent idiopathic scoliosis (AIS) who underwent surgical treatment. Methods: Retrospective study of radiographic data analysis. Data were collected from 25 radiographs of patients with AIS, and 18 cases were included. The mean age was 15.2 years (13-17 years); all subjects were female, operated from March 2010 to October 2015. Pre and postoperatively, cervical lordosis (C2-C7), thoracic kyphos...

  5. Radiation-induced scoliosis

    International Nuclear Information System (INIS)

    Sekine, Kiichi; Morii, Kazue; Ohmi, Keiko; Akanuma, Atsuo.

    1976-01-01

    Observation was made as to 9 cases who received x-ray therapy (1,500 - 3,500 R) over the abdomen at their childhood and description was also made as to scoliosis. Mild scoliosis was recognized in 6 cases, which was probably due to their age under ten years old. The future observation was necessary in cases who passed through the period of adolescent growth spurt. There was a case who showed wedge shape deformation of the spine at 1,500 R. Abnormal case was not recognized in lordosis. (Serizawa, K.)

  6. Radiation-induced scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, K [Saitama Cancer Center, Ageo (Japan); Morii, K; Ohmi, K; Akanuma, A

    1976-02-01

    Observation was made as to 9 cases who received x-ray therapy (1,500 - 3,500 R) over the abdomen at their childhood and description was also made as to scoliosis. Mild scoliosis was recognized in 6 cases, which was probably due to their age under ten years old. The future observation was necessary in cases who passed through the period of adolescent growth spurt. There was a case who showed wedge shape deformation of the spine at 1,500 R. Abnormal case was not recognized in lordosis.

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

    Directory of Open Access Journals (Sweden)

    Wyatt Lawrence A

    2005-11-01

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

  8. Genetics Home Reference: adolescent idiopathic scoliosis

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Adolescent idiopathic scoliosis Adolescent idiopathic scoliosis Printable PDF Open All Close All ... Javascript to view the expand/collapse boxes. Description Adolescent idiopathic scoliosis is an abnormal curvature of the ...

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

    NARCIS (Netherlands)

    Schlösser, Tom P C; van Stralen, M; Chu, Winnie C W; Lam, Tsz-Ping; Ng, Bobby K W; Vincken, Koen L; Cheng, Jack C Y; Castelein, RM

    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

  10. The etiologic relevance of 3-d pathoanatomy of adolescent idiopathic scoliosis

    NARCIS (Netherlands)

    Schlösser, Tom; Brink, Rob; Castelein, René

    2017-01-01

    Despite many years of dedicated research into the etiopathogenesis of adolescent idiopathic scoliosis, there is still no single distinct cause for this puzzling condition. In this overview, we attempt to link knowledge on the complex three-dimensional pathoanatomy of AIS, based on our ongoing

  11. Predicting operative blood loss during spinal fusion for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ialenti, Marc N; Lonner, Baron S; Verma, Kushagra; Dean, Laura; Valdevit, Antonio; Errico, Thomas

    2013-06-01

    Patient and surgical factors are known to influence operative blood loss in spinal fusion for adolescent idiopathic scoliosis (AIS), but have only been loosely identified. To date, there are no established recommendations to guide decisions to predonate autologous blood, and the current practice is based primarily on surgeon preference. This study is designed to determine which patient and surgical factors are correlated with, and predictive of, blood loss during spinal fusion for AIS. Retrospective analysis of 340 (81 males, 259 females; mean age, 15.2 y) consecutive AIS patients treated by a single surgeon from 2000 to 2008. Demographic (sex, age, height, weight, and associated comorbidities), laboratory (hematocrit, platelet, PT/PTT/INR), standard radiographic, and perioperative data including complications were analyzed with a linear stepwise regression to develop a predictive model of blood loss. Estimated blood loss was 907±775 mL for posterior spinal fusion (PSF, n=188), 323±171 mL for anterior spinal fusion (ASF, n=124), and 1277±821 mL for combined procedures (n=28). For patients undergoing PSF, stepwise analysis identified sex, preoperative kyphosis, and operative time to be the most important predictors of increased blood loss (Ploss in PSF: blood loss (mL)=C+Op-time (min)×(6.4)-pre-op T2-T12 kyphosis (degrees)×(8.7), C=233 if male and -270 if female. We find sex, operative time, and preoperative kyphosis to be the most important predictors of increased blood loss in PSF for AIS. Mean arterial pressure and operative time were predictive of estimated blood loss in ASF. For posterior fusions, we also present a model that estimates blood loss preoperatively and can be used to guide decisions regarding predonation of blood and the use of antifibrinolytic agents. Retrospective study: Level II.

  12. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

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

    Science.gov (United States)

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

    2015-07-01

    The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. 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 Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, 2.6±0.5, 3.3±0.1, 4.0±0.5, and 4.6±0.0, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (pneurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery.

  14. Responsiveness and Minimal Important Changes of the Scoliosis Research Society-22 Patient Questionnaire in Subjects With Mild Adolescent and Moderate Adult Idiopathic Scoliosis Undergoing Multidisciplinary Rehabilitation.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

    2017-06-01

    Single-center, prospective study. Evaluating the responsiveness and minimal important changes (MICs) for the Scoliosis Research Society-22 Patient Questionnaire (SRS-22) in adolescent idiopathic scoliosis (AIS) and adult idiopathic scoliosis (AS). Despite the SRS-22 properties have been investigated in various different languages, there is still a lack of information concerning responsiveness and MIC, limiting the use of SRS-22 for clinical and research purposes. At the beginning and end of multidisciplinary rehabilitation programs, 149 subjects with mild AIS (Cobb angle self-perceived image, 0.40 (0.609;79;42) for AIS and 0.60 (0.751;61;82) for AS. Correlations between change scores of the SRS-22 domains and GPE were low to moderate, ranging from -0.347 to -0.667. The SRS-22 was sensitive in detecting clinical changes in subjects with adolescent and adult scoliosis. We recommend taking the MICs provided into account when assessing patients' improvement or planning studies in these clinical contexts. 3.

  15. 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

  16. A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.

    Science.gov (United States)

    Wilson, Philip L; Newton, Peter O; Wenger, Dennis R; Haher, Thomas; Merola, Andrew; Lenke, Larry; Lowe, Thomas; Clements, David; Betz, Randy

    2002-09-15

    A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. To evaluate the association between an objective radiographic scoring system and patient quality of life measures as determined by the Scoliosis Research Society outcomes instrument. Although surgical correction of scoliosis has been reported to be positively correlated with patient outcomes, studies to date have been unable to demonstrate an association between radiographic measures of deformity and outcomes measures in patients with adolescent idiopathic scoliosis. A standardized radiographic deformity scoring system and the Scoliosis Research Society outcome tool were used prospectively in seven scoliosis centers to collect data on patients with adolescent idiopathic scoliosis. A total of 354 data points for 265 patients consisting of those with nonoperative or preoperative curves >or=10 degrees, as well as those with surgically treated curves, were analyzed. Correlation analysis was performed to identify significant relationships between any of the radiographic measures, the Harms Study Group radiographic deformity scores (total, sagittal, coronal), and the seven Scoliosis Research Society outcome domains (Total Pain, General Self-Image, General Function, Activity, Postoperative Self-Image, Postoperative Function, and Satisfaction) as well as Scoliosis Research Society outcomes instrument total scores. Radiographic measures that were identified as significantly correlated with Scoliosis Research Society outcome scores were then entered into a stepwise regression analysis. The coronal measures of thoracic curve and lumbar curve magnitude were found to be significantly correlated with the Total Pain, General Self-Image, and total Scoliosis Research Society scores (P Society domain and total scores. No radiographic measures taken after surgery were significantly correlated with the postoperative domains of the Scoliosis Research Society

  17. Correlation analysis between change in thoracic kyphosis and multilevel facetectomy and screw density in main thoracic adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

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

    2016-09-01

    Controversy exists regarding the effects of multilevel facetectomy and screw density on deformity correction, especially thoracic kyphosis (TK) restoration in adolescent idiopathic scoliosis (AIS) surgery. This study aimed to evaluate the effects of multilevel facetectomy and screw density on sagittal plane correction in patients with main thoracic (MT) AIS curve. A retrospective correlation and comparative analysis of prospectively collected, consecutive, non-randomized series of patients at a single institution was undertaken. Sixty-four consecutive patients with Lenke type 1 AIS treated with posterior correction and fusion surgery using simultaneous double-rod rotation technique were included. Patient demographics and preoperative and 2-year postoperative radiographic measurements were the outcome measures for this study. Multiple stepwise linear regression analysis was conducted between change in TK (T5-T12) and the following factors: age at surgery, Risser sign, number of facetectomy level, screw density, preoperative main thoracic curve, flexibility in main thoracic curve, coronal correction rate, preoperative TK, and preoperative lumbar lordosis. Patients were classified into two groups: TKcorrect hypokyphosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Evaluation and management of adolescent idiopathic scoliosis: a review.

    Science.gov (United States)

    Jada, Ajit; Mackel, Charles E; Hwang, Steven W; Samdani, Amer F; Stephen, James H; Bennett, James T; Baaj, Ali A

    2017-10-01

    Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options. Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS. Patients with AIS can be managed very well with a combination of conservative and surgical options. Outcomes for these children are excellent with sustained longer-term results.

  19. 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.

  20. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Metin Keskin

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

  1. Genome-wide association studies of adolescent idiopathic scoliosis suggest candidate susceptibility genes

    Science.gov (United States)

    Sharma, Swarkar; Gao, Xiaochong; Londono, Douglas; Devroy, Shonn E.; Mauldin, Kristen N.; Frankel, Jessica T.; Brandon, January M.; Zhang, Dongping; Li, Quan-Zhen; Dobbs, Matthew B.; Gurnett, Christina A.; Grant, Struan F.A.; Hakonarson, Hakon; Dormans, John P.; Herring, John A.; Gordon, Derek; Wise, Carol A.

    2011-01-01

    Adolescent idiopathic scoliosis (AIS) is an unexplained and common spinal deformity seen in otherwise healthy children. Its pathophysiology is poorly understood despite intensive investigation. Although genetic underpinnings are clear, replicated susceptibility loci that could provide insight into etiology have not been forthcoming. To address these issues, we performed genome-wide association studies (GWAS) of ∼327 000 single nucleotide polymorphisms (SNPs) in 419 AIS families. We found strongest evidence of association with chromosome 3p26.3 SNPs in the proximity of the CHL1 gene (P protein related to Robo3. Mutations in the Robo3 protein cause horizontal gaze palsy with progressive scoliosis (HGPPS), a rare disease marked by severe scoliosis. Other top associations in our GWAS were with SNPs in the DSCAM gene encoding an axon guidance protein in the same structural class with Chl1 and Robo3. We additionally found AIS associations with loci in CNTNAP2, supporting a previous study linking this gene with AIS. Cntnap2 is also of functional interest, as it interacts directly with L1 and Robo class proteins and participates in axon pathfinding. Our results suggest the relevance of axon guidance pathways in AIS susceptibility, although these findings require further study, particularly given the apparent genetic heterogeneity in this disease. PMID:21216876

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

    OpenAIRE

    Weiss, Hans-Rudolf; Negrini, Stefano; Hawes, Martha C; Rigo, Manuel; Kotwicki, Tomasz; Grivas, Theodoros B; Maruyama, Toru

    2006-01-01

    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 interna...

  3. Artificial Intelligence Study (AIS).

    Science.gov (United States)

    1987-02-01

    ARTIFICIAL INTELLIGNECE HARDWARE ....... 2-50 AI Architecture ................................... 2-49 AI Hardware ....................................... 2...ftf1 829 ARTIFICIAL INTELLIGENCE STUDY (RIS)(U) MAY CONCEPTS 1/3 A~NLYSIS AGENCY BETHESA RD R B NOJESKI FED 6? CM-RP-97-1 NCASIFIED /01/6 M |K 1.0...p/ - - ., e -- CAA- RP- 87-1 SAOFŔ)11 I ARTIFICIAL INTELLIGENCE STUDY (AIS) tNo DTICFEBRUARY 1987 LECT 00 I PREPARED BY RESEARCH AND ANALYSIS

  4. 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.

  5. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Discriminative validity of the Scoliosis Research Society 22 questionnaire among five curve-severity subgroups of adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Berliner, Jonathan L; Verma, Kushagra; Lonner, Baron S; Penn, Phedra U; Bharucha, Neil J

    2013-02-01

    Previous studies of the Scoliosis Research Society (SRS) 22 discriminative validity have lacked sufficiently matched study groups and were limited to a comparison with three or fewer subgroups of disease severity. To evaluate the discriminative validity of SRS-22 by assessing the questionnaire's ability to discriminate among five groups of pretreatment adolescent idiopathic scoliosis (AIS) patients with increasing curve severity. Retrospective review of prospectively administered surveys. Two hundred eighty-six SRS-22 questionnaires were issued to two AIS pretreatment patient populations: 67 nonoperative and 219 preoperative. Study subjects were separated into five subgroups depending on the major Cobb angle (nonoperative 0°-19° and 20°-40° and preoperative 41°-50°, 51°-60°, and >60°). Each group (n=31) was matched for age (within 1 year) and sex (23 females and 8 males), resulting in a total of 155 study subjects. Analysis of variance was used to determine statistically significant differences (pself-image than all three preoperative groups. Both nonoperative groups' total scores were significantly higher than all three preoperative groups' scores, with the exception of the 20° to 40° subgroup versus the >60° subgroup. No significant differences were found between groups within the same planned treatment category. The SRS-22 questionnaire demonstrated good discriminative validity between small nonoperative curves and larger surgical curves within the pain, image, and total domains. However, SRS-22 lacked the ability to differentiate between small intervals of curve magnitude, suggesting a limitation to the questionnaire's discriminative capacity. The discriminative validity of the Scoliosis Research Society (SRS) 22 has not been clearly defined. Our analysis of 155 adolescent idiopathic scoliosis patients evaluates the instrument's discriminative validity among five age- and sex-matched curve-severity subgroups. The SRS-22 questionnaire lacked the

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

    Science.gov (United States)

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

    2015-04-01

    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). 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 Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Cobb's angle and coronal balance improved significantly after surgery (Pself-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction.

  8. Tranexamic Acid Reduced the Percent of Total Blood Volume Lost During Adolescent Idiopathic Scoliosis Surgery.

    Science.gov (United States)

    Jones, Kristen E; Butler, Elissa K; Barrack, Tara; Ledonio, Charles T; Forte, Mary L; Cohn, Claudia S; Polly, David W

    2017-01-01

    Multilevel posterior spine fusion is associated with significant intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent that reduces intraoperative blood loss. The goal of this study was to compare the percent of total blood volume lost during posterior spinal fusion (PSF) with or without tranexamic acid in patients with adolescent idiopathic scoliosis (AIS). Thirty-six AIS patients underwent PSF in 2011-2014; the last half (n=18) received intraoperative tranexamic acid. We retrieved relevant demographic, hematologic, intraoperative and outcomes information from medical records. The primary outcome was the percent of total blood volume lost, calculated from estimates of intraoperative blood loss (numerator) and estimated total blood volume per patient (denominator, via Nadler's equations). Unadjusted outcomes were compared using standard statistical tests. Tranexamic acid and no-tranexamic acid groups were similar (all p>0.05) in mean age (16.1 vs. 15.2 years), sex (89% vs. 83% female), body mass index (22.2 vs. 20.2 kg/m2), preoperative hemoglobin (13.9 vs. 13.9 g/dl), mean spinal levels fused (10.5 vs. 9.6), osteotomies (1.6 vs. 0.9) and operative duration (6.1 hours, both). The percent of total blood volume lost (TBVL) was significantly lower in the tranexamic acid-treated vs. no-tranexamic acid group (median 8.23% vs. 14.30%, p = 0.032); percent TBVL per level fused was significantly lower with tranexamic acid than without it (1.1% vs. 1.8%, p=0.048). Estimated blood loss (milliliters) was similar across groups. Tranexamic acid significantly reduced the percentage of total blood volume lost versus no tranexamic acid in AIS patients who underwent PSF using a standardized blood loss measure.Level of Evidence: 3. Institutional Review Board status: This medical record chart review (minimal risk) study was approved by the University of Minnesota Institutional Review Board.

  9. Do Sublaminar Polyester Bands Affect the Outcomes of Postoperative Infections After Adolescent Idiopathic Scoliosis Surgery?

    Science.gov (United States)

    Issa, Samir P; Angelliaume, Audrey; Vidal, Christophe; Mazda, Keyvan; Ilharreborde, Brice

    2017-12-01

    The incidence of surgical site infections (SSI) after adolescent idiopathic scoliosis (AIS) surgery ranges from 0.5% to 7%. There is currently a regain of interest in hybrid constructs, combining lumbar pedicle screws and thoracic sublaminar bands, but some authors have raised concerns about the risk of SSI and the difficulty of bacterial eradication. The goal of this study was therefore to assess the outcomes of SSI after AIS surgery using sublaminar bands. A total of 524 consecutive patients operated for AIS using sublaminar bands between June 2006 and June 2014 were included. SSI cases were identified and analyzed retrospectively. Radiologic and functional outcomes were evaluated at follow-up using EOS imaging and SRS 30 scores, and compared with a control group. The overall SSI rate was 5.3%, with a majority of monomicrobial (86%) infections occurring in the first 6 weeks postoperative (93%). The most frequent pathogens were skin germs (Staphylococcus aureus and Propionibacterium acnes) with a community profile. Patients were treated successfully with surgical debridement without implants removal, associated with 6 weeks of antibiotherapy. However, 25% of patients required >1 surgical debridement. Instrumentation removal was decided in the 2 cases with late SSI, and performed uneventfully. Radiologic and functional outcomes at follow-up were not affected by the occurrence of SSI. Sublaminar bands are not associated with a higher risk of infection. However, the SSI rate in the current study stands in the upper range of the literature, and other preventive strategies should be considered. In case of early infection, bands removal is not necessary to obtain pathogen eradication, but the sublaminar implants can be pulled out safely in case of late SSI. The occurrence of SSI does not alter the outcomes at follow-up. Level III.

  10. Comparison of novel ultra-high molecular weight polyethylene tape versus conventional metal wire for sublaminar segmental fixation in the treatment of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Takahata, Masahiko; Ito, Manabu; Abumi, Kuniyoshi; Kotani, Yoshihisa; Sudo, Hideki; Ohshima, Shigeki; Minami, Akio

    2007-08-01

    Retrospective study. To compare the surgical outcomes of posterior translational correction and fusion using hybrid instrumentation systems with either sublaminar Nesplon tape or sublaminar metal wire to treat adolescent idiopathic scoliosis (AIS). Nesplon tape, which consists of a thread of ultra-high molecular weight polyethylene fibers, has advantages over metal wire: (1) its soft and flexible properties avoid neural damage and (2) its flat configuration avoids focal distribution of the stresses to lamina; however, the efficacy of Nesplon tape in the correction of spinal deformity is as yet, still unclear. Thirty AIS patients at a single institution underwent posterior correction and fusion using hybrid instrumentation containing hook, pedicle screw, and either sublaminar polyethylene taping (15) or sublaminar metal wiring (15). Patients were evaluated preoperatively, immediately after surgery, and at a 2-year follow-up according to the radiographic changes in curve correction, operating time, intraoperative blood loss, complications, and the Scoliosis Research Society patient questionnaire (SRS-24) score. The average correction rate was 63.0% in the Nesplon tape group and 59.9% in the metal wire group immediately after surgery (P = 0.62). Fusion was obtained in all the patients without significant correction loss in both groups. There was no significant difference in operative time, intraoperative blood loss, and postoperative SRS-24 scores between the 2 groups. Complications were superficial skin infection in a single patient in the Nesplon tape group, and transient sensory disturbance in 1 patient and temporal superior mesenteric artery syndrome in another patient in the metal wire group. The efficacy of Nesplon tape in correction of deformity is equivalent to that of metal wire, and fusion was completed without significant correction loss. The soft and flexible properties and flat configuration of Nesplon tape make this a safe application for the treatment

  11. Hybrid constructs for tridimensional correction of the thoracic spine in adolescent idiopathic scoliosis: a comparative analysis of universal clamps versus hooks.

    Science.gov (United States)

    Ilharreborde, Brice; Even, Julien; Lefevre, Yan; Fitoussi, Franck; Presedo, Ana; Penneçot, Georges-François; Mazda, Keyvan

    2010-02-01

    Retrospective study of prospectively collected data. Compare Universal Clamps (UCs) and hooks for the thoracic correction of adolescent idiopathic scoliosis (AIS). In scoliosis surgery, sagittal correction is as important as frontal correction due to the risk of junctional kyphosis. Compared to all-screw constructs, hybrid constructs with lumbar pedicle screws and thoracic hooks or sublaminar wires have been shown to achieve similar coronal correction while providing superior postoperative thoracic kyphosis. The authors used a novel sublaminar thoracic implant, the UC with improvements over sublaminar wires. Hybrid constructs using thoracic UCs were compared to those with thoracic hooks. This series involved 150 patients treated for AIS with hybrid constructs. A total of 75 consecutive patients operated from 2001 to 2003, who had thoracic hooks with in situ contouring, distraction, and compression (Group 1), were compared to 75 consecutive patients operated from 2004 to 2006, who had thoracic UCs with posteromedial translation (Group 2). All had intraoperative somatosensory/motor-evoked potential monitoring and at least 2-years follow-up. Except for follow-up (longer in Group 1), the 2 groups were similar before surgery. The UCs achieved better thoracic coronal correction (P motor-evoked potentials. UC reduced operative time by 20% (60 minutes; P < 0.001) and blood loss by 23% (250 mL; P < 0.001). Although both of these hybrid constructs efficaciously corrected the coronal and axial deformities in AIS, the results of the UC technique were superior to those achieved with hooks in all 3 planes, especially the sagittal plane. Moreover, the UC technique is straightforward and safe, reducing both operative duration and blood loss.

  12. Treatment of the idiopathic scoliosis with brace and physiotherapy.

    Science.gov (United States)

    Hundozi-Hysenaj, Hajrije; Dallku, Iliriana Boshnjaku; Murtezani, Ardiana; Rrecaj, Shkurte

    2009-01-01

    Scoliosis is a three-dimensional deformation of the spine with a lateral curvature or deviation greater than 10 degrees and associated with vertebral rotation. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their effectiveness is still questioned. The objective of this study was to define the effectiveness of braces and individual physiotherapy for the comprehensive treatment of idiopathic scoliosis in adolescents. A retrospective study of 57 children with idiopathic thoracic dextroscoliosis with the magnitude of the thoracic curve between 20 degrees-35 degrees, treated in Orthopedic and Physiatrist Clinic as well as National Ortho-prosthetic Center within University Clinical Center of Kosova in Prishtina, during the period of 2003-2006. Inclusion of kinesitherapy in the comprehensive management of idiopathic scoliosis varied in the improvement of the muscle strength (satisfied and moderate) in almost 80% of the children while the correction of the curve was small in approximately 42.1% of cases. For children with idiopathic scoliosis, who require braces, an exercise program helps chest mobility, muscle strength, proper breathing flexibility in the spine, correct posture and keeps muscles in tone so that the transition period after brace removal is easier.

  13. Risk factors for scoliosis in children with neuroblastoma

    International Nuclear Information System (INIS)

    Paulino, Arnold C.; Fowler, B. Zach

    2005-01-01

    Purpose: To determine the risk factors for scoliosis in children treated for neuroblastoma. Methods and materials: From 1957 to 1997, 58 children with neuroblastoma were treated at one institution and have survived a minimum of 5 years. There were 35 boys and 23 girls with a median age of 6 months (range, 2 weeks to 15 years) at initial diagnosis. Primary site was located in the adrenal gland in 25 (43.1%), abdominal/nonadrenal in 16 (27.6%), thoracic in 12 (20.7%), cervical in 3 (5.3%), and pelvic region in 2 (3.5%). The International Neuroblastoma Staging System (INSS) stage was Stage 1 in 10 (17.2%), Stage 2A in 7 (12.1%), Stage 2B in 5 (8.6%), Stage 3 in 22 (37.9%), Stage 4 in 4 (6.9%), and Stage 4S in 10 (17.2%). Thirty-three (56.9%) received chemotherapy whereas 5 (8.6%) had a laminectomy as part of the surgical procedure. Twenty-seven (46.6%) received radiotherapy (RT). Beam energy was 1.25 MV in 11 (41%), 250 kV in 10 (37%), 4 MV in 4 (15%), and 6-MV photons in 1 patient. One patient received 300 cGy in 1 fraction total skin RT using 6-MeV electrons. For the remaining patients, fraction size was 100 cGy in 6 (22%), 150-180 cGy in 11 (41%), 200 cGy in 4 (15%), and 250-300 cGy in 3. Three patients had total body irradiation at 333 cGy for 3 fractions. For all children who received RT, median total dose was 2000 cGy (range, 300-3900 cGy). Patients who were treated with RT had plain films of the irradiated area every 1 to 2 years until at least the age of puberty. Median follow-up was 10 years (range, 5-46 years). Results: The overall 5-, 10-, and 15-year scoliosis-free rates were 87.6%, 79.0%, and 76.0% respectively. Twelve (21%) developed scoliosis at a median time of 51 months (range, 8-137 months). The degree of scoliosis was mild (≤20 deg ) in 8 (67%). Four had scoliosis ranging from 30 deg to 66 deg ; 3 of these patients required surgical intervention, whereas 1 had an underlying Duchenne muscular dystrophy which manifested itself 8 years after

  14. 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....

  15. Titanium vs cobalt chromium: what is the best rod material to enhance adolescent idiopathic scoliosis correction with sublaminar bands?

    Science.gov (United States)

    Angelliaume, Audrey; Ferrero, E; Mazda, K; Le Hanneur, M; Accabled, F; de Gauzy, J Sales; Ilharreborde, B

    2017-06-01

    Cobalt chromium (CoCr) rods have recently gained popularity in adolescent idiopathic scoliosis (AIS) surgical treatment, replacing titanium (Ti) rods, with promising frontal correction rates in all-screw constructs. Posteromedial translation has been shown to emphasize thoracic sagittal correction, but the influence of rod material in this correction technique has never been investigated. The aim of this study was to compare the postoperative correction between Ti and CoCr rods for the treatment of thoracic AIS using posteromedial translation technique. 70 patients operated for thoracic (Lenke 1 or 2) AIS, in 2 institutions, between 2010 and 2013, were included. All patients underwent posterior fusion with hybrid constructs using posteromedial translation technique. The only difference between groups in the surgical procedure was the rod material (Ti or CoCr rods). Radiological measurements were compared preoperatively, postoperatively and at last follow-up (minimum 2 years). Preoperatively, groups were similar in terms of coronal and sagittal parameters. Postoperatively, no significant difference was observed between Ti and CoCr regarding frontal corrections, even when the preoperative flexibility of the curves was taken into account (p = 0.13). CoCr rods allowed greater restoration of T4T12 thoracic kyphosis, which remained stable over time (p = 0.01). Most common postoperative complication was proximal junctional kyphosis (n = 4). However, no significant difference was found between groups regarding postoperative complications rate. CoCr and Ti rods both provide significant and stable frontal correction in AIS treated with posteromedial translation technique using hybrid constructs. However, CoCr might be considered to emphasize sagittal correction in hypokyphotic patients.

  16. Association between vitamin d levels and adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. Body image in patients with adolescent idiopathic scoliosis: validation of the Body Image Disturbance Questionnaire--Scoliosis Version.

    Science.gov (United States)

    Auerbach, Joshua D; Lonner, Baron S; Crerand, Canice E; Shah, Suken A; Flynn, John M; Bastrom, Tracey; Penn, Phedra; Ahn, Jennifer; Toombs, Courtney; Bharucha, Neil; Bowe, Whitney P; Newton, Peter O

    2014-04-16

    Appearance concerns in individuals with adolescent idiopathic scoliosis can result in impairment in daily functioning, or body image disturbance. The Body Image Disturbance Questionnaire (BIDQ) is a self-reported, seven-question instrument that measures body image disturbance in general populations; no studies have specifically examined body image disturbance in those with adolescent idiopathic scoliosis. This study aimed to validate a modified version of the BIDQ in a population with adolescent idiopathic scoliosis and to establish discriminant validity by comparing responses of operatively and nonoperatively treated patients with those of normal controls. In the first phase, a multicenter study of forty-nine patients (mean age, fourteen years; thirty-seven female) with adolescent idiopathic scoliosis was performed to validate the BIDQ-Scoliosis version (BIDQ-S). Participants completed the BIDQ-S, Scoliosis Research Society (SRS)-22, Children's Depression Index (CDI), and Body Esteem Scale for Adolescents and Adults (BESAA) questionnaires. Descriptive statistics and Pearson correlation coefficients were calculated. In the second phase, ninety-eight patients with adolescent idiopathic scoliosis (mean age, 15.7 years; seventy-five female) matched by age and sex with ninety-eight healthy adolescents were enrolled into a single-center study to evaluate the discriminant validity of the BIDQ-S. Subjects completed the BIDQ-S and a demographic form before treatment. Independent-sample t tests and Pearson correlation coefficients were calculated. The BIDQ-S was internally consistent (Cronbach alpha = 0.82), and corrected item total correlations ranged from 0.47 to 0.67. The BIDQ-S was significantly correlated with each domain of the SRS-22 and the total score (r = -0.50 to -0.72, p ≤ 0.001), with the CDI (r = 0.31, p = 0.03), and with the BESAA (r = 0.60, p image disturbance compared with healthy controls. To our knowledge, this user-friendly instrument is the first to

  19. Pelvis morphology, trunk posture and standing imbalance and their relations to the Cobb angle in moderate and severe untreated AIS.

    Directory of Open Access Journals (Sweden)

    Georges Dalleau

    Full Text Available Adolescent idiopathic scoliosis (AIS is the most common form of scoliosis and usually affects young girls. Studies mostly describe the differences between scoliotic and non-scoliotic girls and focus primarily on a single set of parameters derived from spinal and pelvis morphology, posture or standing imbalance. No study addressed all these three biomechanical aspects simultaneously in pre-braced AIS girls of different scoliosis severity but with similar curve type and their interaction with scoliosis progression. The first objective of this study was to test if there are differences in these parameters between pre-braced AIS girls with a right thoracic scoliosis of moderate (less than 27° and severe (more than 27° deformity. The second objective was to identify which of these parameters are related to the Cobb angle progression either individually or in combination of thereof. Forty-five scoliotic girls, randomly selected by an orthopedic surgeon from the hospital scoliosis clinic, participated in this study. Parameters related to pelvis morphology, pelvis orientation, trunk posture and quiet standing balance were measured. Generally moderate pre-brace idiopathic scoliosis patients displayed lower values than the severe group characterized by a Cobb angle greater than 27°. Only pelvis morphology and trunk posture were statistically different between the groups while pelvis orientation and standing imbalance were similar in both groups. Statistically significant Pearson coefficients of correlation between individual parameters and Cobb angle ranged between 0.32 and 0.53. Collectively trunk posture, pelvis morphology and standing balance parameters are correlated with Cobb angle at 0.82. The results suggest that spinal deformity progression is not only a question of trunk morphology distortion by itself but is also related to pelvis asymmetrical bone growth and standing neuromuscular imbalance.

  20. T'ai Chi

    Science.gov (United States)

    ... are different styles of t'ai chi, including: Chen style Hao (or Wu Shi) style Hu Lei ... medical advice, diagnoses, and treatment, consult your doctor. © 1995- The Nemours Foundation. All rights reserved. Images provided ...

  1. Modeling Progress in AI

    OpenAIRE

    Brundage, Miles

    2015-01-01

    Participants in recent discussions of AI-related issues ranging from intelligence explosion to technological unemployment have made diverse claims about the nature, pace, and drivers of progress in AI. However, these theories are rarely specified in enough detail to enable systematic evaluation of their assumptions or to extrapolate progress quantitatively, as is often done with some success in other technological domains. After reviewing relevant literatures and justifying the need for more ...

  2. MUSCLE DISORDERS IN ADOLESCENT IDIOPATHIC SCOLIOSIS: LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Débora Pinheiro Lédio Alves

    2016-03-01

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

  3. Imaging in scoliosis from the orthopaedic surgeon's point of view

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Marc [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany); Abel, Rainer [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany)]. E-mail: rainer.abel@ok.uni-heidelberg.de

    2006-04-15

    For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy. The combined effort of orthopaedic surgeons and radiologists helps detect treatable causes of scoliosis at an early stage, define the need and timing for surgery, and ensure that every precaution is taken to minimize the risks of surgery. Neurosurgical causes, with particular reference to spinal cord tumours and syringomyelia, need to be addressed before scoliosis surgery can be contemplated.

  4. Clinical balance tests, proprioceptive system and adolescent idiopathic scoliosis.

    Science.gov (United States)

    Le Berre, Morgane; Guyot, Marc-Alexandre; Agnani, Olivier; Bourdeauducq, Isabelle; Versyp, Marie-Christine; Donze, Cécile; Thévenon, André; Catanzariti, Jean-Francois

    2017-06-01

    Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spinal column of unknown etiology. Multiple factors could be involved, including neurosensory pathways and, potentially, an elective disorder of dynamic proprioception. The purpose of this study was to determine whether routine balance tests could be used to demonstrate an elective alteration of dynamic proprioception in AIS. This was a multicentre case-control study based on prospectively collected clinical data, in three hospitals pediatric, with spine consultation, from January 2013 through April 2015. From an original population of 547 adolescents, inclusion and non-inclusion criteria indentified 114 adolescents with right thoracic AIS (mean age 14.5 ± 1.9 years, Cobb angle 35.7 ± 15.3°) and 81 matched adolescents without scoliosis (mean age 14.1 ± 1.9 years). Participants performed three routine clinical balance tests to assess the static and dynamic proprioception: the Fukuda-Utenberger stepping test (angle of rotation in degrees and distance of displacement in cm) to assess dynamic balance; the sharpened Romberg test and the unipedal stance test (eyes closed) to assess static balance. There was no significant difference between AIS subjects and controls for the static tests, but there was a significant difference for the dynamic test for both measures: distance of displacement (p tests can be performed in routine practice. Their validity as a biomarker for screening and monitoring purposes should be assessed.

  5. Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace

    Science.gov (United States)

    2017-01-01

    We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group–SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients’ follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23–35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0–27). A control group of 42 healthy females (healthy controls group—HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent

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

    Science.gov (United States)

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

    2014-02-01

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

  7. Analysis and evaluation of the radiological aspects of scoliosis

    International Nuclear Information System (INIS)

    Vargas Gonzalez, Paula

    2012-01-01

    surgical drastic measures, before that the others vital organs such as lungs and abdomen are affected by the curve. The use of specialized imaging is limited in patients with suspected of condition by soft tissues, neurological, suspected of medullary condition, such as syringomyelia, and suspected tumor. The corset is used in scoliosis under 40 degrees, otherwise it is recommended surgical treatment. The success of the use of the King-Lenke classification has proved for surgical management. The surgery is chosen as appropriate, taking into account the type of scoliosis, measurement and classification. The monitoring has been important in the case of patients that have used corset, to prevent progression; as those that have been surgically treated for possible complications [es

  8. Areal Informations Systemet - AIS

    DEFF Research Database (Denmark)

    Nielsen, K.; Stjernholm, M.; Olsen, B. Ø.

    Forord: Denne rapport giver en kort beskrivelse af Areal Informations Systemet (AIS), som er et databasesystem med natur- og miljødata, som kan stedfæstes geografisk. Projektet er gennemført i perioden 1996-2000 som et samarbejdsprojekt mellem Danmarks Miljøundersøgelser (DMU), Danmarks og...... og enkeltpersoner med interesse for natur- og miljøforhold i Danmark. Yderligere oplysninger om Areal Informations Systemet, herunder adgangsforhold, kan fås på DMU's hjemmeside med følgende adresse: http://ais.dmu.dk/ Projektet er finansieret af Miljø- og Energiministeriet, mens en række...... (planlægning, beskyttelse), geologi (overfladegeologi og marin geologi), samt marin dybdemodel. # Etablering af dataadgang for Miljø- og Energiministeriets institutioner til AIS-data. # Afprøvning af systemet i forhold til konkrete projekter. # Formidling af produkterne til brugerkredsen....

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

    Directory of Open Access Journals (Sweden)

    Bruno Moreira Gavassi

    2015-06-01

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

  10. Patient evaluation in idiopathic scoliosis: Radiographic assessment, trunk deformity and back asymmetry.

    Science.gov (United States)

    Rigo, Manuel

    2011-01-01

    Progressive adolescent idiopathic scoliosis (AIS) produces specific signs and symptoms, including trunk and spinal deformity and imbalance, impairment of breathing function, pain, progression during adult life, and psychological problems, as a whole resulting in an alteration of the health-related quality of life. A scoliosis-specific rehabilitation program attempts to prevent, improve, or minimize these signs and symptoms by using exercises and braces as the main tools in the rehabilitation treatment. Patient evaluation is an essential point in the decision-making process and determines the selection of the specific exercises and the specifications of the brace design. However, this article is not addressed to scoliosis management. In this present article, a complete definition and discussion of radiological aspects, such as the Cobb angle, axial rotation, curve pattern classifications, and sagittal configuration, follow a short description of the three-dimensional nature of AIS. The relationship between AIS and growth is also discussed. There is also a section dedicated to the assessment of trunk deformity and back asymmetry. Other important clinical aspects, such as pain and disability, changes in other regions of the body, muscular balance, breathing function, and health-related quality of life, are not discussed in this present article.

  11. Effects of novel corrective spinal technique on adolescent idiopathic scoliosis as assessed by radiographic imaging.

    Science.gov (United States)

    Noh, Dong Koog; You, Joshua Sung-H; Koh, Jae-Hyun; Kim, Hoseong; Kim, Donghyun; Ko, Sung-Mok; Shin, Ji-Youn

    2014-01-01

    To compare the therapeutic effects of a 3-dimensional corrective spinal technique (CST) and a conventional exercise program (CE) on altered spinal curvature and health related quality-of-life in patients with adolescent idiopathic scoliosis (AIS). Adolescents with idiopathic scoliosis (N=32, 6 males and 26 females) between 10 and 19 years of age (14.34 ± 2.60 years) were recruited and underwent the CST or CE for 60 minutes/day, 2-3 times a week, and an average of total 30 sessions. Diagnostic X-ray imaging technique was used to determine intervention-related changes in the Cobb angle, thoracic kyphosis angle, lumbar lordosis angle, sacral slope, pelvic tilt, pelvic incidence, and vertebral rotation (Nash-Moe method). The Scoliosis Research Society-22 (SRS-22) health related quality-of-life questionnaire was used. Data were analysed using independent t-test, paired t-test, and non-parametric Mann-Whitney U-test at p self-image and treatment satisfaction subscale scores and total score, p=0.026, p=0.039, and p=0.041, respectively) as compared to the controls. There were no significant changes in the other measures between the two groups. This is the first clinical trial to investigate the effects of the 3-dimensional CST on spinal curvatures and health related quality-of-life in AIS, providing the important clinical rationale and compelling evidence for the effective management of AIS.

  12. MassAI

    DEFF Research Database (Denmark)

    2011-01-01

    A software tool for general analysis and data-mining of mass-spectrometric datasets. The program features a strong emphasis on scan-by-scan identification and results-transparency. MassAI also accommodates residue level analysis of labelled runs, e.g. HDX.......A software tool for general analysis and data-mining of mass-spectrometric datasets. The program features a strong emphasis on scan-by-scan identification and results-transparency. MassAI also accommodates residue level analysis of labelled runs, e.g. HDX....

  13. The Scoliosis Research Society-22 questionnaire adapted for adolescent idiopathic scoliosis patients in China: reliability and validity analysis.

    Science.gov (United States)

    Zhao, Li; Zhang, Yong; Sun, Xiaotang; Du, Qing; Shang, Lei

    2007-12-01

    Outcome investigation to verify the internal consistency, reproducibility and validity of the adapted Chinese version of the Scoliosis Research Society-22 (SRS-22) questionnaire for measuring health-related quality of life (HRQoL) in children with idiopathic scoliosis. To develop this questionnaire for the outcome measurement in treating Chinese adolescents with idiopathic scoliosis and evaluate its metric qualities. The SRS-22 questionnaire has proven to be a valid instrument for clinical assessment of patients with idiopathic scoliosis and has been successfully translated into Spanish and Turkish. In most developing countries, however, quality of life and psychological health have been poorly described when treating children with idiopathic scoliosis. Trans-cultural adaptation of the SRS-22 questionnaire was carried out according to the International Quality of Life Assessment Project guidelines. The final version was approved by a committee of experts. The questionnaire was completed by 86 adolescents with idiopathic scoliosis who had been treated with a brace; this included 11 males and 75 females, aged from 10 to 18 years (mean 13.9 years). Curve magnitude ranged from 25 degrees to 45 degrees (mean 35.6 degrees ). A subgroup of 30 patients completed the questionnaire again in 3 or 4 weeks. Five common factors were acquired from factorial analysis, and the cumulative contribution ratio was 67.66%. The overall alpha coefficient of the questionnaire was 0.88. Coefficients for individual domains were as follows: function/activity, 0.70; pain, 0.80; self-image, 0.80; mental health, 0.88; and satisfaction, 0.81. The questionnaire as a whole had a test-retest correlation coefficient of 0.97. Test-retest correlation coefficients for individual domains were as follows: function, 0.85; pain, 0.96; self-image, 0.96; mental health, 0.95; and satisfaction, 0.91. The Chinese version of the SRS-22 questionnaire is eligible in terms of reliability and validity, and can be

  14. A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.

    Science.gov (United States)

    Merola, Andrew A; Haher, Thomas R; Brkaric, Mario; Panagopoulos, Georgia; Mathur, Samir; Kohani, Omid; Lowe, Thomas G; Lenke, Larry G; Wenger, Dennis R; Newton, Peter O; Clements, David H; Betz, Randal R

    2002-09-15

    A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). To evaluate the patient based outcome of the surgical treatment of adolescent idiopathic scoliosis. A paucity of information exists with respect to patient measures of outcome regarding the surgical treatment of adolescent idiopathic scoliosis. To our knowledge, no prospective outcome study on this topic thus far exists. Using the SRS 24 questionnaire, seven scoliosis centers agreed to prospectively assess outcome for surgically treated patients with adolescent idiopathic scoliosis. Data were collected before surgery and at 24 months after surgery. Data were analyzed using paired and independent samples t test for all seven SRS 24 questionnaire domains (Pain, General Self-Image, Postoperative Self-Image, Postoperative Function, Function From Back Condition, General Level of Activity, and Satisfaction) using Statistical Package for Social Science. The domains were analyzed with respect to the total cohort, gender, curve magnitude, and type of surgery using independent-samples t tests. A total of 242 patients were included in our analysis. A baseline preoperative pain level of 3.68 of 5 was found. This improved to 4.63 after surgery, representing an improvement of 0.95 points. Surgical intervention was associated with improving outcome when compared with preoperative status. Pain, General Self-Image, Function From Back Condition, and Level of Activity all demonstrated statistically significant improvement as compared with preoperative status (P adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with

  15. Tweeting AI: Perceptions of AI-Tweeters (AIT) vs Expert AI-Tweeters (EAIT)

    OpenAIRE

    Manikonda, Lydia; Dudley, Cameron; Kambhampati, Subbarao

    2017-01-01

    With the recent advancements in Artificial Intelligence (AI), various organizations and individuals started debating about the progress of AI as a blessing or a curse for the future of the society. This paper conducts an investigation on how the public perceives the progress of AI by utilizing the data shared on Twitter. Specifically, this paper performs a comparative analysis on the understanding of users from two categories -- general AI-Tweeters (AIT) and the expert AI-Tweeters (EAIT) who ...

  16. Eye-hand laterality and right thoracic idiopathic scoliosis.

    Science.gov (United States)

    Catanzariti, Jean-François; Guyot, Marc-Alexandre; Agnani, Olivier; Demaille, Samantha; Kolanowski, Elisabeth; Donze, Cécile

    2014-06-01

    The adolescent idiopathic scoliosis (AIS) pathogenesis remains unknown. Certain studies have shown that there is a correlation between manual laterality and scoliotic deviation. A full study of manual laterality needs to be paired with one for visual dominance. With the aim of physiopathological research, we have evaluated the manual and visual laterality in AIS. A retrospective study from prospective data collection is used to evaluate the distribution of eye-hand laterality (homogeneous or crossed) of 65 right thoracic AIS (mean age 14.8 ± 1.8 years; mean Cobb angle: 32.8°) and a control group of 65 sex and age-matched (mean age 14.6 ± 1.8 years). The manual laterality was defined by the modified Edinburgh Handedness Inventory. The evaluation of the visual laterality is done using three tests (kaleidoscope test, hole-in-the-card test, distance-hole-in-the-card test). The group of right thoracic AIS presents a significantly higher frequency of crossed eye-hand laterality (63 %) than the control group (63 vs. 29.2 %; p laterality is "right hand dominant-left eye dominant" (82.9 %). There is no relationship with the Cobb angle. Those with right thoracic AIS show a higher occurrence of crossed eye-hand laterality. This could point physiopathological research of AIS towards functional abnormality of the optic chiasma through underuse of cross visual pathways, and in particular accessory optic pathways. It would be useful to explore this by carrying out research on AISs through neuroimaging and neurofunctional exploration.

  17. 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...

  18. 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

    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...... by exome sequencing after filtration and an initial genotyping validation. However, we could not verify any association to idiopathic scoliosis in the large cohort of 1,739 cases and 1,812 controls. We did not find any variants in the 5'UTR, noncoding exon and promoter regions of LBX1. CONCLUSIONS: Here...... 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...

  19. Schroth physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis: how many patients require treatment to prevent one deterioration? – results from a randomized controlled trial - “SOSORT 2017 Award Winner”

    Directory of Open Access Journals (Sweden)

    Sanja Schreiber

    2017-11-01

    Full Text Available Abstract Background Recent randomized controlled trials (RCTs support using physiotherapeutic scoliosis-specific exercises (PSSE for adolescents with idiopathic scoliosis (AIS. All RCTs reported statistically significant results favouring PSSE but none reported on clinical significance. The number needed to treat (NNT helps determine if RCT results are clinically meaningful. The NNT is the number of patients that need to be treated to prevent one bad outcome in a given period. A low NNT suggests that a therapy has positive outcomes in most patients offered the therapy. The objective was to determine how many patients require Schroth PSSE added to standard care (observation or brace treatment to prevent one progression (NNT of the Largest Curve (LC or Sum of Curves (SOC beyond 5° and 10°, respectively over a 6-month interval. Methods This was a secondary analysis of a RCT. Fifty consecutive participants from a scoliosis clinic were randomized to the Schroth PSSE + standard of care group (n = 25 or the standard of care group (n = 25. We included males and females with AIS, age 10–18 years, all curve types, with curves 10°- 45°, with or without brace, and all maturity levels. We excluded patients awaiting surgery, having had surgery, having completed brace treatment and with other scoliosis diagnoses. The local ethics review board approved the study (Pro00011552. The Schroth intervention consisted of weekly 1-h supervised Schroth PSSE sessions and a daily home program delivered over six months in addition to the standard of care. A prescription algorithm was used to determine which exercises patients were to perform. Controls received only standard of care. Cobb angles were measured using a semi-automatic system from posterior-anterior standing radiographs at baseline and 6 months. We calculated absolute risk reduction (ARR and relative risk reduction (RRR. The NTT was calculated as: NNT = 1/ARR. Patients with missing values (PSSE

  20. AIS ASM Operational Integration Plan

    Science.gov (United States)

    2013-08-01

    Rack mount computer AIS Radio Interface Ethernet Switch 192.168.0.x Firewall Cable Modem 192.168.0.1 VTS Accred. Boundary AIS ASM Operational... AIS ASM Operational Integration Plan Distribution Statement A: Approved for public release; distribution is unlimited. August 2013 Report No...CD-D-07-15 AIS ASM Operational Integration Plan ii UNCLAS//Public | CG-926 R&DC | I. Gonin, et al. | Public August 2013 N O T I C

  1. General general game AI

    OpenAIRE

    Togelius, Julian; Yannakakis, Georgios N.; 2016 IEEE Conference on Computational Intelligence and Games (CIG)

    2016-01-01

    Arguably the grand goal of artificial intelligence research is to produce machines with general intelligence: the capacity to solve multiple problems, not just one. Artificial intelligence (AI) has investigated the general intelligence capacity of machines within the domain of games more than any other domain given the ideal properties of games for that purpose: controlled yet interesting and computationally hard problems. This line of research, however, has so far focuse...

  2. AI and health

    OpenAIRE

    Martin Anderson

    2018-01-01

    ntelligence refers to the ability of an individual to learn or understand something, or to deal with a new situation. When a machine or software exhibits such characteristics, it is referred to as artificial intelligence (AI). Artificial Intelligence is therefore defined as the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages.

  3. Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis : A CT-Based Study

    NARCIS (Netherlands)

    Brink, Rob C.; Schlösser, Tom P C; Colo, Dino; Vincken, Koen L.; van Stralen, Marijn; Hui, Steve C N; Chu, Winnie C W; Cheng, Jack C Y; Castelein, RM

    2017-01-01

    Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and

  4. AI and Mathematical Education

    Directory of Open Access Journals (Sweden)

    Angel Garrido

    2012-01-01

    Full Text Available From ancient times, the history of human beings has developed by a succession of steps and sometimes jumps, until reaching the relative sophistication of the modern brain and culture. Researchers are attempting to create systems that mimic human thinking, understand speech, or beat the best human chess player. Understanding the mechanisms of intelligence, and creating intelligent artifacts are the twin goals of Artificial Intelligence (AI. Great mathematical minds have played a key role in AI in recent years; to name only a few: Janos Neumann (also known as John von Neumann, Konrad Zuse, Norbert Wiener, Claude E. Shannon, Alan M. Turing, Grigore Moisil, Lofti A. Zadeh, Ronald R. Yager, Michio Sugeno, Solomon Marcus, or Lászlo A. Barabási. Introducing the study of AI is not merely useful because of its capability for solving difficult problems, but also because of its mathematical nature. It prepares us to understand the current world, enabling us to act on the challenges of the future.

  5. Reliability and validity of adapted French Canadian version of Scoliosis Research Society Outcomes Questionnaire (SRS-22) in Quebec.

    Science.gov (United States)

    Beauséjour, Marie; Joncas, Julie; Goulet, Lise; Roy-Beaudry, Marjolaine; Parent, Stefan; Grimard, Guy; Forcier, Martin; Lauriault, Sophie; Labelle, Hubert

    2009-03-15

    Prospective validation study of a cross-cultural adaptation of the Scoliosis Research Society (SRS) Outcomes Questionnaire. To provide a French Canadian version of the SRS Outcomes Questionnaire and to empirically test its response in healthy adolescents and adolescent idiopathic scoliosis (AIS) patients in Québec. The SRS Outcomes Questionnaire is widely used for the assessment of health-related quality of life in AIS patients. French translation and back-translation of the SRS-22 (SRS-22-fv) were done by an expert committee. Its reliability was measured using the coefficient of internal consistency, construct validity with a factorial analysis, concurrent validity by using the short form-12 and discriminant validity using ANOVA and multivariate linear regression, on 145 AIS patients, 44 patients with non clinically significant scoliosis (NCSS), and 64 healthy patients. The SRS-22-fv showed a good global internal consistency (AIS: Cronbach alpha = 0.86, NCSS: 0.81, and controls: 0.79) and in all of its domains for AIS patients. The factorial structure was coherent with the original questionnaire (47.4% of explained variance). High correlation coefficients were obtained between SRS-22-fv and short form-12 corresponding domains. Boys had higher scores than girls, scores worsened with age, and with increasing body mass index. Mean Total, Pain, Self-image, and Satisfaction scores, were correlated with Cobb angle. Adjusted regression models showed statistically significant differences between the AIS, NCSS, and control groups in the Total, Pain, and Function scores. The SRS-22-fv showed satisfactory reliability, factorial, concurrent, and discriminant validity. This study provides scores in a significant group of healthy adolescents and demonstrates a clear gradient in response between subjects with AIS, NCSS, and controls.

  6. Clavicle Chest Cage Angle Difference: Is It a Radiographic and Clinical Predictor of Postoperative Shoulder Imbalance in Lenke I Adolescent Idiopathic Scoliosis?

    Science.gov (United States)

    Han, Xiao; Liu, Zhen; Qiu, Yong; Sha, Shifu; Yan, Huang; Jin, Mengran; Zhu, Zezhang

    2016-09-01

    A retrospective study. To evaluate the effect of preoperative clavicle chest cage angle difference (CCAD) on postoperative radiographic shoulder imbalance, cosmetic shoulder balance, patient's satisfaction, and surgeon's fulfillment in Lenke I adolescent idiopathic scoliosis (AIS). CCAD is a novel predictor of postoperative radiographic shoulder imbalance in AIS. However, radiographic shoulder balance does not always correspond to cosmetic shoulder balance. Forty-four Lenke I AIS patients treated with posterior spinal fusion with a minimum 2-year follow-up were analyzed. Shoulder height difference (SHD) and CCAD were measured on anteroposterior standing radiographs. The inner shoulder height (SHi) and the outer shoulder height (SHo) were measured using the patients' photographs. The patients' satisfaction and the surgeons' fulfillment were evaluated using a questionnaire. A receiver operative characteristic curve analysis was performed to explore the threshold values of preoperative CCAD in the prediction of the final follow-up radiographic shoulder imbalance, patients' satisfaction, and surgeons' fulfillment. At the final follow-up, the preoperative CCAD was significantly greater in patients with unbalanced shoulders (SHD ≥1 cm). For cosmetic shoulder balance at the final follow-up, there was no significant difference in preoperative CCAD between Group 1i (SHi ≥1 cm, n = 14) and Group 2i (SHi imbalance, patients' satisfaction, and surgeons' fulfillment was 5.5°. CCAD is a good radiographic predictor for postoperative radiographic shoulder imbalance in Lenke I AIS patients. Moreover, it is also associated with the patients' satisfaction and surgeons' fulfillment postoperatively. However, CCAD cannot predict postoperative cosmetic shoulder balance. 4.

  7. Biomechanical spinal growth modulation and progressive adolescent scoliosis – a test of the 'vicious cycle' pathogenetic hypothesis: Summary of an electronic focus group debate of the IBSE

    Directory of Open Access Journals (Sweden)

    Burwell R Geoffrey

    2006-10-01

    Full Text Available 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 text for this debate was written by Dr Ian A Stokes. It evaluates the hypothesis that in progressive scoliosis vertebral body wedging during adolescent growth results from asymmetric muscular loading in a "vicious cycle" (vicious cycle hypothesis of pathogenesis by affecting vertebral body growth plates (endplate physes. A frontal plane mathematical simulation tested whether the calculated loading asymmetry created by muscles in a scoliotic spine could explain the observed rate of scoliosis increase by measuring the vertebral growth modulation by altered compression. The model deals only with vertebral (not disc wedging. It assumes that a pre-existing scoliosis curve initiates the mechanically-modulated alteration of vertebral body growth that in turn causes worsening of the scoliosis, while everything else is anatomically and physiologically 'normal' The results provide quantitative data consistent with the vicious cycle hypothesis. Dr Stokes' biomechanical research engenders controversy. A new speculative concept is proposed of vertebral symphyseal dysplasia with implications for Dr Stokes' research and the etiology of AIS. What is not controversial is the need to test this hypothesis using additional factors in his current model and in three-dimensional quantitative models that incorporate intervertebral discs and simulate thoracic as well as lumbar scoliosis. The growth modulation process in the vertebral body can be viewed as one type of the biologic phenomenon of mechanotransduction. In certain connective tissues this involves the

  8. What's New in Congenital Scoliosis?

    Science.gov (United States)

    Pahys, Joshua M; Guille, James T

    2018-03-01

    Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery. Earlier hemivertebra excision and short-segment posterior spinal fusion have been advocated to prevent future curve progression of the deformity and/or the development of large compensatory curves. It has been shown in recent long-term follow-up studies that growth rates of the vertebral body and spinal canal are not as dramatically affected by pedicle screw instrumentation at a young age as once thought. Growth friendly surgery with either spine-based or rib-based anchors has demonstrated good results with curve correction while maintaining spinal growth. Rib-based anchors are typically more commonly indicated in the setting of chest wall abnormalities and/or when spinal anatomy precludes placement of spinal instrumentation. Recently, magnetically controlled growing rods have shown promising results in several studies that include a small subset of congenital scoliosis cases. A literature search was performed to identify existing studies related to the treatment of congenital scoliosis published from January 1, 2005 to June 1, 2016. Databases included PubMed, Medline, and the Cochrane Library. The search was limited to English articles and yielded 36 papers. This project was initiated by the Pediatric Orthopaedic Society of North America Publications Committee and was reviewed and approved by the Pediatric Orthopaedic Society of North America Presidential Line. A total of

  9. [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. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Progression of scoliosis in patients with spastic quadriplegia after the insertion of an intrathecal baclofen pump.

    Science.gov (United States)

    Ginsburg, Glen M; Lauder, Anthony J

    2007-11-15

    Medical and radiographic review of 19 consecutive patients with spastic quadriplegia before and after intrathecal baclofen pump insertion with special attention paid to progression of scoliosis. Many orthopedic surgeons who treat spastic quadriplegic patients have noticed a trend of marked scoliosis progression after the administration of intrathecal baclofen (ITB) via subcutaneous pump and catheter. The purpose of this study is to quantify scoliosis progression in this patient population before and after baclofen administration and compare this to published natural history data. The authors had noted rapid progression of scoliosis in spastic quadriplegic patients after intrathecal baclofen pump insertion. This had been noted at other centers, but no significant statistical analysis had been done comparing prepump to postpump scoliosis progression in these patients. To document the magnitude and rate of scoliosis progressions after the placement of an ITB pump, the charts and radiographs of 19 consecutive nonambulatory patients with spastic quadriplegia and an ITB pump were reviewed. To document the rate of scoliosis progression, each patient had at least 2 pre and 2 postpump insertion spinal radiographs made. All radiographs were made with the patients in the supine position without orthoses. A board-certified orthopedic surgeon reviewed these radiographs. Skeletal maturity was assessed using Risser grading. Catheter tip location and rate of baclofen administration were recorded. For 19 patients with complete radiographic data, average Cobb angles were 10.2 degrees before pump insertion and 25 degrees at an average of 20.9 months after pump insertion (P quadriplegia and ITB pump. The authors are now performing spinal fusions for curves that exceed 40 degrees to 50 degrees in the presence of an ITB pump as recommended by previous reviews of scoliosis and accompanying quadriplegia.

  11. Development of a non-fusion scoliosis correction device. Numerical modelling of scoliosis correction.

    NARCIS (Netherlands)

    Meijer, Gerdine

    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

  12. THE ETIOLOGIC RELEVANCE OF 3-D PATHOANATOMY OF ADOLESCENT IDIOPATHIC SCOLIOSIS

    Directory of Open Access Journals (Sweden)

    Tom Schlösser

    Full Text Available ABSTRACT Despite many years of dedicated research into the etiopathogenesis of adolescent idiopathic scoliosis, there is still no single distinct cause for this puzzling condition. In this overview, we attempt to link knowledge on the complex three-dimensional pathoanatomy of AIS, based on our ongoing research in this field, with etiopathogenic questions. Evidence from multiple recent cross-sectional imaging studies is provided that supports the hypothesis that AIS has an intrinsic biomechanical basis: an imbalance between the biomechanical loading of the upright human spine due to its unique sagittal configuration on the one hand, and the body’s compensating mechanisms on the other. The question that remains in the etiology of AIS, and the focus of our ongoing research, is to determine what causes or induces this imbalance.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Background: Since 2008 the primary non-surgical treatment of adolescent idiopathic scoliosis (AIS) in the southern part of Denmark, went from full-time bracing with Boston brace, to Providence nighttime bracing. Aim: To evaluate the effectiveness of nighttime bracing, with the Providence brace...... with the Providence nighttime brace and an acceptable 18 % failure rate. The nighttime brace is an excellent alternative to standard conservative treatment, and reduces the need for physiotherapy after brace termination. The patients tolerate the nighttime brace treatment well, and compliance within the cohort......, in AIS. Method: Patients diagnosed with AIS. With an apex from TH7 and below and with a cobb angel between 20-45 degrees. The patients were evaluated every 6 months with standing x-rays and the brace treatment was continued until two years post menarche. Cobb angle of the major curve pretreatment, in...

  14. Adolescent idiopathic scoliosis correction achieved by posteromedial translation using polyester bands: A comparative study of subtransverse process versus sublaminar fixation.

    Science.gov (United States)

    Hirsch, C; Ilharreborde, B; Fournier, J; Mazda, K; Bonnard, C

    2014-11-01

    Sublaminar polyester bands have been used in hybrid construct to achieve correction of adolescent idiopathic scoliosis since 2003. Despite the reported safety of the bands, some surgeons remain reluctant at the idea of approaching the canal because of the potential neurological complications reported with the Luque wiring. Sub transverse bands might be an alternative. The present study is the first to compare sublaminar polyester band fixation to fixation of polyester bands around the transverse processes in hybrid constructs used to treat AIS. Two cohorts of consecutive patients treated for thoracic AIS were retrospectively reviewed, with a minimum 2-year follow-up. Posteromedial translation was used for main curve correction in all cases. Sublaminar polyester bands were used in group 1 (20 patients). In group 2 (20 patients), the same implant was used, but the bands were passed around the transverse process instead of the lamina. Radiographic analysis included frontal Cobb angle measurements for each curve, thoracic kyphosis and rotation of the apical vertebra (RVA). Mean operative time was similar in groups 1 and 2 (235±35 and 240±30minutes, respectively). Mean frontal correction achieved for the main curve was similar in both groups, 62.5±17.4% in group 1 and 54.1±19.4% in group 2. Sagittal correction was similar, with a final mean thoracic kyphosis of 30.9°±9.7° and 27.8°± 6.8° in group 1 and 2, respectively. Correction of RVA was similar in both groups postoperatively, 65.8% (±29.1) and 54.4% (±42.7) in group 1 and 2 respectively. No transverse process or lamina fracture was observed during insertion of the bands or curve correction in any of the groups. This study confirms that anchorage of Universal clamps (UCs) around transverse processes is a safe and efficacious technique in both the frontal and sagittal planes, providing a useful alternative for the correction of moderate AIS. UCs attached to transverse processes can achieve correction of

  15. Reproducibility of thoracic kyphosis measurements in patients with adolescent idiopathic scoliosis.

    Science.gov (United States)

    Ohrt-Nissen, Søren; Cheung, Jason Pui Yin; Hallager, Dennis Winge; Gehrchen, Martin; Kwan, Kenny; Dahl, Benny; Cheung, Kenneth M C; Samartzis, Dino

    2017-01-01

    Current surgical treatment for adolescent idiopathic scoliosis (AIS) involves correction in both the coronal and sagittal plane, and thorough assessment of these parameters is essential for evaluation of surgical results. However, various definitions of thoracic kyphosis (TK) have been proposed, and the intra- and inter-rater reproducibility of these measures has not been determined. As such, the purpose of the current study was to determine the intra- and inter-rater reproducibility of several TK measurements used in the assessment of AIS. Twenty patients (90% females) surgically treated for AIS with alternate-level pedicle screw fixation were included in the study. Three raters independently evaluated pre- and postoperative standing lateral plain radiographs. For each radiograph, several definitions of TK were measured as well as L1-S1 and nonfixed lumbar lordosis. All variables were measured twice 14 days apart, and a mixed effects model was used to determine the repeatability coefficient (RC), which is a measure of the agreement between repeated measurements. Also, the intra- and inter-rater intra-class correlation coefficient (ICC) was determined as a measure of reliability. Preoperative median Cobb angle was 58° (range 41°-86°), and median surgical curve correction was 68% (range 49-87%). Overall intra-rater RC was highest for T2-T12 and nonfixed TK (11°) and lowest for T4-T12 and T5-T12 (8°). Inter-rater RC was highest for T1-T12, T1-nonfixed, and nonfixed TK (13°) and lowest for T5-T12 (9°). Agreement varied substantially between pre- and postoperative radiographs. Inter-rater ICC was highest for T4-T12 (0.92; 95% CI 0.88-0.95) and T5-T12 (0.92; 95% CI 0.88-0.95) and lowest for T1-nonfixed (0.80; 95% CI 0.72-0.88). Considerable variation for all TK measurements was noted. Intra- and inter-rater reproducibility was best for T4-T12 and T5-T12. Future studies should consider adopting a relevant minimum difference as a limit for true change in TK.

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

    Science.gov (United States)

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

    2017-01-01

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

  17. 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.

  18. Effect of Surgical Approach on Pulmonary Function in Adolescent Idiopathic Scoliosis Patients: A Systemic Review and Meta-analysis.

    Science.gov (United States)

    Lee, Andy C H; Feger, Mark A; Singla, Anuj; Abel, Mark F

    2016-11-15

    Systemic review and meta-analysis. To analyze the effect of spinal fusion and instrumentation for adolescent idiopathic scoliosis (AIS) on absolute pulmonary function test (PFTs). Pulmonary function is correlated with severity of deformity in AIS patients and studies that have analyzed the effect of spinal fusion and instrumentation on PFTs for AIS have reported inconsistent results. There is a need to analyze the effect of spinal fusion on PFTs with stratification by surgical approach. Our analysis included 22 studies. Cohen's d effect sizes were calculated for absolute PFT outcome measures with 95% confidence intervals (CI). Meta-analyses were performed at each postoperative time frame for six homogeneous surgical approaches: (i) combined anterior release and posterior fusion with instrumentation; (ii) combined video assisted anterior release and posterior fusion with instrumentation without thoracoplasty; (iii) posterior fusion with instrumentation without thoracoplasty; (iv) anterior fusion with instrumentation and without thoracoplasty; (v) video assisted anterior fusion with instrumentation without thoracoplasty; and (vi) any scoliosis surgery with additional thoracoplasty. Anterior spinal fusion with instrumentation, any scoliosis surgery with concomitant thoracoplasty, or video-assisted anterior fusion with instrumentation for AIS had similar absolute PFTs at their 2 year postoperative follow up compared with their preoperative PFTs (effect sizes ranging from -0.2-0.2 with all CI crossing "0"). Posterior spinal fusion with instrumentation (with or without an anterior release) demonstrated small to moderate increases in PFTs 2 years postoperatively (effect sizes ranging from 0.35-0.65 with all CI not crossing "0"). Anterior fusion with instrumentation, regardless of the approach, and any scoliosis surgery with concomitant thoracoplasty do not lead to significant change in pulmonary functions 2 year after surgery. Posterior spinal fusion with instrumentation

  19. [Optimization of radiological scoliosis assessment].

    Science.gov (United States)

    Enríquez, Goya; Piqueras, Joaquim; Catalá, Ana; Oliva, Glòria; Ruiz, Agustí; Ribas, Montserrat; Duran, Carmina; Rodrigo, Carlos; Rodríguez, Eugenia; Garriga, Victoria; Maristany, Teresa; García-Fontecha, César; Baños, Joan; Muchart, Jordi; Alava, Fernando

    2014-07-01

    Most scoliosis are idiopathic (80%) and occur more frequently in adolescent girls. Plain radiography is the imaging method of choice, both for the initial study and follow-up studies but has the disadvantage of using ionizing radiation. The breasts are exposed to x-ray along these repeated examinations. The authors present a range of recommendations in order to optimize radiographic exam technique for both conventional and digital x-ray settings to prevent unnecessary patients' radiation exposure and to reduce the risk of breast cancer in patients with scoliosis. With analogue systems, leaded breast protectors should always be used, and with any radiographic equipment, analog or digital radiography, the examination should be performed in postero-anterior projection and optimized low-dose techniques. The ALARA (as low as reasonable achievable) rule should always be followed to achieve diagnostic quality images with the lowest feasible dose. Copyright © 2014. Published by Elsevier Espana.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  1. AI 3D Cybug Gaming

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this short paper I briefly discuss 3D war Game based on artificial intelligence concepts called AI WAR. Going in to the details, I present the importance of CAICL language and how this language is used in AI WAR. Moreover I also present a designed and implemented 3D War Cybug for AI WAR using CAICL and discus the implemented strategy to defeat its enemies during the game life.

  2. Functional exercise capacity, lung function and chest wall deformity in patients with adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Evandro Fornias Sperandio

    Full Text Available AbstractIntroduction The adolescent idiopathic scoliosis (AIS causes changes on the compliance of the chest. These changes may be associated with impaired lung function and reduced functional exercise capacity of these adolescents. We aimed to evaluate the correlation between functional exercise capacity, lung function and geometry of the chest at different stages of AIS.Materials and methods The study was carried out in a cross-sectional design which were evaluated 27 AIS patients at different stages of the disease. For chest wall evaluation, were created geometry angles/distances (A/D, which were quantified by Software Postural Assessment. The functional exercise capacity was assessed by a portable gas analyzer during the incremental shuttle walk test (ISWT. Besides that, manovacuometry and spirometry were also performed.Results Linear regressions showed that oxygen uptake (peak VO2 was correlated with distance travelled in the ISWT (R2 = 0.52, maximal respiratory pressures, cough peak flow (R2 = 0.59 and some thoracic deformity markers (D1, D2 and A6.Discussion We observed that the chest wall alterations, lung function and respiratory muscle strength are related to the functional exercise capacity and may impair the physical activity performance in AIS patients.Final considerations There is correlation between functional exercise capacity, lung function and geometry of the chest in AIS patients. Our results point to the possible impact of the AIS in the physical activities of these adolescents. Therefore, efforts to prevent the disease progression are extremely important.

  3. 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.)

  4. Spinal decompensation in degenerative lumbar scoliosis

    NARCIS (Netherlands)

    de Vries, A.A.; Mullender, M.G.; Pluymakers, W.J.; Castelein, R.M.; van Royen, B.J.

    2010-01-01

    Due to the aging population, degenerative scoliosis is a growing clinical problem. It is associated with back pain and radicular symptoms. The pathogenesis of degenerative scoliosis lies in degenerative changes of the spinal structures, such as the intervertebral disc, the facet joints and the

  5. Imaging in scoliosis: What, why and how?

    International Nuclear Information System (INIS)

    Cassar-Pullicino, V.N.; Eisenstein, S.M.

    2002-01-01

    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)

  6. 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)

  7. 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.

  8. 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.

  9. Polish adaptation of scoliosis research society-22 questionnaire.

    Science.gov (United States)

    Glowacki, Maciej; Misterska, Ewa; Laurentowska, Maria; Mankowski, Przemyslaw

    2009-05-01

    Polish adaptation of the original version of Scoliosis Research Society (SRS) instrument. The transcultural adaptation of SRS-22 and evaluation of its internal consistency. High psychometric value of the SRS-22 Questionnaire has made it an effective evaluation instrument in clinically assessing the functional status of patients with adolescent idiopathic scoliosis. First, 2 translators translated the original version into Polish. Afterwards, the translators identified differences between the translations and produced a consensus version. In the third stage, 2 native English speakers produced back translations. Finally, a team of 2 orthopedic surgeons, translators, a statistician and a psychologist reviewed all the translations to produce a prefinal version. The questionnaire was administered to 60 girls at the age of 16.6, SD 2.0 with adolescent idiopathic scoliosis treated with the Cotrel-Dubousset method in Pediatric Orthopaedics and Traumatology Clinic in Poznań. The internal consistency in the Polish version equaled 0.89 for the overall result and 0.81 for function, 0.81 for pain, 0.80 for mental health, 0.77 for self-image, and 0.69 for treatment satisfaction domains, respectively. The Polish version of SRS-22 is characterized by high internal consistency for all domains and for the overall score, which makes it an evaluation tool after surgical treatment compatible with the original SRS-22.

  10. AI its nature and future

    CERN Document Server

    Boden, Margaret A

    2016-01-01

    least - on the Internet. Margaret Boden considers the realistic and unrealistic expectations we have placed on AI, analyses its progress, and considers the value of its byproducts. ations we have placed on AI, analyses its progress, and considers the value of its byproducts.

  11. Prospective evaluation of quality of life in adolescent idiopathic scoliosis before and after surgery.

    Science.gov (United States)

    Pellegrino, Luciano N; Avanzi, Osmar

    2014-12-01

    Prospective observational study. To assess patient quality of life before and after surgical treatment of adolescent idiopathic scoliosis (AIS) and determine whether an association exists between quality of life and curve magnitude, curve correction, and type of instrumentation. Assessment of AIS surgery outcomes has always been based on analysis of radiographic measurements and postoperative curve correction. However, there is a current trend toward greater emphasis on patient-centered outcomes. Assessment of treatment success on the basis of these outcomes requires prospective use of quality-of-life surveys before and after AIS treatment. Prospective study of 33 patients undergoing surgical treatment of AIS. Mean age was 15.6 years and mean Cobb angle was 70.5 degrees. Patients were randomly allocated into one of 2 instrumentation groups (hybrid and pedicle screws alone), and the Scoliosis Research Society-30 questionnaire (SRS-30) and Short Form-36 Health Survey (SF-36) questionnaires were administered preoperatively and at 3-, 6-, and 12-month follow-up. Statistical testing was performed to determine whether survey scores correlated with Cobb angle, curve correction, or type of instrumentation. SRS-30 and SF-36 scores improved significantly. The greatest changes occurred in the self-image and satisfaction with management domains of the SRS-30 survey. SRS-30 and SF-36 scores showed worsening pain and decreased function at 3-month follow-up, but significant improvement from baseline at 12 months. Total SRS-30 scores were significantly improved at 6- and 12-month follow-up, as were subscores in the general health, vitality, and social functioning domains of SF-36. Curve magnitude, percent curve correction, and type of instrumentation had no significant influence on final SRS-30 and SF-36 scores. Surgical treatment of AIS improved patient quality of life, as shown by significant improvement on all SRS-30 and SF-36 domains. Questionnaire scores did not correlate

  12. Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Vidal, Christophe; Ilharreborde, Brice; Azoulay, Robin; Sebag, Guy; Mazda, Keyvan

    2013-06-01

    Radiological reproducibility study. To assess intra and interobserver reliability of radiographic measurements for global sagittal balance parameters and sagittal spine curves, including cervical spine. Sagittal spine balance in adolescent idiopathic scoliosis (AIS) is a main issue and many studies have been reported, showing that coronal and sagittal deformities often involve sagittal cervical unbalance. Global sagittal balance aims to obtain a horizontal gaze and gravity line at top of hips when subject is in a static position, involving adjustment of each spine curvature in the sagittal plane. To our knowledge, no study did use a methodologically validated imaging analysis tool able to appreciate sagittal spine contours and distances in AIS and especially in the cervical region. Lateral full-spine low-dose EOS radiographs were performed in 75 patients divided in three groups (control subjects, AIS, operated AIS). Three observers digitally analyzed twice each radiograph and 11 sagittal measures were collected for each image. Reliability was assessed calculating intraobserver Pearson's r correlation coefficient, interobserver intra-class correlation coefficient (ICC) completed with a two-by-two Bland-Altman plot analysis. This measurement method has shown excellent intra and interobserver reliability in all parameters, sagittal curvatures, pelvic parameters and global sagittal balance. This study validated a simple and efficient tool in AIS sagittal contour analysis. It defined new relevant landmarks allowing to characterize cervical segmental curvatures and cervical involvement in global balance.

  13. Growth hormone receptor (GHR) gene polymorphism and scoliosis in Prader-Willi syndrome.

    Science.gov (United States)

    Butler, Merlin G; Hossain, Waheeda; Hassan, Maaz; Manzardo, Ann M

    2018-04-01

    A growth hormone receptor (GHR) gene polymorphism impacts sensitivity to endogenous and exogenous growth hormone (GH) to moderate growth and development. Increased sensitivity may accelerate spinal growth and contribute to scoliosis, particularly in GH-deficient and treated populations such as Prader-Willi syndrome (PWS). Therefore, we examined the relationship between GHR genotype and scoliosis (case and control) in PWS cohorts. We utilized a case-control design in a study of 73 subjects (34M; 39F) with genetically confirmed PWS in 32 individuals previously diagnosed with moderate to severe scoliosis (mean age=16.9±10.2years; age range of 1 to 41years) and 41 adults with no evidence of scoliosis (mean age=30.8±9.7years; age range of 18 to 56years). The GHR gene polymorphism was determined using PCR specific primers to capture the two recognized GHR gene fragment sizes [i.e., full length (fl) or exon 3 deletions (d3)]. Twenty-three (72%) of the 32 case subjects with scoliosis required surgical correction with an approximately equal balance for gender and PWS genetic subtype among cases and 41 control subjects without scoliosis. The GHR d3/d3 genotype was identified in N=2 of 8 (25%) cases with scoliosis and the d3/fl genotype was identified in N=11 of 25 (44%) cases with scoliosis but the distribution difference did not statistically differ. The GHR fl/fl genotype was correlated with a significantly faster rate and heavier weight gain among case subjects. Our examination of demographic and genetic markers associated with scoliosis and surgical repair in PWS found no evidence to support differences in gender, PWS genetic subtype or GHR d3 allele distributions among the case vs control groups. Those with fl/fl alleles were heavier than those with d3/d3 or d3/fl genotypes and warrant further study with a larger sample size and possibly to include other vulnerable populations requiring growth hormone treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis?

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    Cheshire, James; Gardner, Adrian; Berryman, Fiona; Pynsent, Paul

    2017-01-01

    Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS. The aim of this study was to examine whether the Scoliosis Research Society-22 (SRS-22) outcome questionnaire reflects the degree of measurable external asymmetry of the back in AIS and thus is a measure of patient outcome for external appearance. A total of 102 pre-operative AIS patients were identified retrospectively. Objective parameters were measured using ISIS2 surface topography. The associations between these parameters and the self-image and mental health domains of the SRS-22 questionnaire were investigated using correlation coefficients. All correlations between the parameters of asymmetry and SRS-22 self-image score were of weak strength. Similarly, all correlations between the parameters of asymmetry and SRS-22 mental health score were of weak strength. The SRS-22 mental health and self-image domains correlate poorly with external measures of deformity. This demonstrates that the assessment of mental health and self-image by the SRS-22 has little to do with external torso shape. Whilst the SRS-22 assesses the patient as a whole, it provides little information about objective measures of deformity over which a surgeon has control.

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

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    Alain Moreau

    2013-03-01

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

  16. Code AI Personal Web Pages

    Science.gov (United States)

    Garcia, Joseph A.; Smith, Charles A. (Technical Monitor)

    1998-01-01

    The document consists of a publicly available web site (george.arc.nasa.gov) for Joseph A. Garcia's personal web pages in the AI division. Only general information will be posted and no technical material. All the information is unclassified.

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

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    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.

  18. [Therapy of scoliosis from a historical perspective].

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    Harms, J; Rauschmann, M; Rickert, M

    2015-12-01

    Scoliosis can be considered as one of the classical orthopedic diseases of the spine. The history of orthopedics is closely connected to the development of the therapy of scoliosis. In the eighteenth and the beginning of the nineteenth centuries the therapy of scoliosis was mainly a conservative corrective orthopedic treatment with a variety of corset forms and extension bed treatment. In the middle of the nineteenth century physiotherapy (movement therapy) became established as an supplementary active treatment. The first operations for treatment of scoliosis were carried out in 1839. The real success with surgical procedures for improvement in corrective options was connected to the introduction of metal spinal implants in the early 1960s.

  19. Critical review on non-operative management of adolescent idiopathic scoliosis.

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    Wong, M S; Liu, W C

    2003-12-01

    There are a number of different non-operative interventions which aim to control moderate adolescent idiopathic scoliosis (AIS) from progression. Clinicians may find difficulties in the selection of appropriate interventions for AIS. A comprehensive literature review was carried out to study all contemporary non-operative interventions, it was noted that rigid spinal orthoses apparently give more curve control; however, it would compromise the patient's quality of life via those inevitable factors--physical constraint, poor acceptance and psychological disturbance. There is a trend to develop more effective, acceptable and user-friendly interventions. Under such an aspiration, the theories and clinical evidence of different interventions should be developed along the clinical pathway of early intervention with reliable indicators/predictors, patient's active participation, dynamic control mechanism, holistic psychological and psychosocial considerations, and effective and long-lasting outcome.

  20. Etiologic theories of idiopathic scoliosis. Somatic nervous system and the NOTOM escalator concept as one component in the pathogenesis of adolescent idiopathic scoliosis.

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    Burwell, R G; Dangerfield, P H; Freeman, B J C

    2008-01-01

    There is no generally accepted scientific theory for the causes of adolescent idiopathic scoliosis (AIS). In recent years encouraging advances thought to be related to the pathogenesis of AIS have been made in several fields. After reviewing concepts of AIS pathogenesis we formulated a collective model of pathogenesis. The central concept of this collective model is a normal neuro-osseous timing of maturation (NOTOM) system operating in a child's internal world during growth and maturation; this provides a dynamic physiological balance of postural equilibrium continuously renewed between two synchronous, polarized processes (NOTOM escalator) linked through sensory input and motor output, namely: 1) osseous escalator-increasing skeletal size and relative segmental mass, and 2) neural escalator - including the CNS body schema. The latter is recalibrated continuously as the body adjusts to biomechanical and kinematic changes resulting from skeletal enlargement, enabling it to coordinate motor actions. We suggest that AIS progression results from abnormality of the neural and/or osseous components of these normal escalator in time and/or space - as asynchrony and/or asymmetries - which cause a failure of neural systems to control asymmetric growth of a rapidly enlarging and moving adolescent spine. This putative initiating asymmetric growth in the spine is explained in separate papers as resulting from dysfunction of the hypothalamus expressed through the sympathetic nervous system (leptin-sympathetic nervous system concept for AIS pathogenesis). In girls, the expression of AIS may result from disharmony between the somatic and autonomic nervous systems - relative postural maturational delay in the somatic nervous system and hypothalamic dysfunction in the autonomic nervous system, with the conflict being fought out in the spine and trunk of the girl and compounded by biomechanical spinal growth modulation.

  1. Duchenne muscular dystrophy: the management of scoliosis

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    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. PMID:27757431

  2. Comparison of low density and high density pedicle screw instrumentation in Lenke 1 adolescent idiopathic scoliosis.

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    Shen, Mingkui; Jiang, Honghui; Luo, Ming; Wang, Wengang; Li, Ning; Wang, Lulu; Xia, Lei

    2017-08-02

    The correlation between implant density and deformity correction has not yet led to a precise conclusion in adolescent idiopathic scoliosis (AIS). The aim of this study was to evaluate the effects of low density (LD) and high density (HD) pedicle screw instrumentation in terms of the clinical, radiological and Scoliosis Research Society (SRS)-22 outcomes in Lenke 1 AIS. We retrospectively reviewed 62 consecutive Lenke 1 AIS patients who underwent posterior spinal arthrodesis using all-pedicle screw instrumentation with a minimum follow-up of 24 months. The implant density was defined as the number of screws per spinal level fused. Patients were then divided into two groups according to the average implant density for the entire study. The LD group (n = 28) had fewer than 1.61 screws per level, while the HD group (n = 34) had more than 1.61 screws per level. The radiographs were analysed preoperatively, postoperatively and at final follow-up. The perioperative and SRS-22 outcomes were also assessed. Independent sample t tests were used between the two groups. Comparisons between the two groups showed no significant differences in the correction of the main thoracic curve and thoracic kyphosis, blood transfusion, hospital stay, and SRS-22 scores. Compared with the HD group, there was a decreased operating time (278.4 vs. 331.0 min, p = 0.004) and decreased blood loss (823.6 vs. 1010.9 ml, p = 0.048), pedicle screws needed (15.1 vs. 19.6, p density and high density pedicle screw instrumentation achieved satisfactory deformity correction in Lenke 1 AIS patients. However, the operating time and blood loss were reduced, and the implant costs were decreased with the use of low screw density constructs.

  3. Do postoperative radiographically verified technical success, improved cosmesis, and trunk shift corroborate with patient-reported outcomes in Lenke 1C adolescent idiopathic scoliosis?

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    Sharma, Shallu; Bünger, Cody Eric; Andersen, Thomas; Sun, Haolin; Wu, Chunsen; Hansen, Ebbe Stender

    2015-07-01

    To examine correlation between postoperative radiographic and cosmetic improvements in Lenke 1C adolescent idiopathic scoliosis (AIS) with patients' self-rated outcomes of health and disability at follow-up as determined by the Scoliosis Research Society questionnaire (SRS-30), Oswestry Disability Index score (ODI) and measure of overall health quality Euroqol-5d (EQ-5D). 24 Lenke 1C scoliosis patients, mean age 16.5 (12.8-38.1) years, treated with posterior pedicle screw-only construct, were included. The coronal profile indices (radiographic and cosmetic) regarding magnitude of spinal deformity and truncal balance were measured preoperatively, postoperatively and at final follow-up. A comprehensive index of overall back symmetry was also measured by means of the Posterior Trunk Symmetry Index (POTSI). Pearson's correlation analysis determined the association between the radiographic-cosmetic indices and patient-rated outcomes. Mean follow-up for the cohort was 4.4 (±1.86) years. The thoracic apical vertebra-first thoracic vertebra horizontal distance (AV-TI) correction had significant correlation with function, self-image, and mental health SRS-30 scores (0.55, 0.54, 0.66). Similarly, thoracic apical vertebra horizontal translation from central sacral vertical line (AV-CSVL) correction at follow-up had significant correlation with self-image and management domains (0.57, 0.50). Follow-up POTSI correlated well with SRS-30 and EQ-5D scores (r = -0.64, -0.54). Postoperative leftward trunk shift/spinal imbalance did not influence overall cosmesis and outcomes; significant spinal realignment was evident in follow-up resulting in physiological balance and acceptable cosmesis and outcomes. Significant, but less than "perfect" correlations were observed between the radiographic, cosmetic measures and patient-rated outcomes. Thoracic AV-CSVL, AV-T1 correction and POTSI associated significantly with SRS-30 scores. Whereas, thoracic Cobb angle, Cobb correction, and

  4. Neuropathological aspects of conservative treatment of scoliosis. A theoretical view point.

    Science.gov (United States)

    Czupryna, Krzysztof; Nowotny-Czupryna, Olga; Nowotny, Janusz

    2012-01-01

    An upright body posture cannot be maintained passively for reasons including a high location of the centre of gravity (COG) and a small support area. Proper alignment of body parts is maintained automatically, tending towards a pattern encoded in the CNS. A particularly important role in posture regulation is played by the short muscles of the back, which respond to being stretched with a contraction. During the early phase of scoliosis, the CNS automatically corrects abnormalities, but over time habituation occurs and the CNS treats them as something normal. Any attempt to restore proper body alignment is treated as an error and CNS automatically restores this abnormal pattern. With a prolonged deviation in body part alignment, CNS treats it as a defect and runs compensatory mechanisms to restore the balance of the body as a whole. Balance is ensured by postural compensation, but this does not restore proper body part alignment. In the treatment of scoliosis, it is important both to slow down progression and to prevent the development of abnormal postural habits, which are part of a vicious circle even without progression. Secondary prevention is therefore needed in all patients. Passive observation limits the possibilities for prevention and contradicts the principle of early implementation of rehabilitation. Depending on the size of the angle of curvature, recommended treatments of scoliosis comprise observation, corset bracing, and surgery. Physiotherapy is often treated as an unconventional and ineffective treatment. Often, the biggest problem is transferring the resulting correction to automatic maintenance of a correct posture in the vertical position. The aim of this paper was to discuss the conservative treatment of scoliosis with regard to difficulties maintaining the correct alignment of the body parts in the vertical position that accompany scoliosis.

  5. A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria.

    Science.gov (United States)

    Guo, Jing; Lam, Tsz Ping; Wong, Man Sang; Ng, Bobby Kin Wah; Lee, Kwong Man; Liu, King Lok; Hung, Lik Hang; Lau, Ajax Hong Yin; Sin, Sai Wing; Kwok, Wing Kwan; Yu, Fiona Wai Ping; Qiu, Yong; Cheng, Jack Chun Yiu

    2014-12-01

    SpineCor is a relatively innovative brace for non-operative treatment of adolescent idiopathic scoliosis (AIS). However, the effectiveness of SpineCor still remains controversial. The objective of the current study was to compare the treatment outcomes of SpineCor brace with that of rigid brace following the standardized Scoliosis Research Society (SRS) criteria on AIS brace study. Females subjects with AIS and aged 10-14 were randomly allocated into two groups undergoing treatment of SpineCor (S Group, n = 20) or rigid brace (R Group, n = 18). During SpineCor treatment, patients who had curve progression of >5° would be required to switch to rigid brace treatment. The effectiveness of the two brace treatments was assessed using the SRS standardized criteria. Before skeletal maturity, 7 (35.0%) patients in the S Group and 1 (5.6%) patient in the R Group had curve progression >5° (P = 0.026). At skeletal maturity, 5 of the 7 (71.4%) patients who failed with SpineCor bracing showed control from further progression by changing to rigid bracing. At the latest follow-up with a mean duration of 45.1 months after skeletally maturity, 29.4% of patients who were successfully treated by rigid brace showed further curve progression beyond skeletal maturity, versus 38.5% of patients in the SpineCor group (P > 0.05). For both groups, the primary curves were slightly improved at the time of brace weaning, but additionally increased at the latest follow-up, with a rate of 1.5° per year for post-maturity progression. Curve progression rate was found to be significantly higher in the SpineCor group when compared with the rigid brace group. Changing to rigid bracing could control further curve progression for majority of patients who previously failed with SpineCor bracing. For both SpineCor and rigid brace treatments, 30-40% of patients who were originally successfully treated by bracing would exhibit further curve progression beyond skeletal maturity. The post

  6. The Role of Correction in the Conservative Treatment of Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Ng, Shu-Yan; Nan, Xiao-Feng; Lee, Sang-Gil; Tournavitis, Nico

    2017-01-01

    Physiotherapeutic Scoliosis-Specific Exercises (PSSE) and bracing have been found to be effective in the stabilization of curves in patients with Adolescent Idiopathic Scoliosis (AIS). Yet, the difference among the many PSSEs and braces has not been studied. The present review attempts to investigate the role of curve correction in the outcome of treatment for PSSEs and braces. A PubMed manual search has been conducted for studies on the role of correction in the effectiveness of PSSE and bracing. For the PSSEs, the key words used were "adolescent idiopathic scoliosis, correction, physiotherapy, physical therapy, exercise, and rehabilitation." For bracing, the key words used were "adolescent idiopathic scoliosis, correction and brace". Only papers that were published from 2001-2017 were included and reviewed, as there were very few relevant papers dating earlier than 2001. The search found no studies on the role of correction on the effectiveness of different PSSEs. The effectiveness of different PSSEs might or might not be related to the magnitude of curve correction during the exercises. However, many studies showed a relationship between the magnitude of in-brace correction and the outcome of the brace treatment. The role of correction on the effectiveness of PSSE has not been studied. In-brace correction, however, has been found to be associated with the outcome of brace treatment. An in-brace correction of 40-50% was associated with an increased rate of brace treatment success ( i.e . stabilization or improvement of curves). Thus, in the treatment of AIS, patients should be advised to use highly corrective braces, in conjunction with PSSE since exercises have been found to help stabilize the curves during weaning of the brace. Presently, no specific PSSE can be recommended. Braces of high in-brace correction should be used in conjunction with PSSEs in the treatment of AIS. No specific PSSE can be recommended as comparison studies of the effectiveness of

  7. Optimal management of idiopathic scoliosis in adolescence

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    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

  8. Comparison of untreated adolescent idiopathic scoliosis with normal controls: a review and statistical analysis of the literature.

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    Rushton, Paul R P; Grevitt, Michael P

    2013-04-20

    Review and statistical analysis of studies evaluating health-related quality of life (HRQOL) in adolescents with untreated adolescent idiopathic scoliosis (AIS) using Scoliosis Research Society (SRS) outcomes. To apply normative values and minimum clinical important differences for the SRS-22r to the literature. Identify whether the HRQOL of adolescents with untreated AIS differs from unaffected peers and whether any differences are clinically relevant. The effect of untreated AIS on adolescent HRQOL is uncertain. The lack of published normative values and minimum clinical important difference for the SRS-22r has so far hindered our interpretation of previous studies. The publication of this background data allows these studies to be re-examined. Using suitable inclusion criteria, a literature search identified studies examining HRQOL in untreated adolescents with AIS. Each cohort was analyzed individually. Statistically significant differences were identified by using 95% confidence intervals for the difference in SRS-22r domain mean scores between the cohorts with AIS and the published data for unaffected adolescents. If the lower bound of the confidence interval was greater than the minimum clinical important difference, the difference was considered clinically significant. Of the 21 included patient cohorts, 81% reported statistically worse pain than those unaffected. Yet in only 5% of cohorts was this difference clinically important. Of the 11 cohorts included examining patient self-image, 91% reported statistically worse scores than those unaffected. In 73% of cohorts this difference was clinically significant. Affected cohorts tended to score well in function/activity and mental health domains and differences from those unaffected rarely reached clinically significant values. Pain and self-image tend to be statistically lower among cohorts with AIS than those unaffected. The literature to date suggests that it is only self-image which consistently differs

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

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    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

  10. Clinical Outcomes of Extreme Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

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    Adam M. Caputo

    2012-01-01

    Full Text Available Introduction. The use of extreme lateral interbody fusion (XLIF and other lateral access surgery is rapidly increasing in popularity. However, limited data is available regarding its use in scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis treated with XLIF. Methods. Thirty consecutive patients with adult degenerative scoliosis treated by a single surgeon at a major academic institution were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Validated clinical outcome scores were obtained on patients preoperatively and at most recent follow-up. Complications were recorded. Results. The study group demonstrated improvement in multiple clinical outcome scores. Oswestry Disability Index scores improved from 24.8 to 19.0 (P < 0.001. Short Form-12 scores improved, although the change was not significant. Visual analog scores for back pain decreased from 6.8 to 4.6 (P < 0.001 while scores for leg pain decreased from 5.4 to 2.8 (P < 0.001. A total of six minor complications (20% were recorded, and two patients (6.7% required additional surgery. Conclusions. Based on the significant improvement in validated clinical outcome scores, XLIF is effective in the treatment of adult degenerative scoliosis.

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

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    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. THE EFFECT OF CORRECTIVE SURGERY OF SCOLIOSIS ON CERVICAL LORDOTIC AXIS

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    ALDO CALADO

    Full Text Available ABSTRACT Objectives: To quantify the changes in cervical sagittal alignment of patients with adolescent idiopathic scoliosis (AIS who underwent surgical treatment. Methods: Retrospective study of radiographic data analysis. Data were collected from 25 radiographs of patients with AIS, and 18 cases were included. The mean age was 15.2 years (13-17 years; all subjects were female, operated from March 2010 to October 2015. Pre and postoperatively, cervical lordosis (C2-C7, thoracic kyphosis (T5-T12 and lumbar lordosis (L1-S1 were measured. Scoliotic curves were analyzed and measured in anterior posterior views by the Cobb method and classified according to the Lenke classification. Results: Eighteen adolescent patients were evaluated with a mean follow-up of 31.3 months. There was a negative correlation (-0.613 between post-surgical and pre-surgical cervical lordosis variation, that is, the largest the angulations obtained, on average, the greatest the reductions. Thus, the correlation becomes positive when compared to postoperative period (0.579. Conclusion: We concluded that the correction of adolescent idiopathic scoliosis did not bring about statistically significant changes in the cervical spine, with respect to angle values. Lordotic cervical curves with greater angular value showed a greater variation in the postoperative period, resulting in a better biomechanical balance.

  13. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

    Directory of Open Access Journals (Sweden)

    van Loon Piet JM

    2012-10-01

    Full Text Available Abstract Study design A prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis. Summary of background data Conservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention. Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis. Methods A consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve Results Before treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p Conclusion Conservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

  14. Use of the scoliosis research society outcomes instrument to evaluate patient outcome in untreated idiopathic scoliosis patients in Japan: part I: comparison with nonscoliosis group: preliminary/limited review in a Japanese population.

    Science.gov (United States)

    Watanabe, Kei; Hasegawa, Kazuhiro; Hirano, Toru; Uchiyama, Seiji; Endo, Naoto

    2005-05-15

    This preliminary study evaluates untreated Japanese patients with idiopathic scoliosis using the Scoliosis Research Society Outcomes Instrument (SRS-24). To determine the baseline patient outcome score using the SRS-24 for untreated Japanese scoliosis patients compared with a nonscoliosis group. The SRS instrument with 24 questions was developed to help evaluate patient-perceived outcomes of idiopathic scoliosis treatment. Evaluation of untreated Japanese idiopathic scoliosis patients using the SRS instrument has not been reported. Japanese idiopathic scoliosis patients (n = 141) (mean age, 13.6 years; range, 10-17 years) with a Cobb angle of more than 20 degrees who were not treated with a brace or surgery, were evaluated in comparison with a nonscoliosis group (healthy junior high school students; n = 72) using the SRS-24. The scoliosis group was categorized as mild deformity group with a major curve Cobb angle of less than 30 degrees, moderate deformity group with 30 degrees to 49 degrees, and severe deformity group with more than 50 degrees. The patients were evaluated using section 1 (15 questions) of the SRS-24, which was divided into four domains: total pain, general self-image, general function, and activity. Reliability, as determined by internal consistency, was validated using Cronbach's alpha for these domain scales. The severe deformity group had the lowest scores compared with the other deformity groups and the nonscoliosis group in pain (P self-image (P self-image of back appearance, were significantly lower in the scoliosis group than those in the nonscoliosis group. This tendency was more significant in the patients with greater curve magnitude. Scores for questions 14 and 15, evaluation of general self-image, in the scoliosis group were, however, higher than those in the nonscoliosis group. Internal consistency using Cronbach's alpha was 0.57 (pain), 0.27 (general self-image), -0.08 (general function), and 0.15 (overall level of activity

  15. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Peter Obid

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  16. Calibrating AIS images using the surface as a reference

    Science.gov (United States)

    Smith, M. O.; Roberts, D. A.; Shipman, H. M.; Adams, J. B.; Willis, S. C.; Gillespie, A. R.

    1987-01-01

    A method of evaluating the initial assumptions and uncertainties of the physical connection between Airborne Imaging Spectrometer (AIS) image data and laboratory/field spectrometer data was tested. The Tuscon AIS-2 image connects to lab reference spectra by an alignment to the image spectral endmembers through a system gain and offset for each band. Images were calibrated to reflectance so as to transform the image into a measure that is independent of the solar radiant flux. This transformation also makes the image spectra directly comparable to data from lab and field spectrometers. A method was tested for calibrating AIS images using the surface as a reference. The surface heterogeneity is defined by lab/field spectral measurements. It was found that the Tuscon AIS-2 image is consistent with each of the initial hypotheses: (1) that the AIS-2 instrument calibration is nearly linear; (2) the spectral variance is caused by sub-pixel mixtures of spectrally distinct materials and shade, and (3) that sub-pixel mixtures can be treated as linear mixtures of pure endmembers. It was also found that the image can be characterized by relatively few endmembers using the AIS-2 spectra.

  17. Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Clément, Jean-Luc; Geoffray, Anne; Yagoubi, Fatima; Chau, Edouard; Solla, Federico; Oborocianu, Ioana; Rampal, Virginie

    2013-11-01

    Sagittal spine and pelvic alignment of adolescent idiopathic scoliosis (AIS) is poorly described in the literature. It generally reports the sagittal alignment with regard to the type of curve and never correlated to the thoracic kyphosis. The objective of this study is to investigate the relationship between thoracic kyphosis, lumbar lordosis and sagittal pelvic parameters in thoracic AIS. Spinal and pelvic sagittal parameters were evaluated on lateral radiographs of 86 patients with thoracic AIS; patients were separated into hypokyphosis group (n = 42) and normokyphosis group (n = 44). Results were statistically analyzed. The lumbar lordosis was lower in the hypokyphosis group, due to the low proximal lordosis. The thoracic kyphosis was not correlated with any pelvic parameters but with the proximal lordosis. The pelvic incidence was correlated with sacral slope, pelvic tilt, lumbar lordosis and highly correlated with distal lumbar lordosis in the two groups. There was a significant linear regression between thoracic kyphosis and proximal lordosis and between pelvic incidence and distal lordosis. We can consider that the proximal part of the lordosis depends on the thoracic kyphosis and the distal part depends on the pelvic incidence. The hypokyphosis in AIS is independent of the pelvic parameters and could be described as a structural parameter, characteristic of the scoliotic deformity.

  18. Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study.

    Science.gov (United States)

    Brink, Rob C; Schlösser, Tom P C; Colo, Dino; Vincken, Koen L; van Stralen, Marijn; Hui, Steve C N; Chu, Winnie C W; Cheng, Jack C Y; Castelein, René M

    2017-01-01

    Cross-sectional. To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p = .005, lumbar: 95.8% vs. 97.2%; p transverse pedicle angle was greater (12.3° vs. 5.7°; p transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level 4. Copyright © 2016 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  19. The importance of trunk perception during brace treatment in moderate juvenile idiopathic scoliosis: What is the impact on self-image?

    Science.gov (United States)

    Paolucci, Teresa; Piccinini, Giulia; Iosa, Marco; Piermattei, Cristina; De Angelis, Simona; Zangrando, Federico; Saraceni, Vincenzo Maria

    2017-01-01

    The perception of body image and the deformity of the trunk in patients with adolescent idiopathic scoliosis (AIS) are a silver lining that has yet to be discussed in the relevant literature during brace rehabilitation treatment. To determine whether and how the use of the brace changes perception of the trunk in patients with AIS by the drawing test. We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects). Trunk perception and quality of life were evaluated using the Trunk Appearance Perception Scale and Scoliosis Research Society-22 questionnaire, and the perception of one's back was measured by the drawing test. Pain was lower in BG versus CG (p= 0.095). Satisfaction with the treatment was higher in BG than in CG (p= 0.002). Self-image did not differ significantly between the groups in terms of TAPS. Drawings of the most severe cases of scoliosis were made by the group without the brace. The use of the brace corrects the function of the trunk and has a positive influence on its perception.

  20. Scoliosis

    Science.gov (United States)

    ... bigger braces. Braces are usually named after the cities where they were invented and have names like ... During the operation, the orthopedic surgeon fuses the bones in the spine together so that they can ...

  1. Scoliosis

    Science.gov (United States)

    ... or low-back pain that goes down the legs Weakness or tired feeling in the spine after sitting or standing for a long time Uneven hips or shoulders (one shoulder may be higher than the other) Spine curves more to one side Exams and Tests The health care provider will perform a physical ...

  2. Defining the bone morphometry, micro-architecture and volumetric density profile in osteopenic vs non-osteopenic adolescent idiopathic scoliosis.

    Science.gov (United States)

    Wang, Zhi-Wei; Lee, Wayne Yuk-Wai; Lam, Tsz-Ping; Yip, Benjamin Hon-Kei; Yu, Fiona Wai-Ping; Yu, Wing-Sze; Zhu, Feng; Ng, Bobby Kin-Wah; Qiu, Yong; Cheng, Jack Chun-Yiu

    2017-06-01

    Osteopenia has been widely reported in about 30 % of girls with adolescent idiopathic scoliosis (AIS). However, the bone quality profile of the 70 % non-osteopenic AIS defined by areal bone mineral density (BMD) with conventional dual-energy X-ray absorptiometry (DXA) has not been adequately studied. Our purpose was to verify whether abnormal volumetric BMD (vBMD) and bone structure (morphometry and micro-architecture) also existed in the non-osteopenic AIS when compared with matched controls using both DXA and high-resolution peripheral computed tomography (HR-pQCT). This was a case-control cross-sectional study. 257 AIS girls with a mean age of 12.7 (SD = 0.8) years old and 187 age- and gender-matched normal controls with an average age of 12.9 (SD = 0.5) years old were included. Areal BMD (aBMD) and bone quality were measured with standard DXA and HR-pQCT, respectively. The parameters of HR-pQCT could be categorized as bone morphometry, vBMD and bone micro-architecture. The results were compared between the osteopenic AIS and osteopenic control, and between the non-osteopenic AIS and non-osteopenic control. In addition to the lower aBMD and vBMD, osteopenic AIS showed significantly greater cortical perimeter and trabecular area than the osteopenic control even after adjustments of age (P architecture and volumetric density profile compared with their normal matched controls. The observed abnormalities were suggestive of decreased endocortical bone apposition or active endocortical resorption that could affect the mechanical bone strength in AIS. The underlying pathomechanism might be attributed to abnormal bone modeling/remodeling that could be associated with the etiopathogenesis of AIS.

  3. Scoliosis in osteogenesis imperfecta caused by COL1A1/COL1A2 mutations - genotype-phenotype correlations and effect of bisphosphonate treatment.

    Science.gov (United States)

    Sato, Atsuko; Ouellet, Jean; Muneta, Takeshi; Glorieux, Francis H; Rauch, Frank

    2016-05-01

    Bisphosphonates are widely used to treat children with osteogenesis imperfecta (OI), a bone fragility disorder that is most often caused by mutations in COL1A1 or COL1A2. However, it is unclear whether this treatment decreases the risk of developing scoliosis. We retrospectively evaluated spine radiographs and charts of 437 patients (227 female) with OI caused by mutations in COL1A1 or COL1A2 and compared the relationship between scoliosis, genotype and bisphosphonate treatment history. At the last follow-up (mean age 11.9 [SD: 5.9] years), 242 (55%) patients had scoliosis. The prevalence of scoliosis was highest in OI type III (89%), followed by OI type IV (61%) and OI type I (36%). Moderate to severe scoliosis (Cobb angle ≥25°) was rare in individuals with COL1A1 haploinsufficiency mutations but was present in about two fifth of patients with triple helical glycine substitutions or C-propeptide mutations. During the first 2 to 4years of bisphosphonate therapy, patients with OI type III had lower Cobb angle progression rates than before bisphosphonate treatment, whereas in OI types I and IV bisphosphonate treatment was not associated with a change in Cobb angle progression rates. At skeletal maturity, the prevalence of scoliosis (Cobb angle >10°) was similar in patients who had started bisphosphonate treatment early in life (before 5.0years of age) and in patients who had started therapy later (after the age of 10.0years) or had never received bisphosphonate therapy. Bisphosphonate treatment decreased progression rate of scoliosis in OI type III but there was no evidence of a positive effect on scoliosis in OI types I and IV. The prevalence of scoliosis at maturity was not influenced by the bisphosphonate treatment history in any OI type. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The effects of scoliosis and subsequent surgery on the shape of the torso

    Directory of Open Access Journals (Sweden)

    Adrian Gardner

    2017-11-01

    Full Text Available Abstract Background Adolescent idiopathic scoliosis (AIS causes asymmetry of the torso, and this is often the primary concern of patients. Surgery aims to minimise the visual asymmetry. It is not clear how scoliosis makes the torso asymmetric or how scoliosis surgery changes that asymmetry when compared to the distribution of asymmetries seen in a non-scoliotic group of normal controls. Methods Surface topography images were captured for a group with AIS both pre-operatively and post-operatively. Identifiable points were compared between the images to identify the effects of AIS on the shape of the torso by looking at the relative heights and distances from the midline of the shoulders, axillae and waist in a two-dimensional coronal view. This was then compared to a previously reported group of normal non-scoliotic children to analyse whether surgery recreated normality. Results There were 172 pairs of images with 164 females and 8 males, mean age at pre-operative scan of 13.7 years. The normal group was 642 images (237 females and 405 males from 116 males and 79 females, mean age of 12.5 years. The curve patterns seen in the scoliotic group matched the patterns of a main thoracic curve (n = 146 and main thoracolumbar curve (n = 26. The asymmetries seen in both shoulders, axillae and waist were different between the two different types of curve. Across both groups, the shoulder asymmetry was less than that of the corresponding axillae. There was a statistically significant reduction in all asymmetries following surgery in the main thoracic group (p < 0.001. This was not seen in the main thoracolumbar group, thought to be due to the small sample size. In the main thoracic group, there were statistically significant differences in the asymmetries between the post-operative and normal groups in the shoulders and axillae (p < 0.001 but not the waist. Conclusions This paper demonstrates quantitatively the range of asymmetries seen

  5. Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

    Science.gov (United States)

    Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

    2017-08-01

    This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

  6. 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.

  7. Congenital scoliosis: an up-to-date

    Science.gov (United States)

    Burnei, G; Gavriliu, S; Vlad, C; Georgescu, I; Ghita, RA; Dughilă, C; Japie, EM; 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 PMID:26351546

  8. harnessing_ai_20180319.pptx

    OpenAIRE

    Johnson, Matthew

    2018-01-01

    There have been great strides made in Artificial Intelligence in recent years, but it is often not clear how to apply these recent advances to new problems. In this talk I propose one method of thinking about problems in the sciences and how to find the right AI techniques to aid in research.

  9. Intraspinal anomalies in scoliosis: An MRI analysis of 177 consecutive scoliosis patients

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2010-01-01

    Full Text Available Background : The association of intraspinal neural anomalies with scoliosis is known for more than six decades. However, there are no studies documenting the incidence of association of intraspinal anomalies in scoliotic patients in the Indian population. The guide lines to obtain an magnetic resonance imaging (MRI scan to rule out neuro-axial abnormalities in presumed adolescent idiopathic scoliosis are also not clear. We conducted a prospective study (a to document and analyze the incidence and types of intraspinal anomalies in different types of scoliosis in Indian patients. (b to identify clinico-radiological ′indicators′ that best predict the findings of neuro-axial abnormalities in patients with presumed adolescent idiopathic scoliosis, which will alert the physician to the possible presence of intraspinal anomalies and optimize the use of MRI in this sub group of patients. Materials and Methods : The data from 177 consecutive scoliotic patients aged less than 21 years were analyzed. Patients were categorized into three groups; Group A - congenital scoliosis (n=60, group B -presumed idiopathic scoliosis (n=94 and group C - scoliosis secondary to neurofibromatosis, neuromuscular and connective tissue disorders (n=23. The presence and type of anomaly in the MRI was correlated to patient symptoms, clinical signs and curve characteristics. Results : The incidence of intraspinal anomalies in congenital scoliosis was 35% (21/60, with tethered cord due to filum terminale being the commonest anomaly (10/21. Patients with multiple vertebral anomalies had the highest incidence (48% of neural anomalies and isolated hemi vertebrae had none. In presumed ′idiopathic′ scoliosis patients the incidence was higher (16% than previously reported. Arnold Chiari-I malformation (AC-I with syringomyelia was the most common neural anomaly (9/15 and the incidence was higher in the presence of neurological findings (100%, apical kyphosis (66.6% and early

  10. Quality of Life in Adolescent’s Idiopathic Scoliosis before and after Physical Therapy: A Preliminary Study

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    Shkurta Rrecaj-Malaj

    2018-06-01

    Full Text Available Adolescent Idiopathic Scoliosis (AIS accounts for 80% of all types of diagnosed scoliosis, occurring in 2%-3% of growing age population. This disorder is quite complicated and physical therapy is important factor in the treatment. The aim of this study is to evaluate the effi cacy of physical therapy in quality of life in adolescent idiopathic scoliosis. This research was conducted in 56 consecutive adolescent idiopathic scoliosis patients (32 females and 24 males, aged 10-17 years, Cobb angle 10º-45º, at Physical and Rehabilitation Medicine Clinic, University Clinical Center of Kosovo (UCCK, Prishtina, Kosovo, during the period 2016-2017. The physical therapy protocol, including combined Schroth and Pilates exercise were performed during 3 months. The evaluation of Quality of Life (QoL is done by SRS-22r questionnaire at the beginning and the end of the treatment. Results displayed that supervised combined Schroth and Pilates exercises have provided benefi t to the standard of care by improving QoL before and after physical therapy in all components: the mean for function has improved from 3.15 to 3.45, pain from 3.23 to 5.54, self-image from 3.36 to 5.46, mental health from 3.01 to 3.35, and in overall QoL was improved from 3.30 to 3.68. Quality of life was signifi cantly better after physical therapy (p<0.05. The study shows that physical therapy in scoliosis patients achieves good results in daily living life.

  11. Use of the Universal Clamp in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Sales de Gauzy, Jérôme; Jouve, Jean-Luc; Ilharreborde, Brice; Blondel, Benjamin; Accadbled, Franck; Mazda, Keyvan

    2014-07-01

    The Universal Clamp (UC) equipped with a soft sublaminar band is a relatively new thoracic anchor that can be used in hybrid constructs. A dedicated reduction tool that applies traction to the sublaminar band permits gentle translation of the thoracic curve to the pre-contoured fusion rods, which have been previously anchored distally by pedicle screws and proximally by hooks in a claw configuration. A literature review concerning the use of UC in adolescent idiopathic Scoliosis was performed. The results confirm the efficacy with the UC hybrid constructs, the good correction (71-66%) of the main thoracic curve and low loss of correction at 2-year follow-up (3-4%). The thoracic curve correction achieved and maintained in the AIS patients appears to be substantially higher than that reported for all hook and hook hybrid techniques. Regardless of the deformity correcting method employed with all-screw constructs, the Cobb angle correction achieved is equivalent to that achieved with UC hybrid devices. Among the present AIS patients who had normal values of thoracic kyphosis pre-operatively, there was almost no change in average thoracic kyphosis at the latest follow-up. However, among the patients with low pre-operative values of T5-T12 kyphosis, the average T5-T12 kyphosis improved. Hybrid construct with UC is safe, with reduced operative time and blood loss. While achieving deformity correction in the coronal and axial planes equivalent to the best-reported results of all screw or previous hybrid constructs, the UC hybrid technique appears to provide superior correction in the sagittal plane. The excellent outcome is maintained at the 2-year follow-up.

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

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    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

  13. Rehabilitation treatment in children with scoliosis

    International Nuclear Information System (INIS)

    Fonseca, Galia

    1998-01-01

    The scoliosis is classified as the problem more common of the spinal cord in the pediatric population. It is defined like a lateral abnormal bend of the spinal cord. It exists a wide range of unique or combined interventions that they will guarantee that the bend in most of the cases remains stable and in others that it diminishes until the period of the boy's growth is completed. The election of the type of intervention observation, orthesis, bandage in plaster or surgical it will depend on the skeletal maturity and of the classification that is made of the scoliosis. Every time that the intervention begins in a patient with scoliosis an individual analysis of each situation should be carried out, for this reason the rehabilitation services have an interdisciplinary team that looks for, above all, the execution of the elected treatment. The paper includes physical exam, methods and intervention types

  14. Escoliosis y síndrome de Prader-Willi: a propósito de 5 casos intervenidos quirúrgicamente Escoliose e síndrome de Prader-Willi: análise de cinco casos tratados cirurgicamente Scoliosis and Prader-Willi syndrome: review of five cases treated surgically

    Directory of Open Access Journals (Sweden)

    Jose Grass Pedrals

    2012-06-01

    em dois (14,3% e cifose depois da instrumentação em um caso (7,1%. Não foram verificadas complicações graves. CONCLUSÕES: Mesmo que a literatura mostre autores pouco inclinados a indicar cirurgia nesse tipo de pacientes, por causa da elevada taxa de complicações graves, a ausência dessas complicações em nossa prática valida os mesmos critérios cirúrgicos da escoliose idiopática.OBJECTIVE: Analyze the results and complications of scoliosis surgery in patients with Prader-Willi syndrome to verify if this kind of treatment is justified. METHODS: Retrospective analysis of clinical records and radiographs of five patients with Prader-Willi syndrome treated at the Department of Scoliosis between 2005 and 2010. RESULTS: The average age of patients at the first visit was 3.6 years. The average scoliosis was 61°, which increased to 65° at the time of surgery. The average number of surgeries performed per patient was 2.8, reaching an average correction of 35%. The reasons for re-interventions were correction loss in 4 cases (28.5%, loosening of hooks in two cases (14.3%, and kyphosis after instrumentation in one case (7.1%. There were no serious complications. CONCLUSIONS: Even though the literature shows authors unwilling to indicate surgery in such patients because of the high rate of severe complications, the absence of these complications in our practice validates the use of the same surgical criteria of idiopathic scoliosis.

  15. Preoperative and perioperative factors effect on adolescent idiopathic scoliosis surgical outcomes.

    Science.gov (United States)

    Sanders, James O; Carreon, Leah Y; Sucato, Daniel J; Sturm, Peter F; Diab, Mohammad

    2010-09-15

    Prospective multicenter database. To identify factors associated with outcomes from adolescent idiopathic scoliosis (AIS) surgery outcomes and especially poor results. Because AIS is rarely symptomatic during adolescence, excellent surgical results are expected. However, some patients have poor outcomes. This study seeks to identify factors correlating with results and especially those making poor outcomes more likely. Demographic, surgical, and radiographic parameters were compared to 2-year postoperative Scoliosis Research Society (SRS) scores in 477 AIS surgical patients using stepwise linear regression to identify factors predictive of 2-year domain and total scores. Poor postoperative score patients (>2 SD below mean) were compared using t tests to those with better results. The SRS instrument exhibited a strong ceiling effect. Two-year scores showed more improvement with greater curve correction (self-image, pain, and total), and were worse with larger body mass index (pain, mental, total), larger preoperative trunk shift (mental and total), larger preoperative Cobb (self-image), and preoperative symptoms (function). Poor results were more common in those with Lenke 3 curve pattern (pain), less preoperative coronal imbalance, trunk shift and rib prominence (function), preoperative bracing (self-image), and anterior procedures (mental). Poor results also had slightly less average curve correction (50% vs. 60%) and larger curve residuals (31° vs. 23°). Complications, postoperative curve magnitude, and instrumentation type did not significantly contribute to postoperative scores, and no identifiable factors contributed to satisfaction. Curve correction improves patient's self-image whereas pain and poor function before surgery carry over after surgery. Patients with less spinal appearance issues (higher body mass index, Lenke 3 curves) are less happy with their results. Except in surgical patient selection, many of these factors are beyond physician control.

  16. A validation study on the traditional Chinese version of Spinal Appearance Questionnaire for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Guo, Jing; Lau, Ajax Hong Yin; Chau, Jack; Ng, Bobby Kin Wah; Lee, Kwong Man; Qiu, Yong; Cheng, Jack Chun Yiu; Lam, Tsz Ping

    2016-10-01

    "Simplified Chinese" version of Spinal Appearance Questionnaire (SC-SAQ) for patients with adolescent idiopathic scoliosis (AIS) was available but did not fit for communities using "Traditional Chinese" as their primary language. We developed a traditional Chinese version of SAQ (TC-SAQ) and evaluated its reliability and validity. TC-SAQ was administered to 112 AIS patients, of which 101 bilingual (English and Chinese) patients completed E-SAQ and the traditional Chinese version of Scoliosis Research Society-22 questionnaire (TC-SRS-22). Internal consistency and test-retest reliability were evaluated. Concurrent validity was evaluated by comparing TC-SAQ score with E-SAQ score, and convergent validity by comparing TC-SAQ score with TC-SRS-22 self-image domain score, and discriminant validity by analyzing the relationship between TC-SAQ score and patients' characteristics. Internal consistency of individual TC-SAQ domain was high (Cronbach's α = 0.785 to 0.940), except for general (Cronbach's α = 0.665) and shoulders (Cronbach's α = 0.421) domain. Test-retest reliability of TC-SAQ was good (ICCs of each domain from 0.798 to 0.865). Concurrent validity demonstrated an excellent correlation between TC-SAQ and E-SAQ scores (r = 0.820 to 0.954, P self-image domain was weak to moderate. TC-SAQ total score and individual domain scores (except waist and chest domains) were positively correlated to major curve magnitude. TC-SAQ had good internal consistency and test-retest reliability. Concurrent validity evaluated against the original English version was excellent. TC-SAQ was both reliable and valid for clinical use for AIS patients using traditional Chinese as their primary language.

  17. 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.

  18. Correction Capability in the 3 Anatomic Planes of Different Pedicle Screw Designs in Scoliosis Instrumentation.

    Science.gov (United States)

    Wang, Xiaoyu; Aubin, Carl-Eric; Coleman, John; Rawlinson, Jeremy

    2017-05-01

    Computer simulations to compare the correction capabilities of different pedicle screws in adolescent idiopathic scoliosis (AIS) instrumentations. To compare the correction and resulting bone-screw forces associated with different pedicle screws in scoliosis instrumentations. Pedicle screw fixation is widely used in surgical instrumentation for spinal deformity treatment. Screw design, correction philosophies, and surgical techniques are constantly evolving to achieve better control of the vertebrae and correction of the spinal deformity. Yet, there remains a lack of biomechanical studies that quantify the effects and advantages of different screw designs in terms of correction kinematics. The correction capabilities of fixed-angle, multiaxial, uniaxial, and saddle axial screws were kinematically analyzed, simulated, and compared. These simulations were based on the screw patterns and correction techniques proposed by 2 experienced surgeons for 2 AIS cases. Additional instrumentations were assessed to compare the correction and resulting bone-screw forces associated with each type of screw. The fixed-angle, uniaxial and saddle axial screws had similar kinematic behavior and performed better than multiaxial screws in the coronal and transverse planes (8% and 30% greater simulated corrections, respectively). Uniaxial and multiaxial screws were less effective than fixed-angle and saddle axial screws in transmitting compression/distraction to the anterior spine because of their sagittal plane mobility between the screw head and shank. Only the saddle axial screws allow vertebra angle in the sagittal plane to be independently adjusted. Pedicle screws of different designs performed differently for deformity corrections or for compensating screw placement variations in different anatomic planes. For a given AIS case, screw types should be determined based on the particular instrumentation objectives, the deformity's stiffness and characteristics so as to make the best of

  19. Overweight is not predictive of bracing failure in adolescent idiopathic scoliosis: results from a retrospective cohort study.

    Science.gov (United States)

    Zaina, Fabio; Donzelli, Sabrina; Negrini, Stefano

    2017-06-01

    Overweight was found to be a negative predictor of brace effectiveness for adolescent idiopathic scoliosis (AIS), with a threefold higher risk of progression than in normal weight patients. The aim of this study is to investigate overweight, as a predictor of brace results in AIS patients. Design: retrospective cohort study. 351 AIS patients (306 females), mean age 12.9 ± 1.4, mean Cobb 35.6 ± 11.4°, mean ATR 11 ± 4.3°, BMI 19.7 ± 3, median Risser: 2. no previous treatment, full-time prescription of brace at first visit (18-23 h per day), scoliosis physiotherapeutic exercise according to the SEAS protocol associated. improved, progressed, and stable according to the 5° Cobb agreed threshold. a stepwise linear regression was used to look for the effect of BMI as a predictor of result. A Chi-square test and logistic regression were used for the overweight category (BMI ≥ 85th percentile). Control for possible confounders was applied. BMI is poorly correlated with final results. Confounders' adjustment did not change the correlation, and the predictive model explained about 10% of the result. Brace results were not statistically different in overweight and normal weight: 44 vs 52% improved, 52 vs 41% stable, and 3 vs 7% worsened, respectively. Brace results were similar in overweight and normal weight subjects. These findings subvert the previous results and disprove the role of overweight as a negative predictor. Treatment management, brace type and effectiveness may play a major role in reducing the risks of scoliosis progression.

  20. Optimal management of idiopathic scoliosis in adolescence

    Science.gov (United States)

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

    2013-01-01

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

  1. Changes in life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis with and without surgical intervention.

    Science.gov (United States)

    Zhang, Jingtao; He, Dawei; Gao, Juan; Yu, Xiuchun; Sun, Haining; Chen, Ziqiang; Li, Ming

    2011-04-20

    Pre-/poststudy comparing surgical and nonsurgical treatment. To identify whether orthopedic spinal surgery can effectively improve life satisfaction and self-esteem in patients with adolescent idiopathic scoliosis. There have been many studies about the effect of spinal deformity and its various treatments on the mental health of patients with adolescent idiopathic scoliosis. Scoliosis has been reported to have a negative effect on the life quality and mental health of patients. It has also been reported that no matter what the treatment, the existence of scoliosis is a risk factor for depression. However, there has been no report on whether orthopedic spinal surgery affects the life satisfaction and self-esteem of scoliosis patients. Forty-six patients with Cobb angles of more than 30° were recruited from a group of patients that were treated from January 2007 to August 2007. Twenty-one patients with Cobb angles of more than 40° underwent surgical correction while the remaining patients received regular observation (n = 11) or bracing (n = 14). Self-esteem and life satisfaction were assessed before and approximately 1 year after treatment using previously validated scales. There were no between-group differences in age, sex, or major curve location between the surgically and nonsurgically treated groups. The major curve Cobb angle decreased significantly following treatment in the surgically treated (52° ± 10° to 15° ± 8°, P life satisfaction (8 ± 1 vs. 7 ± 10); however, preintervention self-esteem scores were significantly higher in the nonsurgically treated group (28 ± 4 vs. 25 ± 3, P = 0.008). Postintervention, both life satisfaction (9 ± 1) and self-esteem (31 ± 2) scores improved significantly (P Self-esteem levels decreased significantly in the nonsurgically treated group (P self-esteem and life satisfaction scores were significantly higher in the surgically treated than the nonsurgically treated group (P self-esteem and life satisfaction.

  2. Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.

    Directory of Open Access Journals (Sweden)

    Ewa Misterska

    Full Text Available We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS, who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG, were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients' follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23-35. Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0-27. A control group of 42 healthy females (healthy controls group-HG matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI, the Rolland-Morris Questionnaire (RMQ, the Quebec Back Pain Disability Scale (QDS, the Neck Disability Index (NDI and the Copenhagen Neck Functional Disability Scale (CNFDS. Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent

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

    Science.gov (United States)

    2015-10-01

    by advertising our study on Children’s Tumor Foundation and The Littlest Tumor Foundation Midwest Society. The study was also posted on...Identification of 53 Single- Nucleotide Polymorphism (SNP) Markers 6 Associated with Scoliosis Progression in Adolescent Idiopathic Scoliosis Fake ID...23 105 dystrophic 24 26 non dystrophic 25 35 dystrophic 26 43 non dystrophic 27 53 dystrophic 28 70 non dystrophic 29 7 non dystrophic Fake

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

    Science.gov (United States)

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

    2006-10-01

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

  5. Organisational intelligence and distributed AI

    OpenAIRE

    Kirn, Stefan

    1995-01-01

    The analysis of this chapter starts from organisational theory, and from this it draws conclusions for the design, and possible organisational applications, of Distributed AI systems. We first review how the concept of organisations has emerged from non-organised black-box entities to so-called computerised organisations. Within this context, organisational researchers have started to redesign their models of intelligent organisations with respect to the availability of advanced computing tec...

  6. Optimizing Limousine Service with AI

    OpenAIRE

    Chun, Andy Hon Wai

    2011-01-01

    A common problem for companies with strong business growth is that it is hard to find enough experienced staff to support expansion needs. This problem is particular pronounced for operations planners and controllers who must be very highly knowledgeable and experienced with the business domain. This article is a case study of how one of the largest travel agencies in Hong Kong alleviated this problem by using AI to support decision-making and problem-solving so that their planners and contro...

  7. Simulation of Scoliosis Treatment Using a Brace

    Directory of Open Access Journals (Sweden)

    J. Čulík

    2004-01-01

    Full Text Available Ivo Maoík M.D. has treated many child patients with scoliosis at the "Centre for Locomotor Defects", Olšanská 7, 130 00 Prague 3. The author has cooperated with him, and composed the computer program for the spine stress state under brace effects and for simulating scoliosis treatment. The program simulates the spinal curve remodelling in time for a specific child patients, and the algorithm for stress state calculation and treatment simulation is given.Orthopaedists in the Czech Republic use Cheneau-type or Cerny-type corrective braces. The brace exerts force effects on the skeleton of a child. The brace is made individually for each patient, in the following way: first, a negative plaster form of the child`s trunk is made, and then the positive plaster form is created. The orthopaedist determines the places where brace has to load the patient`s trunk, and the plaster form deepened in these places on the basis of his advice. The laminate brace made according to this plaster form constricts the child`s trunk (like a tight shoe.This paper shows how the stress state is determined in vertebrae and in inter-vertebral discs, and the solution of spinal curvature correction under brace force effects for a specific child patient. The project aims to find the dependence of the activation and velocity of spinal curvature correction in the spinal stress state for many patients. The paper shows the computing algorithms for spinal deformations and the stress state under brace force effects, and a simulation of spinal curvature correction.Spinal curvature is determined according to measured values on an X-ray of a patient before a brace is applied. The stress state in the spine and the spinal deformation are investigated by the finite element method as beam (spine in an elastic ground (soft tissue. Two algorithms are used. The first algorithm deals with the spine above and below the soft tissues, and it is loaded by given displacements of the trunk surface

  8. Posterior-only surgery with preoperative skeletal traction for management of severe scoliosis.

    Science.gov (United States)

    Mehrpour, Saeedreza; Sorbi, Reza; Rezaei, Reza; Mazda, Keyvan

    2017-04-01

    The surgical treatment of severe adolescent spinal deformities is challenging and carries substantial risks of mortality and morbidity. To mitigate this risk, surgeons have employed various methods as this study designed to evaluate the safety and effectiveness of preoperative halo-femoral or halo gravity traction (HGT) followed by posterior-only surgery in the management of severe scoliosis. A total number of 23 patients with severe scoliosis treated by preoperative skeletal traction (halo gravity or halo femoral) followed by posterior fusion and instrumentation in one stage. All patients were followed for a minimum of 2 years after surgery. The average age of the patients was 12.7 years at the time of surgery. Mean of the Cobb angle improved from 99.9° ± 8.2° preoperatively to 75.3° ± 8° post-traction and 49.5° ± 7.7° postoperatively. Kyphosis angle corrected from 56.4° ± 9.5° to 38.6° ± 5.8°. The preop-FVC% was 41 ± 6.1% and after 1 year follow-up FVC% was 45.7 ± 7.7%. No patients required an anterior release due to amount of their deformity. Despite the benefits of modern instrumentation procedures, the treatment of severe scoliosis can be very competing. We think that by applying preoperative halo femoral traction and halo-gravity traction, managing severe scoliosis will be in safe and easy manner and can lead to better deformity correction and less neurological complications and facilitate to avoid anterior operation for severe scoliosis and its related complications.

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

    Directory of Open Access Journals (Sweden)

    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. Long-term impact of pre-operative physical rehabilitation protocol on the 6-min walk test of patients with adolescent idiopathic scoliosis: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    V.L. dos Santos Alves

    2015-05-01

    Full Text Available Background: Monitored physical activities in patients with adolescent idiopathic scoliosis (AIS have been shown to improve physical performance, endurance and cardiopulmonary function and may be assessed by the 6-min walk test (6MWT. We aimed to evaluate the long-term results of the 6MWT after a rehabilitation protocol employed before surgical correction for AIS. Methods: This prospective randomized clinical trial studied the impact of a 4-month pre-operative physical rehabilitation protocol on post-operative cardiopulmonary function and physical endurance, by using the 6MWT, in patients with AIS submitted to surgical correction, comparing them to matched controls without physical rehabilitation. Studied variables were heart and respiratory rate, systolic and diastolic blood pressure, peripheral blood oxygen saturation, Borg score, and distance walked. Patients were assessed at baseline, after 4 months of rehabilitation, and 3, 6 and 12 months post-operatively. Results: A total of 50 patients with AIS were included in the study and allocated blindly, by simple randomization, into either one of the two groups, with 25 patients each: study group (pre-operative physical rehabilitation and control group. The physical rehabilitation protocol promoted significant progressive improvement in heart and respiratory rate, peripheral blood oxygen saturation, distance walked, and level of effort assessed by the Borg scale after surgery. Conclusions: Post-surgical recovery, evaluated by 6MWT, was significantly better in patients who underwent a 4-month pre-operative physical rehabilitation protocol. Keywords: Scoliosis, Exercise, Exercise movement techniques, Exercise therapy, Exercise test

  11. EOS suspension test for the assessment of spinal flexibility in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Hirsch, Caroline; Ilharreborde, Brice; Mazda, Keyvan

    2015-07-01

    The assessment of spinal flexibility is essential for the planning of adolescent idiopathic scoliosis (AIS) surgery. Various radiographic methods have been used but none of them has shown any superiority. The new low-dose stereography system EOS (EOS imaging, Paris, France) captures whole body images in a single scan without vertical distortion. EOS is now used in routine clinical use for AIS follow-up. The aim of this study was to prospectively evaluate the feasibility and the reproducibility of a new suspension test during the EOS imaging for the assessment of spinal flexibility in AIS. Fifty AIS patients scheduled for surgery were prospectively included. For each patient, a standard EOS radiograph was obtained, then a suspension test in the EOS and a classic traction test on the cotrel frame were performed. The examinations were compared in terms of radiation exposure, tolerance, mean traction force, and Cobb angle reduction for each curve. Axial and sagittal reductions during suspension were analyzed on three-dimensional EOS reconstructions. The tolerance of the suspension test was lower than the traction test but it was less operator dependent. Radiation exposure was 7 times lower during the suspension test. Cobb angle reductions achieved in the proximal and main curves by the two tests were similar. The traction test achieved greater reduction of the distal curve. Flexibility in the axial plane and in the sagittal plane was analyzed with the suspension test. The reduction in apical rotation was not correlated with the reduction in Cobb angle. The EOS suspension test can be used for the assessment of spinal flexibility in AIS. It gives a global vision of the deformity with new flexibility indices in the axial and sagittal planes.

  12. Segmental torso masses in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Keenan, Bethany E; Izatt, Maree T; Askin, Geoffrey N; Labrom, Robert D; Pettet, Graeme J; Pearcy, Mark J; Adam, Clayton J

    2014-08-01

    Adolescent idiopathic scoliosis is the most common type of spinal deformity whose aetiology remains unclear. Studies suggest that gravitational forces in the standing position play an important role in scoliosis progression, therefore anthropometric data is required to develop biomechanical models of the deformity. Few studies have analysed the trunk by vertebral level and none have performed investigations of the scoliotic trunk. The aim of this study was to determine the centroid, thickness, volume and estimated mass, for sections of the scoliotic trunk. Existing low-dose CT scans were used to estimate vertebral level-by-level torso masses for 20 female adolescent idiopathic scoliosis patients. ImageJ processing software was used to analyse the CT images and enable estimation of the segmental torso mass corresponding to each vertebral level. The patients' mean age was 15.0 (SD 2.7) years with mean major Cobb angle of 52 (SD 5.9)° and mean patient weight of 58.2 (SD 11.6) kg. The magnitude of torso segment mass corresponding to each vertebral level increased by 150% from 0.6kg at T1 to 1.5kg at L5. Similarly, segmental thickness from T1-L5 increased inferiorly from a mean 18.5 (SD 2.2) mm at T1 to 32.8 (SD 3.4) mm at L5. The mean total trunk mass, as a percentage of total body mass, was 27.8 (SD 0.5) % which was close to values reported in previous literature. This study provides new anthropometric reference data on segmental (vertebral level-by-level) torso mass in adolescent idiopathic scoliosis patients, useful for biomechanical models of scoliosis progression and treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-07-28

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

  14. MUSCLE DISORDERS IN ADOLESCENT IDIOPATHIC SCOLIOSIS: LITERATURE REVIEW

    OpenAIRE

    Débora Pinheiro Lédio Alves; Barbara de Araújo

    2016-01-01

    ABSTRACT Scoliosis is characterized by three-dimensional changes of the spine and is estimated to be present in 4% of the population worldwide. The most common form is the adolescent idiopathic. The purpose of this study is to identify the major muscle abnormalities found in patients with adolescent idiopathic scoliosis through a literature review. We conducted an electronic search of the national databases PubMed, Lilacs, PEDro, and EMBASE using the keywords "scoliosis", "biomechanics", "exe...

  15. Cerebral glucose metabolic abnormality in patients with congenital scoliosis

    OpenAIRE

    Park, Weon Wook; Suh, Kuen Tak; Kim, Jeung Il; Ku, Ja Gyung; Lee, Hong Seok; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Lee, Jung Sub

    2008-01-01

    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 ...

  16. School scoliosis screening programme-a systematic review.

    Science.gov (United States)

    Sabirin, J; Bakri, R; Buang, S N; Abdullah, A T; Shapie, A

    2010-12-01

    A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.

  17. Posterior Surgery for Adolescent Idiopathic Scoliosis With Pedicle Screws and Ultrahigh-Molecular Weight Polyethylene Tape: Achieving the Ideal Thoracic Kyphosis.

    Science.gov (United States)

    Imagama, Shiro; Ito, Zenya; Wakao, Norimitsu; Ando, Kei; Hirano, Kenichi; Tauchi, Ryoji; Muramoto, Akio; Matsui, Hiroki; Matsumoto, Tomohiro; Sakai, Yoshihito; Katayama, Yoshito; Matsuyama, Yukihiro; Ishiguro, Naoki

    2016-10-01

    Prospective clinical case series. To describe our surgical procedure and results for posterior correction and fusion with a hybrid approach using pedicle screws, hooks, and ultrahigh-molecular weight polyethylene tape with direct vertebral rotation (DVR) (the PSTH-DVR procedure) for treatment of adolescent idiopathic scoliosis (AIS) with satisfactory correction in the coronal and sagittal planes. Introduction of segmental pedicle screws in posterior surgery for AIS has facilitated good correction and fusion. However, procedures using only pedicle screws have risks during screw insertion, higher costs, and decreased postoperative thoracic kyphosis. We have obtained good outcomes compared with segmental pedicle screw fixation in surgery for AIS using a relatively simple operative procedure (PSTH-DVR) that uses fewer pedicle screws. The subjects were 30 consecutive patients with AIS who underwent the PSTH-DVR procedure and were followed for a minimum of 2 years. Preoperative flexibility, preoperative and postoperative Cobb angles, correction rates, loss of correction, thoracic kyphotic angles (T5-T12), coronal balance, sagittal balance, and shoulder balance were measured on plain radiographs. Rib hump, operation time, estimated blood loss, spinal cord monitoring findings, complications, and scoliosis research society (SRS)-22 scores were also examined. The mean preoperative curve of 58.0 degrees (range, 40-96 degrees) was corrected to a mean of 9.9 degrees postoperatively, and the correction rate was 83.6%. Fusion was obtained in all patients without loss of correction. In 10 cases with preoperative kyphosis angles (T5-T12) correction of deformity with PSTH-DVR is equivalent to that of all-pedicle screw constructs. The procedure gives favorable correction, is advantageous for kyphosis compared with segmental screw fixation, and uses the minimum number of pedicle screws. Therefore, the PSTH-DVR procedure may be useful for treatment of idiopathic scoliosis.

  18. 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.

  19. Asymmetrical trunk movement during walking improved to normal range at 3 months after corrective posterior spinal fusion in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Wong-Chung, Daniel A C F; Schimmel, Janneke J P; de Kleuver, Marinus; Keijsers, Noël L W

    2018-02-01

    To investigate the effects of posterior spinal fusion (PSF) and curve type on upper body movements in Adolescent Idiopathic Scoliosis (AIS) patients during gait. Twenty-four girls (12-18 years) with AIS underwent PSF. 3D-Gait-analyses were performed preoperatively, at 3 months and 1 year postoperatively. Mean position (0° represents symmetry) and range of motion (ROM) of the trunk (thorax-relative-to-pelvis) in all planes were assessed. Lower body kinematics and spatiotemporal parameters were also evaluated. Mean trunk position improved from 7.0° to 2.9° in transversal plane and from 5.0° to - 0.8° in frontal plane at 3 months postoperative (p maintenance of normal gait can explain the rapid recovery and well functioning in daily life of AIS patients, despite undergoing a fusion of large parts of their spine.

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

    Science.gov (United States)

    Fazal, Akil; Lakdawala, Riaz H

    2012-01-01

    and fusion is a reliable and satisfactory technique to treat adolescent idiopathic scoliosis.

  1. Active Treatment for Idiopathic Adolescent Scoliosis (ACTIvATeS): a feasibility study.

    Science.gov (United States)

    Williams, Mark A; Heine, Peter J; Williamson, Esther M; Toye, Francine; Dritsaki, Melina; Petrou, Stavros; Crossman, Richard; Lall, Ranjit; Barker, Karen L; Fairbank, Jeremy; Harding, Ian; Gardner, Adrian; Slowther, Anne-Marie; Coulson, Neil; Lamb, Sarah E

    2015-07-01

    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 of controlled trials evaluating the efficacy of SSE in AIS; (2) survey UK orthopaedic surgeons and physiotherapists to determine current practice, patient populations and equipoise; (3) randomise 50 adolescents to a feasibility trial of either usual care or SSE interventions across a range of sites; (4) develop, document and assess acceptability and adherence of interventions; (5) assess and describe training requirements of physiotherapists; and (6) gain user input in all relevant stages of treatment and protocol design. Multicomponent feasibility study including UK clinician survey, systematic literature review and a randomised feasibility trial. The randomised feasibility study involved four secondary care NHS trusts providing specialist care for patients with AIS. The randomised feasibility study recruited people aged 10-16 years with mild AIS (Cobb angle of physiotherapy SSE programme supported by a home exercise plan. Our choice of intervention was informed by a systematic review of exercise interventions for AIS. The main outcome was feasibility of recruitment to the randomised study. Other elements were to inform choice of outcomes for a definitive trial and included curve severity, quality of life, requirement for surgery/brace, adverse events, psychological symptoms, costs and health utilities. A UK survey of orthopaedic consultants and physiotherapists indicated a wide variation in current provision of exercise therapy through physiotherapy services. It also found

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

    Directory of Open Access Journals (Sweden)

    Savvidou Olga D

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Enguer Beraldo Garcia

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Qian Bangping

    2010-09-01

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

  5. 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.

  6. 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.

  7. 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.

    Science.gov (United States)

    Chu, Winnie Cw; Lam, Wynnie Mw; Ng, Bobby Kw; Tze-Ping, Lam; Lee, Kwong-Man; Guo, Xia; Cheng, Jack Cy; Burwell, R Geoffrey; Dangerfield, Peter H; Jaspan, Tim

    2008-06-27

    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 the spinal cord to vertebral growth interaction during adolescence in scoliosis. Using the multi-planar reconstruction technique of magnetic resonance imaging they investigated the relative length of spinal cord to vertebral column including ratios in 28 girls with AIS (mainly thoracic or double major curves) and 14 age-matched normal girls. Also evaluated were cerebellar tonsillar position, somatosensory evoked potentials (SSEPs), and clinical neurological examination. In severe AIS compared with normal controls, the vertebral column is significantly longer without detectable spinal cord lengthening. They speculate that anterior spinal column overgrowth relative to a normal length spinal cord exerts a stretching tethering force between the two ends, cranially and caudally leading to the initiation and progression of thoracic AIS. They support and develop the Roth-Porter concept of uncoupled neuro-osseous growth in the pathogenesis of AIS which now they prefer to term 'asynchronous neuro-osseous growth'. Morphological evidence about the curve apex suggests that the spinal cord is also affected, and a 'double pathology' is suggested. AIS is viewed as a disorder with a wide spectrum and a common neuroanatomical abnormality namely, a spinal cord of normal length but short relative to an abnormally lengthened anterior vertebral column. Neuroanatomical changes and/or abnormal neural function may be expressed only in severe cases. This asynchronous neuro-osseous growth concept is regarded as

  8. An SDR based AIS receiver for satellites

    DEFF Research Database (Denmark)

    Larsen, Jesper Abildgaard; Mortensen, Hans Peter; Nielsen, Jens Frederik Dalsgaard

    2011-01-01

    For a few years now, there has been a high interest in monitoring the global ship traffic from space. A few satellite, capable of listening for ship borne AIS transponders have already been launched, and soon the AAUSAT3, carrying two different types of AIS receivers will also be launched. One...... of the AIS receivers onboard AAUSAT3 is an SDR based AIS receiver. This paper serves to describe the background of the AIS system, and how the SDR based receiver has been integrated into the AAUSAT3 satellite. Amongst some of the benefits of using an SDR based receiver is, that due to its versatility, new...... detection algorithms are easily deployed, and it is easily adapted the new proposed AIS transmission channels....

  9. Spine kinematics exhibited during the stop-jump by physically active individuals with adolescent idiopathic scoliosis and spinal fusion.

    Science.gov (United States)

    Kakar, Rumit Singh; Li, Yumeng; Brown, Cathleen N; Kim, Seock-Ho; Oswald, Timothy S; Simpson, Kathy J

    2018-01-01

    Individuals with adolescent idiopathic scoliosis post spinal fusion often return to exercise and sport. However, the movements that individuals with spinal fusion for adolescent idiopathic scoliosis (SF-AIS) use to compensate for the loss of spinal flexibility during high-effort tasks are not known. The objective of this study was to compare the spinal kinematics of the trunk segments displayed during the stop-jump, a maximal effort task, between SF-AIS and healthy control groups. The study used a case-controlled design. Ten SF-AIS (physically active, posterior-approach spinal fusion: 11.2±1.9 fused segments, postop time: 2±.6 years) and nine control individuals, pair matched for gender, age (17.4±1.3 years and 20.6±1.5 years, respectively), mass (63.50±12.2 kg and 66. 40±10.9 kg), height (1.69±.09 m and 1.72±.08 m), and level of physical activity, participated in the study. Individuals with spinal fusion for adolescent idiopathic scoliosis and controls (CON) performed five acceptable trials of the stop-jump task. Spatial locations of 21 retroreflective trunk and pelvis markers were recorded via high-speed motion capture methodology. Mean differences and analysis of covariance (jump height=covariate, pjump height and RelAng were detected in the three phases of stop-jump. Individuals with spinal fusion for adolescent idiopathic scoliosis displayed 3.2° greater transverse plane RelAng of LT compared with CON (p=.059) in the stance phase. Group differences for RelAng ranged from 0° to 15.3°. For SegAng in the stance phase, LT demonstrated greater SegAng in the sagittal and frontal planes (mean difference: 3.2°-6.2°), whereas SegAng for MT was 5.1° greater in the sagittal plane and had a tendency of 2° greater displacement in the frontal plane (p=.070). In the vertical flight phase, greater LT displacement in the frontal plane was observed for SF-AIS than CON. In the flight phase, LT had a tendency for greater SegAng for SF-AIS than for CON

  10. Measurement Properties of the Scoliosis Research Society Outcomes Questionnaire in Adolescent Patients With Spondylolisthesis.

    Science.gov (United States)

    Gutman, Gabriel; Joncas, Julie; Mac-Thiong, Jean-Marc; Beauséjour, Marie; Roy-Beaudry, Marjolaine; Labelle, Hubert; Parent, Stefan

    2017-09-01

    Prospective validation of the Scoliosis Research Society Outcomes Questionnaire French-Canadian version (SRS-22fv) in adolescent patients with spondylolisthesis. To determine the measurement properties of the SRS-22fv. The SRS-22 is widely used for the assessment of health-related quality of life in adolescent idiopathic scoliosis (AIS) and other spinal deformities. Spondylolisthesis has an important effect on quality of life. The instrument was previously used in this population, although its measurement properties remained unknown. We aim to determine its reliability, factorial, concurrent validity, and its discriminant capacity in an adolescent spondylolisthesis population. The SRS-22fv was tested in 479 subjects (272 patients with spondylolisthesis, 143 with AIS, and 64 controls) at a single institution. Its reliability was measured using the coefficient of internal consistency, concurrent validity by the short form-12 (SF-12v2 French version) and discriminant validity using multivariate analysis of variance, analysis of covariance, and multivariate linear regression. The SRS-22fv showed a good global internal consistency (spondylolisthesis: Cronbach α = 0.91, AIS: 0.86, and controls: 0.78) in all its domains for spondylolisthesis patients. It showed a factorial structure consistent with the original questionnaire, with 60% of explained variance under four factors. Moderate to high correlation coefficients were found for specifically corresponding domains between SRS-22fv and SF-12v2. Boys had higher scores than do girls, scores worsened with increasing age and body mass index. Analysis of covariance showed statistically significant differences between patients with spondylolisthesis, patients with AIS, and controls when controlling for age, sex, body mass index, pain, function, and self-image scores. In the spondylolisthesis group, scores on all domains and mean total scores were significantly lower in surgical candidates and in patients with high

  11. USACE AIS Transmit Technical Support Summary Report

    Science.gov (United States)

    2014-09-01

    the TAG block for the correct transmitters, and then send to the USACE AIS network. B. Outbound openings in the USCG firewall for the USCG Message...USACE AIS Transmit Technical Support Summary Report Distribution Statement A: Approved for public release; distribution is unlimited...September 2014 Report No. CD-D-09-15 USACE AIS Transmit Technical Support Summary Report ii UNCLAS//Public | CG-926 RDC | I. Gonin et al. Public

  12. Adaptive Motion Gaming AI for Health Promotion

    OpenAIRE

    Paliyawan, Pujana; Kusano, Takahiro; Nakagawa, Yuto; Harada, Tomohiro; Thawonmas, Ruck

    2017-01-01

    This paper presents a design of a non-player character (AI) for promoting balancedness in use of body segments when engaging in full-body motion gaming. In our experiment, we settle a battle between the proposed AI and a player by using FightingICE, a fighting game platform for AI development. A middleware called UKI is used to allow the player to control the game by using body motion instead of the keyboard and mouse. During gameplay, the proposed AI analyze health states of the player; it d...

  13. Beyond AI: Artificial Dreams Conference

    CERN Document Server

    Zackova, Eva; Kelemen, Jozef; Beyond Artificial Intelligence : The Disappearing Human-Machine Divide

    2015-01-01

    This book is an edited collection of chapters based on the papers presented at the conference “Beyond AI: Artificial Dreams” held in Pilsen in November 2012. The aim of the conference was to question deep-rooted ideas of artificial intelligence and cast critical reflection on methods standing at its foundations.  Artificial Dreams epitomize our controversial quest for non-biological intelligence, and therefore the contributors of this book tried to fully exploit such a controversy in their respective chapters, which resulted in an interdisciplinary dialogue between experts from engineering, natural sciences and humanities.   While pursuing the Artificial Dreams, it has become clear that it is still more and more difficult to draw a clear divide between human and machine. And therefore this book tries to portrait such an image of what lies beyond artificial intelligence: we can see the disappearing human-machine divide, a very important phenomenon of nowadays technological society, the phenomenon which i...

  14. The horizontal plane appearances of scoliosis

    DEFF Research Database (Denmark)

    Illés, Tamás S.; Burkus, Máté; Somoskeőy, Szabolcs

    2017-01-01

    Purpose: A posterior-anterior vertebral vector is proposed to facilitate visualization and understanding of scoliosis. The aim of this study was to highlight the interest of using vertebral vectors, especially in the horizontal plane, in clinical practice. Methods: We used an EOS two-/three-dimen......Purpose: A posterior-anterior vertebral vector is proposed to facilitate visualization and understanding of scoliosis. The aim of this study was to highlight the interest of using vertebral vectors, especially in the horizontal plane, in clinical practice. Methods: We used an EOS two...... cases of a normal spine and a thoracic scoliosis are presented. Results: For a normal spine, vector projections in the transverse plane are aligned with the posterior-anterior anatomical axis. For a scoliotic spine, vector projections in the horizontal plane provide information on the lateral...... decompensation of the spine and the lateral displacement of vertebrae. In the horizontal plane view, vertebral rotation and projections of the sagittal curves can also be analyzed simultaneously. Conclusions: The use of posterior-anterior vertebral vector facilitates the understanding of the 3D nature...

  15. Companion Cognitive Systems: A Step toward Human-Level AI

    OpenAIRE

    Forbus, Kenneth D.; Hinrichs, Thomas R.

    2006-01-01

    We are developing Companion Cognitive Systems, a new kind of software that can be effectively treated as a collaborator. Aside from their potential utility, we believe this effort is important because it focuses on three key problems that must be solved to achieve human-level AI: Robust reasoning and learning, interactivity, and longevity. We describe the ideas we are using to develop the first architecture for Companions: analogical processing, grounded in cognitive science for reasoning and...

  16. Evaluation of the stress level of children with idiopathic scoliosis in relation to the method of treatment and parameters of the deformity.

    Science.gov (United States)

    Leszczewska, Justyna; Czaprowski, Dariusz; Pawłowska, Paulina; Kolwicz, Aleksandra; Kotwicki, Tomasz

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Justyna Leszczewska

    2012-01-01

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

  18. 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.

  19. Cerebral glucose metabolic abnormality in patients with congenital scoliosis

    International Nuclear Information System (INIS)

    Nam, H. Y.; Seo, G. T.; Lee, J. S.; Kim, S. C.; Kim, I. J.; Kim, Y. K.; Jeon, S. M.

    2007-01-01

    A possible association between congenital scoliosis and low mental status has been recognized, but there are no reports describing the mental status or cerebral metabolism in patients with congenital scoliosis in detail. We investigated the mental status using a mini-mental status exam as well as the cerebral glucose metabolism using F-18 fluorodeoxyglucose brain positron emission tomography in 12 patients with congenital scoliosis and compared them with those of 14 age-matched patients with adolescent idiopathic scoliosis. The mean mini-mental status exam score in the congenital scoliosis group was significantly lower than that in the adolescent idiopathic scoliosis group. Group analysis found that various brain areas of patients with congenital scoliosis showed glucose hypometabolisms in the left prefrontal cortex (Brodmann area 10), right orbitofrontal cortex (Brodmann area 11), left dorsolateral prefrontal cortex (Brodmann area 9), left anterior cingulate gyrus (Brodmann area 24) and pulvinar of the left thalamus. From this study, we could find the metabolic abnormalities of brain in patients with congenital scoliosis and suggest the possible role of voxel-based analysis of brain fluorodeoxyglucose positron emission tomography

  20. 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.

  1. Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis.

    Science.gov (United States)

    Chang, Yi-Tzu; Meng, Ling-Fu; Chang, Chun-Ju; Lai, Po-Liang; Lung, Chi-Wen; Chern, Jen-Suh

    2017-01-01

    Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12-18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central

  2. Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Yi-Tzu Chang

    2017-06-01

    Full Text Available Subjective visual vertical (SVV judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS. Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs, the present study examined the effect of postural control demands (PDs on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group and 13 age-matched adolescents (control group aged 12–18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion, SVV (accuracy and reaction time, and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1 during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2 the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Carrasco, Maria Isabel Bonilla; Ruiz, Maria Carmen Solano

    2014-08-01

    To learn about the experiences of adolescents diagnosed with idiopathic scoliosis. Integrative review of the literature published within a specified time frame. 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. Spinal deformity exerts a psychological effect on adolescent girls.

  5. [Conservative treatment of idiopathic scoliosis with physical therapy and orthoses].

    Science.gov (United States)

    Weiss, H-R

    2003-02-01

    Opinions differ in the international literature about the efficacy of conservative approaches to scoliosis treatment. Because this divergence of opinion corresponds to a great discrepancy in the standards applied to conservative treatment methods, it is not astonishing that the results of conservative treatment as described in the literature also differ. Scoliosis normally does not have such dramatic effects that immediate surgery would be indicated.Moreover, it is clear from the published literature that it is the functional and physiological impairments of scoliosis patients--including pain, torso deformity, psychological disturbance, and pulmonary dysfunction--which require therapeutic intervention. In Germany the triad of outpatient physiotherapy, intensive inpatient rehabilitation, and bracing has proven effective in conservative scoliosis treatment.Indication, content, and results of the individual treatment procedures are described and discussed. The positive outcomes of this practice validate a policy of offering conservative scoliosis treatment as an alternative to patients, including those for whom surgery is indicated.

  6. Rod rotation and differential rod contouring followed by direct vertebral rotation for treatment of adolescent idiopathic scoliosis: effect on thoracic and thoracolumbar or lumbar curves assessed with intraoperative computed tomography.

    Science.gov (United States)

    Seki, Shoji; Kawaguchi, Yoshiharu; Nakano, Masato; Makino, Hiroto; Mine, Hayato; Kimura, Tomoatsu

    2016-03-01

    Although direct vertebral rotation (DVR) is now used worldwide for the surgical treatment of adolescent idiopathic scoliosis (AIS), the benefit of DVR in reducing vertebral body rotation in these patients has not been determined. We investigated a possible additive effect of DVR on further reduction of vertebral body rotation in the axial plane following intraoperative rod rotation or differential rod contouring in patients undergoing surgical treatment for AIS. The study was a prospective computed tomography (CT) image analysis. We analyzed the results of the two intraoperative procedures in 30 consecutive patients undergoing surgery for AIS (Lenke type I or II: 15; Lenke type V: 15). The angle of reduction of vertebral body rotation taken by intraoperative CT scan was measured and analyzed. Pre- and postoperative responses to the Scoliosis Research Society 22 Questionnaire (SRS-22) were also analyzed. To analyze the reduction of vertebral body rotation with rod rotation or DVR, intraoperative cone-beam CT scans of the three apical vertebrae of the major curve of the scoliosis (90 vertebrae) were taken pre-rod rotation (baseline), post-rod rotation with differential rod contouring, and post-DVR in all patients. The angle of vertebral body rotation in these apical vertebrae was measured and analyzed for statistical significance. Additionally, differences between thoracic curve scoliosis (Lenke type I or II; 45 vertebrae) and thoracolumbar or lumbar curve scoliosis (Lenke type V; 45 vertebrae) were analyzed. Pre- and postoperative SRS-22 scores were evaluated in all patients. The mean (90 vertebrae) vertebral body rotation angles at baseline, post-rod rotation or differential rod contouring, and post-rod rotation or differential rod contouring or post-DVR were 17.3°, 11.1°, and 6.9°, respectively. The mean reduction in vertebral body rotation with the rod rotation technique was 6.8° for thoracic curves and 5.7° for thoracolumbar or lumbar curves (pself

  7. Serial elongation derotation flexion (EDF) casting for patients with infantile and juvenile scoliosis.

    Science.gov (United States)

    Canavese, Federico; Rousset, Marie; Mansour, Mounira; Samba, Antoine; Dimeglio, Alain

    2016-02-01

    Infantile and juvenile scoliosis, among different types of spinal deformity, is still a challenge for pediatric orthopedic surgeons. The ideal treatment of infantile and juvenile scoliosis has not yet been identified as both clinicians and surgeons still face multiple challenges, including preservation of the thoracic spine, thoracic cage, lung growth and cardiac function without reducing spinal motion. Elongation, derotation, flexion (EDF) casting technique is a custom-made thoracolumbar cast based on a three dimensional correction concept. This cast offers three-dimensional correction and can control the evolution of the deformity in some cases. Spinal growth can be guided by EDF casting as it can influence the initially curved spine to grow straighter. This article aimed to provide a comprehensive review of how infantile and juvenile scoliosis can affect normal spine and thorax and how these deformities can be treated with serial EDF casting technique. A current literature review is mandatory in order to understand the principles of the serial EDF casting technique and the effectiveness of conservative treatment in young and very young patients.

  8. Wound healing without drains in posterior spinal fusion in idiopathic scoliosis

    International Nuclear Information System (INIS)

    Alsiddiky, A.; Nisar, K.A.; Alhuzaimi, F.; Albishi, W.; Alnuaim, B.; Albarrag, M.; Meo, S.A.

    2013-01-01

    To determine the frequency of wound infection and neurological injuries in patients with idiopathic scoliosis who underwent posterior spinal fusion without use of drains. Study Design: Case series. Place and Duration of Study: Department of Orthopaedics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2007 to June 2010. Methodology: Patients who underwent similar technique of posterior spinal fusion instrumentation for the correction of scoliosis without use of drain were included. Wound Demographics, wound healing, complications and duration of hospital stay were considered and described as frequency and mean values. Results: The average age at the time of surgery was 12.80 +- 1.30 years, duration of surgery was 3.80 +- 0.86 hours, hospital stay was 3.84 +- 0.78 days and patients were followed-up over the last 30 months. There was no incidence of any neurological complication and deep infection. However, only 2 (4.16%) cases with superficial skin infection were treated with dressing and antibiotics with full recovery. Conclusion: The wound healing is adequate without using drain for patients with idiopathic scoliosis who underwent posterior spinal fusion and instrumentation when good wash, watertight closure technique and appropriate antibiotics coverage is provided. (author)

  9. Utility of an allograft tendon for scoliosis correction via the costo-transverse foreman.

    Science.gov (United States)

    Sun, Dong; McCarthy, Michael; Dooley, Adam C; Ramakrishnaiah, Raghu H; Shelton, R Shane; McLaren, Sandra G; Skinner, Robert A; Suva, Larry J; McCarthy, Richard E

    2017-01-01

    Current convex tethering techniques for treatment of scoliosis have centered on anterior convex staples or polypropylene tethers. We hypothesized that an allograft tendon tether inserted via the costo-transverse foramen would correct an established spinal deformity. In the pilot study, six 8-week-old pigs underwent allograft tendon tethering via the costo-transverse foreman or sham to test the strength of the transplanted tendon to retard spine growth. After 4 months, spinal deformity in three planes was induced in all animals with allograft tendons. In the treatment study, the allograft tendon tether was used to treat established scoliosis in 11 8-week-old pigs (spinal deformity > 50°). Once the deformity was observed (4 months) animals were assigned to either no treatment group or allograft tendon tether group and progression assessed by monthly radiographs. At final follow-up, coronal Cobb angle and maximum vertebral axial rotation of the treatment group was significantly smaller than the non-treatment group, whereas sagittal kyphosis of the treatment group was significantly larger than the non-treatment group. In sum, a significant correction was achieved using a unilateral allograft tendon spinal tether, suggesting that an allograft tendon tethering approach may represent a novel fusion-less procedure to correct idiopathic scoliosis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:183-192, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Scoliosis Surgery in Cystic Fibrosis: Surgical Considerations and the Multidisciplinary Approach of a Rare Case

    Directory of Open Access Journals (Sweden)

    George I. Mataliotakis

    2016-01-01

    Full Text Available Spinal deformity in patients with cystic fibrosis (CF is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17. She underwent a posterior spinal fusion T2-L3 with the use of unilateral segmental instrumentation. Preoperative workup included respiratory, cardiac, anaesthetic, endocrine, and dietician reviews, as well as bone density optimisation with zoledronic acid and prophylactic antibiotics. Surgical time was 150 minutes and intraoperative blood loss was 47% of total blood volume. Postoperative intensive care included noninvasive ventilation, antibiotic cover, pain management, chest physiotherapy, pancreatic enzyme supplementation, and nutritional support. She was discharged on day 9. At follow-up she had a good cosmetic outcome, no complaints of her back, and stable respiratory function. Multidisciplinary perioperative care and meticulous surgical technique may reduce the associated risks of major surgery in CF patients, while achieving adequate deformity correction and a good functional outcome.

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

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    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)

  12. Treatment of postoperative infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis.

    Science.gov (United States)

    Ghattas, Paul J; Mehlman, Charles T; Eichten, David

    2014-02-01

    According to the literature, patients with neuromuscular scoliosis have a higher rate of infection after spinal fusion. No randomized controlled trials have been completed to assess the optimal treatment and related outcomes for patients with infections after posterior spinal fusion. In this article, we examine the data and report a case in which a vacuum-assisted closure (VAC) device was used as definitive treatment for a deep wound infection after posterior spinal fusion and instrumentation in a patient with neuromuscular scoliosis. Our patient, a 17-year-old adolescent girl with progressive neuromuscular scoliosis, underwent posterior spinal fusion with instrumentation and bone graft from T2 to sacrum without complication. One month after surgery, she presented with a draining wound. She underwent repeat surgical irrigation and debridement with subsequent use of a wound VAC. The wound VAC was used for more than 2 months, until skin closure was complete. The deep polymicrobial wound infection was treated successfully and definitively with a wound VAC. This case report suggests that good long-term outcomes can be achieved with use of a wound VAC for definitive closure, with possible avoidance of other secondary surgeries requiring skin grafts or flaps for wound closure.

  13. Development and assessment of a digital X-ray software tool to determine vertebral rotation in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Eijgenraam, Susanne M; Boselie, Toon F M; Sieben, Judith M; Bastiaenen, Caroline H G; Willems, Paul C; Arts, Jacobus J; Lataster, Arno

    2017-02-01

    The amount of vertebral rotation in the axial plane is of key importance in the prognosis and treatment of adolescent idiopathic scoliosis (AIS). Current methods to determine vertebral rotation are either designed for use in analogue plain radiographs and not useful in digital images, or lack measurement precision and are therefore less suitable for the follow-up of rotation in AIS patients. This study aimed to develop a digital X-ray software tool with high measurement precision to determine vertebral rotation in AIS, and to assess its (concurrent) validity and reliability. In this study a combination of basic science and reliability methodology applied in both laboratory and clinical settings was used. Software was developed using the algorithm of the Perdriolle torsion meter for analogue AP plain radiographs of the spine. Software was then assessed for (1) concurrent validity and (2) intra- and interobserver reliability. Plain radiographs of both human cadaver vertebrae and outpatient AIS patients were used. Concurrent validity was measured by two independent observers, both experienced in the assessment of plain radiographs. Reliability-measurements were performed by three independent spine surgeons. Pearson correlation of the software compared with the analogue Perdriolle torsion meter for mid-thoracic vertebrae was 0.98, for low-thoracic vertebrae 0.97 and for lumbar vertebrae 0.97. Measurement exactness of the software was within 5° in 62% of cases and within 10° in 97% of cases. Intraclass correlation coefficient (ICC) for inter-observer reliability was 0.92 (0.91-0.95), ICC for intra-observer reliability was 0.96 (0.94-0.97). We developed a digital X-ray software tool to determine vertebral rotation in AIS with a substantial concurrent validity and reliability, which may be useful for the follow-up of vertebral rotation in AIS patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. JGOMAS: New Approach to AI Teaching

    Science.gov (United States)

    Barella, A.; Valero, S.; Carrascosa, C.

    2009-01-01

    This paper presents a new environment for teaching practical work in AI subjects. The main purpose of this environment is to make AI techniques more appealing to students and to facilitate the use of the toolkits which are currently widely used in research and development. This new environment has a toolkit for developing and executing agents,…

  15. Adaptive game AI with dynamic scripting

    NARCIS (Netherlands)

    Spronck, P.; Ponsen, M.J.V.; Sprinkhuizen-Kuyper, I.G.; Postma, E.O.

    2006-01-01

    Online learning in commercial computer games allows computer-controlled opponents to adapt to the way the game is being played. As such it provides a mechanism to deal with weaknesses in the game AI, and to respond to changes in human player tactics.We argue that online learning of game AI should

  16. The Relevance of AI Research to CAI.

    Science.gov (United States)

    Kearsley, Greg P.

    This article provides a tutorial introduction to Artificial Intelligence (AI) research for those involved in Computer Assisted Instruction (CAI). The general theme is that much of the current work in AI, particularly in the areas of natural language understanding systems, rule induction, programming languages, and socratic systems, has important…

  17. 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.

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

    Science.gov (United States)

    Romano, Michele; Negrini, Stefano

    2008-01-22

    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. 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. 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. 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.

  19. A correlational study of scoliosis and trunk balance in adult patients with mandibular deviation.

    Directory of Open Access Journals (Sweden)

    Shuncheng Zhou

    Full Text Available Previous studies have confirmed that patients with mandibular deviation often have abnormal morphology of their cervical vertebrae. However, the relationship between mandibular deviation, scoliosis, and trunk balance has not been studied. Currently, mandibular deviation is usually treated as a single pathology, which leads to poor clinical efficiency. We investigated the relationship of spine coronal morphology and trunk balance in adult patients with mandibular deviation, and compared the finding to those in healthy volunteers. 35 adult patients with skeletal mandibular deviation and 10 healthy volunteers underwent anterior X-ray films of the head and posteroanterior X-ray films of the spine. Landmarks and lines were drawn and measured on these films. The axis distance method was used to measure the degree of scoliosis and the balance angle method was used to measure trunk balance. The relationship of mandibular deviation, spine coronal morphology and trunk balance was evaluated with the Pearson correlation method. The spine coronal morphology of patients with mandibular deviation demonstrated an "S" type curve, while a straight line parallel with the gravity line was found in the control group (significant difference, p1°, while the control group had a normal trunk balance (imbalance angle <1°. There was a significant difference between the two groups (p<0.01. The degree of scoliosis and shoulder imbalance correlated with the degree of mandibular deviation, and presented a linear trend. The direction of mandibular deviation was the same as that of the lateral bending of thoracolumbar vertebrae, which was opposite to the direction of lateral bending of cervical vertebrae. Our study shows the degree of mandibular deviation has a high correlation with the degree of scoliosis and trunk imbalance, all the three deformities should be clinically evaluated in the management of mandibular deviation.

  20. [Scoliosis in the children: the new approaches to the treatment and rehabilitation].

    Science.gov (United States)

    Zaytseva, T N; Kulikov, A G; Yarustovskaya, O V

    Scoliosis is the most widespread orthopaedic condition affecting both the children and the adolescents. The electrostatic field is known to promote the development of vibrations of varying strength in the biological tissues and their penetration rather deep into their interior. The objective of the present study was to elucidate the possibilities and practicability of the application of a low-frequency electrostatic field for the conservative treatment of grade I and II scoliosis in the children and to develop the scientifically sound substantiation for the use of this technique in the clinical practice. We examined and treated 94 children randomly divided into two groups (main and control) matched for the age and major clinical manifestation of the disease. All the patients received basic therapy. Those in the study group were additionally given low-frequency electrostatic therapy. The comparative analysis of the results of the treatment gave evidence that the application of a low-frequency electrostatic field for the conservative treatment of grade I and II scoliosis in the children resulted in the well apparent positive changes in their health status. These changes manifested themselves in the favourable dynamics of both the clinical symptoms of the disease and as the improvement of the topographic and thermographic characteristics. Of special importance is the alleviation of the symptoms of scoliotic deformation of the vertebral column under effect of the low-frequency electrostatic field. The present study has demonstrated that the application of the low-frequency electrostatic field significantly increases the effectiveness of the treatment of grade I and II scoliosis in the children and adolescents and promotes regression of this pathological condition.

  1. Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis.

    Science.gov (United States)

    Negrini, Stefano; Zaina, Fabio; Romano, Michele; Negrini, Alessandra; Parzini, Silvana

    2008-06-01

    To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis. Prospective controlled cohort observational study. Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously. Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation. There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened. These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.

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

    Directory of Open Access Journals (Sweden)

    Kotwicki Tomasz

    2011-01-01

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

  3. Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?

    Science.gov (United States)

    Di Silvestre, Mario; Lolli, Francesco; Greggi, Tiziana; Vommaro, Francesco; Baioni, Andrea

    2013-01-01

    Study Design. A retrospective study. Purpose. Posterolateral fusion with pedicle screw instrumentation used for degenerative lumbar scoliosis can lead to several complications. In elderly patients without sagittal imbalance, dynamic stabilization could represent an option to avoid these adverse events. Methods. 57 patients treated by dynamic stabilization without fusion were included. All patients had degenerative lumbar de novo scoliosis (average Cobb angle 17.2°), without sagittal imbalance, associated in 52 cases (91%) with vertebral canal stenosis and in 24 (42%) with degenerative spondylolisthesis. Nineteen patients (33%) had previously undergone lumbar spinal surgery. Results. At an average followup of 77 months, clinical results improved with statistical significance. Scoliosis Cobb angle was 17.2° (range, 12° to 38°) before surgery and 11.3° (range, 4° to 26°) at last follow-up. In the patients with associated spondylolisthesis, anterior vertebral translation was 19.5% (range, 12% to 27%) before surgery, 16.7% (range, 0% to 25%) after surgery, and 17.5% (range, 0% to 27%) at followup. Complications incidence was low (14%), and few patients required revision surgery (4%). Conclusions. In elderly patients with mild degenerative lumbar scoliosis without sagittal imbalance, pedicle screw-based dynamic stabilization is an effective option, with low complications incidence, granting curve stabilization during time and satisfying clinical results. PMID:23781342

  4. Nonlinear study of AI Velorum

    International Nuclear Information System (INIS)

    Cox, A.N.; Hodson, S.W.

    1979-01-01

    Using results from earlier studies of double-mode dwarf Cepheids by Cox, King, and Hodson, hydrodynamic calculations were undertaken for AI Vel. The earlier derived evolution theory mass of 1.8 M sub solar, a luminosity of of 23 L sub solar and a T/sub e/ of 7500 0 K give the observed period of 0.11 day and the observed period ratio PI 1 /PI 0 = 0.773. A cooler T/sub e/ than the observed one (7620 0 K) was used because 7620 0 K is beyond the fundamental pulsation mode blue edge. The composition used is X = 0.70 Z = 0.01. This lower than normal Z is necessary to make the period ratio as large as observed. The goal is to see if double-mode behavior, due to either mode switching or a permanent state, can be predicted for the model. Progress in converging the model to a periodic pulsation solution by the von Sengbusch--Stellingwerf relaxation method will be reported. 17 references

  5. Return to sports after surgery to correct adolescent idiopathic scoliosis: a survey of the Spinal Deformity Study Group.

    Science.gov (United States)

    Lehman, Ronald A; Kang, Daniel G; Lenke, Lawrence G; Sucato, Daniel J; Bevevino, Adam J

    2015-05-01

    There are no guidelines for when surgeons should allow patients to return to sports and athletic activities after spinal fusion for adolescent idiopathic scoliosis (AIS). Current recommendations are based on anecdotal reports and a survey performed more than a decade ago in the era of first/second-generation posterior implants. To identify current recommendations for return to sports and athletic activities after surgery for AIS. Questionnaire-based survey. Adolescent idiopathic scoliosis after corrective surgery. Type and time to return to sports. A survey was administered to members of the Spinal Deformity Study Group. The survey consisted of surgeon demographic information, six clinical case scenarios, three different construct types (hooks, pedicle screws, hybrid), and questions regarding the influence of lowest instrumented vertebra (LIV) and postoperative physical therapy. Twenty-three surgeons completed the survey, and respondents were all experienced expert deformity surgeons. Pedicle screw instrumentation allows earlier return to noncontact and contact sports, with most patients allowed to return to running by 3 months, both noncontact and contact sports by 6 months, and collision sports by 12 months postoperatively. For all construct types, approximately 20% never allow return to collision sports, whereas all surgeons allow eventual return to contact and noncontact sports regardless of construct type. In addition to construct type, we found progressively distal LIV resulted in more surgeons never allowing return to collision sports, with 12% for selective thoracic fusion to T12/L1 versus 33% for posterior spinal fusion to L4. Most respondents also did not recommend formal postoperative physical therapy (78%). Of all surgeons surveyed, there was only one reported instrumentation failure/pullout without neurologic deficit after a patient went snowboarding 2 weeks postoperatively. Modern posterior instrumentation allows surgeons to recommend earlier return

  6. Relation between self-image score of SRS-22 with deformity measures in female adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Wang, L; Wang, Y P; Yu, B; Zhang, J G; Shen, J X; Qiu, G X; Li, Y

    2014-11-01

    Adolescent idiopathic scoliosis (AIS) is a pathology which affects the individual's functioning in the widely understood physical, psychic, and social aspects. More attention should be paid to patients' perception of self-image when evaluating the spine deformity. The present retrospective study evaluated the associations between the deformity measures and self-image score as determined by the SRS-22 questionnaire in Chinese female AIS patients. The self-image score correlates significantly with deformity measures. The location of main curve apex and the number of curve could affect the self-image score. We retrospectively reviewed the records of 202 female patients, collected data on patient's age, body mass index, radiographic and physical measures and self-image score of SRS-22 questionnaire. According to the location of main curve apex and the number of curve, the patients were divided to different subgroups. Correlations between deformity measures and self-image score of different groups were evaluated by the Spearman correlation test. The self-image score correlated negatively with the main Cobb angle, apical vertebral translation (AVT), and razor hump height. There is no significant difference of self-image score between thoracic curve (TC) and thoracolumbar curve (TL/LC) subgroups. And the self-image scores of one-curve, two-curve and three-curve subgroups are similar. For Chinese female AIS patients in our study, self-image was found to correlate negatively with the main Cobb angle, AVT and razor hump height. And the location of scoliosis apex and the number of curve are not influencing factors of self-image perception. Level IV, retrospective study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Flexibility analysis in adolescent idiopathic scoliosis on side-bending images using the EOS imaging system.

    Science.gov (United States)

    Hirsch, C; Ilharreborde, B; Mazda, K

    2016-06-01

    Analysis of preoperative flexibility in adolescent idiopathic scoliosis (AIS) is essential to classify the curves, determine their structurality, and select the fusion levels during preoperative planning. Side-bending x-rays are the gold standard for the analysis of preoperative flexibility. The objective of this study was to examine the feasibility and performance of side-bending images taken in the standing position using the EOS imaging system. All patients who underwent preoperative assessment between April 2012 and January 2013 for AIS were prospectively included in the study. The work-up included standing AP and lateral EOS x-rays of the spine, standard side-bending x-rays in the supine position, and standing bending x-rays in the EOS booth. The irradiation dose was measured for each of the tests. Two-dimensional reducibility of the Cobb angle was measured on both types of bending x-rays. The results were based on the 50 patients in the study. No significant difference was demonstrated for reducibility of the Cobb angle between the standing side-bending images with the EOS imaging system and those in the supine position for all types of Lenke deformation. The irradiation dose was five times lower during the EOS bending imaging. The standing side-bending images in the EOS device contributed the same results as the supine images, with five times less irradiation. They should therefore be used in clinical routine. 2. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Artificial intelligence. Fears of an AI pioneer.

    Science.gov (United States)

    Russell, Stuart; Bohannon, John

    2015-07-17

    From the enraged robots in the 1920 play R.U.R. to the homicidal computer H.A.L. in 2001: A Space Odyssey, science fiction writers have embraced the dark side of artificial intelligence (AI) ever since the concept entered our collective imagination. Sluggish progress in AI research, especially during the “AI winter” of the 1970s and 1980s, made such worries seem far-fetched. But recent breakthroughs in machine learning and vast improvements in computational power have brought a flood of research funding— and fresh concerns about where AI may lead us. One researcher now speaking up is Stuart Russell, a computer scientist at the University of California, Berkeley, who with Peter Norvig, director of research at Google, wrote the premier AI textbook, Artificial Intelligence: A Modern Approach, now in its third edition. Last year, Russell joined the Centre for the Study of Existential Risk at Cambridge University in the United Kingdom as an AI expert focusing on “risks that could lead to human extinction.” Among his chief concerns, which he aired at an April meeting in Geneva, Switzerland, run by the United Nations, is the danger of putting military drones and weaponry under the full control of AI systems. This interview has been edited for clarity and brevity.

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

    Directory of Open Access Journals (Sweden)

    Mercier Pierre

    2009-08-01

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

  10. Relevant areas of functioning in patients with adolescent idiopathic scoliosis on the International Classification of Functioning, Disability and Health: The patients' perspective.

    Science.gov (United States)

    Du, Chunping; Yu, Jiadan; Zhang, Jiaqi; Jiang, Jiaojiao; Lai, Huabin; Liu, Wei; Liu, Yang; Li, Hao; Wang, Pu

    2016-10-12

    To investigate relevant aspects of functioning and disability, and environmental factors in people with adolescent idiopathic scoliosis according to patients' self-reports based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Multicentre, empirical, cross-sectional study. Four departments of orthopaedics in 4 hospitals, and 5 departments of rehabilitation medicine in 5 hospitals. Semi-structured interviews were conducted with 975 patients with adolescent idiopathic scoliosis from 5 hospitals according to the patients' self-reporting. In addition, patients were divided into 3 groups according to clinical outcome. Participant information included demographic and disease-related characteristics. Three adolescent idiopathic scoliosis groups were then compared with respect to the problems identified. Interviews were transcribed verbatim. Categories identified by qualitative analysis were subsequently mapped to the ICF-CY using established linking rules. In order to enrich these findings, we also translated the Scoliosis Research Society 22 Patient Questionnaire (SRS-22 PQ) into the language of the ICF-CY, based on ICF linking rules. A total of 1278 themes that linked to 54 ICF-CY cate-gories from 18 chapters were identified. Twenty-two (41%) categories were identified as Body Functions, 7 (13%) as Body Structures, 15 (27%) as Activities and Participation, and 10 (19%) as Environmental Factors. Of the 54 categories, 45 (83%) were second-level, 5 (9%) were third-level, and 4 (7%) were fourth-level. Differences between the SRS-22 PQ results and our findings were observed for several ICF-CY categories. Patients with AIS reported activity limitations and participation restrictions combined with impaired body structures and functions. Environmental factors may act as a barrier to, or facilitator of, patient functioning in daily life. The ICF-CY provides a valuable framework for representing the complexity and

  11. "All-In-One Test" (AI1)

    DEFF Research Database (Denmark)

    Giacalone, Davide; Bredie, Wender Laurentius Petrus; Frøst, Michael Bom

    2013-01-01

    by the Check-All-That-Apply (CATA) technique is reported. In this exploratory "All-In-One Test"(AI1), subjects (N = 160) filled out a questionnaire with demographic and psychographic variables, and appropriateness ratings for specific sensory descriptors of beer. Subsequently, subjects gave hedonic ratings...... between appropriateness and actual hedonic response. Overall, the AI1 test provided interpretable results concerning consumer perception (sensory/hedonic) of the beers, and revealed relations with consumers' background information. Initial results with AI1 test show that it is an efficient and versatile...

  12. Health Information in French (français)

    Science.gov (United States)

    ... Biopsy - français (French) Bilingual PDF Health Information Translations Breast Biopsy - français (French) Bilingual PDF Health Information Translations Colposcopy - français (French) Bilingual PDF ...

  13. 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

    . Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome.Conclusion: In the correct indications, fourth-generation posterior instrumentation and fusion is a reliable and satisfactory technique to treat adolescent idiopathic scoliosis.Keywords: scoliosis, adolescent, idiopathic, spine, instrumentation, Pakistan

  14. THE RESULTS OF KINESIOTAPING IN PATIENTS WITH SCOLIOSIS

    Directory of Open Access Journals (Sweden)

    Dmitry Anatolevich Kiselev

    2016-10-01

    Full Text Available The kinesiotaping method has put into practice on the Rehabilitation and Sport medicine chair of the RNIMU named by N.I. Pirogov which is situated in the Medical Rehabilitation Department of RDKB. This method showed high theatment efficacy and results were stable and continuous. Kinesiotaping isn’t the main treatment method of scoliosis, but its good efficacy in reaching particular rehabilitation goals, potentiation of some methods of treatment of scoliosis, pain elimination and so on, support the idea to invent this method in the rehabilitation process circle in case of such difficult disease as scoliosis.

  15. Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rate

    Directory of Open Access Journals (Sweden)

    Mueller Franz J

    2012-06-01

    Full Text Available Abstract Background For many years, the CD instrumentation has been regarded as the standard device for the surgical correction of adolescent idiopathic scoliosis (AIS. Nevertheless, scientific long-term results on this procedure are rare. Therefore, we conducted a retrospective follow-up study of patients treated for AIS with CD instrumentation and spondylodesis. Methods A total of 40 patients with AIS underwent CD instrumentation in our department within 3 years and between 1990 and 1992. For the retrospective analysis, first all the patient documents were reviewed, and pre-/postoperative X-ray images as well as those at the latest follow-up were analysed. Furthermore, it was attempted to conduct a clinical survey using the SRS-24 questionnaire, which was sent to the patients after a preceding announcement on the phone. Results Radiologically, the frontal main curvature was improved from a preoperative angle of 69.2° to a postoperative angle of 35.4°, and the secondary curvature was improved from a preoperative angle of 42.6° to a postoperative angle of 20.5°. The latest radiological follow-up at average 57.4 months post surgery showed an average loss of correction of 9.6° (main curvature and 4.6° (secondary curvature, respectively. Within the first 30 days post surgery, 3 out of 40 patients (7.5% received early operative revision for the dislocation of hooks or rods. At an average of 45.7 months (range 11 to 142 months, 19 out of 40 patients (47.5%; including 2 patients with early revision received late operative revisions: The reasons were late infection (10 out of 40 patients; 25% with the development of fistulae (7 cases or putrid secretion (3 cases, which was resolved with the complete removal of instrumentation after all. The average time until revision was 35.5 months (range 14 to 56 months after CD instrumentation. Furthermore, complete implant removal was necessary in 8 out of 40 patients (20% for late operate site

  16. AIS Ship Traffic: Hawaii: 2011-2012

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Ship position data from a satellite-based Automatic Identification System (AIS) were obtained jointly by PacIOOS (J. Potemra), SOEST/ORE of the University of Hawaii...

  17. Cracks appear in the AI gravy train

    Energy Technology Data Exchange (ETDEWEB)

    Mill, J.

    1983-10-01

    This article highlights some of the problems facing the Alvey committee and outlines some reasons for believing that the optimistically founded Alvey and Esprit funding programmes are no guarantee Britain will win the AI race.

  18. National AIS at 1 Minute Intervals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — OCM plans to contract for AIS data per the following description. The United States Automatic Identification System Database contains vessel traffic data for...

  19. AI applications in sheet metal forming

    CERN Document Server

    Hussein, Hussein

    2017-01-01

    This book comprises chapters on research work done around the globe in the area of artificial intelligence (AI) applications in sheet metal forming. The first chapter offers an introduction to various AI techniques and sheet metal forming, while subsequent chapters describe traditional procedures/methods used in various sheet metal forming processes, and focus on the automation of those processes by means of AI techniques, such as KBS, ANN, GA, CBR, etc. Feature recognition and the manufacturability assessment of sheet metal parts, process planning, strip-layout design, selecting the type and size of die components, die modeling, and predicting die life are some of the most important aspects of sheet metal work. Traditionally, these activities are highly experience-based, tedious and time consuming. In response, researchers in several countries have applied various AI techniques to automate these activities, which are covered in this book. This book will be useful for engineers working in sheet metal industri...

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

    Science.gov (United States)

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

    2015-08-01

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

  1. Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.

    Science.gov (United States)

    Upasani, Vidyadhar V; Caltoum, Christine; Petcharaporn, Maty; Bastrom, Tracey P; Pawelek, Jeff B; Betz, Randal R; Clements, David H; Lenke, Lawrence G; Lowe, Thomas G; Newton, Peter O

    2008-05-01

    A multicenter study of changes in Scoliosis Research Society (SRS) outcome measures after surgical treatment of adolescent idiopathic scoliosis (AIS). To evaluate changes in patient determined outcome measures between 2 and 5 years after AIS surgery. Current surgical procedures have been shown to improve subjective measures in patients with AIS. At 2-year follow-up, AIS patients reported significant improvement in all 4 preoperative domains of the SRS questionnaire. In addition, the major Cobb angle was shown to be negatively correlated with preoperative scores in the pain, general self-image, and general function domains. Five-year SRS scores have not been evaluated previously. A multicenter, prospectively generated database was used to obtain perioperative, radiographic, and SRS-24 outcomes data. The inclusion criteria were: a diagnosis of AIS, surgical treatment (anterior, posterior, or combined), a comprehensive set of radiographic measures, and completed preoperative, 2-year, and 5-year SRS questionnaires. Repeated measures analysis of variance was used to compare changes in patient responses for each of the 7 outcome domains. Univariate analysis of variance was used to compare the change in pain score at 5 years to the level of the lowest instrumented vertebrae and surgical approach. A correlation analysis was used to determine the association between changes in any of the radiographic variables and changes in SRS scores. The data were checked for normality and equal variances, and the level of significance was set at P < 0.01. Forty-nine patients (42 women, 7 men; 14.2 +/- 2.1 year old; 5.4 +/- 0.6 years follow-up) met the inclusion criteria for this study. Thirty-seven of 49 (76%) of these patients underwent an open or thoracoscopic anterior procedure. SRS-24 scores improved significantly in 3 of the 4 preoperative domains at the 2-year visit. At 5 years postop, a statistically significant decrease in the pain score (4.2 +/- 0.6 to 3.9 +/- 0.9, P = 0

  2. The Effect of Manual Therapy on the Adolescent Idiopathic Scoliosis in a 28 Years Old Woman

    OpenAIRE

    Marzieh Mohamadi; Farahnaz Ghaffari-Nejhad

    2013-01-01

    Idiopathic scoliosis (IS) is the most common type of scoliosis. Clinical signs and symptoms of scoliosis impair quality of life and daily function. Manual therapy is commonly used for treatment of scoliosis. This is a case report of scoliosis treatment with manual therapy in a 28 years old patient. A 28 years old woman complained of low back pain for 4 years. Spine x-ray, showed scoliosis with a 32 degrees Cobb angle. The patient received a manual therapy procedure of two visits per week for ...

  3. [Early onset scoliosis. What are the options?].

    Science.gov (United States)

    Farrington, D M; Tatay-Díaz, A

    2013-01-01

    The prognosis of children with progressive early onset scoliosis has improved considerably due to recent advances in surgical and non-surgical techniques and the understanding of the importance of preserving the thoracic space. Improvements in existing techniques and development of new methods have considerably improved the management of this condition. Derotational casting can be considered in children with documented progression of a <60° curve without previous surgical treatment. Both single and dual growing rods are effective, but the latter seem to offer better results. Hybrid constructs may be a better option in children who require a low-profile proximal anchor. The vertical expandable prosthetic titanium rib (VEPTR(®)) appears to be beneficial for patients with congenital scoliosis and fused ribs, and thoracic Insufficiency Syndrome. Children with medical comorbidities who may not tolerate repeated lengthenings should be considered for Shilla or Luque Trolley technique. Growth modulation using shape memory alloy staples or other tethers seem promising for mild curves, although more research is required to define their precise indications. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Role of thoracoscopy for the sagittal correction of hypokyphotic adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Ferrero, E; Pesenti, S; Blondel, B; Jouve, J L; Mazda, K; Ilharreborde, B

    2014-12-01

    Thoracic adolescent idiopathic scoliosis (AIS) curves (Lenke 1-4) are often characterized by hypokyphosis. Sagittal alignment remains challenging to correct, even with recent posterior segmental instrumentation. Some authors recommend anterior endoscopic release (AER) to reduce anterior column height, and facilitate thoracic kyphosis correction. The aim of this study was to assess the contribution of AER to sagittal correction in hypokyphotic AIS. Fifty-six hypokyphotic (T4T12<20°) AIS patients were included. In group 1 (28 patients), patients first underwent AER, followed by posterior instrumentation and correction 5-7 days later. In group 2 (28 patients), patients underwent the same posterior procedure without AER. Posterior correction was performed in all cases using posteromedial translation and hybrid constructs consisting of lumbar pedicle screws and thoracic sublaminar bands. From radiological measurements performed using low-dose EOS radiographs, the correction of thoracic kyphosis was compared between the two groups. Groups 1 and 2 were comparable regarding demographic data and preoperative thoracic kyphosis (group 1: 11.7° ± 6.9° vs group 2: 12.1° ± 6.3°, p = 0.89). Postoperative thoracic kyphosis increase averaged 18.3° ± 13.6° in group 1 and 15.2° ± 9.0° in group 2. The benefit of anterior release was not statistically significant (p = 0.35). Although previous studies have suggested that thoracoscopic release improved correction compared to posterior surgery alone, the current study did not confirm this finding. Moreover, results of the current series showed that no significant benefit can be expected from AER in terms of sagittal plane improvement when the posteromedial translation technique is used, even in challenging hypokyphotic patients.

  5. Sagittal spino-pelvic adjustment in severe Lenke 1 hypokyphotic adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Vidal, Christophe; Mazda, Keyvan; Ilharreborde, Brice

    2016-10-01

    The human standing position requires permanent reciprocal spino-pelvic adjustments to obtain a dynamic and economic posture. This study focuses on a hypokyphotic Lenke 1 adolescent idiopathic scoliosis (AIS) patients cohort and points out their particular lumbo-pelvic adaptive mechanisms to maintain a neutral sagittal balance. Preoperative retrospective analysis of prospectively collected data on a monocentric cohort of 455 AIS patients planned for corrective surgery. Radiological low-dose system coupled with a validated clinical routine software allowed to obtain data from eighty-four hypokyphotic [thoracic kyphosis (TK) <20°] Lenke 1 patients and were separately analyzed. Bilateral Student and one-way ANOVAs were conducted for statistical analysis. Mean Cobb angle was 46.3° (±7.2), TK was 11° (±7.1), sagittal vertical axis (SVA) was -10.1 mm (±30.9), pelvic incidence (PI) was 55.7° (±12.9). Fifty percents of patients were posteriorly imbalanced. Among them, patients with a low PI used an anteversion of their pelvis [indicated by a high pelvic tilt (PT) angle] but were not able to increase their lumbar lordosis (LL) to minimize the posterior spinal shift. Hypokyphotic Lenke 1 AIS patients use lumbo-pelvic compensatory mechanisms to maintain their global balance with a poor effectiveness. Subjects with a low PI have a restricted range of LL adaptation. Attention should be paid during surgical planning not to overcorrect lordosis in the instrumented levels in case of non-selective fusion, that may induce posterior shift of the fusion mass and expose to junctional syndromes and poor functional outcomes in this particular patients.

  6. Determinants of Pre-Operative Shoulder Imbalance in Patients with Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Hassan Ghandhari

    2017-01-01

    Full Text Available Background Disfiguring complications of adolescent idiopathic scoliosis (AIS could significantly affect the patients’ satisfaction. In this regard, shoulder imbalance has recently received much attention in spite of its poorly understood challenge. Objectives While the majority of previous studies have attempted to explore preoperative determinants of postoperative shoulder imbalance, in this study we aimed to investigate the factors correlated with the preoperative shoulder imbalance. Methods A total of 72 AIS patients with no previous history of corrective surgery took part in this study. The study sample comprised 63 females and 9 males with the mean age of 15.72 ± 3.08 years, ranging from 11 to 26 years. Shoulder imbalance parameters including T1 tilt, first rib angle (FRA, and clavicle angle (CA were assessed and their correlation with radiographic characteristics of the curves and patients’ demographic data including age and sex was evaluated. Results T1 tilt was more severe in males (mean -8.2° than females (mean -2.8° (P = 0.04. Moreover, a significant correlation was found between age and FRA (P = 0.04. A significant correlation was also observed between main thoracic (MT curve size and all the three parameters of shoulder imbalance (P < 0.001. The reverse correlation of T5 - T12 kyphosis angle with FRA was also significant (P = 0.04. Conclusions According to our results, in AIS, pre-operative radiographic shoulder imbalance could be affected by some curve parameters including MT and kyphosis size and demographic characteristics of patients including age and gender.

  7. Learning game AI programming with Lua

    CERN Document Server

    Young, David

    2014-01-01

    If you are a game developer or a general programmer who wishes to focus on programming systems and techniques to build your game AI without creating low-level interfaces in a game engine, then this book is for you. Knowledge of C++ will come in handy to debug the entirety of the AI sandbox and expand on the features present within the book, but it is not required.

  8. Adaptive game AI with dynamic scripting

    OpenAIRE

    Spronck, P.; Ponsen, M.J.V.; Sprinkhuizen-Kuyper, I.G.; Postma, E.O.

    2006-01-01

    Online learning in commercial computer games allows computer-controlled opponents to adapt to the way the game is being played. As such it provides a mechanism to deal with weaknesses in the game AI, and to respond to changes in human player tactics.We argue that online learning of game AI should meet four computational and four functional requirements. The computational requirements are speed, effectiveness, robustness and ef- ficiency. The functional requirements are clarity, variety, consi...

  9. Research Directions for AI in Computer Games

    OpenAIRE

    Fairclough, Chris; Fagan, Michael; Cunningham, Padraig; Mac Namee, Brian

    2001-01-01

    The computer games industry is now bigger than the film industry. Until recently, technology in games was driven by a desire to achieve real-time, photo-realistic graphics. To a large extent, this has now been achieved. As game developers look for new and innovative technologies to drive games development, AI is coming to the fore. This paper will examine how sophisticated AI techniques, such as those being used in mainstream academic research, can be applied to computer games ...

  10. Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery.

    Science.gov (United States)

    Ferrero, Emmanuelle; Mazda, Keyvan; Simon, Anne-Laure; Ilharreborde, Brice

    2018-04-24

    Preoperative planning of scoliosis surgery is essential in the effective treatment of spine pathology. Thus, precontoured rods have been recently developed to avoid iatrogenic sagittal misalignment and rod breakage. Some specific issues exist in adolescent idiopathic scoliosis (AIS), such as a less distal lower instrumented level, a great variability in the location of inflection point (transition from lumbar lordosis to thoracic kyphosis), and sagittal correction is limited by both bone-implant interface. Since 2007, stereoradiographic imaging system is used and allows for 3D reconstructions. Therefore, a software was developed to perform preoperative 3D surgical planning and to provide rod's shape and length. The goal of this preliminary study was to assess the feasibility, reliability, and the clinical relevance of this new software. Retrospective study on 47 AIS patients operated with the same surgical technique: posteromedial translation through posterior approach with lumbar screws and thoracic sublaminar bands. Pre- and postoperatively, 3D reconstructions were performed on stereoradiographic images (EOS system, Paris, France) and compared. Then, the software was used to plan the surgical correction and determine rod's shape and length. Simulated spine and rods were compared to postoperative real 3D reconstructions. 3D reconstructions and planning were performed by an independent observer. 3D simulations were performed on the 47 patients. No difference was found between the simulated model and the postoperative 3D reconstructions in terms of sagittal parameters. Postoperatively, 21% of LL were not within reference values. Postoperative SVA was 20 mm anterior in 2/3 of the cases. Postoperative rods were significantly longer than precontoured rods planned with the software (mean 10 mm). Inflection points were different on the rods used and the planned rods (2.3 levels on average). In this preliminary study, the software based on 3D stereoradiography low

  11. Comparison of Complications and Surgical Outcomes of Adolescent Idiopathic Scoliosis Between Junior Attending Surgeons and Senior Attending Surgeons.

    Science.gov (United States)

    Qiao, Jun; Xiao, Lingyan; Xu, Leilei; Shi, Benlong; Qian, Bangping; Zhu, Zezhang; Qiu, Yong

    2018-04-24

    To our knowledge, few studies have compared complications and surgical outcomes of adolescent idiopathic scoliosis (AIS) between junior attending surgeons and senior attending surgeons. To compare surgical strategies, complications, and outcomes of posterior corrective surgery for AIS between junior attending surgeons and senior attending surgeons. According to experience level of operation surgeons, the patients were assigned to 2 groups. Group A was the "junior surgeon" group. Group B was the "senior surgeon" group. The following parameters were compared between the 2 groups: age, sex, diagnosis, hospital of record, surgeon experience level, type of instrumentation, type of screws, estimated blood loss, duration of surgery, length of fusion, correction techniques, main curve correction, and thoracic kyphosis correction. A total of 132 patients with AIS were included in group A, whereas 207 were in group B. The translational technique was used more often in group A (P Senior surgeons used more monoaxial screws than junior surgeons (P senior group (P senior group had significant better correction rates of severe main curve (>70°) and thoracic kyphosis than the junior group (P Senior attending surgeons outperformed junior surgeons in blood loss control, thoracic kyphosis correction, and correction of severe curves. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Bone density determination using I125 densitometry with idiopathic scoliosis

    International Nuclear Information System (INIS)

    Weinberger, N.

    1984-01-01

    Based on the assumption that radiographs from patients with idiopathic scoliosis show osteoporotic changes in the curved area, investigation with I 125 -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) [de

  13. The genetic implication of scoliosis in osteogenesis imperfecta: a review

    Science.gov (United States)

    Liu, Gang; Chen, Jia; Zhou, Yangzhong; Zuo, Yuzhi; Liu, Sen; Chen, Weisheng

    2017-01-01

    Osteogenesis imperfecta (OI) is a kind of heritable connective tissue disorder, including blue sclerae, hearing loss, skeletal dysplasia causing bone fragility and deformities. It is typically caused by collagen related gene mutations, which could lead to bone formation abnormalities. Scoliosis is one of the most common and severe spinal phenotype which has been reported in approximately 26–74.5% of all OI patients. Recent breakthroughs have suggested that OI can be divided into more than 16 types based on genetic mutations with different degrees of scoliosis. In this review, we summarize the etiology of scoliosis in OI, especially the genetic studies of different types. We aim to provide a systematic review of the genetic etiology and clinical suggestions of scoliosis in OI. PMID:29354746

  14. 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.)

  15. CELSR2 is a candidate susceptibility gene in idiopathic scoliosis

    DEFF Research Database (Denmark)

    Einarsdottir, Elisabet; Grauers, Anna; Wang, Jingwen

    2017-01-01

    and the US. No association was found to variants in CELSR1 or CELSR3. Our findings suggest a rare variant in CELSR2 as causative for idiopathic scoliosis in a family with dominant segregation and further highlight common variation in CELSR2 in general susceptibility to idiopathic scoliosis in the Swedish......-Danish population. Both variants are located in the highly conserved GAIN protein domain, which is necessary for the auto-proteolysis of CELSR2, suggesting its functional importance....

  16. Video-game-assisted physiotherapeutic scoliosis-specific exercises for idiopathic scoliosis: case series and introduction of a new tool to increase motivation and precision of exercise performance.

    Science.gov (United States)

    Wibmer, Christine; Groebl, Petra; Nischelwitzer, Alexander; Salchinger, Beate; Sperl, Matthias; Wegmann, Helmut; Holzer, Hans-Peter; Saraph, Vinay

    2016-01-01

    It is important to monitor how patients with juvenile and adolescent idiopathic scoliosis comply with their physiotherapeutic scoliosis-specific exercises (PSSE). Physiogame, a newly developed video game using the Game-Trak 3D interactive game controller, combines correct PSSE performance with gaming. It tracks the position of the working limb in 3D space during the exercises as participants aim to hit certain targets and avoid others, and gives direct feedback by stopping the game if the working limb leaves the target 3D space, which is chosen to secure the corrective position according to the Schroth method. Physiogame records the quality and frequency of the exercises performed. We aimed to investigate the influence of this tool on motivation to perform regularly and, correctly, and with self-assessment of performance quality. This case series included 8 consecutive patients with idiopathic scoliosis (thoracolumbar 7, lumbar 1), ages 7-13 years, all female and treated according to SOSORT guidelines; the COBB angle of primary curve at the start of brace therapy was 22-34°. In addition to Full Time Rigid Bracing (FTRB, Cheneau) and PSSE (Schroth), the participants were to perform two standardized Schroth exercises (muscle cylinder in standing position, mainly addressing the thoracic curve, and in side-lying position, mainly addressing the lumbar curve) with video game assistance every day for 6 months. The development (first to last month) of the following parameters was analyzed with descriptive methods: the actual training time to assess motivation, the ratio of the actual playing time versus total playing time to assess exercise improvement, and self-assessment of quality of performance. The average number of sessions with Physiogame was 217 per study participant (range 24 to 572, the study protocol targeted at least 180); actual training time decreased from 79 to 52 min (first to last month). Actual playing time increased from 73% of the total playing time

  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

    Science.gov (United States)

    2009-01-01

    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 implications. In the somatic

  18. 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

  19. Intraspinal anomalies in early-onset idiopathic scoliosis.

    Science.gov (United States)

    Pereira, E A C; Oxenham, M; Lam, K S

    2017-06-01

    In the United Kingdom, lower incidences of intraspinal abnormalities in patients with early onset idiopathic scoliosis have been observed than in studies in other countries. We aimed to determine the rates of these abnormalities in United Kingdom patients diagnosed with idiopathic scoliosis before the age of 11 years. This retrospective study of patients attending an urban scoliosis clinic identified 71 patients satisfying a criteria of: clinical diagnosis of idiopathic scoliosis; age of onset ten years and 11 months or less; MRI screening for intraspinal abnormalities. United Kingdom census data combined with patient referral data was used to calculate incidence. Mean age at diagnosis was six years with 39 right-sided and 32 left-sided curves. Four patients (5.6%) were found to have intraspinal abnormalities on MRI. These consisted of: two combined Arnold-Chiari type 1 malformations with syrinx; one syrinx with a low lying conus; and one isolated syrinx. Overall annual incidence of early onset idiopathic scoliosis was one out of 182 000 (0.0006%). This study reports the lowest rates to date of intraspinal anomalies in patients with early onset idiopathic scoliosis, adding to knowledge regarding current incidences of these abnormalities as well as any geographical variation in the nature of the disease. Cite this article: Bone Joint J 2017;99-B:829-33. ©2017 The British Editorial Society of Bone & Joint Surgery.

  20. Neurophysiological detection of impending spinal cord injury during scoliosis surgery.

    Science.gov (United States)

    Schwartz, Daniel M; Auerbach, Joshua D; Dormans, John P; Flynn, John; Drummond, Denis S; Bowe, J Andrew; Laufer, Samuel; Shah, Suken A; Bowen, J Richard; Pizzutillo, Peter D; Jones, Kristofer J; Drummond, Denis S

    2007-11-01

    Despite the many reports attesting to the efficacy of intraoperative somatosensory evoked potential monitoring in reducing the prevalence of iatrogenic spinal cord injury during corrective scoliosis surgery, these afferent neurophysiological signals can provide only indirect evidence of injury to the motor tracts since they monitor posterior column function. Early reports on the use of transcranial electric motor evoked potentials to monitor the corticospinal motor tracts directly suggested that the method holds great promise for improving detection of emerging spinal cord injury. We sought to compare the efficacy of these two methods of monitoring to detect impending iatrogenic neural injury during scoliosis surgery. We reviewed the intraoperative neurophysiological monitoring records of 1121 consecutive patients (834 female and 287 male) with adolescent idiopathic scoliosis (mean age, 13.9 years) treated between 2000 and 2004 at four pediatric spine centers. The same group of experienced surgical neurophysiologists monitored spinal cord function in all patients with use of a standardized multimodality technique with the patient under total intravenous anesthesia. A relevant neurophysiological change (an alert) was defined as a reduction in amplitude (unilateral or bilateral) of at least 50% for somatosensory evoked potentials and at least 65% for transcranial electric motor evoked potentials compared with baseline. Thirty-eight (3.4%) of the 1121 patients had recordings that met the criteria for a relevant signal change (i.e., an alert). Of those thirty-eight patients, seventeen showed suppression of the amplitude of transcranial electric motor evoked potentials in excess of 65% without any evidence of changes in somatosensory evoked potentials. In nine of the thirty-eight patients, the signal change was related to hypotension and was corrected with augmentation of the blood pressure. The remaining twenty-nine patients had an alert that was related directly to a

  1. The SPoRT concept of bracing for idiopathic scoliosis.

    Science.gov (United States)

    Zaina, Fabio; Fusco, Claudia; Atanasio, Salvatore; Negrini, Stefano

    2011-01-01

    The SPoRT (acronym: Symmetrical, Patient-oriented, Rigid, Three-dimensional, active) concept of bracing is a new way to build braces based on our 20 years of experience and the biomechanical principles of scoliosis correction, inclusive of the Sibilla and Sforzesco braces. The concept always requires a custom brace, which is made according to the patient's individual requirements. New technologies such as CAD-CAM can be applied, and often for better results, without the customary use of prebuilt forms whose measurements are stored in databases. Once the initial draft brace is completed, a final test must be made on the patient to modify and adapt it, depending on his or her real interaction between the body and the brace. The results that are today available on the SPoRT concept relate to the Sforzesco brace and are necessarily short-term, because the first treated patients are now reaching the fourth-year follow-up examination and haven't yet completed their treatments. On the basis of the initial evaluations, we can state that the Sforzesco brace is more effective than the Lyon brace after 6 months of treatment and that the Sforzesco brace is equally effective as the Risser Plast brace.

  2. Analysis of risk factors for loss of lumbar lordosis in patients who had surgical treatment with segmental instrumentation for adolescent idiopathic scoliosis.

    Science.gov (United States)

    Trobisch, Per D; Samdani, Amer F; Betz, Randal R; Bastrom, Tracey; Pahys, Joshua M; Cahill, Patrick J

    2013-06-01

    Iatrogenic flattening of lumbar lordosis in patients with adolescent idiopathic scoliosis (AIS) was a major downside of first generation instrumentation. Current instrumentation systems allow a three-dimensional scoliosis correction, but flattening of lumbar lordosis remains a significant problem which is associated with decreased health-related quality of life. This study sought to identify risk factors for loss of lumbar lordosis in patients who had surgical correction of AIS with the use of segmental instrumentation. Patients were included if they had surgical correction for AIS with segmental pedicle screw instrumentation Lenke type 1 or 2 and if they had a minimum follow-up of 24 months. Two groups were created, based on the average loss of lumbar lordosis. The two groups were then compared and multivariate analysis was performed to identify parameters that correlated to loss of lumbar lordosis. Four hundred and seventeen patients were analyzed for this study. The average loss of lumbar lordosis at 24 months follow-up was an increase of 10° lordosis for group 1 and a decrease of 15° for group 2. Risk factors for loss of lumbar lordosis included a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and the particular operating surgeon. The lowest instrumented vertebra or spinopelvic parameters were two of many parameters that did not seem to influence loss of lumbar lordosis. This study identified important risk factors for decrease of lumbar lordosis in patients who had surgical treatment for AIS with segmental pedicle screw instrumentation, including a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and factors attributable to a particular operating surgeon that were not quantified in this study.

  3. Development of the Italian version of the revised Scoliosis Research Society-22 Patient Questionnaire, SRS-22r-I: cross-cultural adaptation, factor analysis, reliability, and validity.

    Science.gov (United States)

    Monticone, Marco; Baiardi, Paola; Calabrò, David; Calabrò, Fabio; Foti, Calogero

    2010-11-15

    Evaluation of the psychometric properties of a translated and culturally adapted questionnaire. Translating, culturally adapting, and validating the Italian version of the revised Scoliosis Research Society-22 Patient Questionnaire (SRS-22r-I) in order to allow its use with Italian-speaking patients with adolescent idiopathic scoliosis (AIS). Increasing attention is being given to health-related quality of life measures as a means of adding information about the evaluation of AIS. A translated form of the revised SRS-22 has never been validated in Italian patients with AIS. The development of the SRS-22 questionnaire involved its translation and back-translation, a final review by an Expert Committee, and testing of the prefinal version to establish its correspondence to the original English version. Psychometric testing included factor analysis, reliability by internal consistency (Cronbach alpha) and test-retest repeatability (Intraclass Coefficient Correlation), and concurrent validity (Pearson correlation) by comparing the SRS-22r-I domains with the Short-Form Health Survey (SF-36) subscales. It took 4 months to develop a shared version of the SRS-22r-I, which proved to be satisfactorily acceptable when administered to 223 subjects with AIS. Factor analysis indicated a 4-factor solution (54% of the explained variance), and the questionnaire had an acceptable level of internal consistency (α = 0.77) and a high level of test-retest reliability (intraclass correlation coefficient = 0.957). In terms of concurrent validity, the correlations with the related Short-Form-36 subscales were moderate to good in the case of the Pain and Mental Health domains, and moderate in the case of the Function and Self-Image domains. The Italian translation of the SRS-22r has a good factorial structure and psychometric properties, and replicates the results of existing English versions of the questionnaire. Its use for research purposes can therefore be recommended.

  4. Anatomical Origin of Abnormal Somatosensory-Evoked Potential (SEP) in Adolescent Idiopathic Scoliosis With Different Curve Severity and Correlation With Cerebellar Tonsillar Level Determined by MRI.

    Science.gov (United States)

    Chau, Wai Wang; Chu, Winnie C W; Lam, Tsz Ping; Ng, Bobby K W; Fu, Linda L K; Cheng, Jack C Y

    2016-05-01

    A prospective cohort study. The aim of this study was to compare the somatosensory-evoked potential (SEP) findings of adolescent idiopathic scoliosis (AIS) subjects of different curve severity with age- and gender-matched controls and to evaluate any correlation between the site of the SEP abnormality with cerebellar tonsillar level measured by magnetic resonance imaging (MRI). Our previous studies showed that a higher percentage of SEP abnormality and cerebellar tonsillar ectopia was present in AIS patients than in normal controls. However, the relationship between the anatomical site of the neurophysiological abnormality and the severity in AIS patients has not been defined. SEP measurement was conducted on 91 Chinese AIS girls with major right thoracic curve of different curve severity (mild, moderate, severe) and 49 matched normal controls. Waveform characteristics (latency and amplitude) were compared among groups. Specific location of SEP abnormality was identified from tibial to cortical levels. Cerebellar tonsillar ectopia was defined by the previously established reference line between basion and opisthion on MRI. Significant prolonged P37 latency was found on the right side between severe AIS patients and normal controls, while increased inter-side P37 latency difference was found between severe versus moderate, and severe versus normal controls. Cerebellar tonsillar ectopia was detected in 27.3% of severe group, 5.8% to 6.7% in mild and moderate group, but none in normal controls. Abnormal SEP occurred superior to C5 region in all surgical (severe) patients, of whom 58% had cerebellar tonsillar ectopia. AIS patients showed significant prolonged latency and increased latency difference on the side of major curvature. The incidence of SEP abnormality increased with curve severity and occurred above the C5 level. The findings suggested that there was a subgroup of progressive AIS with subclinical neurophysiological dysfunction, associated with underlying

  5. The TGFB1 gene is associated with curve severity but not with the development of adolescent idiopathic scoliosis: a replication study in the Chinese population.

    Science.gov (United States)

    Xu, Leilei; Sun, Weixiang; Qin, Xiaodong; Qiu, Yong; Zhu, Zezhang

    2016-01-13

    The transforming growth factor beta-1 (TGFB1) gene was recently reported to be a new susceptible gene of adolescent idiopathic scoliosis (AIS) in Russian population. This study aimed to replicate the relationship between the TGFB1 gene and the susceptibility of AIS in a Chinese population, and to further describe its association with the curve severity. A total of 1251 female AIS patients and 994 age-matched healthy controls were included in this study. The rs1800469 of TGFB1 gene was genotyped for all participants using the PCR-based Invader assay. The differences of genotype and allele distributions between AIS patients and healthy controls were assessed using the Chi-square test. One-way ANOVA test was used to compare the mean Cobb angles among patients with different genotypes. There was no significant difference in terms of the genotype and the allele frequency between the patients and the controls. The mean Cobb angle was 34.7 ± 11.9° (range 25-61°). Case-only analysis showed that rs1800469 was significantly associated with the curve severity. Patients with genotype TT had remarkably higher curve magnitude (39.1 ± 12.8°) than those with genotype CT (34.8 ± 11.1°) or CC (32.1 ± 10.6°). The TGFB1 gene may not be a predisposition gene of AIS in the Chinese population. However, it can play a role in the curve progression of AIS. Replication studies in other ethnic groups are warranted to understand the implication of TGFB1 gene in AIS.

  6. Association Between the Estrogen Receptor Beta (ESR2) Rs1256120 Single Nucleotide Polymorphism and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhao, Linlu; Roffey, Darren M; Chen, Suzan

    2017-06-01

    A systematic review and meta-analysis. The aim of this study was to assess and synthesize the current evidence on the association between the rs1256120 single nucleotide polymorphism (SNP) of the estrogen receptor beta gene (ESR2) and adolescent idiopathic scoliosis (AIS). Hormonal disturbance has been postulated as a potential etiological factor in the development of AIS. As estrogen receptors are important mediators of estrogen response, mutations in these genes, including rs1256120 of ESR2, have been chosen as susceptibility candidates for AIS predisposition. The association of rs1256120 with AIS has been investigated in several recent studies, but showed conflicting evidence. We conducted a systematic review to evaluate the strength of this body of evidence and quantitative synthesis to examine sources of heterogeneity. This study conformed to PRISMA guidelines. Using a sensitive search strategy, PubMed (MEDLINE), EMBASE, and HuGE Literature Finder databases were searched to identify relevant studies for inclusion in the systematic review and meta-analysis. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. The inverse variance model was used to calculate summary odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the allelic (C vs. T) and genotypic comparisons. Planned subgroup and sensitivity analyses were performed. Three studies were included for systematic review and meta-analysis (n = 1264 AIS cases and n=1020 controls). A null relationship was found between rs1256120 and AIS (allelic OR = 1.20, 95% CI: 0.81-1.78, P = 0.36, I = 84.9%), with the first reported association likely to be false-positive and contributing substantially to heterogeneity. Findings from the systematic review and meta-analysis suggest that rs1256120 of ESR2 is unlikely to be a predisposing or disease-modifying genetic risk factor for AIS. 2.

  7. 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

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

    OpenAIRE

    Misterska, Ewa; G?owacki, Maciej; Panek, S?awomir; Igny?-O?Byrne, Anna; G?owacki, Jakub; Igny?, Iwona; Krauss, Hanna; Pi?tek, Jacek

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Szulc Andrzej

    2007-12-01

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

  10. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

    NARCIS (Netherlands)

    Mullender, M.G.; Blom, N.; de Kleuver, M.; Fock, J.; Hitters, W.; Horemans, A.; Kalkman, C.; Pruijs, J.; Timmer, R.; Titarsolej, P.; van Haasteren, N.; Jager, M.V.; van Vught, A.; van Royen, B.J.

    2008-01-01

    Background: Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is

  11. Beyond AI: Interdisciplinary Aspects of Artificial Intelligence

    CERN Document Server

    Romportl, Jan; Zackova, Eva; Beyond Artificial Intelligence : Contemplations, Expectations, Applications

    2013-01-01

    Products of modern artificial intelligence (AI) have mostly been formed by the views, opinions and goals of the “insiders”, i.e. people usually with engineering background who are driven by the force that can be metaphorically described as the pursuit of the craft of Hephaestus. However, since the present-day technology allows for tighter and tighter mergence of the “natural” everyday human life with machines of immense complexity, the responsible reaction of the scientific community should be based on cautious reflection of what really lies beyond AI, i.e. on the frontiers where the tumultuous ever-growing and ever-changing cloud of AI touches the rest of the world.   The chapters of this boo are based on the selected subset of the presentations that were delivered by their respective authors at the conference “Beyond AI: Interdisciplinary Aspects of Artificial Intelligence” held in Pilsen in December 2011.   From its very definition, the reflection of the phenomena that lie beyond AI must be i...

  12. Two new Oxalis species (Oxalidaceae) from the Ai-Ais / Richtersveld Transfrontier Park, South Africa

    NARCIS (Netherlands)

    Roets, F.; Oberlander, K.C.; Dreyer, L.L.

    2012-01-01

    South Africa has a rich, but scantily surveyed, desert flora. Documenting annual and geophytic species in this biome is challenging, as they usually only flower after adequate precipitation, which is characteristically erratic and infrequent. Recent floristic surveys in the Ai-Ais / Richtersveld

  13. Use of AI-1024 and AI-4096 analyzers in multiple regimes

    International Nuclear Information System (INIS)

    Zaika, N.D.; Kovtunenko, I.S.; Savchuk, O.G.

    1975-01-01

    The operation of pulse multichannel analyzers in the following multidimensional modes: AI-1024-4 - amplitude mode from several transducers; amplitude mode from several transducers at different time intervals; AI-4096-3M - amplitude mode at different time intervals in each of four groups with unit BVI-1

  14. Scoliosis associated with airflow obstruction due to endothoracic vertebral hump.

    Science.gov (United States)

    Ito, Kenyu; Kawakami, Noriaki; Miyasaka, Kazuyoshi; Tsuji, Taichi; Ohara, Tetsuya; Nohara, Ayato

    2012-12-01

    A retrospective clinical study of scoliosis-associated airflow obstruction due to endothoracic vertebral hump. The purpose of this study was to evaluate and present anatomical features of patients with scoliosis who showed airflow obstruction caused by endothoracic vertebral hump. It is well known that severe scoliosis causes airflow restriction due to thoracic cage deformity. There have been few reports of clinical data and anatomical features on scoliosis associated with airflow obstruction due to endothoracic vertebral hump. The subjects were 6 patients. The diagnoses were idiopathic scoliosis in 3 patients, symptomatic scoliosis in 2 patients, and thoracogenic scoliosis in 1 patient. The radiological outcome, comorbidities, pre- and postoperative respiratory function, and surgical complication were analyzed. Four patients had preoperative atelectasis on the convex side of the lower lobe and improved after the operations. All patients showed main thoracic curves and their apex was located at T7-T9. All patients had lordoscoliosis except 1, who demonstrated kyphosing scoliosis. The correction rate was 78% (62.8%-83.5%). Preoperative thoracic lordosis within the range of -5° to -47° was postoperatively corrected to a substantially normal kyphosis within the range of 9° to 24°. The average vital capacity, percent VC improved from 0.72 L (0.33-1.17 L) to 1.21 L (0.82-1.71 L) and 45.5% (37.3%- 50.8%) to 63.7% (41.0%-88.6%) relatively. Spine Penetration Index improved from 23% (18%-35%) to 16% (13%-19%). Endothoracic hump ratio improved from 1.34 (0.98-1.93) to 1.12 (0.86-1.28). Each patient with symptomatic scoliosis and thoracogenic scoliosis required relatively long periods of respiration management. Patients having lordoscoliosis with an apex located between T7 and T9 may develop airflow obstruction due to an endothoracic vertebral hump. Correction of lordoscoliosis through anterior and posterior approaches successfully improved endothoracic hump ratio and

  15. Poor outcomes and satisfaction in adolescent idiopathic scoliosis surgery: the relevance of the body mass index and self-image.

    Science.gov (United States)

    Pérez-Prieto, Daniel; Sánchez-Soler, Juan Francisco; Martínez-Llorens, Juana; Mojal, Sergi; Bagó, Joan; Cáceres, Enric; Ramírez, Manuel

    2015-02-01

    The purpose of this study was to evaluate patients with adolescent idiopathic scoliosis (AIS) to determine whether a low body mass index (BMI) influences surgery outcomes and satisfaction. There were 39 patients in this prospective 3-year cohort study. The BMI, Cobb angle, the Body Shape Questionnaire 14 (BSQ-14), the Scoliosis Research Society Questionnaire 22 (SRS-22) and eight satisfaction questions results were obtained. Having a BMI greater than or less than 18 kg/m(2) was used as a determiner to allocate patients to groups. As a low BMI is related to the presence of a disturbance in body perception, patients were also dichotomized by using the BSQ-14. All scales were worse in both slimmer patients and the group with a body perception disorder. The group with a BMI 18 kg/m(2) (p = 0.001). In terms of satisfaction, the percentage of patients that would undergo surgery again was 30.8 vs 69.2 % (p = 0.054). Patients with an alteration of physical perception obtained a total SRS-22 of 82.90 points versus 96.10 points in the control group (p < 0.001). No differences in terms of the Cobb correction (p = 0.29) or the percentage of correction (p = 0.841) were found in any case. The alteration of physical perception and a low BMI negatively affect the outcomes in AIS surgery, regardless of the curve magnitude and the percentage of correction. Considerable care should be taken in recommending surgical correction to these patients.

  16. 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

    Directory of Open Access Journals (Sweden)

    Burwell R Geoffrey

    2008-06-01

    Full Text Available 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 the spinal cord to vertebral growth interaction during adolescence in scoliosis. Using the multi-planar reconstruction technique of magnetic resonance imaging they investigated the relative length of spinal cord to vertebral column including ratios in 28 girls with AIS (mainly thoracic or double major curves and 14 age-matched normal girls. Also evaluated were cerebellar tonsillar position, somatosensory evoked potentials (SSEPs, and clinical neurological examination. In severe AIS compared with normal controls, the vertebral column is significantly longer without detectable spinal cord lengthening. They speculate that anterior spinal column overgrowth relative to a normal length spinal cord exerts a stretching tethering force between the two ends, cranially and caudally leading to the initiation and progression of thoracic AIS. They support and develop the Roth-Porter concept of uncoupled neuro-osseous growth in the pathogenesis of AIS which now they prefer to term 'asynchronous neuro-osseous growth'. Morphological evidence about the curve apex suggests that the spinal cord is also affected, and a 'double pathology' is suggested. AIS is viewed as a disorder with a wide spectrum and a common neuroanatomical abnormality namely, a spinal cord of normal length but short relative to an abnormally lengthened anterior vertebral column. Neuroanatomical changes and/or abnormal neural function may be expressed only in severe cases. This asynchronous neuro-osseous growth

  17. Artificial Intelligence Safety and Cybersecurity: a Timeline of AI Failures

    OpenAIRE

    Yampolskiy, Roman V.; Spellchecker, M. S.

    2016-01-01

    In this work, we present and analyze reported failures of artificially intelligent systems and extrapolate our analysis to future AIs. We suggest that both the frequency and the seriousness of future AI failures will steadily increase. AI Safety can be improved based on ideas developed by cybersecurity experts. For narrow AIs safety failures are at the same, moderate, level of criticality as in cybersecurity, however for general AI, failures have a fundamentally different impact. A single fai...

  18. Tweeting AI: Perceptions of Lay vs Expert Twitterati

    OpenAIRE

    Manikonda, Lydia; Kambhampati, Subbarao

    2017-01-01

    With the recent advancements in Artificial Intelligence (AI), various organizations and individuals are debating about the progress of AI as a blessing or a curse for the future of the society. This paper conducts an investigation on how the public perceives the progress of AI by utilizing the data shared on Twitter. Specifically, this paper performs a comparative analysis on the understanding of users belonging to two categories -- general AI-Tweeters (AIT) and expert AI-Tweeters (EAIT) who ...

  19. Strategic Team AI Path Plans: Probabilistic Pathfinding

    Directory of Open Access Journals (Sweden)

    Tng C. H. John

    2008-01-01

    Full Text Available This paper proposes a novel method to generate strategic team AI pathfinding plans for computer games and simulations using probabilistic pathfinding. This method is inspired by genetic algorithms (Russell and Norvig, 2002, in that, a fitness function is used to test the quality of the path plans. The method generates high-quality path plans by eliminating the low-quality ones. The path plans are generated by probabilistic pathfinding, and the elimination is done by a fitness test of the path plans. This path plan generation method has the ability to generate variation or different high-quality paths, which is desired for games to increase replay values. This work is an extension of our earlier work on team AI: probabilistic pathfinding (John et al., 2006. We explore ways to combine probabilistic pathfinding and genetic algorithm to create a new method to generate strategic team AI pathfinding plans.

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

    Directory of Open Access Journals (Sweden)

    Pliarchopoulou Fani M

    2007-10-01

    Full Text Available 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 patients with deformities related to rare disorders. These patients were reviewed as regards to characteristics of underlying disorder and spine deformity, treatment and results, complications, intraoperative and anaesthesiologic difficulties particular to each case. Results In 13 cases, the spine deformity presented in relation to rare disorders. The underlying disorder was rare neurological disease in 2 cases (Rett syndrome, progressive hemidystonia, muscular disorders (facioscapulohumeral muscular dystrophy, arthrogryposis in 2 patients, osteogenesis imperfecta in 2 cases, Marfan syndrome, osteopetrosis tarda, spondyloepiphyseal dysplasia congenita, cleidocranial dysplasia and Noonan syndrome in 1 case each. In 2 cases scoliosis was related to other congenital anomalies (phocomelia, blindness. Nine of these patients were surgically treated. Surgery was avoided in 3 patients. Conclusion This study illustrates the fact that different disorders are related with curves with different characteristics, different accompanying problems and possible complications. Investigation and understanding of the underlying pathology is an essential part of the clinical evaluation and preoperative work-up, as clinical experience at any specific center is limited.

  1. Hemivertebrectomy and fixation with titanium cable for congenital scoliosis in children younger than five years

    International Nuclear Information System (INIS)

    Arango, Luis Alberto; Meneses, David; Montero, Carlos; Naquira, Luis Felipe

    2004-01-01

    A retrospective study was performed. The general objective was to describe the results and behavior of patients with congenital scoliosis secondary to hemivertebrae, treated with hemivertebral resection and fixation with titanium cable. There are different types of treatment: anterior fusion, posterior fusion, hemiepiphyseodesis and hemivertebral resection with or without instrumentation. Instrumentation in young children less than five years is difficult because of the pediatric spine devices are still big for this patient group. Between January 1999 and December 2003, 11 hemivertebrae resection in ten children were evaluated clinically and radiologically at admission, after surgery and at mean follow up of 12 months. The mean deformity angle before surgery was 40.8 degrades, 20.4 degrades alter surgery and 12.4 degrades at final follow up. There was one superficial infection and one of two cables rupture. The mean surgical time for double approach was 7.1 hours and for posterior approach was 3.6 hours. The bleeding for double approach was 656cc and for posterior approach was 186cc. The hemivertebral resection with titanium cable fixation is safe and success alternative for treating congenital scoliosis secondary hemivertebrae in young children

  2. AI Researchers, Video Games Are Your Friends!

    OpenAIRE

    Togelius, Julian

    2016-01-01

    If you are an artificial intelligence researcher, you should look to video games as ideal testbeds for the work you do. If you are a video game developer, you should look to AI for the technology that makes completely new types of games possible. This chapter lays out the case for both of these propositions. It asks the question "what can video games do for AI", and discusses how in particular general video game playing is the ideal testbed for artificial general intelligence research. It the...

  3. AI, automation and the Flight Telerobotic Servicer

    Science.gov (United States)

    Goforth, Andre; Dominy, Robert

    1988-01-01

    A NASA study for the preliminary definition of a teleoperated robotic device has been recently completed. The Fligt Telerobotic Servicer (FTS) will be used to assist astronauts in many of the on-board tasks of assembly, maintenance, servicing, and inspection of the Space Station. The role of artificial intelligence (AI) in furthering the FTS automation capabilities and, hence, extending its capacity for growth and evolution is discussed. Relevant system engineering issues are identified, and an approach for insertion of AI technology is presented in terms of the NASA/NBS Standard Reference Model control architecture NASREM.

  4. New method of scoliosis assessment: preliminary results using computerized photogrammetry.

    Science.gov (United States)

    Aroeira, Rozilene Maria Cota; Leal, Jefferson Soares; de Melo Pertence, Antônio Eustáquio

    2011-09-01

    A new method for nonradiographic evaluation of scoliosis was independently compared with the Cobb radiographic method, for the quantification of scoliotic curvature. To develop a protocol for computerized photogrammetry, as a nonradiographic method, for the quantification of scoliosis, and to mathematically relate this proposed method with the Cobb radiographic method. Repeated exposure to radiation of children can be harmful to their health. Nevertheless, no nonradiographic method until now proposed has gained popularity as a routine method for evaluation, mainly due to a low correspondence to the Cobb radiographic method. Patients undergoing standing posteroanterior full-length spine radiographs, who were willing to participate in this study, were submitted to dorsal digital photography in the orthostatic position with special surface markers over the spinous process, specifically the vertebrae C7 to L5. The radiographic and photographic images were sent separately for independent analysis to two examiners, trained in quantification of scoliosis for the types of images received. The scoliosis curvature angles obtained through computerized photogrammetry (the new method) were compared to those obtained through the Cobb radiographic method. Sixteen individuals were evaluated (14 female and 2 male). All presented idiopathic scoliosis, and were between 21.4 ± 6.1 years of age; 52.9 ± 5.8 kg in weight; 1.63 ± 0.05 m in height, with a body mass index of 19.8 ± 0.2. There was no statistically significant difference between the scoliosis angle measurements obtained in the comparative analysis of both methods, and a mathematical relationship was formulated between both methods. The preliminary results presented demonstrate equivalence between the two methods. More studies are needed to firmly assess the potential of this new method as a coadjuvant tool in the routine following of scoliosis treatment.

  5. Evaluation of scoliosis using baropodometer and artificial neural network

    Directory of Open Access Journals (Sweden)

    Caroline Meireles Fanfoni

    Full Text Available Abstract Introduction: One of the most recurrent pathologies in the spine is scoliosis. It occurs in the frontal plane and is formed by one or more curves in the spinal column. The scoliosis causes global postural misalignment in an individual. One of the modifications produced by postural misalignment is the way in which an individual distributes weight to the feet. We aimed to implement an electronic system for separating patients with Degree I scoliosis (i.e., 1° to 19° scoliosis according to the Ricard classification into two groups: C1 (1°-9° and C2 (10°-9°. The highest percentage of patients with scoliosis is in this range: those who do not need to wear vests or undergo surgery and whose treatment is performed via special physical exercise and frequent evaluations by healthcare professionals. Methods The electronic system consists of a baropodometer and artificial neural networks (ANNs. The classification of patients in the scoliosis groups was performed with MATLAB software and a Single Layer Perceptron network using the backpropagation training algorithm. Evaluations were performed on 63 volunteers. Results The mean classification sensitivity was 93.7% in the C1 group and 94.5% in the C2 group. The classification accuracy was 83.3% in the C1 group and 96.0% in the C2 group. Conclusion The implemented system can contribute to the treatment of patients with scoliosis grades ranging from 1° to 19°, which represents the highest incidence of this pathology, for which the monitoring of the clinical condition using noninvasive techniques is of fundamental importance.

  6. Dry eyes and AIs: If you don't ask you won't find out.

    Science.gov (United States)

    Inglis, Holly; Boyle, Frances M; Friedlander, Michael L; Watson, Stephanie L

    2015-12-01

    Our objective was to investigate the hypothesis that women on adjuvant aromatase inhibitors (AIs) for treatment of breast cancer have a higher prevalence of dry eye syndrome (DES) compared with controls. Exposure and control groups were recruited. A cross sectional questionnaire-based study was performed. Demographic data and medical histories were collected. The presence of dry eye syndrome was determined by the ocular surface disease index (OSDI). The Functional Assessment of Cancer Treatment - Endocrine Subscale (FACT-ES) was performed to investigate correlations with other side effects of AIs. 93 exposure group and 100 control group questionnaires were included. The groups were similar in all demographic variables. The prevalence of dry eye syndrome was 35% (exposure) and 18% (control) (p dry eyes. The OSDI score was negatively correlated with the total FACT-ES score and positively correlated with duration of treatment. Our study is the first to use a validated questionnaire to assess for DES in this population. DES is significantly more prevalent in women on AIs compared with controls. This is a newly emerging, and easily treated side effect of AIs. Self-reporting of dry eye symptoms underestimates the prevalence of DES with AIs. We recommend routine screening of patients on AIs with the OSDI with the aim of improving patient quality of life and possibly adherence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Substituted Benzamides Containing Azaspiro Rings as Upregulators of Apolipoprotein A-I Transcription

    Directory of Open Access Journals (Sweden)

    Bin Hong

    2012-06-01

    Full Text Available Apolipoprotein A-I (Apo A-I is the principal protein component of high density lipoprotein (HDL, which is generally considered as a potential therapeutic target against atherosclerosis. The understanding of the Apo A-I regulation mechanism has fuelled the development of novel HDL targeted therapeutic approaches. To identify novel agents that can upregulate Apo A-I expression, we performed a cell-based reporter assay to screen 25,600 small molecules. Based on the dataset obtained from screening, a series of novel analogs of substituted benzamides containing azaspiro rings were assessed for their ability to induce the transcription of the Apo A-I gene, and the structure-activity relationship (SAR around these analogs was also proposed. The results indicated that the trifluoromethyl substituted benzamide containing an azaspiro ring is a promising backbone for designing Apo A-I transcriptional upregulator and could be viable leads for development of new drugs to prevent and treat atherosclerosis in the future.

  8. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures.

    Science.gov (United States)

    Sabo, Alex; Hatgis, Jesse; Granville, Michelle; Jacobson, Robert E

    2017-12-19

    Osteoporotic patients can present with either single or multiple fractures secondary to repeated falls and progressive osteoporosis. Multiple fractures often lead to additional spinal deformity and are a sign of more severe osteoporosis. In the thoracic spine, multiple fractures are associated with the development of gradual thoracic kyphosis but neurologic deficits are uncommon. In the lumbar spine, patients with multiple lumbar fractures have more constant lumbar pain, may have symptoms related to concurrent lumbar stenosis or degenerative scoliosis, and may present with radiculopathy, especially with fractures at L4 and L5. In a review of a series of patients with recurrent multiple lumbar fractures or 'cascading' fractures, it was found that all the patients were female, had severe osteoporosis, often untreated, had a previous history of multiple previous thoracic and lumbar fractures, and all had associated scoliotic spinal deformities ranging from 6 o to 50 o . It was found that if the curve progressed and the greater the degree of curvature, the more frequently subsequent multiple fractures developed, leading to recurrent acute episodes of pain. Forty percent also had additional sacral insufficiency fractures, an unusually high percentage. Biomechanically, the lumbar spine is both more mobile and supports a larger portion of the spinal load compared to the thoracic spine. The existence or worsening of a lumbar spinal deformity from degenerative lumbar scoliosis shifts the mechanical forces more to one side on already weakened osteoporotic lumbar vertebrae and sacrum, leading to an increased incidence of these fractures. Because of the chronic and uneven lower lumbar spinal load with severe vertebral osteoporosis in certain patients with repeat lumbar fractures and worsening degenerative lumbar scoliosis, there may be a rationale to add preventive vertebroplasty at adjacent vertebral endplates when treating acute recurrent lumbar fractures to decrease the

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

    Directory of Open Access Journals (Sweden)

    Alessandro Landi

    2016-12-01

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

  10. A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

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    Paulo Alvim Borges

    Full Text Available OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

  11. Reproducibility of thoracic kyphosis measurements in patients with adolescent idiopathic scoliosis

    DEFF Research Database (Denmark)

    Ohrt-Nissen, Søren; Cheung, Jason Pui Yin; Hallager, Dennis Winge

    2017-01-01

    ) surgically treated for AIS with alternate-level pedicle screw fixation were included in the study. Three raters independently evaluated pre- and postoperative standing lateral plain radiographs. For each radiograph, several definitions of TK were measured as well as L1-S1 and nonfixed lumbar lordosis. All...

  12. Analysis of cervical kyphosis and spinal balance in young idiopathic scoliosis patients classified by the apex of thoracic kyphosis.

    Science.gov (United States)

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

    2016-10-01

    Sagittal balance has recently been the focus of studies aimed at understanding the correction force required for both coronal and sagittal malalignment. However, the correlation between cervical kyphosis and sagittal balance in AIS patients has yet to be thoroughly investigated. This study aimed to clarify the correlation between cervical alignment and spinal balance in patients with adolescent idiopathic scoliosis (AIS). Here, we hypothesized that cervical kyphosis patients can be classified into groups by the apex of thoracic kyphosis. This study included 92 AIS patients (84 females, 8 males; mean age, 15.1 years). Patients were divided into the cervical lordosis (CL), cervical sigmoid (CS), or cervical kyphosis (CK) groups and further classified according to the apex of thoracic kyphosis into High (above T3), Middle (T4-T9), and Low (below T10) groups. There were 17 (18.5 %), 22 (23.9 %), and 53 (57.6 %) patients with CL, CS, and CK, respectively. In the CK group, 13 had CK-High, 35 had CK-Middle, and 5 had CK-Low. The C7 sagittal vertical axis (C7SVA) measurements were most backward in CK-High and most forward in CK-Low. The T5-12 kyphosis (TK) measurement was significantly lower in CK-High. Most AIS patients had kyphotic cervical alignment. Patients with CK can be classified as having CK-High, CK-Middle, or CK-Low according to the apex of thoracic kyphosis. CK-High is due to thoracic hypokyphosis with a backward balanced C7SVA. CK-Middle is well-balanced cervical kyphosis. CK-Low has forward-bent global kyphosis of the cervicothoracic spine that positioned the C7SVA forward.

  13. Behavior of scoliosis during growth in children with osteogenesis imperfecta.

    Science.gov (United States)

    Anissipour, Alireza K; Hammerberg, Kim W; Caudill, Angela; Kostiuk, Theodore; Tarima, Sergey; Zhao, Heather Shi; Krzak, Joseph J; Smith, Peter A

    2014-02-05

    Spinal deformities are common in patients with osteogenesis imperfecta, a heritable disorder that causes bone fragility. The purpose of this study was to describe the behavior of spinal curvature during growth in patients with osteogenesis imperfecta and establish its relationship to disease severity and medical treatment with bisphosphonates. The medical records and radiographs of 316 patients with osteogenesis imperfecta were retrospectively reviewed. The severity of osteogenesis imperfecta was classified with the modified Sillence classification. Serial curve measurements were recorded throughout the follow-up period for each patient with scoliosis. Regression analysis was used to determine the effect of disease severity (Sillence type), patient age, and bisphosphonate treatment on the progression of scoliosis as measured with the Cobb method. Of the 316 patients with osteogenesis imperfecta, 157 had associated scoliosis, a prevalence of 50%. Scoliosis prevalence (68%) and mean progression rate (6° per year) were the highest in the group of patients with the most severe osteogenesis imperfecta (modified Sillence type III). A group with intermediate osteogenesis imperfecta severity, modified Sillence type IV, demonstrated intermediate scoliosis values (54%, 4° per year). The patient group with the mildest form of osteogenesis imperfecta, modified Sillence type I, had the lowest scoliosis prevalence (39%) and rate of progression (1° per year). Early treatment-before the patient reached the age of six years-of type-III osteogenesis imperfecta with bisphosphonate therapy decreased the curve progression rate by 3.8° per year, which was a significant decrease. Bisphosphonate treatment had no demonstrated beneficial effect on curve behavior in patients with other types of osteogenesis imperfecta or in patients of older age. The prevalence of scoliosis in association with osteogenesis imperfecta is high. Progression rates of scoliosis in children with osteogenesis

  14. Idiopathic scoliosis, growth zones, magnetic therapy.

    Science.gov (United States)

    Arsenev, A; Dudin, M; Lednev, V; Belova, N; Mikhailov, V; Sokolov, G

    2012-01-01

    The study has been performed to investigate the influence of pulsed magnetic field on the bone growth plates to get new grounds of magneto therapy in AIS treatment. Were used methods of "strong" and "weak" pulsed magnetic fields influence. Application of pulsed magnetic field causes an authentic inhibition of chondrocytes' active proliferation processes, decreases the index of labeled nuclei, indicating the suppression of DNA synthesis, takes place an increase in the unit weight of the more "mature" differentiated chondrocytes. The final result of these effects is the accelerated synostosis of bones' growth plates. Regardless of the reasons that cause growth infringements, the operating organ in the chain is the body's growth plate. Therefore, the appliance of magnetic fields in AIS treatment can be considered as a perspective one concerning growth plates' functional activity local management. To our point of view, the potential of magneto therapy methods in child's orthopedic treatment is significantly higher compared with modern practice.

  15. SNAP and AI Fuel Summary Report

    International Nuclear Information System (INIS)

    Lords, R.E.

    1994-08-01

    The SNAP and AI Fuel Summary Report provides a detailed overview of treatment and storage of these fuels from fabrication through current storage including design parameters and reactor history. Chemical and physical characteristics are described, and potential indicators of as-stored fuel conditions are emphasized

  16. Ogilvie′s syndrome following posterior spinal arthrodesis for scoliosis

    Directory of Open Access Journals (Sweden)

    Athanasios I Tsirikos

    2013-01-01

    Full Text Available We report Ogilvie′s syndrome following posterior spinal arthrodesis on a patient with thoracic and lumbar scoliosis associated with intraspinal anomalies. Postoperative paralytic ileus can commonly complicate scoliosis surgery. Ogilvie′s syndrome as a cause of abdominal distension and pain has not been reported following spinal deformity correction and can mimic post-surgical ileus. 12 year old female patient with double thoracic and lumbar scoliosis associated with Arnold-Chiari 1 malformation and syringomyelia. The patient underwent posterior spinal fusion from T 4 to L 3 with segmental pedicle screw instrumentation and autogenous iliac crest grafting. She developed abdominal distension and pain postoperatively and this deteriorated despite conservative management. Repeat ultrasounds and abdominal computer tomography scans ruled out mechanical obstruction. The clinical presentation and blood parameters excluded toxic megacolon and cecal volvulus. As the symptoms persisted, a laparotomy was performed on postoperative day 16, which demonstrated ragged tears of the colon and cecum. A right hemi-colectomy followed by ileocecal anastomosis was required. The pathological examination of surgical specimens excluded inflammatory bowel disease and vascular abnormalities. The patient made a good recovery following bowel surgery and at latest followup 3.2 years later she had no abdominal complaints and an excellent scoliosis correction. Ogilvie′s syndrome should be included in the differential diagnosis of postoperative ileus in patients developing prolonged unexplained abdominal distension and pain after scoliosis correction. Early diagnosis and instigation of conservative management can prevent major morbidity and mortality due to bowel ischemia and perforation.

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

    Science.gov (United States)

    Sud, Alok; Tsirikos, Athanasios I

    2013-03-01

    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.

  18. How Is Pulmonary Function and Exercise Tolerance Affected in Patients With AIS Who Have Undergone Spinal Fusion?

    Science.gov (United States)

    Jeans, Kelly A; Lovejoy, John F; Karol, Lori A; McClung, Anna M

    2017-11-01

    Prospectively enrolled AIS patients who underwent spinal fusion, with 2 year follow-up. To evaluate the cardiovascular fitness and activity level in patients with AIS pre- and post-spinal fusion and to determine if initial curve magnitude or pulmonary function is predictive of exercise capacity. Researchers have tried to link pulmonary function testing (PFT) to exercise capacity; the results are mixed. Some report no improvement in PFTs or aerobic activity after surgical correction, and PFT measures were not predictive of exercise capacity. Conflicting results have shown Vo 2max results to fall within normal range in AIS patients while PFTs show minimal impairment. AIS patients underwent PFT and oxygen consumption (VO 2 ) testing during a submaximal graded exercise test (GXT) pre- and post-spinal fusion. Vo 2max was predicted in those patients who completed the test to 85% of maximal heart rate. Pre- to postoperative changes were assessed and then compared to age-matched control subjects. Correlations between Vo 2max and curve severity, pulmonary function, and activity level were assessed. Thirty-seven patients participated. Vo 2max was predicted in 23 patients pre- and postoperation. There was a significant reduction in Vo 2max postfusion (39.5 ± 6.5 mL/kg/min vs 42.1 ± 8.1 mL/kg/min, p = .033); however, compared with controls (40.5 ± 6.5 mL/kg/min), all data were within the normal range (p > .05). AIS patients reporting high activity had significantly greater Vo 2max than those reporting low activity both pre and postoperatively, but this difference only met statistical significance preop (p .05). Vo 2max in patients with AIS is within normal range both pre- and postfusion. Pulmonary limitations are accommodated for with a slightly increased breathing rate and a slightly reduced overall workload. Activity level rather than curve severity affects Vo 2max outcomes following fusion in AIS. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc

  19. Sagittal curve and high metal density in adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Fabio Araújo Fernandes

    2014-01-01

    Full Text Available Objectives: To analyze radiographically the postoperative kyphosis from patients undergoing surgical treatment for AIS with pedicle screws in all vertebrae included in the arthrodesis. Methods: Retrospective study. The following measurements were evaluated: Cobb angle in anteroposterior radiograph of the three curves (proximal thoracic, main thoracic, and lumbar, Cobb angle in the lateral view of the two curves: thoracic kyphosis (T5-T12 and lumbar lordosis (T12-S1. Results: Of the 25 patients evaluated preoperatively, four (16% were hypokyphotic, 20 patients (80% were normokyphotic and only one (4% was hyperkyphotic. For hypokyphotic and hiperkyphotic patients a satisfactory correction of thoracic kyphosis was obtained in 100% of cases, which was preserved in the final result. The same pattern of thoracic kyphosis was observed for all normokyphotic patients throughout the follow-up. Conclusion: Radiographic evaluation of thoracic kyphosis in patients with AIS treated surgically with pedicle screws in all vertebrae showed satisfactory results with respect to the correction of thoracic kyphosis.

  20. Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

    Science.gov (United States)

    Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

    2005-10-15

    Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

  1. [Treatment of juvenile scoliosis: Increasing the lengthening interval with the growing rod technique should not necessarily compromise thoracic growth].

    Science.gov (United States)

    Pizones, J; Rodríguez-López, T; Zúñiga, L; Sánchez-Mariscal, F; Álvarez-González, P; Izquierdo, E

    2014-01-01

    Serial lengthening with growing rods is recommended every six months for the treatment of early onset scoliosis. The objective of this study was to evaluate the longitudinal growth of the thorax and control of the deformity in a series of patients with juvenile scoliosis when time intervals were increased between lengthenings. Retrospective study of eight patients. The following variables were measured: the Cobb angle, the apical vertebral translation, the coronal balance, thoracic T1-L1 length, thoracic T5-T12 kyphosis, the proximal junctional kyphosis (PJK) angle, and the lumbar lordosis. Complications were recorded. Five idiopathic and three syndromic scoliosis cases (mean age 9.4 ± 1.5 years) were evaluated. The initial surgery was followed by with an average of two distractions per patient. The mean time between distractions was 15.7 months. The final coronal main curve correction was 58%. Apical translation and coronal balance were improved and maintained after the surgeries. The thoracic (T1-L1) preoperative length was 20.8 cm, the postoperative length was 24.4 cm, and the final length was 26 cm. At the end of follow-up, the average growth of the thorax was 5.2 cm. The preoperative (T5-T12) kyphosis was 33.5°, and final 32.1°. The change in the PJK angle was 2.5° at the end of follow-up. Most complications were related to instrumentation. Two superficial wound infections were encountered. For less severe juvenile scoliosis patients treated with growing rods, spacing out lengthenings over more than a year can decrease the number of surgeries, while still controlling the deformity and allowing longitudinal thoracic growth. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  2. Spinal penetration index assessment in adolescent idiopathic scoliosis using EOS low-dose biplanar stereoradiography.

    Science.gov (United States)

    Ilharreborde, Brice; Dubousset, Jean; Skalli, Wafa; Mazda, Keyvan

    2013-11-01

    The spinal penetration index (SPI) quantifies the portion of the rib cage occupied by vertebrae. When measured by computed tomography (CT) or magnetic resonance imaging, SPI can only be determined in the reclining position, which modifies spinal and thoracic morphology. CT results in high radiation exposure. The authors studied rib cage and spinal morphology using low-dose biplanar stereoradiography and their impact on respiratory function in adolescent idiopathic scoliosis (AIS). In eighty thoracic AIS patients, a slot-scanning radiologic device allowing simultaneous acquisition of orthogonal images and 3D reconstructions with low exposure to radiation (EOS) was used to determine thoracic volume, mean spinal penetration index (SPIm), apical spinal penetration index (SPIa), main thoracic (MT) curve Cobb angle, T4-T12 kyphosis, and apical vertebral rotation (AVR). Thoracic volume was correlated with thoracic kyphosis (r = 0.31, p = 0.006), but not with SPI, MT Cobb angle, or AVR. SPIm and SPIa were negatively correlated with thoracic kyphosis. Forced vital capacity and forced expiratory volume in 1 s were significantly lower in the hypokyphotic patients (p = 0.04, p = 0.03, respectively) and correlated with thoracic volume and T4-T12 kyphosis. No correlation was found between spinal penetration indices and pulmonary function tests, but SPIm was significantly greater in patients with obstructive syndrome (p = 0.01). With little radiation exposure, EOS biplanar stereoradiography permits routine imaging is a functional standing position. Hypokyphotic patients had significantly decreased FEV1 and FVC. SPIm was significantly higher in patients with obstructive syndrome.

  3. Intraspinal canal rod migration causing late-onset paraparesis 8 years after scoliosis surgery.

    Science.gov (United States)

    Obeid, Ibrahim; Vital, Jean-Marc; Aurouer, Nicolas; Hansen, Steve; Gangnet, Nicolas; Pointillart, Vincent; Gille, Olivier; Boissiere, Louis; Quraishi, Nasir A

    2016-07-01

    Complete intraspinal canal rod migration with posterior bone reconstitution has never been described in the adolescent idiopathic scoliosis (AIS) population. We present an unusual but significant delayed neurological complication after spinal instrumentation surgery. A 24-year-old woman presented with lower limb weakness (ASIA D) 8 years after posterior instrumentation from T2 to L4 for AIS. CT scan and MRI demonstrated intra-canal rod migration with complete laminar reconstitution. The C-reactive protein was slightly elevated (fluctuated between 10 and 20 mg/l). Radiographs showed the convex rod had entered the spinal canal. The patient was taken into the operating room for thoracic spinal decompression and removal of the convex rod. This Cotrel-Dubousset rod, which had been placed on the convexity of the thoracic curve had completely entered the canal from T5 to T10 and was totally covered by bone with the eroded laminae entirely healed and closed. There was no pseudarthrosis. Intra-operatively, the fusion mass was opened along the whole length of this rod and the rod carefully removed and the spinal cord decompressed. The bacteriological cultures returned positive for Propionibacterium acnes. The patient recovered fully within 2 months post-operatively. We opine that the progressive laminar erosion with intra-canal rod migration resulted from mechanical and infectious-related factors. The very low virulence of the strain of Propionibacterium acnes is probably involved in this particular presentation where the rod was trapped in the canal, owing to the quite extensive laminar reconstitution.

  4. Pathologies of AI: Responsible use of artificial intelligence in professional work

    NARCIS (Netherlands)

    Stamper, R.K.

    1988-01-01

    Although the AI paradigm is useful for building knowledge-based systems for the applied natural sciences, there are dangers when it is extended into the domains of business, law and other social systems. It is misleading to treat knowledge as a commodity that can be separated from the context in

  5. Scoliosis and Syringomyelia With Chiari Malformation After Lumbar Shunting

    Directory of Open Access Journals (Sweden)

    Hsin-Hung Chen

    2010-07-01

    Full Text Available Unsteady gait was noted in a 2-year-old boy with a lumboperitoneal (LP shunt that had been inserted 1 year earlier for increased head circumference caused by communicating hydrocephalus. Scoliosis was also noted during postoperative follow-up. Magnetic resonance imaging revealed new hindbrain tonsillar herniation and an extensive syrinx from C3 to L1. The malfunctioning LP shunt was removed and posterior fossa decompression with ventriculoperitoneal shunt insertion was performed. The unsteady gait recovered completely and scoliosis improved. Magnetic resonance imaging demonstrated resolution of the syrinx and tonsillar herniation. Acquired Chiari I malformation after LP shunt is well documented; usually, patients have no symptoms. This is the first report to have all the cause and effect mechanisms among syringomyelia, scoliosis and Chiari I malformation in 1 patient. We review the literature and discuss the possible mechanisms.

  6. The BSM-AI project: SUSY-AI-generalizing LHC limits on supersymmetry with machine learning

    Energy Technology Data Exchange (ETDEWEB)

    Caron, Sascha [Radboud Universiteit, Institute for Mathematics, Astro- and Particle Physics IMAPP, Nijmegen (Netherlands); Nikhef, Amsterdam (Netherlands); Kim, Jong Soo [UAM/CSIC, Instituto de Fisica Teorica, Madrid (Spain); Rolbiecki, Krzysztof [UAM/CSIC, Instituto de Fisica Teorica, Madrid (Spain); University of Warsaw, Faculty of Physics, Warsaw (Poland); Ruiz de Austri, Roberto [IFIC-UV/CSIC, Instituto de Fisica Corpuscular, Valencia (Spain); Stienen, Bob [Radboud Universiteit, Institute for Mathematics, Astro- and Particle Physics IMAPP, Nijmegen (Netherlands)

    2017-04-15

    A key research question at the Large Hadron Collider is the test of models of new physics. Testing if a particular parameter set of such a model is excluded by LHC data is a challenge: it requires time consuming generation of scattering events, simulation of the detector response, event reconstruction, cross section calculations and analysis code to test against several hundred signal regions defined by the ATLAS and CMS experiments. In the BSM-AI project we approach this challenge with a new idea. A machine learning tool is devised to predict within a fraction of a millisecond if a model is excluded or not directly from the model parameters. A first example is SUSY-AI, trained on the phenomenological supersymmetric standard model (pMSSM). About 300, 000 pMSSM model sets - each tested against 200 signal regions by ATLAS - have been used to train and validate SUSY-AI. The code is currently able to reproduce the ATLAS exclusion regions in 19 dimensions with an accuracy of at least 93%. It has been validated further within the constrained MSSM and the minimal natural supersymmetric model, again showing high accuracy. SUSY-AI and its future BSM derivatives will help to solve the problem of recasting LHC results for any model of new physics. SUSY-AI can be downloaded from http://susyai.hepforge.org/. An on-line interface to the program for quick testing purposes can be found at http://www.susy-ai.org/. (orig.)

  7. The BSM-AI project: SUSY-AI-generalizing LHC limits on supersymmetry with machine learning

    International Nuclear Information System (INIS)

    Caron, Sascha; Kim, Jong Soo; Rolbiecki, Krzysztof; Ruiz de Austri, Roberto; Stienen, Bob

    2017-01-01

    A key research question at the Large Hadron Collider is the test of models of new physics. Testing if a particular parameter set of such a model is excluded by LHC data is a challenge: it requires time consuming generation of scattering events, simulation of the detector response, event reconstruction, cross section calculations and analysis code to test against several hundred signal regions defined by the ATLAS and CMS experiments. In the BSM-AI project we approach this challenge with a new idea. A machine learning tool is devised to predict within a fraction of a millisecond if a model is excluded or not directly from the model parameters. A first example is SUSY-AI, trained on the phenomenological supersymmetric standard model (pMSSM). About 300, 000 pMSSM model sets - each tested against 200 signal regions by ATLAS - have been used to train and validate SUSY-AI. The code is currently able to reproduce the ATLAS exclusion regions in 19 dimensions with an accuracy of at least 93%. It has been validated further within the constrained MSSM and the minimal natural supersymmetric model, again showing high accuracy. SUSY-AI and its future BSM derivatives will help to solve the problem of recasting LHC results for any model of new physics. SUSY-AI can be downloaded from http://susyai.hepforge.org/. An on-line interface to the program for quick testing purposes can be found at http://www.susy-ai.org/. (orig.)

  8. A new look at the etiopathogenesis ofadolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Maciej Brzęczek

    2016-06-01

    Full Text Available Adolescent idiopathic scoliosis is the most common form of spinal deformity in children. The aetiology of the condition has not been elucidated. Currently, the multifactorial theory seems to be the most probable. Certain authors propose that melatonin should be considered as a causative factor of adolescent idiopathic scoliosis. Their assumption is supported by a range of research studies conducted on animal models with removed pineal gland, which induced scoliosis. Melatonin has been proven to exert direct and indirect effects on the development of the skeletal system. The role of calmodulin or osteoprotegerin seems equally important. In patients with this condition, the levels of platelet calmodulin and calmodulin in the specimens of the paraspinal muscles on the convex side of the curve have been shown to rise. Osteoprotegerin, in turn, modifies osteoclastic and osteoblastic differentiation. These substances have a direct influence on the cellular calcium and phosphate metabolism and can be potentially responsible for spinal deformity in adolescents. The role of oestrogens is being investigated. Moreover, the role of growth factors or thrombospondins still remains obscure. Additionally, molecular tests have revealed a number of genes that can predispose to adolescent idiopathic scoliosis. It still needs to be determined which of the musculoskeletal disorders occur first in the development of scoliosis and which are secondary to the deformity. The identification of the aetiological factor and factors responsible for scoliosis progression determines the manner of treatment.

  9. 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.

  10. Late-onset superior mesenteric artery syndrome four years following scoliosis surgery – a case report

    Directory of Open Access Journals (Sweden)

    Abol Oyoun Nariman

    2015-01-01

    Full Text Available Background: Superior mesenteric artery (SMA syndrome has been reported as an uncommon condition of external vascular compression of the SMA particularly after rapid weight loss, body casts, or after corrective surgery for spinal deformities, usually within the first few weeks after surgery. Methods: This is a retrospective report of a case of a non-verbal autistic female patient who started to develop SMA syndrome at the age of 16, 4 years after posterior spinal fusion surgery for scoliosis. She was treated conservatively by increasing oral caloric intake, which resulted in increased body weight and relief of symptoms. Results: Seen at 10 years’ follow up, the patient is doing well, and is functional within the limits of her suboptimal cognitive and verbal conditions. She maintains good trunk balance with solid spinal fusion and intact instrumentation at latest follow up. Conclusion: Spinal surgeons should maintain a high index of suspicion for diagnosis of SMA syndrome even years after scoliosis surgery, especially for patients with communication problems, like the case we present here. Appropriate conservative measures can succeed in relieving the symptoms, increasing body weight, and preventing complications including the risk of death.

  11. Changes in cardiac index and blood pressure on positioning children prone for scoliosis surgery.

    Science.gov (United States)

    Brown, Z E; Görges, M; Cooke, E; Malherbe, S; Dumont, G A; Ansermino, J M

    2013-07-01

    In this prospective observational study we investigated the changes in cardiac index and mean arterial pressure in children when positioned prone for scoliosis correction surgery. Thirty children (ASA 1-2, aged 13-18 years) undergoing primary, idiopathic scoliosis repair were recruited. The cardiac index and mean arterial blood pressure (median (IQR [range])) were 2.7 (2.3-3.1 [1.4-3.7]) l.min(-1).m(-2) and 73 (66-80 [54-91]) mmHg, respectively, at baseline; 2.9 (2.5-3.2 [1.7-4.4]) l.min(-1).m(-2) and 73 (63-81 [51-96]) mmHg following a 5-ml.kg(-1) fluid bolus; and 2.5 (2.2-2.7 [1.4-4.8]) l.min(-1).m(-2) and 69 (62-73 [46-85]) mmHg immediately after turning prone. Turning prone resulted in a median reduction in cardiac index of 0.5 l.min(-1).m(-2) (95% CI 0.3-0.7 l.min(-1).m(-2), p=0.001), or 18.5%, with a large degree of inter-subject variability (+10.3% to -40.9%). The changes in mean arterial blood pressure were not significant. Strategies to predict, prevent and treat decreases in cardiac index need to be developed. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  12. Assessment of Coronal Radiographic Parameters of the Spine in the Treatment of Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Karami, Mohsen; Maleki, Arash; Mazda, Keyvan

    2016-10-01

    To determine the most important preoperative factors that affect postoperative coronal parameters of scoliotic curves. All Adolescent Idiopathic Scoliosis (AIS) patients included in the study were classified according to Lenke and King Classification. The fusion levels were selected according to the rigidity of the existing curves (correction less than 50%), tilt of T1 and shoulders, sagittal angle of the curves and with considering stable and neutral end vertebra. The radiographic coronal parameters: shoulders tilt angle, iliolumbar angle and coronal balance were measured in all patients before, after, and in the last follow-up visit. One hundred twenty patients after mean of 25 months follow-up (18-40 months) were included in the study. Before operation, abnormal coronal balance (more than 2 cm shift) was noticed in 46 patents (38%) and in the last visit, was noted in 22 patients (18%). Multivariate regression analysis revealed a significant predictive value of the preoperative coronal balance on the last visit coronal balance ( P value=0.01). Preoperative coronal balance is very important to make a balanced spine after surgery. Other parameters like Lenke classification or main thoracic overcorrection did not affect postoperative coronal decompensation.

  13. Bluetooth wireless database for scoliosis clinics.

    Science.gov (United States)

    Lou, E; Fedorak, M V; Hill, D L; Raso, J V; Moreau, M J; Mahood, J K

    2003-05-01

    A database system with Bluetooth wireless connectivity has been developed so that scoliosis clinics can be run more efficiently and data can be mined for research studies without significant increases in equipment cost. The wireless database system consists of a Bluetooth-enabled laptop or PC and a Bluetooth-enabled handheld personal data assistant (PDA). Each patient has a profile in the database, which has all of his or her clinical history. Immediately prior to the examination, the orthopaedic surgeon selects a patient's profile from the database and uploads that data to the PDA over a Bluetooth wireless connection. The surgeon can view the entire clinical history of the patient while in the examination room and, at the same time, enter in any new measurements and comments from the current examination. After seeing the patient, the surgeon synchronises the newly entered information with the database wirelessly and prints a record for the chart. This combination of the database and the PDA both improves efficiency and accuracy and can save significant time, as there is less duplication of work, and no dictation is required. The equipment required to implement this solution is a Bluetooth-enabled PDA and a Bluetooth wireless transceiver for the PC or laptop.

  14. The natural history of adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Wong Hee-Kit

    2010-01-01

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

  15. Segmental vs non-segmental thoracic pedicle screws constructs in adolescent idiopathic scoliosis: is there any implant alloy effect?

    Science.gov (United States)

    Di Silvestre, Mario; Bakaloudis, Georgeous; Ruosi, Carlo; Pipola, Valerio; Colella, Gianluca; Greggi, Tiziana; Ruffilli, Alberto; Vommaro, Francesco

    2017-10-01

    The aim of this study is to understand how many anchor sites are necessary to obtain maximum posterior correction of idiopathic scoliotic curve and if the alloy of instrumentation, stainless steel or titanium, may have a role in the percent of scoliosis correction. We reviewed 143 consecutive patients, affected by AIS (Lenke 1-2), who underwent a posterior spinal fusion with pedicle screw-only instrumentation between 2002 and 2005. According to the implant density and alloy used we divided the cohort in four groups. All 143 patients were reviewed at an average follow-up of 7, 2 years, the overall final main thoracic curve correction averaged 61.4%, whereas the implant density within the major curve averaged 71%. A significant correlation was observed between final% MT correction and preoperative MT flexibility and implant density. When stainless steel instrumentation is used non-segmental pedicle screw constructs seem to be equally effective as segmental instrumentations in obtaining satisfactory results in patients with main thoracic AIS. When the implant alloy used is titanium one, an implant density of ≥60% should be guaranteed to achieve similar results.

  16. Launching AI in NASA ground systems

    Science.gov (United States)

    Perkins, Dorothy C.; Truszkowski, Walter F.

    1990-01-01

    This paper will discuss recent operational successes in implementing expert systems to support the complex functions of NASA mission control systems at the Goddard Space Flight Center, including fault detection and diagnosis for real time and engineering analysis functions in the Cosmic Background Explorer and Gamma Ray Observatory missions and automation of resource planning and scheduling functions for various missions. It will also discuss ongoing developments and prototypes that will lead to increasingly sophisticated applications of artificial intelligence. These include the use of neural networks to perform telemetry monitoring functions, the implementation of generic expert system shells that can be customized to telemetry handling functions specific to NASA control centers, the applications of AI in training and user support, the long-term potential of implementing systems based around distributed, cooperative problem solving, and the use of AI to control and assist system development activities.

  17. AI systems approach in particle accelerators

    International Nuclear Information System (INIS)

    Kataria, S.K.; Bhagwat, P.V.; Kori, S.A.

    1992-01-01

    The large particle accelerators machines like pelletron accelerator at Tata Institute of Fundamental Research (T.I.F.R) have several levels of controls with operators responsible for overall global control decisions and closed loop feedback controllers for relatively small subsystems of the machines. As the accelerator machines are becoming more complicated and the requirements more stringent, there is a need to provide the operators with an artificial intelligence (AI) system to aid in the tuning the machine and in failure diagnosis. There are few major areas in the pelletron operation, which can be done more efficiently using AI systems approach so that useful beam is available for much more time: 1) Accelerator Conditioning, 2) Accelerator Tuning, and 3) Maintaining the Tune beams. The feasibility study for using expert system for above areas and also for safety evaluation of the various subsystems is carried out. (author). 10 refs., 4 figs

  18. Deploying Embodied AI into Virtual Worlds

    Science.gov (United States)

    Burden, David J. H.

    The last two years have seen the start of commercial activity within virtual worlds. Unlike computer games where Non-Player-Character avatars are common, in most virtual worlds they are the exception — and until recently in Second Life they were non-existent. However there is real commercial scope for Als in these worlds — in roles from virtual sales staff and tutors to personal assistants. Deploying an embodied AI into a virtual world offers a unique opportunity to evaluate embodied Als, and to develop them within an environment where human and computer are on almost equal terms. This paper presents an architecture being used for the deployment of chatbot driven avatars within the Second Life virtual world, looks at the challenges of deploying an AI within such a virtual world, the possible implications for the Turing Test, and identifies research directions for the future.

  19. Managing bioengineering complexity with AI techniques.

    Science.gov (United States)

    Beal, Jacob; Adler, Aaron; Yaman, Fusun

    2016-10-01

    Our capabilities for systematic design and engineering of biological systems are rapidly increasing. Effectively engineering such systems, however, requires the synthesis of a rapidly expanding and changing complex body of knowledge, protocols, and methodologies. Many of the problems in managing this complexity, however, appear susceptible to being addressed by artificial intelligence (AI) techniques, i.e., methods enabling computers to represent, acquire, and employ knowledge. Such methods can be employed to automate physical and informational "routine" work and thus better allow humans to focus their attention on the deeper scientific and engineering issues. This paper examines the potential impact of AI on the engineering of biological organisms through the lens of a typical organism engineering workflow. We identify a number of key opportunities for significant impact, as well as challenges that must be overcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The Potential of AI Techniques for Remote Sensing

    Science.gov (United States)

    Estes, J. E.; Sailer, C. T. (Principal Investigator); Tinney, L. R.

    1984-01-01

    The current status of artificial intelligence AI technology is discussed along with imagery data management, database interrogation, and decision making. Techniques adapted from the field of artificial intelligence (AI) have significant, wide ranging impacts upon computer-assisted remote sensing analysis. AI based techniques offer a powerful and fundamentally different approach to many remote sensing tasks. In addition to computer assisted analysis, AI techniques can also aid onboard spacecraft data processing and analysis and database access and query.

  1. AI in space: Past, present, and possible futures

    Science.gov (United States)

    Rose, Donald D.; Post, Jonathan V.

    1992-01-01

    While artificial intelligence (AI) has become increasingly present in recent space applications, new missions being planned will require even more incorporation of AI techniques. In this paper, we survey some of the progress made to date in implementing such programs, some current directions and issues, and speculate about the future of AI in space scenarios. We also provide examples of how thinkers from the realm of science fiction have envisioned AI's role in various aspects of space exploration.

  2. Direct vertebral body derotation, thoracoplasty, or both: which is better with respect to inclinometer and scoliosis research society-22 scores?

    Science.gov (United States)

    Samdani, Amer F; Hwang, Steven W; Miyanji, Firoz; Lonner, Baron; Marks, Michelle C; Sponseller, Paul D; Newton, Peter O; Cahill, Patrick J; Shufflebarger, Harry L; Betz, Randal R

    2012-06-15

    Prospective, longitudinal cohort (nonrandomized). To compare thoracoplasty (Th), direct vertebral body derotation (DVBD), and Th and DVBD with respect to correction of the rib prominence and Scoliosis Research Society (SRS) self-image scores in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Rib prominence correction is one of the main goals of AIS surgery. Th and DVBD are powerful tools for correction of the rib prominence; however, a paucity of literature exists comparing Th, DVBD, and Th and DVBD. A prospective longitudinal database was queried to identify patients with AIS who underwent a posterior spinal fusion with pedicle screws and 2 years of follow-up. A total of 326 patients were identified and divided into 3 groups: (1) Th alone (N = 47), (2) DVBD alone (N = 196), and (3) both Th and DVBD (N = 83). Patients were subdivided into categories on the basis of their preoperative inclinometer reading: (1) ≤9° (mild), (2) 10 to 15° (moderate), and (3) ≥ 16° (severe). Pre- and postoperative inclinometer readings and SRS self-image scores were compared using analysis of variance. Overall, the groups were similar preoperatively except for the DVBD group having higher percentage of thoracic flexibility. The preoperative rib prominence values were Th = 13.2, DVBD = 14.0, and Th and DVBD = 12.9 (P = 0.27). Taken collectively, the postoperative 2-year inclinometer readings were similar for all 3 groups (Th = 5.2, DVBD = 7.0, Th and DVBD = 5.6; P = 0.66). However, the SRS-22 self-image scores were significantly better for patients having both Th and DVBD (Th = 3.37, DVBD = 3.44, Th and DVBD = 3.76; P self-image scores were highest in the Th and DVBD group. In patients with larger rib prominences, the addition of Th was necessary for optimal rib prominence correction, but there was no difference in SRS-22 self-image scores. Our results suggest that Th alone, DVBD alone, or both Th and DVBD provide equivalent inclinometer results in patients

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

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

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

  4. Discriminative and predictive validity of the scoliosis research society-22 questionnaire in management and curve-severity subgroups of adolescents with idiopathic scoliosis.

    Science.gov (United States)

    Parent, Eric C; Hill, Doug; Mahood, Jim; Moreau, Marc; Raso, Jim; Lou, Edmond

    2009-10-15

    Prospective cross-sectional measurement study. To determine the ability of the Scoliosis Research Society (SRS)-22 questionnaire to discriminate among management and scoliosis severity subgroups and to correlate with internal and external measures of curve severity. In earlier studies of the SRS-22 discriminative ability, age was not a controlled factor. The ability of the SRS-22 to predict curve severity has not been thoroughly examined. The SRS-22 was completed by 227 females with adolescent idiopathic scoliosis. Using Analysis of covariance analyses controlling for age, the SRS-22 scores were compared among management subgroups (observation, brace, presurgery, and postsurgery) and curve-severity subgroups (in nonoperated subjects: Cobb angles of 50 degrees). A stepwise discriminant analysis was used to identify the SRS-22 domains most discriminative for curve-severity categories. Correlation between SRS-22 scores and radiographic or surface topography measurements was used to determine the predictive ability of the questionnaire. Pain was better for subjects treated with braces than for those planning surgery. Self-image was better for subjects under observation or postsurgery than for those planning surgery. Satisfaction was better for the brace and postsurgery subgroups than for the observation or presurgery subgroups. Statistically significant mean differences between subgroups were all larger than 0.5, which is within the range of minimal clinically important differences recommended for each of the 5-point SRS-22 domain scoring scales. Pain and mental health were worse for those with Cobb angles of >50 degrees than with Cobb angles of 30 degrees to 50 degrees. Self-image and total scores were worse for those with Cobb angles of >50 degrees than both other subgroups. Using discriminant analysis, self-image was the only SRS-22 domain score selected to classify subjects within curve severity subgroups. The percentage of patients accurately classified was 54

  5. SDI satellite autonomy using AI and Ada

    Science.gov (United States)

    Fiala, Harvey E.

    1990-01-01

    The use of Artificial Intelligence (AI) and the programming language Ada to help a satellite recover from selected failures that could lead to mission failure are described. An unmanned satellite will have a separate AI subsystem running in parallel with the normal satellite subsystems. A satellite monitoring subsystem (SMS), under the control of a blackboard system, will continuously monitor selected satellite subsystems to become alert to any actual or potential problems. In the case of loss of communications with the earth or the home base, the satellite will go into a survival mode to reestablish communications with the earth. The use of an AI subsystem in this manner would have avoided the tragic loss of the two recent Soviet probes that were sent to investigate the planet Mars and its moons. The blackboard system works in conjunction with an SMS and a reconfiguration control subsystem (RCS). It can be shown to be an effective way for one central control subsystem to monitor and coordinate the activities and loads of many interacting subsystems that may or may not contain redundant and/or fault-tolerant elements. The blackboard system will be coded in Ada using tools such as the ABLE development system and the Ada Production system.

  6. Monitoring severe accidents using AI techniques

    International Nuclear Information System (INIS)

    No, Young Gyu; Ahn, Kwang Il; Kim, Ju Hyun; Na, Man Gyun; Lim, Dong Hyuk

    2012-01-01

    After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

  7. Monitoring severe accidents using AI techniques

    Energy Technology Data Exchange (ETDEWEB)

    No, Young Gyu; Ahn, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Ju Hyun; Na, Man Gyun [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Lim, Dong Hyuk [Korea Institute of Nuclear Nonproliferation and Control, Daejon (Korea, Republic of)

    2012-05-15

    After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

  8. Why Don't Accounting Students like AIS?

    Science.gov (United States)

    Vatanasakdakul, Savanid; Aoun, Chadi

    2011-01-01

    Purpose: The demand for Accounting Information Systems (AIS) knowledge has increased exponentially over the past two decades, but studying AIS has not proved easy for many accounting students. The aim of the study is to understand the challenges accounting students face in studying AIS through investigation of the factors which may be contributing…

  9. Dicty_cDB: FC-AI04 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI04 (Link to dictyBase) - - - Contig-U15121-1 FC-AI04E (Li...nk to Original site) - - - - - - FC-AI04E 772 Show FC-AI04 Library FC (Link to library) Clone ID FC-AI04 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI04Q.Seq.d/ Representative seq. ID FC-AI...04E (Link to Original site) Representative DNA sequence >FC-AI04 (FC-AI04Q) /CSM/FC/FC-AI/FC-AI04Q.Seq....qvnkhqqvvtktvsd vlvphqvhnqvfphipqqmtlvnkhqpvvtktvsdvlvphqvhnqvfphtpqlkiqvylq vfqvvvvtiisai

  10. Dicty_cDB: FC-AI10 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI10 (Link to dictyBase) - - - Contig-U16270-1 FC-AI10F (Li...nk to Original site) FC-AI10F 405 - - - - - - Show FC-AI10 Library FC (Link to library) Clone ID FC-AI10 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI10Q.Seq.d/ Representative seq. ID FC-AI...10F (Link to Original site) Representative DNA sequence >FC-AI10 (FC-AI10Q) /CSM/FC/FC-AI/FC-AI10Q.Seq.... sequence RKKRKSDYTSFSTYIHKLLKQITPPTNAKSNEKGDRKFTISSKAMSVMNSFVHDIFDRIA TEASGLAKKKKRQTLHSRDIQVAVRIILTGELAXHAI

  11. Dicty_cDB: FC-AI23 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI23 (Link to dictyBase) - - - Contig-U15308-1 FC-AI23Z (Li...nk to Original site) - - FC-AI23Z 603 - - - - Show FC-AI23 Library FC (Link to library) Clone ID FC-AI23 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI23Q.Seq.d/ Representative seq. ID FC-AI...23Z (Link to Original site) Representative DNA sequence >FC-AI23 (FC-AI23Q) /CSM/FC/FC-AI/FC-AI23Q.Seq....LNTLAKKNEQVVEGEILAKQLTGVTAEELSEFKACFSHFDKDN DNKLNRLEFSSCLKSIGDELTEEQLNQVISKIDTDGNGTISFEEFIDYMVSSRKGTDSVE STKAAFKVMAEDKDFITEAQIRAAI

  12. Dicty_cDB: FC-AI05 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI05 (Link to dictyBase) - - - Contig-U15516-1 FC-AI05E (Li...nk to Original site) - - - - - - FC-AI05E 1189 Show FC-AI05 Library FC (Link to library) Clone ID FC-AI05 (L...//dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI05Q.Seq.d/ Representative seq. ID FC-AI...05E (Link to Original site) Representative DNA sequence >FC-AI05 (FC-AI05Q) /CSM/FC/FC-AI/FC-AI05Q.Seq...KIVGEASLKNKGKMSRVLAAKAALSARFD ALCEVSDTSYGIAYKGAVDRRAAAIEGREVRKSLNAVKPEKSGNVAKYDHTKSATTNTTR DVATKSSKESSIKQEKQ

  13. Dicty_cDB: FC-AI21 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI21 (Link to dictyBase) - - - Contig-U16254-1 FC-AI21Z (Li...nk to Original site) - - FC-AI21Z 696 - - - - Show FC-AI21 Library FC (Link to library) Clone ID FC-AI21 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI21Q.Seq.d/ Representative seq. ID FC-AI...21Z (Link to Original site) Representative DNA sequence >FC-AI21 (FC-AI21Q) /CSM/FC/FC-AI/FC-AI21Q.Seq....YPGYMYTDLSTIYERAGRIQGRNGSITQI PILTMPNDDITHPIPDLTGYITEGQIFIDRQINNRQIYPPINVLPSLSRLMKSAI

  14. Study on AI-2 signaling molecules activity and the effect of matrine on AI-2 in Staphylococcus epidermidis LuxS/AI-2 quorum sensing%产膜表皮葡萄球菌LuxS/AI-2型密度感应系统AI-2的活性及苦参碱对其的影响

    Institute of Scientific and Technical Information of China (English)

    李雪; 何芳; 卢金霞; 管翠萍; 周学章

    2017-01-01

    [Objective] This study investigated the activity of AI-2 signaling molecules in Staphylococcus epidermidis planktonic bacteria and biofilm bacteria and the effect of matrine.[Method] The growth curve of Staphylococcus epidermidis planktonic bacteria and biofilm bacteria was drawn and AI-2 concentration was measured using the V.harveyi bioluminescence assay.The transcription level of luxS gene was analyzed using real-time PCR.The AI-2 signaling molecules of Staphylococcus epidermidis ATCC35984 were treated with matrine and the changes of AI-2 signaling molecules activity were determined.[Result] In Staphylococcus epidermidis planktonic bacteria growth process,AI-2 signaling molecule activity and the relative expression quantity of luxS gene reached the maximum in the logarithmic phase before decreasing gradually.Their change curves were similar with planktonic growth curve.However,in the growth process of Staphylococcus epidermidis biofilm bacteria,the activity trend was similar with the biofilm growth.The relative expression quantity of luxS gene had an opposite trend to biofilm growth.Matrine had inhibitory effect on AI-2 signaling molecule activity in planktonic and biofilm bacteria,and the inhibitory effect was stronger to planktonic bacteria.[Conclusion] AI-2 signaling molecule activity and relative expression quantity of luxS gene highly correlated with the growth of Staphylococcus epidermidis and its biofilm formation.Matrine significantly reduced the AI-2 signaling molecule activity of Staphylococcus epidermidis.%[目的]研究产膜表皮葡萄球菌生物被膜菌和液相浮游菌LuxS/AI-2型密度感应系统中AI-2信号分子的活性及苦参碱对其的影响.[方法]绘制产膜表皮葡萄球菌ATCC35984液相浮游菌及生物被膜菌的生长曲线;利用哈维氏弧菌BB170(Vibrio harveyi BB170)作为报告菌株检测表皮葡萄球菌AI-2信号分子的活性;用荧光定量PCR法检测luxS基因的转录水平;用苦参碱

  15. A regulator's viewpoint on the use of AI in the nuclear industry

    International Nuclear Information System (INIS)

    Wainwright, N.

    1995-01-01

    The regulatory position within the UK places the responsibility for safety on a nuclear site with the licensee. The licensee must produce a safety case that demonstrates that the plant is safe. Assessment of this safety case is performed by the regulator in the Health and Safety Executive (HSE) using HSE's published Safety Assessment Principles. This paper presents the personal views of a regulator on the use of artificial intelligence (AI) in the nuclear industry. The AI-based system considered are restricted to expert systems, neural networks and fuzzy logic. Some of the safety issues are discussed. The particular concerns associated with software-based systems are compounded by some of the inherent problems of AI-based systems. Such is the nature of these concerns that an acceptable safety case will be difficult to mount for safety systems and post-accident monitoring systems. However, given the present maturity of the technology, acceptable safety cases might be formulated in the areas of operator advisory systems designed to reduce accident frequencies, and robotics where dose reduction is important. There are also arguments that suggests that suitable safety cases could be formulated for AI-based plant control systems. Nevertheless, AI-based systems should be treated with caution - further research is required into suitable designs and safety demonstration techniques. (author)

  16. [Analysis of the quality of life in patients affected by scoliosis].

    Science.gov (United States)

    Leal-Hernández, M; Martínez-Monje, F; Pérez-Valencia, M; García-Romero, R; Mena-Poveda, R; Caballero-Cánovas, J

    2017-05-11

    To assess the quality of life using the SRS 22 test in patients with scoliosis of 20 or more degrees Cobb. A prospective descriptive study was conducted between April and May 2016 on patients with scoliosis of at least 20 degrees Cobb and aged between 10 and 20 years. A record was made of weight, height, body mass index, and the SR 22 specific quality of life questionnaire for patients with scoliosis was completed. Patients were divided into two groups for analysis: a) scoliosis between 20 and 29 degrees Cobb (n=44); and b) scoliosis with a Cobb of 30 degrees or greater (n=32). There were significant differences in the dimensions that assess pain, image self-perception, and satisfaction with treatment, being valued worse when the degree of scoliosis Cobb is 30 degrees or higher. There were no significant differences in function/activity or mental health. The overall score of the questionnaire was also worse in the group with the highest degree of scoliosis. The weight, height, and BMI showed no significant differences due to the varying degrees of scoliosis. Scoliosis significantly affects the quality of life of people who suffer it, and there is a negative correlation between the severity of scoliosis measured by degrees Cobb and quality of life. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

    Schlösser, Tom P C; 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

    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. 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. 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%; P<0.001) and lumbar lordosis (+7.8%; P<0.001). For all primary as well as compensatory curves, we observed linear correlations between the coronal Cobb angle, axial rotation and the anterior-posterior length difference (r≥0.729 for thoracic curves; r≥0.485 for (thoraco)lumbar curves). 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

  18. Steel syndrome: dislocated hips and radial heads, carpal coalition, scoliosis, short stature, and characteristic facial features.

    Science.gov (United States)

    Flynn, John M; Ramirez, Norman; Betz, Randal; Mulcahey, Mary Jane; Pino, Franz; Herrera-Soto, Jose A; Carlo, Simon; Cornier, Alberto S

    2010-01-01

    A syndrome of children with short stature, bilateral hip dislocations, radial head dislocations, carpal coalitions, scoliosis, and cavus feet in Puerto Rican children, was reported by Steel et al in 1993. The syndrome was described as a unique entity with dismal results after conventional treatment of dislocated hips. The purpose of this study is to reevaluate this patient population with a longer follow-up and delineate the clinical and radiologic features, treatment outcomes, and the genetic characteristics. This is a retrospective cohort study of 32 patients in whom we evaluated the clinical, imaging data, and genetic characteristics. We compare the findings and quality of life in patients with this syndrome who have had attempts at reduction of the hips versus those who did not have the treatment. Congenital hip dislocations were present in 100% of the patients. There was no attempt at reduction in 39% (25/64) of the hips. In the remaining 61% (39/64), the hips were treated with a variety of modalities fraught with complications. Of those treated, 85% (33/39) remain dislocated, the rest of the hips continue subluxated with acetabular dysplasia and pain. The group of hips that were not treated reported fewer complaints and limitation in daily activities compared with the hips that had attempts at reduction. Steel syndrome is a distinct clinical entity characterized by short stature, bilateral hip and radial head dislocation, carpal coalition, scoliosis, cavus feet, and characteristic facial features with dismal results for attempts at reduction of the hips. Prognostic Study Level II.

  19. 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.

  20. Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

    Directory of Open Access Journals (Sweden)

    Alexander Armstrong

    2013-01-01

    Full Text Available Study Design. A Case Report. Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO. Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine. Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved. Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding. Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

  1. Idiopathic Scoliosis from Psychopathological and Mind-Body Medicine Perspectives.

    Science.gov (United States)

    Talić, Goran; Ostojić, Ljerka; Bursać, Snježana Novaković; Nožica-Radulović, Tatjana; Stevanović-Papić, Đurđica

    2016-12-01

    Idiopathic scoliosis, defined as a three-dimensional spine and trunk deformity, which appears in otherwise healthy subjects, exhibits complex relations with various forms of personal well-being and psychopathology. Most research studies have documented a higher proportion of psychological disturbances (e.g., self-criticism, negative body image, low self-esteem) and mental disorders (e.g., anxiety and depressive disorders, personality disorders) among idiopathc scoliosis patients compared to healthy controls. In addition, there are some reports, although more systematic research is warranted, on the role of mental health and personality traits in relation to the adherence to conservative treatment. Given the increasing role of surgical treatment in the management of scoliosis, as well as several reports on negative psychological outcomes of such interventions, there is a growing need for ongoing screening and mental health care in this population. It seems this also holds true for non-operative treatments, particularly bracing therapy. One should keep in mind that these scoliosis-psychopathology relations are deduced from a limited number of empirical studies, usually conducted on small sample sizes, suggesting the need for further large-scale investigations, preferrably those with longitudinal research designs. Understanding the complex interplay between personality/psychopathology and spinal deformities within the framework of personalized mind-body medicine, should help clinicians tailor more individualized and specific treatments and predict therapeutic outcomes in this clinical population.

  2. 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.)

  3. Do Current Recommendations for Upper Instrumented Vertebra Predict Shoulder Imbalance? An Attempted Validation of Level Selection for Adolescent Idiopathic Scoliosis.

    Science.gov (United States)

    Bjerke, Benjamin T; Cheung, Zoe B; Shifflett, Grant D; Iyer, Sravisht; Derman, Peter B; Cunningham, Matthew E

    2015-10-01

    Shoulder balance for adolescent idiopathic scoliosis (AIS) patients is associated with patient satisfaction and self-image. However, few validated systems exist for selecting the upper instrumented vertebra (UIV) post-surgical shoulder balance. The purpose is to examine the existing UIV selection criteria and correlate with post-surgical shoulder balance in AIS patients. Patients who underwent spinal fusion at age 10-18 years for AIS over a 6-year period were reviewed. All patients with a minimum of 1-year radiographic follow-up were included. Imbalance was determined to be radiographic shoulder height |RSH| ≥ 15 mm at latest follow-up. Three UIV selection methods were considered: Lenke, Ilharreborde, and Trobisch. A recommended UIV was determined using each method from pre-surgical radiographs. The recommended UIV for each method was compared to the actual UIV instrumented for all three methods; concordance between these levels was defined as "Correct" UIV selection, and discordance was defined as "Incorrect" selection. One hundred seventy-one patients were included with 2.3 ± 1.1 year follow-up. For all methods, "Correct" UIV selection resulted in more shoulder imbalance than "Incorrect" UIV selection. Overall shoulder imbalance incidence was improved from 31.0% (53/171) to 15.2% (26/171). New shoulder imbalance incidence for patients with previously level shoulders was 8.8%. We could not identify a set of UIV selection criteria that accurately predicted post-surgical shoulder balance. Further validated measures are needed in this area. The complexity of proximal thoracic curve correction is underscored in a case example, where shoulder imbalance occurred despite "Correct" UIV selection by all methods.

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

    Directory of Open Access Journals (Sweden)

    Terufumi Kokabu

    Full Text Available 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.

  5. The differences in postural reactions between scoliosis and scoliotic posture

    Directory of Open Access Journals (Sweden)

    Jacek Wilczyński

    2017-05-01

    Full Text Available The aim of the research was to demonstrate the differences in amplitudes of postural reactions in girls with scoliotic posture and idiopathic scoliosis. 28 girls aged 7-18 years old were involved in the study. Children attended to the Interschool Centre of Corrective Exercises in Starachowice. The research was conducted in June 2011. Spine research was made by Exhibeon digital radiography. Based on the size of the angle of spinal curvature there were identified: scoliotic posture: 1-9° and scoliosis: ≥10°. Postural reactions were examined by static-dynamic Tecnobody’s ST 310 Plus Stability System platform. There were 21 (75% children with scoliotic posture, and 7 (25% with idiopathic scoliosis. Student's t-test showed a significantly higher postural reactions for scoliosis in relation to scoliotic postures in case of: Average Forward-Backward Speed (OE, (p=0,05, Medium-Lateral Standard Deviation X (CE, (p=0,002, and Ellipse area (CE, (p=0,012. To verify the significant differences, demonstrating the lack of homogeneity of variance, the Mann–Whitney U-test has been used, which showed a significant differences between the scoliotic posture and scoliosis in case of: Medium-Lateral Standard Deviation X (CE, (p=0,0012, Average Forward-Backward Speed (OE, (p=0,0548, and Ellipse area (CE (p=0,0047. Together with an increase of the angle of curvature, the value of these postural reactions also grew. Most of postural reactions didn’t fit the norm.

  6. 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.

  7. Progression of trunk imbalance in adolescent idiopathic scoliosis with a thoracolumbar/lumbar curve: is it predictable at the initial visit?

    Science.gov (United States)

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

    2017-11-01

    OBJECTIVE Progression of trunk imbalance is an important finding during follow-up of patients with adolescent idiopathic scoliosis (AIS). Nevertheless, no factors that predict progression of trunk imbalance have been identified. The purpose of this study was to identify parameters that predict progression of trunk imbalance in cases of AIS with a structural thoracolumbar/lumbar (TL/L) curve. METHODS This study included 105 patients with AIS and a structural TL/L curve who were followed up at an outpatient clinic. Patients with trunk imbalance (trunk shift ≥ 20 mm) at the initial visit were excluded. All patients were followed up for more than 2 years. Patients were divided into the following groups according to progression of trunk imbalance: 1) Group P, trunk shift ≥ 20 mm at the final visit and degree of progression ≥ 10 mm; and 2) Group NP, trunk shift imbalance with progression ≥ 10 mm at the final visit (Group P). Multivariate logistic regression analysis identified a lower Risser grade (p = 0.002) and a greater initial AVR (p = 0.020) as predictors of progressive trunk imbalance. A change in LEV tilt during follow-up was associated with trunk imbalance (p = 0.001). CONCLUSIONS Risser grade and AVR measured at the initial visit may predict progression of trunk imbalance. Surgeons should consider the risk of progressive trunk imbalance if patients show skeletal immaturity and a greater AVR at the initial visit.

  8. Dicty_cDB: FC-AI01 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI01 (Link to dictyBase) - - - Contig-U15592-1 FC-AI01E (Li...nk to Original site) - - - - - - FC-AI01E 307 Show FC-AI01 Library FC (Link to library) Clone ID FC-AI01 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI01Q.Seq.d/ Representative seq. ID FC-AI...01E (Link to Original site) Representative DNA sequence >FC-AI01 (FC-AI01Q) /CSM/FC/FC-AI/FC-AI01Q.Seq....uences producing significant alignments: (bits) Value FC-AI01 (FC-AI01Q) /CSM/FC/FC-AI/FC-AI01Q.Seq.d/ 68 8e

  9. Dicty_cDB: FC-AI13 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI13 (Link to dictyBase) - - - Contig-U16263-1 FC-AI13F (Li...nk to Original site) FC-AI13F 507 - - - - - - Show FC-AI13 Library FC (Link to library) Clone ID FC-AI13 (Li.../dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI13Q.Seq.d/ Representative seq. ID FC-AI...13F (Link to Original site) Representative DNA sequence >FC-AI13 (FC-AI13Q) /CSM/FC/FC-AI/FC-AI13Q.Seq....nificant alignments: (bits) Value FC-AI13 (FC-AI13Q) /CSM/FC/FC-AI/FC-AI13Q.Seq.d/ 963 0.0 VSA730 (VSA730Q)

  10. The Effect of Manual Therapy on the Adolescent Idiopathic Scoliosis in a 28 Years Old Woman

    Directory of Open Access Journals (Sweden)

    Marzieh Mohamadi

    2013-04-01

    Full Text Available Idiopathic scoliosis (IS is the most common type of scoliosis. Clinical signs and symptoms of scoliosis impair quality of life and daily function. Manual therapy is commonly used for treatment of scoliosis. This is a case report of scoliosis treatment with manual therapy in a 28 years old patient. A 28 years old woman complained of low back pain for 4 years. Spine x-ray, showed scoliosis with a 32 degrees Cobb angle. The patient received a manual therapy procedure of two visits per week for 16 weeks including myofascial release technique, mobilization and manipulation. The Cobb angle was reduced 15.62% after 8 weeks and 21.87% after 16 weeks. In addition the pain was reduced by 50%. We can state that manual therapy was useful for this patient.

  11. Scoliosis: review of types of curves, etiological theories and conservative treatment.

    Science.gov (United States)

    Shakil, Halima; Iqbal, Zaheen A; Al-Ghadir, Ahmad H

    2014-01-01

    Scoliosis is the deviation in the normal vertical spine. Although there are numerous studies available about treatment approaches for scoliosis, the numbers of studies that talk about its etiology and pathology are limited. Aim of this study was to discuss the different types of scoliosis; its curves and etiological theories; and to note their implication on its treatment. We examined various electronic databases including Pub MED, Medline, Cinhal, Cochrane library and Google scholar using key words "scoliosis", "etiology", "pathology" and "conservative treatment". References of obtained articles were also examined for cross references. The search was limited to articles in English language. A total of 145 papers, about Prevalence, History, Symptoms, classification, Biomechanics, Pathogenesis, Kinematics and Treatment of scoliosis were identified to be relevant. To choose the appropriate treatment approach for scoliosis we need to understand its etiology and pathogenesis first. Early intervention with conservative treatment like physiotherapy and bracing can prevent surgery.

  12. Developing Pokemon AI For Finding Comfortable Settings

    OpenAIRE

    Panumate, Chetprayoon; Iida, Hiroyuki

    2016-01-01

    This paper explores an innovative way to find a comfortable setting of video games. Pokemon is chosen as benchmark and game refinement measure is employed for the assessment. The number of Pokemon that one trainer can carry (i.e., setting with n=6) has never been changed after the first episode of Pokemon was released in 1996. Pokemon battle is simulated and various AIs are developed for the experiments. The results show that the original setting is the best for many players of various levels.

  13. Video-game-assisted physiotherapeutic scoliosis-specific exercises for idiopathic scoliosis: case series and introduction of a new tool to increase motivation and precision of exercise performance

    Directory of Open Access Journals (Sweden)

    Christine Wibmer

    2016-11-01

    Full Text Available Abstract Background It is important to monitor how patients with juvenile and adolescent idiopathic scoliosis comply with their physiotherapeutic scoliosis-specific exercises (PSSE. Physiogame, a newly developed video game using the Game-Trak 3D interactive game controller, combines correct PSSE performance with gaming. It tracks the position of the working limb in 3D space during the exercises as participants aim to hit certain targets and avoid others, and gives direct feedback by stopping the game if the working limb leaves the target 3D space, which is chosen to secure the corrective position according to the Schroth method. Physiogame records the quality and frequency of the exercises performed. We aimed to investigate the influence of this tool on motivation to perform regularly and, correctly, and with self-assessment of performance quality. Methods This case series included 8 consecutive patients with idiopathic scoliosis (thoracolumbar 7, lumbar 1, ages 7-13 years, all female and treated according to SOSORT guidelines; the COBB angle of primary curve at the start of brace therapy was 22-34°. In addition to Full Time Rigid Bracing (FTRB, Cheneau and PSSE (Schroth, the participants were to perform two standardized Schroth exercises (muscle cylinder in standing position, mainly addressing the thoracic curve, and in side-lying position, mainly addressing the lumbar curve with video game assistance every day for 6 months. The development (first to last month of the following parameters was analyzed with descriptive methods: the actual training time to assess motivation, the ratio of the actual playing time versus total playing time to assess exercise improvement, and self-assessment of quality of performance. Results The average number of sessions with Physiogame was 217 per study participant (range 24 to 572, the study protocol targeted at least 180; actual training time decreased from 79 to 52 min (first to last month. Actual playing

  14. 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.

  15. Scoliosis circa 2000: radiologic imaging perspective. Pt. 1. Diagnosis and pretreatment evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, A.E. [Radiology Department, Children`s Hospital Medical Center, Cincinnati, OH (United States); Young, L.W. [Department of Pediatric Radiology, Loma Linda University Children`s Hospital, CA (United States); Young Poussaint, T. [Department of Radiology, Children`s Hospital, Boston, MA (United States)

    1998-11-01

    Plain film imaging remains important for the diagnosis and surveillance of scoliosis, as well as for the detection of complications after surgery. Advances in CT and MR imaging have greatly improved the ability to detect or confirming nonidiopathic causes of scoliosis, including abnormalities within the spinal canal. Three-dimensional thinking has become more important in evaluating and understanding scoliosis. (orig.) With 11 figs., 3 tabs., 75 refs.

  16. "Rehabilitation schools for scoliosis" thematic series: describing the methods and results

    OpenAIRE

    Rigo, Manuel D; Grivas, Theodoros B

    2010-01-01

    Abstract The Scoliosis Rehabilitation model begins with the correct diagnosis and evaluation of the patient, to make treatment decisions oriented to the patient. The treatment is based on observation, education, scoliosis specific exercises, and bracing. The state of research in the field of conservative treatment is insufficient. There is some evidence supporting scoliosis specific exercises as a part of the rehabilitation treatment, however, the evidence is poor and the different methods ar...

  17. Influence of Cobb Angle and ISIS2 Surface Topography Volumetric Asymmetry on Scoliosis Research Society-22 Outcome Scores in Scoliosis.

    Science.gov (United States)

    Brewer, Paul; Berryman, Fiona; Baker, De; Pynsent, Paul; Gardner, Adrian

    2013-11-01

    Retrospective sequential patient series. To establish the relationship between the magnitude of the deformity in scoliosis and patients' perception of their condition, as measured with Scoliosis Research Society-22 scores. A total of 93 untreated patients with adolescent idiopathic scoliosis were included retrospectively. The Cobb angle was measured from a plain radiograph, and volumetric asymmetry was measured by ISIS2 surface topography. The association between Scoliosis Research Society scores for function, pain, self-image, and mental health against Cobb angle and volumetric asymmetry was investigated using the Pearson correlation coefficient. Correlation of both Cobb angle and volumetric asymmetry with function and pain was weak (all self-image, was higher, although still moderate (-.37 for Cobb angle and -.44 for volumetric asymmetry). Both were statistically significant (Cobb angle, p = .0002; volumetric asymmetry; p = .00001). Cobb angle contributed 13.8% to the linear relationship with self-image, whereas volumetric asymmetry contributed 19.3%. For mental health, correlation was statistically significant with Cobb angle (p = .011) and volumetric asymmetry (p = .0005), but the correlation was low to moderate (-.26 and -.35, respectively). Cobb angle contributed 6.9% to the linear relationship with mental health, whereas volumetric asymmetry contributed 12.4%. Volumetric asymmetry correlates better with both mental health and self-image compared with Cobb angle, but the correlation was only moderate. This study suggests that a patient's own perception of self-image and mental health is multifactorial and not completely explained through present objective measurements of the size of the deformity. This helps to explain the difficulties in any objective analysis of a problem with multifactorial perception issues. Further study is required to investigate other physical aspects of the deformity that may have a role in how patients view themselves. Copyright

  18. [Is local bone graft sufficient to maintain the surgical correction in adolescent idiopathic scoliosis curves?].

    Science.gov (United States)

    Mardomingo, A; Sánchez-Mariscal, F; Alvarez, P; Pizones, J; Zúñica, L; Izquierdo, E

    2013-01-01

    The purpose of this study was to compare postoperative clinical and radiological results in adolescent idiopathic scoliosis curves treated by posterior arthrodesis using autogenous bone graft from iliac crest (CI) versus only local autograft bone (HL). A retrospective matched cohort study was conducted on 73 patients (CI n=37 and HL n=36) diagnosed with adolescent idiopathic scoliosis and treated surgically by posterior arthrodesis. The mean post-operative follow-up was 126 months in the CI group vs. 66 months in the HL group. The radiographic data collected consisted of preoperative, postoperative, and final follow-up antero-posterior and lateral full-length radiographs. Loss of correction and quality of arthrodesis were evaluated by comparing the scores obtained from the Spanish version of the SRS-22 questionnaire. There were significant differences in the post-operative results as regards the correction of the Cobb angle of the main curve (HL 61 ± 15% vs. CI 51 ± 14%, P<.004), however a greater loss of correction was found in the local bone group (CI 4.5 ± 7.3° vs. HL 8.5 ± 6.3°, P=.02). There were no significant differences as regards the correction of the Cobb angle of the main curve at the end of follow-up. There were no clinical differences between the two groups in the SRS-22 scores. At 5 years of follow-up, there was a statistically significant greater loss of radiographic correction at the end of final follow-up in the local bone graft group. However clinical differences were not observed as regards the SRS-22 scores. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  19. 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.

  20. Manipulation for the control of back pain and curve progression in patients with skeletally mature idiopathic scoliosis: two cases.

    Science.gov (United States)

    Tarola, G A

    1994-05-01

    This report of two cases illustrates the potential effect of chiropractic manipulative therapy on back pain and curve progression in the at-risk, skeletally mature patient with adolescent idiopathic scoliosis. Two patients suffering from lumbar scoliosis and chronic back pain. Both had scoliosis that had progressed after skeletal maturity. Diversified type chiropractic manipulative therapy was used palliatively for back pain relief in one case, and routinely 1-2 times per month in the other case. The manipulation was applied manually, with the patients in the prone and side-posture positions. Vertebral levels manipulated were identified as fixated/dysfunctional segments based on static and/or motion palpation. They were generally applied to areas above and/or below the curve apex. When applied at the apex, cavitation was more easily achieved when the direction of thrust was into the concave side. This was also tolerated better by the patient. No attempt was made to "straighten the curve" by thrusting into the convex side. Gentle manual intersegmental mobilization, stretching and muscle massage techniques were also applied. The case treated palliatively had curve progression consistent with the literature over an 8-yr period. The case treated routinely did not. The procedure was effective in both cases for subjective relief of back pain. Diversified-type CMT has a favorable effect on acute back pain when used palliatively. The procedure may also have a favorable long term effect of preventing recurrence of back pain and on retarding curve progression when used routinely 1-2 times per month.

  1. Do adolescents with idiopathic scoliosis have body schema disorders? A cross-sectional study.

    Science.gov (United States)

    Picelli, Alessandro; Negrini, Stefano; Zenorini, Andrea; Iosa, Marco; Paolucci, Stefano; Smania, Nicola

    2016-01-01

    To date etiology of adolescent idiopathic scoliosis appears complex and still remains unclear. A distorted body schema has been proposed to be a part of a sequence of pathological events in the development of adolescent idiopathic scoliosis. To investigate the awareness of trunk misalignment in adolescents with idiopathic scoliosis. Information about 44 adolescents with idiopathic scoliosis was collected as follows: age; sex; handedness; family history of scoliosis; back pain; sport practice; shoulder and waist line symmetry; leg length; dorsal kyphosis; back hump; rehabilitation; scoliotic curve; Risser sign. We evaluated awareness of trunk misalignment with a graphic table displaying pictures of progressively increasing scoliotic curves. Patients were asked to indicate which picture corresponded to their perceived own spinal alignment. Patients with thoracolumbar scoliosis overestimated their actual thoracic spine curve. Patients with thoracic-thoracolumbar scoliosis underestimated their actual thoracolumbar spine curve and overestimated their actual lumbar spine curve. Scoliotic curve > 15°, double curve, younger age, back pain, family history of scoliosis and lower Risser score related with a misperception of trunk alignment. Our results support the hypothesis that adolescents with idiopathic scoliosis have an altered corporeal awareness of their trunk alignment.

  2. AI techniques in geomagnetic storm forecasting

    Science.gov (United States)

    Lundstedt, Henrik

    This review deals with how geomagnetic storms can be predicted with the use of Artificial Intelligence (AI) techniques. Today many different Al techniques have been developed, such as symbolic systems (expert and fuzzy systems) and connectionism systems (neural networks). Even integrations of AI techniques exist, so called Intelligent Hybrid Systems (IHS). These systems are capable of learning the mathematical functions underlying the operation of non-linear dynamic systems and also to explain the knowledge they have learned. Very few such powerful systems exist at present. Two such examples are the Magnetospheric Specification Forecast Model of Rice University and the Lund Space Weather Model of Lund University. Various attempts to predict geomagnetic storms on long to short-term are reviewed in this article. Predictions of a month to days ahead most often use solar data as input. The first SOHO data are now available. Due to the high temporal and spatial resolution new solar physics have been revealed. These SOHO data might lead to a breakthrough in these predictions. Predictions hours ahead and shorter rely on real-time solar wind data. WIND gives us real-time data for only part of the day. However, with the launch of the ACE spacecraft in 1997, real-time data during 24 hours will be available. That might lead to the second breakthrough for predictions of geomagnetic storms.

  3. Dissecting phenotypic variation among AIS patients

    International Nuclear Information System (INIS)

    Wang Minghua; Wang Jiucun; Zhang Zhen; Zhao Zhimin; Zhang Rongmei; Hu Xiaohua; Tan Tao; Luo Shijing; Luo Zewei

    2005-01-01

    We have created genital skin fibroblast cell lines directly from three patients in a Chinese family affected by androgen insensitivity syndrome (AIS). All patients in the family share an identical AR Arg 840 Cys mutant but show different disease phenotypes. By using the cell lines, we find that the mutation has not influenced a normal androgen-binding capacity at 37 deg C but has reduced the affinity for androgens and may cause thermolability of the androgen-receptor complex. The impaired nuclear trafficking of the androgen receptor in the cell lines is highly correlated with the severity of donors' disease phenotype. The transactivity of the mutant is substantially weakened and the extent of the reduced transactivity reflects severity of the donors' disease symptom. Our data reveal that although etiology of AIS is monogenic and the mutant may alter the major biological functions of its wild allele, the function of the mutant AR can also be influenced by the different genetic backgrounds and thus explains the divergent disease phenotypes

  4. Monitoring Severe Accidents Using AI Techniques

    International Nuclear Information System (INIS)

    No, Young Gyu; Kim, Ju Hyun; Na, Man Gyun; Ahn, Kwang Il

    2011-01-01

    It is very difficult for nuclear power plant operators to monitor and identify the major severe accident scenarios following an initiating event by staring at temporal trends of important parameters. The objective of this study is to develop and verify the monitoring for severe accidents using artificial intelligence (AI) techniques such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH) and fuzzy neural network (FNN). The SVC and PNN are used for event classification among the severe accidents. Also, GMDH and FNN are used to monitor for severe accidents. The inputs to AI techniques are initial time-integrated values obtained by integrating measurement signals during a short time interval after reactor scram. In this study, 3 types of initiating events such as the hot-leg LOCA, the cold-leg LOCA and SGTR are considered and it is verified how well the proposed scenario identification algorithm using the GMDH and FNN models identifies the timings when the reactor core will be uncovered, when CET will exceed 1200 .deg. F and when the reactor vessel will fail. In cases that an initiating event develops into a severe accident, the proposed algorithm showed accurate classification of initiating events. Also, it well predicted timings for important occurrences during severe accident progression scenarios, which is very helpful for operators to perform severe accident management

  5. Acute ischemic stroke in a 6 year old boy, treated with mechanical thrombectomy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gi Hong; Lee, Mu Sook; Yang, Tae Ki [Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2016-11-15

    Pediatric acute ischemic stroke (AIS) is a relatively rare disease with an annual estimated incidence of 2.4-13 per 100000 children. However, pediatric AIS can lead to significant morbidity and mortality. Stroke in children differs from that in adults with respect to etiology, clinical presentation, or management. Therapeutic options for adult AIS are intravenous tissue plasminogen activator, intra-arterial pharmacological thrombolysis, and mechanical thrombectomy. However, management strategies for pediatric AIS, extrapolated largely from those of adult AIS, remain controversial. In this article, we present our experience in a boy with AIS, who was successfully treated with mechanical thrombectomy, by utilizing the Solitaire FR revascularization device.

  6. AI model for computer games based on case based reasoning and AI planning

    NARCIS (Netherlands)

    Menkovski, V.; Metafas, D.

    2008-01-01

    Making efficient AI models for games with imperfect information can be a particular challenge. Considering the large number of possible moves and the incorporated uncertainties building game trees for these games becomes very difficult due to the exponential growth of the number of nodes at each

  7. AI Based Personal Learning Environments: Directions for Long Term Research. AI Memo 384.

    Science.gov (United States)

    Goldstein, Ira P.; Miller, Mark L.

    The application of artificial intelligence (AI) techniques to the design of personal learning environments is an enterprise of both theoretical and practical interest. In the short term, the process of developing and testing intelligent tutoring programs serves as a new experimental vehicle for exploring alternative cognitive and pedagogical…

  8. Intra-observer reproducibility and interobserver reliability of the radiographic parameters in the Spinal Deformity Study Group's AIS Radiographic Measurement Manual.

    Science.gov (United States)

    Dang, Natasha Radhika; Moreau, Marc J; Hill, Douglas L; Mahood, James K; Raso, James

    2005-05-01

    Retrospective cross-sectional assessment of the reproducibility and reliability of radiographic parameters. To measure the intra-examiner and interexaminer reproducibility and reliability of salient radiographic features. The management and treatment of adolescent idiopathic scoliosis (AIS) depends on accurate and reproducible radiographic measurements of the deformity. Ten sets of radiographs were randomly selected from a sample of patients with AIS, with initial curves between 20 degrees and 45 degrees. Fourteen measures of the deformity were measured from posteroanterior and lateral radiographs by 2 examiners, and were repeated 5 times at intervals of 3-5 days. Intra-examiner and interexaminer differences were examined. The parameters include measures of curve size, spinal imbalance, sagittal kyphosis and alignment, maximum apical vertebral rotation, T1 tilt, spondylolysis/spondylolisthesis, and skeletal age. Intra-examiner reproducibility was generally excellent for parameters measured from the posteroanterior radiographs but only fair to good for parameters from the lateral radiographs, in which some landmarks were not clearly visible. Of the 13 parameters observed, 7 had excellent interobserver reliability. The measurements from the lateral radiograph were less reproducible and reliable and, thus, may not add value to the assessment of AIS. Taking additional measures encourages a systematic and comprehensive assessment of spinal radiographs.

  9. Escoliose idiopática do adolescente (eia: perfil clínico e radiográfico da lista de espera para tratamento cirúrgico em hospital terciário de alta complexidade do Sistema Público de Saúde Brasileiro Escoliosis idiopática del adolescente (eia: perfil clínico y la radiografía de la lista de espera para el tratamiento quirúrgico en el hospital de tercer nivel de alta complejidad del Sistema Brasileño de Salud Pública Adolescent idiopathic scoliosis (ais: clinical and radiographic profile of waiting list for surgical treatment in tertiary hospital high complexity of Brazilian Public Heatlth System

    Directory of Open Access Journals (Sweden)

    Paulo Candido de Lima Júnior

    2011-01-01

    Moe, la clasificación de King y otros, y Lenke et al en el momento de la indicación de tratamiento quirúrgico y el tiempo de espera para la cirugía. RESULTADOS: De los 51 pacientes, 42 mujeres y 9 hombres, edad promedio de 15,53 años (10-46 años. Todos los pacientes tenían edades comprendidas entre 10 y 17 años al momento del diagnóstico. El promedio de espera fue de 25,41 meses (desde 2 a 180 meses. El promedio de edad de la menarquía fue 12,13 años (11-14 años, 10 pacientes no tenían la menarquía, y 23 pacientes con esqueleto inmaduro (Risser cero a tres. La curva primaria promedio fue de 60,4 grados (que va desde 40 hasta 120 grados. Los tipos de curva de las más frecuentes fueron de tipo King III y 19 pacientes con Lenke 1BN con 11 pacientes. CONCLUSIÓN: DEBIDO a la morbilidad se definen en la literatura en pacientes con EIA no tratadas y el número de la muestra, es las medidas apropiadas en términos de política pública para el tratamiento de estos pacientes en nuestro país.OBJECTIVE: To describe through descriptive cross-sectional study, the clinical and radiographic parameters of patients with adolescent idiopathic scoliosis (AIS that are on the waiting list for elective surgery in a tertiary university hospital of high complexity of the SUS. METHODS: To define the clinical and radiographic profile, the following data were collected: menarche, sex, age, Risser sign, Cobb value, Nash-Moe, classification of King et al. and Lenke et al., at the time of indication for surgical treatment, and waiting time for surgery. RESULTS: Of the 51 patients, 42 were females and 9 males, mean age was 15.53 years (10-46 years. All patients were aged between 10 and 17 years at diagnosis. The average wait was 25.41 months (ranging from 2 to 180 months. The average age at menarche was 12.13 years (11-14 years, 10 patients had no menarche, and 23 skeletally immature patients (Risser zero to three. The average primary curve was 60.4 degrees (ranging from 40 to 120

  10. Risk Reducing Effect of AIS Implementation on Collision Risk

    DEFF Research Database (Denmark)

    Lützen, Marie; Friis-Hansen, Peter

    2003-01-01

    AIS (Automatic Identification System) is a transponder system developed for sea traffic purposes. The system sends and receives important ship information and other safety-related information between other ships and shore-based AIS stations. The implementation of AIS has now been initiated and......, as a result, the community will undoubtedly observe an increase in navigational safety. However, to the authors? knowledge, no study has so far rigorously quantified the risk reducing effect of using AIS as an integrated part of the navigational system. The objective of this study is to fill this gap....... The risk reducing effect of AIS is quantified by building a Bayesian network facilitating an evaluation of the effect of AIS on the navigational officer?s reaction ability in a potential, critical collision situation. The time-dependent change in the risk reducing effect on ship collisions is analysed...

  11. Comparison of Srs-24 And Srs-22 Scores in Thirty Eight Adolescent Idiopathic Scoliosis Patients Who Had Undergone Surgical Correction

    OpenAIRE

    CYW Chan; LB Saw; MK Kwan

    2009-01-01

    Adolescent idiopathic scoliosis is a spinal deformity that affects patients’ self image and confidence. Surgery is offered when the curvature is greater than 50 degrees based on the likelihood of curvature progression. Outcome measures for scoliosis correction can be described in terms of radiological improvement or improvement of health related quality of life scores. The Scoliosis Research Society 22 (SRS-22) and Scoliosis Research Society 24 (SRS-24) questionnaires are widely accepted and ...

  12. Towards a science of integrated AI and Robotics

    OpenAIRE

    Rajan, Kanna; Saffiotti, Alessandro

    2017-01-01

    The early promise of the impact of machine intelligence did not involve the partitioning of the nascent field of Artificial Intelligence. The founders of AI envisioned the notion of embedded intelligence as being conjoined between perception, reasoning and actuation. Yet over the years the fields of AI and Robotics drifted apart. Practitioners of AI focused on problems and algorithms abstracted from the real world. Roboticists, generally with a background in mechanical and electrical engineer...

  13. Discussion on AI Technology in Information Library Design

    OpenAIRE

    日比野, 省三; Shozo, HIBINO; 中京大学社会学部

    1987-01-01

    This paper deals with the discussion on the importance of AI (Artificial Intelligence) Technology in planning and designing a library information system in the near future. First of all, the history of Library and Information Science is reviewed and it is identified that the key technology in the future library will be AI as a mega-trend. After reviewing the concepts of AI technology, a model of a Knowledge-Base system is discussed as a case study, using micro-PROLOG.

  14. Humans and Machines in the Evolution of AI in Korea

    OpenAIRE

    Zhang, Byoung-Tak

    2016-01-01

    Artificial intelligence in Korea is currently prospering. The media is regularly reporting AI-enabled products such as smart advisors, personal robots, autonomous cars, and human-level intelligence machines. The IT industry is investing in deep learning and AI to maintain the global competitive edge in their services and products. The Ministry of Science, ICT, and Future Planning (MSIP) has launched new funding programs in AI and cognitive science to implement the government’s newly adopted e...

  15. Automatic Identification System (AIS) Transmit Testing in Louisville Phase 2

    Science.gov (United States)

    2014-08-01

    Firewall Louisville QM 65.206.28.x NAIS Site Controller PC RS232 Serial cable TV32 Computer Cmd Center Serial splitter SAAB R40 AIS Base Station...172.17.14.6 Rack mount computer AIS Radio Interface Ethernet Switch 192.168.0.x Firewall Cable Modem 192.168.0.1 VTS Accred. Boundary serial connection...Automatic Identification System ( AIS ) Transmit Testing in Louisville Phase 2 Distribution Statement A: Approved for public release

  16. Triplanar correction of adolescent idiopathic scoliosis by asymmetrically shaped and simultaneously applied rods associated with direct vertebral rotation: clinical and radiological analysis of 36 patients.

    Science.gov (United States)

    Faldini, Cesare; Perna, Fabrizio; Geraci, Giuseppe; Pardo, Francesco; Mazzotti, Antonio; Pilla, Federico; Ruffilli, Alberto

    2018-04-17

    Aim of this study was to investigate the effectiveness of a new surgical corrective manoeuvre for adolescent idiopathic scoliosis (AIS) by asymmetrically shaped and simultaneously applied rods and in combination with direct vertebral rotation, to control both the triplanar deformity and the kyphosis apex location. We retrospectively reviewed 36 patients who undergo surgical treatment using simultaneous translation on two differently contoured rods, in combination with direct vertebral rotation. Patients were divided into three main groups according to the scoliotic curve type. The average follow-up was 1.8 years (range 1-3 years). Mean thoracic Cobb angle decreased from 64.6° to 17.0 (p < 0.05). Mean lumbar Cobb angle decreased from 54.9 to 13°. T5-T12 kyphosis values improved from 16.2 to 22.8° (p < 0.05). Apical vertebral rotation decreased from 25.3 to 9.7°. Mean total SRS-22 score values improved from 2.3 on pre-operative to 3.8 at the last available follow-up. Two major and two minor perioperative complications were recorded. Nor deformity progression or screw pull-out or non-union was recorded at the last available follow-up. The corrective manoeuvre using two differently contoured rods simultaneously in combination with direct vertebral rotation can provide a good triplanar deformity correction and improve patient's quality of life and self-image perception in mild-to-moderate AIS. Moreover, the described technique allows the positioning of the desired kyphosis apex at a different level from the scoliosis apex. This procedure allows a better sagittal contour restoration while maintaining a comparable amount of correction on the frontal and axial plane of the already available techniques. These slides can be retrieved under Electronic Supplementary Material.

  17. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Randomized controlled trial to investigate the effects of growth hormone treatment on scoliosis in children with Prader-Willi syndrome.

    NARCIS (Netherlands)

    Lind van Wijngaarden, R.F. de; Klerk, L.W. de; Festen, D.A.M.; Duivenvoorden, H.J.; Otten, B.J.; Hokken-Koelega, A.C.S.

    2009-01-01

    CONTEXT: The prevalence of scoliosis in children with Prader-Willi syndrome (PWS) is 30-80%, depending on age. Although reports about effects of GH treatment on scoliosis in children with PWS are limited, scoliosis is generally considered a contraindication for GH treatment. OBJECTIVE: The aim was

  19. The implementation of AI technologies in computer wargames

    Science.gov (United States)

    Tiller, John A.

    2004-08-01

    Computer wargames involve the most in-depth analysis of general game theory. The enumerated turns of a game like chess are dwarfed by the exponentially larger possibilities of even a simple computer wargame. Implementing challenging AI is computer wargames is an important goal in both the commercial and military environments. In the commercial marketplace, customers demand a challenging AI opponent when they play a computer wargame and are frustrated by a lack of competence on the part of the AI. In the military environment, challenging AI opponents are important for several reasons. A challenging AI opponent will force the military professional to avoid routine or set-piece approaches to situations and cause them to think much deeper about military situations before taking action. A good AI opponent would also include national characteristics of the opponent being simulated, thus providing the military professional with even more of a challenge in planning and approach. Implementing current AI technologies in computer wargames is a technological challenge. The goal is to join the needs of AI in computer wargames with the solutions of current AI technologies. This talk will address several of those issues, possible solutions, and currently unsolved problems.

  20. 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

  1. Little AI: Playing a constructivist robot

    Science.gov (United States)

    Georgeon, Olivier L.

    Little AI is a pedagogical game aimed at presenting the founding concepts of constructivist learning and developmental Artificial Intelligence. It primarily targets students in computer science and cognitive science but it can also interest the general public curious about these topics. It requires no particular scientific background; even children can find it entertaining. Professors can use it as a pedagogical resource in class or in online courses. The player presses buttons to control a simulated "baby robot". The player cannot see the robot and its environment, and initially ignores the effects of the commands. The only information received by the player is feedback from the player's commands. The player must learn, at the same time, the functioning of the robot's body and the structure of the environment from patterns in the stream of commands and feedback. We argue that this situation is analogous to how infants engage in early-stage developmental learning (e.g., Piaget (1937), [1]).

  2. AI tools in computer based problem solving

    Science.gov (United States)

    Beane, Arthur J.

    1988-01-01

    The use of computers to solve value oriented, deterministic, algorithmic problems, has evolved a structured life cycle model of the software process. The symbolic processing techniques used, primarily in research, for solving nondeterministic problems, and those for which an algorithmic solution is unknown, have evolved a different model, much less structured. Traditionally, the two approaches have been used completely independently. With the advent of low cost, high performance 32 bit workstations executing identical software with large minicomputers and mainframes, it became possible to begin to merge both models into a single extended model of computer problem solving. The implementation of such an extended model on a VAX family of micro/mini/mainframe systems is described. Examples in both development and deployment of applications involving a blending of AI and traditional techniques are given.

  3. The effect of solid content on silylated-γ-AI2O3/PVDF-HFP-coated PE separators for lithium secondary battery

    International Nuclear Information System (INIS)

    Im, Jong Su; Sohn, Joon Yong; Shin, Jun Hwa; Nho, Young Chang; Kim, Jeong Soo

    2009-01-01

    Several PVDF-HFP/silylated γ-AI 2 O 3 -coated PE (polyethylene) separators with various solidities (various compositions of PVDF-HFP/silylated γ-AI 2 O 3 ) were prepared by a dip-coating of PE separators in PVDF-HFP/silylated γ-AI 2 O 3 /acetone mixtures. FT-IR spectroscopy was used to confirm the chemical reactions between silane coupling agent and γ-AI 2 O 3 . The SEM images of the coated separators showed that various morphologies could be produced by changing the composition of total contents of binder and solid contents. The effects of composition in inorganic material (silane coupling agent-treated γ-AI 2 O 3 ) and binder (PVDF-HFP) on the physio-chemical properties of the prepared separators such as liquid electrolyte uptake, and ion conductivity were investigated and reported in this paper

  4. The oldest record of aquatic amniote congenital scoliosis.

    Directory of Open Access Journals (Sweden)

    Tomasz Szczygielski

    Full Text Available We report the first occurrence of congenital scoliosis in an early Permian aquatic parareptile, Stereosternum tumidum from Paraná state, Brazil. The spine malformation is caused by a congenital hemivertebra. These observations give insight into the biomechanical aspects of underwater locomotion in an axial skeleton-compromised aquatic amniote. This is the oldest record of a hemivertebra in an aquatic animal.

  5. One stage surgical treatment for scoliosis associated with intraspinal abnormalities

    Directory of Open Access Journals (Sweden)

    Kai WANG

    2017-09-01

    Full Text Available Objective To evaluate the effectiveness and safety of one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities. Methods The data of 6 patients who underwent one stage surgical treatment for scoliosis and coexisting intraspinal abnormalities from October 2016 to January 2017 were retrospectively analyzed. Treatment for intraspinal abnormalities, posterior correction, osteotomy and internal fixation were performed simultaneously. The clinical and radiologic presentations, operative details, complications and postoperative outcomes were evaluated. Results The success rate was 100%. The operating time was (470.83 ± 136.20 min and intraoperative bleeding amount was 1350 (625, 2150 ml. Total fusion segments were 11.00 ± 2.76. Both Cobb angle of scoliosis [postoperation (19.60 ± 5.94° vs. preoperation (59.40 ± 14.31°, P = 0.007] and kyphosis [postoperation (25.80 ± 10.87° vs. preoperation (62.40 ± 21.04°, P = 0.005] were improved after operation. Tethered cords were released and epidermoid cyst, ganglioglioma and lipoma were excised. Syringomyelia was left untreated. No neurological functional defect or worsening was found. Muscle strength of all patients was improved. Muscular tone of 4 patients and difficulty in urination of 5 patients were also improved. The mean hospital stay was (8.83 ± 3.31 d. No severe complications, such as infection, cerebrospinal fluid (CSF leakage, failed internal fixation, fractured pedicle screws or rods occurred after operation. None of the patients died, or experienced deterioration of neurological function, delayed infection, pseudoarthrosis, or loss correction during the (7.50 ± 1.22 months follow - up. Conclusions The one stage surgical treatment for scoliosis and intraspinal abnormalities seems to be a safe and effective approach. Neurological functional defect can be improved after operation. Osteotomy can improve correction result. DOI: 10.3969/j.issn.1672-6731.2017.09.011

  6. Comparison of short-term and long-term outcomes of spinal fusion with and without posterior instrumentation in congenital scoliosis

    Directory of Open Access Journals (Sweden)

    Behtash H.

    2007-10-01

    Full Text Available Background: Congenital scoliosis is a developmental disorder defined as a lateral curvature of the spine. Its progressive trend and complications, such as cosmetic problems, pain and pulmonary symptoms, have put scoliosis as an important skeletal deformity that should be corrected. One of the currently accepted methods of treatment is posterior spinal fusion (PSF that may be performed with or without instrumentation. However, the use of implants in conjunction with PSF in congenital spine deformity has been debated over the past three decades primarily because of increased risk of neurological deficit and implant displacement. The aim of this study was to compare short-term and long-term outcomes of spinal fusion with and without posterior instrumentation in congenital scoliosis.Methods: In this historical cohort study, 41 patients with congenital scoliosis were recruited. All patients underwent PSF surgery between 1977 and 1996. They were divided into two groups according to the use of instrumentation: 22 congenital scoliotic patients who were treated by PSF without any instrumentation (group A, and 19 instrumented PSF patients (group B. Instrumentation was mostly performed using the Harrington rod. The major curve angle was measured before surgery, two weeks and one year after PSF surgery and at the end of the follow-up period. Results: The mean baseline curve angles were 66.3° and 69.1° in groups A and B, respectively. The mean Cobb angles one year after PSF were 43.1° and 38.4° in groups A and B, respectively. The mean follow-up period was 8 years (SD=3 and, at the end of this period, the final Cobb angles were 47.3° and 39.4° in groups A and B, respectively. Therefore, the final angle correction was 28.7% in patients without instrumentation and 43% in patients with instrumentation. The mean loss of correction was 5.5% and 4.3% in groups A and B, respectively. The final curve angles was significantly more corrected for those patients

  7. Are we simplifying balance evaluation in adolescent idiopathic scoliosis?

    Science.gov (United States)

    Pasha, Saba; Baldwin, Keith

    2018-01-01

    Clinical evaluation of the postural balance in adolescent idiopathic scoliosis has been measured by sagittal vertical axis and frontal balance. The impact of the scoliotic deformity in three planes on balance has not been fully investigated. 47 right thoracic and left lumbar curves adolescent idiopathic scoliosis and 10 non-scoliotic controls were registered prospectively. 13 spinopelvic postural parameters were calculated from the 3-dimantional reconstructions of X-rays. 7 balance variables describing the position and sway of the center of pressure were recorded using a pressure mat. A regression analysis was used to predict sagittal vertical axis and frontal balance from the 7 balance variables. A canonical correlation analysis was performed between all the postural parameters and balance variables and the significant associations between the postural and balance variables were determined. sagittal vertical axis and frontal balance were not significantly associated with the position or sway of the center of pressure (p>0.05). Canonical correlation analysis showed significant associations between the postural variables in the 3 planes and center of pressure position (R 2 =0.81) and sway (R 2 =0.62), pbalance contributed to the postural balance in the cohort. The compensatory role of the pelvis and distal kyphosis in sagittal plane was underlined. Multidimensional analyses between the postural and balance variables showed the alignment of the thoracic, lumbar, and pelvis in the 3 planes, in addition to the global head-pelvic position impact on adolescent idiopathic scoliosis balance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. 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.

  9. Mechanism to induce scoliosis in Duchenne muscular dystrophy

    International Nuclear Information System (INIS)

    Ando, Noriaki; Fujimoto, Yasuyo; Takayanagi, Tetsuya; Mano, Yukio.

    1992-01-01

    We studied the mechanism to induce scoliosis in Duchenne muscular dystrophy (DMD) by use of X-ray computed tomography (CT) of paraspinal muscles. CT examination of paraspinal muscles was performed on 15 DMD patients at the following six levels: (1) Th3 vertebrae (upper thoracic spine level); (2) Th6 vertebrae (middle thoracic spine level); (3) Th10 vertebrae (lower thoracic spine level); (4) L1 vertebrae (upper lumbar spine level); (5) L3 vertebrae (middle lumbar spine level); (6) L5 vertebrae (lower lumbar spine level). We evaluated the degeneration of paraspinal muscle by a decrese in ratio-density of the muscle which indicates infiltration of fatty tissue. The degeneration of the lateral portion of paraspinal muscle was more marked than that of the medial portion. The muscle was most severely affected at the middle lumbar spine level, showing a tendency to increase degeneration at the lower level of the spine. In cases showing laterality of the degeneration of paraspinal muscle, the less affected muscle on CT was located at the convex site of scoliosis. We speculate that the scoliosis occurs when DMD patients have asymmetrical paraspinal muscle degeneration, leading them to take compensatory posture. (author)

  10. 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.

  11. MRI evaluation of multifidus muscles in adolescent idiopathic scoliosis

    International Nuclear Information System (INIS)

    Chan Yu-Leung; King, A.D.; Griffith, J.F.; Metreweli, C.; Cheng, J.C.Y.; Guo Xia

    1999-01-01

    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.)

  12. Rehabilitation of scoliosis patients with pain after surgery.

    Science.gov (United States)

    Weiss, Hans-Rudolf

    2002-01-01

    In our centre, the postoperative scoliosis rehabilitation consists in stabilizing postural and respiratory exercises lasting several hours a day (5 1/2 to 7 hours). Additionally to pain treatment, we apply pain physiotherapy, physical therapy, acupuncture and besides manual medicine, also a psychological intervention and pain treatment by medication. 46 patients suffered from heavier pain 10 or more years after scoliosis surgery. The patients reported their pain at the beginning and at the end of 3-6 week in-patient rehabilitation programme. We applied a visual analogous scale (VAS), a numerical scale (NS), a standardized adjective scale (VRS), and a pain frequency scale. All the patients with an average age of 36 years old (SD=16) and an average curve angle of 35 degrees thoracic (SD=36) and 26 degrees lumbar (SD=22) showed a decrease of the values on the pain intensity scale. Pain reduction was highly significant, as well as pain frequency. Chronic pain as a late result following scoliosis surgery can be reduced by an intensive in-patient rehabilitation, at least in the short term. There are further necessary studies in order to follow-up the long-term effect of postoperative rehabilitation.

  13. Subdural Hemorrhage after Scoliosis and Detethering of Cord Surgery

    Directory of Open Access Journals (Sweden)

    Rohan Bhimani

    2018-01-01

    Full Text Available Introduction. Intracranial hypotension may occur when CSF leaks from the subarachnoid space. Formation of intracranial, subdural, and subarachnoid hemorrhage has been observed after significant CSF leak as seen in lumbar puncture or ventricular shunt placement. However, very few cases, referring to these remote complications following spine surgery, have been described in literature. We present a case of a 10-year-old male child operated for idiopathic scoliosis with low-lying conus medullaris who postoperatively developed subdural hemorrhage. Case Report. A case of a 10-year-old male operated for idiopathic scoliosis with low-lying conus medullaris is presented. To correct this, detethering was done at the L3 level, laminectomy was done from L2 to L3 with pedicular screw fixation from T3 to L2, and bone grafting with right costoplasty was done from the 3rd to the 6th ribs. On the 5th day postoperatively, the patient developed convulsions and drowsiness and recovered subsequently by postoperative day 7. Conclusion. We report a rare case of an acute intracranial subdural hemorrhage caused by intracranial hypotension following scoliosis and detethering of cord surgery. This report highlights the potential morbidity associated with CSF leak occurring after this surgery.

  14. Scoliosis in a Case of Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Özlem SOLAK

    2010-05-01

    Full Text Available Neurofibromatosis Type 1 (NF1 is a multisystemic disease, manifesting as abnormalities ofthe nervous tissue, bones, soft tissue, and skin. The entity is dominantly inherited and affects 1in 4000 individuals. Cafe-au-lait spots, peripheral neurofibromas, Lisch nodules and axillaryfreckling are the characteristics of NF1. Bone abnormalities are usually observed in NF1. Scoliosis is a skeletal anomaly reported to beassociated with NF1. We made a diagnosis of NF1 and scoliosis secondary to NF1 in our 26-year-old male case with complaints of low back pain, a mass on his left hip beginning 10 yearsago and growing and with cafe-au-lait spots on his back. We think that, in daily practice, it isimportant to look for cafe-au-lait spots with inspection in the patients coming with the complaintof low back pain and when these spots are observed a diagnosis of NF1 should be suspected.Besides, we wanted to emphasize that scoliosis should be searched in the patients with adiagnosis of NF1 and low back pain.

  15. Dicty_cDB: FC-AI17 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI17 (Link to dictyBase) - - - Contig-U15690-1 FC-AI17P (Li...nk to Original site) FC-AI17F 587 FC-AI17Z 626 FC-AI17P 1212 - - Show FC-AI17 Library FC (Link to library) Clone ID FC-AI...nal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI17Q.Seq.d/ Representative seq. ID FC-AI...17P (Link to Original site) Representative DNA sequence >FC-AI17 (FC-AI17Q) /CSM/FC/FC-AI/FC-AI...slated Amino Acid sequence ANIATVGDFLKADTVVPKMIITYNKRKQGTDYLKAVIGPILSNVIKQELNLELKPNLVYA AIISEQEIRTGEKSTLDRNV

  16. Dicty_cDB: FC-AI18 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available FC (Link to library) FC-AI18 (Link to dictyBase) - - - Contig-U15590-1 FC-AI18P (Li...nk to Original site) FC-AI18F 621 FC-AI18Z 703 FC-AI18P 1324 - - Show FC-AI18 Library FC (Link to library) Clone ID FC-AI...nal site URL http://dictycdb.biol.tsukuba.ac.jp/CSM/FC/FC-AI/FC-AI18Q.Seq.d/ Representative seq. ID FC-AI...18P (Link to Original sit