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Van Oirschot G, Doherty C. Designing multimedia patient education materials for adolescent idiopathic scoliosis: A protocol for a feasibility randomized controlled trial of patient education videos. PLoS One 2024; 19:e0297394. [PMID: 38781168 PMCID: PMC11115215 DOI: 10.1371/journal.pone.0297394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Triple-masked three-armed feasibility parallel randomized controlled trial. Multimedia patient education materials are increasingly used in healthcare. While much research focuses on optimising their scientific content, research is equally needed to optimise design and implementation. This study aims to determine the feasibility of a study examining how the implementation of scientific advice on design affects patient outcomes. Participants aged 10-18 with radiographically confirmed adolescent idiopathic scoliosis will be recruited from community settings in Ireland and randomized into usual care or receiving multimedia educational videos with or without evidence-informed design principles. Participants will be masked in the two video intervention arms, as will the therapist sending the educational videos. Outcomes will include the number of participants recruited and randomized, the number analysed post-intervention and at week eight, and the outcomes for baseline, post-intervention, and week 8. Adverse events will also be reported. This feasibility randomized controlled trial will offer insight into the feasibility of implementing advice from the literature in designing a trial of multimedia patient education materials for a population with adolescent idiopathic scoliosis. Trial registration: Clinical Trail: Trial is registered on ClinicalTrials.gov as NCT06090344.
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Affiliation(s)
- Garett Van Oirschot
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland
| | - Cailbhe Doherty
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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Cai J, Zhou Y, Chen X, Huang X, Li L, Zhu Y, Cai Q, Huang J, Sun Z. Is refractive error a factor affecting scoliosis? PLoS One 2024; 19:e0303324. [PMID: 38739623 PMCID: PMC11090344 DOI: 10.1371/journal.pone.0303324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Scoliosis is one of the most common surgical disorders of the pediatric spine. Refractive errors are commonly associated with vision impairment worldwide. However, it is currently unclear whether refractive error correlates directly with the development of scoliosis. METHODS A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was employed among school-aged students in Nantong City, China. Univariate and multivariate logistic regression analyses were used to investigate specific correlations between scoliosis and related parameters; various types of refractive errors were also included in the study. RESULTS The prevalence of scoliosis among school-aged students was 2.2% in Nantong city. Multiple logistic regression analyses showed that myopia, hyperopia, astigmatism, and anisometropia were not correlated with the development of scoliosis (all, p≥0.05). Lower body mass index (BMI) [adjusted odds ratio (aOR) = 0.92; 95% confidence interval (CI): 0.88-0.95; p<0.001], living in rural areas (aOR = 1.40; 95% CI: 1.05-1.86; p = 0.020), and older age (aOR = 1.32; 95% CI: 1.25-1.38; p<0.001) had significantly higher risks of scoliosis. CONCLUSIONS Refractive errors did not correlate with the development of scoliosis. However, BMI, living in rural areas and older age did correlate with the development of scoliosis.
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Affiliation(s)
- Jianru Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yue Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaojuan Chen
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Xiaobo Huang
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Lele Li
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Yan Zhu
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Qi Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
| | - Jianping Huang
- Nantong Center for Disease Control and Prevention in Jiangsu Province, Jiangsu Province, China
| | - ZhiMin Sun
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China
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Li J, Tseng C, Yuan Y, Jiang D, Qian Z, Hu Z, Zhu Z, Qiu Y, Liu Z. Determining the association between the radiographic parameters and the SRS-22 scores in Chinese female patients with adolescent idiopathic scoliosis: does curve pattern matter? Br J Neurosurg 2024; 38:349-355. [PMID: 33491493 DOI: 10.1080/02688697.2021.1875396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/16/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
Background: The Scoliosis Research Society (SRS)-22 outcomes have been shown to be correlated with radiographic parameter of adolescent idiopathic scoliosis (AIS). A recent study suggested that curve patterns might play a role in assessing the influence of deformity on patient's reported outcomes. The aim of this study was to examine the relationship between radiographic parameters and SRS-22 questionnaire outcomes in female patients with adolescent AIS among the Chinese population based on five curve patterns.Patients and Methods: The radiographic data and SRS-22 questionnaires of 259 female AIS patients were reviewed. Radiographic measurements included: Cobb angle of the major curve, T1 tilt angle, apical vertebral rotation, apical vertebral translation (AVT), thoracic kyphosis, and lumbar lordosis. Curve patterns included single thoracic (T), single thoracolumbar/lumbar (TL), double thoracic (DT), double major (DM), and triple major (TM). The correlation between radiographic measurements and each domain in SRS-22 was determined by Pearson's correlation coefficient.Results: The curve magnitude and AVT of the major curve were found to be significantly correlated with the self-image domain in all cases (Cobb angle: r = -0.426, p = 0.002; AVT: r = -0.281, p=0.006) and in all curve patterns except for TM. Compared to other groups, the TM group had a significantly larger major curve than the DT group and TL group (p ≤ 0.004). In TM group, the self-image scores were lower than TL group (p =0.018), and the function scores were lower than that in T, TL (p < 0.001) and DM groups (p =0.013). In the DT group, the T1 tilt was significantly correlated with the self-image domain (r = -0.376, p =0.004). In the T group, coronal curve magnitude was significantly correlated with function domain (r = -0.397, p < 0.001).Conclusion: Our findings suggested curve patterns should be considered in evaluating the correlations between radiographic parameters and SRS-22 outcomes in patients with AIS.
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Affiliation(s)
- Jie Li
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Changchun Tseng
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yiwen Yuan
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Dengxu Jiang
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zhikai Qian
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zongshan Hu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zezhang Zhu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yong Qiu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zhen Liu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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Zheng JL, Li Y, Hogue G, Johnson M, Anari JB, Baldwin KD. Adolescent Idiopathic Scoliosis Minimum Data Set: Towards Standardization of Data Elements in History and Physical Examination. Cureus 2024; 16:e58332. [PMID: 38752033 PMCID: PMC11095914 DOI: 10.7759/cureus.58332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Nonoperative care represents a cornerstone of adolescent idiopathic scoliosis (AIS) management, although no consensus exists for a minimal data set. We aimed to determine a consensus in critical data points to obtain during clinical AIS visits. METHODS A REDCap-based survey was distributed to Pediatric Orthopedic Society of America (POSNA), Pediatric Spine Study Group (PSSG), and International Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT). Respondents ranked the importance of data points in history, physical examination, and bracing during AIS visits. Results: One hundred eighty-one responses were received (26% response rate), of which 86% were physicians and 14% were allied health professionals. About 80% of respondents worked at pediatric hospitals or pediatric spaces within adult hospitals, and 82% were academic, with the majority (57%) seeing 150+ unique AIS patients annually. Most respondents recommended six-month follow-up for patients under observation (60%) and bracing (54%). Most respondents (75%) considered family history and pain important (69%), with the majority (69%) asking about pain at every visit. Across all time points, Adam's forward bend test, shoulder level, sagittal contour, trunk shift, and curve stiffness were all considered critically important (>60%). At the first visit, scapular prominence, leg lengths, motor and neurological examination, gait, and iliac crest height were also viewed as critical. At the preoperative visit, motor strength and scapular prominence should also be documented. About 39% of respondents use heat sensors to monitor bracing compliance, and average brace wear since the prior visit was considered the most important (85%) compliance data point. CONCLUSIONS This study establishes recommendations for a 19-item minimum data set for clinical AIS evaluation, including history, physical exam, and bracing, to allow for future multicenter registry-based studies.
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Affiliation(s)
- Jenny L Zheng
- Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Ying Li
- Orthopedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, USA
| | - Grant Hogue
- Orthopedic Surgery, Boston Children's Hospital, Boston, USA
| | - Megan Johnson
- Orthopedic Surgery, Scottish Rite for Children, Dallas, USA
| | - Jason B Anari
- Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Keith D Baldwin
- Division of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, USA
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Al Rashdan A, Alessa M, Ababneh F, Al Taimeh F, Althunaibat Z. Effectiveness of Facetectomy in Correction of Adolescent Idiopathic Scoliosis. Cureus 2024; 16:e55768. [PMID: 38463404 PMCID: PMC10921130 DOI: 10.7759/cureus.55768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Surgical correction of adolescent idiopathic scoliosis (AIS) using the facetectomy technique with the utilization of segmental pedicle screws aims to achieve correction of coronal and sagittal imbalances and preserve normal neurological function. In this study, we aimed to certify the effectiveness of the facetectomy technique in the correction of AIS by analyzing technique outcomes. METHODS This is a retrospective, single-center study. From January 2018 to March 2022, a total of 51 patients with AIS who underwent inferior facetectomy with segmental pedicle screw constructs at the Royal Rehabilitation Center were reviewed. Radiological parameters including the major curve Cobb angle, and global coronal balance were evaluated preoperatively, postoperatively, and at the final follow-up. Surgical parameters and complications were also reported. RESULTS The mean major curve Cobb angle was 59.5 ± 4.9° preoperatively, 13.6 ± 2.7° postoperatively, and 14.5 ± 2.6° at the final follow-up, with correction rates of 77.2% and 75.7%, respectively. The mean global coronal balance was 2.7 ± 1.1 cm preoperatively, 1.7 ± 0.73 cm postoperatively, and 1.4 ± 0.55 cm at the final follow-up. Two cases of pleural injuries were reported intraoperatively. Postoperatively, two cases experienced superficial wound infections, one experienced pulmonary embolism, and one patient had revision surgery due to the loosening of a single screw. None of these complications lasted long. CONCLUSIONS When combined with posterior segmental pedicle screw constructs, inferior facetectomy can provide an effective rate of correction in a reasonably safe manner.
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Affiliation(s)
| | - Monther Alessa
- Department of Orthopedics, Royal Medical Services, Amman, JOR
| | - Faris Ababneh
- Department of Orthopedics, Royal Medical Services, Amman, JOR
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Liu L, Wang X, Du S, Zhang W, Xue Y, Li X, Gao T, Gao Y, Wang S, Chen Y. Prevalence of adolescent idiopathic scoliosis in Shijiazhuang, Hebei, China: a cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:673-679. [PMID: 38006475 DOI: 10.1007/s00586-023-08030-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE This study is a large-scale screening supported by government departments to investigate the prevalence of scoliosis in Shijiazhuang. METHODS In this cross-sectional study, all students underwent body posture evaluation and the Adam's forward flexure test to examine the back, and also underwent radiographic evaluation when scoliosis was suspected. RESULTS In total, 181,935 students participated in the research, of which 289 students were diagnosed with scoliosis, with a prevalence of 2.5%, significantly higher in female (3.01%) than in male children (1.63%) (P < 0.001). Most of the patients (79.5%) had a Cobb angle from 10° to 19°.The mean Cobb angle of scoliosis was positively associated with age. The prevalence of a single curve (75.4%) was significantly higher than double curves (23.2%) and triple curves (1.38%). The percentage of scoliosis in which the thoracolumbar segment was involved (46.4%) was significantly higher than that of the single thoracic scoliosis (31.8%) and single lumbar scoliosis (21.8%). CONCLUSIONS The prevalence of adolescent idiopathic scoliosis in XXX was high (2.50%). It is necessary to strengthen the education of adolescent scoliosis, and improve the awareness and attention of social to scoliosis. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Lu Liu
- Preventive Treatment of Disease, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, 050000, China
| | - Xuan Wang
- College of Integrative Medicine, Hebei University of Chinese Medicine, Shijiazhuang, 050200, China
| | - Shuangqing Du
- Department of Orthopaedics, Hebei Provincial Hospital of Traditional Chinese Medicine, 389 Zhongshan East Road, Shijiazhuang, 050000, China.
| | - Wei Zhang
- Preventive Treatment of Disease, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, 050000, China
| | - Yuqiang Xue
- School of Basic Medical, Hebei University of Chinese Medicine, Shijiazhuang, 050200, China
| | - Xi Li
- Department of Orthopaedics, Hebei Provincial Hospital of Traditional Chinese Medicine, 389 Zhongshan East Road, Shijiazhuang, 050000, China
| | - Tianci Gao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, 050200, China
| | - Yang Gao
- Preventive Treatment of Disease, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, 050000, China
| | - Shaobiao Wang
- School of Acupuncture and Massage, Hebei University of Chinese Medicine, Shijiazhuang, 050200, China
| | - Yaxuan Chen
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, 400016, China
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Liu F, Liu F, Wang H. Half of the adolescent idiopathic scoliosis patients may have lumbar adjacent segment degeneration following spinal fusion: A systemic review and meta-analysis. J Orthop Surg (Hong Kong) 2024; 32:10225536241248711. [PMID: 38647667 DOI: 10.1177/10225536241248711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE This study aims to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS). METHODS We conducted a comprehensive search of four electronic databases from their inception until March 30, 2023. Two independent reviewers screened titles, abstracts, and full texts and evaluated the methodological quality of the studies. A random-effects model was used to calculate the incidence of ASD. RESULTS Our analysis included 14 studies involving 651 individuals. The overall incidence of ASD was 47% (95%CI: 0.37, 0.56). Subgroup analyses revealed that the prevalence of ASD increased with postoperative time (53% (95%CI: 0.31, 0.75) versus 48% (95%CI: 0.36, 0.60) versus 39% (95%CI: 0.22, 0.56)). For the number of fused segments, a group with more than 10 segments had a higher prevalence (49% (95%CI: 0.38, 0.60) versus 44% (95%CI: 0.21, 0.69)). In terms of regions, East Asia had the highest prevalence, followed by Occident and West Asia (52% (95%CI: 0.41, 0.62) versus 43% (95%CI: 0.20, 0.68) versus 37% (95%CI: 0.17, 0.59)). However, the surgical approach, male ratio, and the position of the lowest instrumented vertebra (LIV) did not show significant differences between groups. Funnel plots and Egger's test did not reveal any significant publication bias (Egger's test: t = 1.62, p-value = .1274). CONCLUSION This meta-analysis found that nearly half of AIS patients following spinal fusion surgery experienced ASD. Long-term follow-up, regular screening, and timely interventions are essential to reduce the prevalence of ASD.
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Affiliation(s)
- Fuze Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Fuhui Liu
- School of Clinical Medical, Weifang Medical University, Weifang, China
| | - Hai Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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Han S, Zhao H, Zhang Y, Yang C, Han X, Wu H, Cao L, Yu B, Wen JX, Wu T, Gao B, Wu W. Application of machine learning standardized integral area algorithm in measuring the scoliosis. Sci Rep 2023; 13:19255. [PMID: 37935731 PMCID: PMC10630500 DOI: 10.1038/s41598-023-44252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023] Open
Abstract
This study was to develop a computer vision evaluation method to automatically measure the degree of scoliosis based on the machine learning algorithm. For the X-ray images of 204 patients with idiopathic scoliosis who underwent full-spine radiography, histogram equalization of original image was performed before a flipping method was used to magnify asymmetric elements, search for the global maximum pixel value in each line, and scan local maximal pixel value, with the intersection set of two point sets being regarded as candidate anchor points. All fine anchors were fitted with cubic spline algorithm to obtain the approximate curve of the spine, and the degree of scoliosis was measured by the standardized integral area. All measured data were analyzed. In manual measurement, the Cobb angle was 11.70-25.00 (20.15 ± 3.60), 25.20-44.70 (33.89 ± 5.41), and 45.10-49.40 (46.98 ± 1.25) in the mild, moderate and severe scoliosis group, respectively, whereas the value for the standardized integral area algorithm was 0.072-0.298 (0.185 ± 0.040), 0.100-0.399 (0.245 ± 0.050), and 0.246-0.901 (0.349 ± 0.181) in the mild, moderate and severe scoliosis group, respectively. Correlation analysis between the manual measurement of the Cobb angle and the evaluation of the standardized integral area algorithm demonstrated the Spearman correlation coefficient r = 0.643 (P < 0.001). There was a positive correlation between the manual measurement of the Cobb angle and the measurement of the standardized integral area value. Two methods had good consistency in evaluating the degree of scoliosis. ROC curve analysis of the standardized integral area algorithm to measure the degree of scoliosis showed he cutoff value of the standardized integral area algorithm was 0.20 for the moderate scoliosis with an AUC of 0.865, sensitivity 0.907, specificity 0.635, accuracy 0.779, positive prediction value 0.737 and negative prediction value 0.859, and the cutoff value of the standardized integral area algorithm was 0.40 for the severe scoliosis with an AUC of 0.873, sensitivity 0.188, specificity 1.00, accuracy 0.936, positive prediction value 1 and a negative prediction value 0.935. Using the standardized integral area as an independent variable and the Cobb angle as a dependent variable, a linear regression equation was established as Cobb angle = 13.36 + 70.54 × Standardized area, the model has statistical significance. In conclusion, the integrated area algorithm method of machine learning can quickly and efficiently assess the degree of scoliosis and is suitable for screening the degree of scoliosis in a large dataset as a useful supplement to the fine measurement of scoliosis Cobb angle.
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Affiliation(s)
- Shuman Han
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Hongyu Zhao
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Yi Zhang
- Hebei University of Science and Technology, Shijiazhuang, 050051, Hebei, China.
| | - Chen Yang
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Xiaonan Han
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Huizhao Wu
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Lei Cao
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Baohai Yu
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Jin-Xu Wen
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Tianhao Wu
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Bulang Gao
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Wenjuan Wu
- Department of Radiology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
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Feustel A, Konradi J, Wolf C, Huthwelker J, Westphal R, Chow D, Hülstrunk C, Drees P, Betz U. Influence of Lateral Sitting Wedges on the Rasterstereographically Measured Scoliosis Angle in Patients Aged 10-18 Years with Adolescent Idiopathic Scoliosis. Bioengineering (Basel) 2023; 10:1086. [PMID: 37760188 PMCID: PMC10525467 DOI: 10.3390/bioengineering10091086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional axial deviation of the spine diagnosed in adolescence. Despite a long daily sitting duration, there are no studies on whether scoliosis can be positively influenced by sitting on a seat wedge. For the prospective study, 99 patients with AIS were measured with the DIERS formetric III 4D average, in a standing position, on a level seat and with three differently inclined seat wedges (3°, 6° and 9°). The rasterstereographic parameters 'scoliosis angle' and 'lateral deviation RMS' were analysed. The side (ipsilateral/contralateral) on which the optimal correcting wedge was located in relation to the lumbar/thoraco-lumbar convexity was investigated. It was found that the greatest possible correction of scoliosis occurred with a clustering in wedges with an elevation on the ipsilateral side of the convexity. This clustering was significantly different from a uniform distribution (p < 0.001; chi-square = 35.697 (scoliosis angle); chi-square = 54.727 (lateral deviation RMS)). It should be taken into account that the effect of lateral seat wedges differs for individual types of scoliosis and degrees of severity. The possibility of having a positive effect on scoliosis while sitting holds great potential, which is worth investigating in follow-up studies.
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Affiliation(s)
- Andreas Feustel
- Department of Orthopaedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Janine Huthwelker
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Ruben Westphal
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, D-55118 Mainz, Germany
| | - Daniel Chow
- Department of Health & Physical Education of The Education University of Hong Kong, Hong Kong
| | - Christian Hülstrunk
- Asklepios Katharina-Schroth-Klinik Bad Sobernheim, D-55566 Bad Sobernheim, Germany
| | - Philipp Drees
- Department of Orthopaedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
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Turhan B, Alcin FN, Dogan H, Cetisli-Korkmaz N. Are Craniofacial Asymmetries Related to Trunk Asymmetries? J Craniofac Surg 2023:00001665-990000000-00915. [PMID: 37523416 DOI: 10.1097/scs.0000000000009572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/24/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate whether craniofacial asymmetries could be a predictor of spine asymmetries or not. METHODS Female individuals aged between 18 and 25 years participated in this cross-sectional descriptive-analytic study. The angle of trunk rotation was measured by a scoliometer in conjunction with the Adams forward-bending test. Individuals in the control group (n = 57) had spinal curvature of 0 to 3 degrees, and individuals in the study group (n = 53) had spinal curvature of between 4 and 6 degrees. Facial anthropometric measurements of individuals were evaluated by referencing anatomical landmarks determined on the face with 2-dimensional photogrammetry using ImageJ (Version 1.53q) program. RESULTS Both groups were similar in terms of facial measurements (P > 0.05). Axial trunk rotation values of the mid-thoracic and thoraco-lumbar regions were significantly higher on both sides of the asymmetry group (P < 0.05). The distances between facial landmarks are not associated with asymmetries of spine regions (P > 0.05). CONCLUSION Although the sensitivity and predictive value of facial asymmetries in determining trunk asymmetries and sagittal spinal posture were low, it was concluded that comparative studies are needed, especially in individuals with asymmetry at the level of scoliosis, as the asymmetries of the individuals in our study were not at the level of scoliosis.
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Affiliation(s)
- Begumhan Turhan
- Baskent University, Faculty of Medicine, Department of Anatomy, Ankara
| | - Fatma Nur Alcin
- Burdur Mehmet Akif Ersoy University, Golhisar Vocational School of Health Services, Burdur
| | - Hilal Dogan
- Harran University, Vocational School of Health Services, Sanliurfa
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Jegnie M, Mulu A, Gissila A, Jegnie M, Minichil F. The Prevalence of Scoliosis among Adolescent Chest Radiographs Obtained at Tikur Anbessa Specialized Hospital in 2019. Ethiop J Health Sci 2023; 33:641-648. [PMID: 38784216 PMCID: PMC11111177 DOI: 10.4314/ejhs.v33i4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2024] Open
Abstract
Background Scoliosis is an abnormal side-to-side spinal curve of greater than or equal to 100 Cobb angle. It is the most common spinal deformity in children and adolescents. Epidemiological evidence about scoliosis is scarce in Africa, including Ethiopia. This study was aimed at determining the prevalence of scoliosis among adolescents and analysing its association with age and sex using plain chest radiographs obtained for non-spinal reasons in Tikur Anbessa Specialized Hospital. Method All non-tilted, non-rotated, and non-poorly penetrated digital plain chest radiographs of adolescents aged 10 to 19 years obtained at Tikur Anbessa Specialized Hospital between January 1 and December 31, 2019, were measured for the coronal Cobb angle. The data were cleaned, coded, and entered into SPSS version 26 for analysis. Chi-square, and linear regression, and logistic regression analyses were also carried out to evaluate the effect of sex and age on scoliosis. Results The Cobb angles of 1,369 posteroanterior chest radiographs of adolescents were measured. Thirty (2.2%, 95% CI: 1.4%, 3.0%) of these were found to have scoliosis. The mean coronal Cobb angle was 2.270±6.320. There was no statistically significant difference between the prevalence of scoliosis in boys (2.21%) and girls (2.17%) (X2=0.003, P=0.954). Likewise, age did not show any statistically significant difference in the prevalence of scoliosis (X2=2.655, P=0.265). Conclusion This study revealed that incidental finding of adolescent scoliosis in plain chest radiographs is common. Further study using whole spine radiography should be carried out to determine the true general population prevalence of scoliosis in Ethiopia.
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Affiliation(s)
- Mihretu Jegnie
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abay Mulu
- Department of Anatomy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azmera Gissila
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Misganaw Jegnie
- Department of Radiology, College of Medicine and Health Sciences, Hawassa University, Sidama, Ethiopia
| | - Fetahi Minichil
- Department of Radiology, St. Peter's Specialized Hospital, Addis Ababa, Ethiopia
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Lee JS, Shin K, Ryu SM, Jegal SG, Lee W, Yoon MA, Hong GS, Paik S, Kim N. Screening of adolescent idiopathic scoliosis using generative adversarial network (GAN) inversion method in chest radiographs. PLoS One 2023; 18:e0285489. [PMID: 37216382 DOI: 10.1371/journal.pone.0285489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Conventional computer-aided diagnosis using convolutional neural networks (CNN) has limitations in detecting sensitive changes and determining accurate decision boundaries in spectral and structural diseases such as scoliosis. We devised a new method to detect and diagnose adolescent idiopathic scoliosis in chest X-rays (CXRs) employing the latent space's discriminative ability in the generative adversarial network (GAN) and a simple multi-layer perceptron (MLP) to screen adolescent idiopathic scoliosis CXRs. MATERIALS AND METHODS Our model was trained and validated in a two-step manner. First, we trained a GAN using CXRs with various scoliosis severities and utilized the trained network as a feature extractor using the GAN inversion method. Second, we classified each vector from the latent space using a simple MLP. RESULTS The 2-layer MLP exhibited the best classification in the ablation study. With this model, the area under the receiver operating characteristic (AUROC) curves were 0.850 in the internal and 0.847 in the external datasets. Furthermore, when the sensitivity was fixed at 0.9, the model's specificity was 0.697 in the internal and 0.646 in the external datasets. CONCLUSION We developed a classifier for Adolescent idiopathic scoliosis (AIS) through generative representation learning. Our model shows good AUROC under screening chest radiographs in both the internal and external datasets. Our model has learned the spectral severity of AIS, enabling it to generate normal images even when trained solely on scoliosis radiographs.
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Affiliation(s)
- Jun Soo Lee
- Department of Industrial Engineering, Seoul National University, Seoul, Korea
| | - Keewon Shin
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung Min Ryu
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seong Gyu Jegal
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woojin Lee
- Department of Radiology, Hanyang University Hospital, Seoul, Korea
| | - Min A Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gil-Sun Hong
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sanghyun Paik
- Department of Radiology, Hanyang University Hospital, Seoul, Korea
| | - Namkug Kim
- Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Spinal Manual Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7928429. [PMID: 36644168 PMCID: PMC9833903 DOI: 10.1155/2023/7928429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023]
Abstract
Objective We conducted this meta-analysis to provide better evidence of the efficacy of manual therapy (MT) on adolescent idiopathic scoliosis (AIS). Methods All RCTs of MT for the management of patients with AIS were included in the present study. The treatment difference between the experimental and control group was mainly MT. The outcomes consisted of the total effective rate, the Cobb angle, and Scoliosis Research Society-22 (SRS-22) questionnaire score. Electronic database searches were conducted from database inception to July 2022, including the Cochrane Library, PubMed, Web of Science, Embase, Wanfang Data, CNKI, and VIP. The pooled data were analyzed using RevMan 5.4 software. Results Four RCTs with 213 patients in the experimental group were finally included. There are 2 studies of standalone MT in the experimental group and 3 studies of MT with identical conservative treatments in the control group. Three trials reported total effective rate, and a statistically significant difference was found (P = 0.004). Three trials reported Cobb angle, and a statistical difference was found (P = 0.01). Then, sensitivity analysis showed that there was a significant difference in the additional MT subgroup (P < 0.00001) while not in the standalone MT subgroup (P = 0.41). Three trials reported SRS-22 scores (P = 0.55) without significant differences. Conclusion There is insufficient data to determine the effectiveness of spinal manipulation limited by the very low quality of included studies. High-quality studies with appropriate design and follow-up periods are warranted to determine if MT may be beneficial as an adjunct therapy for AIS. Currently, there is no evidence to support spinal manipulation.
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Bowden D, Michielli A, Merrill M, Will S. Systematic review and meta-analysis for the impact of rod materials and sizes in the surgical treatment of adolescent idiopathic scoliosis. Spine Deform 2022; 10:1245-1263. [PMID: 35737287 PMCID: PMC9579082 DOI: 10.1007/s43390-022-00537-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess surgical and safety outcomes associated with different rod materials and diameters in adolescent idiopathic scoliosis (AIS) surgery. METHODS A systematic literature review and meta-analysis evaluated the surgical management of AIS patients using pedicle screw fixation systems (i.e., posterior rods and pedicle screws) with rods of different materials and sizes. Postoperative surgical outcomes (e.g., kyphosis and coronal correction) and complications (i.e., hyper/hypo-lumbar lordosis, proximal junctional kyphosis, revisions, reoperations, and infections) were assessed. Random-effects models (REMs) pooled data for outcomes reported in ≥ 2 studies. RESULTS Among 75 studies evaluating AIS surgery using pedicle screw fixation systems, 46 described rod materials and/or diameters. Two studies directly comparing titanium (Ti) and cobalt-chromium (CoCr) rods found that CoCr rods provided significantly better postoperative kyphosis angle correction vs. Ti rods during a shorter follow-up (0-3 months, MD = - 2.98°, 95% CI - 5.79 to - 0.17°, p = 0.04), and longer follow-up (≥ 24 months, MD = - 3.99°, 95% CI - 6.98 to - 1.00, p = 0.009). Surgical infection varied from 2% (95% CI 1.0-3.0%) for 5.5 mm rods to 4% (95% CI 2.0-7.0%) for 6 mm rods. Reoperation rates were lower with 5.5 mm rods 1% (95% CI 0.0-3.0%) vs. 6 mm rods [6% (95% CI 2.0-9.0%); p = 0.04]. Differences in coronal angle, lumbar lordosis, proximal junctional kyphosis, revisions, and infections did not differ significantly (p > 0.05) among rods of different materials or diameters. CONCLUSION For AIS, CoCr rods provided better correction of thoracic kyphosis compared to Ti rods. Patients with 5.5 mm rods had fewer reoperations vs. 6.0 and 6.35 mm diameter rods. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Dawn Bowden
- DePuy Synthes Spine, Johnson & Johnson Medical Devices, 325 Paramount Drive, Raynham, MA, 02767, USA.
| | - Annalisa Michielli
- DePuy Synthes Spine, Johnson & Johnson Medical Devices, 325 Paramount Drive, Raynham, MA, 02767, USA
| | - Michelle Merrill
- DePuy Synthes Spine, Johnson & Johnson Medical Devices, 325 Paramount Drive, Raynham, MA, 02767, USA
| | - Steven Will
- DePuy Synthes Spine, Johnson & Johnson Medical Devices, 325 Paramount Drive, Raynham, MA, 02767, USA
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15
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Pre-operative respiratory assessment for children with spinal deformity. Paediatr Respir Rev 2022; 43:60-66. [PMID: 35337746 DOI: 10.1016/j.prrv.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/25/2022] [Indexed: 11/21/2022]
Abstract
Pre-operative respiratory assessment of children with spinal deformity requires an understanding of the deformity, the proposed surgery and most importantly the children themselves. The assessment and the tailoring of investigations will differ according to the age, developmental level and co-morbidities of the child. This review uses a mixture of evidence and case-based practice in order to set out a suggested framework for pre-operative spinal assessment, and suggested recommendations that may be provided to best support children undergoing surgery for spinal deformity.
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Zhou L, Yang H, Hai Y, Hai JJ, Cheng Y, Yin P, Yang J, Zhang Y, Wang Y, Zhang Y, Han B. Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study. Front Public Health 2022; 10:983095. [PMID: 36062094 PMCID: PMC9437421 DOI: 10.3389/fpubh.2022.983095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/01/2022] [Indexed: 01/25/2023] Open
Abstract
Background The average altitude of Qinghai-Tibetan Plateau is 4,500 m and most of the residents are Tibetan ethnicity. The purpose of this study was to investigate the prevalence of scoliosis and associated factors among children in this region through a scoliosis screening program. Methods A cross-sectional study was preformed between May 2020 and December 2020 in Qinghai-Tibetan Plateau. A total of 9,856 children aged 6-17 years from schools and nearby villages were screened using visual inspection, the Adams forward-bending test, the angle of trunk rotation, and radiography. A self-designed questionnaire was used to collect demographic data. The prevalence of scoliosis and associated factors were analyzed. Results The overall prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%, with 5.38% for females and 2.11% for males. The prevalence of scoliosis was 3.50% in children resided below 4,500 m while 5.63% in those resided above 4,500 m (P = 0.001). The prevalence of congenital scoliosis (2.14 vs. 0.42%, P < 0.001) and neuromuscular scoliosis (0.34 vs. 0.07%, P = 0.041) were significantly higher in the altitude above 4,500 m. 50.00% of patients resided above 4,500 m were recommended for surgery while 16.24% in those resided below 4,500 m (P < 0.001). Independent associated factors were detected as female (OR = 2.217, 95 CI% 1.746-2.814, P < 0.001), BMI < 18.5 (OR = 1.767, 95 CI% 1.441-2.430, P = 0.005), altitude of residence ≥ 4,500 m (OR = 1.808, 95 CI% 1.325-2.483, P = 0.002), and sleep time < 8 h (OR = 2.264, 95 CI% 1.723-2.846, P = 0.001). Conclusion The prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%. With increasing altitudes, the prevalence of scoliosis and its major type were different from that at lower altitudes. Female, BMI < 18.5, altitude of residence ≥ 4,500 m, and sleep time < 8 h were independently associated with the prevalence of this disease. Early screening should be carried out before the age of 7 years, especially in the high-altitude, underdeveloped, and rural areas.
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Affiliation(s)
- Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China,*Correspondence: Lijin Zhou
| | - Honghao Yang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China,Yong Hai
| | - Junrui Joanthan Hai
- Princeton International School of Mathematics and Science, Princeton, NJ, United States
| | - Yunzhong Cheng
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Peng Yin
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Jincai Yang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yangpu Zhang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yunsheng Wang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Yiqi Zhang
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Bo Han
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
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Analysis of Scoliosis-related Medical Services in South Korea Between 2010 and 2018: A Cross-sectional Study Using Health Insurance Review and Assessment Service Data. Spine (Phila Pa 1976) 2022; 47:E499-E506. [PMID: 35752897 DOI: 10.1097/brs.0000000000004349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective, cross-sectional study. OBJECTIVES The aim of this study was to analyze types and cost of care for scoliosis and present health care utilization by patients to provide data on the standard treatment and cost for scoliosis in South Korea. SUMMARY OF BACKGROUND DATA Scoliosis is defined as an abnormally laterally curved spine with a Cobb angle of ≥10°.Data are lacking on which treatments are popular for general scoliosis and which service categories incur the most cost in South Korea. METHODS Data from the Health Insurance Review and Assessment Service-National Patient Sample were used. In total, 108,643 final cases and 32,362 patients in South Korea who received Western medicine care or Korean medicine care at least once with scoliosis (ICD-10 code M41) as the principal diagnosis during January 2010 to December 2018 comprised the study sample. We analyzed health care utilization according to certain factors (e.g., age, sex, payer type, type of visit, and medical institution), health care utilization by service category and service code, and medication prescriptions filled by private or hospital pharmacies. RESULTS Patients aged 24 years or younger most frequently utilized health care services, with more female (64.84%) than male patients (35.16%). Most patients received only Western medicine care (92.18%), whereas 6.56% only received Korean medicine care. Most cases (99.37%) corresponded to outpatient. Regarding service category, treatment and surgery, examination, special equipment and radiologic diagnosis accounted for a substantial percentage. Regarding service code, cost of examination, imaging, and physiotherapy comprised a high percentage of Western medicine, whereas cost of examination, acupuncture, and cupping therapy accounted for a high percentage of Korean medicine. The most commonly prescribed medications for scoliosis in pharmacies were anti-inflammatory analgesics (nonsteroidal anti-inflammatory drugs), antacids, and skeletal muscle relaxers. CONCLUSION The findings can be used as foundational data for experts such as health care policymakers, clinicians, and researchers.Level of Evidence: 4.
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Hu M, Zhang Z, Zhou X, Gao R, Wang C, Ma J, Meng Y, Zhou X. Prevalence and determinants of adolescent idiopathic scoliosis from school screening in Huangpu district, Shanghai, China. Am J Transl Res 2022; 14:4132-4138. [PMID: 35836864 PMCID: PMC9274610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify the prevalence of adolescent idiopathic scoliosis (AIS) and potential disease-related factors in children aged 11 to 16 years in the Huangpu district, Shanghai, China. METHODS A total of 10,731 children (5,518 boys and 5,213 girls) were screened in the year of 2019. The screening process included a bending forward test and scoliometer measurements. The children who were deemed to be at risk for scoliosis from the screening were referred for a X-ray examination to confirm the diagnosis. Data from basic and clinical characteristics of the screened children were collected. RESULTS 214 children (138 girls and 76 boys, P<0.05) were diagnosed with scoliosis with a prevalence of 2.00%. The mean angel was 15.61°. The groups with the highest prevalence were girls aged 14 and boys aged 15. CONCLUSION The prevalence of AIS in Huangpu district, Shanghai, China is 2.00% and is moderatley high, and it can occur more often in female children.
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Affiliation(s)
- Miao Hu
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Zheng Zhang
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Xin Zhou
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Rui Gao
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Ce Wang
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Jun Ma
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Yichen Meng
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
| | - Xuhui Zhou
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University Shanghai 200003, P. R. China
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Johnson MA, Gohel S, Flynn JM, Anari JB, Cahill PJ, Winell JJ, Baldwin KD. "Will I Need a Brace?": likelihood of curve progression to bracing range in adolescent idiopathic scoliosis. Spine Deform 2022; 10:537-542. [PMID: 35028915 DOI: 10.1007/s43390-021-00457-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/04/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Bracing treatment for adolescent idiopathic scoliosis (AIS) is typically initiated in skeletally immature patients with primary curves greater than 25°. The goal of this study was to develop a model predicting a patient's likelihood of progressing to bracing treatment. METHODS All patients with AIS presenting to a large pediatric spine center with a primary curve below 25° and skeletally immature (Sanders stage 1-6) were included. A patient was considered to have progressed into the bracing range if their primary curve reached a 25° threshold prior to skeletal maturity. Binary logistic regression analysis was performed to predict the likelihood of curve progression into bracing range. RESULTS A total of 180 patients (71% female) were included in this study with an average presenting age of 13.2 ± 1.4 years. At presentation, 31 (17%) were pre-peak height velocity, 62 (34%) were at their peak height velocity, and 87 (48%) were in the late adolescent growth stage. The high-risk patient group was defined as Sanders 1-2 and curve size > 10 and < 25° or Sanders 3-6 and curve size > 20 but < 25°. Those in the high-risk group demonstrated an over 5 times higher risk of progression to bracing range when accounting for age, sex, and curve location (OR: 5.168, 95% CI: 2.212-12.071, p < 0.001). CONCLUSION Patient's curve magnitude and skeletal maturity can be used to predict their likelihood of curve progression to greater than 25° and thus require bracing treatment. Orthopaedic providers can consider earlier treatment interventions or stricter follow-up adherence for patients at high risk for progression. LEVEL OF EVIDENCE 3-retrospective cohort study.
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Affiliation(s)
- Mitchell A Johnson
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shivani Gohel
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John M Flynn
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jason B Anari
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Patrick J Cahill
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer J Winell
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Keith D Baldwin
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Effectiveness of Acupuncture for Scoliosis: A Systematic Review. JOURNAL OF ACUPUNCTURE RESEARCH 2022. [DOI: 10.13045/jar.2021.00325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Scoliosis is a 3-dimensional change of the spine, presenting 10° above Cobb angle. Various acupuncture methods are being increasingly performed to correct scoliosis. However, no systematic review has been published. Therefore, we report on the effectiveness of acupuncture on mild scoliosis in this systematic review. We searched various databases for acupuncture treatment for scoliosis published before June 2021. The primary outcome was Cobb angle, and the secondary outcomes were patient-centered scores. Six studies were identified. RCTs that compared combination therapy with acupuncture, and other treatment methods and showed significant improvement in the Cobb angle, and effective rate, but, with low quality evidence. Acupuncture monotherapy resulted in significant improvement in the Cobb angle and had high heterogeneity compared with other treatment methods, but no significant improvement in the effective rate was observed, and the quality of evidence was low. Regardless of the type of scoliosis, acupuncture monotherapy or combination therapy with acupuncture showed significant improvement in the Cobb angle, and the quality of evidence was moderate. No serious adverse events were observed in the 6 studies reviewed. Acupuncture is considered safe, and it is more effective when performed with other conventional treatments.
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Wen JX, Yang HH, Han SM, Cao L, Wu HZ, Yang C, Li H, Chen LL, Li NN, Yu BH, Gao BL, Wu WJ. Trunk balance, head posture and plantar pressure in adolescent idiopathic scoliosis. Front Pediatr 2022; 10:979816. [PMID: 36340704 PMCID: PMC9627203 DOI: 10.3389/fped.2022.979816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The relationship of trunk balance with head posture and plantar pressure is unknown in patients with adolescent idiopathic scoliosis (AIS). OBJECTIVE To investigate the relationship of trunk balance with head posture and plantar pressure by analyzing the imaging data of patients with AIS. MATERIALS AND METHODS This retrospective study was performed on 80 AIS patients who had whole spine frontal and lateral radiographs, and the imaging parameters were measured and analyzed. RESULTS The coronal trunk imbalance rate was 67.5%, the trunk offset direction was towards left in 65 cases and right in 15 cases, and the head offset direction was towards left in 66 cases and right in 14 cases. The sagittal trunk imbalance rate was 57.25%. The distance of apical vertebrae and head offset in the coronal trunk balance group was significantly (P < 0.05) smaller than that in the imbalance group. The apical vertebrae offset distance and head offset distance were positively correlated with the tilt angle of trunk (r = 0.484 and 0.642, respectively, P < 0.05). The difference in the percentage of pressure load on the left and right foot was significantly (P < 0.05) greater in the coronal imbalance group than that in the balance group.The center of pressure (COP) sway area was significantly (P < 0.05) larger in the overall trunk imbalance group (both coronal and sagittal imbalance) than in the balanced group. CONCLUSION Most AIS patients have trunk imbalance which is severer on the coronal than on the sagittal plane. AIS patients with trunk imbalance show more significant local deformities, greater head offset, greater COP sway area, and decreased head and standing stability.
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Affiliation(s)
- Jin-Xu Wen
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Hui-Hui Yang
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Shu-Man Han
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Lei Cao
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Hui-Zhao Wu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Chen Yang
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Han Li
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Lin-Lin Chen
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Nuan-Nuan Li
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Bao-Hai Yu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Bu-Lang Gao
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Wen-Juan Wu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
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Yang JH, Chang DG, Suh SW. Diagnosis and conservative treatment of adolescent idiopathic scoliosis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.11.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Adolescent idiopathic scoliosis (AIS) has a diagnosis rate of 3% to 5% per year, but the number of cases requiring surgical treatments is very small, accounting for only 0.17% to 1.75% of all AIS patients. Most patients with AIS are diagnosed, treated, and managed in outpatient clinics.Current Concepts: AIS is a disease that occurs more frequently, and progresses faster, in females than in males. Scoliosis deformity can occur due to various causes. To differentially diagnose AIS, it is necessary to perform careful physical examinations, investigate family history, and check for neurological, growth, and developmental abnormalities. Definitive diagnosis of AIS can be performed through radiographic imaging. In the case of atypical curvature and symptoms, examinations such as magnetic resonance imaging could be required in addition to radiographic imaging. Treatment of AIS patients in outpatient clinics can be performed through observation, exercise, and orthosis. The selection and application of treatment methods and the termination period of the treatments are complexly affected by the age at the time of diagnosis; pattern, location and size of the curve; and growth potential.Discussion and Conclusion: AIS is a disease in which good results can be obtained with conservative treatments such as exercise and orthosis, which is generally applied in an outpatient setting. To properly treat AIS, it is necessary to have an in-depth understanding of the characteristics of AIS, timing of treatment, and factors influencing treatment.
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Mu X, Cui Y, Bian R, Long L, Zhang D, Wang H, Shen Y, Wu J, Zou G. In-depth learning of automatic segmentation of shoulder joint magnetic resonance images based on convolutional neural networks. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 211:106325. [PMID: 34536635 DOI: 10.1016/j.cmpb.2021.106325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) is gradually replacing computed tomography (CT) in the examination of bones and joints. The accurate and automatic segmentation of the bone structure in the MRI of the shoulder joint is essential for the measurement and diagnosis of bone injuries and diseases. The existing bone segmentation algorithms cannot achieve automatic segmentation without any prior knowledge, and their versatility and accuracy are relatively low. For this reason, an automatic segmentation algorithm based on the combination of image blocks and convolutional neural networks is proposed. METHODS First, we establish 4 segmentation models, including 3 U-Net-based bone segmentation models (humeral segmentation model, joint bone segmentation model, humeral head and articular bone segmentation model as a whole) and a block-based Alex Net segmentation model; Then we use 4 segmentation models to obtain the candidate bone area, and accurately detect the location area of the humerus and joint bone by voting. Finally, the Alex Net segmentation model is further used in the detected bone area to segment the bone edge with the accuracy of the pixel level. RESULTS The experimental data is obtained from 8 groups of patients in the orthopedics department of our hospital. Each group of scan sequence includes about 100 images, which have been segmented and labeled. Five groups of patients were used for training and five-fold cross-validation, and three groups of patients were used to test the actual segmentation effect. The average accuracy of Dice Coefficient, Positive Predicted Value (PPV) and Sensitivity reached 0.91 ± 0.02, respectively. 0.95 ± 0.03 and 0.95 ± 0.02. CONCLUSIONS The method in this paper is for a small sample of patient data sets, and only through deep learning on 2D medical images, very accurate shoulder joint segmentation results can be obtained, provide clinical diagnostic guidance to orthopedics. At the same time, the proposed algorithm framework has a certain versatility and is suitable for the precise segmentation of specific organs and tissues in MRI based on a small sample data.
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Affiliation(s)
- Xinhong Mu
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China.
| | - Yi Cui
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Rongpeng Bian
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Long Long
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Daliang Zhang
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Huawen Wang
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Yidong Shen
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Jingjing Wu
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
| | - Guoyou Zou
- Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, 166 Yulong Road West, Tinghu District, China; The First People's Hospital of Yancheng, 166 Yulong Road West, Tinghu District, China
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Bondar K, Nguyen A, Vatani J, Kessler J. The Demographics and Epidemiology of Infantile, Juvenile, and Adolescent Idiopathic Scoliosis in a Southern California Integrated Health Care System. Spine (Phila Pa 1976) 2021; 46:1468-1477. [PMID: 33813584 DOI: 10.1097/brs.0000000000004046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prognostic study, Level III. OBJECTIVES The aim of this study was to determine the incidence and demographics of idiopathic scoliosis (IS) in a large cohort of children in a Southern California integrated healthcare system, and to identify the demographic or clinical factors associated with the greatest risk of IS. SUMMARY OF BACKGROUND DATA Although many authors have reported on the incidence and prevalence of IS in children, there have been few incidence studies in the United States on large, self-contained populations. METHODS A retrospective chart analysis was done on diagnosed cases of IS within our integrated health care system in patients under age 18 years during the entire 2013 calendar year. Patient demographics were recorded and the incidence of IS was determined. Odds ratios (ORs) for having IS and for having more severe initial curve magnitudes based on demographics were determined using logistic regression models. RESULTS IS Incidence was 3.9, 28.6, and 393 per 100,000, respectively, for the infantile, juvenile, and adolescent group. The female incidence was more than twice that of males in all age groups. Multivariate logistic regression analysis showed Asians and non-Hispanic Whites had the highest OR of IS (OR 1.54 and 1.32 with 95% confidence interval [CI] 1.33-1.79 and 1.19-1.47). Whites, Blacks, and mixed-race patients had a significantly higher initial curve magnitude than Hispanics; females also had a significantly greater initial curve magnitude than boys (18.1° vs. 16.7°). Underweight patients had a 50% increased OR of IS versus normal weight (95% CI 1.16-1.94) with a progressively decreased OR of IS as weight increased. CONCLUSION Our study of a large integrated healthcare system sheds light on the incidence of IS and the ORs based on weight, sex, and ethnicity/race. The overall incidence was lower overall than previously thought.Level of Evidence: 3.
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Affiliation(s)
- Kevin Bondar
- Department of Education, The University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Annie Nguyen
- University of California, Irvine, School of Medicine, Irvine, CA
| | - Jasmine Vatani
- University of Virginia School of Medicine, Charlottesville, VA
| | - Jeffrey Kessler
- Kaiser Los Angeles Medical Center Department of Orthopedics, Los Angeles, CA
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Experimental Analysis of Fabricated Synthetic Midthoracic Paediatric Spine as Compared to the Porcine Spine Based on Range of Motion (ROM). Appl Bionics Biomech 2021; 2021:2799415. [PMID: 34608402 PMCID: PMC8487360 DOI: 10.1155/2021/2799415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
The present study is aimed at investigating the mechanical behaviour of fabricated synthetic midthoracic paediatric spine based on range of motion (ROM) as compared to porcine spine as the biological specimen. The main interest was to ensure that the fabricated synthetic model could mimic the biological specimen behaviour. The synthetic paediatric spine was designed as a 200% scaled-up model to fit into the Bionix Servohydraulic spine simulator. Biomechanical tests were conducted to measure the ROM and nonlinearity of sigmoidal curves at six degrees of freedom (DOF) with moments at ±4 Nm before the specimens failed. Results were compared with the porcine spine (biological specimen). The differences found between the lateral bending and axial rotation of synthetic paediatric spine as compared to the porcine spine were 18% and 3%, respectively, but was still within the range. Flexion extension of the synthetic spine is a bit stiff in comparison of porcine spine with 45% different. The ROM curves of the synthetic paediatric spine exhibited nonlinearities for all motions as the measurements of neutral zone (NZ) and elastic zone (EZ) stiffness were below “1.” Therefore, it showed that the proposed synthetic paediatric spine behaved similarly to the biological specimen, particularly on ROM.
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Prevalence of Back Pain and Idiopathic Scoliosis in Adolescents From the Semiarid Region of Brazil: A Cross-sectional Study. J Chiropr Med 2021; 20:97-107. [DOI: 10.1016/j.jcm.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022] Open
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Factors affecting the prevalence of idiopathic scoliosis among children aged 8-15 years in Prishtina, Kosovo. Sci Rep 2021; 11:16786. [PMID: 34408255 PMCID: PMC8373958 DOI: 10.1038/s41598-021-96398-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
Prospective study, Level of evidence II. The aim of the study was to assess the prevalence of scoliosis among children aged 8–15 years old and to identify the impact of schoolbag weight in developing adolescent idiopathic scoliosis (AIS). AIS is a common disease whose prevalence varies between countries and gender, with an increased rate among females compared to males. Screening children in primary school settings for idiopathic scoliosis (IS) is an important public health issue and is crucial for early detection, prevention of further deformity, and healthy child growth. Our sample was composed of 1619 pupils from the municipality of Prishtina, surveyed from March to April 2019. Measurements were made with a scoliometer on the basis of the Adams test process. Three measurements were taken for each of the participants. Additionally, all the pupils were subjected to bare-foot height and weight measurements with and without school bags. The mean ± standard deviation age of pupils was 11.67 ± 2.00 years old and 49% were females. The prevalence of the angle of trunk rotation (ATR) ≥ 5 ° was 26.1%, females had 1.49 higher odds (95%CI 1.19–1.86) to develop an ATR of ≥ 5° compared to males. The highest rate of ATR of ≥ 5° was seen among the ninth-grade students (31.3%). 56.5% of 4th grade students carry a schoolbag weighing over 12.5% of body weight. Relatively high prevalence of idiopathic scoliosis was found in primary schools in Prishtina. The highest prevalence was found in students attending the ninth grade, while females gender dominated.
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Cheung AKP, Lau CCY, Chan MCM, Kwan KYH. Development and validation of the scoliosis misconception scale (SMS) for assessing level of misconception of patients with adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:3517-3524. [PMID: 34341882 DOI: 10.1007/s00586-021-06943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about patients' understanding of adolescent idiopathic scoliosis (AIS). This paper aims to develop and validate the Scoliosis Misconception Scale (SMS) and to explore patients' level of misconception about AIS. METHODS A total of 195 patients who were newly referred with newly diagnosed AIS were recruited to assess their levels of misconception and psychological distress before and after their first consultation with a specialist. The 17-item SMS was administered to assess patients' level of misconception about AIS and the Kessler Psychological Distress Scale (K10) was used to measure their level of distress. RESULTS According to the Item Response Theory, all items were within the acceptable range from -3.69 to 2.39 for difficulty parameters, which determined the difficulty of the scale, while most of the items were within the acceptable range from 0.11 to 1.54 for the discrimination parameters, which determined the rate at which the probability of endorsing a correct item changes given ability levels. Internal consistency by marginal reliability was 0.66. One-sample t test revealed that participants on average scored 6.79 (SD = 2.12) before the first clinic session and 6.45 (SD = 2.51) after the first clinic session, both significantly higher than 0 [t(75) = 27.86, p < .001; t(75) = 22.43, p < .001]. CONCLUSIONS Despite a longstanding clinical model that functions well to treat AIS, most patients still have significant misconceptions about the condition. This highlights the necessity to assess patients' knowledge level of a medical condition and potential generalisability of misconception-distress link to the forefront across other illnesses.
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Affiliation(s)
- Amy Ka Po Cheung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong
| | - Charlie Chiu Yi Lau
- Department of Rehabilitation Sciences, The Polytechnic University of Hong Kong, Pokfulam, Hong Kong
| | - Meanne Ching Man Chan
- Wofoo Joseph Lee Consulting and Counselling Psychology Research Centre, Lingnan University, Tuen Mun, Hong Kong
| | - Kenny Yat Hong Kwan
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong.
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Incidence and Surgery Rate of Idiopathic Scoliosis: A Nationwide Database Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158152. [PMID: 34360445 PMCID: PMC8346015 DOI: 10.3390/ijerph18158152] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Idiopathic scoliosis is the most common cause of three-dimensional deformities of the spine. Most of the previous studies have been cross-sectional studies to estimate the prevalence in the general population. An age-matched, population-based study is performed using nationwide databases between 2011 and 2015. The incidence rates of idiopathic scoliosis by age group, sex, and region are identified. We also investigate the pattern of medical institution use and the surgery rate of patients with idiopathic scoliosis. Our results show that a total of 268,372 patients were diagnosed with idiopathic scoliosis. The overall incidence was 0.497%, and the incidence for females was 1.44 times higher than for males. By age group, the incidence of adolescent idiopathic scoliosis in patients aged 10–14 years was 0.821% compared to 0.029%, 0.192%, and 0.709% for those patients aged 0–2, 3–9, and 15–19 years, respectively. Both male and female urban populations had higher incidences than rural populations with no age differences at diagnosis. Survival analysis confirmed that 0.7% of diagnosed patients underwent surgical treatment within five years. Understanding the epidemiology of idiopathic scoliosis is helpful in diagnosing high risk patients and monitoring surgical interventions.
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Jeon KK, Kim DI. Low Body Mass Index Levels and Idiopathic Scoliosis in Korean Children: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:570. [PMID: 34356550 PMCID: PMC8303972 DOI: 10.3390/children8070570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of idiopathic scoliosis is rapidly increasing in Korean children, but research on the disorder is limited compared to that in other countries. Accordingly, in the present study, we aimed to investigate the relationship between idiopathic scoliosis and body mass index (BMI) levels in Korean children. METHODS This cross-sectional study enrolled elementary school students and middle school first graders in the Capital Area in Korea. The participants underwent body composition measurements and screening for idiopathic scoliosis. Idiopathic scoliosis was defined as a Cobb angle of ≥10°. The students were classified into three groups-the severely underweight (SUW: BMI < 16 kg/m2) group, the underweight group (UW: 16 ≤ BMI < 18.5 kg/m2), and the normal weight group (NW: 18.5 ≤ BMI < 25 kg/m2) to compare the risk of idiopathic scoliosis across BMI levels. RESULTS The final cohort comprised 1375 participants. The odds ratio (OR) of idiopathic scoliosis was 0.69 (95% confidence interval (CI): 0.50-0.94) and 0.66 (95% CI: 0.49-0.89) for the UW and the NW groups, respectively, with the SUW group as the reference. This shows that the risk decreased significantly by 31% and 34% in the UW and the NW groups, respectively. After controlling for age and sex, the corresponding ORs were 0.72 (95% CI: 0.52-0.98) and 0.70 (95% CI: 0.51-0.96), and the risk significantly decreased by 28% and 30% in the UW and the NW groups, respectively. CONCLUSIONS Low body weight is closely associated with spinal deformity and idiopathic scoliosis.
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Affiliation(s)
- Kyoung-kyu Jeon
- Division of Sports Science, Incheon National University, Incheon 22012, Korea;
- Sport Science Institute, Incheon National University, Incheon 22012, Korea
- Health Promotion Center, Incheon National University, Incheon 22012, Korea
- Functional Rehabilitation Biomechanics Laboratory, Incheon National University, Incheon 22012, Korea
| | - Dong-il Kim
- Sport Science Institute, Incheon National University, Incheon 22012, Korea
- Health Promotion Center, Incheon National University, Incheon 22012, Korea
- Division of Health and Kinesiology, Incheon National University, Incheon 22012, Korea
- Exercise Medicine & Disability & Rehabilitation Laboratory, Incheon National University, Incheon 22012, Korea
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Thomas JJ, Stans AA, Milbrandt TA, Kremers HM, Shaughnessy WJ, Larson AN. Trends in Incidence of Adolescent Idiopathic Scoliosis: A Modern US Population-based Study. J Pediatr Orthop 2021; 41:327-332. [PMID: 34096545 PMCID: PMC8542350 DOI: 10.1097/bpo.0000000000001808] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND A successful disease screening strategy requires a high incidence of the condition, efficacy of early treatment, and efficient detection. There is limited population-based data describing trends in incidence of adolescent idiopathic scoliosis (AIS) in the United States and potential role of school screening programs on the incidence of AIS. Thus, we sought to evaluate the incidence of AIS over a 20-year period between 1994 and 2013 using a population-based cohort. METHODS The study population comprised 1782 adolescents (aged 10 to 18 y) with AIS first diagnosed between January 1, 1994 and December 31, 2013. The complete medical records and radiographs were reviewed to confirm diagnosis and coronal Cobb angles at first diagnosis. Age-specific and sex-specific incidence rates were calculated and adjusted to the 2010 United States population. Poisson regression analyses were performed to examine incidence trends by age, sex, and calendar period. RESULTS The overall age-adjusted and sex-adjusted annual incidence of AIS was 522.5 [95% confidence interval (CI): 498.2, 546.8] per 100,000 person-years. Incidence was about 2-fold higher in females than in males (732.3 vs. 338.8/100,000, P<0.05). The incidence of newly diagnosed AIS cases with radiographs showing a Cobb angle >10 degrees was 181.7 (95% CI: 167.5, 196.0) per 100,000 person-years. The overall incidence of AIS decreased significantly after discontinuation of school screening in 2004 (P<0.001). The incidence of bracing and surgery at initial diagnosis was 16.6 (95% CI: 12.3, 20.9) and 2.0 (95% CI: 0.5, 3.4) per 100,000 person-years, respectively. CONCLUSIONS Overall population-based incidence of AIS decreased after school screening was discontinued. However, incidence of patients with a Cobb angle >10 degrees, initiation of bracing and surgery did not change significantly over time. This provides further data to help determine the role of scoliosis screening. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Joshua J Thomas
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
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Idiopathic scoliosis and associated factors among school children: a school-based screening in Ethiopia. ACTA ACUST UNITED AC 2021; 79:107. [PMID: 34144710 PMCID: PMC8212494 DOI: 10.1186/s13690-021-00633-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022]
Abstract
Background Early detection of scoliosis is a preface to prevent progression. In resource-constrained countries like Ethiopia, there is a need for a cost-effective reliable solution for screening. The surprising fact is that there is neither idiopathic scoliosis screening nor reporting of data from Ethiopia. This study aimed to identify the magnitude, associated factors of scoliosis among school children by using non-invasive and less expensive scoliometer Smartphone app and Adams forward bending test. Methods A school-based cross-sectional survey was carried out from March to June 2019 at seven primary schools. Children were screened by using physical examination (Adams forward bend test) and scoligauge iPhone app. Univariate and multivariable binary logistic regression model analysis was used to identify factors associated with idiopathic scoliosis. Results A total of 1905 children aged between 5 and 16 years were screened, 3.3 % (95 % CI 2.5–4.1) of them were found positive using the scoligauge HD and among them only 1.8 % were identified positive for Adam’s forward bend test. The associated factors of idiopathic scoliosis identified by multivariate analysis were; spinal pain (AOR 4.1, 95 % CI 2.42, 6.89), student sitting on stool: (AOR, 7.03; 95 % CI, 1.52, 32.5), sitting on the bench with a backrest (AOR 4.12; 95 %CI, 1.12, 15.14) and sitting on the bench without backrest: (AOR 4.56; 95 % CI 1.20, 17.34). Conclusions The magnitude of idiopathic scoliosis was relatively low in study setup. More attention is needed towards sitting furniture designs and for children reporting spinal pain.There is a reasonable level of recommendation to advocate that large school-based scoliosis screening was able to detect scoliosis among school children. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00633-0.
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Shear wave elastography of the lateral abdominal muscles in C-shaped idiopathic scoliosis: a case-control study. Sci Rep 2021; 11:6026. [PMID: 33727639 PMCID: PMC7966386 DOI: 10.1038/s41598-021-85552-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/03/2021] [Indexed: 01/09/2023] Open
Abstract
Considering that knowledge about lateral abdominal muscles (LAM) in idiopathic scoliosis (IS) is still very limited, the aims of this study were: (a) to compare LAM thickness and elasticity between C-shaped IS and non-scoliotic population; and (b) to compare LAM thickness and elasticity between C-shaped thoracic, thoracolumbar, and lumbar IS. A total of 259 adolescents were included in the final analysis; among these, 108 were IS and 151 were non-IS. LAM thickness and elasticity were measured at rest and during isometric contraction by an Aixplorer ultrasound scanner. Out of all LAM, only OE thickness was higher on the convex body side compared to the concave side in lumbar and thoracolumbar scoliosis. It may be related with muscle’s atrophy/hypertrophy or other tissues displacement rather than different force generated by the muscle on both body sides, because an asymmetry in the elasticity of the LAM between the convex and concave side was not presented. The only TrA was stiffer in lumbar scoliosis compared to thoracolumbar and thoracic scoliosis. LAM elasticity was similar in IS and non-IS adolescents.
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Park SJ, Lee KH, Lee CS, Kim KT, Jang JH, Shin DH, Kim MS, Kim J, Cho SY, Jin DK. Impact of growth hormone treatment on scoliosis development and progression: analysis of 1128 patients with idiopathic short stature. J Pediatr Endocrinol Metab 2021; 34:243-250. [PMID: 33180047 DOI: 10.1515/jpem-2020-0393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the impact of recombinant human growth hormone (rhGH) on the development and progression of scoliosis in patients with idiopathic short stature (ISS). METHODS Patients with ISS who underwent rhGH treatment from 1997 to 2017 and were followed up for scoliosis screening with serial radiographic examination were included. For assessing scoliosis development, patients who did not have scoliosis at the time of rhGH treatment were included and followed up to determine whether de novo scoliosis developed during the treatment. For evaluating scoliosis progression, patients who already had scoliosis were analyzed. Univariate and multivariate Cox regression analyses of demographic and radiographic variables were performed to determine the related factors in the development and progression of scoliosis. RESULTS For assessing scoliosis development, 1093 patients were included. The average duration of rhGH treatment was about 2 years. De novo scoliosis developed in 32 patients (3.7%). The analysis revealed that sex (p=0.016) and chronological age (p=0.048) were statistically significant factors associated with scoliosis development. However, no relationship was observed between scoliosis development and rhGH treatment types or duration. Among 67 patients who already had scoliosis at the time of rhGH treatment, 11 (16.4%) showed scoliosis progression. However, the rhGH types and duration also did not affect scoliosis progression. CONCLUSIONS De novo scoliosis developed in 3.7% and scoliosis progressed in 16.4% of the patients during rhGH treatment. However, scoliosis development or progression was not affected by the types or duration of rhGH treatment in patients with ISS.
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Affiliation(s)
- Se-Jun Park
- Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Keun-Ho Lee
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Chong-Suh Lee
- Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ki-Tack Kim
- Department of Orthopedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Republic of Korea
| | - Jun Hyuk Jang
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Dae Hun Shin
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Min Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jiyeon Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lee SW, Chu HY, Kim H, Lee SG, Choi JY, Lee YJ, Choi KE. A Review of the Domestic Trends of Korean Traditional Medicine for Idiopathic Scoliosis. ACTA ACUST UNITED AC 2020. [DOI: 10.18325/jkmr.2020.30.4.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Sang-Woon Lee
- Departments of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Hui-Yeong Chu
- Departments of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Ho Kim
- Departments of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Sang-Gun Lee
- Departments of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Jae-Yong Choi
- Departments of Rehabilitation Medicine of Korean Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Yu-Jin Lee
- Korean Internal Medicine, Haeundae Jaseng Hospital of Korean Medicine
| | - Kang-Eah Choi
- Oriental Neuropsychiatry Medicine, Haeundae Jaseng Hospital of Korean Medicine
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Płaszewski M, Grantham W, Jespersen E. Screening for scoliosis - New recommendations, old dilemmas, no straight solutions. World J Orthop 2020; 11:364-379. [PMID: 32999857 PMCID: PMC7507078 DOI: 10.5312/wjo.v11.i9.364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/29/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
This opinion review considers the prevailing question of whether to screen or not to screen for adolescent idiopathic scoliosis. New and improved standards of people-oriented care and person-centredness, as well as improved principles of preventive screening and guideline development, have been postulated and implemented in health care systems and cultures. Recommendations addressing screening for scoliosis differ substantially, in terms of their content, standards of development and screening principles. Some countries have discontinued issuing recommendations. In the last decade, a number of updated and new recommendations and statements have been released. Systematically developed guidelines and recommendations are confronted by consensus and opinion-based statements. The dilemmas and discrepancies prevail. The arguments concentrate on the issues of the need for early detection through screening in terms of the effectiveness of early treatment, on costs and cost-effectiveness issues, scientific and epidemiologic value of screenings, and the credibility of the sources of evidence. The problem matter is of global scale and applies to millions of people. It regards clinical and methodological dilemmas, but also the matter of vulnerable and fragile time of adolescence and, more generally, children's rights. The decisions need to integrate people's values and preferences - screening tests need to be acceptable to the population, and treatments need to be acceptable for patients. Therefore we present one more crucial, but underrepresented in the discussion, issue of understanding and implementation of the contemporary principles of person-centred care, standards of preventive screening, and guideline development, in the context of screening for scoliosis.
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Affiliation(s)
- Maciej Płaszewski
- Department of Rehabilitation in Biała Podlaska, Józef Piłsudski University of Physical Education, Biała Podlaska 21-500, Poland
| | - Weronika Grantham
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education, Biała Podlaska 21-500, Poland
| | - Ejgil Jespersen
- Department of Rehabilitation in Biała Podlaska, Józef Piłsudski University of Physical Education, Biała Podlaska 21-500, Poland
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Etemadifar M, Hadi A, Nazem K, Esfahani MA, Rabiei A, Taghvaee F, Mostajeran M, Nemati A. Epidemiology of adolescent idiopathic scoliosis in Isfahan, Iran: A school-based study during 2014-2015. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:48. [PMID: 32765618 PMCID: PMC7377126 DOI: 10.4103/jrms.jrms_418_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/30/2017] [Accepted: 03/20/2020] [Indexed: 11/04/2022]
Abstract
Background: Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors. Materials and Methods: This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded. Results: A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%. Conclusion: The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment.
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Affiliation(s)
- Mohammadreza Etemadifar
- Department of Orthopaedic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdollah Hadi
- Department of Orthopaedic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khalilollah Nazem
- Department of Orthopaedic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Meisam Abdar Esfahani
- Student Research, Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Rabiei
- Student Research, Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshte Taghvaee
- Student Research, Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Mostajeran
- Student Research, Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Nemati
- Department of Orthopaedic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research, Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Chung LY, Nam HK, Rhie YJ, Huh R, Lee KH. Prevalence of idiopathic scoliosis in girls with central precocious puberty: effect of a gonadotropin-releasing hormone agonist. Ann Pediatr Endocrinol Metab 2020; 25:92-96. [PMID: 32615688 PMCID: PMC7336263 DOI: 10.6065/apem.1938164.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/28/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and occurs in children between 10 to 18 years old, during periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), due to early growth spurt, AIS is expected to develop before 10 years of age. Both AIS and CPP are more common in girls than in boys. The aim of this study was to determine the prevalence of AIS in girls with CPP and to evaluate the effect of treatment with gonadotropin-releasing hormone (GnRH) agonists on progression of scoliosis in these patients. METHODS We retrospectively reviewed medical records of 553 girls, 338 with CPP and 215 without CPP. Scoliosis angle was measured on the standing frontal radiograph of each patient according to the Cobb method. Patients with a Cobb angle of 10° or more were diagnosed with scoliosis. For girls with CPP, followup spine radiographs were collected 1 year after treatment with GnRH agonists. Progression of scoliosis before and after treatment was compared in terms of Cobb angle changes. RESULTS AIS was more prevalent in girls that were affected by CPP compared to controls without CPP (11.5% vs. 6.0%, CPP girls vs. non-CPP girls, respectively, P=0.031). The peak serum luteinizing hormone level positively correlated with Cobb angle (R2=0.015, P=0.023) in the CPP group. No progression of scoliosis was observed in CPP girls after one year of GnRH agonist treatment. Additionally, the prevalence of scoliosis decreased in CPP girls after 1 year of the treatment. CONCLUSION We report that the prevalence of AIS is higher in girls with CPP than in non-CPP patients. A regular follow-up schedule for spine radiographs should be considered to reduce the risk of progression. Furthermore, GnRH agonist treatment for CPP may have a suppressive effect on progression of AIS.
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Affiliation(s)
- Lindsey Yoojin Chung
- Department of Pediatrics, Myongji Hospital, Hanyang University College of Medicine, Ilsan, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea,Address for correspondence: Kee-Hyoung Lee, MD, PhD Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Goryeodae-ro Seongbuk-gu, Seoul 02841, Korea Tel: +82-2-920-6604 Fax: +82-2-922-7476 E-mail:
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A Practical Study of Diagnostic Accuracy: Scoliosis Screenings of Middle School Students by a Trained Nurse With a Smartphone Versus a Spine Surgeon With a Scoliometer. Spine (Phila Pa 1976) 2020; 45:E266-E271. [PMID: 31568349 DOI: 10.1097/brs.0000000000003256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE This study aimed to assess the accuracy of smartphone-aided diagnosis of scoliosis by a trained nurse compared with scoliometer-based diagnosis by a spine surgeon. SUMMARY OF BACKGROUND DATA Many assessments have been developed to estimate the reliability of smartphone-aided measurements in diagnosing scoliosis. However, clinical studies assessing the accuracy of smartphone-aided diagnosis with radiographs or scoliometers are scarce. METHODS A total of 2702 grade 7 students (mean age 13.56 yrs, range 13-15) at 10 middle schools were first screened with a smartphone by a trained nurse from the orthopedics department. Approximately half a year later, most of the students underwent a chest x-ray examination as part of a compulsory medical examination. Students with suspicious findings in either the first screen or the chest x-ray were recommended to a scoliosis clinic for single-blind tests, such as a forward bending test (FBT) and an analysis of the angle of trunk rotation (ATR) with a scoliometer, performed by an experienced spine surgeon. Finally, the Cobb method was conducted with full-spine radiographs to serve as the gold standard. RESULTS The agreement between the first screening by the nurse and the second test by the spine surgeon was low in cases with a Cobb angle <10° (κ = 0.128 [0.04-0.22], P = 0.035) and fair in cases with a Cobb angle >10° (κ = 0.349 [0.19-0.50], P < 0.001). The results of receiver operating characteristic (ROC) curve analysis also suggested that these two tests were similar in their ability to diagnose scoliosis. However, when the Cobb angle cutoff was adjusted to 15°, the latter had markedly better diagnostic ability than the former. Overall, the sensitivity of the smartphone screening was not acceptable for recognizing scoliosis. CONCLUSION This study revealed that smartphone-aided screening for scoliosis is risky. LEVEL OF EVIDENCE 3.
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Ekşi MŞ, Özcan-Ekşi EE, Huet SE, Dinç T, Özmen BB, Akçal MA. Prevalence of Thoracic Scoliosis in Adolescents in Turkey: Analysis of 1065 Chest Radiographs. World Neurosurg 2020; 135:e527-e540. [DOI: 10.1016/j.wneu.2019.12.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 11/30/2022]
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Pan XX, Huang CA, Lin JL, Zhang ZJ, Shi YF, Chen BD, Zhang HW, Dai ZY, Yu XP, Wang XY. Prevalence of the thoracic scoliosis in children and adolescents candidates for strabismus surgery: results from a 1935-patient cross-sectional study in China. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:786-793. [PMID: 32112152 DOI: 10.1007/s00586-020-06341-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE No study so far has paid attention to strabismus-related spinal imbalance. This study aimed to determine the epidemiology of thoracic scoliosis in children and adolescents with strabismus and investigate the association of two diseases. METHODS AND DESIGN A cross-sectional study. Study group consists of 1935 consecutive candidates for strabismus surgery (4-18 years); Control group consists of the age- and sex-matched patients with respiratory diseases. All subjects underwent a screening program based on chest plain radiographs using the Cobb method. Their demographic information, clinical variables and results of Cobb angle were recorded and analyzed. RESULTS A significantly higher prevalence of thoracic scoliosis (289/1935, 14.94% versus 58/1935, 3.00%) was found in study group compared with control group. Among strabismic patients, the coronal thoracic scoliosis curve mainly distributed in right and in main thoracic (198/289) and in the curves 10°-19° (224/289); Age range 7-9 years (103/1935), female (179/1935) and concomitant exotropia patients (159/851) were more likely to have thoracic scoliosis. According to the logistic regression, thoracic scoliosis had no significant association with age, BMI, duration of illness and onset age (p > 0.05). However, gender, BCVA, type of strabismus and degree of strabismus showed a significant relationship with the prevalence of thoracic scoliosis (p < 0.05). CONCLUSIONS With a pooled prevalence of 14.94%, strabismus patients showed a great higher risk of developing thoracic scoliosis. Screening for scoliosis in strabismus patients can be helpful to discover a high prevalence of potential coronal scoliosis. More attention should be paid to ophthalmological problems in patients with scoliosis. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Xiang-Xiang Pan
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chong-An Huang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jia-Liang Lin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zeng-Jie Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi-Feng Shi
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bo-Da Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hua-Wei Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhi-Yue Dai
- Ophthalmology Department, The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Center for Clinical Medical Research (Eye Diseases), Zhengzhou Second Hospital, Zhengzhou, China
| | - Xin-Ping Yu
- Ophthalmology Department, The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- National Center for Clinical Medical Research (Eye Diseases), Zhengzhou Second Hospital, Zhengzhou, China
| | - Xiang-Yang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Zhejiang Spine Research Center, Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325000, Zhejiang, China.
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Development and validation of a bespoke phantom to test accuracy of Cobb angle measurements. Radiography (Lond) 2020; 26:e78-e87. [PMID: 32052769 DOI: 10.1016/j.radi.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is a spinal deformity that causes the spine to bend laterally. Patients with AIS undergo frequent X-ray examinations to monitor the progression of the disorder by through the measurement of the Cobb angle. Frequent exposure of adolescents poses the risk of radiation-induced cancer. The aim of this research was to design and build a bespoke phantom representing a 10-year-old child with AIS to allow optimisation of imaging protocols for AIS assessment through the accuracy of Cobb angle measurements. METHODS Poly-methyl methacrylate (PMMA) and plaster of Paris (PoP) were used to represent human soft tissue and bone tissue, respectively, to construct a phantom exhibiting a 15° lateral curve of the spine. The phantom was validated by comparing the Hounsfield unit (HU) of its vertebrae with that of human and sheep. Additionally, comparisons of signal-to-noise ratio (SNR) to those from a commercially available phantom. An assessment of the accuracy of the radiographic assessment of the Cobb angle measurement was performed. RESULTS The HU of the PoP vertebrae was 628 (SD = 56), human vertebrae was 598 (SD = 79) and sheep vertebra was 605 (SD = 83). The SNR values of the two phantoms correlated strongly (r = 0.93 (p = 0.00)). The measured scoliosis angle was 14°. CONCLUSION The phantom has physical characteristics (in terms of spinal deformity) and radiological characteristics (in terms of HU and SNR values) of the spine of a 10-year-old child with AIS. This phantom has utility for the optimisation of x-ray imaging techniques in 10 year old children. IMPLICATIONS FOR PRACTICE A phantom to investigate new x-ray imaging techniques and technology in the assessment of scoliosis and to optimise currently used protocols.
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Low Body Mass Index for Early Screening of Adolescent Idiopathic Scoliosis: A Comparison Based on Standardized Body Mass Index Classifications. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:24-29. [DOI: 10.1016/j.anr.2019.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/25/2019] [Accepted: 12/26/2019] [Indexed: 01/25/2023] Open
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Faulty posture: Prevalence and its relationship with Body Mass Index and Physical Activity among female adolescents. BIOMEDICAL HUMAN KINETICS 2020. [DOI: 10.2478/bhk-2020-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Study aim: The aim of this study was to determine the prevalence of postural disorders and their associated risk factors among high school girls in the city of Tabriz, Iran.
Material and methods: A cross-sectional study was conducted on 400 female students aged 14 to 18 years. Students were examined using a scoliometer, a Debrunner kyphometer, and a flexible ruler, and were directly studied for genu varum/valgum. The information about possible risk factors such as age, BMI, school bag, study time, use of social networks, and physical activity was collected through demographic survey and the International Physical Activity Questionnaire. Data were analyzed by SPSS ver. 22 through independent t-test, chi-square, and logistic regression.
Results: 181 participants (45%) had one or more abnormalities such as scoliosis (4%), kyphosis (5%), genu varum (5.7%), genu valgum (9.7%), hyperlordosis (11.2%), and asymmetrical shoulder (24.5%). The risk of hyperlordosis increased with increase in weight (OR: 1.08, 95%CI: 1.02 to 1.15; p = 0.014) and BMI (OR: 1.37, 95%CI: 1.13 to 1.67; p = 0.002). Moreover, the odds for genu valgum increased with increase in weight (OR: 1.07, 95%CI: 1.01 to 1.13; p = 0.045) and BMI (OR: 1.84, 95%CI: 1.29 to 2.62; p < 0.001); but it decreased with increase in age (OR: 0.62, 95%CI: 0.39 to 0.98; p = 0.039) and not using a study table (OR: 0.31, 95%CI: 0.12 to 0.78; p = 0.013).
Conclusions: Forty-five percent of female students had one or more postural abnormalities. Asymmetrical shoulder was the most common disorder. Weight and BMI were associated with genu valgum and hyperlordosis.
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Golalizadeh D, Toopchizadeh V, Fasaie N, Dolatkhah N. Body composition indices in a sample of female adolescents with postural deformity: a case control study. BMC Res Notes 2019; 12:754. [PMID: 31747969 PMCID: PMC6865060 DOI: 10.1186/s13104-019-4794-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives Normal posture is considered to be an indicative of good musculoskeletal health in school aged adolescents. Little is known about the body composition indices in relation with postural deformities in adolescents. The aim of this study was to assess relation of body composition analysis indices with postural deformities in a sample of female high school adolescents. Results In this case–control study, 37 eligible female adolescents with any postural deformities and 33 normal posture subjects enrolled in the study by random cluster sampling. Body composition analysis performed by bioelectrical impedance analysis (BIA) method to quantity body fat mass (BFM), soft lean mass (SLM) and lean body mass (LBM). The binary logistic regressions were performed to evaluate the associations of body composition indices which were significantly different between two groups at significance level of 0.05 with postural disorders in the two groups. There was no significant difference between subjects with postural disorders with their normal controls concerning demographic variables. We observed an inverse association between postural deformity risk and LBM (OR = 0.803; 95% CI 0.690–0.934) and SLM (OR = 0.774; 95% CI 0.649–0.922) after adjusting the analysis by height of participants.
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Affiliation(s)
- Dina Golalizadeh
- Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Vahideh Toopchizadeh
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran
| | - Negar Fasaie
- Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran.
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Toombs C, Lonner B, Fazal A, Boachie-Adjei O, Bastrom T, Pellise F, Ramadan M, Koptan W, ElMiligui Y, Zhu F, Qiu Y, Shufflebarger H. The Adolescent Idiopathic Scoliosis International Disease Severity Study: Do Operative Curve Magnitude and Complications Vary by Country? Spine Deform 2019; 7:883-889. [PMID: 31731998 DOI: 10.1016/j.jspd.2019.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The prevalence of adolescent idiopathic scoliosis (AIS) in diverse regions of the world has been studied. Access to care varies widely, and differences in disease severity and operative treatment outcomes are not well understood. This study aimed to determine variation in disease presentation and operative complications for AIS patients from an international cohort. METHODS This is a retrospective study carried out at seven surgical centers in the United States (Manhattan and Miami), Ghana, Pakistan, Spain, Egypt, and China. A total of 541 consecutive patients with AIS were evaluated. Preoperative major curve magnitude, operative parameters, and complications were compared among sites using analysis of variance with post hoc tests and Pearson correlation coefficients. Univariate and multivariate forward stepwise binary logistic regressions determined the variables most predictive of complications. RESULTS Countries with lowest-access to care (Ghana, Egypt, and Pakistan) displayed larger curves, more levels fused, longer operative time (OT), and greater estimated blood loss (EBL) than the other countries (p ≤ .001). Increasing curve magnitude was correlated with greater levels fused, longer OT, and greater EBL in all groups (p = .01). In the univariate regression analysis, Cobb magnitude, levels fused, EBL, and OT were associated with complication occurrence. Only OT remained significantly associated with complication occurrence after adjusting for Cobb magnitude, levels fused, and site (odds ratio [OR] = 1.005, 95% confidence interval 1.001-1.007, p = .003). Complications were greatest in Pakistan and Ghana (21.7% and 13.5%, respectively) and lowest in Miami (6.5%). CONCLUSIONS Larger curve magnitudes in the least-access countries correlated with more levels fused, longer OT, and greater EBL, indicating that increased curve magnitude at surgery could explain the difference in operative morbidity between low- and high-access countries. With OT as the prevailing predictive factor of complications, we suggest that increased curve magnitude leads to longer OTs and more complications. A lack of access to orthopedic care may be the largest contributor to the postponement of treatment. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Courtney Toombs
- Department of Orthopaedics & Rehabilitation, Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, USA
| | - Baron Lonner
- Mount-Sinai Beth Israel Medical Center, Department of Orthopedics, 281 1st Ave, New York, NY 10003, USA.
| | - Akil Fazal
- Nairobi Spine and Orthopaedic Centre, Department of Orthopaedics, Fortis Suites, 1st Floor, Hospital Rd, Nairobi, Kenya
| | | | - Tracey Bastrom
- Pediatric Orthopedics & Scoliosis Center, Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92123, USA
| | - Ferran Pellise
- Department of Traumatology, Orthopaedic Surgery and Emergency, Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - Mohamed Ramadan
- Department of Orthopaedics, Tanta University, El-Gaish, Tanta Qism 2, Tanta, Gharbia Governorate, Tanta, Egypt
| | - Wael Koptan
- Department of Orthopaedics and Traumatology, Cairo University, 1 Gamaa Street, P.O. Box 12613, Giza, Cairo, Egypt
| | - Yasser ElMiligui
- Department of Orthopaedics and Traumatology, Cairo University, 1 Gamaa Street, P.O. Box 12613, Giza, Cairo, Egypt
| | - Feng Zhu
- Spine Surgery, Nanjing University Drum Tower Hospital, 321 Zhongshan Rd, Gulou Qu, Nanjing Shi, Jiangsu Sheng, China 210008
| | - Yong Qiu
- Spine Surgery, Nanjing University Drum Tower Hospital, 321 Zhongshan Rd, Gulou Qu, Nanjing Shi, Jiangsu Sheng, China 210008
| | - Harry Shufflebarger
- Division of Pediatric Spinal Surgery, Miami Children's Hospital, 3100 SW 62nd Ave, Miami, FL 33155, USA
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KIM K, MULLINEAUX DR, JEON K. A Comparative Study of Spinal Deformity and Plantar Pressure according to the Static Standing Posture of Female Adolescents with or without Idiopathic Scoliosis. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:345-346. [PMID: 31205890 PMCID: PMC6556179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Kewwan KIM
- Division of Exercise and Health Science, College of Arts and Physical Education, Incheon National University, Incheon, Korea
| | - David R. MULLINEAUX
- School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, United Kingdom
| | - Kyoungkyu JEON
- Division of Exercise and Health Science, College of Arts and Physical Education, Incheon National University, Incheon, Korea, Sport Science Institute, Incheon National University, Incheon, Republic of Korea,Corresponding Author:
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Trends in Treatment of Scheuermann Kyphosis: A Study of 1,070 Cases From 2003 to 2012. Spine Deform 2019; 7:100-106. [PMID: 30587300 PMCID: PMC7102192 DOI: 10.1016/j.jspd.2018.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/24/2018] [Accepted: 06/02/2018] [Indexed: 01/09/2023]
Abstract
STUDY DESIGN Retrospective review of KID Inpatient Database (KID) from 2003, 2006, 2009, and 2012. OBJECTIVES The aim of this study was to evaluate the impact of advances in spinal surgery on patient outcomes in the treatment of Scheuermann kyphosis (SK). SUMMARY OF BACKGROUND DATA SK is one of the most common causes of back pain in adolescents. Trends in diagnoses and surgical treatment and approach to SK have not been well described. METHODS SK patients aged 0-20 years in KID were identified by ICD-9 code 732.0. KID-supplied year- and hospital-trend weights were used to establish prevalence. Patient demographics, surgical details, and outcomes were analyzed with analysis of variance. RESULTS A total of 1,070 SK patients were identified (33.2% female), with increasing incidence of SK diagnosed from 2003 to 2012 (3.6-7.5 per 100,000, p < .001). The average age of operative patients was 16.1±2.0 years and did not change (16.27-16.06 years, p = .905). The surgical rate has not changed over time (72.8%-72.8%, p = .909). Overall, 96.3% of operative patients underwent fusion, with 82.2% of cases spanning ≥4 levels; in addition, 8.6% underwent an anterior-only surgery, 74.6% posterior-only, and 13.6% combined approach. From 2003 to 2012, rates of posterior-only surgeries increased (62.4%-84.4%, p < .001) whereas the rate of combined-approach surgeries decreased (37.6%-8.8%, p < .001). Overall complication rates for SK surgeries have decreased (2003: 20.9%; 2012: 11.9%, p = .029). Concurrently, the rate of ≥4-level fusions has increased (43.5%-89.6%, p < .001), as well as the use of Smith-Peterson (7.8%-23.6%, p < .001) and three-column osteotomies (0.0%-2.7%, p = .011). In subanalysis comparing posterior to combined approaches, complication rates were significantly different (posterior: 9.88%, combined: 19.46%, p = .005). Patients undergoing a combined approach have a longer length of stay (LOS) than patients undergoing a posterior-only approach (7.8 vs. 5.6 days, p < .001). CONCLUSIONS Despite unchanged demographics and operative rates in SK, there has been a shift from combined to isolated posterior approaches, with a concurrent increase in levels treated. A combined approach was associated with increased complication rates, LOS, and total charges compared to isolated approaches. Awareness of these inherent differences is important for surgical decision making and patient education. LEVELS OF EVIDENCE Level III.
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Moalej S, Asadabadi M, Hashemi R, Khedmat L, Tavacolizadeh R, Vahabi Z, Shariatpanahi G. Screening of scoliosis in school children in Tehran: The prevalence rate of idiopathic scoliosis. J Back Musculoskelet Rehabil 2018; 31:767-774. [PMID: 29578478 DOI: 10.3233/bmr-171078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Scoliosis is the abnormal sideways curve of the spine. Screening for scoliosis is controversial, and there has been significant heterogeneity between studies. In Iran, there is still no suitable device to screen sideways curves in spine. OBJECTIVE To investigate the simple scolioscreen software for screening the students of elementary schools for detecting schoolchildren scoliosis. This students has been examined by trained medical student and data entered in scolioscreen application of an iPhone. METHODS One hundred forty-four 7-12 years old students from primary schools in the 17th district of Tehran were randomly invited to participate. Initial screening of the students was done in schools by health care provider or medical student who has been trained by a pediatrician to undergo a vertebral examination. Scoliometer for iPhone's smartphone has been used for measuring the angle of deviation. RESULTS 1.4% of students had overt scoliosis and 10.4% were suspected to have a kind of mild abnormality in spine curve. These individuals were referred to clinic for radiologic evaluation and it was confirmed that relative frequency of this abnormality was defined as 4.86% in our population study. There was no significant correlation between sex and degree of spinal curve. CONCLUSIONS Regarding the high rate of scoliosis in our population and approval of this screening test in different studies, routine use of this screening method is highly recommended in schoolchildren. It is cost beneficial and can be effective in prevention and early treatment of scoliosis.
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Affiliation(s)
- Sepehr Moalej
- School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Asadabadi
- Pediatrics Department, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rezvan Hashemi
- Geriatrics Department, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Khedmat
- Department of Community Medicine, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Reza Tavacolizadeh
- Pediatrics Department, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Vahabi
- Geriatrics Department, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Shariatpanahi
- Pediatrics Department, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
In clinical practice, we found a unilateral instability in patients with right thoracic scoliosis during asymmetric spinal stabilization exercise (ASSE), which can be an important clue to identify the pathophysiology of idiopathic scoliosis (IS).We investigated the relationship between unilateral postural instability and weakness of paraspinal muscles according to curve pattern. And finally, we propose the new exercise method based on the curve pattern.Combined use of prospective and retrospective clinical trials.Fifteen participants without IS and 10 patients with IS in 1 tertiary referral hospital.In 15 participants without IS, surface electromyography (sEMG) was used to evaluate the muscular activation patterns in the bilateral erector spinae (ES), rectus abdominis (RA), and external oblique (EO) muscles during ASSE. In addition, to assess the clinical effect of ASSE, Cobb angle and rotation grade were measured from 10 patients with IS.The most significant findings from the sEMG data were the increased activities of ipsilateral 7th thoracic ES during hand-up motion, ipsilateral 3rd lumbar ES during leg-up motion, and 12th thoracic and 3rd lumbar ES during side-bridging. In a radiographic analysis, specific components of ASSE that activates the concave side muscles were found to be effective for IS.The paraspinal muscle strengthening of the concave side using ASSE can improve the severity of scoliosis. Based on this research, we could propose a new exercise protocol that can be personalized according to the curve pattern.
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Affiliation(s)
- Jin Young Ko
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si
| | - Jee Hyun Suh
- Department of Rehabilitation Medicine, Bobath children's clinic, Yongin, Gyeonggi-do, South Korea
| | - Hayoung Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si
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