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Ye H, Xu Y, Mi R, Liu Y, Lyu Y, Wu S, Wu G. Evaluation of Paravertebral Muscle Structure Asymmetry in Idiopathic Scoliosis Using Imaging Techniques. World Neurosurg 2024:S1878-8750(24)01534-1. [PMID: 39245133 DOI: 10.1016/j.wneu.2024.08.165] [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: 08/24/2024] [Accepted: 08/31/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE This study aimed to assess variances in paravertebral muscle structure in individuals with idiopathic scoliosis (IS) through imaging techniques. METHODS A cohort of 112 patients diagnosed with IS and treated at our institution between January and December 2023 was included in the analysis. During the same period, 37 patients with secondary scoliosis (SS) were included as controls. Imaging data were used to measure the Cobb angle of the apical vertebrae in scoliosis patients, along with the area and fat infiltration of the paravertebral muscles on both sides. Finally, the cross-sectional area of the paravertebral muscles and the degree of fat infiltration were comparatively evaluated. RESULTS In patients with IS, the paravertebral muscles on the concave side of the main curve were significantly larger than those on the convex side (P < 0.05). The concave/convex muscle area ratio in IS patients showed a positive correlation with the Cobb angle and scoliosis duration (both P < 0.05). There was no significant difference in the muscle area ratio between patients with IS and those with SS (P > 0.05). In IS, the paravertebral muscles on the concave side of the main curve exhibited more fat infiltration than those on the convex side, with this fat infiltration positively correlating with body mass index, Cobb angle, age, and scoliosis duration. Similarly, the degree of fat infiltration in the paravertebral muscles on the concave side of SS was more than that observed on the convex side. Furthermore, the degree of fat infiltration in the paravertebral muscles associated with SS was more pronounced compared to that seen in IS (P < 0.05). CONCLUSIONS In IS patients, the paravertebral muscles on the concave side are more prominent and exhibit more fat infiltration compared to those on the convex side. This fat infiltration positively correlates with the Cobb angle, scoliosis duration, body mass index, and age, possibly indicating scoliosis progression.
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Affiliation(s)
- Hai Ye
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Yajing Xu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Rui Mi
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Yumeng Liu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Yungang Lyu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Songxiong Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Guangyao Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China.
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Zhang T, Sui W, Li B, Shao X, Deng Y, Zhang Z, Yang J, Huang Z, Yang W, Yang J. The morphological discrepancy of neuromuscular junctions between bilateral paraspinal muscles in patients with adolescent idiopathic scoliosis: A quantitative immunofluorescence assay. JOR Spine 2024; 7:e1358. [PMID: 39011366 PMCID: PMC11247395 DOI: 10.1002/jsp2.1358] [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: 03/19/2024] [Revised: 05/23/2024] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction Prior studies suggested that neuromuscular factors might be involved in the pathogenesis of adolescent idiopathic scoliosis (AIS). The neuromuscular junction (NMJ) is the important pivot where the nervous system interacts with muscle fibers, but it has not been well characterized in the paraspinal muscles of AIS. This study aims to perform the quantitative morphological analysis of NMJs from paraspinal muscles of AIS. Methods AIS patients who received surgery in our center were prospectively enrolled. Meanwhile, age-matched congenital scoliosis (CS) and non-scoliosis patients were also included as controls. Fresh samples of paraspinal muscles were harvested intraoperatively. NMJs were immunolabeled using different antibodies to reveal pre-synaptic neuronal architecture and post-synaptic motor endplates. A confocal microscope was used to acquire z-stack projections of NMJs images. Then, NMJs images were analyzed on maximum intensity projections using ImageJ software. The morphology of NMJs was quantitatively measured by a standardized 'NMJ-morph' workflow. A total of 21 variables were measured and compared between different groups. Results A total of 15 AIS patients, 10 CS patients and 5 normal controls were enrolled initially. For AIS group, NMJs in the convex side of paraspinal muscles demonstrated obviously decreased overlap when compared with the concave side (34.27% ± 8.09% vs. 48.11% ± 10.31%, p = 0.0036). However, no variables showed statistical difference between both sides of paraspinal muscles in CS patients. In contrast with non-scoliosis controls, both sides of paraspinal muscles in AIS patients demonstrated significantly smaller muscle bundle diameters. Conclusions This study first elucidated the morphological features of NMJs from paraspinal muscles of AIS patients. The NMJs in the convex side showed smaller overlap for AIS patients, but no difference was found in CS. This proved further evidence that neuromuscular factors might contribute to the mechanisms of AIS and could be considered as a novel potential therapeutic target for the treatment of progressive AIS.
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Affiliation(s)
- Tianyuan Zhang
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Wenyuan Sui
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Bin Li
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Xiexiang Shao
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Yaolong Deng
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Zifang Zhang
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Jingfan Yang
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Zifang Huang
- Department of Spine Surgery The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China
| | - Wenjun Yang
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Junlin Yang
- Spine Center, Department of Pediatric Orthopedics Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
- Department of Spine Surgery The Third Affiliated Hospital of Sun Yat-sen University Guangzhou China
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Zhao X, Hai Y. Answer to the letter to the editor of T. Ozudogru Celik concerning "greater pelvic obliquity in adolescent idiopathic scoliosis combined with hip dysplasia" by Zhao X, et al. (Eur Spine J [2024]: doi: 10.1007/s00586-023-08055-y). 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; 33:2923-2924. [PMID: 38902535 DOI: 10.1007/s00586-024-08360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 05/31/2024] [Indexed: 06/22/2024]
Affiliation(s)
- Xiaoxiong Zhao
- Department Orthopedics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing, China.
| | - Yong Hai
- Department Orthopedics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing, China
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Yerli S, Yinanç SB, Yağcı G, Erbahçeci F, Özçakar L. Thoracolumbar fascia and chronic low back pain in idiopathic lumbar scoliosis: an ultrasonographic 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; 33:2469-2475. [PMID: 38653872 DOI: 10.1007/s00586-024-08266-x] [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: 12/28/2023] [Revised: 03/29/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The role of thoracolumbar fascia (TLF) in the development of chronic low back pain (CLBP) has growing evidence in the literature. Although CLBP is reported in individuals with idiopathic scoliosis (IS), its relationship with the TLF has yet not been established. This study aims to evaluate the TLF and its relationship with CLBP in IS. METHODS A total of 60 individuals were included in the study. They were divided into three groups as follows: painful scoliosis (n = 20, age: 17.1 ± 3.7 years, Cobb angle: 15-43°), non-painful scoliosis (n = 20, age: 16.4 ± 3.4 years, Cobb angle: 15-45°), and healthy group (n = 20, age: 16.4 ± 4.7 years). Pain was evaluated using the short form of the McGill Pain Questionnaire. TLF thickness was evaluated on the lumbar region using ultrasonography. Trunk range of motion was assessed using a universal goniometer, and flexibility was assessed with sit-and-reach test. RESULTS The thickness of the right TLF was greatest in the painful group, followed by non-painful (p = 0.007) and healthy (p < 0.001) groups. The thickness of the left TLF in the non-painful and painful groups was greater compared to the healthy group (p < 0.001). In the painful group, right TLF thickness was negatively correlated with trunk flexion/extension (r = -0.540, p = 0.014/r = -0.514, p = 0.020) and left rotation (r = -0.499, p = 0.025) but positively correlated with pain (r = 0.562, p = 0.01). CONCLUSIONS Thickening of the TLF was observed in IS, whereby, in the presence of CLBP, it was further intensified. We suggest considering fascial thickening as a potential contributing factor to both pain and limited motion in relevant patients.
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Affiliation(s)
- Sibel Yerli
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Satuk Buğrahan Yinanç
- Yozgat Bozok University Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat, Turkey
| | - Gözde Yağcı
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Fatih Erbahçeci
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One 2024; 19:e0303086. [PMID: 38776317 PMCID: PMC11111046 DOI: 10.1371/journal.pone.0303086] [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: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.
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Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Edoardo Passarotto
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
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Kong PW, Kan TYW, Bin Mohamed Jamil RAG, Teo WP, Pan JW, Hafiz Abd Halim N, Kuddoos Abu Bakar Maricar H, Hostler D. Low back pain and biomechanical characteristics of back muscles in firefighters. ERGONOMICS 2024; 67:650-659. [PMID: 37459607 DOI: 10.1080/00140139.2023.2236821] [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: 03/14/2023] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
Firefighters often experience low back pain (LBP), but their back muscle characteristics are not well studied. This study aimed to 1) compare the biomechanical characteristics of back muscles and self-reported back disabilities in frontline firefighters with and without LBP history, and 2) examine the relationships between back disability and biomechanical measurements. We recruited 42 male firefighters and assessed their perceived pain and disabilities, maximum isometric back extension strength, passive stiffness, and fatigability of the longissimus. 54.8% of the participants experienced LBP within the past year. Those indicating higher pain intensity also had greater disability as indicated by the Oswestry Disability Index. There were no significant differences in strength, stiffness or fatigability of the back muscles between firefighters with and without LBP history. Multiple linear regression analysis revealed no significant relationship between the back disability and any biomechanical or demographic measures, likely due to the high functional abilities of the participants.
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Affiliation(s)
- Pui W Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Tommy Y W Kan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | | | - Wei P Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Jing W Pan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore
| | - Noor Hafiz Abd Halim
- Responder Performance Centre, Civil Defence Academy, Singapore Civil Defence Force, Singapore
| | | | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, USA
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Chan WWY, Fu SN, Chong TF, Singh G, Tsai DSJ, Wong MCY, Zheng YP, Parent EC, Cheung JPY, Wong AYL. Associations between paraspinal muscle characteristics and spinal curvature in conservatively treated adolescent idiopathic scoliosis: a systematic review. Spine J 2024; 24:692-720. [PMID: 38008187 DOI: 10.1016/j.spinee.2023.11.008] [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] [Received: 11/21/2022] [Revised: 10/08/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND CONTEXT Children with adolescent idiopathic scoliosis (AIS) may show asymmetrical paraspinal muscle characteristics. PURPOSE To summarize the evidence regarding: (1) the associations between various paraspinal muscle characteristics and spinal curvature; (2) whether paraspinal muscle properties significantly differed between children with and without AIS; and (3) whether baseline paraspinal muscle characteristics predicted curve progression. STUDY DESIGN/SETTING Systematic literature review. METHODS Five databases (CINAHL, Academic Search Premier, MEDLINE, Scopus, and PubMed) were searched from inception to May 2022. This protocol was registered in the PROSPERO database of systematic reviews CRD 42020171263. The Critical appraisal skills program, the Appraisal Tool for Cross-Sectional Studies and Quality In Prognosis Studies tool were used to evaluate the risk of bias of the included studies. The strength of evidence of each identified association was determined by the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE). RESULTS Of 1,530 identified citations, four cohort, 17 cross-sectional, and 23 case-control studies including 31 with low, nine with moderate and four with high risk of bias were included. Low to very low-strength evidence supported that the convex side of the curve had more type I muscle fibers, higher muscle volume and paraspinal muscle activity, while the concavity had more intramuscular fatty infiltration. Very low-strength evidence substantiated greater side-to-side surface electromyography signals during left trunk bending in prone lying, standing, and standing with perturbation between people with and without AIS. Also, low to very low-strength evidence supported that a larger side-to-side surface electromyography ratio at the lower end vertebra predicted curve progression. CONCLUSIONS Our review highlights that paraspinal muscles on the concavity of the curve demonstrate consistent changes (ie, altered muscle-related gene expression, muscle atrophy, increased fatty infiltration, reduced type I fibers, and reduced muscle activity), which may be the cause or consequence.
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Affiliation(s)
- Winnie W Y Chan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Tsz-Fung Chong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Gurjiven Singh
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Desmond S J Tsai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Mathew C Y Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Eric C Parent
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Corbett Hall, 8205 114 St NW, Edmonton, Alberta T6G 2G4, Canada
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China.
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Lim HJ, Yoon H, Kim J, Han K, So Y, Park M, Park KB, Lee MJ. Comparison of elasticity changes in the paraspinal muscles of adolescent patients with scoliosis treated with surgery and bracing. Sci Rep 2024; 14:5623. [PMID: 38453994 PMCID: PMC10920829 DOI: 10.1038/s41598-024-56189-w] [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: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
Scoliosis is a three-dimensional spinal deformity, and paraspinal muscles play an important role as stabilizers of the spinal curve. In this prospective study, we compared elasticity changes in the paraspinal muscles of adolescent patients with scoliosis after surgery or bracing. Elasticity was measured on the concave and convex sides of the paraspinal muscles at the apex of the curve at the beginning of treatment and 6 and 12 months after treatment. Twenty-six patients with correction surgery (n = 15) or bracing (n = 11) were included. At initial evaluation, the Cobb angle was larger in the surgery group (72.3 ± 20.2° in surgery vs. 30.6 ± 5.1° in brace, p < 0.001). The estimated mean elasticity value of the paraspinal muscles was lower in the surgery group at baseline on the convex side (15.8 vs. 22.8 kPa, p = 0.037) and 6 months on both the concave (12.1 vs. 22.7 kPa, p = 0.004) and convex (13.4 vs. 23.8 kPa, p = 0.005) sides. There was a significant stiffness decrease from baseline to 6 months on the concave side in the surgery group (5.9 kPa, p = 0.025). However, the elasticity change recovered at 12 months without significant differences between the two groups.
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Affiliation(s)
- Hyun Ji Lim
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Haesung Yoon
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Jisoo Kim
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Kyunghwa Han
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yuri So
- Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, South Korea
| | - Mincheol Park
- Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kun-Bo Park
- Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Mi-Jung Lee
- Department of Pediatric Radiology, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
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Fan Y, Zheng H, Feng L, To MKT, Kuang GM, Yeung EHK, Cheung KMC, Liu L, Cheung JPY. Elasticity and cross-sectional thickness of paraspinal muscles in progressive adolescent idiopathic scoliosis. Front Pediatr 2024; 12:1323756. [PMID: 38516354 PMCID: PMC10954774 DOI: 10.3389/fped.2024.1323756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives (1) Compare the cross-sectional thickness (CST) and shear wave speed (SWS) of paraspinal muscles (PSM) in adolescent idiopathic scoliosis (AIS) with and without curve progression; (2) investigate the relationship between CST/SWS and radiographic characteristics in AIS with curve progression; (3) compare the CST/SWS between AIS and non-scoliosis controls. Methods This cross-sectional study analyzed the CST and SWS of PSM in 48 AIS with mild to moderate curvature and 24 non-scoliosis participants. Participants with scoliosis greater than 45° of Cobb angles were excluded. The Change of Cobb angles within the last 6-months was retrieved to allocate AIS into progression and non-progression groups. The SWS and CST of multifidus; longissimus and iliocostalis of the major curve were measured using B-mode ultrasound image with an elastography mode. Discrepancies of the SWS (SWS-ratio: SWS on the convex side divided by SWS on the concave side) and CST (CST-ratio: CST on the convex side divided by CST on the concave side) at the upper/lower end and apical vertebrae were studied. Results A higher SWS at the apical vertebrae on the concave side of the major curve (multifidus: 3.9 ± 1.0 m/s vs. 3.1 ± 0.6 m/s; p < 0.01, longissimus: 3.3 ± 1.0 m/s vs. 3.0 ± 0.9 m/s; p < 0.01, iliocostalis: 2.8 ± 1.0 m/s vs. 2.5 ± 0.8 m/s; p < 0.01) was observed in AIS with curve progression. A lower SWS-ratio at apical vertebrae was detected with a greater vertebral rotation in participants with curve progression (multifidus [grade II]: 0.7 ± 0.1 vs. grade I: 0.9 ± 0.2; p = 0.03, longissimus [grade II]: 0.8 ± 0.2 vs. grade I: 1.1 ± 0.2; p < 0.01). CST was not different among the progressive, non-progressive AIS and non-scoliosis controls. Conclusions Increased SWS of PSM without change of CST was observed on the concave side of the major curve in participants with progressive AIS.
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Affiliation(s)
- Yunli Fan
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Haiping Zheng
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lin Feng
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael K T To
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Guan-Ming Kuang
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Eric H K Yeung
- Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Li Liu
- Department of Medical Imaging-Ultrasound Division, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Zhao X, Pan A, Hai Y. Greater pelvic obliquity in adolescent idiopathic scoliosis combined with hip dysplasia. 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; 33:680-686. [PMID: 38097782 DOI: 10.1007/s00586-023-08055-y] [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: 06/26/2023] [Revised: 10/18/2023] [Accepted: 11/14/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects adolescents and poses a challenging public health problem. Compared to the general population, adolescents with AIS have a higher prevalence of hip dysplasia. However, the mechanisms underlying the impact of hip dysplasia on the coronal balance of the spine remain poorly understood. We hypothesized that the combination of AIS with hip dysplasia would exacerbate coronal imbalance. METHODS We retrospectively analyzed the medical records and radiographs of adolescents diagnosed with AIS between 2015 and 2020. Participants were divided into two groups: those with hip dysplasia and those without. We recorded parameters related to the coronal deformity of the spine, sacral and pelvic obliquity, and center edge angle (CEA). We investigated differences in these parameters in those with and without hip dysplasia and analyzed their relationships in those with combined AIS and hip dysplasia. RESULTS A total of 103 adolescents were included, 36 with hip dysplasia and 67 without. Those with hip dysplasia had significantly higher sacroiliac discrepancy (SID) compared to those without (t = - 2.438, P = 0.017). In adolescents with hip dysplasia, only iliac obliquity angle (IOA) was significantly correlated with SID (r = - 0.803, P < 0.001), with a linear relationship between them (r2 = 0.645, P < 0.001). CONCLUSIONS The incidence of hip dysplasia is higher in the AIS population. In adolescents with combined AIS and hip dysplasia, pelvic obliquity is greater, potentially contributing to the increased prevalence of low back pain.
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Affiliation(s)
- Xiaoxiong Zhao
- Department Orthopedics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Aixing Pan
- Department Orthopedics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Yong Hai
- Department Orthopedics, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, China.
- Academic Department of Orthopedic Surgery, Capital Medical University, Beijing, China.
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11
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Zhang P, Shen X, Zhang L, Wang S, Wu Q. Effect of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis: A twelve-week randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:379-388. [PMID: 38043003 DOI: 10.3233/bmr-230102] [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: 12/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is the most common structural deformity of the spine during adolescence, which could cause varying degrees of physical and mental damage to patients. Schroth therapy and sling exercise are widely used in the treatment of patients with AIS currently, and have shown the significant therapeutic effect relatively. OBJECTIVE To observe the efficacy of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis (MIS). METHODS Sixty patients with AIS were randomly divided into the Schroth+sling group (n= 31) and the Schroth group (n= 29). Patients in both groups received Schroth therapy, and sling exercise was added in the Schroth+sling group. Before and after 12 weeks of treatment, the Cobb angle, angle of trunk rotation (ATR), Scoliosis Research Society-22 (SRS-22) scale score and averaged electromyography (AEMG) of bilateral paraspinal muscles were evaluated. RESULTS After the treatment, Cobb angle, ATR in both groups were decreased compared with those before (P< 0.001), and the decrease in the Schroth+sling group was more obvious (P< 0.05). The AEMG of bilateral paraspinal muscles and the total score, posture, mental health of SRS-22 of the two groups improved compared with those before treatment (P< 0.05), and the Schroth+sling group had a significant improvement than the Schroth group (P< 0.05). CONCLUSION Schroth therapy improved the degree of scoliosis, torticollis, quality of life, and bilateral paraspinal strength on adolescents with mild idiopathic scoliosis. The effect was more pronounced when the sling exercise was included in the treatment regimens.
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Affiliation(s)
- Peng Zhang
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Xiangyu Shen
- School of Physical Education and Sports, Soochow University, Suzhou, Jiangsu, China
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Lin Zhang
- Shanghai University of Sport, Shanghai, China
| | - Sheng Wang
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Qinfeng Wu
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
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12
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Rodrigues-de-Souza DP, Casas-Castro A, Carmona-Pérez MC, García-Luque L, Alcaraz-Clariana S, Garrido-Castro JL, Alburquerque-Sendín F. Between-sexes differences in lumbopelvic muscle mechanical properties of non-climacteric adults: a cross-sectional design. Sci Rep 2023; 13:21612. [PMID: 38062151 PMCID: PMC10703780 DOI: 10.1038/s41598-023-48984-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
The lumbopelvic muscle mechanical properties (MMPs) are clinically relevant, but their dependence on sex remains unknown. Therefore, this study aimed to identify if lumbopelvic MMPs depend on the sex in a young adult population. Thirty-five healthy nulliparous women and 35 healthy men were analyzed (age range: 18-50). Lumbopelvic MMPs, that is, tone, stiffness, elasticity, relaxation and creep, assessed with MyotonPRO®, and pelvic floor (PF) health questionnaires were compared between-sexes. Intra-group correlations between sociodemographic and clinical data, and MMPs were also determined. The MMPs of PF were different between healthy non-climacteric adults of both sexes, with women showing higher values of tone and stiffness and lower values of elasticity and viscoelastic properties than men (in all cases, p < 0.03). At lumbar level, tone and stiffness were higher for men at both sides (in all cases, p < 0.04), and relaxation was lower at left side (p = 0.02). The MMPs showed few correlations with sociodemographic data within women. However, within males, there were positive correlations for PF stiffness and viscoelastic parameters with age, BMI and function (0.334 < r < 0.591) and, at lumbar level, negative correlations for tone and stiffness ( - 0.385 < r < -0.590) and positive correlations for viscoelastic properties (0.564 < r < 0.719), with BMI. This indicated that between-sexes differences of lumbopelvic MMPs depend on the specific location of assessment in healthy non-obese young individuals. Women show higher tone and stiffness and lower elasticity and viscoelasticity than men, at PF level.
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Affiliation(s)
- Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain
| | - Azahara Casas-Castro
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - María Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain
| | - Juan Luis Garrido-Castro
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071, Córdoba, Spain
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain.
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Córdoba, Spain.
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Rong Z, Yang Z, Zhang C, Pu R, Chen C, Xu J, Luo F. Bioinformatics analysis of paravertebral muscles atrophy in adult degenerative scoliosis. J Muscle Res Cell Motil 2023; 44:287-297. [PMID: 37209232 PMCID: PMC10665243 DOI: 10.1007/s10974-023-09650-8] [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: 01/13/2023] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
Paravertebral muscles (PVM) act as one of the major dynamic factors to maintain human upright activities and play a remarkable role in maintaining the balance of the trunk. Adult degenerative scoliosis (ADS) has become one of the important causes of disability in the elderly population owing to the changes in spinal biomechanics, atrophy and degeneration of PVM, and imbalance of the spine. Previously, many studies focused on the physical evaluation of PVM degeneration. However, the molecular biological changes are still not completely known. In this study, we established a rat model of scoliosis and performed the proteomic analysis of the PVM of ADS. The results showed that the degree of atrophy, muscle fat deposition, and fibrosis of the PVM of rats positively correlated with the angle of scoliosis. The proteomic results showed that 177 differentially expressed proteins were present in the ADS group, which included 105 upregulated proteins and 72 downregulated proteins compared with the PVM in individuals without spinal deformities. Through the construction of a protein-protein interaction network, 18 core differentially expressed proteins were obtained, which included fibrinogen beta chain, apolipoprotein E, fibrinogen gamma chain, thrombospondin-1, integrin alpha-6, fibronectin-1, platelet factor 4, coagulation factor XIII A chain, ras-related protein Rap-1b, platelet endothelial cell adhesion molecule 1, complement C1q subcomponent subunit A, cathepsin G, myeloperoxidase, von Willebrand factor, integrin beta-1, integrin alpha-1, leukocyte surface antigen CD47, and complement C1q subcomponent subunit B. Further analysis of the Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) and immunofluorescence showed that the neutrophil extracellular traps (NETs) formation signaling pathway plays a major role in the pathogenesis of PVM degeneration in ADS. The results of the present study preliminarily laid the molecular biological foundation of PVM atrophy in ADS, which will provide a new therapeutic target for alleviating PVM atrophy and decreasing the occurrence of scoliosis.
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Affiliation(s)
- Zhigang Rong
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China
| | - Zhong Yang
- Department of Pharmacy and Laboratory Medicine, Third Military Medical University (Army Medical University), Chongqing, 400038, People's Republic of China
| | - Chengmin Zhang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China
| | - Rongxi Pu
- Department of Pharmacy and Laboratory Medicine, Third Military Medical University (Army Medical University), Chongqing, 400038, People's Republic of China
| | - Can Chen
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China
| | - Jianzhong Xu
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China.
| | - Fei Luo
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China.
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Szurmik T, Ogrodzka-Ciechanowicz K, Kurzeja P, Gąsienica-Walczak B, Prusak J, Bibrowicz K. Assessment of the functional state of the back muscles in girls with C-shaped low-grade scoliosis in a tensiomyographic image: An observational cross-sectional study. PLoS One 2023; 18:e0292555. [PMID: 37847728 PMCID: PMC10581459 DOI: 10.1371/journal.pone.0292555] [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: 05/18/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023] Open
Abstract
PURPOSE The study aimed to test the feasibility of using tensiomyography to assess the functional status of the latissimus dorsi and erector spinae muscles in girls with C-shaped low back scoliosis. MATERIALS AND METHODS Twenty-five girls aged 13-15 took part in an observational (cross-sectional) study. The examination involved measurements using the tensiomyography method (TMG). Two groups of muscles were tested: latissimus dorsi and erector spinae on the concave and convex side of low-grade scoliosis. The following indicators were analyzed: Td-delay time, Tc-contraction time, and Dm-maximal muscle displacement. RESULTS The analysis of Td revealed that values of this variable on the concave side were slightly lower compared to the convex side in both tested groups of muscles. Similarly, Tc values on the concave side were slightly lower than on the convex side of the curvature in both groups of muscles. In the case of Dm, lower displacement values and, consequently, greater muscle rigidity were observed on the concave side of the latissimus dorsi and the convex side of the erector spinae. CONCLUSIONS The TMG method can be potentially used to diagnose the functional condition of muscles in patients with low-grade scoliosis. There were differences between the functional condition of the muscles on the concave and convex sides of the curvature.
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Affiliation(s)
- Tomasz Szurmik
- Faculty of Arts and Educational Science, University of Silesia, Cieszyn, Poland
| | | | - Piotr Kurzeja
- Institute of Health Sciences, Podhale State College of Applied Sciences, Nowy Targ, Poland
| | | | - Jarosław Prusak
- Institute of Health Sciences, Podhale State College of Applied Sciences, Nowy Targ, Poland
| | - Karol Bibrowicz
- Science and Research Center of Body Posture, Kazimiera Milanowska College of Education and Therapy, Poznań, Poland
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15
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Xu W, Zang J, Wu F. Association between lean mass and adolescent idiopathic scoliosis: a meta-analysis. BMC Musculoskelet Disord 2023; 24:671. [PMID: 37620820 PMCID: PMC10463644 DOI: 10.1186/s12891-023-06622-4] [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] [Received: 02/23/2023] [Accepted: 06/09/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE The objective of this meta-analysis was to evaluate the association between lean mass and adolescent idiopathic scoliosis (AIS). METHODS English databases CENTRAL (The Cochrane Library and the Cochrane Back Review Group Trials Register), MEDLINE, EMBASE, PubMed, Web of Science and Chinese databases CBM, CNKI, VIP, WANGFANG DATA were searched for the relevant case control studies and cross-sectional studies. Two authors selected studies and extracted data independently. Data analysis was performed by Stata15.0. RESULTS Eight studies were included, with a total of 1771 cases of AIS and 6340 controls. AIS group had a lower lean mass compared to control group [MD = - 1.95, 95% CI (- 2.96, - 0.93)]. In the subgroup analysis, female AIS patients had a lower lean mass than the control group [MD = - 1.76, 95% CI (- 2.63, - 0.88)]. The mean difference of lean mass between AIS patients and control group in studies with adults [MD = - 3.96, 95% CI (- 7.26, - 0.67)] is much greater than studies without adults [MD = - 1.04, 95% CI (- 1.59, - 0.49)]. There was not statistically significant in European studies [MD = - 2.10, 95% CI (- 4.35, 0.14)], but in Asian studies lean mass in AIS patients was lower than the control group [MD = - 2.26, 95% CI (- 3.98, - 0.54)]. Study type, gender, age, and geography condition were thought to have no effect on the primary outcome of lean mass by subgroup analysis. CONCLUSION In the meta-analysis, AIS group had a lower lean mass compared to control group, which indicated that lean mass may be involved in the pathogenesis of AIS. But limited by the number of studies we included; the above conclusions need to be validated by more high-quality studies.
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Affiliation(s)
- Wei Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025 China
| | - Jiajie Zang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Fan Wu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025 China
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16
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Pan A, Hai Y, Lenke LG, Zheng Z, Yang J. Apical Vertebras Distribution Modifier for Coronal Balance Classification in Adult Idiopathic Scoliosis. J Pers Med 2023; 13:897. [PMID: 37373886 DOI: 10.3390/jpm13060897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Background: We aimed to propose the apical vertebras distribution modifier to supplement the coronal balance (CB) classification for adult idiopathic scoliosis (AdIS). An algorithm to predict postoperative coronal compensation and avoid postoperative coronal imbalance (CIB) was proposed. Methods: Patients were categorized into CB and CIB groups according to the preoperative coronal balance distance (CBD). The apical vertebras distribution modifier was defined as negative (-) if the centers of the apical vertebras (CoAVs) were on either side of the central sacral vertical line (CSVL) and positive (+) if the CoAVs were on the same side of the CSVL. Results: A total of 80 AdIS patients, with an average age of 25.97 ± 9.20 years, who underwent posterior spinal fusion (PSF) were prospectively recruited. The mean Cobb angle of the main curve was 107.25 ± 21.11 degrees at preoperation. The mean follow-up time was 3.76 ± 1.38 (2-8) years. At postoperation and follow-up, CIB occurred in 7 (70%) and 4 (40%) CB- patients, 23 (50%) and 13 (28.26%) CB+ patients, 6 (60%) and 6 (60%) CIB- patients, and 9 (64.29%) and 10 (71.43%) CIB+ patients. Health-related quality of life (HRQoL) was significantly better in the CIB- group compared with that of the CIB+ group in the dimension of back pain. To avoid postoperative CIB, the correction rate of the main curve (CRMC) should match the compensatory curve for CB-/+ patients; the CRMC should be greater than the compensatory curve for CIB- patients; and the CRMC should be less than the compensatory curve for CIB+ patients, and the inclination of the LIV needs to be reduced. Conclusions: CB+ patients have the least postoperative CIB rate and the best coronal compensatory ability. CIB+ patients are at a high risk of postoperative CIB and have the poorest coronal compensatory capacity in the event of postoperative CIB. The proposed surgical algorithm facilitates the handling of each type of coronal alignment.
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Affiliation(s)
- Aixing Pan
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yong Hai
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Lawrence G Lenke
- New York-Presbyterian Och Spine Hospital, New York, NY 10034, USA
| | - Zhaomin Zheng
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510062, China
| | - Jincai Yang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Grześkowiak M, Kocur P, Łochyński D. Relationship between morphometric and mechanical properties of superficial lumbosacral soft tissue layers in healthy young adults. Front Physiol 2023; 14:1175035. [PMID: 37260591 PMCID: PMC10228649 DOI: 10.3389/fphys.2023.1175035] [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] [Received: 02/27/2023] [Accepted: 04/17/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction: It is commonly considered that myotonometry is a non-invasive method capable of quantifying linear elastic and viscoelastic properties of the myofascial tissue through the application of a weak mechanical impulse to the surface of the skin. However, before the impulse can reach the myofascial tissue, it must cross more superficial tissues such as the skin and subcutaneous tissue (ST). All these superficial tissues have different distributions and organizations of structural components. Therefore, the study aimed to examine the potential relationships between the mechanical and morphometric properties of various superficial soft tissues surrounding the lumbar multifidus muscle (LM). Methods: Myotonometric measurements of dynamic stiffness, logarithmic decrement, and creep, and ultrasonographic measurements of thickness and echogenicity of cutaneous, subcutaneous, perimuscular tissue, and LM were obtained from 50 healthy individuals in the resting prone position and during contralateral arm lift. Results: The most important findings were that in both the relaxed and contracted LM state, the dynamic stiffness strongly negatively (r = -0.69; p < 0.001 in relaxation, r = -0.83; p < 0.001 in contraction) and creep strongly positively (r = 0.79; p < 0.001 in relaxation, r = 0.85; p < 0.001 in contraction) correlated with the thicknesses of the ST. Similar but weaker correlations were noticed between both these measures and the perimuscular tissue thickness. Elasticity was uncorrelated to the thicknesses of the tissues. With LM contraction (change from the relaxed to contracted state), the relative increase in dynamic stiffness was correlated with the relative decrease in dermis (r = -0.51; p < 0.001) and ST (r = -0.47; p = 0.001) thickness, and with the relative increase in LM (r = 0.36; p = 0.010) thickness. Moreover, the relative decrease (thinning) in the ST thickness was correlated with the relative increase in logarithmic decrement (i.e., decrease in soft tissue elasticity, r = -0.37, p = 0.011). The mechanical properties of the soft tissues were not related to their echogenicity. Discussion: In conclusion, the thicker the subcutaneous and perimuscular layers, the lesser the stiffness and the greater the time-dependent deformation to the external force of the tissues surrounding the LM during its relaxation and isometric contraction. Moreover, the greater the thinning of the ST and the thickening of the LM during its contraction, the higher the increase in lumbosacral tissue stiffness and the decrease in elasticity. Therefore, one should consider the thickness of the ST before planning or analyzing the outcomes of myotonometric or other external biomechanical measurements to avoid drawing the wrong conclusions about the mechanical properties of the myofascial tissue.
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Affiliation(s)
- Marcin Grześkowiak
- Department of Cardiological and Rheumatological Rehabilitation, Poznan University of Physical Education, Poznan, Poland
| | - Piotr Kocur
- Department of Musculoskeletal Physiotherapy, Poznan University of Physical Education, Poznan, Poland
| | - Dawid Łochyński
- Department of Neuromuscular Physiotherapy, Poznan University of Physical Education, Poznan, Poland
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18
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Shao X, Fu X, Yang J, Sui W, Li S, Yang W, Lin X, Zhang Y, Jia M, Liu H, Liu W, Han L, Yu Y, Deng Y, Zhang T, Yang J, Hu P. The asymmetrical ESR1 signaling in muscle progenitor cells determines the progression of adolescent idiopathic scoliosis. Cell Discov 2023; 9:44. [PMID: 37185898 PMCID: PMC10130095 DOI: 10.1038/s41421-023-00531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 02/21/2023] [Indexed: 05/17/2023] Open
Abstract
Adolescent Idiopathic Scoliosis (AIS) is a common pediatric skeletal disease highly occurred in females. The pathogenesis of AIS has not been fully elucidated. Here, we reveal that ESR1 (Estrogen Receptor 1) expression declines in muscle stem/progenitor cells at the concave side of AIS patients. Furthermore, ESR1 is required for muscle stem/progenitor cell differentiation and disrupted ESR1 signaling leads to differentiation defects. The imbalance of ESR1 signaling in the para-spinal muscles induces scoliosis in mice, while reactivation of ESR1 signaling at the concave side by an FDA approved drug Raloxifene alleviates the curve progression. This work reveals that the asymmetric inactivation of ESR1 signaling is one of the causes of AIS. Reactivation of ESR1 signaling in para-spinal muscle by Raloxifene at the concave side could be a new strategy to treat AIS.
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Affiliation(s)
- Xiexiang Shao
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Fu
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingfan Yang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyuan Sui
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sheng Li
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjun Yang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingzuan Lin
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyuan Zhang
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Minzhi Jia
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Huan Liu
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Wei Liu
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Lili Han
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Yang Yu
- Centre Testing International Medical Laboratory (CTI-Medlab), Shanghai, China
| | - Yaolong Deng
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyuan Zhang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junlin Yang
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ping Hu
- Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Guangzhou Laboratory, Guangzhou International Bio Island, Guangzhou, Guangdong, China.
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China.
- Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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Chan RYH, Ma ACF, Cheung TSK, Chan JCL, Kwok RWY, Fu ACL, Tsang SMH. Effect of muscle fatigue of the thoracic erector spinae on neuromuscular control when performing the upper extremity functional tasks in people with adolescent idiopathic scoliosis. PLoS One 2023; 18:e0281001. [PMID: 36706062 PMCID: PMC9882757 DOI: 10.1371/journal.pone.0281001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) disrupts spinal alignment and increases the intrinsic demand for active stabilization to maintain postural stability. Understanding the paraspinal muscle fatigability and its effects on spinal alignment and kinematics informs the importance of paraspinal muscle endurance for postural stability. This study aims to investigate the effects of fatigue of thoracic erector spinae on the spinal muscle activity and spinal kinematics in individuals with scoliosis. Spinal muscle activity, posture and mobility measured by electromyography and surface tomography were compared between 15 participants with scoliosis and 15 age- and gender-matched healthy controls during unilateral shoulder flexion and abduction with and without holding a 2-kg weight and performed before and after a fatigue task (prone isometric chest raise). No between-groups difference was found for the spinal extensor endurance. Erector spinae activity at the convex side of AIS group was significantly higher than that at their concave side and than that of healthy controls during shoulder elevations, regardless of the fatigue status. Significant decreases in translational and rotational mobility were found at convex side of AIS group during weighted abduction tasks after fatigue. In contrast, a significant increase in rotational mobility was demonstrated at convex side of AIS participants during weighted flexion tasks after fatigue. Our results revealed a comparable level of spinal extensor endurance between individuals with or without AIS. The increase in muscle activation post-fatigue provides no additional active postural stability but may increase the risk of back pain over the convex side in individuals with scoliosis. Findings highlight imbalances in muscles and the potential implications in optimising neuromuscular activation and endurance capacity in the rehabilitation for AIS patients. Future research is needed to investigate if endurance training of the convex-sided back extensors could optimize the impaired neuromuscular control in the AIS patients.
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Affiliation(s)
- Ray Y. H. Chan
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Aiden C. F. Ma
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tammy S. K. Cheung
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jenny C. L. Chan
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ruby W. Y. Kwok
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Allan C. L. Fu
- School of Health Sciences, University of Sydney, Sydney, Australia
| | - Sharon M. H. Tsang
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- * E-mail:
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Bravo-Sánchez A, Abián P, Sánchez-Infante J, Ramírez-delaCruz M, Esteban-García P, Jiménez F, Abián-Vicén J. Five-Compressions Protocol as a Valid Myotonometric Method to Assess the Stiffness of the Lower Limbs: A Brief Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14425. [PMID: 36361308 PMCID: PMC9654301 DOI: 10.3390/ijerph192114425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The objective of this study was to evaluate the validity of a short assessment MyotonPRO protocol to measure the stiffness of the superficial muscles and tendons of the lower limbs. The stiffness of the dominant lower limb vastus lateralis (VL), rectus femoris (RF) and patellar tendon (PT) was evaluated in 52 healthy participants (26.9 ± 3.4 years) with two MyotonPRO protocols: the standard protocol (10 mechanical taps) and the short protocol (five mechanical taps). The myotonometry was performed at the midpoint of the length from the upper pole of the patella to the greater trochanter for the VL, and to the anterior superior iliac spine for the RF. The PT was evaluated 1 cm caudal from the inferior pole of the patella. Pearson's correlation coefficients were calculated to determine the relationships between protocols. The validity of the short protocol was evaluated with Student's t-test. High positive correlations were observed between the short and standard protocols in the stiffness of the VL (r = 0.959; p < 0.001), the RF (r = 0.967; p < 0.001) and the PT (r = 0.953; p < 0.001) and no differences were found between both protocols in the stiffness assessment of the VL, RF and PT (p > 0.05). Therefore, the five-compressions protocol is a valid protocol for the assessment of lower limb mechanical properties.
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Affiliation(s)
- Alfredo Bravo-Sánchez
- Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Pablo Abián
- Faculty of Humanities and Social Sciences, Comillas Pontifical University, C. Alberto Aguilera 23, 28049 Madrid, Spain
| | | | - María Ramírez-delaCruz
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Paula Esteban-García
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Fernando Jiménez
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory (DEPORSALUD), Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
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Asymmetries of the Muscle Mechanical Properties of the Pelvic Floor in Nulliparous and Multiparous Women, and Men: A Cross-Sectional Study. Symmetry (Basel) 2022. [DOI: 10.3390/sym14102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to identify if the muscle mechanical properties (MMPs) of both sides of pelvic floor muscles (PFMs) are symmetrical in different populations of both sexes. Between-sides comparisons of MMPs of PFMs, assessed with manual myotonometry, were performed in three groups, with 31 subjects each, composed of healthy nulliparous women (without any type of delivery or pregnancy), multiparous women (with at least two vaginal deliveries), and healthy adult men. Intra-group correlations between MMPs and age, body mass index (BMI), or clinical state of pelvic floor were also obtained. The nulliparous women and the men showed no between-sides differences in any MMP of PFMs. However, the multiparous women showed that the right side displayed less frequency (−0.65 Hz, 95% CI = −1.01, −0.20) and decrement (0.5, 95% CI = 0.11, 0.01), and more relaxation (1.00 ms, 95% CI = 0.47, 1.54) and creep (0.07 De, 95% CI = 0.03, 0.11), than the left side. Further, MMPs were related to age, sex, and BMI, also depending on the population, with the multiparous women being the only group with some between-sides asymmetries, which in this case were positive and of fair intensity for the left side of the PFMs, between BMI, and frequency and stiffness (rho Spearman coefficient: 0.365 and 0.366, respectively). The symmetry of MMPs of the PFMs could depend on the subject’s condition. Multiparous women show a higher tendency to asymmetries than nulliparous women and men, which should be considered in research and clinical settings.
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Pan A, Cao W, Wu B, Yin L, Ding H, Guo R, Liu Y, Hai Y, Zhou L. Elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis after posterior selective fusion surgery. Clin Biomech (Bristol, Avon) 2022; 99:105763. [PMID: 36122528 DOI: 10.1016/j.clinbiomech.2022.105763] [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] [Received: 05/17/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND We sought to assess the elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 curves after posterior selective fusion surgery. METHODS The shear wave elasticity imaging system was used to assess the elasticity of the thoracic paravertebral muscles and fascia both on the concave and convex sides. Three regions of interest, including the apex, upper end, and lower end of the main curve, were tested. FINDINGS Ten female patients, with an average age of 16.6 ± 2.7 years old, were included. The average post-operation follow-up period was 9.0 ± 2.4 months. The Cobb angle was significantly corrected from 63.6 ± 12.0° to 10.7 ± 5.4° (p < 0.05). The length of the trunk increased from 40.4 ± 2.5 cm to 46.0 ± 2.8 cm (p < 0.05). The elasticity of deep fascia didn't show a significant change post-operation (p > 0.05). The elasticity of the paravertebral muscle on the concave side had a significant increase at the final follow-up (p < 0.05). The elasticity of the paravertebral muscle on the convex side also increased at the upper end (p < 0.05). The elasticity asymmetry of the deep fascia decreased, but the elasticity asymmetry of the paravertebral muscle increased at the upper end of the curve (p < 0.05). INTERPRETATION The paravertebral muscle on the concave side is stiffer after surgery. Elastic asymmetry of paravertebral muscle increased and elastic asymmetry of the deep fascia decreased at the upper end of the curvature. Further study is needed to elucidate the mechanism by which the paravertebral soft tissue responds after surgery.
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Affiliation(s)
- Aixing Pan
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Wen Cao
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Bingchao Wu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Li Yin
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Hongtao Ding
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Ruijun Guo
- Ultrasonic Department, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8, Chaoyang District, Beijing 100020, China
| | - Yuzeng Liu
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China
| | - Yong Hai
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
| | - Lijin Zhou
- Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, China.
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Effects of cervicothoracic postures on the stiffness of trapezius muscles. Med Biol Eng Comput 2022; 60:3009-3017. [DOI: 10.1007/s11517-022-02655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
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Li H, Yang Z, Li D, Qiao F. A Novel Low-Cost 3D Printed Brace Design Method for Early Onset Scoliosis. J Med Device 2022. [DOI: 10.1115/1.4054998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Early onset scoliosis (EOS) is a type of spine deformity that presents before 10 years of age. The biomechanical properties in scoliosis have been found to be di?erent, especially in the case of the concave and convex paraverte-bral muscles. Based on this fact, a novel 3d printed patient-specific asymmetric stiffness brace design method is proposed in this paper, aiming to provide asymmetric stiffness to match "imbalanced" biomechanical properties of the concave and convex paravertebral muscles, respectively, and treat EOS by applying the block-structure brace.A 3d CAD draft model of the brace contour was implemented from 3D scanning. The asymmetric stiffness block-structure brace was designed in Rhinoceros and the Finite Ele-ment (FE) model was imported into ABAQUS. FE simulation was employed to study the mechanical characteristics of the brace, which provided a quan-titative index for the "imbalanced" property of brace stiffness. The results of the FE simulation showed that the stiffnesses of the concave and convex sides were 145.88 N/mm and 35.95 N/mm, respectively. The block-structure brace was fabricated using 3d printing. Asymmetric stiffness was evaluated by corrective force measurements, which were obtained from a thin-film pressure sensor equipped on the brace. The patient-specific asymmetric stiffness brace was applied to clinical practice in a one-year old EOS patient. A novel low-cost 3D printed brace design method for EOS was proposed in this study that could potentially be useful in patient treatment acceptance.
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Affiliation(s)
- Hongwei Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University , Xi'an, Shaanxi 710049, China
| | - Zhangkai Yang
- Department of Neurosurgery, Xi'an Children's Hospital, The Affiliated Children's Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi 710003, China
| | - Dichen Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University , Xi'an, Shaanxi 710049, China
| | - Feng Qiao
- Honghui Hospital, Xi'an Jiaotong University , No.555, Youyidong Rd, Xi'an, Shaanxi 710054, China
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Yong JH, Hong JP, Lee YH, Huang CC, Huang SW, Lin HW. Association and Risk of Axial Spondyloarthritis of Scoliosis Patients: A Database Study. Spine (Phila Pa 1976) 2022; 47:438-443. [PMID: 34610609 DOI: 10.1097/brs.0000000000004248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective longitudinal cohort study. OBJECTIVE To investigate the incidence and risk of axial spondyloarthritis (axSpA) in patients with scoliosis in Taiwan. SUMMARY OF BACKGROUND DATA Scoliosis and axSpA causes back pain which reduces quality of life in many patients. Both scoliosis and axSpA had attracted numerous research attention, but the association between the two was hardly known. METHODS In this retrospective study, the data of 25,566 patients were obtained from Taiwan's National Health Insurance Research Database. We identified patients diagnosed with scoliosis and included them in the study cohort. We included age- and sex-matched patients without scoliosis in the control cohort. The total follow-up period was 7 years. Cox proportional hazards models were used to analyze the retrieved data. Hazard ratios (HRs) and adjusted HRs were calculated. RESULTS The study and control cohorts included 4261 and 21,305 patients, respectively. The incidences of axSpA were 141 and 46 per 100,000 person-years in the study and control cohorts, respectively. The crude HRs and adjusted HRs for patients with scoliosis were 2.98 (95% confidence interval, 1.87-4.73; P < 0.001) and 2.78 (95% confidence interval, 1.74-4.43; P < 0.001), respectively. The prevalence of comorbidities such as chronic obstructive pulmonary disease, osteoporosis, depression, autoimmune diseases (rheumatoid arthritis and systemic lupus erythematosus), and thyroid disease was significantly higher in the study cohort. CONCLUSION Our findings indicate an association between scoliosis and axSpA. Additional studies should be performed to explain this phenomenon.Level of Evidence: 3.
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Affiliation(s)
- Jocelyn Huan Yong
- Department of Primary Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jia-Pei Hong
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hui-Wen Lin
- Department of Mathematics, Soochow University, Taipei, Taiwan
- ICF Research Center, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Wu Z, Ye X, Ye Z, Hong K, Chen Z, Wang Y, Li C, Li J, Huang J, Zhu Y, Lu Y, Liu W, Xu X. Asymmetric Biomechanical Properties of the Paravertebral Muscle in Elderly Patients With Unilateral Chronic Low Back Pain: A Preliminary Study. Front Bioeng Biotechnol 2022; 10:814099. [PMID: 35223786 PMCID: PMC8866935 DOI: 10.3389/fbioe.2022.814099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Clinical incidences of chronic low back pain among the elderly are increasing. However, studies have not fully elucidated on changes in biomechanical properties of paravertebral muscles in patients with unilateral chronic low back pain. We evaluated the changes in biomechanical properties of painful and non-painful paravertebral muscles in elderly patients with unilateral chronic low back pain.Methods: Biomechanical properties of paravertebral muscles, including muscle tone and stiffness, in elderly patients with unilateral chronic low back pain were measured using MyotonPRO. Lumbar Lordosis and Sacral Slope were measured by magnetic resonance imaging. Cross-sectional areas of paravertebral muscles were evaluated using ImageJ software version 1.53. Chronic low back pain severity was assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores. The correlations between VAS scores, ODI scores, Lumbar Lordosis, Sacral Slope, cross-sectional areas (painful side), disease duration, and biomechanical properties of paravertebral muscles in the painful side were analyzed.Results: A total of 60 elderly patients with unilateral chronic low back pain were enrolled in this study. The muscle tone and stiffness of paravertebral muscles on the painful side were significantly higher than those on the non-painful side (p < .05). Cross-sectional areas of paravertebral muscles on the painful side at the L3 level were smaller than those of the non-painful side (p < .05). The VAS scores and ODI scores were significantly positively correlated with muscle tone and stiffness of paravertebral muscles on the painful side (p < .05 and p < .01, respectively). There were no significant correlations between disease duration, cross-sectional areas (painful side), Lumbar Lordosis, or Sacral Slope and muscle tone and stiffness of paravertebral muscles on the painful side (p > .05).Conclusion: In elderly patients with unilateral chronic low back pain, muscle tone and stiffness of paravertebral muscles on the painful side are higher than for those on the non-painful side. The asymmetry of biomechanical properties of paravertebral muscles is associated with severity of chronic low back pain.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kunhao Hong
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinyou Huang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yue Zhu
- Baishui Health Center, Qujing, China
| | - Yanyan Lu
- Luoyang Orthopedic Hospital Of Henan Province (Orthopedic Hospital of Henan Province), Zhengzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
| | - Wengang Liu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
| | - Xuemeng Xu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
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Lv X, Xu J, Jiang J, Wu P, Tan R, Wang B. Genetic animal models of scoliosis: A systematical review. Bone 2021; 152:116075. [PMID: 34174503 DOI: 10.1016/j.bone.2021.116075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023]
Abstract
Scoliosis is a complex disease with undetermined pathogenesis and has a strong relationship with genetics. Models of scoliosis in animals have been established for better comprehending its pathogenesis and treatment. In this review, we searched all the genetic animal models with body curvature in databases, and reviewed the related genes and scoliosis types. Meanwhile, we also summarized the pathogenesis of scoliosis reported so far. Summarizing the positive phenotypic animal models contributes to a better understanding on the pathogenesis of scoliosis and facilitates the selection of experimental models when a possible pathogenic factor is concerned.
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Affiliation(s)
- Xin Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Jinghong Xu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Jiajiong Jiang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Pengfei Wu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Renchun Tan
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China.
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Aranda-Valera IC, Ladehesa-Pineda L, Puche-Larrubia MÁ, Carmona-Pérez C, Rodrigues-de-Souza DP, Alburquerque-Sendín F. Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study. Diagnostics (Basel) 2021; 11:1898. [PMID: 34679595 PMCID: PMC8535094 DOI: 10.3390/diagnostics11101898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022] Open
Abstract
Different musculoskeletal disorders are a source of pain in the spinal region; most of them can be divided into mechanical, such as low back pain (LBP), or inflammatory origins, as is the case of axial spondyloarthritis (axSpA). Nevertheless, insufficient information is available about the muscle negative consequences of these conditions. Thus, the objective of this study was to identify whether mechanical muscle properties (MMPs) of cervical and lumbar muscles are different between patients with axSpA, subacute LBP (sLBP), and healthy controls. Furthermore, we aimed identify whether MMPs were related to sociodemographic and clinical variables in various study groups. The MMPs, sociodemographic, and clinical variables were obtained in 43 patients with axSpA, 43 subjects with sLBP, and 43 healthy controls. One-way ANOVAs and ROC curves were applied to identify whether the MMPs could differentiate between the study groups. Intra-group Pearson r coefficients to test the associations between MMPs and the rest of the variables were calculated. The results showed that axSpA subjects have a higher tone and stiffness and a lower relaxation and creep than sLBP and healthy ones (p < 0.05). All lumbar and cervical MMPs, except for decrement, could correctly classify axSpA and healthy subjects and axSpA and sLBP patients (in both cases, Area Under the Curve > 0.8). However, no MMP could differentiate between sLBP and healthy subjects. Each group had a different pattern of bivariate correlations between MMPs and sociodemographic and clinical data, with a worse state and progression of the axSpA group associated with a higher tone and stiffness in both spinal regions. This study supports that MMPs are different and show different patterns of correlations depending on the type of spinal pain.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Cordoba, 14071 Cordoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
| | - I. Concepción Aranda-Valera
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Lourdes Ladehesa-Pineda
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - María Ángeles Puche-Larrubia
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
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Berry DB, Grant CD, Farnsworth CL, Englund EK, Newton PO, Shahidi B. The influence of 3D curve severity on paraspinal muscle fatty infiltration in patients with adolescent idiopathic scoliosis. Spine Deform 2021; 9:987-995. [PMID: 33751482 DOI: 10.1007/s43390-021-00318-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/18/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE In a sex-inclusive cohort of patients with adolescent idiopathic scoliosis (AIS): (1) assess the relationship between 3D curve severity, curve flexibility, and paraspinal muscle fatty infiltration, and (2) describe three-dimensional (3D) fatty infiltration of the paraspinal muscles. METHODS Fat signal fraction of the paravertebral muscles was measured in pre-operative magnetic resonance images (MRIs) of males and females with AIS at the apex, ± 1, and ± 2 levels from the apex of the curve (n = 62). In a subset of patients with biplanar erect radiographic imaging (n = 35), 3D measures of deformity (axial rotation of the apical vertebrae, thoracic kyphosis, and coronal Cobb angle) were measured. RESULTS Contrary to previous studies, no relationship between coronal Cobb angle and fatty infiltration was found. However, axial apical rotation and sagittal Cobb angle were found to be significant predictors of paravertebral fatty infiltration (R2 = 0.196-0.222). Curve concavity, female sex, and proximity to the curve apex were found to be the strongest predictors of fatty infiltration. Greater fatty infiltration of the paravertebral muscles was found on the concave side of the curve (15-24% vs. 11-13%), with increasing fatty infiltration toward the apex of the curve. Fatty infiltration was protected on the convex side of the curve, with no differences in the amount of fatty infiltration across levels. CONCLUSION These findings highlight that coronal curve severity and flexibility are not the primary influencing factors for the degree of paraspinal fatty infiltration in patients with AIS. This may have implications for nonsurgical rehabilitation strategies such as bracing and physical therapy. LEVEL OF EVIDENCE II.
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Affiliation(s)
| | | | | | - Erin K Englund
- Department of Orthopaedic Surgery, University of California, 9500 Gilman Drive (MC0863), La Jolla, San Diego, CA, 92093, USA
| | - Peter O Newton
- Rady Children's Hospital, San Diego, USA.,Department of Orthopaedic Surgery, University of California, 9500 Gilman Drive (MC0863), La Jolla, San Diego, CA, 92093, USA
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, University of California, 9500 Gilman Drive (MC0863), La Jolla, San Diego, CA, 92093, USA.
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Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study. Diagnostics (Basel) 2021; 11:diagnostics11020352. [PMID: 33672470 PMCID: PMC7923441 DOI: 10.3390/diagnostics11020352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/26/2022] Open
Abstract
Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups. Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated. The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls. Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls. This study supports a tendency of the affectation of other spinal regions when only one is affected.
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Mapping of Back Muscle Stiffness along Spine during Standing and Lying in Young Adults: A Pilot Study on Spinal Stiffness Quantification with Ultrasound Imaging. SENSORS 2020; 20:s20247317. [PMID: 33352767 PMCID: PMC7766024 DOI: 10.3390/s20247317] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
Muscle stiffness in the spinal region is essential for maintaining spinal function, and might be related to multiple spinal musculoskeletal disorders. However, information on the distribution of muscle stiffness along the spine in different postures in large subject samples has been lacking, which merits further investigation. This study introduced a new protocol of measuring bilateral back muscle stiffness along the thoracic and lumbar spine (at T3, T7, T11, L1 & L4 levels) with both ultrasound shear-wave elastography (SWE) and tissue ultrasound palpation system (TUPS) in the lying and standing postures of 64 healthy adults. Good inter-/intra-reliability existed in the SWE and TUPS back muscle stiffness measurements (ICC ≥ 0.731, p < 0.05). Back muscle stiffness at the L4 level was found to be the largest in the thoracic and lumbar regions (p < 0.05). The back muscle stiffness of males was significantly larger than that of females in both lying and standing postures (p < 0.03). SWE stiffness was found to be significantly larger in standing posture than lying among subjects (p < 0.001). It is reliable to apply SWE and TUPS to measure back muscle stiffness. The reported data on healthy young adults in this study may also serve as normative reference data for future studies on patients with scoliosis, low back pain, etc.
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Shao X, Chen J, Yang J, Sui W, Deng Y, Huang Z, Hu P, Yang J. Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis. Med Sci Monit 2020; 26:e924415. [PMID: 32778639 PMCID: PMC7412933 DOI: 10.12659/msm.924415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Paraspinal muscle (PSM) has been suggested to have a role in adolescent idiopathic scoliosis (AIS). Few studies have investigated the fiber type-specific changes of PSM in detail. Material/Methods Bilateral multifidus muscles were harvested from the apical vertebra level (T7–T10) of 12 AIS patients and 6 control individuals. Immunohistological staining was performed to evaluate the muscle fiber type composition, fiber type-specific cross-sectional area (CSA), myonuclei density, and the total and activated satellite cell (SC) density. The correlations between these characteristics and curve initiation/severity were analyzed. Results In comparison with the PSM in convexity and the control group, PSM in concavity showed a significant reduction of CSA (concavity, 2601.1±574.1 μm2; convexity, 3732.1±545.1 μm2; control, 3426.5±248.4 μm2), myonuclei density (concavity, 2.0±0.3 myonuclei/fiber; convexity, 2.5±0.4 myonuclei/fiber; control, 2.2±0.2 myonuclei/fiber), and activated SC density (concavity, 0.7±0.4 cells/100 fibers; convexity, 1.5±0.7 cells/100 fibers; control, 1.2±0.3 cells/100 fibers) for fiber type I. The Cobb angle was positively correlated with the bilateral ratio of CSA (convexity/concavity) for both fiber types. The apical vertebral translation was positively correlated with bilateral difference of myonuclei density (type I), total SC density (types I and II), and activated SC density (type I). Conclusions The fiber type-specific pathological changes on the concave side seemed to be more severe. Some fiber type-specific characteristics (CSA, myonuclei density, total/activated SC density) were closely associated with curve severity. More attention should be paid to PSM physiotherapy treatment on the concave side.
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Affiliation(s)
- Xiexiang Shao
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Jian Chen
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Jingfan Yang
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Wenyuan Sui
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Yaolong Deng
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
| | - Zifang Huang
- Department of Spine Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China (mainland)
| | - Ping Hu
- CAS, Center for Excellence in Molecular Cell Science, Shanghai, China (mainland)
| | - Junlin Yang
- Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland)
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Tang Y, Yang S, Chen C, Luo K, Chen Y, Wang D, Tan J, Dai Q, Zhang C, Wu W, Xu J, Luo F. Assessment of the association between paraspinal muscle degeneration and quality of life in patients with degenerative lumbar scoliosis. Exp Ther Med 2020; 20:505-511. [PMID: 32509021 PMCID: PMC7271738 DOI: 10.3892/etm.2020.8682] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/11/2020] [Indexed: 12/13/2022] Open
Abstract
The present study aimed to determine the characteristics of multifidus, erector spinae and psoas major degeneration in elderly patients with degenerative lumbar scoliosis (DLS) and the correlation between asymmetric changes and patient quality of life. A total of 49 patients with lumbar scoliosis (DLS group) and 38 healthy individuals (control group) were prospectively examined. The functional cross-sectional area, cross-sectional area difference index (CDI) and fat infiltration rate (FIR) of the multifidus, erector spinae and psoas major at the apical vertebral level were measured using MRI. The visual analogue scale (VAS) score, Oswestry Disability Index (ODI) and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient quality of life. Correlations between the degree of asymmetric muscular degeneration and quality of life were analysed. The CDI of the multifidus, erector spinal and psoas major was higher in the DLS group compared with that in the control group. The CDI of the multifidus was found to be positively associated with the Cobb angle of lumbar scoliosis. Similar results were obtained for fat infiltration between the two groups. In addition, the CDI and FIR difference index of the multifidus was positively correlated with the VAS score and ODI but negatively correlated with the SF-36 score. The quality of life significantly decreased with increasing asymmetric atrophy and fat infiltration in the multifidus. Thus, strategies to enhance the function of the multifidus may have a positive impact on quality of life (Chinese Clinical Trial Registry, registration date, 2018.11.12; registration no. ChiCTR1800019459.).
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Affiliation(s)
- Yong Tang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China.,Department of Orthopaedics, The 72nd Group Army Hospital, Huzhou University, Huzhou, Zhejiang 313000, P.R. China
| | - Sen Yang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Can Chen
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Keyu Luo
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Yueqi Chen
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Donggui Wang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Jiulin Tan
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Qijie Dai
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Chengmin Zhang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Wenjie Wu
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Jianzhong Xu
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
| | - Fei Luo
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing 400038, P.R. China
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Wu Z, Zhu Y, Xu W, Liang J, Guan Y, Xu X. Analysis of Biomechanical Properties of the Lumbar Extensor Myofascia in Elderly Patients with Chronic Low Back Pain and That in Healthy People. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7649157. [PMID: 32149135 PMCID: PMC7049445 DOI: 10.1155/2020/7649157] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/04/2019] [Accepted: 01/09/2020] [Indexed: 11/17/2022]
Abstract
There is limited research on the changes of biomechanical characteristics of the lumbar extensor myofascia in elderly patients with chronic low back pain. This study aimed to compare the biomechanical properties of the lumbar extensor myofascia in elderly patients with chronic low back pain and healthy people when resting and to analyze the relationship between the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score, Cobb angle, and disease course and the biomechanical characteristics of the lumbar extensor myofascia. This case-control study included 40 elderly patients with chronic low back pain and 40 healthy volunteers. MyotonPRO was used to measure the biomechanical properties of the bilateral lumbar extensor myofascia (at L3/L4 level) in all participants, and the reliability of the MyotonPRO test was measured. Cobb angle was measured from lumbar computed tomography or magnetic resonance imaging data. JOA and VAS scores were used to evaluate lumbar function and pain. We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls. The JOA score was negatively correlated, while the VAS score was positively correlated with the mean values of tone, stiffness, and elasticity of the bilateral lumbar extensor myofascia (logarithmic decrement). Disease course had no significant correlation with muscle tone, stiffness, and elasticity of the lumbar extensor myofascia. No significant correlation was found between Cobb angle and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia in either group.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, China
| | - Yue Zhu
- Baishui Town Health Center, Zhanyi District, Qujing 655000, China
| | - Wu Xu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou 510000, China
| | - Junquan Liang
- Guangzhou University of Chinese Medicine, Guangzhou 510000, China
| | - Yingxin Guan
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, China
| | - Xuemeng Xu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou 510000, China
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Peng H, Jin F, Meng D, Li J, Yu S, Zhang S, Zeng G. Exploring the Pathological Role of Collagen in Paravertebral Muscle in the Progression of Idiopathic Scoliosis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1527403. [PMID: 32802834 PMCID: PMC7421238 DOI: 10.1155/2020/1527403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Paravertebral muscle (PVM) is considered as a contributing factor of idiopathic scoliosis (IS); collagen is crucial for maintaining the mechanical properties of PVM, but only a few researches have described this field. In this study, we observed the muscle stiffness of PVM and the curvature of the spine by adjusting the content of collagen in PVM of rats and explored the role of collagen in the progression of IS. METHODS 32 female Sprague Dawley rats were randomly divided into four groups: neutralizing antibody (NA) group (group 1), normal control group (group 2), IS group (group 3), and IS with NA group (group 4). TGF-β1 NA was injected into PVM in group 1 and group 4, while Normal saline in group 2 and group 3. The Cobb angle and muscle stiffness were measured before and after injection; the rats were sacrificed at one week after injection, and performed histological, Western Blot, and qRT-PCR examinations. RESULTS X-rays showed that scoliosis occurred in group 1 and relieved in group 4. The stiffness of PVM was decreased significantly on the convex side in group 1, while on the concave side in group 4. The expression of TGF-β1 and COL1 on the concave side in IS rats (group 3) was significantly increased than that in normal rats (group 2), the concentration of COL1 and COL3 in group 3 was significantly higher than that in group 2, and the addition of TGF-β1 NA significantly downregulated COL1 and COL3 in group 1 and group 4. The concentration of COL1 in convex PVM was negatively related to Cobb angle in group 1 and group 2, and in concave PVM was positively related to Cobb angle in group 3 and group 4. However, no significant correlation was found between COL3 and Cobb angle in group 3 and group 4. CONCLUSIONS Asymmetric biomechanical characteristics of PVM was an important etiological factor of IS, which was directly correlated with collagen, it could be adjusted by local intramuscular injecting of TGF-β1 NA, and finally had an effect on the shape of the spine.
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Affiliation(s)
- Haidong Peng
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Feng Jin
- 2Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Depeng Meng
- 3Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jun Li
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Shuhan Yu
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Shen Zhang
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Guigang Zeng
- 1Department of Rehabilitation, Changzheng Hospital, Second Military Medical University, Shanghai, China
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