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Unuvar BS, Yilmaz K, Celik F. The acute effects of brace use on lower extremity performance in individuals with adolescent idiopathic scoliosis. Ir J Med Sci 2024; 193:1313-1319. [PMID: 38133839 DOI: 10.1007/s11845-023-03588-z] [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: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Braces have been a popular treatment option for scoliosis among healthcare professionals for many years. However, the effect of braces on scoliosis treatment remains a subject of ongoing debate and research. AIMS Our study aimed to evaluate the effects of wearing a spinal brace on vertical jump, postural control, reach distance, and fall risk in patients with Adolescent Idiopathic Scoliosis (AIS). METHODS We included 33 patients with AIS aged between 10 to 18 years old in our cross-sectional study. Patients were randomly subjected to vertical jump test, standing long jump test, timed up and go test, postural control, and forward reach test, while wearing and not wearing the scoliosis brace, respectively. RESULTS Our findings revealed that patients wearing scoliosis braces had significantly lower vertical jumps (p = .001), standing long jumps (p < .001), and forward reach distances with their dominant (p = .002) and non-dominant limbs (p = .007) compared to those who did not wear the brace. However, there was no significant difference in postural control and timed up and go test between the two groups (p > .05). CONCLUSIONS Our study suggests that wearing a scoliosis brace may negatively affect an individual's vertical and standing long jumps, and forward reach distances. However, wearing or not wearing the brace had no significant effect on postural control and timed stand-up test. Long-term follow-up studies are needed to evaluate the overall effectiveness of scoliosis braces in treating AIS.
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Affiliation(s)
- Bayram Sonmez Unuvar
- Faculty of Health Sciences, Department of Audiology, KTO Karatay University, Karatay, Konya, Turkey.
| | - Kamil Yilmaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, KTO Karatay University, Karatay, Konya, Turkey
| | - Fatih Celik
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, Ankara, Turkey
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2
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Al Rashdan A, Alessa M, Ababneh F, Al Taimeh F, Althunaibat Z. Effectiveness of Facetectomy in Correction of Adolescent Idiopathic Scoliosis. Cureus 2024; 16:e55768. [PMID: 38463404 PMCID: PMC10921130 DOI: 10.7759/cureus.55768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Surgical correction of adolescent idiopathic scoliosis (AIS) using the facetectomy technique with the utilization of segmental pedicle screws aims to achieve correction of coronal and sagittal imbalances and preserve normal neurological function. In this study, we aimed to certify the effectiveness of the facetectomy technique in the correction of AIS by analyzing technique outcomes. METHODS This is a retrospective, single-center study. From January 2018 to March 2022, a total of 51 patients with AIS who underwent inferior facetectomy with segmental pedicle screw constructs at the Royal Rehabilitation Center were reviewed. Radiological parameters including the major curve Cobb angle, and global coronal balance were evaluated preoperatively, postoperatively, and at the final follow-up. Surgical parameters and complications were also reported. RESULTS The mean major curve Cobb angle was 59.5 ± 4.9° preoperatively, 13.6 ± 2.7° postoperatively, and 14.5 ± 2.6° at the final follow-up, with correction rates of 77.2% and 75.7%, respectively. The mean global coronal balance was 2.7 ± 1.1 cm preoperatively, 1.7 ± 0.73 cm postoperatively, and 1.4 ± 0.55 cm at the final follow-up. Two cases of pleural injuries were reported intraoperatively. Postoperatively, two cases experienced superficial wound infections, one experienced pulmonary embolism, and one patient had revision surgery due to the loosening of a single screw. None of these complications lasted long. CONCLUSIONS When combined with posterior segmental pedicle screw constructs, inferior facetectomy can provide an effective rate of correction in a reasonably safe manner.
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Affiliation(s)
| | - Monther Alessa
- Department of Orthopedics, Royal Medical Services, Amman, JOR
| | - Faris Ababneh
- Department of Orthopedics, Royal Medical Services, Amman, JOR
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Del Prete CM, Tarantino D, Viva MG, Murgia M, Vergati D, Barassi G, Sparvieri E, Di Stanislao E, Perpetuini D, Russo EF, Filoni S, Pellegrino R. Spinal Orthosis in Adolescent Idiopathic Scoliosis: An Overview of the Braces Provided by the National Health Service in Italy. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:3. [PMID: 38276037 PMCID: PMC10818494 DOI: 10.3390/medicina60010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral, rotated curvature of the spine. It is a 3-dimensional deformity that arises in otherwise healthy children at or around puberty. AIS is the most common form of scoliosis in the pediatric population. The etiology is multifactorial, including genetic and environmental factors. The incidence is roughly equal between males and females, while there is a higher risk of progression in females. Guidelines for AIS treatment identify three levels of treatment: observation, physiotherapy scoliosis-specific exercises, and braces. In this paper, we carried out a review of the scientific literature about the indication and success rates of the braces provided for free by the National Health Service in Italy (SSN). Despite a general consensus on the efficacy of rigid bracing treatment and its use in AIS, an important heterogeneity about the treatment is present in the scientific literature, demonstrating a high degree of variability. The overall success rate of the braces provided by the SSN is high, suggesting an important therapeutic role in the treatment of AIS. Robust guidelines are needed to ensure uniform and effective treatments.
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Affiliation(s)
| | - Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
| | - Mattia Giuseppe Viva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00183 Rome, Italy; (M.G.V.); (M.M.)
| | - Massimiliano Murgia
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00183 Rome, Italy; (M.G.V.); (M.M.)
| | | | - Giovanni Barassi
- Center for Physiotherapy, Rehabilitation and Re-Education-CeFiRR-Gemelli Molise, 86100 Campobasso, Italy;
| | | | | | - David Perpetuini
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy;
| | | | - Serena Filoni
- I.R.R.C.S. Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano–Pazzallo, Switzerland;
- Santa Chiara Institute, 73100 Lecce, Italy
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4
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Bae BH, Ham CH, Patel U, Suh Y. Psychosocial Effect of Brace Treatment in Adolescent Idiopathic Scoliosis: A Study Using EQ-5D. Clin Spine Surg 2023; 36:E488-E492. [PMID: 37482631 DOI: 10.1097/bsd.0000000000001489] [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] [Received: 10/31/2022] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE To evaluate psychosocial effect of brace treatment in adolescent idiopathic scoliosis (AIS) using EuroQoL 5-dimension (EQ-5D) depression and anxiety category. BACKGROUND AIS is a structural abnormality of the spine often affecting patients during the puberty, a critical period of developing psychosocial problems. Many questionnaires had been adapted to evaluate mental health and health-related quality of life of AIS patients. However, these questionnaires are often time consuming and difficult to obtain. Therefore, a simpler substitute-EQ-5D-was evaluated. METHODS This is a single-center retrospective cohort analysis of adult idiopathic scoliosis patients aged between 8 and 19, visiting outpatient's clinic. Beck's depression inventory, EQ-5D and EuroQoL visual assessment scale, and Objectified Body Consciousness Scale for Youth were compared between brace group and non-brace group of AIS patients. Furthermore, difference between male and female were evaluated within brace group. RESULTS None of the questionnaire showed significant difference between brace and non-brace group. However, when male and female patients were compared within brace group, female patients were significantly more susceptible to depression and anxiety based on EQ-5D and body consciousness. Furthermore, depression and anxiety according to both BDI and EQ-5D were significantly correlated to health-related quality of life. CONCLUSION During brace treatment of female AIS patients, psychosocial status played a significant role in health-related quality of life. EQ-5D is a simple way to monitor the mental health status.
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Affiliation(s)
| | | | - Udit Patel
- Orthopedics, Korea University Guro Hospital, Korea University College of Medicine, Seoul
| | - Yunsun Suh
- Chadwick International School, Incheon, Republic of Korea
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Mbamalu EK, Hyacinthe J, Hui A, Tirabady P, Alvandi L, Gomez J. Early Onset Scoliosis and Adolescent Idiopathic Scoliosis: A Review of the Literature and Correlations With Pulmonary Dysfunction. Cureus 2023; 15:e48900. [PMID: 38111427 PMCID: PMC10726067 DOI: 10.7759/cureus.48900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/20/2023] Open
Abstract
In the management of early onset scoliosis (EOS) and adolescent idiopathic scoliosis (AIS), orthopedic surgeons are tasked with considering the effects that curves and their treatment can have on the respiratory system, possibly the most relevant being pulmonary dysfunction due to thoracic cage changes. The pulmonary impairment that occurs as a result of scoliosis varies widely and requires a multimodal response, including physiologic testing, such as pulmonary function tests (PFTs) and consistent psychosocial monitoring of the patient. This forces healthcare providers to consider all factors affecting the patient's quality of life (QOL) and not just the primary pathology they are treating. One method that could be utilized to ensure a more holistic approach to treatment is the use of patient-reported outcome measures (PROMs) to assess the QOL domains. Thus, this review serves to highlight the importance of addressing and correcting pulmonary dysfunction in the care of children with EOS and AIS in a holistic manner.
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Affiliation(s)
| | - Julia Hyacinthe
- Orthopaedic Surgery, Albert Einstein College of Medicine, New York, USA
| | - Aaron Hui
- Orthopaedic Surgery, Albert Einstein College of Medicine, New York, USA
| | - Parsa Tirabady
- Orthopaedic Surgery, Albert Einstein College of Medicine, New York, USA
| | - Leila Alvandi
- Orthopaedic Surgery, Montefiore Medical Center, New York, USA
| | - Jaime Gomez
- Orthopaedic Surgery, Montefiore Medical Center, New York, USA
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Yan LI, Wong AY, Cheung JP, Zhu B, Lee KC, Liang SR, Ll JY, Ho BYW, Bressington D. Psychosocial interventions for teenagers with adolescent idiopathic scoliosis: A systematic literature review. J Pediatr Nurs 2023; 73:e586-e593. [PMID: 37951727 DOI: 10.1016/j.pedn.2023.10.037] [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: 05/24/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Psychosocial interventions can improve teenagers' self-esteem, mental health and bracing compliance. There is a need to compile available evidence of psychosocial care in adolescent idiopathic scoliosis. This systematic review aimed to identify and evaluate the effects of existing interventional studies of psychosocial care for the adolescent idiopathic scoliosis population. METHODS A comprehensive search of relevant literature published from the inception to March 2023 was conducted using nine databases. A google scholar search was performed on 1 July 2023, to update the searching results. Two reviewers independently assessed the methodological quality and extracted details of the included studies. Given the heterogeneity of the selected articles, the findings were synthesized narratively without conducting a meta-analysis. RESULTS Four randomized controlled trials reported in six articles involving 385 teenagers were included. The interventions appeared acceptable with high recruitment rates and low dropout rates reported. Psychosocial interventions had shown significant positive effects on postoperative pain, engagement in daily and social activities as well as brace use, coping abilities and anxiety. CONCLUSION Psychosocial interventions are generally feasible and acceptable among the adolescent idiopathic scoliosis population and have produced positive effects on a variety of physical and psychosocial outcomes. Study findings need to be interpreted with caution due to the limited number of available articles and the methodological concerns of the reviewed articles. PRACTICAL IMPLICATIONS Well-designed clinical trials are warranted in people from cultural backgrounds to develop and implement effective psychosocial interventions for teenagers with adolescent idiopathic scoliosis, not only for those at the post-surgery stage but also for those receiving conservative treatment.
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Affiliation(s)
- L I Yan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, SAR, China.
| | - Arnold Yl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, SAR, China
| | - Jason Py Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, Pokfulam, Hong Kong, SAR, China
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, 227 S Chongqing Rd, Shanghai, China
| | - Kit Ching Lee
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, SAR, China
| | - Sui Rui Liang
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, SAR, China
| | - Jia Ying Ll
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong, SAR, China
| | - Bryan Ying Wai Ho
- School of Nursing and Health Studies, the Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, SAR, China
| | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT 0810, Australia
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Cherian D, Samdani AF, Schüpper AJ, Stein AA, Naseer Z, Pahys JM, Nice E, Hwang SW. Early outcomes in hybrid fixation for idiopathic scoliosis: posterior fusion combined with anterior vertebral body tethering. Patient series. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23331. [PMID: 37910004 PMCID: PMC10566524 DOI: 10.3171/case23331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Anterior vertebral body tethering (AVBT) and posterior spinal fusion (PSF) are options for patients with idiopathic scoliosis. Combining both procedures in patients with double curves, a procedure in which PSF is performed for the thoracic curve and AVBT for the lumbar curve, provides maximal correction of the thoracic curve with a theoretical maintenance of motion in the lumbar spine. OBSERVATIONS The authors retrospectively reviewed 20 skeletally immature patients diagnosed with idiopathic scoliosis at a single institution with an average age of 12.7 ± 1.6 years and who had undergone hybrid treatment with an average follow-up of 8 months. The PSF procedures averaged 276 ± 63 minutes with 442.8 ± 295 mL of blood loss, and the AVBT averaged 275 ± 54 minutes with 118.3 ± 80 mL of blood loss. Following the hybrid correction, the thoracic and lumbar coronal curve angles improved from 67.6° to 21.6° and from 65.2° to 24°, respectively. The three-dimensional kyphosis improved from 3.3° to 24°. LESSONS A combined approach of PSF and AVBT is safe and effective for idiopathic scoliosis. This approach combines the gold standard of thoracic fusion with the motion preservation benefits of AVBT in the lumbar spine. This study will continue to refine indications for AVBT.
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Affiliation(s)
- Daniel Cherian
- Departments of1Neurosurgery
- 2Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | | | - Alexander J Schüpper
- Departments of1Neurosurgery
- 3Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York; and
| | - Alan A Stein
- Departments of1Neurosurgery
- 4Brain and Spine Institute at Westchester Medical Center, Valhalla, New York
| | - Zan Naseer
- Departments of1Neurosurgery
- 4Brain and Spine Institute at Westchester Medical Center, Valhalla, New York
| | | | - Emily Nice
- 6Clinical Research, Shriners Children's - Philadelphia, Philadelphia, Pennsylvania
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Bazancir-Apaydin Z, Yagci G, Tarhan-Altinok E, Bayramoğlu C, Kaya MH, Demirkiran HG, Yakut Y. Does in-brace correction affect coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis? A retrospective cohort study. Acta Orthop Belg 2023; 89:399-408. [PMID: 37935221 DOI: 10.52628/89.3.10767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The aim of the study is to identify the effects of in-brace correction on coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis (IS). The coronal spinal parameters [Cobb angle, apical vertebral rotation (AVR), lateral trunk shift, coronal alignment, biacromial slope and pelvic asymmetry] and the thoracic cage parameters [T1- 12 height, T1-S1 height, thoracic transverse diameter, and apical vertebral body-rib ratio (AVB-R)] of 89 child and adolescent patients were measured on posterior-anterior full-spine radiographs at pre-brace and in-brace conditions using Surgimap software. The initial in-brace correction (IBC) was calculated as a percentage decrease in the Cobb angle on the in-brace radiographs. The mean IBC rate for the primary curve was 37% (range = 10-100%). In the in- brace condition, the Cobb angle (p<0.001), AVR (p<0.001) and lateral trunk shift (p<0.001) decreased significantly; no statistically significant difference was found in the biacromial slope (p=0.713) and the coronal alignment (p=0.074). The T1-12 height and the T1-S1 height increased significantly (p<0.001) whereas the thoracic transverse diameter and the AVB-R decreased significantly (p<0.001). Unlike IBC rate was below 30% as IBC rate was above 30%, the T1-12 height (p<0.001) increased and the AVB-R decreased (p<0.001). The bracing improved the lateral trunk shift, the AVB-R, the thoracic and spine heights, but decreased the thoracic transverse diameter. The thoracic cage parameters may be better when the IBC rate is above 30%.
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Cerillo JL, Becsey AN, Sanghadia CP, Root KT, Lucke-Wold B. Spine Bracing: When to Utilize-A Narrative Review. BIOMECHANICS (BASEL, SWITZERLAND) 2023; 3:136-154. [PMID: 36949902 PMCID: PMC10029751 DOI: 10.3390/biomechanics3010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Spinal bracing is a common non-surgical technique that allows clinicians to prevent and correct malformations or injuries of a patient's spinal column. This review will explore the current standards of practice on spinal brace utilization. Specifically, it will highlight bracing usage in traumatic injuries, pregnancy, pediatrics, osteoporosis, and hyperkyphosis; address radiological findings concurrent with brace usage; and provide an overview of the braces currently available and advancements in the field. In doing so, we aim to improve clinicians' understanding and knowledge of bracing in common spinal pathologies to promote their appropriate use and improve patient outcomes.
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Affiliation(s)
- John L. Cerillo
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, FL 33759, USA
| | | | - Chai P. Sanghadia
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, AZ 85721, USA
| | - Kevin T. Root
- College of Medicine, University of Florida, Gainesville, FL 32608, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
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10
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Wei W, Zhang T, Yang J, Qian Y, Dong Y. Material sensitivity of patient-specific finite element models in the brace treatment of scoliosis. Front Bioeng Biotechnol 2023; 11:1111449. [PMID: 36873369 PMCID: PMC9978187 DOI: 10.3389/fbioe.2023.1111449] [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: 11/29/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
Objectives: To study the mechanical sensitivity of different intervertebral disc and bone material parameters and ligaments under different force configurations and magnitudes in the scoliosis model. Methods: The finite element model of a 21-year-old female is built using computed tomography. Local range of motion testing and global bending simulations are performed for the model verification. Subsequently, Five force of different directions and configurations were applied to the finite element model applying the brace pad position. The material parameters of the model were related to different spinal flexibilities and included different material parameters of cortical bone, cancellous bone, nucleus and annulus. The virtual X-ray technique measured Cobb angle, thoracic Lordosis, and lumbar Kyphosis. Results: The difference in peak displacement is 9.28 mm, 19.99 mm, 27.06 mm, 43.99 mm, and 50.1 mm under five force configurations. The maximum Cobb angle difference due to material parameters are 4.7° and 6.2°, which are converted to thoracic and lumbar in-brace correction difference of 18% and 15.5%. The maximum difference in Kyphosis and Lordosis angle is 4.4° and 5.8°. The average thoracic and lumbar Cobb angle variation difference in intervertebral disc control group is larger than that in bone control group, while the average Kyphosis and Lordosis angle is inverse. The displacement distribution of models with or without ligaments is similar, with a peak displacement difference of 1.3 mm in C5. The peak stress occurred at the junction of the cortical bone and ribs. Conclusion: Spinal flexibility largely influences the treatment effect of the brace. The intervertebral disc has a greater effect on the Cobb angle, the bone has a greater effect on the Kyphosis and Lordosis angles, and the rotation is affected by both. Patient-specific material is the key to increasing accuracy in the personalized finite element model. This study provides a scientific basis for using controllable brace treatment for scoliosis.
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Affiliation(s)
- Wenqing Wei
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Tianyuan Zhang
- Spine Surgery Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junlin Yang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Spine Surgery Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Qian
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Yating Dong
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
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Limbers CA, Baskin A, Cohen LA. Disordered Eating and Body Image Concerns in Young Adult Women With Scoliosis. CLINICAL MEDICINE INSIGHTS. ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2023; 16:11795441231166010. [PMID: 37122586 PMCID: PMC10134120 DOI: 10.1177/11795441231166010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/06/2023] [Indexed: 05/02/2023]
Abstract
Background Researchers have called for more investigation into disordered eating behaviors in females with scoliosis. Objective The objective of the current study was to assess the associations between body image concerns, disease-specific indicators of scoliosis (ie, age of diagnosis, having undergone bracing treatment, being told by a physician your scoliosis required surgery, having a spinal fusion), quality of life, and disordered eating in a sample of young adult women diagnosed with idiopathic scoliosis during adolescence. Design This study was cross-sectional in design. Methods Participants were 177 young adult women ages 18 to 30 years diagnosed with idiopathic scoliosis by a physician who completed questionnaires online. Results Undergoing bracing treatment (r = -.440; P < .001), greater age at scoliosis diagnosis (r = .563; P < .001), being told scoliosis required surgery (r = -.196; P < .050), annual income (r = .306; P < .001), level of education (r = .228; P < .010), and race/ethnicity (r = -.213; P < .050) were associated with the EDE-Q Global Score. The Body Shape Questionnaire Total Score and EDE-Q Global Score (r = .848; P < .001) and EDE-Q Weight Concern Score (r = .813; P < .001) were associated. The strongest correlations between the EDE-Q and the SRS-22-Revised Subscales were generally evidenced on the SRS-22-Revised Mental Health Subscale (rs ranged from -.200 to -.371; P < .001). After controlling for annual income, highest level of education, undergoing bracing treatment, and age of scoliosis diagnosis, the Body Shape Questionnaire Total Score was significantly correlated with the EDE-Q Eating Concern Score (standardized beta coefficient = .618; P < .001). Conclusions These findings underscore the importance of assessing body image concerns in young adult women with scoliosis experiencing disordered eating as this information may provide valuable information relevant to treatment planning.
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Affiliation(s)
- Christine A Limbers
- Christine A Limbers, Department of Psychology and Neuroscience, Baylor University, One Bear Place #97334, Waco, TX 76798, USA.
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Hart DA. Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle? Front Physiol 2023; 14:1127689. [PMID: 37113695 PMCID: PMC10126777 DOI: 10.3389/fphys.2023.1127689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be "imprinted" in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.
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Fercho J, Krakowiak M, Yuser R, Szmuda T, Zieliński P, Szarek D, Pettersson SD, Miękisiak G. Evaluation of Movement Restriction of Spinal Orthoses Using Inertial Measurement Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16515. [PMID: 36554395 PMCID: PMC9779723 DOI: 10.3390/ijerph192416515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Despite the frequent use of orthopedic braces or spine stabilizers in diseases such as kyphosis, lordosis, and scoliosis, as well as in the case of injuries and rehabilitation after surgeries, there is no clear evidence of their proper stabilization of the spine while carrying out daily activities. This study sought to assess the spine's mobility while wearing three different orthopedic braces while performing basic tasks. Ten healthy subjects were enrolled. Three Inertial Measurement Units (IMUs) were attached superficially along the spine at approximate levels: cervical (C7), between thoracic (T8) and lumbar (L3), and sacrum. The angle between sensors was monitored to provide data on the sagittal profile. In addition, the displacement of the spine's longitudinal axis was measured (rotation). There are three types of orthopedic braces: the semi-rigid Hohmann corset, the Jewett brace, and the Thoracolumbar Fixed Spinal Orthosis (TLSO). Four tasks were monitored: standing, sitting, walking, and picking up an item from the floor with one hand. All braces provided a similar level of stability in both the sagittal plane and rotational axis while lifting an object. On the other hand, while walking and sitting, the TLSO was the only orthosis providing a statistically significant rigidity in the sagittal plane. When performing a more voluntary task, the measured rigidity of softer braces was significantly increased when compared with more involuntary tasks. A certain degree of motion restriction with spinal orthoses may come from the feedback pressure, which stimulates paraspinal muscles to contract and thus increases the overall rigidity of the trunk.
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Affiliation(s)
- Justyna Fercho
- Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Michał Krakowiak
- Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Rami Yuser
- Scientific Circle of Neurology and Neurosurgery, Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Tomasz Szmuda
- Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Piotr Zieliński
- Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
| | - Dariusz Szarek
- Department of Neurosurgery, Marciniak’s Hospital, 54-049 Wrocław, Poland
| | - Samuel D. Pettersson
- Scientific Circle of Neurology and Neurosurgery, Neurosurgery Department, Medical University of Gdansk, 80-214 Gdańsk, Poland
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Kardash K, Koutras C, Otaduy MA. Design of personalized scoliosis braces based on differentiable biomechanics—Synthetic study. Front Bioeng Biotechnol 2022; 10:1014365. [DOI: 10.3389/fbioe.2022.1014365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
This work describes a computational methodology for the design of braces for adolescent idiopathic scoliosis. The proposed methodology relies on a personalized simulation model of the patient’s trunk, and automatically searches for the brace geometry that optimizes the trade-off between clinical improvement and patient comfort. To do this, we introduce a formulation of differentiable biomechanics of the patient’s trunk, the brace, and their interaction. We design a simulation model that is differentiable with respect to both the deformation state and the brace design parameters, and we show how this differentiable model is used for the efficient update of brace design parameters within a numerical optimization algorithm. To evaluate the proposed methodology, we have obtained trunk models with personalized geometry for five patients of adolescent idiopathic scoliosis, and we have designed Boston-type braces. In a simulation setting, the designed braces improve clinical metrics by 45% on average, under acceptable comfort conditions. In the future, the methodology can be extended beyond synthetic validation, and tested with physical braces on the actual patients.
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Normand E, Franco A, Alos N, Parent S, Moreau A, Marcil V. Circulatory Adipokines and Incretins in Adolescent Idiopathic Scoliosis: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1619. [PMID: 36360347 PMCID: PMC9688531 DOI: 10.3390/children9111619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 08/26/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional malformation of the spine of unknown cause that develops between 10 and 18 years old and affects 2-3% of adolescents, mostly girls. It has been reported that girls with AIS have a taller stature, lower body mass index (BMI), and bone mineral density (BMD) than their peers, but the causes remain unexplained. Energy metabolism discrepancies, including alterations in adipokine and incretin circulatory levels, could influence these parameters and contribute to disease pathophysiology. This pilot study aims to compare the anthropometry, BMD, and metabolic profile of 19 AIS girls to 19 age-matched healthy controls. Collected data include participants' fasting metabolic profile, anthropometry (measurements and DXA scan), nutritional intake, and physical activity level. AIS girls (14.8 ± 1.7 years, Cobb angle 27 ± 10°), compared to controls (14.8 ± 2.1 years), were leaner (BMI-for-age z-score ± SD: -0.59 ± 0.81 vs. 0.09 ± 1.11, p = 0.016; fat percentage: 24.4 ± 5.9 vs. 29.2 ± 7.2%, p = 0.036), had lower BMD (total body without head z-score ± SD: -0.6 ± 0.83 vs. 0.23 ± 0.98, p = 0.038; femoral neck z-score: -0.54 ± 1.20 vs. 0.59 ± 1.59, p = 0.043), but their height was similar. AIS girls had higher adiponectin levels [56 (9-287) vs. 32 (7-74) μg/mL, p = 0.005] and lower leptin/adiponectin ratio [0.042 (0.005-0.320) vs. 0.258 (0.024-1.053), p = 0.005]. AIS participants with a Cobb angle superior to 25° had higher resistin levels compared to controls [98.2 (12.8-287.2) vs. 32.1 (6.6-73.8), p = 0.0013]. This pilot study suggests that adipokines are implicated in AIS development and/or progression, but more work is needed to confirm their role in the disease.
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Affiliation(s)
- Emilie Normand
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Anita Franco
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Viscogliosi Laboratory in Molecular Genetics and Musculoskeletal Diseases, Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Nathalie Alos
- Endocrine Service, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC H3T 1J4, Canada
| | - Stefan Parent
- Department of Surgery, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
| | - Alain Moreau
- Viscogliosi Laboratory in Molecular Genetics and Musculoskeletal Diseases, Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC H3A 1J4, Canada
| | - Valérie Marcil
- Research Center of the CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
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Rezaeian Z, Andalib A, Bokaee F, Poorpooneh Najafabadi M, Yeowell G, Sadeghi-Demneh E. The efficacy of trunk bracing with an instrumented corrective exercise on spinal deformity, pulmonary function, trunk muscle endurance and quality of life in adolescent idiopathic scoliosis: Protocol for a parallel-groups clinical study (Preprint). JMIR Res Protoc 2022; 12:e43265. [PMID: 36989018 PMCID: PMC10131677 DOI: 10.2196/43265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis is a 3D spine distortion with an unidentified etiology. It results in noticeable trunk deformity, decreased muscle strength and endurance at the trunk, changes in chest volume, breathing issues, and ultimately a decline in the quality of life. Trunk bracing and corrective exercises make up most of the treatment of patients with scoliosis when their deformity is between 20° and 45°, and they have not yet attained skeletal maturity. Evidence suggests that spinal deformity in people with scoliosis may result from improper motor control. Automatic response training is an exercise therapy technique that can modify the pattern of trunk muscle control for supporting the spinal column in normal alignment. An apparatus called a cantilever device is required for this type of exercise, which facilitates training at home. In spite of research showing the benefit of braces and therapeutic exercise in adolescents with scoliosis, less emphasis has been given to the impact of home-based training, especially when this intervention is paired with braces. OBJECTIVE We aim to compare the efficacy of bracing and a conventional exercise program to a combination treatment that includes trunk bracing and exercises with a cantilever device performed at home on the degree of spine curvature, pulmonary function, trunk muscular endurance, and quality of life. METHODS This study was a 2-arms parallel-group clinical study. A total of 16 adolescents with idiopathic scoliosis and single lumbar and thoracolumbar curves of 20°-45° were recruited and randomly assigned into 2 groups. Group A received a combination of trunk bracing and exercise using an instrument known as a "cantilever." Group B (controls) received trunk bracing and a conventional exercise program (without a tool). The study outcomes were the Cobb angle of the scoliotic curve, pulmonary function, the endurance of the trunk muscles, and quality of life. The study outcomes were measured at 2 time points: before the intervention (T1) and 12 weeks following the start of the intervention (T2; at this time, the intervention period has been completed). Multivariate analysis of variance was used to test between- and within-group differences. RESULTS Recruitment for this study began in fall 2022 and is expected to be completed by the end of summer 2023. CONCLUSIONS We studied the efficacy of a combined trunk bracing program and postural response exercises using a cantilever device in treating adolescent idiopathic scoliosis and compared it with trunk bracing and conventional home exercises. Exercises performed at home using a cantilever device are anticipated to raise the endurance of trunk muscles, which will help reduce trunk deformity, enhance pulmonary function, and improve the quality of life of participants. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20220330054371N1; https://www.irct.ir/trial/62811. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43265.
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Affiliation(s)
- Zeinab Rezaeian
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Andalib
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Bokaee
- Department of Physiotherapy, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ebrahim Sadeghi-Demneh
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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da Silveira GE, Andrade RM, Guilhermino GG, Schmidt AV, Neves LM, Ribeiro AP. The Effects of Short- and Long-Term Spinal Brace Use with and without Exercise on Spine, Balance, and Gait in Adolescents with Idiopathic Scoliosis. Medicina (B Aires) 2022; 58:medicina58081024. [PMID: 36013490 PMCID: PMC9413676 DOI: 10.3390/medicina58081024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder in adolescents. Previous studies have shown biomechanical changes of the gait in the lower limb of AIS patients. To minimize the progression of scoliotic curvature, a spinal brace is used, which has been shown to be efficient. Usually, a brace is worn strictly for 20–22 h every day. To our knowledge, no study has assessed the short- and long-term effects of spinal brace use with or without an exercise program (6 months) to improve clinical and biomechanical parameters. The aim of our study was to verify the effects of short- and long-term spinal brace use, with or without an exercise program on the spine, body balance, and plantar load distribution during gait in AIS. Materials and Methods: A prospective randomized study was conducted with intention-to-treat analysis in forty-five adolescents diagnosed with AIS undergoing conservative treatment at a center specialized in spinal rehabilitation. Adolescents were evaluated at two stages of intervention: (1) spinal orthopedic brace, with acute use 24 h/day (n = 22) and (2) spinal orthopedic brace, with acute use between 15–18 h/day associated with a specific rehabilitation exercise protocol for six consecutive months (six months and 12 total sessions, n = 23). The evaluated parameters were: spine pain, using a visual analog scale (VAS); Cobb angle measurement using radiograph exams, as well as the Risser sign; and static balance and plantar pressure of the feet during gait, carried out using a pressure platform. Results: AIS patients showed significant improvements in the main scoliotic curvature, with a 12-degree reduction in Cobb angle pre- and post-short-term immediate use of spinal brace and a 5.3 degree correction after six months of spinal brace use in combination with specific exercises (long term). In addition, short- and long-term brace use with an exercise program showed a significant increase in anteroposterior and mediolateral balance and a reduction in plantar overload on the heel during gait, with an effect size between moderate and high. Conclusions: Intervention via the short- or long-term use of a spinal brace combined with specific exercises in adolescents with idiopathic scoliosis proved to be effective for correcting scoliotic curvature. In addition, intervention also showed improvements to the antero-posterior and mediolateral body balance and a reduction in the plantar load on the rearfoot region during gait, demonstrating effective mechanical action on the spine.
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Affiliation(s)
- Guilherme Erdmann da Silveira
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
| | | | | | - Ariane Verttú Schmidt
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
| | - Lucas Melo Neves
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
- Department of Psychiatry, University of Sao Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Paula Ribeiro
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
- Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
- Correspondence: ; Tel.: +55-11-99139-2168
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18
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Koutras C, Shayestehpour H, Pérez J, Wong C, Rasmussen J, Tournier M, Nesme M, Otaduy MA. Biomechanical Morphing for Personalized Fitting of Scoliotic Torso Skeleton Models. Front Bioeng Biotechnol 2022; 10:945461. [PMID: 35928945 PMCID: PMC9343806 DOI: 10.3389/fbioe.2022.945461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022] Open
Abstract
The use of patient-specific biomechanical models offers many opportunities in the treatment of adolescent idiopathic scoliosis, such as the design of personalized braces. The first step in the development of these patient-specific models is to fit the geometry of the torso skeleton to the patient’s anatomy. However, existing methods rely on high-quality imaging data. The exposure to radiation of these methods limits their applicability for regular monitoring of patients. We present a method to fit personalized models of the torso skeleton that takes as input biplanar low-dose radiographs. The method morphs a template to fit annotated points on visible portions of the spine, and it relies on a default biomechanical model of the torso for regularization and robust fitting of hardly visible parts of the torso skeleton, such as the rib cage. The proposed method provides an accurate and robust solution to obtain personalized models of the torso skeleton, which can be adopted as part of regular management of scoliosis patients. We have evaluated the method on ten young patients who participated in our study. We have analyzed and compared clinical metrics on the spine and the full torso skeleton, and we have found that the accuracy of the method is at least comparable to other methods that require more demanding imaging methods, while it offers superior robustness to artifacts such as interpenetration of ribs. Normal-dose X-rays were available for one of the patients, and for the other nine we acquired low-dose X-rays, allowing us to validate that the accuracy of the method persisted under less invasive imaging modalities.
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Affiliation(s)
- Christos Koutras
- Department of Computer Science, Universidad Rey Juan Carlos, Madrid, Spain
- *Correspondence: Christos Koutras,
| | - Hamed Shayestehpour
- Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Jesús Pérez
- Department of Computer Science, Universidad Rey Juan Carlos, Madrid, Spain
| | - Christian Wong
- Orthopedics Department, University Hospital of Hvidovre, Hvidovre, Denmark
| | - John Rasmussen
- Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | | | | | - Miguel A. Otaduy
- Department of Computer Science, Universidad Rey Juan Carlos, Madrid, Spain
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19
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Proteinuria from first-morning urine in a child due to brace treatment for adolescent idiopathic scoliosis. CEN Case Rep 2022; 11:490-493. [DOI: 10.1007/s13730-022-00708-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022] Open
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Abstract
Scoliosis is an abnormal curvature of the spine, which generally develops during childhood or adolescence. It affects 2–4 percent of the global population and is more prevalent among girls. Scoliosis is classified by its etiology: idiopathic, congenital, or neuromuscular. Among these, the former is the most common. Treatment options for scoliosis vary depending on the severity of the curve. Most scoliosis diagnoses tend to be mild and only require monitoring. However, curves between 20 and 40 degrees require bracing, while 40 degrees and above require surgery. There are various bracings available, such as Boston, Charleston, and Milwaukee. In severe cases of scoliosis, either fusion or fusionless surgery may be required. This review aims to discuss etiologies and different treatment interventions for scoliosis.
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21
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Wei W, Zhang T, Huang Z, Yang J. Finite element analysis in brace treatment on adolescent idiopathic scoliosis. Med Biol Eng Comput 2022; 60:907-920. [DOI: 10.1007/s11517-022-02524-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
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Wang L, Xia N, Wang C, Zheng Q, Ma CZ, Youssef ASA, Zhang C, Deng Y, Zhu G, Huang X. Optimized scheme for paired transverse corrective forces in S-shaped scoliosis via ultrasound and application in Chêneau brace: a pilot study. Prosthet Orthot Int 2022; 46:42-49. [PMID: 34789711 PMCID: PMC8865621 DOI: 10.1097/pxr.0000000000000064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is currently no consensus on the optimal positions of the transverse corrective forces (TCFs) for scoliosis braces. OBJECTIVES This study aimed to explore an optimal scheme of placing paired TCF for S-shaped adolescent idiopathic scoliosis and its feasibility in Chêneau brace (CB) treatment. STUDY DESIGN Cross-over feasibility pilot trial. METHODS Ten S-shaped adolescent idiopathic scoliosis participants were invited to receive four tests with different paired TCF positions under ultrasound. The positions of the paired TCF were test 1: thoracic apical vertebra (AV), lumbar AV; test 2: 2 cm inferior to thoracic AV, lumbar AV; test 3: thoracic AV, 2 cm superior to lumbar AV; and test 4: 2 cm inferior to thoracic AV, 2 cm superior to lumbar AV. The test scheme with the highest mean in-force correction rate (IFCR) for the thoracic spinous process angle (SPA) was further applied in the CB fabrication of 4 additional participants. RESULTS A significant higher mean IFCR of the thoracic SPA of 63.6% was found in test 2 (P < 0.001), which also contributed to its higher overall IFCR of the SPA of 64.6% (P = 0.001). Moreover, the mean in-brace correction rates for the thoracic and overall curves in CB were 46.4% and 51.8%, respectively. No adverse events were reported. CONCLUSIONS Placing paired TCF at the lumbar AV and 2 cm inferior to the thoracic AV achieved better treatment efficacy than other schemes. The practical application of this scheme on the CB was feasible.
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Affiliation(s)
- Li Wang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun Wang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Rehabilitation Medicine, Shantou Central Hospital, Shantou, China
| | - Qian Zheng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Christina Zonghao Ma
- Department of Biomedical Engineering, the Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ahmed S. A. Youssef
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Basic Science Department, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Chao Zhang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youbin Deng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoli Zhu
- School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolin Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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23
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Ikwuezunma I, Wang K, Margalit A, Sponseller P, Jain A. Cost-utility Analysis Comparing Bracing Versus Observation for Skeletally Immature Patients with Thoracic Scoliosis. Spine (Phila Pa 1976) 2021; 46:1653-1659. [PMID: 34366411 DOI: 10.1097/brs.0000000000004189] [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 Cost-utility analysis. OBJECTIVE This study aimed to investigate the cost-utility of bracing versus observation in patients with thoracic scoliosis who would be indicated for bracing. SUMMARY OF BACKGROUND DATA There is high-quality evidence that bracing can prevent radiographic progression of spinal curvature in adolescent idiopathic scoliosis (AIS) patients with curves between 25° and 40° and Risser 0 to 2 skeletal maturity index. However, to our knowledge, the cost-utility of bracing in AIS has not been established. METHODS A decision-analysis model comparing bracing versus observation was developed for a hypothetical 10-year old girl (Risser 0, Sanders 3) with a 35° main thoracic curve. We estimated the probability, cost, and quality-adjusted life years (QALY) for each node based on comprehensive review of the literature. Costs were adjusted for inflation based on Consumer Price Index and reported in terms of 2020 real dollars. Incremental net monetary benefit (INMB) was calculated based on a probabilistic sensitivity analysis using Monte Carlo simulations of 1000 hypothetical patients. One-way sensitivity analyses were performed by varying cost, probability, and QALY estimates. RESULTS Our decision-analysis model revealed that bracing was the dominant treatment choice over observation at $50,000/QALY willingness to pay threshold. In simulation analysis of a hypothetical patient cohort, bracing was associated with lower net lifetime costs ($60,377 ± $5,340 with bracing vs. $85,279 ± $4543 with observation) and higher net lifetime QALYs (24.1 ± 2.0 with bracing vs. 23.9 ± 1.8 with observation). Bracing was associated with an INMB of $36,093 (95% confidence interval $18,894-$55,963) over observation over the patient's lifetime. The model was most sensitive to the impact of bracing versus observation on altering the probability of requiring surgery, either as an adolescent or an adult. CONCLUSION Cost-utility analysis supports scoliosis bracing as the preferred choice in management of appropriately indicated AIS patients with thoracic scoliosis.Level of Evidence: 5.
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Affiliation(s)
- Ijezie Ikwuezunma
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Yang JH, Chang DG, Suh SW. Diagnosis and conservative treatment of adolescent idiopathic scoliosis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.11.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Adolescent idiopathic scoliosis (AIS) has a diagnosis rate of 3% to 5% per year, but the number of cases requiring surgical treatments is very small, accounting for only 0.17% to 1.75% of all AIS patients. Most patients with AIS are diagnosed, treated, and managed in outpatient clinics.Current Concepts: AIS is a disease that occurs more frequently, and progresses faster, in females than in males. Scoliosis deformity can occur due to various causes. To differentially diagnose AIS, it is necessary to perform careful physical examinations, investigate family history, and check for neurological, growth, and developmental abnormalities. Definitive diagnosis of AIS can be performed through radiographic imaging. In the case of atypical curvature and symptoms, examinations such as magnetic resonance imaging could be required in addition to radiographic imaging. Treatment of AIS patients in outpatient clinics can be performed through observation, exercise, and orthosis. The selection and application of treatment methods and the termination period of the treatments are complexly affected by the age at the time of diagnosis; pattern, location and size of the curve; and growth potential.Discussion and Conclusion: AIS is a disease in which good results can be obtained with conservative treatments such as exercise and orthosis, which is generally applied in an outpatient setting. To properly treat AIS, it is necessary to have an in-depth understanding of the characteristics of AIS, timing of treatment, and factors influencing treatment.
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25
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León-Morillas F, de Oliveira-Sousa SL, Andrade-Ortega JA, Ibáñez-Vera AJ, Lomas-Vega R, Zagalaz-Anula N. The Type of Conservative Management Could Be Related to the Strength of the Inspiratory Muscles of Adolescents with Idiopathic Scoliosis—A Case Series. CHILDREN 2021; 8:children8111002. [PMID: 34828715 PMCID: PMC8619345 DOI: 10.3390/children8111002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine with a Cobb angle of at least 10° with an unknown etiology. It is recognized that AIS may affect respiratory function. This study aims to describe and compare respiratory function in a case series of patients with scoliosis who underwent different types of therapeutic management: no intervention, orthotic brace, and global postural reeducation (GPR). Fifteen AIS patients were included in this study (seven no intervention, four orthotic brace and four GPR). Lung function and inspiratory muscle strength were measured and analyzed, as well as sociodemographic, clinical, and anthropometric variables. Significant correlations were observed between height (cm) and maximum inspiratory pressure (MIP) reference (cmH2O) and forced vital capacity (FVC) (liters) (r = 0.650 and r = 0.673, respectively; p < 0.01); weight (Kg) and MIP reference (cmH2O) (r = 0.727; p < 0.01); and Main curve degrees (Cobb angle) and FVC% (r = −0.648; p < 0.01). The AIS cases that underwent GPR treatment presented a greater MIP (% predictive) compared to the no intervention and brace cases (201.1% versus 126.1% and 78.4%, respectively; p < 0.05). The results of this case series show a possible relation whereby patients undergoing treatment with the GPR method have greater inspiratory muscle strength compared to the no intervention and brace cases. Studies with larger samples and prospective designs must be performed to corroborate these results.
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Affiliation(s)
- Felipe León-Morillas
- Department of Physiotherapy, Catholic University of Murcia UCAM, Avenida de los Jerónimos, 30107 Murcia, Spain;
| | | | - Juan Alfonso Andrade-Ortega
- Department of Physical Medicine and Rehabilitation, Complejo Hospitalario de Jaen, Avenue of Madrid, 23001 Jaén, Spain;
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
- Correspondence: ; Tel.: +34-953-213-519
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
| | - Noelia Zagalaz-Anula
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
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The ISJ 3D Brace, a Providence Brace Evolution, as a Surgery Prevention Method in Idiopathic Scoliosis. J Clin Med 2021; 10:jcm10173915. [PMID: 34501360 PMCID: PMC8432137 DOI: 10.3390/jcm10173915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The high incidence of idiopathic scoliosis worldwide as well as the serious health problems it can cause in adulthood, make it necessary to seek effective treatments to prevent the progression of the disease to more aggressive treatments such as surgery and improve patients’ quality of life. The use of night braces, besides a less severe influence on the patient’s quality of life, is effective in stopping the progression of the curve in idiopathic scoliosis. Methods: A longitudinal study was performed with an experimental population of 108 participants who attended orthotic treatment at the University Hospital of Barcelona, with ages between 4 and 15 years old, with a main curvature greater than 25 degrees and a Risser between 0 and 3. The participants received treatment with Providence ISJ-3D night braces until their pubertal change (mean duration of 2.78 years for males and 1.97 years for females). Results: The implementation of night-time orthotic treatment in children with idiopathic scoliosis is effective in slowing the progression of the curve and in the prevention of more aggressive treatments such as surgery, maintaining the patient’s quality of life. Conclusions: The use of night braces is efficacious in the treatment of idiopathic scoliosis, although new studies including more sociodemographic data as well as curves from 20 degrees of progression are necessary.
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Ruffilli A, Fiore M, Barile F, Pasini S, Faldini C. Evaluation of night-time bracing efficacy in the treatment of adolescent idiopathic scoliosis: a systematic review. Spine Deform 2021; 9:671-678. [PMID: 33258070 DOI: 10.1007/s43390-020-00248-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/03/2020] [Indexed: 10/22/2022]
Abstract
STUDY DESIGN Systematic review of the literature. PURPOSE To systematically review the literature to assess the efficacy of night-time bracing in controlling curve progression with respect to traditional full-time thoraco-lumbo-sacral orthoses (TLSOs) in patient with adolescent idiopathic scoliosis. METHODS PubMed, Ovid, Cochrane Reviews and Google Scholar were all accessed and a combination of terms and keywords pertaining to the core concept was used in the research. Case reports, technical notes, instructional courses, literature reviews, biomechanical and/or in vitro studies were all excluded, as well as case series (level IV studies). The methodological quality of the selected articles was assessed using the MINORS methodology score. Given the overall level and quality of the available evidence, conclusions were drawn based on a summary of the evidence. RESULTS Seven studies were included. Five papers reported no differences in curve progression between traditional TLSOs and night-time braces and the remaining two studies reported TLSO to be superior. CONCLUSION The current available literature does not permit us to draw conclusions about night-time braces. The low methodological quality of the studies examined makes it impossible to compare the effectiveness of the night-time braces with that of traditional TLSOs. Prospective well-designed clinical trials applying SRS inclusion and evaluation criteria are mandatory to better define the role of night-time orthosis in the treatment of adolescent idiopathic scoliosis.
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Affiliation(s)
- Alberto Ruffilli
- Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Michele Fiore
- Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
| | - Francesca Barile
- Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Stefano Pasini
- Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neuromotor Science-DIBINEM, 1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
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Cheung PWH, Cheung JPY. Sanders stage 7b: Using the appearance of the ulnar physis improves decision-making for brace weaning in patients with adolescent idiopathic scoliosis. Bone Joint J 2021; 103-B:141-147. [DOI: 10.1302/0301-620x.103b1.bjj-2020-1240.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to investigate whether including the stages of ulnar physeal closure in Sanders stage 7 aids in a more accurate assessment for brace weaning in patients with adolescent idiopathic scoliosis (AIS). Methods This was a retrospective analysis of patients who were weaned from their brace and reviewed between June 2016 and December 2018. Patients who weaned from their brace at Risser stage ≥ 4, had static standing height and arm span for at least six months, and were ≥ two years post-menarche were included. Skeletal maturity at weaning was assessed using Sanders staging with stage 7 subclassified into 7a, in which all phalangeal physes are fused and only the distal radial physis is open, with narrowing of the medial physeal plate of the distal ulna, and 7b, in which fusion of > 50% of the medial growth plate of distal ulna exists, as well as the distal radius and ulna (DRU) classification, an established skeletal maturity index which assesses skeletal maturation using finer stages of the distal radial and ulnar physes, from open to complete fusion. The grade of maturity at the time of weaning and any progression of the curve were analyzed using Fisher’s exact test, with Cramer’s V, and Goodman and Kruskal’s tau. Results We studied a total of 179 patients with AIS, of whom 149 (83.2%) were female. Their mean age was 14.8 years (SD 1.1) and the mean Cobb angle was 34.6° (SD 7.7°) at the time of weaning. The mean follow-up was 3.4 years (SD 1.8). At six months after weaning, the rates of progression of the curve for patients weaning at Sanders stage 7a and 7b were 11.4% and 0%, respectively for those with curves of < 40°. Similarly, the rates of progression of the curve for those being weaned at ulnar grade 7 and 8 using the DRU classification were 13.5% and 0%, respectively. The use of Sanders stages 6, 7a, 7b, and 8 for the assessment of maturity at the time of weaning were strongly and significantly associated (Cramer’s V 0.326; p = 0.016) with whether the curve progressed at six months after weaning. Weaning at Sanders stage 7 with subclassification allowed 10.6% reduction of error in predicting the progression of the curve. Conclusion The use of Sanders stages 7a and 7b allows the accurate assessment of skeletal maturity for guiding brace weaning in patients with AIS. Weaning at Sanders stage 7b, or at ulnar grade 8 with the DRU classification, is more appropriate as the curve did not progress in any patient with a curve of < 40° immediately post-weaning. Thus, reaching full fusion in both distal radial and ulnar physes (as at Sanders stage 8) is not necessary and this allows weaning from a brace to be initiated about nine months earlier. Cite this article: Bone Joint J 2021;103-B(1):141–147.
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Affiliation(s)
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong SAR, China
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Spinal Deformities and Advancement in Corrective Orthoses. Bioengineering (Basel) 2020; 8:bioengineering8010002. [PMID: 33375594 PMCID: PMC7824216 DOI: 10.3390/bioengineering8010002] [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: 11/19/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/04/2022] Open
Abstract
Spinal deformity is an abnormality in the spinal curves and can seriously affect the activities of daily life. The conventional way to treat spinal deformities, such as scoliosis, kyphosis, and spondylolisthesis, is to use spinal orthoses (braces). Braces have been used for centuries to apply corrective forces to the spine to treat spinal deformities or to stabilize the spine during postoperative rehabilitation. Braces have not modernized with advancements in technology, and very few braces are equipped with smart sensory design and active actuation. There is a need to enable the orthotists, ergonomics practitioners, and developers to incorporate new technologies into the passive field of bracing. This article presents a review of the conventional passive braces and highlights the advancements in spinal orthoses in terms of improved sensory designs, active actuation mechanisms, and new construction methods (CAD/CAM, three-dimensional (3D) printing). This review includes 26 spinal orthoses, comprised of passive rigid/soft braces, active dynamics braces, and torso training devices for the rehabilitation of the spine.
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Pérez-Machado G, Berenguer-Pascual E, Bovea-Marco M, Rubio-Belmar PA, García-López E, Garzón MJ, Mena-Mollá S, Pallardó FV, Bas T, Viña JR, García-Giménez JL. From genetics to epigenetics to unravel the etiology of adolescent idiopathic scoliosis. Bone 2020; 140:115563. [PMID: 32768685 DOI: 10.1016/j.bone.2020.115563] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/11/2022]
Abstract
Scoliosis is defined as the three-dimensional (3D) structural deformity of the spine with a radiological lateral Cobb angle (a measure of spinal curvature) of ≥10° that can be caused by congenital, developmental or degenerative problems. However, those cases whose etiology is still unknown, and affect healthy children and adolescents during growth, are the commonest form of spinal deformity, known as adolescent idiopathic scoliosis (AIS). In AIS management, early diagnosis and the accurate prediction of curve progression are most important because they can decrease negative long-term effects of AIS treatment, such as unnecessary bracing, frequent exposure to radiation, as well as saving the high costs of AIS treatment. Despite efforts made to identify a method or technique capable of predicting AIS progression, this challenge still remains unresolved. Genetics and epigenetics, and the application of machine learning and artificial intelligence technologies, open up new avenues to not only clarify AIS etiology, but to also identify potential biomarkers that can substantially improve the clinical management of these patients. This review presents the most relevant biomarkers to help explain the etiopathogenesis of AIS and provide new potential biomarkers to be validated in large clinical trials so they can be finally implemented into clinical settings.
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Affiliation(s)
| | | | | | - Pedro Antonio Rubio-Belmar
- Institute for Health Research La Fe, IISLaFe, Valencia, Spain; Spine Surgery Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Eva García-López
- EpiDisease S.L., University of Valencia. Scientific Park. Paterna, Valencia, Spain
| | - María José Garzón
- EpiDisease S.L., University of Valencia. Scientific Park. Paterna, Valencia, Spain
| | - Salvador Mena-Mollá
- EpiDisease S.L., University of Valencia. Scientific Park. Paterna, Valencia, Spain; Department of Physiology, University of Valencia, Faculty of Medicine and Dentistry, Valencia, Spain
| | - Federico V Pallardó
- EpiDisease S.L., University of Valencia. Scientific Park. Paterna, Valencia, Spain; Department of Physiology, University of Valencia, Faculty of Medicine and Dentistry, Valencia, Spain; Consortium Center for Biomedical Network Research ISCIII. Instituto de Salud Carlos III, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain
| | - Teresa Bas
- Institute for Health Research La Fe, IISLaFe, Valencia, Spain; Spine Surgery Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Juan R Viña
- INCLIVA Health Research Institute, Valencia, Spain; Department of Biochemistry, University of Valencia, Faculty of Medicine and Dentistry, Valencia, Spain
| | - José Luis García-Giménez
- EpiDisease S.L., University of Valencia. Scientific Park. Paterna, Valencia, Spain; Department of Physiology, University of Valencia, Faculty of Medicine and Dentistry, Valencia, Spain; Consortium Center for Biomedical Network Research ISCIII. Instituto de Salud Carlos III, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain.
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Li K, Miao J, Zhang J. Pelvic rotation parameters related to in-brace correction in patients with idiopathic scoliosis. Eur J Med Res 2020; 25:41. [PMID: 32943112 PMCID: PMC7495828 DOI: 10.1186/s40001-020-00437-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022] Open
Abstract
Background To identify the pelvic parameters affecting in-brace correction (IBC) in patients with idiopathic scoliosis (IS). Methods Patients with IS receiving Chêneau brace treatment in our scoliosis center from January 2019 to November 2019 were retrospectively analyzed. Pelvic rotation parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L/R ratio, were collected. Other radiographic data, such as Risser sign, coronal and sagittal balance, curve location, kyphosis, lordosis of each patient were also recorded to analyze their correlations with IBC. Correlation analyses were performed to identify the classified variables influencing IBC. The principal component analysis was used to extract common factors of radiographic parameters to eliminate interaction effects. The linear regression equation was established using principal components, the variables influencing IBC were identified. Results A cohort of 44 patients with IS (36 girls and 8 boys) were included in the present study. The mean IBC was 49.87% (range, 3%–100%). IBC of lumbar IS was negatively correlated with apical rotate factor (ARF, B = –0.385), mainly consisted of pelvic coronal plane rotation (PCPR, 0.449), Cobb angle (CA, 0.575), apical vertebral rotation (AVR, 0.918), and pelvic rotate factor (PRF, B = –0.387), mainly consisted of PT (0.861), PI (0.728), PCPR (–0.570). The regression equation of lumbar IS had statistical significance (F = 6.500, P = 0.005, R2 = 0.317), whereas statistically significance was not found in the regression equation of thoracic IS (F = 2.913, P = 0.106). The remaining parameters were not related to IBC. Conclusions For lumbar IS, ARF and PRF have negative effects on IBC, coronal and sagittal rotation of the pelvis is related to IBC.
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Affiliation(s)
- Kepeng Li
- Clinical Department of Orthopaedics, Tianjin Medical University, 406 Jiefang South Road, Hexi District, Tianjin, China
| | - Jun Miao
- Spine Surgery, Tianjin Hospital, 406 Jiefang South Road, Hexi District, Tianjin, China.
| | - Jingan Zhang
- Tianjin Hospital, 406 Jiefang South Road, Hexi District, Tianjin, China
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Bearce EA, Grimes DT. On being the right shape: Roles for motile cilia and cerebrospinal fluid flow in body and spine morphology. Semin Cell Dev Biol 2020; 110:104-112. [PMID: 32693941 DOI: 10.1016/j.semcdb.2020.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022]
Abstract
How developing and growing organisms attain their proper shape is a central problem of developmental biology. In this review, we investigate this question with respect to how the body axis and spine form in their characteristic linear head-to-tail fashion in vertebrates. Recent work in the zebrafish has implicated motile cilia and cerebrospinal fluid flow in axial morphogenesis and spinal straightness. We begin by introducing motile cilia, the fluid flows they generate and their roles in zebrafish development and growth. We then describe how cilia control body and spine shape through sensory cells in the spinal canal, a thread-like extracellular structure called the Reissner fiber, and expression of neuropeptide signals. Last, we discuss zebrafish mutants in which spinal straightness breaks down and three-dimensional curves form. These curves resemble the common but little-understood human disease Idiopathic Scoliosis. Zebrafish research is therefore poised to make progress in our understanding of this condition and, more generally, how body and spine shape is acquired and maintained through development and growth.
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Affiliation(s)
- Elizabeth A Bearce
- Institute of Molecular Biology, Department of Biology, University of Oregon, Eugene, OR, 97403, USA.
| | - Daniel T Grimes
- Institute of Molecular Biology, Department of Biology, University of Oregon, Eugene, OR, 97403, USA.
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Zagalaz-Anula N, León-Morillas F, Andradre-Ortega JA, Ibáñez-Vera AJ, de Oliveira-Sousa SL, Lomas-Vega R. Case Report: Conservative Treatment of Adolescent Idiopathic Scoliosis Can Alter the Perception of Verticality. A Preliminary Study. Front Pediatr 2020; 8:609555. [PMID: 33569361 PMCID: PMC7868533 DOI: 10.3389/fped.2020.609555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine of at least 10° Cobb's angle of unknown etiology. Some studies have found that patients with AIS have a Visual Verticality (VV) perception similar to healthy controls. This study aimed to analyze VV perception and postural balance differences in patients with AIS depending on the management, either based on observation or conservative treatment. Eighteen patients with AIS were included in this study. Nine patients were managed based on observation. The other nine underwent conservative treatment, such as bracing or exercise. Subjective Visual Vertical (SVV) and posturographic parameters were measured and analyzed. In the SVV test, patients who underwent treatment showed poor constant error in absolute values and mean absolute error, with statistically significant differences (p < 0.05). Only the Romberg Quotient for sway area was within the limits of statistical significance for posturographic parameters, with a lower value for patients under observation. This study found worse perception of verticality in patients receiving some type of conservative treatment than patients receiving only observation; whereas posturography showed similar values in both observation and treatment groups. Our results can be interpreted as the effect of treatment on the previous verticality perception adapted to the curvature.
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Affiliation(s)
| | - Felipe León-Morillas
- Health Sciences PhD Program, Catholic University of Murcia (UCAM), Guadalupe, Spain
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