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Daher M, Aoun M, Kreichati G, Kharrat K, Sebaaly A. Hybrid vs all pedicle screws constructs in adolescent idiopathic scoliosis: a metaanalysis of clinical and radiological outcomes. Spine Deform 2024; 12:1229-1239. [PMID: 38684642 DOI: 10.1007/s43390-024-00886-z] [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: 03/12/2024] [Accepted: 04/13/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) affects around 1 to 3% of young individuals, leading to spinal deformities typically exceeding a Cobb angle of 10 degrees without congenital or neuromuscular causes. Advances in treatment now include various surgical techniques such as posterior fusion utilizing all-pedicle screw constructs or hybrid constructs. METHODS PubMed, Cochrane, and Google Scholar (pages 1-20) were searched up until February 2024. Comparative studies in which the cohort was separated into two groups (HC and PSC) were included. Data consisting of, surgery-related outcomes, sagittal radiographic outcomes, coronal radiographic outcomes, and patient-reported outcomes, was extracted and compared. RESULTS Twenty-eight studies including 3435 patients were included. Higher rates of complications (Odds-Ratio = 1.99, p < 0.00001) and reoperations (Odds-Ratio = 2.82, p < 0.00001) were seen in the hybrid group. Better radiographic coronal correction was seen in the PSC group in both the major curve (Mean Difference = 5.97, p < 0.00001) and the secondary curve (Mean Difference = - 10.73, p < 0.0001). However, restoration of sagittal alignment was better in the HC group when assessing thoracic kyphosis (Mean Difference = 2.97, p = 0.02) and lumbar lordosis (Mean Difference = 3.17, p = 0.005). CONCLUSION While all-pedicle screw constructs demonstrated greater stability in AIS compared to hybrid constructs, resulting in reduced rates of reoperations and complications, as well as improved correction of major and secondary curves, they were unable to fully restore optimal sagittal alignment.
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Affiliation(s)
- Mohammad Daher
- Department of Orthopedic Surgery, Brown University, Providence, RI, 02906, USA
- Faculty of Medicine, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Marven Aoun
- Faculty of Medicine, School of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Gaby Kreichati
- Faculty of Medicine, School of Medicine, Saint Joseph University, Beirut, Lebanon
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Khalil Kharrat
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Amer Sebaaly
- Faculty of Medicine, School of Medicine, Saint Joseph University, Beirut, Lebanon.
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon.
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Gan X, Liu X, Cai D, Zhang R, Li F, Fang H, Huang J, Qiu C, Zhan H. Wearable accelerometers reveal objective assessment of walking symmetry and regularity in idiopathic scoliosis patients. PeerJ 2024; 12:e17739. [PMID: 39035168 PMCID: PMC11259127 DOI: 10.7717/peerj.17739] [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: 04/12/2024] [Accepted: 06/23/2024] [Indexed: 07/23/2024] Open
Abstract
Background Scoliosis is a multifaceted three-dimensional deformity that significantly affects patients' balance function and walking process. While existing research primarily focuses on spatial and temporal parameters of walking and trunk/pelvic kinematics asymmetry, there remains controversy regarding the symmetry and regularity of bilateral lower limb gait. This study aims to investigate the symmetry and regularity of bilateral lower limb gait and examine the balance control strategy of the head during walking in patients with idiopathic scoliosis. Methods The study involved 17 patients with idiopathic scoliosis of Lenke 1 and Lenke 5 classifications, along with 17 healthy subjects for comparison. Three-dimensional accelerometers were attached to the head and L5 spinous process of each participant, and three-dimensional motion acceleration signals were collected during a 10-meter walking test. Analysis of the collected acceleration signals involved calculating five variables related to the symmetry and regularity of walking: root mean square (RMS) of the acceleration signal, harmonic ratio (HR), step regularity, stride regularity, and gait symmetry. Results Our analysis reveals that, during the walking process, the three-dimensional motion acceleration signals acquired from the lumbar region of patients diagnosed with idiopathic scoliosis exhibit noteworthy disparities in the RMS of the vertical axis (RMS-VT) and the HR of the vertical axis (HR-VT) when compared to the corresponding values in the healthy control (RMS-VT: 1.6 ± 0.41 vs. 3 ± 0.47, P < 0.05; HR-VT: 3 ± 0.72 vs. 3.9 ± 0.71, P < 0.05). Additionally, the motion acceleration signals of the head in three-dimensional space, including the RMS in the anterior-posterior and vertical axis, the HR-VT, and the values of step regularity in both anterior-posterior and vertical axis, as well as the values of stride regularity in all three axes, are all significantly lower than those in the healthy control group (P < 0.05). Conclusion The findings of the analysis suggest that the application of three-dimensional accelerometer sensors proves efficacious and convenient for scrutinizing the symmetry and regularity of walking in individuals with idiopathic scoliosis. Distinctive irregularities in gait symmetry and regularity manifest in patients with idiopathic scoliosis, particularly within the antero-posterior and vertical direction. Moreover, the dynamic balance control strategy of the head in three-dimensional space among patients with idiopathic scoliosis exhibits a relatively conservative nature when compared to healthy individuals.
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Affiliation(s)
- Xiaopeng Gan
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xin Liu
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Danxian Cai
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Rongbin Zhang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Fanqiang Li
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Haohuang Fang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jingrou Huang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chenguang Qiu
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hongrui Zhan
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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Aoun M, Daher M, Bizdikian AJ, Kreichati G, Kharrat K, Sebaaly A. Implant density in adolescent idiopathic scoliosis: a meta-analysis of clinical and radiological outcomes. Spine Deform 2024; 12:909-921. [PMID: 38573487 DOI: 10.1007/s43390-024-00860-9] [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: 12/08/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) affects 1-3% of adolescents, and treatment approaches, including the density of constructs in surgical fusion, vary among orthopedic surgeons. Studies have sought to establish whether high-density or low-density constructs offer superior clinical and radiological outcomes, yet conclusive results are lacking. This meta-analysis aims to provide a definitive answer to the controversial and ambiguous question surrounding the efficacy of different pedicle screw densities in treating AIS. METHODS PubMed, Cochrane, and Google Scholar (page 1-20) were searched till December 2023. The studied outcomes were Major Cobb angle, major curve correction, lumbar curve, kyphosis (T5-T12), lumbar lordosis, coronal balance, LIV Tilt angle, TAV translation, LAV translation, apical trunk rotation, trunk shift, SRS-22, operative time, blood loss, complications and cost. RESULTS Twenty-four studies (total of 1985 patients, 1045 in LD group and 940 in HD group) were included in this meta-analysis. A statistically significant better improvement in ATR (p = 0.02) and LIV tilt angle (p = 0.02) was seen in the high-density group. On the other hand, longer operative time (p = 0.002), blood loss (p = 0.0004) and costs (p = 0.02) were seen in the high-density group. No difference was seen in the remaining radiographic and clinical outcomes between both surgeries. CONCLUSION Both low-density (LD) and high-density (HD) screw constructs show comparable and satisfactory radiographic and QOL for AIS patients. Furthermore, HD constructs had increased costs, operative time, and blood loss associated. However, a definitive conclusion cannot be made and more studies taking into account multiple additional variables are necessary to do so.
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Affiliation(s)
- Marven Aoun
- School of Medicine, Saint Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - Mohammad Daher
- School of Medicine, Saint Joseph University, Faculty of Medicine, Beirut, Lebanon
- Department of Orthopedic Surgery, Brown University, Providence, RI, 02906, USA
| | - Aren-Joe Bizdikian
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Gaby Kreichati
- School of Medicine, Saint Joseph University, Faculty of Medicine, Beirut, Lebanon
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Khalil Kharrat
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon
| | - Amer Sebaaly
- School of Medicine, Saint Joseph University, Faculty of Medicine, Beirut, Lebanon.
- Department of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Boulevard, Beirut, Lebanon.
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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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Roth C, Heyde CE, Schumann E, Voit D, Frahm J, Hirsch FW, Anders R, Gräfe D. As fast as an X-ray: real-time magnetic resonance imaging for diagnosis of idiopathic scoliosis in children and adolescents. Pediatr Radiol 2024; 54:1168-1179. [PMID: 38687346 PMCID: PMC11182802 DOI: 10.1007/s00247-024-05919-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Idiopathic scoliosis is common in adolescence. Due to the rapid growth of the spine, it must be monitored closely with radiographs to ensure timely intervention when therapy is needed. As these radiographs continue into young adulthood, patients are repeatedly exposed to ionizing radiation. OBJECTIVE This study aimed to investigate whether real-time magnetic resonance imaging (MRI) is equivalent to conventional radiography in juvenile idiopathic scoliosis for determining curvature, rotation and the Risser stage. Additionally, the time requirement should be quantified. MATERIALS AND METHODS Children with idiopathic scoliosis who had postero-anterior whole-spine radiography for clinical indications were included in this prospective study. A real-time spine MRI was performed at 3 tesla in the supine position, capturing images in both the coronal and sagittal planes. The scoliosis was assessed using Cobb angle, rotation was evaluated based on Nash and Moe criteria, and the Risser stage was determined for each modality. The correlations between modalities and a correction factor for the Cobb angle between the standing and supine position were calculated. RESULTS A total of 33 children (aged 5-17 years), who met the inclusion criteria, were recruited. The Cobb angle (R2 = 0.972; P < 0.01) was positively correlated with a correction factor of 1.07 between modalities. Additionally, the degree of rotation (R2 = 0.92; P < 0.01) and the Risser stage (R2 = 0.93; P < 0.01) demonstrated a strong correlation. CONCLUSION Real-time MRI is equivalent to conventional radiography in determining baseline parameters. Furthermore, it is radiation-free and less time-consuming.
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Affiliation(s)
- Christian Roth
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Christoph-Eckhard Heyde
- Department of Orthopedic and Trauma Surgery, Spine Department, University of Leipzig, Leipzig, Germany
| | - Eckehard Schumann
- Department of Orthopedic and Trauma Surgery, Spine Department, University of Leipzig, Leipzig, Germany
| | - Dirk Voit
- Biomedizinische NMR, Max-Planck-Institut Für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut Für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Franz W Hirsch
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Rebecca Anders
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Daniel Gräfe
- Institut für Kinderradiologie, Liebigstr. 20a, 04103, Leipzig, Germany
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Grünwald ATD, Roy S, Lampe R. Measurement of distances and locations of thoracic and lumbar vertebral bodies from CT scans in cases of spinal deformation. BMC Med Imaging 2024; 24:109. [PMID: 38745329 PMCID: PMC11094998 DOI: 10.1186/s12880-024-01293-6] [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: 02/09/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Spinal deformations, except for acute injuries, are among the most frequent reasons for visiting an orthopaedic specialist and musculoskeletal treatment in adults and adolescents. Data on the morphology and anatomical structures of the spine are therefore of interest to orthopaedics, physicians, and medical scientists alike, in the broad field from diagnosis to therapy and in research. METHODS Along the course of developing supplementary methods that do not require the use of ionizing radiation in the assessment of scoliosis, twenty CT scans from females and males with various severity of spinal deformations and body shape have been analysed with respect to the transverse distances between the vertebral body and the spinous process end tip and the skin, respectively, at thoracic and lumbar vertebral levels. Further, the locations of the vertebral bodies have been analysed in relation to the patient's individual body shape and shown together with those from other patients by normalization to the area encompassed by the transverse body contour. RESULTS While the transverse distance from the vertebral body to the skin varies between patients, the distances from the vertebral body to the spinous processes end tips tend to be rather similar across different patients of the same gender. Tables list the arithmetic mean distances for all thoracic and lumbar vertebral levels and for different regions upon grouping into mild, medium, and strong spinal deformation and according to the range of spinal deformation. CONCLUSIONS The distances, the clustering of the locations of the vertebral bodies as a function of the vertebral level, and the trends therein could in the future be used in context with biomechanical modeling of a patient's individual spinal deformation in scoliosis assessment using 3D body scanner images during follow-up examinations.
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Affiliation(s)
- Alexander T D Grünwald
- Department of Clinical Medicine, Center for Digital Health and Technology, Klinikum rechts der Isar, Department of Orthopaedics and Sports Orthopaedics, Research Unit of the Buhl-Strohmaier Foundation for Cerebral Palsy and Paediatric Neuroorthopaedics, Technical University of Munich, TUM School of Medicine and Health, Munich, Germany
| | - Susmita Roy
- Department of Clinical Medicine, Center for Digital Health and Technology, Klinikum rechts der Isar, Department of Orthopaedics and Sports Orthopaedics, Research Unit of the Buhl-Strohmaier Foundation for Cerebral Palsy and Paediatric Neuroorthopaedics, Technical University of Munich, TUM School of Medicine and Health, Munich, Germany
| | - Renée Lampe
- Department of Clinical Medicine, Center for Digital Health and Technology, Klinikum rechts der Isar, Department of Orthopaedics and Sports Orthopaedics, Research Unit of the Buhl-Strohmaier Foundation for Cerebral Palsy and Paediatric Neuroorthopaedics, Technical University of Munich, TUM School of Medicine and Health, Munich, Germany.
- Markus Würth Professorship, Technical University of Munich, Munich, Germany.
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Lai B, Jiang H, Gao Y, Zhou X. Skeletal ciliopathy: pathogenesis and related signaling pathways. Mol Cell Biochem 2024; 479:811-823. [PMID: 37188988 DOI: 10.1007/s11010-023-04765-5] [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: 03/29/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
Cilia are tiny organelles with conserved structures and components in eukaryotic cells. Ciliopathy is a set of diseases resulting from cilium dysfunction classified into first-order and second-order ciliopathy. With the advancement of clinical diagnosis and radiography, numerous skeletal phenotypes, including polydactyly, short limbs, short ribs, scoliosis, a narrow thorax, and numerous anomalies in bone and cartilage, have been discovered in ciliopathies. Mutation in genes encoding cilia core components or other cilia-related molecules have been found in skeletal ciliopathies. Meanwhile, various signaling pathways associated with cilia and skeleton development have been deemed to be significant for the occurrence and progression of diseases. Herein, we review the structure and key components of the cilium and summarize several skeletal ciliopathies with their presumable pathology. We also emphasize the signaling pathways involved in skeletal ciliopathies, which may assist in developing potential therapies for these diseases.
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Affiliation(s)
- Bowen Lai
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai, 200003, China
| | - Heng Jiang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai, 200003, China
| | - Yuan Gao
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai, 200003, China
| | - Xuhui Zhou
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai, 200003, China.
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Baasner AL, Banaschak H, Fauser D, Bethge M. [Facilitating and Hindering Factors in the Implementation of Medical Rehabilitation of Adolescents with Scoliosis before and during the SARS-CoV-2 Pandemic: A Qualitative Study]. DIE REHABILITATION 2024; 63:89-99. [PMID: 38626790 DOI: 10.1055/a-2245-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
PURPOSE Based on the experience during the SARS-CoV-2 pandemic, the study aimed to derive facilitating and hindering factors in the implementation of medical rehabilitation during future pandemics in adolescents with scoliosis. METHODS A qualitative study design with guided expert interviews was chosen. Twelve interviews with adolescents and seven interviews with physiotherapists were conducted. The evaluation was carried out using qualitative content analysis according to Mayring and inductive categorization. RESULTS For 83.3% of the adolescents a therapy considering individual patient needs was a facilitator. Good information management (91.7%), continued availability of leisure activities (66.7%), and a high perception of safety (100%) were facilitating. 71.4% favoured outdoor therapy. The increased exertion caused by wearing a mask (91.7%) and the shortened therapy times (66.7%) were seen as barriers. For 75.0% of the adolescents, social contacts were more difficult. All therapists stated that communication between patients and therapists was more difficult. CONCLUSION For successful rehabilitation during the SARS-CoV-2 pandemic, depending on weather conditions, therapy should be outside, as there is no need to wear mouth-nose protection outdoors. In addition, the physiotherapeutic treatment (Schroth therapy) should be carried out without mask due to the intensity of the exercise. Social contacts among all adolescents should be supported as much as possible. The leisure activities should provide a wide choice and enough free places. Continuation of certain hygienic measures could help to reduce the incidence of illnesses (e. g., gastrointestinal infections) in the future. These were barely noticed in rehabilitation facilities during the pandemic.
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Affiliation(s)
| | - Hannes Banaschak
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - David Fauser
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
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Miao M, Zhao GQ, Zhou Q, Chao YQ, Zou CC. Orthopedic manifestations in children with Prader-Willi syndrome. BMC Pediatr 2024; 24:118. [PMID: 38355440 PMCID: PMC10865681 DOI: 10.1186/s12887-024-04603-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare genetic disease often associated with bone problems, mainly scoliosis and hip dysplasia (HD). This study aimed to analyze the clinical characteristics of orthopedic deformities in patients with PWS. METHODS A retrospective study was conducted on 175 patients up to March 2023. The Cobb angle(CA) of the spine, the alpha angle of the hip joint, and the acetabular index (AI) were measured. This study aimed to evaluate the relationship between demographic parameters and bone deformities. RESULTS Scoliosis was found in 66 patients (43.7%), including 52 (78.8%) with mild scoliosis, 10 (15.2%) with moderate scoliosis, and 4 (6.1%) with severe scoliosis. Only seven patients received orthopedic treatment (10.6%). The median age of scoliosis was 4.5 years old, and the prevalence of scoliosis increased rapidly at the age of 5 years and adolescence. The mean CA in this study increased gradually with age. HD was found in 47 patients (38.2%), and 6 patients received orthopedic treatment (12.7%). The median age at HD was 1.8 years old. The mean AI of the study population decreased with age. The prevalence of HD treated with recombinant human growth hormone (rhGH) was low. No significant differences were observed in sex, genotype, body mass index (BMI), obesity rate, or onset of scoliosis and HD. CONCLUSION The prevalence of scoliosis and HD was higher in patients with PWS. The onset age and developmental trends of the different skeletal malformations were different. Early diagnosis and treatment are important for the prognosis and treatment of orthopedic diseases in patients with PWS.
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Affiliation(s)
- Miao Miao
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, China
| | - Guo-Qiang Zhao
- Department of Emergency Trauma, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Qiong Zhou
- Hangzhou Children's Hospital, No. 195 Wenhui Road, Hangzhou, 310000, China
| | - Yun-Qi Chao
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, China
| | - Chao-Chun Zou
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, China.
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Hengsomboon N, Vongsirinavarat M, Bovonsunthonchai S, Thawalyawichachit L, Hengsomboon P. Association of scoliosis with lower extremity alignments, muscle strengths, and foot characteristics and their alterations in adolescent idiopathic scoliosis. J Back Musculoskelet Rehabil 2024; 37:975-987. [PMID: 38427464 DOI: 10.3233/bmr-230220] [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: 03/03/2024]
Abstract
BACKGROUND The association between changes occurring in the spine and lower body parts is not well understood in adolescent idiopathic scoliosis (AIS). OBJECTIVES The first aim of the study was to investigate the association of scoliosis with lower extremity (LE) alignments, foot characteristics, and muscle strengths in adolescents. Secondly, comparisons of the data among AIS with single and double curves and control groups were determined. METHODS Thirty-one participants were recruited and classified into 3 groups; AIS with a single curve (n= 7), AIS with double curves (n= 14), and controls (n= 10). Association of the presence of scoliosis with LE alignments (Q and TC angles), LE muscle strengths (hip, knee, and ankle), and foot characteristics (arch indexes) were examined using the point biserial correlation, and the data among three groups were compared using the ANOVA. RESULTS Scoliosis was associated with Q angle, arch indexes, and all LE muscle strengths except for hip extensors and ankle plantar flexors strengths. Comparisons among the three groups showed significant increases in LE alignments and foot characteristics in AIS. Almost all LE muscle strengths decreased in AIS, especially for the single curve group. CONCLUSIONS Apart from spinal deformity, the AIS has changed in LE alignments, muscle strengths, and foot characteristics. Therapists should consider these associations and alterations for designing proper management.
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Berlin C, Tielemann S, Quante M, Halm H. Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation. 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 2023; 32:3140-3148. [PMID: 37470846 DOI: 10.1007/s00586-023-07849-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE In surgical treatment of adolescent idiopathic scoliosis (AIS), only a few studies measure both, radiological parameters and PROMs and correlate them. METHODS Prospectively collected AIS-data of one scoliosis-center within a multicenter German-Spine-Society-Study. All patients underwent instrumented posterior spinal correction and fusion with pedicle-screw-dual-rod-systems from 05/2019 to 01/2021. The data were retrospectively analyzed. INCLUSION CRITERIA age 11-17 years, follow-up (FU) at least 12 months. Clinical data, radiographic parameters, and PROMs (SRS-30-questionnaire) were collected. 100% of patients had X-ray images, 88.2% completed SRS-30. Parameters were given as mean ± SD. Differences and subdivision by lower instrumented vertebra (LIV) were analyzed by students t-test (significancy a = 0.05), associations by Pearson's correlation. RESULT Total of 51 patients: 15 ± 1.4 years, BMI 20.7 ± 3.7 kg/m2, FU 16.6 ± 6.1 months, fusion length 9.2 ± 2.3 segments, implant density 93 ± 9%, surgical time 215 ± 71 min, mean blood loss 504 ± 360 ml. Mean preoperative Cobb angle of main curve 64 ± 14°, of secondary main curve 46 ± 12°, corrected by 68 ± 11%, 56 ± 17%, respectively. Mean thoracic rib and lumbar hump significantly decreased by - 8.5 ± 7.0° and - 7.7 ± 8.9° (p < 0.5). High thoracic rib hump almost unchanged, - 0.4 ± 2.8° (p = 0.3). Thoracic kyphosis (- 0.9 ± 12.8°, p = 0.6), lumbar lordosis (1.5 ± 10.1°, p = 0.3), clavicle angle (- 0.5 ± 2.7°) and spinopelvic parameters (p > 0.5) did not significantly change, only LIV-tilt from 24.5 ± 6.7° to 6.5 ± 4.3° (p < 0.05). PROMs significantly improved (p < 0.05), no significant improvement for function/activity (p = 0.4). Preoperative mean total-score was 3.6 ± 0.5, 4.2 ± 0.3 at FU(p < 0.05). Self-image improved in 67%. Moderately strong correlation for PROMs: the better LIV-tilt (r = - 0.5) correction and the shorter surgery time (r = - 0.4), the better SRS-30 total-score. No correlation for curve correction and patient's satisfaction. CONCLUSION In summary, results of this study demonstrate good surgical correction and significant improvement of most PROMs.
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Affiliation(s)
- Clara Berlin
- Spine Surgery with Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany.
| | - Sophie Tielemann
- Spine Surgery with Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany
| | - Markus Quante
- Spine Surgery with Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany
| | - Henry Halm
- Spine Surgery with Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany
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12
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Aflatooni JO, Loving R, Holderread BM, Liberman SR, Harris JD. #Scoliosis: an analysis of patient perception of scoliosis on TikTok. Proc AMIA Symp 2023; 36:671-674. [PMID: 37829238 PMCID: PMC10566427 DOI: 10.1080/08998280.2023.2249371] [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: 04/24/2023] [Accepted: 08/12/2023] [Indexed: 10/14/2023] Open
Abstract
Background Social media presents an opportunity to analyze popular opinion about patient experiences. Idiopathic scoliosis is a spinal pathology commonly identified in younger patients who are the largest users of social media. Objective To analyze posts on the social media platform, TikTok, to better understand the scoliotic patient condition. Methods TikTok posts were searched manually by screening for "#Scoliosis." Variables assessed included number of likes, conveyed tone, gender, activities of daily living, incisional scar, imaging, involved spine level, spinal curvature, pain, formal physical therapy, multiple operations/reoperation, brace use, self-image, mobility, and educational/awareness posts. Number of responses per category were evaluated for the total they represented and the percentage of available posts containing those elements. Odds ratios with 95% confidence intervals were calculated for each collected variable. Results More posts were positive than negative (P < 0.001) and from female users than male users (P < 0.001). Self-image was the most prevalent subject, with many posts not mentioning activities of daily living, incisional scars, imaging, pain, physical therapy, timing, awareness/education, or involved spine levels. Conclusions More females post about scoliosis than males, with most posts containing positive self-image-related themes. This may represent a positive public attitude about scoliosis; however, further research is needed.
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Affiliation(s)
- Justin O. Aflatooni
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Robert Loving
- Texas A&M College of Medicine, College Station, Texas, USA
| | - Brendan M. Holderread
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Shari R. Liberman
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Joshua D. Harris
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA
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13
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Günther F, Schober F, Hunger S, Schellnock J, Derlien S, Schleifenbaum S, Drossel WG, Heyde CE. Improving Home-Based Scoliosis Therapy: Findings From a Web-Based Survey. JMIR Rehabil Assist Technol 2023; 10:e46217. [PMID: 37540557 PMCID: PMC10439467 DOI: 10.2196/46217] [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: 02/09/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Conservative scoliosis therapy in the form of assisted physiotherapeutic scoliosis exercises is supplemented by self-contained training at home, depending on the approach (eg, Schroth, the Scientific Exercises Approach to Scoliosis). Complex exercises, lack of awareness of the importance of training, and missing supervision by therapists often lead to uncertainty and reduced motivation, which in turn reduces the success of home-based therapy. Increasing digitalization in the health care sector offers opportunities to close this gap. However, research is needed to analyze the requirements and translate the potential of digital tools into concrete solution concepts. OBJECTIVE The aim of this study is to evaluate the potential for optimizing home-based scoliosis therapy in terms of motivation, assistive devices, and digital tools. METHODS In collaboration with the Institute of Physiotherapy at the Jena University Hospital, a survey was initiated to address patients with scoliosis and physical therapists. A digital questionnaire was created for each target group and distributed via physiotherapies, scoliosis forums, the Bundesverband für Skoliose Selbsthilfe e. V. newsletter via a link, and a quick response code. The survey collected data on demographics, therapy, exercise habits, motivation, assistive devices, and digital tools. Descriptive statistics were used for evaluation. RESULTS Of 141 survey participants, 72 (51.1%; n=62, 86.1%, female; n=10, 13.9%, male) patients with scoliosis with an average age of 40 (SD 17.08) years and 30 scoliosis therapists completed the respective questionnaires. The analysis of home-based therapy showed that patients with scoliosis exercise less per week (2 times or less; 45/72, 62.5%) than they are recommended to do by therapists (at least 3 times; 53/72, 73.6%). Patients indicated that their motivation could be increased by practicing together with friends and acquaintances (54/72, 75%), a supporting therapy device (48/72, 66.7%), or a digital profile (46/72, 63.9%). The most important assistive devices, which are comparatively rarely used in home-based therapy, included balance boards (20/72, 27.8%), wall bars (23/72, 31.9%), mirrors (36/72, 50%), and long bars (40/72, 55.6%). Therapists saw the greatest benefit of digital tools for scoliosis therapy in increasing motivation (26/30, 87%), improving home therapy (25/30, 83%), monitoring therapy progress (25/30, 83%), and demonstrating exercise instructions (24/30, 80%). CONCLUSIONS In this study, we investigated whether there is any potential for improvement in home-based scoliosis therapy. For this purpose, using online questionnaires, we asked patients with scoliosis and therapists questions about the following topics: exercise habits, outpatient and home-based therapy, motivation, supportive devices, and digital tools. The results showed that a lack of motivation, suitable training equipment, and tools for self-control leads to a low training workload. From the perspective of the patients surveyed, this problem can be addressed through community training with friends or acquaintances, a supportive therapy device, and digital elements, such as apps, with training instructions and user profiles.
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Affiliation(s)
- Florian Günther
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Sandra Hunger
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Julia Schellnock
- Scientific Field Functional Integration and System Integration, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
| | - Steffen Derlien
- Institute for Physical and Rehabilitative Medicine, University Hospital Jena, Jena, Germany
| | - Stefan Schleifenbaum
- Department of Biomechatronics, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Center for Research on Musculoskeletal Systems (ZESBO), Faculty of Medicine, Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | - Welf-Guntram Drossel
- Scientific Field Functional Integration and System Integration, Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany
- Professorship Adaptronics and Lightweight Design, Technical University Chemnitz, Chemnitz, Germany
| | - Christoph-Eckhard Heyde
- Hospital of Orthopaedic Surgery, Traumatology and Plastic Surgery, University of Leipzig Medical Center, Leipzig, Germany
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Ye Y, Wang W, Yang L, He M. Pulmonary Edema After Intracranial Aneurysm Clipping in Kyphosis: A Case Report. Int Med Case Rep J 2023; 16:333-337. [PMID: 37284435 PMCID: PMC10241183 DOI: 10.2147/imcrj.s409578] [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: 02/22/2023] [Accepted: 05/27/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction A 56-year-old female patient was admitted to the hospital for "10+days of right eye droop and 1 day of aggravation". After admission, the physical examination found that the patient had severe scoliosis. 3D reconstruction and enhanced CT scan of the head vessels showed that the right internal carotid artery C6 aneurysms were clipped under general anesthesia. After the operation, the patient had increased airway pressure, with a large number of pink foam sputum attracted from the trachea catheter, and the lungs were scattered with moist rales during auscultation, After the treatment of anti-heart failure, the patient returned to the ICU through the trachea catheter. Eight hours later, the trachea catheter was pulled out and the patient was released from the ventilator. The symptoms were relieved on the fifth day after the operation. This case report describes the perioperative management of intracranial aneurysm with severe scoliosis. After strict monitoring and timely treatment during the perioperative period, the patient turned from crisis to safety, providing some reference for colleagues who encounter such patients in the future. Conclusion In patients with scoliosis, due to long-term compression of the thorax, pulmonary restrictive ventilation dysfunction, small airway function and diffusion function are reduced, and cardiac function is decreased. Therefore, during the operation of intracranial aneurysms, fluid infusion should be careful, and volume monitoring should be done at all times to maintain the effective circulating blood volume of the body and prevent the aggravation of cardiac insufficiency and pulmonary edema.
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Affiliation(s)
- Yuancai Ye
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu City, Sichuan, People’s Republic of China
| | - Weisi Wang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu City, Sichuan, People’s Republic of China
| | - Lei Yang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu City, Sichuan, People’s Republic of China
| | - Min He
- Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu City, Sichuan, People’s Republic of China
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15
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Prost M, Röckner ME, Taday R, Windolf J, Konieczny MR. May bending radiographs be replaced by magnetic resonance imaging in patients with adolescent idiopathic scoliosis? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:1771-1776. [PMID: 36988729 DOI: 10.1007/s00586-023-07659-8] [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: 11/29/2022] [Revised: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE There is no data that shows if it is possible to determine if a curve is structural or non-structural or to assess flexibility of an adolescent idiopathic scoliosis (AIS) by magnetic resonance imaging (MRI) instead of bending radiographs (BR). We investigated if the results of BR may be compared to those of MRI. METHODS We retrospectively analyzed prospectively collected data of patients with AIS in whom a selective spinal fusion was performed and in whom a MRI, BR and full-spine X-rays were obtained preoperatively. We measured the Cobb angles of the main and of the minor curve in full-spine X-ray (FSR), BR and MRI and analyzed the degree of the intervertebral disk degeneration in the MRI. RESULTS After applying inclusion and exclusion criteria, 25 patients were included. We found a significant correlation (p < 0.05, Corr Coeff = 0.41) between the Cobb angle of the main curve in FSR and the Cobb angle of the main curve in the MRI and between the Cobb angle of the minor curve in FSR and the Cobb angle of the minor curve in the MRI (p < 0.001, Corr Coeff = 0.04). All patients with a minor curve of less than 25° in the BR had a Cobb angle of less than 30° in the MRI. CONCLUSION Spinal curves showed a significant correlation between bending radiographs and recumbent images (MRI). In our group of patients, a Cobb angle of the minor curve of less than 30° in the MRI indicated that this minor curve was non-structural according to the classification of Lenke.
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Affiliation(s)
- Max Prost
- Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Melanie Elisabeth Röckner
- Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Roman Taday
- Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Joachim Windolf
- Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Markus Rafael Konieczny
- Department of Orthopedic and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
- Department of Spine Surgery, ATOS Viktoriaklinik, Bochum, Germany
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16
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Quintero Santofimio V, Clement A, O'Regan DP, Ware JS, McGurk KA. Identification of an increased lifetime risk of major adverse cardiovascular events in UK Biobank participants with scoliosis. Open Heart 2023; 10:e002224. [PMID: 37137668 PMCID: PMC10163590 DOI: 10.1136/openhrt-2022-002224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Structural changes caused by spinal curvature may impact the organs within the thoracic cage, including the heart. Cardiac abnormalities in patients with idiopathic scoliosis are often studied post-corrective surgery or secondary to diseases. To investigate cardiac structure, function and outcomes in participants with scoliosis, phenotype and imaging data of the UK Biobank (UKB) adult population cohort were analysed. METHODS Hospital episode statistics of 502 324 adults were analysed to identify participants with scoliosis. Summary 2D cardiac phenotypes from 39 559 cardiac MRI (CMR) scans were analysed alongside a 3D surface-to-surface (S2S) analysis. RESULTS A total of 4095 (0.8%, 1 in 120) UKB participants were identified to have all-cause scoliosis. These participants had an increased lifetime risk of major adverse cardiovascular events (MACEs) (HR=1.45, p<0.001), driven by heart failure (HR=1.58, p<0.001) and atrial fibrillation (HR=1.54, p<0.001). Increased radial and decreased longitudinal peak diastolic strain rates were identified in participants with scoliosis (+0.29, Padj <0.05; -0.25, Padj <0.05; respectively). Cardiac compression of the top and bottom of the heart and decompression of the sides was observed through S2S analysis. Additionally, associations between scoliosis and older age, female sex, heart failure, valve disease, hypercholesterolemia, hypertension and decreased enrolment for CMR were identified. CONCLUSION The spinal curvature observed in participants with scoliosis alters the movement of the heart. The association with increased MACE may have clinical implications for whether to undertake surgical correction. This work identifies, in an adult population, evidence for altered cardiac function and an increased lifetime risk of MACE in participants with scoliosis.
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Affiliation(s)
| | - Adam Clement
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - Declan P O'Regan
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - James S Ware
- National Heart and Lung Institute, Imperial College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Kathryn A McGurk
- National Heart and Lung Institute, Imperial College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, London, UK
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17
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Bottino L, Settino M, Promenzio L, Cannataro M. Scoliosis Management through Apps and Software Tools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085520. [PMID: 37107802 PMCID: PMC10138677 DOI: 10.3390/ijerph20085520] [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: 02/16/2023] [Revised: 03/10/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Background: Scoliosis is curvature of the spine, often found in adolescents, which can impact on quality of life. Generally, scoliosis is diagnosed by measuring the Cobb angle, which represents the gold standard for scoliosis grade quantification. Commonly, scoliosis evaluation is conducted in person by medical professionals using traditional methods (i.e., involving a scoliometer and/or X-ray radiographs). In recent years, as has happened in various medicine disciplines, it is possible also in orthopedics to observe the spread of Information and Communications Technology (ICT) solutions (i.e., software-based approaches). As an example, smartphone applications (apps) and web-based applications may help the doctors in screening and monitoring scoliosis, thereby reducing the number of in-person visits. Objectives: This paper aims to provide an overview of the main features of the most popular scoliosis ICT tools, i.e., apps and web-based applications for scoliosis diagnosis, screening, and monitoring. Several apps are assessed and compared with the aim of providing a valid starting point for doctors and patients in their choice of software-based tools. Benefits for the patients may be: reducing the number of visits to the doctor, self-monitoring of scoliosis. Benefits for the doctors may be: monitoring the scoliosis progression over time, managing several patients in a remote way, mining the data of several patients for evaluating different therapeutic or exercise prescriptions. Materials and Methods: We first propose a methodology for the evaluation of scoliosis apps in which five macro-categories are considered: (i) technological aspects (e.g., available sensors, how angles are measured); (ii) the type of measurements (e.g., Cobb angle, angle of trunk rotation, axial vertebral rotation); (iii) availability (e.g., app store and eventual fee to pay); (iv) the functions offered to the user (e.g., posture monitoring, exercise prescription); (v) overall evaluation (e.g., pros and cons, usability). Then, six apps and one web-based application are described and evaluated using this methodology. Results: The results for assessment of scoliosis apps are shown in a tabular format for ease of understanding and intuitive comparison, which can help the doctors, specialists, and families in their choice of scoliosis apps. Conclusions: The use of ICT solutions for spinal curvature assessment and monitoring brings several advantages to both patients and orthopedics specialists. Six scoliosis apps and one web-based application are evaluated, and a guideline for their selection is provided.
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Affiliation(s)
- Lorella Bottino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marzia Settino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Luigi Promenzio
- Pediatric Orthopaedics Department, Villa Serena for Children, 88100 Catanzaro, Italy
| | - Mario Cannataro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
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Trobisch P, Mahoney JM, Eichenlaub EK, Antonacci CL, Cuddihy L, Amin DB, Razo-Castaneda D, Orbach MR, McGuckin JP, Bucklen BS, Antonacci MD, Betz RR. An investigation of range of motion preservation in fusionless anterior double screw and cord constructs for scoliosis correction. 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 2023; 32:1173-1186. [PMID: 36871254 DOI: 10.1007/s00586-023-07608-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To evaluate the motion-preserving properties of vertebral body tethering with varying cord/screw constructs and cord thicknesses in cadaveric thoracolumbar spines. METHODS In vitro flexibility tests were performed on six fresh-frozen human cadaveric spines (T1-L5) (2 M, 4F) with a median age of 63 (59-to-80). An ± 8 Nm load was applied to determine range of motion (ROM) in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) in the thoracic and lumbar spine. Specimens were tested with screws (T5-L4) and without cords. Single (4.0 mm and 5.0 mm) and double (4.0 mm) cord constructs were sequentially tensioned to 100 N and tested: (1) Single 4.0 mm and (2) 5.0 mm cords (T5-T12); (3) Double 4.0 mm cords (T5-12); (4) Single 4.0 mm and (5) 5.0 mm cord (T12-L4); (6) Double 4.0 mm cords (T12-L4). RESULTS In the thoracic spine (T5-T12), 4.0-5.0 mm single-cord constructs showed slight reductions in FE and 27-33% reductions in LB compared to intact, while double-cord constructs showed reductions of 24% and 40%, respectively. In the lumbar spine (T12-L4), double-cord constructs had greater reductions in FE (24%), LB (74%), and AR (25%) compared to intact, while single-cord constructs exhibited reductions of 2-4%, 68-69%, and 19-20%, respectively. CONCLUSIONS The present biomechanical study found similar motion for 4.0-5.0 mm single-cord constructs and the least motion for double-cord constructs in the thoracic and lumbar spine suggesting that larger diameter 5.0 mm cords may be a more promising motion-preserving option, due to their increased durability compared to smaller cords. Future clinical studies are necessary to determine the impact of these findings on patient outcomes.
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Affiliation(s)
| | - Jonathan M Mahoney
- Musculoskeletal Education and Research Center, A Division of Globus Medical Inc., 2560 General Armistead Ave., Audubon, PA, 19403, USA
| | - Emily K Eichenlaub
- Musculoskeletal Education and Research Center, A Division of Globus Medical Inc., 2560 General Armistead Ave., Audubon, PA, 19403, USA
| | | | - Laury Cuddihy
- Institute for Spine and Scoliosis, Lawrenceville, NJ, USA
| | - Dhara B Amin
- Musculoskeletal Education and Research Center, A Division of Globus Medical Inc., 2560 General Armistead Ave., Audubon, PA, 19403, USA
| | - Dominic Razo-Castaneda
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA , USA
| | - Mattan R Orbach
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA , USA
| | - Joshua P McGuckin
- Musculoskeletal Education and Research Center, A Division of Globus Medical Inc., 2560 General Armistead Ave., Audubon, PA, 19403, USA.
| | - Brandon S Bucklen
- Musculoskeletal Education and Research Center, A Division of Globus Medical Inc., 2560 General Armistead Ave., Audubon, PA, 19403, USA
| | | | - Randal R Betz
- Institute for Spine and Scoliosis, Lawrenceville, NJ, USA
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Dimitrijević V, Šćepanović T, Jevtić N, Rašković B, Milankov V, Milosević Z, Ninković SS, Chockalingam N, Obradović B, Drid P. Application of the Schroth Method in the Treatment of Idiopathic Scoliosis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16730. [PMID: 36554613 PMCID: PMC9779560 DOI: 10.3390/ijerph192416730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Idiopathic scoliosis can be defined as a complex three-dimensional deformity of the spine and trunk, which occurs in basically healthy children. Schroth scoliosis-specific exercises have shown good results in reducing idiopathic scoliosis progression. This study aimed to critically evaluate the effect size of Schroth's method through a systematic review and meta-analysis. (2) Methods: Four databases were included in the search: PubMed, Cochrane Library, Web of Science, and Google Scholar. The following keywords were used: "Schroth exercise", "idiopathic scoliosis", "Cobb angle", "angle of trunk rotation", and "quality of life". Only articles written in English that met the following criteria were included in our study: subjects who had idiopathic scoliosis, the Schroth method was applied, and Cobb angle or angle of trunk rotation or quality of life as outcomes. (3) Results: Ten randomized controlled trials were included in this study. The effect size of the Schroth exercise ranged from almost moderate to large, for the outcomes used: Cobb angle (ES = -0.492, p ˂ 0.005); ATR (ES = -0.471, p = 0.013); QoL (ES = 1.087, p ˂ 0.001). (4) Conclusions: The current meta-analysis indicates that the Schroth method has a positive effect on subjects with idiopathic scoliosis.
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Affiliation(s)
- Vanja Dimitrijević
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Tijana Šćepanović
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | | | - Bojan Rašković
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Vukadin Milankov
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Institute for Children and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia
| | - Zoran Milosević
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Srđan S. Ninković
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK
| | - Borislav Obradović
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
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Muacevic A, Adler JR. Physiotherapy Interventions for Preventing Spinal Curve Progression in Adolescent Idiopathic Scoliosis: A Systematic Review. Cureus 2022; 14:e30314. [PMID: 36381707 PMCID: PMC9650952 DOI: 10.7759/cureus.30314] [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: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 12/02/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is an abnormal curvature of the spine that appears in late childhood or adolescence. The aim of this systematic review was to present and synthesize the most relevant therapeutic advice and evidence on the efficacy of physiotherapy exercises for preventing the growth of spinal curvature caused by adolescent idiopathic scoliosis. "Adolescent idiopathic scoliosis," "exercise," "Cobb angle," and "physiotherapy" were the sole keywords used for the published research. Using these keywords and a combination of them, electronic resources such as PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Elton B. Stephens Company (EBSCO) host, and ScienceDirect (Elsevier) were searched. The search was restricted to studies that were conducted in English between 2010 and 15 January 2022 that were controlled, randomized, and non-randomized. Studies were selected based on their titles and abstracts, with the exception of any that did not pertain to the study's goals. The Cobb angle was the important outcome measure. For each intervention, the Cobb angle's mean change score, the difference between the final and baseline scores, was determined. Nine studies were evaluated to be of outstanding quality out of a total of 20 studies that were reviewed for eligibility. With an exercise regimen of at least seven weeks, controls on lowering the Cobb angle in patients with AIS would provide encouraging outcomes. It also shows that bracing can strengthen the Cobb angle compared to exercise in the community. However, long-term orthotic activity ultimately results in trunk resistance and muscle loss in the center of the back. The combination of techniques and treatment methods seems to have better results in treating scoliosis, particularly using exercises involving the Schroth and scientific exercise approach to scoliosis (SEAS).
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Scaturro D, Balbo A, Vitagliani F, Stramazzo L, Camarda L, Letizia Mauro G. Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review. Nutrients 2022; 14:nu14194011. [PMID: 36235665 PMCID: PMC9572444 DOI: 10.3390/nu14194011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
The etiopathogenesis of idiopathic scoliosis remains unknown, although genetic or hereditary factors, neurological disorders, hormonal and metabolic dysfunctions, biomechanical factors, and environmental factors seem to be involved. Several studies have found that patients with scoliosis have common characteristics of taller stature, lower body mass index (BMI), and low systemic bone mass. We conducted a scoping review to analyze the association between idiopathic scoliosis and BMI. The search for articles was performed on PubMed and Cochrane, including the English language, full-text and free-full-text articles published from 31 December 2011 to 31 December 2021. Most of the results analyzed are in favor of a relationship between low BMI and scoliosis. Having a low BMI could be associated with the presence of scoliosis, although the reason for which is still doubtful. However, further large-scale epidemiological studies on different ethnicities and a comparison of BMI with the healthy population will be needed to better define the correlation between BMI and scoliosis.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Agnese Balbo
- Faculty of Medicine and Surgery, University of Catania, Via Santa Sofia 87, 95100 Catania, Italy
| | - Fabio Vitagliani
- Faculty of Medicine and Surgery, University of Catania, Via Santa Sofia 87, 95100 Catania, Italy
- Correspondence: ; Tel.: +39-3920677899
| | - Leonardo Stramazzo
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Lawrence Camarda
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy
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22
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Park M, Kim YJ, Oh KE, Kang E, Nam HK, Rhie YJ, Lee KH. The association between idiopathic scoliosis and growth hormone treatment in short children. Ann Pediatr Endocrinol Metab 2022; 27:207-213. [PMID: 35592900 PMCID: PMC9537675 DOI: 10.6065/apem.2142186.093] [Citation(s) in RCA: 2] [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: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Idiopathic scoliosis is the most common form of scoliosis, and the risk of onset and progression has been found to correlate with growth spurts. Therefore, treatment with recombinant human growth hormone (GH) treatment in short children may initiate and/or aggravate scoliosis. The aim of this study was to investigate the relationship between idiopathic scoliosis and GH treatment in short children. METHODS The medical records of 113 subjects seen at the participating institution between January 2010 and December 2020 and who were diagnosed with GH deficiency and small for gestational age, had idiopathic short stature, and were treated with GH for at least one year were reviewed. Scoliosis was defined as a Cobb angle greater than 10 degrees as assessed using a spine x-ray. Clinical data and laboratory findings before and 12 months after GH treatment were compared. RESULTS There was significant increase in height, height-standard deviation score, insulin-like growth factor 1, and insulin-like growth factor binding protein 3 (p<0.001) with GH treatment. However, there were no significant differences in the average Cobb angle (6.2°±3.3° vs. 6.1°±3.5°, p=0.842) and the prevalence of scoliosis (9.7% vs. 13.3%, p=0.481) before and after one year of GH treatment. A comparative analysis of both initial Cobb angle and change in Cobb angle during GH treatment showed no relationship with other factors. CONCLUSION Although GH treatment in short children increased height and growth velocity, it was not associated with development or aggravation of idiopathic scoliosis.
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Affiliation(s)
- Mijin Park
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Yu Jin Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Eun Oh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea,Address for correspondence: Young-Jun Rhie Department of Pediatrics, Korea University College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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23
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Kim S. Efficacy of conservative treatment on exacerbation of adolescent idiopathic scoliosis. J Exerc Rehabil 2022; 18:240-247. [PMID: 36110256 PMCID: PMC9449088 DOI: 10.12965/jer.2244320.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
Scoliosis is defined as a deviation from the normal vertical line of the spine and consists of a lateral curvature in which the spine rotates within the curvature. Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and the cause is unknown. In this study, it was investigated whether conservative treatment for adolescent idiopathic scoliosis (CONTRAIS) reduced the patient’s Cobb angle, and the effect of CONTRAIS according to the severity of idiopathic scoliosis and the efficacy of CONTRAIS by spinal region were also verified. Idiopathic scoliosis patients with a Cobb angle of 10° or more were recruited and classified into mild, moderate, and severe groups according to the Cobb angle (°). Cobb angle was measured radiographically before and after 10 weeks of treatment. A combination of CONTRAIS, including physical therapy, exercise therapy, manual therapy, and home exercise was prescribed for all patients. The patients visited the hospital 3 times a week for 10 weeks for treatment, and exercised at home for 20 min every day. In this study, the effect of reducing Cobb angle of CONTRAIS did not differ according to the spinal region. Also, the Cobb angle reduction effect of CONTRAIS was more effective in severe group. This study may suggest that early detection and treatment through CONTRAIS enables successful correction of AIS.
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Affiliation(s)
- Suyeon Kim
- Corresponding author: Suyeon Kim, Gangnam Seran Clinic, 134 Myeongdal-ro, Seocho-gu, Seoul 06656, Korea,
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24
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Prost M, Windolf J, Konieczny MR. Bovine-derived xenograft is a viable bone graft substitute in multilevel, instrumented, spinal fusion. Orthop Rev (Pavia) 2022; 14:37576. [DOI: 10.52965/001c.37576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective To evaluate radiological outcomes following the use of xenogeneic bone graft substitute (BGS) in patients undergoing multisegmental spinal fusion. Summery of Background Data Data exists for single level and short segment fusions, there presently is a paucity of data on fusion rate after bone augmentation with BGS in multisegmental posterior spinal fusion (PSF). The leading concern is pseudarthrosis, which often leads to a loss of correction after PSF. Therefore, the bone graft is an essential aspect of PSF. Methods We retrospectively analysed the radiological data of a consecutive cohort of patients who had been treated for adolescent idiopathic scoliosis (AIS) via multisegmental spinal fusion, in whom a bovine derived BGS had been used and had a complete dataset of 24 months follow-up. The Cobb angle of the main curve was measured pre-operatively and then at 6, 12 and 24 months post-operatively. Loosening of the screws was recorded at the same post-operative time points. Results After applying inclusion and exclusion criteria, 28 patients were included. We found no significant change of the cobb angle from the main curve as well as the cobb angle from the thoracic kyphosis during the 24 months of follow up. No patient showed a lack of bony fusion. There was 1 revision surgery, which was due to trauma. Conclusion In this cohort, all patients showed successful bone fusion during a 24-month follow-up. Additionally, there was no change in the Cobb angle during the 2-year post-operative period. Our data indicates that the use of bovine-derived BGS supports bone fusion after multisegmental posterior instrumented fusion of the spine.
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Affiliation(s)
- Max Prost
- Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Jochaim Windolf
- Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Markus Rafael Konieczny
- Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
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Ronca A, Abbate V, Redaelli DF, Storm FA, Cesaro G, De Capitani C, Sorrentino A, Colombo G, Fraschini P, Ambrosio L. A Comparative Study for Material Selection in 3D Printing of Scoliosis Back Brace. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5724. [PMID: 36013868 PMCID: PMC9413111 DOI: 10.3390/ma15165724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 05/27/2023]
Abstract
In recent years, many research studies have focused on the application of 3D printing in the production of orthopaedic back braces. Several advantages, such as the ability to customise complex shapes, improved therapeutic effect and reduced production costs place this technology at the forefront in the ongoing evolution of the orthopaedic sector. In this work, four different materials, two of them poly(lactic acid) (PLA) and two of them poly(ethylene terephthalate glycol) (PETG), were characterised from a thermal, mechanical, rheological and morphological point of view. Our aim was to understand the effects of the material properties on the quality and functionality of a 3D-printed device. The specimens were cut from 3D-printed hemi-cylinders in two different orientation angles. Our results show that PETG-based samples have the best mechanical properties in terms of elastic modulus and elongation at break. The PLA-based samples demonstrated typical brittle behaviour, with elongation at break one order of magnitude lower. Impact tests demonstrated that the PETG-based samples had better properties in terms of energy absorption. Moreover, 3D-printed PETG samples demonstrated a better surface finishing with a more homogenous fibre-fibre interface. In summary, we demonstrate that the right choice of material and printing conditions are fundamental to satisfy the quality and functionality required for a scoliosis back brace.
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Affiliation(s)
- Alfredo Ronca
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Previati 1/C, 23900 Lecco, Italy
| | - Valentina Abbate
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Previati 1/C, 23900 Lecco, Italy
- Department of Chemical, Materials and Industrial Production Engineering (DICMaPI), University of Naples Federico II, Piazzale V. Tecchio 80, 80125 Napoli, Italy
| | - Davide Felice Redaelli
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA) National Research Council of Italy, Via Previati 1/C, 23900 Lecco, Italy
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy
| | - Fabio Alexander Storm
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy
| | - Giacomo Cesaro
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Campi Flegrei, 34, 80078 Pozzuoli, Italy
| | - Cristina De Capitani
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Previati 1/C, 23900 Lecco, Italy
| | - Andrea Sorrentino
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Previati 1/C, 23900 Lecco, Italy
| | - Giorgio Colombo
- Department of Mechanical Engineering, Politecnico di Milano, Via G. La Masa, 1, 20156 Milano, Italy
| | - Paolo Fraschini
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy
| | - Luigi Ambrosio
- Institute of Polymers, Composites and Biomaterials (IPCB), National Research Council of Italy, Via Campi Flegrei, 34, 80078 Pozzuoli, Italy
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Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159240. [PMID: 35954620 PMCID: PMC9368145 DOI: 10.3390/ijerph19159240] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Abstract
Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.
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Piancino MG, Tortarolo A, Macdonald F, Garagiola U, Nucci L, Brayda-Bruno M. Spinal disorders and mastication: the potential relationship between adolescent idiopathic scoliosis and alterations of the chewing patterns. Orthod Craniofac Res 2022; 26:178-184. [PMID: 35841372 DOI: 10.1111/ocr.12598] [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: 05/27/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE to evaluate mastication in a group of patients with Adolescent Idiopathic Scoliosis (AIS) with a control group, by means of the prevalence of reverse chewing cycles (RCC). MATERIAL AND METHODS this study included a group of patients (N=32; F=24; M=8; mean age ± SD = 14±3 years) with a confirmed diagnosis of Adolescent Idiopathic Scoliosis and a group of control subjects (N=32; F=24; M=8; mean age ± SD = 13±6 years) without spinal disorders. Mastication was recorded with both a hard and a soft bolus, following a standardized protocol, and the prevalence of reverse chewing cycles was compared between the groups. RESULTS The prevalence of reverse chewing cycles was significantly higher in the Adolescent Idiopathic Scoliosis group, with both a soft and a hard bolus, compared to the control group (p<0,001). CONCLUSION the results of this study indicate that the presence of Adolescent Idiopathic Scoliosis influences mastication, i.e. one of the main functions of the stomatognathic system. A multidisciplinary approach to these patients may be relevant in providing the best possible treatment outcomes.
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Affiliation(s)
- Maria Grazia Piancino
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, Turin, Italy
| | - Alessandro Tortarolo
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, Turin, Italy
| | | | - Umberto Garagiola
- Department of Biomedical Sciences, University of Milan, Milan, Italy
| | - Ludovica Nucci
- Department of Surgical Sciences and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marco Brayda-Bruno
- Spine surgery III Scoliosis Department, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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AlAssiri SS, Aleissa SI, Alhandi AA, Konbaz FM, Alhelal F, Abaalkhail M, Al-Annaim MM, Alhabeeb A, Alshehri KM. Prevalence and Predictors of Scoliosis and Back Pain in 591 Adolescents: A Randomized, Stratified, Cross-Sectional Study in Riyadh, Saudi Arabia. Cureus 2022; 14:e26478. [PMID: 35923496 PMCID: PMC9342667 DOI: 10.7759/cureus.26478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Owing to the difficulty of establishing a screening program for scoliosis and back pain, along with their disabling consequences and the lack of local prevalence rates, we sought to study the prevalence of scoliosis and back pain in adolescents in Saudi Arabia and the burden reported by the affected age group on the health system. Materials and methods A school-based, cross-sectional pilot study covering all school districts in Riyadh, Saudi Arabia, was conducted. Students between 12 and 18 years of age were included. Students with any spinal or neurological disorders were excluded. Physical examinations to screen for scoliosis and student-filled questionnaires to assess back pain and health-related quality of life were performed. Results Of the 700 students, 591 met the inclusion criteria. High suspicion of adolescent idiopathic scoliosis (AIS) was considered in 174 students (29.44%). In addition, 45.42% of the students had a history of back pain. The Oswestry Disability Index showed that 87 students had disabilities. The average Scoliosis Research Society-22 score was 3 out of 5. A significant difference was found in the self-image and mental health domains for AIS (p = 0.04, p = 0.02, respectively). Age showed a significant increase in the odds ratio of a positive physical exam for every increase of one year in age (p < 0.01). Conclusion Identifying the prevalence rates and early associated factors during adolescence would help lower the burden on the health system and benefit public health in general. A nationwide study is required to identify the relationship between scoliosis and back pain.
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Villa JJ, Zhao Z, Pan W, Guo Y. Reduction of Adolescent Idiopathic Scoliosis and Improved Z-Axis Alignment of the Entire Spine When Treating a Symptomatic Patient Using a Multidisciplinary Approach: A Case Report. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:917519. [PMID: 36188902 PMCID: PMC9397792 DOI: 10.3389/fresc.2022.917519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022]
Abstract
Background This study presents findings on improvements of both the X-axis and Z-axis posture in a young female with adolescent idiopathic, scoliosis suffering from pain complaints who was treated with a multidisciplinary approach. Case Presentation The 15-year-old patient reported low back pain for several months. Full spine radiographic assessment revealed a cervical kyphosis, forward head translation, a right ribcage translation, a left higher shoulder, and a dextroconvex lumbar scoliosis with a Cobb angle of 23°. The patient was treated with novel ASPINE Systems treatment protocols incorporating posture exercises, muscle balancing exercises, spinal 3D traction, and spinal manipulation. Results Assessment after 50 treatment sessions over 32 weeks revealed a dramatic improvement in postural distortions. The cervical kyphosis was reduced by 9° and was accompanied by a reduction in forward head posture, centering of the thoracic spine, leveling off her shoulders, and a reduction in the dextroconvex scoliosis by 10°. The lower back pain was relieved. Conclusion A reduction of postural distortions including idiopathic adolescent scoliosis resulted from a multidisciplinary approach utilizing ASPINE Systems.
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Affiliation(s)
- Juan Jesus Villa
- Xuyang Doctor Group Co., Ltd., Shanghai, China
- *Correspondence: Juan Jesus Villa
| | - Zhiyang Zhao
- ASPINE Health Group, Inc., Union City, CA, United States
| | - Weicheng Pan
- Department of Orthopedics, Second Affiliated Hospital of Navy Medical University, Shanghai, China
| | - Yongfei Guo
- Department of Orthopedics, Second Affiliated Hospital of Navy Medical University, Shanghai, China
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Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences. J Clin Med 2022; 11:jcm11092602. [PMID: 35566726 PMCID: PMC9104016 DOI: 10.3390/jcm11092602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 01/27/2023] Open
Abstract
The aim was to investigate the role of preoperative magnetic resonance imaging (MRI) and intraoperative monitoring (IOM) in the prevention of correction-related complications in idiopathic scoliosis (IS). We conducted a retrospective case study of 129 patients with juvenile and adolescent IS. The operations took place between 2005 and 2018 in Uppsala University Hospital. Data from MRI scans and IOM were collected. The patients were divided into groups depending on Lenke’s classification, sex, major curve (MC) size, and onset age. Neurophysiological incidences were reported in ten patients (7.8%), while nine of them had no signs of intraspinal pathology. Six patients (4.7%) had transient incidences; however, in four patients (3.1%), an intervention was required for the normalization of action potentials. Three of them had an MC >70 degrees, which was significantly higher than the expected value. Eight patients (6.1%) had intraspinal pathologies, and two of them (1.5%) underwent decompression. We suggest the continuation of MRI screening preoperatively and, most importantly, the use of IOM. In three cases with no signs of pathology in the MRI, IOM prevented possible neurological injuries. MCs >70 degrees should be considered a risk factor for the occurrence of neurophysiological deficiencies that require action to be normalized.
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Analysis of Posture Parameters in Patients with Idiopathic Scoliosis with the Use of 3D Ultrasound Diagnostics-Preliminary Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084750. [PMID: 35457615 PMCID: PMC9025888 DOI: 10.3390/ijerph19084750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Idiopathic scoliosis occurs in 2 to 4% of children between 10 and 16 years of age. Due to the harmfulness of radiological examination, non-invasive devices, including the 3D ultrasound technology and Scolioscan apparatus, are more and more frequently used for postural diagnostics. The aim of the study was to analyze the parameters of posture in patients with idiopathic scoliosis with the use of 3D ultrasound diagnostics. (2) Methods: The study included 20 girls, aged 10 to 16 years, with double-curve idiopathic scoliosis (the value of primary curve ranged from 25–50°), types I and II according to King–Moe classification. On the basis of X-ray scan, the Cobb angle of primary and secondary curves was assessed, the skeletal maturity was evaluated with the Risser test, and the type of scoliosis was determined. The girls participated in a 3-week rehabilitation program. The examinations were performed before and after therapy. A scoliometer was used for measurements. Each of the participants underwent individual therapy. The three-plane approach to asymmetric exercises was based largely on positions that included primary curve correction with hypercorrection of the secondary curve. (3) Results: After the therapy, values of trunk rotation angles and the angle of scoliotic curvature of secondary curve were significantly lower than before the therapy, except for the value of the primary curve angle. The parameters measured by X-ray were significantly and positively related to the results obtained with the scoliometer and the scolioscan. (4) Conclusions: The application of therapy that takes into account summing parameters may prevent the deterioration of the secondary curve when treating patients with idiopathic scoliosis. The observed correlations between the parameters of the radiological examination, the scoliometer, and the scolioscan prove the possibility of their interchangeable application in the assessment of effects of the therapy. Three-dimensional ultrasound diagnostics may become an alternative to radiological examination in assessing the treatment effects of patients with idiopathic scoliosis.
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The effects of vertebral body tethering on sagittal parameters: evaluations from a 2-years follow-up. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:1060-1066. [PMID: 34910244 DOI: 10.1007/s00586-021-07076-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/14/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION While the effects of VBT on coronal parameters have been investigated in various studies, this has not yet been the case for sagittal parameters. This is of particular relevance considering that VBT does not allow direct correction of the sagittal profile. Thus, we investigated the effects of VBT on sagittal parameters in patients with adolescent idiopathic scoliosis. MATERIALS AND METHODS Retrospective, 2-Center study. Patients who underwent VBT and presented a 2-years follow-up were included. The differences in sagittal parameters were evaluated, along with modifications of sagittal profile following Abelin-Genevois' classification. RESULTS Data from 86 patients were obtained. Mean Cobb angle was 52.4 ± 13.9° at thoracic level and 47.6 ± 14.3° at lumbar level before surgery, and 28.5 ± 13.6 and 26.6 ± 12.7° at the 2-year follow-up, respectively. Mean thoracic kyphosis increased from 28.3 ± 13.8 to 33 ± 13°, the lumbar lordosis (LL) was unvaried (from 47.5 ± 13.1 to 48.4 ± 13.5°), PT decreased from 9.4 ± 8.5 to 7.4 ± 6.1°, the sagittal vertical axis SVA decreased from 4.5 ± 31.4 to - 3.6 ± 27.9 mm. No kyphotic effect on LL in patients who underwent lumbar instrumentation was observed. Before surgery, 39 patients had a type 1 sagittal profile, 18 were type 2a, 14 type 2b and 15 type 3. Postoperatively, 54 were type 1, 8 were 2a, 13 were 2b and 11 were type 3. CONCLUSIONS VBT positively influences sagittal parameters and does not have a kyphotic effect on LL.
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Analysis of the pulmonary function in patients undergoing vertebral body tethering for adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:1022-1027. [PMID: 34677678 DOI: 10.1007/s00586-021-07029-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/29/2021] [Accepted: 10/11/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE The literature concerning the effects of scoliosis correction on pulmonary function (PF) is scarce and solely related to spinal fusion. Vertebral body tethering (VBT) represents a new option for scoliosis correction; however, its effects on PF have not yet been investigated. As VBT is a fusion-less technique that does not limit the dynamics of the chest wall, it is expected not to have a negative impact on PF despite the anterior surgical approach. METHODS We analyzed the PF preoperatively and compared it with the PF at 6-weeks, 6-months and 12-monthts postoperatively. Considered parameters were total lung capacity (TLC), forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) expressed as percentages. A change of more than 10% was considered clinically significant. RESULTS Before VBT, overall TLC, FEV1 and FVC measured 98 ± 15%, 85 ± 16% and 91 ± 17%, respectively. Six weeks after surgery, all parameters were comparable to the preoperative values (TLC 96 ± 17%, FEV1 84 ± 14%, FVC 90 ± 16%) and remained so at the last follow-up (TLC 99 ± 15%, FEV1 89 ± 9%, FVC 86 ± 9). While a reduction in FEV1 and FVC was observed at 6-weeks and 6-months in patients with thoracic or double curves compared to thoracolumbar curves, no significant differences were observed at the 12-months follow-up. CONCLUSIONS VBT does not cause a reduction in PF values at a short-term follow-up.
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Idiopathic scoliosis: general characteristics and analysis of etiological theories (literature review). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Idiopathic scoliosis is a severe pathology of the musculoskeletal system that affects children and adolescents all over the world. The disease occurs in approximately 0.2-0.6% of the general population, and is the largest subgroup of spinal curvature in humans (70-90% of all known scoliosis cases). In idiopathic scoliosis, a threedimensional deformation of the vertebral column is formed, leading to the formation of a rib hump, curvature of the ribs and chest, asymmetry of the pelvis and impaired development of internal organs. The main feature of the disease is the spontaneous development of deformity during the growth of the child and the tendency to progress. Scoliosis is not only an orthopedic disease, but also a ignificant cosmetic, and, consequently, a psychological and social problem. The standard of treatment for scoliotic disease remains unchanged for a long time: observation, corset treatment and surgical correction. The prognosis for the development of pathology varies depending on the degree of deformation. The corset-therapy, hospitalization, surgery and treatment of chronic back pain have a negative impact on the psychoemotional state of children and adolescents. Despite significant advances in the methods of diagnosis of deformity, improvement of surgical treatment methods and in the study of pathogenesis, the etiological factor of pathology is still unknown. The search for the causes of idiopathic scoliosis covers almost all aspects of its possible origin: genetic, environmental, hormonal, metabolic, biochemical, neurological, and others. In recent decades, relevant theories of the development of scoliosis have been formulated, but none of the theories reveals the essence of the pathological process and has no clear justification. The greatest number of supporters is the genetic theory: genetic factors play a key role in the occurrence and development of idiopathic scoliosis. Understanding the underlying factors of the disease will enable prevention, early diagnosis, and identification of the risk groups of the patients in question.
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Analysis of the Degree of Involvement of the Lower Limb Muscles in the Pathological Process in Adolescents with Idiopathic Scoliosis. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The problem of the effect of adolescent idiopathic scoliosis on the functional condition of the lower limb muscles is still highlighted insufficiently.Aim. Analysis of the degree of involvement of the lower limb muscles in the pathological process in adolescents with idiopathic scoliosis.Methods. A comparative analysis has been made on the results of examination of 209 adolescents: 25 adolescents with idiopathic scoliosis; 170 normal adolescents; 14 adolescents with congenital scoliosis. The moments of force ofthe lower limb muscles were evaluated using dynamometric stands. Electrophysiological characteristics of the lower limb muscles were registered by the method of global and stimulation electroneuromyography.Results. The decrease in the amplitude of voluntary EMG of the femoral muscles in adolescents with idiopathic and congenital scoliosis is accompanied by dropping the moments of force relative to the values of the control group. The leg muscles are characterized by the preservation of the values of force at the level of normal test subjects under the conditions of the reduced voluntary EMG of high frequency. The amplitude of the M-responses of the indicator muscles and the values of the excitation propagation velocity along the motor fibers were also preserved. There are no statistically significant correlations between the amount of the spine deformity, on the one hand, and the values of asymmetry of the characteristics of the muscles in adolescents with idiopathic scoliosis.Conclusion. In adolescents with idiopathic scoliosis the function of femoral muscles is decreased, and there is no relationship between the amount of the spine deformity and the values of asymmetry of the characteristics of the lower limb muscles. The similar character of muscle function changes in adolescents with idiopathic and congenital scoliosis can testify that the cause of the observed changes is not the disease etiology, but the insufficient level of motor activity.
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Wu N, Shao J, Zhang Z, Wang S, Li Z, Zhao S, Yang Y, Liu L, Yu C, Liu S, Zhao Z, Du Y, Zhang Y, Wang L, Zhao Y, Yu K, Zhao H, Shen J, Qiu G, Wu Z, Zhang TJ. Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis. BMC Musculoskelet Disord 2021; 22:483. [PMID: 34034738 PMCID: PMC8152117 DOI: 10.1186/s12891-021-04361-y] [Citation(s) in RCA: 3] [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: 12/03/2020] [Accepted: 05/10/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied. Methods We evaluated clinical and radiographical results from 146 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis. Results One hundred forty-six adult non-degenerative scoliosis patients were included in our study. There were 23 perioperative complications for 21 (14.4%) patients, eight of which were cardiopulmonary complications, two of which were infection, six of which were neurological complications, three of which were gastrointestinal complications, and four of which were incision-related complication. The independent risk factors for development of total perioperative complications included change in Cobb angle (odds ratio [OR] = 1.085, 95% CI = 1.035 ~ 1.137, P = 0.001) and spinal osteotomy (OR = 3.565, 95% CI = 1.039 ~ 12.236, P = 0.043). The independent risk factor for minor perioperative complications is change in Cobb angle (OR = 1.092, 95% CI = 1.023 ~ 1.165, P = 0.008). The independent risk factors for major perioperative complications are spinal osteotomy (OR = 4.475, 95% CI = 1.960 ~ 20.861, P = 0.036) and change in Cobb angle (OR = 1.106, 95% CI = 1.035 ~ 1.182, P = 0.003). Conclusions Our study indicate that change in Cobb angle and spinal osteotomy are independent risk factors for total perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients. Change in Cobb angle is an independent risk factor for minor perioperative complications. Change in Cobb angle and spinal osteotomy are independent risk factors for major perioperative complications.
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Affiliation(s)
- Nan Wu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China.
| | - Jiashen Shao
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - Zhen Zhang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - Shengru Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ziquan Li
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Sen Zhao
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China
| | - Yang Yang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lian Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - Chenxi Yu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - Sen Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhengye Zhao
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - You Du
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China
| | - Yuanqiang Zhang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China.,Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Lianlei Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Graduate School of Peking Union Medical College, Beijing, 100005, China.,Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Yu Zhao
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Keyi Yu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Hong Zhao
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jianxiong Shen
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Guixing Qiu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China
| | | | - Zhihong Wu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.,Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China.,Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Terry Jianguo Zhang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Key Laboratory of Big Data for Spinal Deformities, Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China.
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Daia C, Scheau C, Toader C, Bumbea AM, Caimac VD, Andone I, Popescu C, Spanu A, Onose G. Radial Extracorporeal Shockwave Therapy versus Ultrasound Therapy in Adult Patients with Idiopathic Scoliosis. J Clin Med 2021; 10:jcm10081701. [PMID: 33920890 PMCID: PMC8071271 DOI: 10.3390/jcm10081701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to compare the effectiveness of radial extracorporeal shockwave and ultrasound therapies in adult patients with idiopathic scoliosis in terms of pain, disability, and quality of life. METHODS Forty-eight patients with idiopathic scoliosis were randomly divided into three groups of 16: shockwave, ultrasound, and control. The patients were evaluated at admission (day one) and at discharge (day 14) for pain, by using the visual analogue scale; for disability, by using the Oswestry disability index; and for the quality of life, with short form-36. RESULTS Radial extracorporeal shockwave therapy was more effective than ultrasound in reducing pain (p = 0.004) and increasing quality of life, bringing extra vitality (p = 0.003) and emotional comfort (p = 0.007) to the patient. Both shockwave therapy (p = 0.001) and ultrasound therapy (p = 0.003) were effective in reducing pain. In terms of disability, both treatments had similar effects (p = 0.439). CONCLUSION Radial shockwave was significantly more effective than ultrasound in reducing pain and increasing the quality of life, bringing additional vitality and emotional comfort to the patient with idiopathic scoliosis. In terms of disability, both treatments had similar effects when associated with kinesitherapy.
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Affiliation(s)
- Cristina Daia
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Neuromuscular Department, Clinical Emergency Hospital “Bagdasar Arseni”, 041914 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence:
| | - Corneliu Toader
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Department of Neurosurgery, National Institute of Cerebro-Vascular Diseases, 041914 Bucharest, Romania
| | - Ana Maria Bumbea
- Department of Medical Rehabilitation, University of Medicine and Pharmacy, 200349 Craiova, Romania; (A.M.B.); (V.D.C.)
- Neurorehabiltation Department, Clinical Neuropsychiatry Hospital, 200473 Craiova, Romania
| | - Visarion Danut Caimac
- Department of Medical Rehabilitation, University of Medicine and Pharmacy, 200349 Craiova, Romania; (A.M.B.); (V.D.C.)
- Neurorehabiltation Department, Clinical Neuropsychiatry Hospital, 200473 Craiova, Romania
| | - Ioana Andone
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Neuromuscular Department, Clinical Emergency Hospital “Bagdasar Arseni”, 041914 Bucharest, Romania
| | - Cristina Popescu
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Neuromuscular Department, Clinical Emergency Hospital “Bagdasar Arseni”, 041914 Bucharest, Romania
| | - Aura Spanu
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Neuromuscular Department, Clinical Emergency Hospital “Bagdasar Arseni”, 041914 Bucharest, Romania
| | - Gelu Onose
- Department of Medical Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 041914 Bucharest, Romania; (C.D.); (C.T.); (I.A.); (C.P.); (A.S.); (G.O.)
- Neuromuscular Department, Clinical Emergency Hospital “Bagdasar Arseni”, 041914 Bucharest, Romania
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Baroncini A, Trobisch PD, Berrer A, Kobbe P, Tingart M, Eschweiler J, Da Paz S, Migliorini F. Return to sport and daily life activities after vertebral body tethering for AIS: analysis of the sport activity questionnaire. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1998-2006. [PMID: 33638722 PMCID: PMC7912966 DOI: 10.1007/s00586-021-06768-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/09/2021] [Accepted: 02/07/2021] [Indexed: 12/23/2022]
Abstract
Purpose Vertebral body tethering (VBT) is an alternative to fusion for selected scoliosis patients. As VBT does not limit spine mobility, it has been propagated that this technique allows a quicker return to physical activity than fusion. However, no data are available to support this statement. Aim of this study was to quantify how much time patients required to resume preoperative activity level and to seek possible associations between return to physical activity and demographic, radiographic and surgical data. Methods One year postoperatively, the validated sport activity questionnaire (SAQ) was administered to all skeletally immature patients who underwent VBT at our institution. SAQ data were analyzed and a multivariate analysis was conducted to investigate associations between SAQ and demographic, radiographic and surgical data. Results Thirty-one patients aged 14.5 years completed the SAQ. Within 3 months from VBT, 97% returned to school, 61% resumed physical education, 97% carried a backpack, 68% run, and 82% rode a bike; 70% bent within a month from VBT. Ninety-four percent of patients returned to their preoperative athletic level. Within 3 months, 63% of responders resumed noncontact, 61% contact and 53% collision sports. No relevant associations were observed between the SAQ and demographic, radiographic and surgical data. In particular, number of instrumented vertebrae, level of the lowest instrumented vertebra and postoperative Cobb angle did not influence patients’ return to preoperative activities. Conclusion VBT allows patients to quickly return to their preoperative activity level, irrespectively of the postoperative Cobb angle or type of instrumentation.
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Affiliation(s)
- Alice Baroncini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany. .,Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany.
| | - Per David Trobisch
- Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany
| | - Angelika Berrer
- Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany
| | - Philipp Kobbe
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Markus Tingart
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Stephanie Da Paz
- Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
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Park SJ, Lee KH, Lee CS, Kim KT, Jang JH, Shin DH, Kim MS, Kim J, Cho SY, Jin DK. Impact of growth hormone treatment on scoliosis development and progression: analysis of 1128 patients with idiopathic short stature. J Pediatr Endocrinol Metab 2021; 34:243-250. [PMID: 33180047 DOI: 10.1515/jpem-2020-0393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the impact of recombinant human growth hormone (rhGH) on the development and progression of scoliosis in patients with idiopathic short stature (ISS). METHODS Patients with ISS who underwent rhGH treatment from 1997 to 2017 and were followed up for scoliosis screening with serial radiographic examination were included. For assessing scoliosis development, patients who did not have scoliosis at the time of rhGH treatment were included and followed up to determine whether de novo scoliosis developed during the treatment. For evaluating scoliosis progression, patients who already had scoliosis were analyzed. Univariate and multivariate Cox regression analyses of demographic and radiographic variables were performed to determine the related factors in the development and progression of scoliosis. RESULTS For assessing scoliosis development, 1093 patients were included. The average duration of rhGH treatment was about 2 years. De novo scoliosis developed in 32 patients (3.7%). The analysis revealed that sex (p=0.016) and chronological age (p=0.048) were statistically significant factors associated with scoliosis development. However, no relationship was observed between scoliosis development and rhGH treatment types or duration. Among 67 patients who already had scoliosis at the time of rhGH treatment, 11 (16.4%) showed scoliosis progression. However, the rhGH types and duration also did not affect scoliosis progression. CONCLUSIONS De novo scoliosis developed in 3.7% and scoliosis progressed in 16.4% of the patients during rhGH treatment. However, scoliosis development or progression was not affected by the types or duration of rhGH treatment in patients with ISS.
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Affiliation(s)
- Se-Jun Park
- Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Keun-Ho Lee
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Chong-Suh Lee
- Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ki-Tack Kim
- Department of Orthopedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Republic of Korea
| | - Jun Hyuk Jang
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Dae Hun Shin
- Department of Orthopedic Surgery, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Min Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jiyeon Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Karaali E, Çiloğlu O, Görgülü FF, Ekiz T. Ultrasonographic measurement of diaphragm thickness in patients with severe thoracic scoliosis. J Ultrasound 2021; 24:75-79. [PMID: 33550575 DOI: 10.1007/s40477-020-00536-w] [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: 08/19/2020] [Accepted: 10/21/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study aimed to measure diaphragm thickness using ultrasound in adult patients with severe idiopathic scoliosis. METHODS This prospective case-control study included patients with severe idiopathic scoliosis and a healthy control group. The control and patient groups' demographic features, pulmonary function tests, diaphragm thickness, and thickening fraction measured using ultrasonography were compared. RESULTS End-expirium values were similar between the two groups (p = 0.902). However, end of inspirium, change level, and diaphragm thickening fraction were significantly lower in the scoliosis group (p < 0.001 for all). Cobb degree values were inversely correlated with forced expiratory volume in 1 s (%) (r = - 0.909, p < 0.001), forced vital capacity (%) (r = - 0.887, p < 0.001), and end-inspirium thickness (r = - 0.673 and p < 0.001) values. Furthermore, diaphragm thickness at the end of inspirium was positively correlated with forced expiratory volume in 1 s (%) (r = 0.636, p = 0.001) and forced vital capacity (%) (r = 0.646, p = 0.001) values. No significant correlation was found between diaphragm thickening fraction and forced expiratory volume in 1 s or forced vital capacity. CONCLUSION Ultrasound can provide valuable information about diaphragm morphology and quantify diaphragm contraction.
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Affiliation(s)
- Evren Karaali
- Department of Orthopedics and Traumatology, University of Health Science Adana City Training and Research Hospital, Mithat Özhan Bulvarı Kışla Mah. No: 1 Yüreği, Adana, Turkey.
| | - Osman Çiloğlu
- Department of Orthopedics and Traumatology, University of Health Science Adana City Training and Research Hospital, Mithat Özhan Bulvarı Kışla Mah. No: 1 Yüreği, Adana, Turkey
| | - Feride Fatma Görgülü
- Department of Radiology, University of Health Science Adana City Training and Research Hospital, Adana, Turkey
| | - Timur Ekiz
- Department of Physical Medicine and Rehabilitation, Türkmenbaşı Medical Center, Adana, Turkey
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Li J, Yang Z, Yu M. Association study of single nucleotide polymorphism in tryptophan hydroxylase 1 gene with adolescent idiopathic scoliosis: A meta-analysis. Medicine (Baltimore) 2021; 100:e23733. [PMID: 33545939 PMCID: PMC7837909 DOI: 10.1097/md.0000000000023733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis is a common spinal deformity among children and adolescents worldwide with its etiology uncertain. Over a decade, a single nucleotide polymorphism rs10488682 in tryptophan hydroxylase 1 (TPH1) gene has been investigated in several association studies. We perform this study to summarize the current evidence of TPH1 rs10488682 polymorphisms and adolescent idiopathic scoliosis (AIS). METHODS Six databases were systematically searched: PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature, and Wanfang database. Eligible case-control studies related to TPH1 and AIS were selected. Reference lists of them were reviewed for more available studies. Two authors independently screened and evaluated the literature and extracted data. The odds ratios and 95% confidence intervals were derived in association tests. Subgroup analysis was conducted by ethnicity. Sensitivity analysis was performed to examine the stability of the overall results. RESULTS A total of 1006 cases and 1557 controls in 3 independent studies were included for meta-analysis. Statistical significance was discovered in heterozygote model (AT vs AA: OR = 1.741, 95%Cl = 1.100-2.753, P = .018 < .05, I2 = 0%), recessive model (AA vs AT + TT: OR = 0.640, 95%Cl = 0.414-0.990, P = .045 < .05, I2 = 0%) and over-dominant model (AT vs AA + TT: OR = 1.366, 95%Cl = 1.115-1.673, P = .003 < .05, I2 = 84.7%) in overall populations. Similar associations were also found in the Caucasian population. No significant associations were found in other genotypic comparisons and allelic comparisons. CONCLUSIONS Statistically significant correlations were discovered between the TPH1 rs10488682 polymorphisms and AIS. Heterozygous AT genotype seems to be risky with an over-dominant effect. Ethnicity appears to modify the disease association. REGISTRATION Not applicable.
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Affiliation(s)
- Junyu Li
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road
| | - Zexi Yang
- School of Clinical Medicine, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Miao Yu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road
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Hell AK, Tsaknakis K, Lippross S, Lorenz HM. Skoliose im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Boehland T, Montgomery AD, Mortenson M. Combination Acupuncture and Cupping for Treating Adult Idiopathic Scoliosis. Med Acupunct 2020; 32:229-233. [PMID: 32879649 DOI: 10.1089/acu.2020.1411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: There is limited previous English-language literature on acupuncture's ability to treat idiopathic scoliosis. This report shows the potential effectiveness of a combination of acupuncture and cupping therapies to treat curvature progression and thoracic back pain in adult idiopathic scoliosis. Intervention: A 34-year-old male veteran of the U.S. Armed Forces with thoracic back pain and muscle spasms originally presented to the chiropractic clinic at the Fargo Veterans Affairs Healthcare System, Fargo, ND. Per radiographs taken prior to the consultation, the chiropractor determined that the patient had an idiopathic right-convex scoliosis curve of ∼21°. Due to immobility of the thoracic spinal vertebra upon adjustment, he was referred to acupuncture care. After a clinical review, the acupuncturist hypothesized that a combination of utilizing acupuncture and cupping techniques would help relax the muscles along the thoracic spine, allowing correction of the patient's abnormal spinal curvature. Combination Traditional Chinese Medicine (TCM), using acupuncture with cupping therapy was given ∼2 times per week for several weeks, resulting in a total of 15 treatments. Results: After 15 treatments, this patient's subjective pain decreased by 85%. Anecdotally, he reported "feeling a bit looser." He continued to receive acupuncture and cupping treatments when his schedule allowed. Conclusions: The combination therapy was effective for treating musculoskeletal pain but was inconclusive with respect to its ability to treat adult idiopathic scoliosis. More research is needed on the efficacy of TCM for treating adult idiopathic scoliosis.
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Affiliation(s)
- Tasha Boehland
- Department of Whole Health, Fargo Veterans Affairs Health Care System, Fargo, ND, USA
| | - Anna Denee Montgomery
- Department of Whole Health, Fargo Veterans Affairs Health Care System, Fargo, ND, USA.,Department of Public Health, North Dakota State University, Fargo, ND, USA
| | - Michael Mortenson
- Department of Whole Health, Fargo Veterans Affairs Health Care System, Fargo, ND, USA.,Chiropractic School, Northwestern Health Sciences University, Bloomington, MN, USA
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Rüwald JM, Upenieks J, Ositis J, Pycha A, Avidan Y, Rüwald AL, Eymael RL, Schildberg FA. Pediatric Scoliosis Surgery-A Comprehensive Analysis of Treatment-Specific Variables and Trends in Latvia. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E201. [PMID: 32344764 PMCID: PMC7230999 DOI: 10.3390/medicina56040201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/02/2022]
Abstract
Background and Objectives: There are currently no data available regarding pediatric scoliosis surgery in Latvia. The aim of this article is to present treatment specific variables, investigate their interrelation, and identify predictors for the length of stay after surgical pediatric scoliosis correction. Materials and Methods: This retrospective study included all surgical pediatric scoliosis corrections in Latvia for the years 2012 to 2016. Analyzed parameters were chosen to portray the patients' demographics, pathology, as well as treatment specific variables. Descriptive, inferential, and linear regression statistics were calculated. Results: A total of 69 cases, 74% female and 26% male, were identified. The diagnostic subgroups consisted of 62% idiopathic (IDI) and 38% non-idiopathic (non-IDI) scoliosis cases. Non-IDI cases had significantly increased operation time, hospital stay, Cobb angle before surgery, and instrumented levels, while IDI cases showed significantly higher Cobb angle percentage correction. For all operated cases, the operation time and the hospital stay decreased significantly over the investigated time period. Early post-operative complications (PCs) occurred in 15.9% of the cases and were associated with increased hospital stay, instrumented levels, and Cobb angle before surgery. The linear regression analysis revealed that operation time and the presence of PCs were significant predictors for the length of the hospital stay. Conclusions: This is the first study to provide comprehensive insight into pediatric scoliosis surgery since its establishment in Latvia. Our regression model offers clinically applicable predictors and further underlines the significance of the operation length on the hospital stay. These results build the foundation for international comparison and facilitate improvement in the field.
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Affiliation(s)
- Julian M. Rüwald
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Janis Upenieks
- Department of Pediatric Surgery, University Children’s Hospital, 1004 Riga, Latvia
- Department of Pediatric Surgery, Riga Stradins University, 1007 Riga, Latvia
| | - Janis Ositis
- Department of Pediatric Surgery, University Children’s Hospital, 1004 Riga, Latvia
- Department of Spine Surgery, North Kurzeme Regional Hospital, 3601 Ventspils, Latvia
| | - Alexander Pycha
- Cantonal Psychiatric Hospital of Lucerne, 6000 Lucerne, Switzerland
| | - Yuval Avidan
- Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, 3436212 Haifa, Israel
| | - Anna L. Rüwald
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
| | - Robin L. Eymael
- Medical Faculty, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Frank A. Schildberg
- Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
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Adamczewska K, Wiernicka M, Kamińska E, Małecka J, Dąbrowska A, Malchrowicz-Mośko E. Annual Observation of Changes in the Angle of Trunk Rotation. Trunk Asymmetry Predictors. A Study from a Scoliosis Screening in School Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061899. [PMID: 32183373 PMCID: PMC7143366 DOI: 10.3390/ijerph17061899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 01/09/2023]
Abstract
Adolescent forms of idiopathic scoliosis are commonly encountered deformities of the thoracic and lumbar spine. They affect a significant number of adolescents, yet their cause is still unknown. The presented research is a cross-sectional analysis of 3933 volunteers (2131 girls and 1802 boys). The participants were primary school students aged 9 to 13 years old. This study determined a relationship between predictors such as: body mass, body height and body mass index (BMI) (independent variables) and angle of trunk rotation (ATR) value (dependent variable). Moreover, a stepwise multiple regression with backward selection was conducted to determine to what extent the dependent variable is explained by body mass, body height and BMI. In the group of 11,12,13-year-old girls, the analyzed results of multiple stepwise regression were statistically significant. Among the all studied predictors, it has been shown that body mass in the 11-year-old girls and body height in 12- and 13-year-old girls are major correlates of a 1-year ATR increase in proximal and main thoracic spine levels.
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Affiliation(s)
- Katarzyna Adamczewska
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
- Correspondence: ; Tel.: +48-(61)-835-5140, +48-(61)-835-5147
| | - Marzena Wiernicka
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Ewa Kamińska
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Joanna Małecka
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Agata Dąbrowska
- Faculty of Sport Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (A.D.); (E.M.-M.)
| | - Ewa Malchrowicz-Mośko
- Faculty of Sport Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (A.D.); (E.M.-M.)
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Reliability of a radiation-free, noninvasive and computer-assisted assessment of the spine in children with cerebral palsy. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:937-942. [PMID: 32036426 DOI: 10.1007/s00586-020-06328-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/14/2019] [Accepted: 01/30/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The radiation-free, noninvasive and computer-assisted Spinal Mouse® (SM) is a reliable and valid measuring instrument for functional analysis of the pediatric spine. The aim of this study was to examine the intra-rater reliability of the SM measurements in children with cerebral palsy (CP) and to investigate differences after a 1 week of the rehabilitation program. METHODS A total of 168 SM investigations in the sagittal plane and frontal plane at three measurement times from a sample of 28 children (n = 10 girls, age 9.7 ± 3.1 years) with CP were eligible for evaluation. For the verification of reliability, the measurement results from the first and second measurement times (t1, t2) were used at intervals of 1 day. In addition, differences after the rehabilitation program the patients underwent (t3) were evaluated using the measurement results of the first and third measurements (5-day interval). RESULTS The results show good to excellent intra-rater reliability for the SM measurements, both in the sagittal and in the frontal plane (ICC values = 0.69-0.99). Furthermore, significant changes may occur after only 1 week of therapeutic intervention for total spinal inclination (t1: 12.82 ± 5.40, t3: 11.11 ± 5.60, p = 0.014, Cohen's d = 0.43) and spine length (t1: 401.75 ± 69.05, t3: 409.25 ± 63.58, p = 0.030, Cohen's d = 0.43). CONCLUSIONS SM can be used to generate reliable values for functional analysis of the spine in children with CP. Furthermore, significant posture differences can be demonstrated by therapeutic interventions, especially in the spine inclination (Inc) and spine length (SL). These slides can be retrieved under Electronic Supplementary Material.
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Wang Y, Yang F, Wang D, Zhao H, Ma Z, Ma P, Hu X, Wang S, Kang X, Gao B. Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis. J Orthop Surg Res 2019; 14:443. [PMID: 31842920 PMCID: PMC6915929 DOI: 10.1186/s13018-019-1451-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/31/2019] [Indexed: 01/09/2023] Open
Abstract
Background Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function. Methods Seventy-two patients with main right thoracic curvature in adolescent idiopathic scoliosis (AIS) underwent a PFT and a radiological parameter evaluation of spinal and thoracic cage deformities. Simple and multiple linear regressions were also used to note whether a combination of variables might better predict PFT values. Means were compared using the two-sample t test or one-way ANOVA with Tukey’s multiple comparison methods. Results Forced vital capacity (FVC)% predicted had significantly negative correlations with main thoracic curve Cobb (MT-Cobb) (R2 = 0.648, p < 0.001), main thoracic curve-rib hump (MT-RH) (R2 = 0.522, p < 0.001), main thoracic curve apical vertebral body-to-rib ratio (MT-AVB-R) (R2 = 0.536, p < 0.001), and main thoracic curve apical vertebra translation (MT-AVT) (R2 = 0.383, p < 0.001). Multiple regression analysis was performed with FVC% predicted as the dependent variable and MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT as the independent variables. MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT were factors with a significant effect on FVC% predicted (p < 0.001). For 45 patients who had preoperative FVC impairment (FVC% predicted < 80%), their MT-Cobb averaged 76.71°. Twenty-seven patients with normal preoperative FVC (FVC% predicted ≥ 80%) had a smaller mean MT-Cobb of 52.03° (p < 0.001). In other radiological parameters, the impaired FVC group had a MT-AVT of 54.29 mm compared to 38.06 mm for the normal FVC group (p < 0.001). MT-AVB-R averaged 2.92 for the impaired FVC group and 1.78 for the normal FVC group (p < 0.001). MT-RH averaged 28.79 mm for the impaired group and 16.62 mm for the normal group (p < 0.001). Further stratification of preoperative PFT results is divided into three groups. The three groups also showed significant differences in MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT (p < 0.001). Conclusion Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs.
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Affiliation(s)
- Yonggang Wang
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Fengguang Yang
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Dongmin Wang
- Medical College of Northwest Minzu University, No. 1 Northwest xincun, Lanzhou, 730030, Gansu Province, China
| | - Haiyan Zhao
- Department of Orthopedics, The First Hospital of Lanzhou University, No.1 Donggang West Road, Lanzhou, 730000, Gansu Province, China
| | - Zhanjun Ma
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Peifen Ma
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Xuchang Hu
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Shixiong Wang
- Department of Cardiac Surgery, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China.,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China
| | - Xuewen Kang
- Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China. .,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China. .,The International Cooperation Base of Gansu Province for the Pain Research in Spinal Disorders, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.
| | - Bingren Gao
- Department of Cardiac Surgery, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Lanzhou, 730030, Gansu Province, China. .,Lanzhou University, No. 222 South Tianshui Road, Lanzhou, 730000, Gansu Province, China.
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A Systematic Review of Chuna Manual Therapy for Adolescent Idiopathic Scoliosis. JOURNAL OF ACUPUNCTURE RESEARCH 2019. [DOI: 10.13045/jar.2019.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Pan Y, Chen Q, Chen T, Wang H, Zhu X, Fang Z, Lu Y. Evaluation of a computer-aided method for measuring the Cobb angle on chest X-rays. 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 2019; 28:3035-3043. [PMID: 31446493 DOI: 10.1007/s00586-019-06115-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 06/19/2019] [Accepted: 08/15/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To automatically measure the Cobb angle and diagnose scoliosis on chest X-rays, a computer-aided method was proposed and the reliability and accuracy were evaluated. METHODS Two Mask R-CNN models as the core of a computer-aided method were used to separately detect and segment the spine and all vertebral bodies on chest X-rays, and the Cobb angle of the spinal curve was measured from the output of the Mask R-CNN models. To evaluate the reliability and accuracy of the computer-aided method, the Cobb angles on 248 chest X-rays from lung cancer screening were measured automatically using a computer-aided method, and two experienced radiologists used a manual method to separately measure Cobb angles on the aforementioned chest X-rays. RESULTS For manual measurement of the Cobb angle on chest X-rays, the intraclass correlation coefficients (ICC) of intra- and inter-observer reliability analysis was 0.941 and 0.887, respectively, and the mean absolute differences were < 3.5°. The ICC between the computer-aided and manual methods for Cobb angle measurement was 0.854, and the mean absolute difference was 3.32°. These results indicated that the computer-aided method had good reliability for Cobb angle measurement on chest X-rays. Using the mean value of Cobb angles in manual measurements > 10° as a reference standard for scoliosis, the computer-aided method achieved a high level of sensitivity (89.59%) and a relatively low level of specificity (70.37%) for diagnosing scoliosis on chest X-rays. CONCLUSION The computer-aided method has potential for automatic Cobb angle measurement and scoliosis diagnosis on chest X-rays. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Yaling Pan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qiaoran Chen
- Shenzhen Yi-Yuan Intelligence Co., Ltd, Shenzhen, 518064, China
| | - Tongtong Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Hanqi Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaolei Zhu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhihui Fang
- Shanghai Quality Creation Intelligent Technology Co., Ltd, Shanghai, 200050, China
| | - Yong Lu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Correlations between Malocclusion and Postural Anomalies in Children with Mixed Dentition. J Funct Morphol Kinesiol 2019; 4:jfmk4030045. [PMID: 33467360 PMCID: PMC7739254 DOI: 10.3390/jfmk4030045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to investigate the possible relationship between malocclusion and body posture anomalies. The original sample involved 127 children (45 males and 82 females) with mixed dentition. Clinical examination of oral cavity was performed by an orthodontist, who recorded molar and canine relationship, cross-bite, lower middle-line deviation, and centric relation (CR) considering mono or bilateral contacts in CR. Orthopedic examination of the body posture was clinically carried out by an orthopedist who detected anomalies such as scoliosis, false scoliosis or paramorphism, kyphosis and lordosis. Of the 127 subjects of the sample, 18 children were orthopedically normal, 80 patients had false scoliosis, 22 scoliosis and 7 showed kyphosis. In our study, we don't consider the 7 patients with kyphosis for the exiguity of the sample; so, our analysis was performed on 120 children (42 males and 78 females). The results obtained revealed that the cross-bite was more frequent when scoliosis became worse. We also found that the relationship between left cross-bite and contralateral side of deviation of the curve of the spine in subjects with scoliosis is statistically significant (p = 0.002). Furthermore, the relationship between lower midline and contralateral side of deviation of the curve of the spine in patients with false scoliosis is statistically significant (p = 0.003). In conclusion, it seems that posture anomalies are correlated to cross-bite and mandible abnormal position.
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