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Danielewicz A, Wójciak M, Sowa I, Kusz M, Wessely-Szponder J, Dresler S, Latalski M. Metabolic Imbalances and Bone Remodeling Agents in Adolescent Idiopathic Scoliosis: A Study in Postmenarcheal Girls. Int J Mol Sci 2023; 24:13286. [PMID: 37686090 PMCID: PMC10487495 DOI: 10.3390/ijms241713286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The causes and mechanisms underlying adolescent idiopathic scoliosis (AIS) remain unclear, and the available information regarding metabolic imbalances in AIS is still insufficient. This investigation aimed to evaluate the concentrations of specific bone remodeling-related agents in postmenarcheal girls diagnosed with AIS. The study encompassed thirty-six scoliosis patients and eighteen age-matched healthy individuals assigned to the control group. The patients underwent clinical and radiological examinations to assess the degree of the spinal deformity, type of curvature, and skeletal maturity. Blood and urine samples were collected from all participants and serological markers were measured using an enzyme-linked immunosorbent assay. Our study results demonstrated that the balance of phosphate-calcium and parathormone levels seems normal in individuals with AIS. Furthermore, no statistically significant differences were observed in the content of Klotho protein, osteocalcin, osteoprotegerin, C-terminal telopeptide of type I collagen (CTX), sclerostin, and alkaline phosphatase. Nevertheless, the serum levels of vitamin D (25-OH-D) were lowered, while N-terminal propeptide of type I procollagen (PINP), and fibroblast growth factor-23 (FGF23) were increased in the AIS group, with p-values of 0.044, 0.001, and 0.022, respectively. This finding indicates the potential involvement of these factors in the progression of AIS, which necessitates further studies to uncover the fundamental mechanisms underlying idiopathic scoliosis.
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Affiliation(s)
- Anna Danielewicz
- Paediatric Orthopaedic Department, Medical University of Lublin, Gębali 6, 20-093 Lublin, Poland;
| | - Magdalena Wójciak
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (M.W.); (I.S.); (S.D.)
| | - Ireneusz Sowa
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (M.W.); (I.S.); (S.D.)
| | - Monika Kusz
- Department of Pediatric Nephrology, Childrens’ University Hospital in Lublin, Gębali 6, 20-093 Lublin, Poland;
| | - Joanna Wessely-Szponder
- Sub-Department of Pathophysiology, Department of Preclinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Life Sciences, 20-033 Lublin, Poland;
| | - Sławomir Dresler
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland; (M.W.); (I.S.); (S.D.)
| | - Michał Latalski
- Paediatric Orthopaedic Department, Medical University of Lublin, Gębali 6, 20-093 Lublin, Poland;
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Di Maria F, Testa G, Carnazza M, Testaì M, Pavone V. Longer Brace Duration Is Associated with Lower Stress Levels and Better Quality of Life in Adolescents with Idiopathic Scoliosis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1120. [PMID: 37508617 PMCID: PMC10378022 DOI: 10.3390/children10071120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Physical and psychological health concerns have been raised due to either spine deformity or orthotic treatment in adolescents with idiopathic scoliosis. To determine whether orthotic bracing duration affects psychological stress and health-related quality of life, a sample of 46 patients (8M, 38F, aged 11-17 years, regularly treated with bracing) with moderate or moderate to severe idiopathic scoliosis were separated into two groups based on whether their treatment duration was up to six months or longer. The brace-related levels of stress and quality of life were investigated in both groups by using the Bad Sobernheim Stress Questionnaire and the Italian Spine Youth Quality of Life, respectively. The questionnaire scores were categorized as low, mean, and high. Our statistical analysis considered the proportion of patients falling into the three categories and the difference in crude score rates between the two groups. Values were considered significant at p < 0.05. The proportion of patients with brace-related stress and impaired quality of life was significantly lower in the group treated longer compared to the group that had only received treatment for up to six months (chi-square test, p < 0.0001). Overall, mean ± SD BSSQ scored 8.72 ± 4.91 and 12.89 ± 4.65 in group 1 and group 2, respectively (Mann-Whitney U test, p = 0.008), while ISYQoL scored 19.94 ± 8.21 and 16.07 ± 6.12, respectively. We argue that the differences could depend on both the physical and psychological adaptation patients make to their brace and that more support should be provided to patients when they start to wear their brace.
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Affiliation(s)
- Fabrizio Di Maria
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico "Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico "Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Michela Carnazza
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico "Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Martina Testaì
- Unit of Clinical Pediatrics, AOU "Policlinico", PO "G. Rodolico", University of Catania, 95123 Catania, Italy
| | - Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico "Rodolico-San Marco", University of Catania, 95123 Catania, Italy
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Grabala P, Danowska-Idziok K, Helenius IJ. A Rare Complication of Thoracic Spine Surgery: Pediatric Horner's Syndrome after Posterior Vertebral Column Resection-A Case Report. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010156. [PMID: 36670706 PMCID: PMC9857723 DOI: 10.3390/children10010156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Horner's syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. It is caused by impairment of a certain pathway in the sympathetic nervous system. It may also appear as part of the clinical signs of other diseases and syndromes, including Pancoast tumors, intradural and/or epidural tumors, thoracic outlet syndrome, syringomyelia, brachial plexus injury, and aortic dissection. Here, we report a very rare complication of vertebral column resection in children, and we present the clinical findings of a case of Horner's syndrome with a current literature review. CASE PRESENTATION A five-year-old child with severe congenital kyphoscoliosis qualified for surgical treatment of the spinal deformity via a posterior approach, with three-column osteotomy and fusion. RESULTS After successful surgery, the patient presented with HS due to distraction of the sympathetic nerve trunk and, thus, innervation to the left eye. At the 4-year follow-up, the child had fully recovered. CONCLUSIONS Pediatric HS after posterior instrumented scoliosis correction surgery with posterior vertebral column resection of the thoracic spine is very rare. This is the first reported case of HS after posterior vertebral column resection and spinal fusion for congenital kyphoscoliosis without the use of epidural analgesia. Symptom resolution may be variable and, in some cases, delayed.
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Affiliation(s)
- Pawel Grabala
- University Children’s Hospital, Department of Pediatric Orthopedic Surgery and Traumatology, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
- Paley European Institute, Al. Rzeczypospolitej 1, 02-972 Warsaw, Poland
- Correspondence:
| | - Kinga Danowska-Idziok
- University Children’s Hospital, Department of Pediatric Orthopedic Surgery and Traumatology, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Ilkka J. Helenius
- Department of Orthopedics and Traumatology, Helsinki University Hospital, 00260 Helsinki, Finland
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Zhang Y, Liu C, Ge X. Clinical and radiographic outcomes of stand-alone oblique lateral interbody fusion in the treatment of adult degenerative scoliosis: a retrospective observational study. BMC Musculoskelet Disord 2022; 23:1133. [PMID: 36575399 PMCID: PMC9793660 DOI: 10.1186/s12891-022-06035-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 11/28/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Open fusion and posterior instrumentation has traditionally been the treatment for adult degenerative scoliosis (ADS). However, minimally invasive treatment such as oblique lateral interbody fusion (OLIF) technique was developed as a new therapeutic method for the treatment of ADS. In addition, it is associated with decreased blood loss and shorter operative time without posterior instrument. The purpose of this study was to evaluate the efficiency of stand-alone OLIF for the treatment of ADS in terms of clinical and radiological results. METHODS A total of 30 patients diagnosed with ADS who underwent stand-alone OLIF in our hospital from July 2017 to September 2018 were enrolled in the study. Scores from the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) obtained preoperatively and at the final follow-up were compared. Radiography and computed tomography were performed preoperatively and at the final follow-up. The coronal cobb angle, lumbar lordosis, disc height, sacral slope, pelvic incidence and Pelvic tilt were recorded at each time point. RESULTS The study cohort comprised 30 patients with a mean age of 64.5 ± 10.8 years and mean follow-up of 19.3 ± 4.2 months. The mean operative time was 96.8 ± 29.4 minutes and the mean estimated blood loss volume was 48.7 ± 9.4 ml. The mean coronal Cobb angle was corrected from 15.0° ± 3.7° preoperatively to 7.2° ± 3.1° postoperatively and 7.2° ± 3.3° at final follow-up (P < 0.0001). Lumbar lordosis significantly improved from 32.2° ± 11.3° preoperatively to 40.3° ± 11.8° postoperatively and 40.7° ± 11.0° at final follow-up (P < 0.01). The respective mean sacral slope and pelvic tilt improved from 26.1° ± 8.1° and 25.1° ± 6.9° preoperatively to 34.3° ± 7.4° and 19.2° ± 5.7° at final follow-up (P < 0.001). The mean disc height (defined as the mean of the anterior and posterior intervertebral disc heights) increased from 0.7 ± 0.3 cm preoperatively to 1.1 ± 0.2 cm at final follow-up (P < 0.0001). The interbody fusion rate on CT was 93.3%. The mean VAS pain score improved from 5.3 ± 0.6 before surgery to 2.3 ± 0.6 at final follow-up (P < 0.001). The mean ODI improved from 29.9% ± 6.8% preoperatively to 12.8% ± 2.4% at final follow-up (P < 0.001). CONCLUSIONS Stand-alone OLIF is an effective and safe option for treating ADS in carefully selected patients. TRIAL REGISTRATION The study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052419).
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Affiliation(s)
- Yu Zhang
- grid.27255.370000 0004 1761 1174School of Medicine, Shandong University, No. 44 Cultural West Road, Lixia District, Jinan City, 250012 Shandong Province China ,grid.27255.370000 0004 1761 1174Anhui Provincial Hospital, Shandong University, Hefei, 230001 Anhui China ,grid.443626.10000 0004 1798 4069Spine Research Center of Wannan Medical College, No.22 Wenchang West Road, Wuhu, 241001 Anhui China ,grid.452929.10000 0004 8513 0241Department of Spine Surgery, First Affiliated Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, 241001 Anhui China
| | - Chen Liu
- grid.443626.10000 0004 1798 4069Spine Research Center of Wannan Medical College, No.22 Wenchang West Road, Wuhu, 241001 Anhui China ,grid.452929.10000 0004 8513 0241Department of Spine Surgery, First Affiliated Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, 241001 Anhui China
| | - Xin Ge
- Department of Spine Surgery, Anqing first people’s Hospital, No. 187 Huazhong Road, Anqing, 241001 Anhui China
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Fiaschi Ramos AC, Ferreira Silva RM, Bizinotto T, Teixeira de Rezende LM, Miñana-Signes V, Monfort-Pañego M, Noll PRES, Noll M. Tools for Assessing Knowledge of Back Health in Adolescents: A Systematic Review Protocol. Healthcare (Basel) 2022; 10:healthcare10081591. [PMID: 36011248 PMCID: PMC9408774 DOI: 10.3390/healthcare10081591] [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: 07/17/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
Back pain is common in adolescents as a result of their typical daily activities. There is a critical need for developing instruments that can assess the adolescents’ knowledge of proper posture, because adequate postural habits are essential for preventing back pain and facilitating physical well-being. Unfortunately, there is insufficient understanding about appropriate back health in the general public, even though this knowledge is decisive in the development of physical skills and attainment of health literacy. Furthermore, relevant substantive literature is scarce. Therefore, the proposed systematic review aims to identify instruments that are used for assessing knowledge of back health in adolescents. Relevant search terms and descriptors will be combined, and searches will be carried out in a uniform sequence within the PubMed, Embase, CINAHL, and Cochrane Library databases. Eligible articles must present data on the assessment of the adolescents’ knowledge of back health and describe the applied instrumentation. Articles will be selected by two reviewers independently; all disagreements will be resolved by a third reviewer. Mendeley and the Rayyan software will be used for the systematic review, and the checklist proposed by Brink and Louw will be used to verify the methodological quality of the included studies. Our findings may confirm the relevance of constructing and validating back health instruments for use in Brazil and other countries.
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Affiliation(s)
| | | | | | | | | | | | - Priscilla Rayanne e Silva Noll
- Campus Ceres, Federal Institute Goiano, Morrinhos 74605-050, Brazil
- Campus São Paulo, University of São Paulo, São Paulo 01246-904, Brazil
| | - Matias Noll
- Campus Goiânia, Federal University of Goiás, Goiânia 74690-631, Brazil
- Campus Ceres, Federal Institute Goiano, Morrinhos 74605-050, Brazil
- Correspondence: (A.C.F.R.); (M.N.)
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Prevalence of Lumbar Segmental Instability in Young Individuals with the Different Types of Lumbar Disc Herniation-Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159378. [PMID: 35954735 PMCID: PMC9368739 DOI: 10.3390/ijerph19159378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Lumbar segmental instability (LSI) can cause pain and disability, and its background can be related to lumbar disc herniation (LDH). This retrospective study was conducted to analyze the prevalence of lumbar segmental instability (LSI) in young patients with different types of lumbar disc herniation (LDH). The study evaluated 133 individuals (18−25 years old) who suffered from LDH and underwent MRI and flexion-extension X-rays. Two groups were created: protrusion (PRO) and extrusion (EXT). LSI was scored positive when translatory motion was greater than 4 mm anteriorly or 2 mm posteriorly at the level of herniation. Statistica 13 was used to perform statistics. The LSI overall prevalence was 18.33% in PRO and 21.92% in EXT (p > 0.05). Out of all LSI positives, higher LSI incidence was observed in females compared to males; in PRO: 63.64%; in EXT: 68.75% (p > 0.05). LSI correlated positively with the passive lumbar extension test (PLE) (R = 0.32; p = 0.01) in the PRO group only. In summary, the results showed that the overall incidence of LSI was higher with severer disc damage. In addition, females were more prone to this pathology. However, the different types of LDH do not significantly affect the prevalence of LSI in young individuals.
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Wynne JH, Houle LR. Short-Term Outcomes of the Boston Brace 3D Program Based on SRS and SOSORT Criteria: A Retrospective Study. CHILDREN 2022; 9:children9060842. [PMID: 35740779 PMCID: PMC9221989 DOI: 10.3390/children9060842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/23/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Background: Adolescent idiopathic scoliosis (AIS) is characterized by a lateral curvature of the spine with a Cobb angle greater than 10 degrees, accompanied by rotation of the vertebral body. Bracing has been shown to be effective in halting the progression of at-risk curves, and, in some cases, even improving the Cobb angle by 6° or more. The Boston Brace 3D is part of the Boston Orthotics and Prosthetics standardized scoliosis program. The orthosis is custom-fabricated from scans, computer-aided design (CAD), and computer-aided manufactured (CAM) thoracolumbosacral orthosis used in the non-operative management of AIS. Aim: To evaluate the outcomes of a scoliosis program utilizing the Boston Brace 3D orthosis for patients with AIS, based on SRS and SOSORT criteria. Design: Retrospective study. Methods: An electronic medical records search was conducted to identify first-time brace wearers fitted between 1 January 2018, and 30 June 2019, at Boston Orthotics and Prosthetics Boston area clinics that met the SRS/SOSORT research guidelines. The initial out-of-brace, in-brace, and last follow-up X-rays (taken at least 12 months after fitting) were compared. Results: 84% of patients presenting with a single curve and 69% of patients with a double curve saw their curves improve (reduced 6° or more) or remain unchanged (±5°). Thirty-one patients started with a single curve between 25° and 30°, and thirty-two presented at 30° or below. Fifty-nine patients started with a double curve between 25° and 30°, and 59 patients presented at 30° or below. In general, the patients who wore their brace for more hours per day saw improved results. Conclusion: The Boston Brace 3D program is effective in controlling (and in some cases improving) curve progression in the non-operative management of adolescent idiopathic scoliosis. The approach is a repeatable system, as shown in this cohort of thirteen clinicians across six area clinics following the Boston Brace 3D clinical guidelines.
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Controlling the Progression of Curvature in Children and Adolescent Idiopathic Scoliosis Following the Administration of Melatonin, Calcium, and Vitamin D. CHILDREN 2022; 9:children9050758. [PMID: 35626935 PMCID: PMC9140159 DOI: 10.3390/children9050758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 12/29/2022]
Abstract
Idiopathic scoliosis affects a severe number of children. Their quality of life and development are also disturbed. Some therapeutic strategies have been developed to control illness progression and to optimize the quality of life. In this perspective, randomized, case-control, interventional study, the impact of using melatonin, calcium, and vitamin D, respectively, on idiopathic scoliosis patients was analyzed. Our preliminary results showed that these drugs positively affected the illness progression quantified by the spine curvature. Patients with idiopathic scoliosis may benefit from a novel treatment by supplementation with vitamin D, calcium, and melatonin.
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De Salvatore S, Ruzzini L, Longo UG, Marino M, Greco A, Piergentili I, Costici PF, Denaro V. Exploring the association between specific genes and the onset of idiopathic scoliosis: a systematic review. BMC Med Genomics 2022; 15:115. [PMID: 35590413 PMCID: PMC9118580 DOI: 10.1186/s12920-022-01272-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Idiopathic Scoliosis (IS) is the most common spinal deformity in adolescents, accounting for 80% of all spinal deformities. However, the etiology remains uncertain in most cases, being identified as Adolescent Idiopathic Scoliosis (AIS). IS treatments range from observation and sport to bracing or surgery. Several risk factors including sex and familiarity, have been linked with IS. Although there are still many uncertainties regarding the cause of this pathology, several studies report a greater incidence of the defect in families in which at least one other first degree relative is affected. This study systematically reviews the available literature to identify the most significant genes or variants related to the development and onset of IS. Methods The research question was formulated using a PIOS approach on the following databases: Medline, Embase, Cinahl, Scopus, Web of Science and Google Scholar. The search was performed from July to August 2021, and articles from the inception of the database to August 2021 were searched. Results 24 of the 919 initially identified studies were included in the present review. The 24 included studies observed a total of 16,316 cases and 81,567 controls. All the considered studies stated either the affected gene and/or specific SNPs. CHD7, SH2B1, ESR, CALM1, LBX1, MATN1, CHL1, FBN1 and FBN2 genes were associated with IS development. Conclusions Although association can be found in some candidate genes the field of research regarding genetic association with the onset of IS still requires more information.
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Affiliation(s)
- Sergio De Salvatore
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Laura Ruzzini
- Department of Orthopedics, Children's Hospital Bambino Gesù, 00165, Palidoro, Rome, Italy
| | - Umile Giuseppe Longo
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy. .,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - Martina Marino
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Alessandra Greco
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Ilaria Piergentili
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Pier Francesco Costici
- Department of Orthopedics, Children's Hospital Bambino Gesù, 00165, Palidoro, Rome, Italy
| | - Vincenzo Denaro
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.,Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
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Exploration of Contributory Factors to an Unpleasant Bracing Experience of Adolescent Idiopathic Scoliosis Patients a Quantitative and Qualitative Research. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050635. [PMID: 35626812 PMCID: PMC9139334 DOI: 10.3390/children9050635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/15/2022] [Accepted: 04/24/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND To obtain a better understanding of the wearing habits and preferences of Adolescent Idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment, we examine what factors contribute to patients' perceived discomfort during the treatment. METHODS Seventeen AIS patients treated with a rigid brace were recruited. We asked them to complete a questionnaire and participate in an interview study. Finally, we measure the interface corrective force and perceived discomfort with the participants for different positions and assess the correlation. RESULTS Our survey reveals that participants scored the lowest in the domains of environmental factors, psycho-spiritual factors, satisfaction, and self-image. Appearance anxiety, physical and psychological discomfort and inconvenience were the three most frequently mentioned problems in the interviews on participants' daily bracing experiences. A significant, moderately positive relationship between corrective force and discomfort level was found only when participants were lying on their left side, but not in any of the other positions. No significant correlation between treatment length and perceived discomfort was found. CONCLUSIONS Future work should focus on reducing the psychological burden and the inconvenience of wearing a brace, rather than on reducing physical discomfort resulting from the corrective force.
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In-Brace versus Out-of-Brace Protocol for Radiographic Follow-Up of Patients with Idiopathic Scoliosis: A Retrospective Study. CHILDREN 2022; 9:children9040465. [PMID: 35455509 PMCID: PMC9029671 DOI: 10.3390/children9040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
The purpose of this retrospective study was to compare two standardized protocols for radiological follow-up (in-brace versus out-of-brace radiographs) to study the rate of curve progression over time in surgically treated idiopathic scoliosis (IS) patients after failed brace treatment. In-brace radiographs have the advantage that proper fit of the brace and in-brace correction can be evaluated. However, detection of progression might theoretically be more difficult. Fifty-one IS patients that underwent surgical treatment after failed brace treatment were included. For 25 patients, follow-up radiographs were taken in-brace. For the other 26 patients, brace treatment was temporarily stopped before out-of-brace follow-up radiographs were taken. Both groups showed significant curve progression compared to baseline after a mean follow-up period of 3.4 years. The protocol with in-brace radiographs was noninferior regarding curve progression rate over time. The estimated monthly Cobb angle progression based on the mixed-effect model was 0.5 degrees in both groups. No interaction effect was found for time, and patients’ baseline Cobb angle (p = 0.98), and for time and patients’ initial in-brace correction (p = 0.32). The results of this study indicate that with both in-brace and out-of-brace protocols for radiographic follow-up, a similar rate of curve progression can be expected over time in IS patients with failed brace treatment.
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A 10-Week Program of Combined Hippotherapy and Scroth's Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study. CHILDREN (BASEL, SWITZERLAND) 2021; 9:children9010023. [PMID: 35053648 PMCID: PMC8774272 DOI: 10.3390/children9010023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023]
Abstract
Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance in AIS compared to traditional physiotherapy (Schroth exercises) alone. Materials and methods: In this randomized controlled trial, fifty-two patients with AIS (10–18 years, 37 girls and 15 boys) participated. They were arbitrarily allocated into two groups: experimental (19 female/8 male; aged 14.74 ± 1.79 years; Cobb angle 18.59 ± 2.66 degrees) and control (18 female/7 male; aged 15.04 ± 1.81 years; Cobb angle 19.32 ± 2.69 degrees) groups. Both groups received Schroth exercises for 10 weeks, three days/week. The experimental group additionally received hippotherapy training. Pre-treatment and post-treatment assessment for the scoliotic, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the anteroposterior, mediolateral and overall stability indices were assessed using the formetric system 4D and Biodex Balance System, respectively. Results: After intervention, both groups illustrated significant improvements in all examined variables (p < 0.05). The experimental group illustrated significant improvements in scoliotic angle, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the stability indices compared to the control group (p < 0.05). Conclusion: In adolescence idiopathic scoliosis, hippotherapy training combined with Schroth exercises improves posture asymmetry and balancing ability more effectively than Schroth exercises alone.
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