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Petrosyan E, Fares J, Ahuja CS, Lesniak MS, Koski TR, Dahdaleh NS, El Tecle NE. Genetics and pathogenesis of scoliosis. NORTH AMERICAN SPINE SOCIETY JOURNAL 2024; 20:100556. [PMID: 39399722 PMCID: PMC11470263 DOI: 10.1016/j.xnsj.2024.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 10/15/2024]
Abstract
Background Scoliosis is defined as a lateral spine curvature of at least 10° with vertebral rotation, as seen on a posterior-anterior radiograph, often accompanied by reduced thoracic kyphosis. Scoliosis affects all age groups: idiopathic scoliosis is the most common spinal disorder in children and adolescents, while adult degenerative scoliosis typically affects individuals over fifty. In the United States, approximately 3 million new cases of scoliosis are diagnosed annually, with a predicted increase in part due to global aging. Despite its prevalence, the etiopathogenesis of scoliosis remains unclear. Methods This comprehensive review analyzes the literature on the etiopathogenetic evidence for both idiopathic and adult degenerative scoliosis. PubMed and Google Scholar databases were searched for studies on the genetic factors and etiopathogenetic mechanisms of scoliosis development and progression, with the search limited to articles in English. Results For idiopathic scoliosis, genetic factors are categorized into three groups: genes associated with susceptibility, disease progression, and both. We identify gene groups related to different biological processes and explore multifaceted pathogenesis of idiopathic scoliosis, including evolutionary adaptations to bipedalism and developmental and homeostatic spinal aberrations. For adult degenerative scoliosis, we segregate genetic and pathogenic evidence into categories of angiogenesis and inflammation, extracellular matrix degradation, neural associations, and hormonal influences. Finally, we compare findings in idiopathic scoliosis and adult degenerative scoliosis, discuss current limitations in scoliosis research, propose a new model for scoliosis etiopathogenesis, and highlight promising areas for future studies. Conclusions Scoliosis is a complex, multifaceted disease with largely enigmatic origins and mechanisms of progression, keeping it under continuous scientific scrutiny.
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Affiliation(s)
- Edgar Petrosyan
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Jawad Fares
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Christopher S. Ahuja
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Maciej S. Lesniak
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Tyler R. Koski
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Nader S. Dahdaleh
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Najib E. El Tecle
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
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Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: A systematic review. J Bodyw Mov Ther 2021; 27:16-25. [PMID: 34391228 DOI: 10.1016/j.jbmt.2021.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/07/2021] [Accepted: 02/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function. PURPOSE to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves. METHODS A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves. RESULTS Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance. CONCLUSIONS The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.
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Hsu PC, Feng CK, Huang SH, Chiu JW, Chou CL, Yang TF. Health-related quality of life in children and adolescent with different types of scoliosis: A cross-sectional study. J Chin Med Assoc 2019; 82:161-165. [PMID: 30839509 DOI: 10.1097/jcma.0000000000000020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The health-related quality of life (HRQoL) was affected in children and adolescents with scoliosis. However, there was lack of study to compare the HRQoL among patients with different types of scoliosis. We aimed to investigate whether the HRQoL differs among patients with idiopathic, congenital, neuromuscular, and syndromic scoliosis. METHODS Children and adolescents with scoliosis were recruited from a single tertiary hospital. The HRQoL, as assessed by the child health questionnaire 50-item parent form, was compared with a reference health sample group using the effect size (ES). Intergroup differences related to scoliosis subtype and severity were explored. RESULTS A total of 67 participants with scoliosis (24 idiopathic, 15 congenital, 15 neuromuscular, and 13 syndromic) were analyzed. The HRQoL in patients with neuromuscular scoliosis was affected the most, in both physical (ES range: 0.97-2.4) and psychosocial domains (ES range: 0.92-2.58). To a lesser extent, the physical (ES range: 0.99-1.13) and psychosocial (ES range: 0.8-1.18) domains were also affected in patients with syndromic scoliosis. The domains of family activities (ES = 1.1), role/social-emotional/behavioral (ES = 0.99), general health perception (ES = 0.94), and self-esteem (ES = 0.87) were affected in patients with idiopathic scoliosis. In contrast, only the general health perception domain (ES = 1.27) was affected in patients with congenital scoliosis. Scoliosis severity correlated with scores in the physical domains and some psychosocial domains, while treatment type correlated with scores in the physical domains only. Scoliosis subtype and severity both affected the physical and psychosocial domains, with a stronger impact for subtype. CONCLUSION Differences in the HRQoL exist among scoliosis subtypes, with neuromuscular scoliosis being most affected. Although the scoliosis subtype and severity both affect the HRQoL, the subtype is more influential than severity.
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Affiliation(s)
- Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chi-Kuang Feng
- Department of Orthopaedics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Hsien Huang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jan-Wei Chiu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chen-Liang Chou
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tsui-Fen Yang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan, ROC
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Yagci G, Ayhan C, Yakut Y. Effectiveness of basic body awareness therapy in adolescents with idiopathic scoliosis: A randomized controlled study1. J Back Musculoskelet Rehabil 2018; 31:693-701. [PMID: 29630516 DOI: 10.3233/bmr-170868] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In scoliosis, curve progresses due to muscle imbalance and poor posture. Basic body awareness therapy (BBAT) aims to improve posture, coordination, and balance by increasing body awareness, which may help decrease deformities. OBJECTIVE This study aimed to investigate effects of Basic body awareness therapy (BBAT) on curve magnitude, trunk asymmetry, cosmetic deformity, and quality of life in adolescent idiopathic scoliosis (AIS) patients. METHODS Twenty female AIS patients were randomly assigned to BBAT and traditional exercises (TEs) groups. The BBAT group received BBAT and traditional exercises (TEs), while the TEs group received only TEs. The following assessments were included: Cobb angles using X-ray, angle of trunk rotation (ATR) using scoliometer, trunk asymmetry using the Posterior Trunk Symmetry Index (POTSI), cosmetic deformity using the Walter Reed Visual Assessment Scale (WRVAS), and quality of life using the SRS-22 test. Measurements were conducted at baseline examination and ten weeks later. Patients were instructed to wear their brace 23 h daily. Results were analyzed using the Wilcoxon rank-sum test to compare repeated measurements and Mann-Whitney U test to compare the groups. RESULTS The BBAT group had greater improvement in the thoracic Cobb angle than the TEs group. Cosmetic deformity improved in both groups, whereas body asymmetry improved in only the BBAT group. SRS-22 scores were unchanged in both groups. CONCLUSIONS BBAT as an additive to bracing and TEs improve curve magnitude, body symmetry and trunk deformity.
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Affiliation(s)
- Gozde Yagci
- School of Physical Therapy and Rehabilitation Sciences, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Cigdem Ayhan
- School of Physical Therapy and Rehabilitation Sciences, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Yavuz Yakut
- Physiotherapy and Rehabilitation Department, Hasan Kalyoncu University, Gaziantep, Turkey
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Kontodimopoulos N, Damianou K, Stamatopoulou E, Kalampokis A, Loukos I. Children's and parents' perspectives of health-related quality of life in newly diagnosed adolescent idiopathic scoliosis. J Orthop 2018; 15:319-323. [PMID: 29556117 PMCID: PMC5856671 DOI: 10.1016/j.jor.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/25/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022] Open
Abstract
The aim of this study is to compare child and parent perceptions of health-related quality of life in Adolescent Idiopathic Scoliosis. The scoliosis-specific SRS-22 and the generic KIDSCREEN-52 were administered to newly diagnosed patients and the latter also to a parent. Strong correlations (r > 0.5, p < 0.001) were revealed between conceptually similar dimensions of the instruments. Parents' assessments of their child's HRQoL were generally higher than the children/adolescents; however score differences were small and insignificant. The significance of parents' perceptions was also confirmed with OLS regressions. In conclusion, HRQoL is thoroughly investigated when both generic and disease-specific instruments are used.
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Affiliation(s)
- Nick Kontodimopoulos
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
- “KAT” General Hospital, Nikis 2, Kifisia, 14561, Athens, Greece
| | - Konstantia Damianou
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
| | | | | | - Ioannis Loukos
- Hellenic Open University, Parodos Aristotelous 18, Perivola, 26335, Patras, Greece
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Lee H, Choi J, Hwang JH, Park JH. Health-related quality of life of adolescents conservatively treated for idiopathic scoliosis in Korea: a cross-sectional study. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:11. [PMID: 27299160 PMCID: PMC4900241 DOI: 10.1186/s13013-016-0071-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/18/2016] [Indexed: 11/25/2022]
Abstract
Background Young adolescents with scoliosis are more likely than adults to experience psychological distress affecting health-related quality of life (HRQoL). Adolescence is a sensitive period of psychological development, and thus physical deformity from scoliosis can negatively affect body image and appearance of adolescents. The present study evaluated HRQoL in young Korean adolescents with idiopathic scoliosis and identified related factors. Methods One hundred and ten adolescents with idiopathic scoliosis were recruited from two tertiary hospital outpatient clinics over one year. HRQoL was measured using the Korean version of the Scoliosis Research Society 22 revision (SRS-22r) questionnaire. In addition, participant medical records were reviewed to collect data on severity of scoliosis, type of treatment and age at which they were first diagnosed with the disease. Results The mean age of the participants was 14.2 years and 48.2 % were first diagnosed at 9–12 years. Most participants (61.8 %) were under observation to follow up the curvature progression and 20.9 % received regular physiotherapy. Almost half the participants (47.3 %) had mild (10°–25°), 41.8 % moderate (25°–40°), and 10.9 % severe (>40°) scoliosis. The total score of the SRS-22r differed significantly between the groups of age at diagnosis (p = 0.033) and type of treatment (p = 0.025). Self-image, a sub-domain of the SRS 22r, was significantly lower in the severe curve deformity group than in the other groups (p = 0.031). Conclusions An earlier age of scoliosis diagnosis and conservative treatment were related to higher HRQoL scores of Korean adolescents with scoliosis. Although the overall HRQoL did not significantly differ by severity of disease, self-image was significantly decreased in adolescents with severe spinal deformity. HRQoL of adolescent patients with idiopathic scoliosis can be affected by several factors that medical staff needs to consider in order to produce the best and most effective treatment outcomes.
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Affiliation(s)
- Hyejung Lee
- College of Nursing, Yonsei University, 250 Seongsan-ro, Seodaemun-gu, 03722 Seoul Korea
| | - Jihea Choi
- Department of Nursing, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, 26426 Gangwon-do Korea
| | - Jin-Ho Hwang
- Department of Orthopaedic Surgery, Severance Children's Hospital, Division of Pediatric Orthopedics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, 06273 Seoul Korea
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Yu KE, Kim JS. Factors Associated with Relative Schoolbag Weight and Musculoskeletal Symptoms Among Elementary School Children. CHILD HEALTH NURSING RESEARCH 2015. [DOI: 10.4094/chnr.2015.21.4.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Posture Management Program Based on Theory of Planned Behavior for Adolescents with Mild Idiopathic Scoliosis. Asian Nurs Res (Korean Soc Nurs Sci) 2013; 7:120-7. [DOI: 10.1016/j.anr.2013.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/13/2013] [Accepted: 06/14/2013] [Indexed: 11/21/2022] Open
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