{"title":"The role of the paravertebral muscles in adolescent idiopathic scoliosis evaluated by temporary paralysis.","authors":"Christian Wong, Kasper Gosvig, Stig Sonne-Holm","doi":"10.1186/s13013-017-0138-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Muscle imbalance has been suggested as implicated in the pathology of adolescent idiopathic scoliosis (AIS). The specific \"pathomechanic\" role of the paravertebral muscles as being scoliogenic (inducing scoliosis) or counteracting scoliosis in the initial development and maintenance of this spinal deformity has yet to be clarified in humans. In the present study, we investigated the radiographic changes of temporal paralysis using botulinum toxin A as localized injection therapy (ITB) in the psoas major muscle in AIS patients.</p><p><strong>Methods: </strong>Nine patients with AIS were injected one time with ITB using ultrasonic and EMG guidance in the selected spine muscles. Radiographic and clinical examinations were performed before and 6 weeks after the injection. Primary outcome parameters of radiological changes were analyzed using Wilcoxon signed-rank test and binomial test, and secondary outcome parameters of short- and long-term clinical effects were obtained.</p><p><strong>Results: </strong>Significant radiological corrective changes were seen in the frontal plane in the thoracic and lumbar spine as well as significant derotational corrective change in the lumbar spine according to Cobb's angle measurements and to Nash and Moe's classification, respectively. No serious adverse events were detected at follow-up.</p><p><strong>Conclusions: </strong>In conclusion, this study demonstrated that the psoas major muscle do play a role into the pathology in adolescent idiopathic scoliosis by maintaining the curvature of the lumbar spine and thoracic spine.</p><p><strong>Trial registration: </strong>EudraCT number 2008-004584-19.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"33"},"PeriodicalIF":0.0000,"publicationDate":"2017-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0138-7","citationCount":"15","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scoliosis and Spinal Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13013-017-0138-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 15
Abstract
Background: Muscle imbalance has been suggested as implicated in the pathology of adolescent idiopathic scoliosis (AIS). The specific "pathomechanic" role of the paravertebral muscles as being scoliogenic (inducing scoliosis) or counteracting scoliosis in the initial development and maintenance of this spinal deformity has yet to be clarified in humans. In the present study, we investigated the radiographic changes of temporal paralysis using botulinum toxin A as localized injection therapy (ITB) in the psoas major muscle in AIS patients.
Methods: Nine patients with AIS were injected one time with ITB using ultrasonic and EMG guidance in the selected spine muscles. Radiographic and clinical examinations were performed before and 6 weeks after the injection. Primary outcome parameters of radiological changes were analyzed using Wilcoxon signed-rank test and binomial test, and secondary outcome parameters of short- and long-term clinical effects were obtained.
Results: Significant radiological corrective changes were seen in the frontal plane in the thoracic and lumbar spine as well as significant derotational corrective change in the lumbar spine according to Cobb's angle measurements and to Nash and Moe's classification, respectively. No serious adverse events were detected at follow-up.
Conclusions: In conclusion, this study demonstrated that the psoas major muscle do play a role into the pathology in adolescent idiopathic scoliosis by maintaining the curvature of the lumbar spine and thoracic spine.
Trial registration: EudraCT number 2008-004584-19.
期刊介绍：
Cessation.Scoliosis and Spinal Disorders is an open access, multidisciplinary journal that encompasses all aspects of research on prevention, diagnosis, treatment, outcomes and cost-analyses of conservative and surgical management of all spinal deformities and disorders. Both clinical and basic science reports form the cornerstone of the journal in its endeavour to provide original, primary studies as well as narrative/systematic reviews and meta-analyses to the academic community and beyond. Scoliosis and Spinal Disorders aims to provide an integrated and balanced view of cutting-edge spine research to further enhance effective collaboration among clinical spine specialists and scientists, and to ultimately improve patient outcomes based on an evidence-based spine care approach.
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