Scoliosis and Spinal Disorders最新文献

{"title":"Supplementary Addendum to \"Radiation dose of digital radiography (DR) versus micro-dose x-ray (EOS) on patients with adolescent idiopathic scoliosis: 2016 SOSORT- IRSSD \"John Sevastic Award\" Winner in Imaging Research\".","authors":"Steve C N Hui,&nbsp;Winnie C W Chu","doi":"10.1186/s13013-017-0148-5","DOIUrl":"https://doi.org/10.1186/s13013-017-0148-5","url":null,"abstract":"<p><p>Regarding the publication entitle \"Radiation dose of digital radiography (DR) versus micro-dose x-ray (EOS) on patients with adolescent idiopathic scoliosis: 2016 SOSORT- IRSSD \"John Sevastic Award\" Winner in Imaging Research\" in <i>Scoliosis and Spinal Disorders</i>, we would like to provide more details to readers about the dose calculated by simulation using PCXMC 2.0. In this study, the data and results are correct based on the given parameters and calculation provided in the manuscript. In the simulation of EOS micro-dose, only a 0.1 mm copper filter was applied. We agree with the suggestion from Dr. Pedersen and colleagues that the inclusion of a 1.5 mm aluminum filter together with the 0.1 mm copper reflects more realistic representation of X-ray filtration which would improve the accuracy of the simulation. We believe that this supplementary addendum would be beneficial to other researchers who are planning to conduct a similar study.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"13 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0148-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35825170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-dimensional digital photography for child body posture evaluation: standardized technique, reliable parameters and normative data for age 7-10 years.","authors":"L Stolinski,&nbsp;M Kozinoga,&nbsp;D Czaprowski,&nbsp;M Tyrakowski,&nbsp;P Cerny,&nbsp;N Suzuki,&nbsp;T Kotwicki","doi":"10.1186/s13013-017-0146-7","DOIUrl":"10.1186/s13013-017-0146-7","url":null,"abstract":"<p><strong>Background: </strong>Digital photogrammetry provides measurements of body angles or distances which allow for quantitative posture assessment with or without the use of external markers. It is becoming an increasingly popular tool for the assessment of the musculoskeletal system. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique.</p><p><strong>Material and methods: </strong>The purpose of the study was twofold. The first one comprised 91 children (44 girls and 47 boys) aged 7-10 (8.2 ± 1.0), i.e., students of primary school, and its aim was to develop the photographic method, choose the quantitative parameters, and determine the intraobserver reliability (repeatability) along with the interobserver reliability (reproducibility) measurements in sagittal plane using digital photography, as well as to compare the Rippstein plurimeter and digital photography measurements. The second one involved 7782 children (3804 girls, 3978 boys) aged 7-10 (8.4 ± 0.5), who underwent digital photography postural screening. The methods consisted in measuring and calculating selected parameters, establishing the normal ranges of photographic parameters, presenting percentile charts, as well as noticing common pitfalls and possible sources of errors in digital photography.</p><p><strong>Results: </strong>A standardized procedure for the photographic evaluation of child body posture was presented. The photographic measurements revealed very good intra- and inter-rater reliability regarding the five sagittal parameters and good reliability performed against Rippstein plurimeter measurements. The parameters displayed insignificant variability over time. Normative data were calculated based on photographic assessment, while the percentile charts were provided to serve as reference values. The technical errors observed during photogrammetry are carefully discussed in this article.</p><p><strong>Conclusions: </strong>Technical developments are allowed for the regular use of digital photogrammetry in body posture assessment. Specific child positioning (described above) enables us to avoid incidentally modified posture. Image registration is simple, quick, harmless, and cost-effective. The semi-automatic image analysis, together with the normal values and percentile charts, makes the technique reliable in terms of child's posture documentation and corrective therapy effects' monitoring.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2017-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0146-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35687651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis?","authors":"James Cheshire,&nbsp;Adrian Gardner,&nbsp;Fiona Berryman,&nbsp;Paul Pynsent","doi":"10.1186/s13013-017-0144-9","DOIUrl":"https://doi.org/10.1186/s13013-017-0144-9","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS. The aim of this study was to examine whether the Scoliosis Research Society-22 (SRS-22) outcome questionnaire reflects the degree of measurable external asymmetry of the back in AIS and thus is a measure of patient outcome for external appearance.</p><p><strong>Methods: </strong>A total of 102 pre-operative AIS patients were identified retrospectively. Objective parameters were measured using ISIS2 surface topography. The associations between these parameters and the self-image and mental health domains of the SRS-22 questionnaire were investigated using correlation coefficients.</p><p><strong>Results: </strong>All correlations between the parameters of asymmetry and SRS-22 self-image score were of weak strength. Similarly, all correlations between the parameters of asymmetry and SRS-22 mental health score were of weak strength.</p><p><strong>Conclusion: </strong>The SRS-22 mental health and self-image domains correlate poorly with external measures of deformity. This demonstrates that the assessment of mental health and self-image by the SRS-22 has little to do with external torso shape. Whilst the SRS-22 assesses the patient as a whole, it provides little information about objective measures of deformity over which a surgeon has control.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2017-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0144-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35654308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcome of non-surgical and surgical management for de novo degenerative lumbar scoliosis: a mean follow-up of 10 years.","authors":"Sayf S A Faraj,&nbsp;Tsjitske M Haanstra,&nbsp;Hugo Martijn,&nbsp;Marinus de Kleuver,&nbsp;Barend J van Royen","doi":"10.1186/s13013-017-0143-x","DOIUrl":"https://doi.org/10.1186/s13013-017-0143-x","url":null,"abstract":"<p><strong>Background: </strong>No studies have evaluated the long-term results of non-surgical and surgical management in de novo degenerative lumbar scoliosis (DNDLS). This study reports on the long-term functional outcome of patients being treated for DNDLS by non-surgical and surgical management.</p><p><strong>Methods: </strong>This is a retrospective review of a single center database of DNDLS patients that underwent surgical or usual non-surgical management between 1996 and 2007. In a total of 88 patients, 50 (57%) underwent non-surgical and 38 (43%) surgical management. Baseline demographic, radiological-, clinical-, and surgical-related variables were collected. An Oswestry Disability Index (ODI) 2.0 questionnaire was sent to all patients after written informed consent.</p><p><strong>Results: </strong>Twenty-nine of 88 patients participated in the study, 15 (52%) had undergone surgical and 14 (48%) non-surgical management with a mean follow-up of 10.9 years (range 8-15 years). There were no significant differences (<i>p</i> > 0.05) between non-surgical and surgical patients at baseline for age, body mass index, coronal Cobb angle, and clinical data. None of the non-surgical patients had undergone surgery during follow-up. In the surgical group, 40% had revision surgery. There was no significant difference in ODI total scores between groups at final follow-up (<i>p</i> = 0.649). A larger proportion of patients in the non-surgical group reported an ODI total score of ≤ 22, reflecting minimal disability (43 versus 20%; <i>p</i> = 0.245).</p><p><strong>Conclusions: </strong>This is the first study that describes the long-term 10-year functional outcome of non-surgical and surgical management in a cohort of patients with DNDLS. No significant difference in functional outcome was found between groups after a mean follow-up of 10 years. Despite the significant potential for selection bias, these results indicate that non-surgical management of patients with DNDLS may lead to adequate functional outcome after long periods of time, with no crossover to surgery. Further study is warranted to define which patients may benefit most from which management regimen.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0143-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35634681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of scoliosis and subsequent surgery on the shape of the torso.","authors":"Adrian Gardner,&nbsp;Fiona Berryman,&nbsp;Paul Pynsent","doi":"10.1186/s13013-017-0140-0","DOIUrl":"https://doi.org/10.1186/s13013-017-0140-0","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) causes asymmetry of the torso, and this is often the primary concern of patients. Surgery aims to minimise the visual asymmetry. It is not clear how scoliosis makes the torso asymmetric or how scoliosis surgery changes that asymmetry when compared to the distribution of asymmetries seen in a non-scoliotic group of normal controls.</p><p><strong>Methods: </strong>Surface topography images were captured for a group with AIS both pre-operatively and post-operatively. Identifiable points were compared between the images to identify the effects of AIS on the shape of the torso by looking at the relative heights and distances from the midline of the shoulders, axillae and waist in a two-dimensional coronal view. This was then compared to a previously reported group of normal non-scoliotic children to analyse whether surgery recreated normality.</p><p><strong>Results: </strong>There were 172 pairs of images with 164 females and 8 males, mean age at pre-operative scan of 13.7 years. The normal group was 642 images (237 females and 405 males) from 116 males and 79 females, mean age of 12.5 years.The curve patterns seen in the scoliotic group matched the patterns of a main thoracic curve (<i>n</i> = 146) and main thoracolumbar curve (<i>n</i> = 26). The asymmetries seen in both shoulders, axillae and waist were different between the two different types of curve. Across both groups, the shoulder asymmetry was less than that of the corresponding axillae.There was a statistically significant reduction in all asymmetries following surgery in the main thoracic group (<i>p</i> < 0.001). This was not seen in the main thoracolumbar group, thought to be due to the small sample size. In the main thoracic group, there were statistically significant differences in the asymmetries between the post-operative and normal groups in the shoulders and axillae (<i>p</i> < 0.001) but not the waist.</p><p><strong>Conclusions: </strong>This paper demonstrates quantitatively the range of asymmetries seen in the AIS torso and the degree to which surgery alters them. Surgery does not recreate normality but does cause a statistically significant change in torso shape towards that seen in a non-scoliotic group.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2017-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0140-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35295481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schroth physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis: how many patients require treatment to prevent one deterioration? - results from a randomized controlled trial - \"SOSORT 2017 Award Winner\".","authors":"Sanja Schreiber, Eric C Parent, Doug L Hill, Douglas M Hedden, Marc J Moreau, Sarah C Southon","doi":"10.1186/s13013-017-0137-8","DOIUrl":"10.1186/s13013-017-0137-8","url":null,"abstract":"<p><strong>Background: </strong>Recent randomized controlled trials (RCTs) support using physiotherapeutic scoliosis-specific exercises (PSSE) for adolescents with idiopathic scoliosis (AIS). All RCTs reported statistically significant results favouring PSSE but none reported on clinical significance. The number needed to treat (NNT) helps determine if RCT results are clinically meaningful. The NNT is the number of patients that need to be treated to prevent one bad outcome in a given period. A low NNT suggests that a therapy has positive outcomes in most patients offered the therapy. The objective was to determine how many patients require Schroth PSSE added to standard care (observation or brace treatment) to prevent one progression (NNT) of the Largest Curve (LC) or Sum of Curves (SOC) beyond 5° and 10°, respectively over a 6-month interval.</p><p><strong>Methods: </strong>This was a secondary analysis of a RCT. Fifty consecutive participants from a scoliosis clinic were randomized to the Schroth PSSE + standard of care group (<i>n</i> = 25) or the standard of care group (<i>n</i> = 25).We included males and females with AIS, age 10-18 years, all curve types, with curves 10°- 45°, with or without brace, and all maturity levels. We excluded patients awaiting surgery, having had surgery, having completed brace treatment and with other scoliosis diagnoses. The local ethics review board approved the study (Pro00011552).The Schroth intervention consisted of weekly 1-h supervised Schroth PSSE sessions and a daily home program delivered over six months in addition to the standard of care. A prescription algorithm was used to determine which exercises patients were to perform. Controls received only standard of care.Cobb angles were measured using a semi-automatic system from posterior-anterior standing radiographs at baseline and 6 months.We calculated absolute risk reduction (ARR) and relative risk reduction (RRR). The NTT was calculated as: NNT = 1/ARR. Patients with missing values (PSSE group; <i>n</i> = 2 and controls; <i>n</i> = 4) were assumed to have had curve progression (worst case scenario). The RRR is calculated as RRR = ARR/CER.</p><p><strong>Results: </strong>For LC, NNT = 3.6 (95% CI 2.0-28.2), and for SOC, NNT = 3.1 (95% CI 1.9-14.2). The corresponding ARR was 28% for LC and 32% for the SOC. The RRR was 70% for LC and 73% for the SOC. Patients with complete follow-up attended 85% of prescribed visits and completed 82.5% of the home program. Assuming zero compliance after dropout, 76% of visits were attended and 73% of the prescribed home exercises were completed.</p><p><strong>Conclusions: </strong>The short term of Schroth PSSE intervention added to standard care provided a large benefit as compared to standard care alone. Four (LC and SOC) patients require treatment for the additional benefit of a 6-month long Schroth intervention to be observed beyond the standard of care in at least one patient.</p><p><strong>Trial registration: </","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2017-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35629720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introversion, the prevalent trait of adolescents with idiopathic scoliosis: an observational study.","authors":"Elisabetta D'Agata,&nbsp;Judith Sánchez-Raya,&nbsp;Juan Bagó","doi":"10.1186/s13013-017-0136-9","DOIUrl":"https://doi.org/10.1186/s13013-017-0136-9","url":null,"abstract":"<p><strong>Background: </strong>A large number of studies about adolescents with idiopathic scoliosis focus on health-related quality of life (HRQOL). However, only a few articles aim at evaluating the personality of these patients. Therefore, the purpose of the present research is to assess the personality traits of adolescents with idiopathic scoliosis and their relationship with HRQOL.Our hypothesis is that adolescents with idiopathic scoliosis present the principal personality trait of introversion, defined as self-reliance and inhibition in social relationships.</p><p><strong>Methods: </strong>This was a cross-sectional study. The examined group consisted of 43 patients (only 4 boys), mean age = 14.3 (SD = 2.23). On the day of the visit, HRQOL tools (Scoliosis Research Society-22 Questionnaire (SRS-22) and Trunk Appearance Perception Scale (TAPS)) and a personality test (16 Personality Factors-Adolescent Personality Questionnaire (16PF-APQ)) were completed; in addition, a posterior-anterior radiography was performed. Correlations among demographic and medical data and HRQOL and personality tests were assessed.</p><p><strong>Results: </strong>Results for SRS-22 were as follows: Function 4.5 (SD = .4), Pain 4.3 (SD = .5), Self-image 3.6 (SD = .7), Mental Health 3.8. (SD = .7), and Subtotal 4.2 (SD = .7). Mean TAPS was 3.5 (SD = .6).In personality, the lowest values were assessed for Extroversion (<i>M</i> = 29.4, SD = 24.7) and Self-reliance (<i>M</i> = 71, SD = 25.3).Independence was negatively related to Self-image (<i>r</i> = -.51), Mental Health (<i>r</i> = -.54), and Subtotal SRS-22 (<i>r</i> = -.60) (<i>p</i> < .01).</p><p><strong>Conclusions: </strong>Adolescents with idiopathic scoliosis presented a common style of personality, characterized by social inhibition (introversion), preference for staying alone, and being self-sufficient (self-reliance).Specific programs in promoting social abilities may help adolescent patients with idiopathic scoliosis in finding a way to express themselves and to become more sociable. Correlational studies between personality and HRQOL need to be performed to better understand these issues.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2017-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0136-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35624164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curve progression after long-term brace treatment in adolescent idiopathic scoliosis: comparative results between over and under 30 Cobb degrees - SOSORT 2017 award winner.","authors":"Angelo G Aulisa,&nbsp;Vincenzo Guzzanti,&nbsp;Francesco Falciglia,&nbsp;Marco Galli,&nbsp;Paolo Pizzetti,&nbsp;Lorenzo Aulisa","doi":"10.1186/s13013-017-0142-y","DOIUrl":"https://doi.org/10.1186/s13013-017-0142-y","url":null,"abstract":"<p><strong>Background: </strong>The factors influencing curve behavior following bracing are incompletely understood and there is no agreement if scoliotic curves stop progressing with skeletal maturity. The aim of this study was to evaluate the loss of the scoliotic curve correction in patients treated with bracing during adolescence and to compare patient outcomes of under and over 30 Cobb degrees, 10 years after brace removal.</p><p><strong>Methods: </strong>We reviewed 93 (87 female) of 200 and nine patients with adolescent idiopathic scoliosis (AIS) who were treated with the Lyon or PASB brace at a mean of 15 years (range 10-35). All patients answered a simple questionnaire (including work status, pregnancy, and pain) and underwent clinical and radiological examination. The population was divided into two groups based on Cobb degrees (< 30° and > 30°). Statistical analysis was performed to test the efficacy of our hypothesis.</p><p><strong>Results: </strong>The patients underwent a long-term follow-up at a mean age of 184.1 months (±72.60) after brace removal. The pre-brace scoliotic mean curve was 32.28° (± 9.4°); after treatment, the mean was 19.35° and increased to a minimum of 22.12° in the 10 years following brace removal. However, there was no significant difference in the mean Cobb angle between the end of weaning and long term follow-up period (<i>p</i> = 0.105). The curve angle of patients who were treated with a brace from the beginning was reduced by 13° during the treatment, but the curve size lost 3° at the follow-up period.The groups over 30° showed a pre-brace scoliotic mean curve of 41.15°; at the end of weaning, the mean curve angle was 25.85° and increased to a mean of 29.73° at follow-up; instead, the groups measuring ≤ 30° showed a pre-brace scoliotic mean curve of 25.58°; at the end of weaning, it was reduced to a mean of 14.24° and it increased to 16.38° at follow-up.There was no significant difference in the mean progression of curve magnitude between the ≤ 30° and > 30° groups at the long-term follow-up.</p><p><strong>Conclusions: </strong>Scoliotic curves did not deteriorate beyond their original curve size after bracing in both groups at the 15-year follow-ups. These results are in contrast with the history of this pathology that normally shows a progressive and lowly increment of the curve at skeletal maturity. Bracing is an effective treatment method characterized by positive long-term outcomes, including for patients demonstrating moderate curves.</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2017-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0142-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35563482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis: results from a preliminary study-SOSORT Award 2017 Winner.","authors":"Kenny Yat Hong Kwan,&nbsp;Aldous C S Cheng,&nbsp;Hui Yu Koh,&nbsp;Alice Y Y Chiu,&nbsp;Kenneth Man Chee Cheung","doi":"10.1186/s13013-017-0139-6","DOIUrl":"https://doi.org/10.1186/s13013-017-0139-6","url":null,"abstract":"<p><strong>Background: </strong>Bracing has been shown to decrease significantly the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis (AIS), but the treatment failure rate remains high. There is evidence to suggest that Schroth scoliosis-specific exercises can slow progression in mild scoliosis. The aim of this study was to evaluate the efficacy of Schroth exercises in AIS patients with high-risk curves during bracing.</p><p><strong>Methods: </strong>A prospective, historical cohort-matched study was carried out. Patients diagnosed with AIS who fulfilled the Scoliosis Research Society (SRS) criteria for bracing were recruited to receive Schroth exercises during bracing. An outpatient-based Schroth program was given. Data for these patients were compared with a 1:1 matched historical control group who were treated with bracing alone. The assessor and statistician were blinded. Radiographic progression, truncal shift, and SRS-22r scores were compared between cases and controls.</p><p><strong>Results: </strong>Twenty-four patients (5 males and 19 females, mean age 12.3 ± 1.4 years) were included in the exercise group, and 24 patients (mean age 11.8 ± 1.1 years) were matched in the control group. The mean follow-up period for the exercise group was 18.1 ± 6.2 months. In the exercise group, spinal deformity improved in 17% of patients (Cobb angle improvement of ≥ 6°), worsened in 21% (Cobb angle increases of ≥ 6°), and remained stable in 62%. In the control group, 4% improved, 50% worsened, and 46% remained stable. In the subgroup analysis, 31% of patients who were compliant (13 cases) improved, 69% remained static, and none had worsened, while in the non-compliant group (11 cases), none had improved, 46% worsened, and 46% remained stable. Analysis of the secondary outcomes showed improvement of the truncal shift, angle of trunk rotation, the SRS function domain, and total scores in favor of the exercise group.</p><p><strong>Conclusion: </strong>This is the first study to investigate the effects of Schroth exercises on AIS patients during bracing. Our findings from this preliminary study showed that Schroth exercise during bracing was superior to bracing alone in improving Cobb angles, trunk rotation, and QOL scores. Furthermore, those who were compliant with the exercise program had a higher rate of Cobb angle improvement. The results of this study form the basis for a randomized controlled trial to evaluate the effect of Schroth exercises during bracing in AIS.</p><p><strong>Trial registration: </strong>HKUCTR-2226. Registered 22 June 2017 (retrospectively registered).</p>","PeriodicalId":21573,"journal":{"name":"Scoliosis and Spinal Disorders","volume":"12 ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2017-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0139-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35532544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the paravertebral muscles in adolescent idiopathic scoliosis evaluated by temporary paralysis.","authors":"Christian Wong,&nbsp;Kasper Gosvig,&nbsp;Stig Sonne-Holm","doi":"10.1186/s13013-017-0138-7","DOIUrl":"https://doi.org/10.1186/s13013-017-0138-7","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":0.0,"publicationDate":"2017-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s13013-017-0138-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35621700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}