Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis.

The scoliometer readings in both standing and sitting position of 2071 children and adolescents (1099 boys and 972 girls) aged from 5 to 18 years old were studied. The angle of trunk rotation (ATR) was measured, in order to quantify the existing trunk asymmetry. Children and adolescents were divided in two groups according to the severity of trunk asymmetry. In the first group asymmetry was 1 to 6 degrees and in the second group was 7 or more degrees. Radiographic and leg length inequality evaluation were also performed in a number of children. The mean frequency of symmetric (ATR = 0 degrees) boys and girls was 67.06% and 65.01% for the standing screening position and 76.5% and 75.1% for the sitting position, respectively. The mean difference of frequency of asymmetry (ATR > 0 degrees) at standing minus sitting forward bending position for boys and girls was 10.22% and 9.37%, respectively. The mean frequency of asymmetry of 7 or more degrees was 3.23% for boys and 3.92% for girls at the standing forward bending position and 1.62% and 2.21% at the sitting, respectively. Girls are found to express higher frequency of asymmetry than boys. Right trunk asymmetry was more common than left. The sitting position is the preferred screening position for examining the rib or loin hump during school screening as it demonstrates the best correlation with the spinal deformity exposing the real trunk asymmetry.

The aim of this report is the appraisal of a possible correlation of trunk asymmetry assessed with a scoliometer and lateralization of the brain as expressed by handedness in a school aged population. Many (8245) students (4173 girls and 4072 boys), 6-18 years of age were examined. A checklist was completed for each student including handedness and trunk asymmetry. The standing forward bending test was performed using the Pruijs scoliometer and the examined children were divided into three groups for each of the three examined regions (mid-thoracic, thoracolumbar and lumbar) according to the recorded asymmetry (no asymmetry, 2-7 degrees and > or =7 degrees ). Ninety-one per cent of children were right-handed, while 9% were left-handed. A significant statistical correlation of trunk asymmetry and handedness was found both in boys and girls in the group of asymmetry 2-7 degrees at mid-thoracic (p < 0.038) but not at thoracolumbar and at lumbar region. These findings show that there is significant correlation of mild mid-thoracic asymmetry and the dominant brain hemisphere in terms of handedness, in children who are entitled at risk of developing scoliosis. These findings are implicating the possible aetiopathogenic role of cerebral cortex function in the determination of the thoracic surface morphology of the trunk.

ObjectiveThe effect of the Dynamic Derotation Brace (DDB) on angle of trunk inclination (ATI) in adolescent idiopathic scoliosis (AIS) children was studied. Study designA prospective clinical study for the assessment of the influence of the DDB, a modified Boston Brace [1] with antirotatory blades, on the surface deformity of conservatively treated scoliotics was performed. MethodsThirty-six scoliotic children (32 female, 4 male) with a mean age of 13.9 years (range 12-17 years), a mean Cobb angle of 28.2 degrees (range 19-38) and a mean angle of trunk inclination (ATI) of 7.8 degrees (range 4-17) were included in the study. The examined children were divided in three subgroups according to the curve type. All the children were treated with the DDB with antirotatory blades and they wore the brace for twenty-three hours per day for a minimum duration of two years. The ATI was assessed using the Pruijs scoliometer [2] during the first examination and during the follow up, with the children out of the brace. ResultsFor double curves, statistical analysis for ATI changes revealed that improvement in the thoracic region was not statistically significant (p < 0.088) but it was significant (p < 0.01) in the thoracolumbar and in the lumbar region (p < 0.013). For right thoracic curves, ATI improvement was not significant for all the examined regions. Finally for thoracolumbar curves ATI improved significantly in the thoracolumbar (p < 0.018) and in lumbar region (p < 0.027), but not in the thoracic region (p < 0.248). ConclusionThe above findings indicate that in curves with a compensatory component (e.g. primary thoracic with compensatory lumbar curve), a deforming rotatory force is present, blocked by the derotatory action of the blades of the DDB, and seems to be more active in the lumbar spine. However DDB beneficially affects the surface deformity of AIS children with all but right thoracic curves. References