Accuracy of a Radiological Evaluation Method for Thoracic and Lumbar Spinal Curvatures Using Spinous Processes

Marchetti, Barbara; Candotti, Cláudia Tarragô; Raupp, Eduardo Gonçalves; Oliveira, Eduardo Bojunga Corrêa de; Furlanetto, Tássia Silveira; Loss, Jefferson Fagundes

doi:10.1016/j.jmpt.2017.07.013

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…The minimally clinical important difference or MCID for changes in spinal curvatures is 10°, [27,28,61] which implies that only changes greater than 10⁰ should be interpreted as a clinically meaningful change. Changes smaller than 10° can be explained by the posture of the patient while taking the X-ray, [62,63] or by the associated measurement error of determining spinal curvature angles. [61] Declaration.…”

Section: Discussionmentioning

confidence: 99%

A narrative review on spinal deformities in people with cerebral palsy: Measurement, norm values, incidence, risk factors and treatment

2020

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The earliest description of cerebral palsy (CP) was made by William J. Little in the mid-1800s. In a series of lectures, entitled 'Deformities of the human frame' , Little included a description of cerebral paralysis. Although his main focus emphasised musculoskeletal complications, such as joint contractures and deformities as a result of chronic spasticity and paralysis, he specifically noted that the spasticity and paralysis was as a result of brain damage during infancy which resulted from preterm birth or perinatal asphyxia. [1] CP was therefore initially referred to as Little's disease. [2] William Osler (1889) and Sigmund Freud (1893) both further contributed to the field of CP. [3,4] In his article 'Cerebral Palsies of Children' Osler documented 151 cases which he classified as 'cerebral palsies' based on neuroanatomical pathology distribution into three main groups: infantile hemiplegia, bilateral spastic hemiplegia (i.e. spastic diplegia) and spastic paraplegia. [3] Freud had contrasting ideas to both Little's and Osler's work, and suggested classifying CP using clinical findings only. He recognised that the pathological findings resulted from both the initial lesion as well as the repair process and, in addition, he noted differences in clinical manifestations in patients with similar neuropathology. Freud further suggested that rather than perinatal asphyxia being the cause of CP, the aetiology of the brain damage present in CP could be multifactorial. He identified three major groups of causal factors: (i) maternal and idiopathic congenital; (ii) perinatal; and (iii) postnatal factors. [4] It is worth noting that Freud's ideas and work still form part of our modern-day definition of CP. [2] The primary condition of CP is non-progressive over time in the neurological sense. [2] However, secondary conditions of CP develop over time as a result of the primary conditions. [5] Manifestations can be grouped into primary and secondary manifestations. Primary manifestations include abnormal tone, loss of motor control, impaired balance, spasticity, hypotonia and dyskinesia. Secondary manifestations are growth and spasticity related and include contractures (initially dynamic and progress to static over time), upper extremity deformities, hip subluxations and dislocations, foot deformities, gait disorders and fractures, and spinal deformities. [6] Spinal deformities are more commonly seen in people with CP and range from a scoliosis to increased thoracic kyphosis, increased lumbar lordosis, spondylolysis and spondylolisthesis. [7] The preferred method of measuring a spinal curvature, is with an X-ray in standing position (if possible). The curvature is described in relation to the body's anatomical planes: coronal (frontal), sagittal (lateral) and horizontal (axial or transverse). [8] The most common spinal abnormalities are a scoliosis, a hyperkyphosis, a hyperlordosis and a spondylolysis and/or spondylolisthesis. Objectives To provide a scientific overview of how spinal curvatures should be measured, what t...

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Section: Discussionmentioning

confidence: 99%

A narrative review on spinal deformities in people with cerebral palsy: Measurement, norm values, incidence, risk factors and treatment

2020

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“…According to the consensus statement endorsed by the international Scienti c Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) and SRS [3], a 5° threshold is utilized to assess the effectiveness of spinal orthosis in controlling spinal curvature progression. Literature have also noted that variations <10° can be contributed by an individual's posture during the x-ray imaging and the associated measurement error of Cobb angle measurements [20][21][22]. Thus, changes ≥ 10° are considered to represent a clinically signi cant difference.…”

Section: Assessmentsmentioning

confidence: 99%

Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis

Wu,

He,

et al. 2024

Preprint

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Background Spinal orthoses are commonly prescribed for moderate adolescent idiopathic scoliosis (AIS), however, their effect on three-dimensional correction is not fully investigated. Moreover, the amount of deformity control largely depends on the corrective forces applied via the orthoses, which remains empirically based due to lack of consensus on optimal force application. This study investigated the effects of different corrective force directions exerted by spinal orthoses on the patients with AIS. Methods A retrospective analysis was conducted on 69 subjects. The trunk was segmented into four quadrants using coronal and sagittal planes from a top-down perspective. Each of the left or right posterolateral quadrant (with 90°) was equally subdivided into zones 1–4 from the sagittal to coronal planes. Based on the zone where the resultant corrective force direction fell, the subjects were categorized into Group 1 (zone 1), Group 2 (zone 2), Group 3 (zone 3), or Group 4 (zone 4). The direction of the corrective force was estimated using the modified models of the subjects’ bodies, designed through the computer-aided design and manufacturing system integral to the orthosis fabrication process. The effects of corrective forces in different zones on scoliotic spine were assessed. Results Of the subjects, 17 were in Group 2 and 52 in Group 3, with no subjects meeting the criteria for Groups 1 and 4. Both Groups 2 and 3 showed significant reductions of Cobb angle in the coronal plane and plane of maximum curvature (PMC) following orthosis fitting (p < 0.05). Group 2 displayed a significant decrease > 5º in thoracic kyphosis (p < 0.05), and a more pronounced reduction > 10º in lumbar lordosis compared to Group 3. PMC orientation remained unchanged over time (p > 0.05) but was notably higher in Group 2 after orthosis fitting (p < 0.05). Conclusions Corrective forces, applied by spinal orthoses, in zones 2 and 3 could effectively control the lateral curvature. However, only those in zone 3 did not reduce thoracic kyphosis and did not worsen the deviation of the scoliotic spine from the sagittal plane. Further research is needed to confirm and extend these results. Trial registration: Not available (This is a retrospective study that analyzed the subjects’ spinal images obtained from the database of a local scoliotic center and does not belong to “a clinical trial “ defined by World Health Organization, which is "any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes" and is required to be registered in an appropriate registry.)

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“…Besides radiographic measurements, non-radiographic modalities are used to assess quantitatively the LLC, such as the spinal mouse method which could be an alternative when radiographs are not feasible, but it consists of measuring soft tissue contours rather than the lordosis itself [ 19 ]. Despite exposure to radiation which represents an issue to a certain extent in radiology, Cobb's angle, also known as the lordotic angle [ 20 ], is widely regarded as the gold standard [ 17 , 21 , 22 ]. However, the authors have shed light upon some relevant limitations for this angle.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the accuracy of new modalities in the assessment and classification of lumbar lordosis: A comparison to Cobb's angle measurement

Eddine

Saleh

et al. 2023

Heliyon

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Accuracy of a Radiological Evaluation Method for Thoracic and Lumbar Spinal Curvatures Using Spinous Processes

Cited by 7 publications

References 28 publications

A narrative review on spinal deformities in people with cerebral palsy: Measurement, norm values, incidence, risk factors and treatment

A narrative review on spinal deformities in people with cerebral palsy: Measurement, norm values, incidence, risk factors and treatment

Effect of different corrective force directions applied by spinal orthoses on the patients with adolescent idiopathic scoliosis

Evaluation of the accuracy of new modalities in the assessment and classification of lumbar lordosis: A comparison to Cobb's angle measurement

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