Analysis of sagittal curvature and its influencing factors in adolescent idiopathic scoliosis

Cong, Zhen; Wang, Yidan; Yu, Jinghong; Jin, Feng; Zhang, Yunfeng; Zhao, Yan; Fu, Yu; Zhang, Kai; Wang, Jianzhong; Dai, Lina; Gao, Ming; Li, Zhijun; Wang, Lidong; Li, Xiaohe; Wang, Haiyan

doi:10.1097/md.0000000000026274

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…Previous coccygeal morphology studies have shown that type V is the least prevalent among the different types 22 – 25 . These results confirm that coccygeal morphology is different in AIS patients, similar with the sagittal spine observed in AIS patients in previous studies 26 , 27 . It has been suggested that the sacrococcygeal joint could be strained by constant pressure on the coccyx during an incorrect sitting posture 28 .…”

Section: Discussionsupporting

confidence: 91%

“…However, previous research on changes in the lumbar sagittal plane in AIS patients has yielded inconsistent results. Zhang et al showed that compared to normal adolescents, AIS patients had significantly larger LL angles, which may be related to the type of scoliosis in AIS patients 27 . In contrast, some studies have shown that the LL angles in AIS patients are similar to those in healthy adolescents and that LL angles within the normal range is also similar among different types of scoliosis 45 .…”

Section: Discussionmentioning

confidence: 99%

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Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

Zhang,

Pan,

et al. 2024

Sci Rep

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The correlation between scoliosis and sagittal curvature of the cervical, thoracic, and lumbar spine have already been reported in previous studies. However, as a part of the spine, the change in coccygeal morphology in AIS patients has not yet been studied. In this study, a retrospective analysis was performed on 400 patients who were divided into a non-scoliotic group (206 patients) and an AIS group (194 patients). The Postacchini coccygeal radiological classification that was modified by Nathan was used to observe and compare the sagittal coccygeal morphology between the two groups. The results showed that the non-scoliotic group had the highest percentage (52.4%) of patients with type I and the lowest (3.4%) proportion of patients with type V; moreover, the AIS group had the highest percentage (69.1%) of patients with type I and the lowest (1.5%) proportion of patients with type V. The coccygeal morphology was significantly different between the non-scoliotic group and the AIS group (P = 0.001). No significant differences in coccygeal morphology were found between the males and females in the two groups (mild and moderate scoliosis and different segmental scoliosis). In addition, a significant correlation between coccygeal morphology and scoliosis (P = 0.035) was found. In conclusion, coccygeal morphology significantly differs between AIS patients and non-scoliotic adolescents. There was a smaller proportion of patients with a type I coccyx and a larger proportion of patients with a type II or type III coccyx in the AIS group than in the non-scoliotic group. In other words, the presence of a more pronounced coccygeal curve in AIS patients may be caused by an incorrect sitting position and an imbalance in the contraction of the pelvic muscles. It should be further studied whether correcting the sitting position and muscular imbalances could change coccygeal morphology and subsequently affect the development of AIS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

Zhang,

Pan,

et al. 2024

Sci Rep

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“…Error in compensatory curve progression prediction could be reduced in future studies by implementing alternative stress sensitivity scaling optimization methods. Lastly, no reduction in kyphosis was observed during curve progression in the current FE models, where such reduction was observed in a patient cohort [ 57 ]. In future analysis, this unmatched trend may be addressed through either compensatory force application to represent any currently missing model scope, or through altering sagittal growth modulation characteristics.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth

2023

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Purpose This study describes the creation of patient-specific (PS) osteo-ligamentous finite element (FE) models of the spine, ribcage, and pelvis, simulation of up to three years of region-specific, stress-modulated growth, and validation of simulated curve progression with patient clinical angle measurements. Research Question: Does the inclusion of region-specific, stress-modulated vertebral growth, in addition to scaling based on age, weight, skeletal maturity, and spine flexibility allow for clinically accurate scoliotic curve progression prediction in patient-specific FE models of the spine, ribcage, and pelvis? Methods Frontal, lateral, and lateral bending X-Rays of five AIS patients were obtained for approximately three-year timespans. PS-FE models were generated by morphing a normative template FE model with landmark points obtained from patient X-rays at the initial X-ray timepoint. Vertebral growth behavior and response to stress, as well as model material properties were made patient-specific based on several prognostic factors. Spine curvature angles from the PS–FE models were compared to the corresponding X-ray measurements. Results Average FE model errors were 6.3 ± 4.6°, 12.2 ± 6.6°, 8.9 ± 7.7°, and 5.3 ± 3.4° for thoracic Cobb, lumbar Cobb, kyphosis, and lordosis angles, respectively. Average error in prediction of vertebral wedging at the apex and adjacent levels was 3.2 ± 2.2°. Vertebral column stress ranged from 0.11 MPa in tension to 0.79 MPa in compression. Conclusion Integration of region-specific stress-modulated growth, as well as adjustment of growth and material properties based on patient-specific data yielded clinically useful prediction accuracy while maintaining physiological stress magnitudes. This framework can be further developed for PS surgical simulation.

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“…The result con rms that the coccygeal morphology in AIS patients are changing, as the sagittal spine changed in AIS patients in previous studies. [20,21] It has been suggested that the sacrococcygeal joint could be strained caused by constant pressure on the coccyx with incorrect sitting posture . [22] Yuan et al found that there were differences in hip pressures between the right and left sides in AIS patients.…”

Section: Comparison Of Coccygeal Morphology Between Male and Female I...mentioning

confidence: 99%

Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

Zhang

Guo

et al. 2023

Preprint

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Objective To observe the coccygeal morphology in adolescent idiopathic scoliosis (AIS) and the differences among different types of scoliosis. Methods A retrospective analysis was performed on 268 patients who received full-length anteroposterior and lateral spine radiographs in the third affiliated hospital of Zhejiang Chinese Medical University from January 2018 to December 2022. They were divided into normal group with 135 cases and AIS group with 133 cases. Postacchini coccygeal radiological classification method modified by Nathan was used to observe and compare the sagittal plane coccygeal morphology in the two groups. The correlations between coccygeal morphology in sagittal plane and gender, scoliosis severity, scoliotic segments were analyzed too. Results There were the highest percentage (50.4%) of Type I and the lowest (5.2%) proportion of Type V in normal group and the highest percentage (33.1%) of Type I and the lowest (2.2%) proportion of Type V in AIS group. The difference in coccygeal morphology was significant between normal group and AIS group (P = 0.006). There were no significant differences in coccygeal morphology between mild and moderate scoliosis (P = 0.489), between male and female (P = 0.812 in normal group, P = 0.287 in AIS group), or among thoracic, thoracolumbar and lumbar scoliosis (P = 0.129). There was a significant correlation between coccygeal morphology and scoliosis (P = 0.049). Conclusions Coccygeal morphology in mild and moderate AIS patients is significantly different from that in normal adolescents. The proportion of coccygeal type I is significantly higher in normal children than in AIS patients, while the proportion of coccygeal type II and type III is significantly lower in normal children. There were some differences in coccygeal morphology between mild and moderate scoliosis, and among different segmental scoliosis, but they were not significant. There was a significant correlation between coccygeal morphology and scoliosis, but the correlations between coccygeal morphology and gender, scoliosis severity, scoliotic segments were non-significant.

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Analysis of sagittal curvature and its influencing factors in adolescent idiopathic scoliosis

Cited by 7 publications

References 24 publications

Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth

Imaging study of coccygeal morphology in adolescent idiopathic scoliosis

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