Changing Curve Pattern in Infantile Idiopathic Scoliosis

Lw, van Rhijn; Ej, Jansen; Cm, Plasmans; Be, Veraart

doi:10.1097/00007632-200108150-00021

Cited by 10 publications

(11 citation statements)

References 7 publications

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“…As reported by van Rhijn et al [12,13], curve pattern in some scoliosis patients changed during bracing. However, these authors measured the changes in a small group of 50 patients using the King classification system, which is generally applied for the decision of the fusion surgery.…”

Section: Introductionmentioning

confidence: 57%

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

et al. 2012

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Summary of background data The curve pattern of idiopathic scoliosis is important for making decisions concerning bracing. However, whether the curve pattern changes during brace treatment have not been fully documented. The aim of this study was to investigate the changes of curve pattern during brace treatment in skeletally immature patients with adolescent idiopathic scoliosis (AIS). MethodsFrom January 2002 to January 2011, AIS patients treated with a Boston or Milwaukee brace were recruited after meeting the following inclusion criteria: older than 10 years of age at initiation of bracing; having a Cobb angle of 25°-40°; with a Risser sign 0-2; being regularly followed until the weaning of brace or the necessity of surgical treatment; and without history of previous treatment. A total of 130 female and 11 male AIS patients were included. The mean age was 12.9 years at initiation of bracing, and the female patients were, on average, 2.7 months past menarche. The mean follow-up period was 2.6 years (range 1.0-5.5 years). The definitions of changes in curve patterns were divided into four categories as follows: (1) shift of the apex of the main curve; (2) change in the curve span of more than two vertebrae; (3) change in the main curve type with regard to the apex location; and (4) change of curve direction. The patients were divided into two groups. Group A was comprised of patients who had experienced one or more categories of curve pattern changes, and Group B was comprised of those who had not. Results Of these 39 patients, 14 had apex shifting, 2 underwent curve span changes, 22 experienced changes in the main curve type, and one female had both changes in the apex and curve span. At the initiation of bracing, patients in Group A demonstrated significantly lower menarchal status (P = 0.018) and lower Risser grade (P = 0.025) than those in Group B. The difference in the percentage of patients who underwent Boston bracing between the two groups was statistically significant (41.5 % for Group A vs. 24.0 % for Group B, P = 0.023). Conclusion Changes in curve pattern can occur during brace treatment. Patients with less skeletal maturity and those treated with a Boston brace are more susceptible to this phenomenon.

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Section: Introductionmentioning

confidence: 57%

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

et al. 2012

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“…The mother appears to have been an obligate carrier, because her daughter had AIS as well. While one set of twins in a study hardly constitutes strong evidence regarding concordance/discordance, their monozygotic status has been confirmed by molecular markers, and so this pair can be added to the other twin pairs in the literature that have been studied for AIS [Wynne‐Davies, 1968; Carr, 1990; Machin, 1996; Kesling and Reinker, 1997; Inoue et al, 1998; van Rhijn et al, 2001a,b; Fraga et al, 2005; Petronis, 2006; Andersen et al, 2007]. Using twin concordance to estimate heritability is never a straightforward method, especially in midline and developmental disorders, because of the mechanisms and associations underlying the monozygotic twinning process [Machin, 1996].…”

Section: Resultsmentioning

confidence: 99%

“…Using twin concordance to estimate heritability is never a straightforward method, especially in midline and developmental disorders, because of the mechanisms and associations underlying the monozygotic twinning process [Machin, 1996]. With enough power, however, studies of monozygous twins may be illustrative of the impact of epigenetic drift and environmental factors in the variable expression of AIS curve type and severity, as in many polygenic, multifactorial disorders [Wynne‐Davies, 1968; Carr, 1990; Machin, 1996; Kesling and Reinker, 1997; Inoue et al, 1998; van Rhijn et al, 2001a,b; Fraga et al, 2005; Petronis, 2006; Andersen et al, 2007].…”

Section: Resultsmentioning

confidence: 99%

“…Early clinical observations and population studies have documented a higher prevalence of scoliosis among relatives of affected individuals than in the general population [Wynne‐Davies, 1968; Riseborough and Wynne‐Davies, 1973; Kostuik, 1990]. Twin studies consistently show monozygous twins have a higher concordance rate for idiopathic scoliosis than dizygous twins [Wynne‐Davies, 1968; Carr, 1990; Machin, 1996; Kesling and Reinker, 1997; Inoue et al, 1998; van Rhijn et al, 2001a,b; Fraga et al, 2005; Petronis, 2006; Andersen et al, 2007].…”

Section: Introductionmentioning

confidence: 99%

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Polygenic inheritance of adolescent idiopathic scoliosis: A study of extended families in Utah

Ward¹,

Ogilvie²,

Argyle³

et al. 2010

American J of Med Genetics Pt A

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A heritability study of 69 extended Utah families with a history of adolescent idiopathic scoliosis (AIS) indicates that AIS is a polygenic, multifactorial condition. Each family reported a history of AIS within four generations; a total of 247 individuals were confirmed via X-rays and medical records to have AIS. Coefficient of kinship was more than 25 standard deviations higher for these 69 families than for the general population. Excluding all probands and assuming autosomal dominant inheritance, 1,260 individuals over the age of 16 were determined to be at risk for AIS because they have a parent with AIS. Assuming 50% of these individuals carry the allele, estimated penetrance in at-risk males is approximately 9%, and estimated penetrance in at-risk females is approximately 29%. Recurrence risk in relatives decreases as the degree of relationship to the affected individual becomes more distant; however, the lowest recurrence risk calculated, for third-degree relatives, is still an average of 9%, well above the general population's risk. Onset of AIS appears to be inherited separate from curve pattern and severity. In a study of phenotypes in 36 of the families, the affected individuals were consistent in either curve severity or curve pattern, but not both. It is unclear whether severity or pattern is more heritable, but it is possible that the location of the curve on the spine is the most heritable trait of the phenotype. The study demonstrates the genetic complexity of AIS, including the low penetrance of its cumulative alleles and variable expression.

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“…A escoliose idiopática, em trabalhos realizados visando encontrar sua etiologia, demonstrou-se fortemente influenciada por fatores genéticos, devido a sua característica peculiar de acometer vários membros de determinadas famílias 1,2,7 . Outros autores, como Carr 8 e Fisher e De George 5 , propuseram que a influência dos aspectos ambientais era capaz de modificar as características e a gravidade da deformidade em gêmeos monozigóticos.…”

Section: Discussionunclassified

Variações na apresentação fenotípica da escoliose idiopática do adolescente

et al. 2010

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OBJETIVO: discutir quais elementos, de acordo com a literatura, são responsáveis pela discordância fenotípica em gêmeos monozigóticos. MÉTODOS: foram levantados os dados ambulatoriais de um par de gêmeas monozigóticas, que incluíram: idade no momento do diagnóstico, tipo de curva, ângulo de Cobb da deformidade na consulta inicial, início do tratamento e último acompanhamento, ápice da curva e ângulo de Cobb aferido nas imagens radiográficas em perfil. RESULTADOS: criança I: curva principal lombar à esquerda, com ângulo de Cobb entre T11-L4 de 17°, e curva torácica direita entre T5-T11 de 14°. Os ápices encontravam-se no disco L1-L2 e na vértebra T8, respectivamente. Um ano depois, se detectou progressão significativa da deformidade, com a curva lombar evoluindo para 24° (T11-L4) e a curva torácica para 23° (T5-T11). Criança II: curva toracolombar de pequena magnitude à direita, com ângulo de Cobb entre T9 e L3 de 18°. O ápice situava-se na vértebra de T12. Um ano depois, observou-se aumento da curva, com o ângulo de Cobb progredindo para 40°. CONCLUSÃO: não obstante a evidência da origem genética para o desenvolvimento da escoliose, admite-se a influência de outros fatores para sua manifestação e progressão. Na literatura, encontram-se algumas explicações para o desenvolvimento da doença, referentes à deficiência de tecidos estruturais encontrada em síndromes e condições específicas, crescimento assimétrico dos membros e tronco, alterações da configuração sagital da coluna vertebral e fatores ligados à natureza, como alimentação.

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Changing Curve Pattern in Infantile Idiopathic Scoliosis

Abstract: This report of idiopathic scoliosis in a father and six children supports the present theories on a genetic origin of the disorder but also stresses the importance of dynamic processes in the development of scoliosis.

Cited by 10 publications

References 7 publications

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

Evolution of the curve patterns during brace treatment for adolescent idiopathic scoliosis

Polygenic inheritance of adolescent idiopathic scoliosis: A study of extended families in Utah

Variações na apresentação fenotípica da escoliose idiopática do adolescente

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