Comparison of Cobb Angle Measurement in Scoliosis by Residents and Spine Experts

Ritter, Rafael; Nagasse, Yoshinobu; Ribeiro, Iberê; Yamazato, Clóvis; Oliveira, Fábio Mastromauro de; Kusabara, René

doi:10.1590/s1808-185120161501147274

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…Scoliosis severity was assessed by degree of scoliosis curve as reported by the surgeon in their preoperative note. We would like to point out that the Cobbs' angle reading by radiography lacks accuracy due to subjective reading variations (Ritter et al, 2016). Questionnaires were administered as described in the 'follow-up' section below.…”

Section: Preoperativementioning

confidence: 99%

Predicting the pain continuum after adolescent idiopathic scoliosis surgery: A prospective cohort study

Chidambaran

Ding

Moore

et al. 2017

European Journal of Pain

136

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Background Chronic postsurgical pain (CPSP) affects half a million children annually in the United States, with dire socioeconomic consequences, including long-term disability into adulthood. The few studies of CPSP in children are limited by sample size, follow-up duration, non-homogeneity of surgical procedure and factors evaluated. Methods In a prospective study of 144 adolescents undergoing a single major surgery (spine fusion), we evaluated demographic, perioperative, surgical and psychosocial factors as predictors of a continuum of postsurgical pain: immediate, pain maintenance at 2–3 months (chronic pain/CP) and persistence of pain a year (persistent pain/PP) after surgery. Results We found an incidence of 37.8% and 41.8% for CP and PP. CP and acute pain were both significant predictors for developing PP (p-value <0.001 and 0.003). Preoperative pain and higher postoperative opioid requirement was significantly associated with CP (p = 0.015, p = 0.002), while Childhood Anxiety Sensitivity Index (p = 0.002) and surgical duration (p = 0.014) predicted PP. The final regression models had reasonable predictive accuracy (c-statistic of 0.73 and 0.83 for CP and PP, respectively). Anxiety scores and catastrophizing for child and parent were found to be significantly correlated (p = 0.005, p = 0.013 respectively). Pain trajectories revealed that 65% of patients who developed PP reported CP and high pain trends; however, 33% of those who developed PP could not be identified using solely pain criteria. Conclusion Persistent postsurgical pain in children is a significant problem. It can be predicted in part by combinations of psychological and clinical variables, which may provide evidence-based measures to prevent development of CPSP in the future. Significance In a homogeneous cohort of adolescents undergoing spine fusion, we report a high incidence of persistent postsurgical pain (41.8%) predicted by child anxiety, perioperative pain, and surgical duration. Our results stress timely preventive and therapeutic strategies.

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Section: Preoperativementioning

confidence: 99%

Predicting the pain continuum after adolescent idiopathic scoliosis surgery: A prospective cohort study

Chidambaran

Ding

Moore

et al. 2017

European Journal of Pain

136

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“…Disparities may occur because the measuring practitioner chooses the lines of delineation–those of the most tilted vertebrae–which is subjective [ 53 ]. Sometimes there can be difficulty in determining these end plates due to poor quality x-ray [ 54 ].…”

Section: Pattern-specific Scoliosis Rehabilitation (Pssr)mentioning

confidence: 99%

Cobb Angle Reduction in a Nearly Skeletally Mature Adolescent (Risser 4) After Pattern-Specific Scoliosis Rehabilitation (PSSR)

Moramarco¹,

Moramarco²,

Fadzan³

2017

TOORTHJ

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Introduction:It has long been said that exercise-based rehabilitation for scoliosis is ineffective, however, these reports studied general exercises. This case report is a prospective one-year follow-up of a nearly skeletally mature adolescent female (Risser 4) with idiopathic scoliosis treated with Pattern-Specific-Scoliosis Rehabilitation (PSSR).Methods:The 15-year old patient recommended for surgery (initial Cobb angle of 45°) completed a 16-hour scoliosis-specific back school (according to Schroth Best Practice®), over the course of five weeks. She continued with her program at home, and followed up with the lead author after 6 months and 1 year.Results:The patient achieved a 13° reduction in her primary thoracic Cobb angle. Postural improvement and reduction in trunk rotation (ATR) was also achieved (-4° in the thoracic spine, and -5° in the lumbar spine).Conclusion:Pattern-specific scoliosis rehabilitation (PSSR) works to reduce the asymmetrical load caused by scoliosis. PSSR is effective in stabilizing Cobb angle, and can, in some cases, reduce Cobb angle in adolescents. Patients recommended for surgery may be candidates for conservative treatment. This case suggests that the practice of discontinuing conservative treatment at Risser stage 4 should be re-evaluated.

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“…That demonstrated difficulties in the method, which cannot even be overcome by expertise. 46 It is well known that multiple X-ray examinations pose a risk of adverse outcomes and are not quite safe. Thus, it is advised to limit the number of radiological evaluations.…”

Section: Discussionmentioning

confidence: 99%

The SpinalMeter biometrical assessment to improve posture diagnosis in school-age girls: a validation study

Kamelska-Sadowska

Protasiewicz-Fałdowska

Zaborowska-Sapeta

et al. 2020

Pol. Ann. Med.

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Introduction: Assessing spinal deformities using an X-ray radiation is the method of choice for posture diagnosis. It is also used for the evaluation of the degree of correction, brace fit, and spinal balance as well as for further management decisions. However, multiple X-ray exposures during control visits could be too burdensome for children. Aim: The aim of this study was to investigate the precision and repeatability of measurement of the variables obtained by a fast, simple postural evaluation in children by the SpinalMeter. Material and methods: The measurements of the angle of trunk rotation (ATR) and SpinalMeter posture assessments were performed 8 to 10 times in a short period of time (6 s). The overall of 300 photos (SpinalMeter) and 1020 measurements (asymmetry, distance between anthropometric points as well as ATR) were obtained from 6 girls (8–15 years old). The validation study comprised of the repeatability, interclass correlation coefficient (Qw) and relative standard deviation (rSD) measurements. Results and discussion: The measurements of the distance between acromion–popliteal fossa, acromion–iliac crest, and acromion–posterior superior iliac spine obtained by SpinalMeter were clearly repeatable (Qw > 0.9). The scapular and pelvic asymmetry in standing and sitting positions were highly repeatable and had low rSD (e.g. for scapular asymmetry 5.6%–80.3%; Qw > 0.8). Conclusions: The precise and reliable postural biometrical measurements were performed by SpinalMeter in the case of the distance between anthropometric points and asymmetry of pelvis and scapula. These measurements could be useful in the assessment of girl’s posture when visiting the pediatrician.

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Comparison of Cobb Angle Measurement in Scoliosis by Residents and Spine Experts

Cited by 9 publications

References 15 publications

Predicting the pain continuum after adolescent idiopathic scoliosis surgery: A prospective cohort study

Predicting the pain continuum after adolescent idiopathic scoliosis surgery: A prospective cohort study

Cobb Angle Reduction in a Nearly Skeletally Mature Adolescent (Risser 4) After Pattern-Specific Scoliosis Rehabilitation (PSSR)

The SpinalMeter biometrical assessment to improve posture diagnosis in school-age girls: a validation study

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