Factors affecting curve flexibility in skeletally immature and mature idiopathic scoliosis

Chen, Ziqiang; Zhao, Yongfei; Bai, Yushu; Liu, Ka Po Gabriel; He, Shisheng; Wang, Chuanfeng; Zhang, Jingtao; Li, Ming

doi:10.1007/s00776-011-0034-6

Cited by 20 publications

(11 citation statements)

References 14 publications

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“…This relationship was not significant in the thoracolumbar region. Our finding is consistent with studies showing thoracic curves are less flexible than thoracolumbar curves in skeletally immature patients [25]. We believe the flexibility mechanisms are different in the thoracic and thoracolumbar curves due to the constraints of the associated rib cage in the thoracic spine and our findings support this theory.…”

Section: Discussionsupporting

confidence: 93%

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

2013

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BackgroundCobb measurement of standing radiographs is the standard for clinical assessment of coronal spinal deformity. Angle of trunk inclination (ATI) is an accepted clinical measurement of trunk asymmetry, and has variable reported correlations with Cobb angles. Transverse plane spine deformity is most accurately measured using axial computed tomography. Aaro and Dahlbourn’s technique for quantifying apical vertebral rotation with respect to the sagittal plane (RAsag) is commonly reported in the literature. To our knowledge no study has correlated ATI with RAsag. The purpose of this study was to determine the relationship between commonly used measures of trunk and spine deformity.MethodsSixteen females that underwent preoperative apical vertebra(e) CT scans were retrospectively studied. Thoracic and thoracolumbar RAsag measurements were date-matched to clinically obtained ATI and Cobb measurements. Two-tailed Pearson correlations were calculated; α = 0.01.ResultsMedian patient age was 14.6 years (11–19); BMI 19.4 (16.0-25.5). Curve patterns: Lenke 1 (5); 2 (5); 3 (1); 4 (1); 5 (2): 6 (2). Twenty-six curves (15T; 11TL) with complete, date-matched data points were analyzed. In thoracic curves, ATI correlated with Cobb (r = 0.711, P < 0.004) and RAsag (r = 0.730, P <0.003). ATI was inversely correlated with Cobb flexibility (r = −0.647, P < 0.01). In thoracolumbar curves, ATI correlated with Cobb (r = 0.789, P < 0.005), and RAsag (r = 0.771, P < 0.006) but not Cobb flexibility (r = −0.452, P = 0.190).ConclusionsTrunk and spine thoracic and thoracolumbar transverse plane deformity are correlated, as are trunk transverse plane and spine coronal plane deformity. Increasing trunk deformity limits thoracic, but not thoracolumbar spine flexibility.

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Section: Discussionsupporting

confidence: 93%

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

2013

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“…The secondary gains are correction of the curve as safe as possible, balancing the trunk decompensation (if present), rib hump elimination and shoulders leveling; while fusing as few vertebrae as possible. In acquiring these goals, numerous factors including surgical technique, type of the instrumentation and deformity, maturity, sex, Cobb angle, location and flexibility of the curve should be taken into account (5, 9-11). …”

Section: Discussionmentioning

confidence: 99%

Generalized Ligamentous Laxity; a Parameter Should not to be Forgotten in Preoperative Planning of Adolescent Idiopathic Scoliosis

Ghayem-Hasankhani¹,

Omidi-Kashani²

2012

Iran Red Crescent Med J

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BackgroundMany factors effect on management (surgical and nonsurgical) of adolescent idiopathic scoliosis (AIS).ObjectivesThe purpose of this study was evaluation of the effects of generalized ligamentous laxity (GLL) on surgical treatment of AIS.Materials and Methods72 patients with AIS were studied between 2002 and 2009. 24 cases (33.4%) were placed in group A (normal) while 48 patients (66.6%) with GLL in group B. Our threshold for adding anterior approach was a curve which could not be corrected to < 50° on the supine lateral bending view.ResultsThe mean age and follow up period were 16.4 (12-22 years) and 3.8 (2-6.5 years), respectively. In the first group, 12 (50%) were operated with combined anterior and posterior approaches while in the later; there were only 6 (12.5%). Curve correction was 73.3% in patients with GLL and 57.1% in patients without it. Both of these differences were significant statistically (P = 0.001).ConclusionsIn preoperative planning of surgical treatment of AIS, GLL is an important factor. In this special group of patients due to much more flexibility, relatively larger scoliotic curves can be safely treated by single posterior approach.

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“…Studies have found that flexibility is closely associated with the Cobb angle and age in AIS patients. 7 – 9 Fulcrum bending films have been shown to be superior in predicting the postoperative Cobb angle and CR, which are also 2 of the key factors in determining the surgical strategies for thoracic curve patients. 16 – 18 Recently, it has been demonstrated that fulcrum bending films have a similar predictive effect in patients with lumbar and superior thoracic curves.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Males usually present with older age and less flexibility, 7 , 8 and sex might not have as much influence on flexibility as age and the Cobb angle. 9 In addition, bracing, which has been shown to be notably effective as a conservative treatment, 10 , 11 was found to be less effective in males compared with female patients. 12 However, few studies have focused on the surgical outcomes of AIS patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Radiographic Postoperative Outcomes Between Males and Females With AIS

Wang

Zhou

et al. 2015

Medicine

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The primary aim was to compare postoperative radiographic outcomes between sexes among adolescent idiopathic scoliosis (AIS) patients. A total of 162 AIS patients (42 males and 120 females) undergoing pedicle screw instrumentation and posterior fusion were included. Coronal and sagittal curves and flexibilities were measured and calculated. The postoperative correction rate (CR), fulcrum bending correction index (FBCI), and Cincinnati correction index were evaluated to compare the surgical benefits between sexes.Males were older (16.79 vs 14.79 years, respectively; P < 0.01) and had stiffer curves than females (lateral bending flexibility percentage: 47.77 vs 52.57, respectively, P = 0.21; traction flexibility percentage: 35.48 vs 36.98, respectively, P = 0.98; fulcrum bending flexibility percentage: 56.13 vs 66.57, respectively, P < 0.05). Males and females exhibited similar Lenke classification schemes (P = 0.72), but had different Risser signs (P < 0.01). Although males had greater postoperative curves (20.81° vs 16.83°, respectively; P = 0.009), no obvious differences in the CRs were noted between males and females (FBCI: 145.20% vs 108.37%, respectively; P = 0.92). Smaller preoperative lumbar lordosis was noted in males than in females (40.05° vs 45.72°, respectively; P = 0.03), yet no statistically significant differences in the preoperative and postoperative sagittal curves were observed between the sexes. In conclusion, considering the preoperative flexibilities, the 2 sexes achieved comparable surgical benefits without sacrificing the sagittal balance.

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Factors affecting curve flexibility in skeletally immature and mature idiopathic scoliosis

Cited by 20 publications

References 14 publications

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

Generalized Ligamentous Laxity; a Parameter Should not to be Forgotten in Preoperative Planning of Adolescent Idiopathic Scoliosis

Comparison of Radiographic Postoperative Outcomes Between Males and Females With AIS

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