The importance of the size of the trunk inclination angle in the early detection of scoliosis in children

Kluszczyński, Marek; Pilis, Anna; Czaprowski, Dariusz

doi:10.1186/s12891-021-04965-4

Cited by 10 publications

(12 citation statements)

References 37 publications

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“…When analysing the differences in the morphology of scoliosis curvatures in relation to the location in the study, it should be emphasized that low-rotated curvatures were significantly more frequent in the lumbar and thoracolumbar sections, which is consistent with the data in the literature [ 2 , 10 , 24 ]. Scoliosis of the first degree (10°-24° Cobb) located in the lumbar region, which develops in the type of low-rotated curvature, may be clinically manifested only by asymmetry of the waist angles, with slight ATI, while an X-ray often shows a significant Cobba ≥ 10 ° angle.…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, other authors found that the ATI/Cobb correlation in 6–9 year old children with scoliosis in the lumbar region is not high [ 4 , 8 , 9 ]. It should be emphasized that the abovementioned morphological types of curvature may be characteristic of all curvatures of scoliosis [ 24 , 29 ] or, what happens much more often, different types refer to its fragment, e.g., low rotation in the lumbar spine and medium or vice versa in the thoracic spine [ 5 , 24 ]. Moreover, with growth and/or progression, the type of low-rotated curvature can change into medium or even high-rotated curvature [ 29 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Scoliosis/curvature highly rotated was very rare in our study (1.3%). It is usually characterized by low progression dynamics [ 10 , 24 , 26 ], and in screening tests, it is responsible for some of the misdiagnosed scoliosis [ 10 ]. There was no significant correlation between the occurrence of this type of curvature in relation to age groups and the location of the curvature.…”

Section: Discussionmentioning

confidence: 99%

“…The structure and support-dynamic function of the pelvis and lower limbs also have an impact on the ATI value in the Adams test [19][20][21][22][23]. The three-dimensional spine in scoliosis is an extremely variable structure individually and difficult to assess through the ATI/Cobb correlation [24]. The subject of the study was the morphological differences in scoliosis curvature resulting from the correlation of the ATI in the clinical examination with the Cobb angle and AVR found on X-ray in relation to the child's age and the location of the curvature [17,24].…”

Section: Discussionmentioning

confidence: 99%

“…The high diagnostic value of the Adams test is confirmed by many publications [1,2,[4][5][6]; however, researchers emphasize that the predictive value of the test is proportional to the degree of curvature [2,9,10]; moreover, it depends on the age of the child, [2,6,9,24] of the spine in which the curvature begins, [24,25] as well as the flexibility of the spine [15,16] and from the investigator's experience [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

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Morphological differences in scoliosis curvatures as a cause of difficulties in its early detection based on angle of trunk inclination

Kluszczyński

Mosler

Wąsik

2022

BMC Musculoskelet Disord

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Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. Materials and methods The group consisted of 229 children who were first examined, aged 6 to 17 years, with an average age of -11.57 years (SD ± 3.26), with symptoms of idiopathic scoliosis. The correlation of the criteria for the diagnosis of scoliosis in the ATI 7° clinical trial with a Cobb angle of 10° three dimensional in the X-ray image was used to distinguish three types of curvature/scoliosis, i.e., low, medium and high rotation. The frequencies of each type were compiled for three age groups and three scoliosis locations. Moreover, the degree of vertebral rotation according to the Perdriolli (AVR) of curvature was correlated with the Cobb angle and ATI. A one-way logistic regression model was used to assess the effectiveness of scoliosis detection in children based on the measurement of the ATI angle alone and the measurement of both ATI and Cobb angles. Results Low-rotated curves were most often found in the age groups of 6–9 and 10–12 years in 65.6% and 71.4% of patients, respectively (p < 0.05). Medium-rotated curvatures were most common in the age group of 13–17 years – 51.6%. With regard to the localization of scoliosis, the low-rotated curvatures were significantly more frequently (p < 0.05) found in the lumbar and thoracolumbar spine. Moreover, the univariate regression model for ATI showed that we could detect scoliosis best by taking the cut-off point of 5° and the mathematically determined Cobb angle was 9.5°. Patients with ATI ≥ 7° had significantly higher AVR values than those with ATI < 7°, and the ATI/AVR correlation was of average strength. Conclusion The specific morphology of the scoliotic curvature of the child’s spine may be manifested by the difference in the ATI/Cobb correlation depending on the location of the scoliosis and change with age. The curvatures of the scoliosis that form can be low, medium and high-rotated, and the low-rotated curvatures were most often found in the 6-9- and 10-12-year-old groups and in the lumbar and thoracolumbar section. To increase the rate of early diagnosis of scoliosis, the results suggest the need to adopt two ATI criteria for the diagnosis of scoliosis at screening, 5° for age of 6–12 years, and when asymmetry affects the lumbar and thoracolumbar section, and 7° for the remaining children.

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Section: Discussionsupporting

confidence: 89%