Abstract
ABSTRACT Objective To determine if there is a statistically significant difference in the flexibility of the curves in the adolescent idiopathic scoliosis (AIS) by using lateral inclination radiographs in supine or prone decubitus. Methods We evaluated 19 patients with AIS, waiting for surgery. Radiographs of the patients were performed in orthostatic anteroposterior incidences and right and left lateral inclinations in prone and supine decubitus. The comparison between prone and supine decubitus was performed through the flexibility rates of the curves measured in each position. Results The mean flexibility rates measured in lateral inclination radiographs with the patient in the supine position were 54.4% ± 38.8% in the proximal thoracic curve, 45.8% ± 15.6% in the main thoracic curve, and 80.5% ± 20.7% in the thoracolumbar / lumbar curve. When the lateral inclination radiographs were performed with the patient in the prone position, we observed mean flexibility rates of 66.4% ± 34.3% in the proximal thoracic curve, 50.1% ± 12.8% in the main thoracic curve, and 80.6% ± 19.0% in the thoracolumbar / lumbar curve. Conclusion This present study did not find a statistically significant difference between the flexibility rates of the curves in the prone and supine positions, suggesting that the two radiographic methods analyzed are similar in the evaluation of the flexibility of the curves in adolescent idiopathic scoliosis. Level of evidence II; Development of diagnostic criteria in consecutive patients (with “gold” reference standard applied).
Highlights
Defined as a three-dimensional spinal deformity,[1] scoliosis affects around 2-3% of children.[2]
The sample was composed of patients who were on a waiting list for surgical treatment of adolescent idiopathic scoliosis, treated and in follow-up at the outpatient spine clinic of the orthopedics and traumatology department of a tertiary hospital that serves the Unified Health System
The evaluation of radiographic aspects showed that all patients had a left proximal thoracic curve, a right main thoracic curve, and a left thoracolumbar/lumbar curve
Summary
Defined as a three-dimensional spinal deformity (involving the sagittal, transverse, and frontal planes),[1] scoliosis affects around 2-3% of children.[2] Its treatment is divided into non-surgical and surgical.[3,4] Observation, with serial imaging examinations is used in cases where the Cobb angle < 20°. In cases of patients with skeletal immaturity (Risser 0, 1, or 2) with curves between 20-40° the use of orthotics is recommended.[3,4,5] Surgical approach is another form of treatment. The indication and planning of surgical treatment involve a detailed analysis of the characteristics of the curves, especially of their magnitude and flexibility, in addition to coronal and sagittal balance.[6] Its classic indication involves cases of curves with Cobb angles > 40-45°.1,3-5
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