Abstract
BackgroundIn patients with structural idiopathic scoliosis the body asymmetries involve the pelvis and the lower limbs; they are included in many theories debating the pathogenesis of idiopathic scoliosis.MethodsHip joint range of motion was studied in 158 adolescent girls, aged 10–18 years (mean 14.2 ± 2.0) with structural idiopathic scoliosis of 20–83° of Cobb angle (mean 43.0° ± 14.5°) and compared to 57 controls, sex and age matched. Hip range of rotation was examined in prone position, the pelvis level controlled with an inclinometer; hip adduction was tested in five different positions.ResultsIn girls with structural scoliosis the symmetry of hip rotation was less frequent (p = 0.0047), the difference between left and right hip range of internal rotation was significantly higher (p = 0.0013), and the static rotational offset of the pelvis, calculated from the mid-points of rotation, revealed significantly greater (p = 0.0092) than in healthy controls. The detected asymmetries comprised no limitation of hip range of motion, but a transposition of the sector of motion, mainly towards internal rotation in one hip and external rotation in the opposite hip. The data failed to demonstrate the curve type, the Cobb angle, the angle of trunk rotation or the curve progression factor to be related to the hip joint asymmetrical range of motion.ConclusionNumerous asymmetries around the hip were detected, most of them were expressed equally in scoliotics and in controls. Pathogenic implications concern producing a "torsional offset" of muscles patterns of activation around the spine in adolescent girls with structural idiopathic scoliosis during gait.
Highlights
In patients with structural idiopathic scoliosis the body asymmetries involve the pelvis and the lower limbs; they are included in many theories debating the pathogenesis of idiopathic scoliosis
We found a significant asymmetry in the internal/external rotation between both hips, which might be the origin of the asymmetry of the "dinner plate mechanism"
Does the "dinner plate" turns asymmetrically? Our study demonstrated a significantly higher static rotational offset of the pelvis in adolescent girls with idiopathic scoliosis comparing to age matched controls
Summary
In patients with structural idiopathic scoliosis the body asymmetries involve the pelvis and the lower limbs; they are included in many theories debating the pathogenesis of idiopathic scoliosis. Pathogenesis of idiopathic scoliosis Idiopathic scoliosis (IS) is a three-dimensional deformity, which concerns the vertebral column, but the whole trunk, including the pelvis [1]. Hypothesis of a failure of control of cyclical rotations in the spine during gait ("dinner plate – flagpole mechanism") was formulated in this theory: the rotation-inducing system ("dinner plate") comprises "gait, femoral anteversion and the pelvis" [6], while the rotation-defending system ("flagpole") involves the rib cage and discs. The failure of rotation control of the spine "develops principally during gait due to asymmetrical forces resulting from rib-vertebra angle asymmetry" [6]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have