Concave Side Research Articles

Experimental study of CLT panels under combined out-of-plane bending and compression

Combined out-of-plane bending and compression is an inevitable loading condition for cross-laminated timber (CLT) walls due to the out of plumbness, initial panel curvature and load eccentricity. Because of the weaker cross layers, the mechanical performance and failure mode of the CLT panels under such loading significantly differ from those of the other wood members, such as sawn timber and glulam. This experimental study focuses on investigating the behavior of CLT panels under the stated loading scenario. The experimental program consisted of 36 specimens, including 12 five-layer CLT panels provided by two Canadian manufacturers, as well as 12 three-layer and 12 five-layer CLT panels provided by a Chinese manufacturer. All the specimens were tested in Canada and China, respectively, using the same test setup. It was found that in the majority of the specimens, the damage was caused by the local buckling near the mid-height of the outer layer on the concave compression side at about 45%–60% of the ultimate failure load and 25%–35% of the ultimate deflection. The dominant failure mode was characterized as the crushing yield of the outer layer on the concave side (fibers in compression) near the mid-height after the local buckling progressed. Signs of shear failure of cross layers were evident almost simultaneously with the outer layer failure. Hence, although the dominant failure mode was likely triggered by the fracture in the cross layers due to rolling shear, the load-carrying capacity of the CLT panels under the combined out-of-plane bending and compression is governed by the compression failure of the longitudinal outer layers. It was found that a cross-layered panel can maintain its integrity before failure. It was also noted that the interaction equations specified in the Canadian design standard are appropriate for the CLT panels under small load eccentricity, while for panels that have large load eccentricity, the appropriateness of the interaction equation is questionable. Based on the test results obtained, the validity of the interaction equation for the prediction of the load-carrying capacity of CLT columns, specified in the CSA O86-19, is confirmed for cases in which Pf/Pr>0.5 and Mf/Mr<0.3. For the cases of Pf/Pr<0.5 and Mf/Mr>0.3, modification of the equation is needed.

DFT investigation of Li storage behavior of sceamless α-graphyne and β-graphyne nanotubes

Graphynes have great potential -as anode materials for lithium-ion batteries (LIBs) owing to their advanced structural and electronic properties. Previously, the curvature of γ-graphyne folded into nanotubes (γGyNTs) caused a significant increase in its Li storage capacity and diffusion ability. Here, using density functional theory (DFT) calculations, we report the same curvature effect in α- and β-graphyne nanotubes (αGyNTs and βGyNTs), whose maximum storage capacities are predicted to be -up to 3488 and 3070 mAh/g, respectively, similar to that of pure Li (3861 mAh/g). Such high capacities are attributed to the graphyne nanotubes having larger specific surface areas and pores than those of other carbon materials. Additionally, climbing -image- nudged-elastic- band calculations reveal that Li atoms can diffuse almost freely through acetylenic rings on the concave side of the αGyNTs, indicating an excellent charge -discharge rate ascribed to weaker adsorption on the 18-membered ring than that on the 12-membered rings of the βGyNTs and γGyNTs. Our results suggest that the αGyNTs are promising as the anode material for LIBs with exceptional overall performance. This study also provides a strategy to design anode materials based on their curvature and topological morphology.

Is posteromedial translation with sublaminar bands effective in correcting axial rotation in adolescent idiopathic scoliosis surgery? A 3D reconstruction study.

Hybrid constructs with sublaminar bands have recently regained popularity as an alternative to all-screw construct for correction of adolescent idiopathic scoliosis (AIS). The aim of this study is to evaluate the ability of hybrid constructs with sublaminar bands to achieve a tridimensional correction of the scoliotic deformity. Our hypothesis is that hybrid construct with sublaminar bands are able to achieve a substantial derotation of the apical vertebrae, while preserving the thoracic kyphosis. A prospective evaluation of 50 consecutive cases (41 F, 9M, mean age 14.7 ± 2years) of AIS correction with hybrid construct was performed. In all cases, sublaminar bands were used at the apex of the main curve on concave side. All patients underwent pre and postoperative X-rays with EOS System, with full 3D reconstruction. Spinopelvic parameters and axial rotation of the vertebrae were measured pre and postoperatively. 2.7 ± 0.9 mean sublaminar bands were used per patient. Mean correction of deformity was 50 ± 9.5%. on the coronal plane. The mean axial rotation of the apical vertebra went from 18° ± 11.5° preoperatively to 9.4° ± 7.2° postoperatively (p < 0.001) with a mean derotation of 47.7%. Thoracic kyphosis went from 32.1° ± 18° preoperatively to 37.3° ± 13.1° postoperatively (p < 0.05). No intraoperative complications due to sublaminar bands were recorded. Hybrid construct with sublaminar band have been showed to be safe and effective in deformity correction and in maintaining or restoring thoracic kyphosis. This study showed that with sublaminar bands applied at the curve apex a substantial derotation of the apical vertebrae can be achieved.

Crystal structure of a heterotrimetallic 12-metallacrown-4 with 2-propylvalerate anion bridges

The synthesis and single-crystal X-ray structure for tetraaquatetrakis(μ-2-propylvalerato)tetrakis(μ4-salicylhydroximato)dysprosiumtetramanganesesodium dimethylformamide tetrasolvate, [DyMn4Na(C7H4NO3)4(C8H15O2)4(H2O)4]·4C3H7NO or DyNa(2-PV)4[12-MCMnIII Nshi-4](H2O)4·4DMF, 1, where MC is metallacrown, shi3− is salicylhydroximate, 2-PV is 2-propylvalerate, and DMF is N,N-dimethylformamide, is reported. The slightly domed metallamacrocycle contains four ring MnIII ions and four shi3− ligands that generate an [MnIII—N—O] repeat unit that recurs four times. The ring MnIII ions are five-coordinate with a square-pyramidal shape. Furthermore, the metallacrown binds both a DyIII ion and a Na+ ion in the central cavity. The central ions are located on opposite faces of the cavity with the DyIII ion located on the convex side of the MC and the Na+ ion located on the concave side. Each central ion is eight-coordinate although they possess different geometries. The DyIII ion has a square-antiprismatic shape, while the Na+ ion has an extremely distorted biaugmented trigonal–prismatic shape. The four 2-propylvalerate anions help to tether the DyIII to the MC cavity by forming bridges between the DyIII ion and each ring MnIII ion. Moreover, the interstitial DMF molecules are hydrogen bonded to the water molecules that complete the coordination environment of the Na+ ion. The metallacrown framework (excluding the DyIII and Na+ ions), the bridging 2-propylvalerate, and the interstitial DMF molecule experience whole-molecule disorder due to the rotational orientation of the metallamacrocycle. Additionally, the main moiety alkyl chain of the 2-propylvalerate is disordered over two additional orientations, and the main moiety interstitial DMF molecule is disordered over one additional orientation. The main moiety of the metallacrown framework refined to 0.9030 (14), while the minor B-moiety refined to 0.0971 (14). The main moiety alkyl chain of the 2-propylvalerate refined to 0.287 (3): 0.309 (3): 0.307 (3), and the minor B-moiety alkyl chain refined to 0.0971 (14). Lastly, the main moiety interstitial DMF refined to 0.549 (3): 0.354 (3), and the minor B-moiety DMF refined to 0.0971 (14).

Surface electromyography study on asymmetry in paravertebral muscle degeneration in patients with degenerative lumbar scoliosis

The asymmetry of paravertebral muscle (PVM) degeneration in degenerative lumbar scoliosis (DLS) patients has been extensively studied by imaging and histological examination and has not yet been verified by surface electromyography (sEMG) techniques. To study the relationship between the surface electromyography (sEMG) and degenerative characteristics of paravertebral muscles (PVMs) in patients with degenerative lumbar scoliosis (DLS). In twenty DLS patients and fifteen healthy subjects, sEMG activity of the PVMs at the level of the upper end vertebra (UEV), apical vertebra (AV) and lower end vertebra (LEV) was measured during static standing and dynamic standing forward flexion and backward extension tasks. Action segmentation was achieved according to inertial measurement unit (IMU) data. The sEMG characteristics of the PVMs on the convex and concave sides were compared, and the relationship of these data with the Cobb angle and lumbar lordotic angle (LL) was analyzed. In the DLS group, there was no difference in sEMG activity between the convex and concave sides at the UEV or AV level, but in the motion and return phases of the standing forward flexion task (P = 0.000, P = 0.015) and the maintenance and return phases of the standing backward extension task (P = 0.001, P = 0.01), there was a significant difference in sEMG activity between the convex and concave sides at the LEV level. Asymmetrical sEMG activity at the LEV level was negatively correlated with the Cobb angle (F = 93.791, P < 0.001) and LL angle (F = 65.564, P < 0.001). In the DLS group, asymmetrical sEMG activity of the PVMs appeared at the LEV level, with the concave side being more active than the convex side. This sEMG characteristics were consistent with their imaging and histological degenerative features and correlated with bone structural parameters.

Evaluation of the mechanical properties of different parts of bending bamboo culm by nanointendation

Abstract Bamboo is a flexible natural material, which has high potential value. However, manufacturing processes for bent bamboo products are highly reliant on manual labor. The main challenge in the industrial processing of raw bamboo is that bamboo’s characteristics have not yet been extracted accurately. This mainly originates from bamboo’s complexity and its response to bending, which depends on chemical composition, structure, and properties of bamboo. In order to understand the response of bamboo to bending, samples from different parts of manual processed bent bamboo culm ring were studied through nanoindentation tests. In this regard, elastic modulus, hardness, irreversible work, and residual depth on different bamboo parts were analyzed. The results show that bending has different effects on the tension side (TS, the convex side) and compression side (CS, the concave side) of the bamboo culm. Moreover, the bending effect was different on the green (GBP) and middle bamboo parts (MBP). It was found that bending improved the elastic modulus of GBP in TS by 101%. Moreover, the hardness of GBP in TS decreased by 21% while that of MBP increased by 12.4%. In CS, the hardness of GBP increased by 10% while that of MBP decreased by 19%. The performed analyses reveal that the ratio of irreversible work to total work increased in the bent bamboo and the difference between GBP and MBP was not large for both TS and CS. The relative residual depth was about 60% for the neutral side (NS) and increased to above 70% in TS and CS. It was proposed that either TS or CS formed a respective complete tension-compression stress system in the bent bamboo specimen.

Numerical study of flow characteristics in compound meandering channels with vegetated floodplains

Large eddy simulations were conducted to simulate the flow in compound meandering channels whose main channel sinuosity was 1.381. Then, the floodplain vegetation was generalized using the momentum equation coupled with the drag force formula. The mean flow pattern, secondary flow, coherent structure, turbulence characteristics, and lateral mass and momentum transport with and without floodplain vegetation with relative depths (Dr) of 0.3–0.5 were studied. Results showed that the floodplain vegetation enabled the flow of the main channel to be more concentrated. The maximum average velocity in the cross section of the main channel increased by 100% and 30% when the relative depth was 0.3 and 0.5. Under the influence of floodplain vegetation, the secondary flow cell transformed greatly with the change in relative depth. When Dr &amp;lt; 0.3, the vegetation caused the vortex center of the secondary flow to move closer to the concave bank side, and the secondary flow distribution presents a flow pattern not flooding the floodplain. When Dr &amp;gt; 0.3, the spatial change in the secondary flow was not obvious. In addition, the floodplain vegetation did not change the large-scale vortex that was separated from the boundary layer of the convex bank side. Meanwhile, the floodplain vegetation increased the overall turbulence intensity, turbulent kinetic energy, and Reynolds stress of the main channel, and it increased the range of lateral mass exchange of the inbank flow and the mean and turbulent transport flux of each cross section.

Evaluating bone quality and asymmetrical aplasia of the thoracic vertebral body in Lenke 1A adolescent idiopathic scoliosis using hounsfield units.

Retrospective analysis. To evaluate bone quality and investigate asymmetrical development of the thoracic vertebral body in adolescent idiopathic scoliosis (AIS) based on Hounsfield unit (HU) measurements obtained from computed-tomography (CT) scans. HU value demonstrated higher reliability and accuracy than the traditional method, indicating that they could be used to individually evaluate and effectively assess the bone quality of every vertebra in the CT films. Total 30 AIS patients classified as Lenke Type 1A and 30 paired controls were included in this study. Regions of interest for HU value were measured on three horizontal images of the thoracic vertebrae. HU measurements of the whole vertebral body in each vertebra were obtained. Using HU value, we separately measured the concave and convex sides of each vertebral body in patients' group, as well as within the left and right sides in controls. In controls, the mean HU value of T1-T12 thoracic vertebral bodies was 240.03 ± 39.77, with no statistical differences among different levels. As for AIS patients, in the structural curve, the apical region had a significantly lower HU compared with the other regions, and asymmetrical change was found between the concave and convex sides, most significantly in the apical region. In the non-structural curve, the average HU value was 254.99 ± 44.48, and no significant difference was found either among the different levels of vertebrae or between the concave and convex sides. Abnormal and asymmetrical changes in bone quality of the thoracic vertebral body in patients with Lenke 1A AIS were indicated. Low bone quality in the convex side of the structural curve indicated stronger internal fixation in surgery to correct the deformity.

Network-Based Analysis to Identify Hub Genes Involved in Spatial Root Response to Mechanical Constrains.

Previous studies report that the asymmetric response, observed along the main poplar woody bent root axis, was strongly related to both the type of mechanical forces (compression or tension) and the intensity of force displacement. Despite a large number of targets that have been proposed to trigger this asymmetry, an understanding of the comprehensive and synergistic effect of the antistress spatially related pathways is still lacking. Recent progress in the bioinformatics area has the potential to fill these gaps through the use of in silico studies, able to investigate biological functions and pathway overlaps, and to identify promising targets in plant responses. Presently, for the first time, a comprehensive network-based analysis of proteomic signatures was used to identify functions and pivotal genes involved in the coordinated signalling pathways and molecular activities that asymmetrically modulate the response of different bent poplar root sectors and sides. To accomplish this aim, 66 candidate proteins, differentially represented across the poplar bent root sides and sectors, were grouped according to their abundance profile patterns and mapped, together with their first neighbours, on a high-confidence set of interactions from STRING to compose specific cluster-related subnetworks (I–VI). Successively, all subnetworks were explored by a functional gene set enrichment analysis to identify enriched gene ontology terms. Subnetworks were then analysed to identify the genes that are strongly interconnected with other genes (hub gene) and, thus, those that have a pivotal role in the bent root asymmetric response. The analysis revealed novel information regarding the response coordination, communication, and potential signalling pathways asymmetrically activated along the main root axis, delegated mainly to Ca2+ (for new lateral root formation) and ROS (for gravitropic response and lignin accumulation) signatures. Furthermore, some of the data indicate that the concave side of the bent sector, where the mechanical forces are most intense, communicates to the other (neighbour and distant) sectors, inducing spatially related strategies to ensure water uptake and accompanying cell modification. This information could be critical for understanding how plants maintain and improve their structural integrity—whenever and wherever it is necessary—in natural mechanical stress conditions.

Comparison of multifidus degeneration between scoliosis and lumbar disc herniation

ObjectiveTo assess and compare the pathological and radiological outcomes of multifidus degeneration in scoliosis and lumbar disc herniation patients.MethodsWe performed a retrospective review on 24 patients with scoliosis and 26 patients with lumbar disc herniation (LDH) in the Third Hospital of Hebei Medical University from January 2017 to March2021. The patients were divided into scoliosis group and LDH group according to the treatment. The MRI fatty infiltration rate (FIR) of multifidus and strength of back muscle were calculated to evaluate muscle condition. Multifidus biopsy samples were obtained during surgery in the affected side at L4 or L5 segment in LDH group and on the concavity side of apical vertebrae in scoliosis group. The biopsy fatty infiltration degree (FID) and FIR in two groups, the FIR of affected and unaffected side in LDH group, and the FIR of concavity and convexity side in scoliosis group were compared. The correlation between concavity-convexity FIR difference and cobb angle in scoliosis group, back muscle strength and FIR in LDH group, FID and FIR in both groups was calculated respectively.ResultsThe FIR was higher in scoliosis group than in LDH group, higher in concavity side than convexity side in scoliosis group (both P < 0.05). The FID was higher in scoliosis group than in LDH group (P < 0.05). No significant difference was found between affected and unaffected side in LDH group (P > 0.05). There was a positive correlation between concavity-convexity FIR difference and cobb angle, FIR and FID (both P < 0.01). There was a negative correlation between back muscle strength and FIR (P < 0.01). The biopsy staining results showed that both two groups were found the existence of rimmed vacuoles, nuclear aggregation, and abnormal enzyme activity, indicating that the scoliosis and LDH may be associated with myogenic diseases.ConclusionThe scoliosis patients showed more serious fatty infiltration than LDH patients and rare pathological findings were found in both diseases.

Reactivation of Vertebral Growth Plate Function in Vertebral Body Tethering in an Animal Model.

Flexible spine tethering is a relatively novel fusionless surgical technique that aims to correct scoliosis based on growth modulation due to the pressure exerted on the vertebral body epiphyseal growth plate. The correction occurs in two phases: immediate intraoperative and postoperative with growth. The aim of this study was to evaluate the reactivation of vertebral growth plate function after applying corrective forces. The rat tail model was used. Asymmetric compression and distraction of caudal growth plates were performed using a modified external fixation apparatus. Radiological and histopathological data were analysed. After three weeks of correction, the activity of the structures increased across the entire growth plate width, and the plate was thickened. The height of the hypertrophic layer and chondrocytes on the concave side doubled in height. The height of chondrocytes and the cartilage thickness on the concave and central sides after the correction did not differ statistically significantly from the control group. Initiation of the correction of scoliosis in the growing spine, with relief of the pressure on the growth plate, allows the return of the physiological activity of the growth cartilage and restoration of the deformed vertebral body.

Kierunek pierwotnego skrzywienia kręgosłupa a rozkład sił nacisku mas ciała na płaszczyźnie podparcia u dzieci ze skoliozą I°

Introduction. As a result of subjective functional assessment, disturbances in the symmetry of body weight distribution on the support plane are commonly observed in children and adolescents with idiopathic scoliosis. The objective of this study was to identify the relationship between the direction of the primary curvature and the body weight distribution on the ground in children with idiopathic scoliosis. Method. Two groups (the study group and the control group) of children aged 7–11 were included in the study. The study group consisted of 96 children rehabilitated due to scoliosis in rehabilitation centres. The control group included children of the corresponding age, height and weight in comparison to the study group. The main element of the study involved measurements of the percentage body weight distribution on the support plane between the “convex” and “concave” side of the body while maintaining a standing position on both legs. Results. Based on the value of the symmetry index and the direction of the primary curvature, the following subgroups were distinguished among the children with scoliosis: children with symmetrical body weight distribution on the support plane (21%); children with asymmetric body weight distribution on the support plane overloading the convex side (51%) and children overloading the concave side (28%). Conclusion. The occurrence of symmetry disorders in the body weight distribution on the support plane in children with idiopathic scoliosis requires taking these features into account in the early stage of rehabilitation of these children.

Changes in inflammatory biomarkers in the nasal mucosal secretion after septoplasty

Deviated nasal septum (DNS) is suggested to be associated with nonspecific inflammation of the nasal mucosa. The authors hypothesized septoplasty may reduce nasal mucosal inflammation, therefore the authors aimed to measure various inflammatory biomarkers in the nasal secretion following septoplasty. Prospectively, 17 patients undergoing elective septoplasty were included. Symptomatic changes after septoplasty were evaluated with Sino-nasal Outcome Test (SNOT-22) and Nasal obstruction symptom evaluation (NOSE) scores. Using acoustic rhinometry, changes of the nasal airway volume were measured. Nasal secretion was collected within 2 weeks and 3 months before and after septoplasty, respectively. The inflammatory biomarker high-mobility group box 1 (HMGB1) and vasoactive intestinal peptide (VIP), and inflammatory cytokines including tumor necrosis factor α (TNF α), interferon γ (IFN-γ), interleukin-4 (IL-4), eotaxin-1, and regulated upon activation, normal T cell expressed and presumably secreted (RANTES) were quantified in the nasal secretion by enzyme-linked immunosorbent assays or multiplex bead array assays. The patients' mean age was 30.5 ± 6.8 (ranging from 19 to 43), consisting of 15 male and 2 female patients. The median SNOT-22 and NOSE scores changed from 54 to 14 and 78 to 15, respectively, both showing a significant decrease. In acoustic rhinometry, nasal cavity volume of convex side significantly increased after septoplasty, whereas significant discrepancy of nasal airway volume between concave and convex sides became insignificant. No significant difference was noted both before and after septoplasty between the concave and convex sides in all seven biomarkers. The HMGB1, RANTES, IL-4, and TNF-α concentrations following septoplasty showed significant decrease in 34 nasal cavities of 17 patients (all p < 0.05). However, when the 17 concave and 17 convex sides were analyzed separately, the significant reduction in four biomarkers were only significant in the concave sides (all p < 0.05), but not significantly reduced in convex sides. Septoplasty may have benefited not only in normalizing the nasal airflow and symptom improvement, but also in nonspecific inflammation attenuation in the nasal airway.

Hounsfield unit for assessing asymmetrical loss of vertebral bone mineral density and its correlation with curve severity in adolescent idiopathic scoliosis.

BackgroundLow bone mass concomitantly occurs in patients with adolescent idiopathic scoliosis (AIS) and can persist until skeletal maturity. The purpose of this study was to assess the asymmetrical loss of vertebral bone mineral density (vBMD) and its correlation with curve severity in patients with AIS using Hounsfield unit (HU) values measured from computed tomography scans.MethodsA total of 93 AIS patients were retrospectively recruited. The HU values of the vertebral body (VB-HU) and pedicle screw trajectory (PST-HU) were measured from four vertebrae above (Apex − 4) to four below (Apex + 4) the apical vertebra (Apex) of the major curve. The VB-HU and PST-HU at the upper end vertebra, Apex, and lower end vertebra within the concave and convex sides of the major and minor curves and stable vertebrae were obtained.ResultsA significant correlation was found between the Cobb angle and VB-HU at the periapical levels of the major curve. VB-HU and PST-HU at periapical levels were significantly greater within the concavity than the convexity of both major and minor curves. The asymmetric ratios of VB-HU and PST-HU were significantly correlated with the major curve Cobb angle, peaked at the apex, and gradually diminished from the apex to the end vertebrae. The asymmetrical loss of vBMD aggravated with the progression of curve severity, presenting as VB-HU, significantly decreased within the convexity and insignificantly decreased within the concavity of the major curve.ConclusionThe asymmetrical loss of vBMD was associated with the progression of curve severity in AIS. For patients with severe AIS, the distraction of the pedicle screws at the concave side should be a priority in correcting the major curve, and supplemental anchors and larger-sized screws should be placed within the convex side around the apex of the major curve to reduce the risk of screw loosening after surgery.

Is Lenke type V adolescent idiopathic scoliosis associated with different muscular morphometry?

The aim of the study was to evaluate the changes in psoas major (PM), erector spinae (ES), multifidus (MF), and rectus abdominis (RA) morphometry in Lenke type V adolescent idiopathic scoliosis (AIS) and control. Forty-two Lenke V AIS patients and 30 control were enrolled. The cross-sectional area (CSA) and CSA index (CI) of the PM, ES, MF, and RA at the T9-L5 levels were measured and compared between Lenke type V patients and control. The CI of the RA was significantly higher in the control group than the Lenke V group in multiple levels. On the other hand, there was no significant difference between patients with Lenke V AIS and control regarding the CI of the RA, ES, and PM. There was no significant difference between concave and convex sides of the Lenke V group regarding the CI of the RA, PM, MF, and ES. RA muscle mass is significantly affected in Lenke type 5 AIS regardless of convex or concave sides. This difference may be related to postural differences and back pain development in Lenke type 5 patients. Level of evidence: Level III.

Changes in the lumbar intervertebral foramen between supine and standing posture in patients with adult spinal deformity: a study with upright computed tomography.

To quantitatively assess the impact of supine and standing positions on the morphological changes in the lumbar intervertebral foramen (LIF) in patients with adult spinal deformity (ASD) using upright CT and conventional supine CT. Thirty patients with ASD were prospectively enrolled in this study. All subjects underwent standing whole spine posterior/anterior radiographs, lateral radiographs, and whole spine CT, both in the supine and upright standing positions. Two orthopedic surgeons independently measured nine radiographic parameters in the radiograph and the lumbar foraminal area (FA) and height (FH) in supine and upright CT. Statistical analyses were performed to evaluate the risk of LIF decrease when standing upright compared to the supine position. The chi-squared, t test, Pearson's coefficients, intra- and inter-rater reliabilities, and ROC curves were calculated. The level of significance was set at p < 0.05. Among the 300 LIFs, both the lumbar FA and FH were either increased or decreased by > 5% in approximately 30% of LIFs each. The FA decreased in the lower lumbar spine. The concave side had a significantly higher rate of decreased FA and FH than the convex side (p < 0.05 and < 0.05, respectively). ROC analysis showed that narrowing of the intervertebral disc (cutoff > 0.05°) is a risk factor for decreased FA and FH. This study describes the details of the changes in the neuroforamen using a novel upright CT. In patients with ASD, approximately 30% of LIFs either increased or decreased in size by > 5% when standing. The risk factors for LIF decrease are the lower lumbar spine, concave side, and narrow side of the disc wedge.

Derotation screws provide no advantage over polyaxial screws regarding coronal & sagittal correction in thoracic curves of AIS patients

PurposeWe compared two techniques for thoracic apical derotation; one using conventional reduction screws (Single-Innie–SI) and one requiring special derotation screws that can be converted to monoaxial screws to enhance dorotation (Dual-Innie–DI) for coronal and sagittal correction and.MethodsA total of 200 patients with thoracic AIS have been included. In the SI-Group (n = 127) the convex rod was applied first. Vertebral derotation was done by translation to the concave rod with the convex rod being in place and center of rotation (COR). In the DI-Group (n = 73) correction started with translation on the concave side as well but now followed by derotation around the concave rod using the DI-mechanism.ResultsThe mean rotation according to Raimondi and coronal correction was not sig. affected (72 (± 12) % in the SI-Group versus 68 (± 15) % in the DI-Group), even when flexibility was respected (Cincinnati Correction Index CCI was 2.9 (± 4.9) versus 3.5 (± 4.4). (p < 0.01). The gain of kyphosis was sig greater (2.7°) in the SI-group, but not clinical relevant.ConclusionThe use of DI screws for apical derotation did not provide an advantage for coronal correction or derotation in thoracic curves. Presumably after translation is performed in the DI-group, there was too much tension and friction in the construct impeding further derotation. Simultaneous translation and derotation in the SI-group, with the convex rod being the COR, yielded similar correction with better kyphosis and was faster and more economic.

Convex–concave and anterior–posterior spinal length discrepancies in adolescent idiopathic scoliosis with major right thoracic curves versus matched controls

PurposeThe apical deformation in adolescent idiopathic scoliosis (AIS) is a combination of rotation, coronal deviation and passive anterior lengthening of the spine. In AIS surgery, posterior–concave lengthening or anterior–convex shortening can be part of the corrective maneuver, as determined by the individual surgeon’s technique. The magnitude of convex–concave and anterior–posterior length discrepancies, and how this needs to be modified to restore optimal spinal harmony, remains unknown.MethodsCT-scans of 80 pre-operative AIS patients with right convex primary thoracic curves were sex- and age-matched to 80 healthy controls. The spinal length parameters of the main thoracic curves were compared to corresponding levels in controls. Vertebral body endplates and posterior elements were semi-automatically segmented to determine the length of the concave and convex side of the anterior column and along the posterior pedicle screw entry points while taking the 3D-orientation of each individual vertebra into account.ResultsThe main thoracic curves showed anterior lengthening with a mean anterior–posterior length discrepancy of + 3 ± 6%, compared to a kyphosis of − 6 ± 3% in controls (p < 0.01). In AIS, the convex side was 20 ± 7% longer than concave (0 ± 1% in controls; p < 0.01). The anterior and posterior concavity were 7 and 22 mm shorter, respectively, while the anterior and posterior convexity were 21 and 8 mm longer compared to the controls.ConclusionsIn thoracic AIS, the concave shortening is more excessive than the convex lengthening. To restore spinal harmony, the posterior concavity should be elongated while allowing for some shortening of the posterior convexity.

Elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis after posterior selective fusion surgery

BackgroundWe sought to assess the elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 curves after posterior selective fusion surgery. MethodsThe shear wave elasticity imaging system was used to assess the elasticity of the thoracic paravertebral muscles and fascia both on the concave and convex sides. Three regions of interest, including the apex, upper end, and lower end of the main curve, were tested. FindingsTen female patients, with an average age of 16.6 ± 2.7 years old, were included. The average post-operation follow-up period was 9.0 ± 2.4 months. The Cobb angle was significantly corrected from 63.6 ± 12.0° to 10.7 ± 5.4° (p < 0.05). The length of the trunk increased from 40.4 ± 2.5 cm to 46.0 ± 2.8 cm (p < 0.05). The elasticity of deep fascia didn't show a significant change post-operation (p > 0.05). The elasticity of the paravertebral muscle on the concave side had a significant increase at the final follow-up (p < 0.05). The elasticity of the paravertebral muscle on the convex side also increased at the upper end (p < 0.05). The elasticity asymmetry of the deep fascia decreased, but the elasticity asymmetry of the paravertebral muscle increased at the upper end of the curve (p < 0.05). InterpretationThe paravertebral muscle on the concave side is stiffer after surgery. Elastic asymmetry of paravertebral muscle increased and elastic asymmetry of the deep fascia decreased at the upper end of the curvature. Further study is needed to elucidate the mechanism by which the paravertebral soft tissue responds after surgery.

Three-dimensional morphological analysis of the thoracic pedicle and related radiographic factors in adolescent idiopathic scoliosis

BackgroundThis study aimed to investigate the laterality of the pedicle morphology at the apical vertebra (AV) level and identify the radiographic factors associated with the laterality ratio of the pedicle morphology at the AV level in patients with adolescent idiopathic scoliosis (AIS).MethodsOverall, 684 pedicles in 57 AIS patients aged 10–20 years, who underwent preoperative computed tomography (CT) and had Lenke type 1 or 2 with right convex main thoracic curves (MTC), were evaluated. Pedicle diameters of the MTC were assessed. We defined and compared the region containing two vertebrae adjacent to the AV (APEX±1) and the region containing two vertebrae adjacent to the neutral vertebra. We analyzed the pedicle diameter and laterality ratio of APEX±1 and performed multiple linear regression analysis to identify the radiographic factors associated with the laterality of the pedicle diameter.ResultsOn the concave side of APEX±1, the pedicles of 15 patients (26.3%) did not accept a 4-mm-diameter pedicle screw (PS), even with 25% cortical bone width expansion. Laterality ratio differences in the pedicle diameters of the cortical bone width in APEX±1 were large in patients with more proximal AV level (p < 0.001) and smaller apical vertebral rotation (AVR) (p = 0.029).ConclusionsPreoperative planning to accurately select and insert the PS in AIS should be based on the anatomical limitations in APEX±1, AV level, and AVR degree. In APEX±1, the correlation between AVR and the laterality ratio of the pedicle diameter may be useful for pathoetiological interpretation of the AIS deformity.