Forms Of Idiopathic Scoliosis Research Articles

Sports participation reduces the progression of idiopathic scoliosis and the need for bracing. An observational study of 511 adolescents with Risser 0-2 maturation stage.

In clinics and the literature, there are doubts about the indications and contraindications of sports to support rehabilitation treatment for adolescents with idiopathic scoliosis (IS). The aim of the study is to assess sports activities' effect and frequency in a large population of adolescents with idiopathic scoliosis (IS). Retrospective observational cohort study. Tertiary referral institute specialized in the conservative treatment of scoliosis. consecutive patients in a clinical database of age ≥10, with juvenile or adolescent IS diagnosis, 11-25° Cobb curve, Risser Bone Maturity Score 0-2, no brace prescription, radiographic follow-up radiographs at 12±3 months. At 12-month follow-up, radiograph, we considered progression an increase of scoliosis curve ≥5° Cobb and failure an increase to ≥25° Cobb - need of a brace. We calculated the Relative risk (RR) to compare the outcome of participants performing sports (SPORTS) or not (NO-SPORTS). We run a logistic regression with covariate adjustment to assess the effect of sports participation frequency on the outcome. We included 511 patients (mean age 11.9±1.2, 415 females). Participants in the NO-SPORTS group showed a higher risk of progression (RR=1.57, 95% CI: 1.16-2.12, P=0.004) and failure (RR=1.85, 95% CI: 1.19-2.86, P=0.007) than participants in SPORTS. Logistic regression confirmed that the more frequent the sports activities, the less probable progression (P=0.0004) and failure (P=0.004) were. This study shows that sports activities have a protective role against progression at 12-month follow-up in adolescents with milder forms of IS. Excluding high-level sports activities, the risks of progression and failure decrease with the increase in sports frequency per week. Albeit non-specific, sports can help in the rehabilitation of patients with idiopathic scoliosis and reduce brace prescription.

Annual Observation of Changes in the Angle of Trunk Rotation. Trunk Asymmetry Predictors. A Study from a Scoliosis Screening in School Adolescents.

Adolescent forms of idiopathic scoliosis are commonly encountered deformities of the thoracic and lumbar spine. They affect a significant number of adolescents, yet their cause is still unknown. The presented research is a cross-sectional analysis of 3933 volunteers (2131 girls and 1802 boys). The participants were primary school students aged 9 to 13 years old. This study determined a relationship between predictors such as: body mass, body height and body mass index (BMI) (independent variables) and angle of trunk rotation (ATR) value (dependent variable). Moreover, a stepwise multiple regression with backward selection was conducted to determine to what extent the dependent variable is explained by body mass, body height and BMI. In the group of 11,12,13-year-old girls, the analyzed results of multiple stepwise regression were statistically significant. Among the all studied predictors, it has been shown that body mass in the 11-year-old girls and body height in 12- and 13-year-old girls are major correlates of a 1-year ATR increase in proximal and main thoracic spine levels.

Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis

BackgroundAdolescent idiopathic scoliosis (AIS) is the most common form of idiopathic scoliosis, and surgery is considered as one of the therapeutic options. However, it is associated with a variety of irreversible complications, in spite of the benefits it provides. Here, we evaluated the long-term outcome of posterior spinal fusion (PSF) of AIS to shed more light on the consequences of this surgery.MethodsIn a cross-sectional study, a total of 42 AIS patients who underwent PSF surgery were radiographically and clinically inspected for the potential post-operative complications. Radiographic assessments included the device failure, union status, and vertebral tilt below the site of fusion. Clinical outcomes were evaluated using the Oswestry disability index (ODI) and visual analogue scale (VAS).ResultsThe mean age of the surgery was 14.4 ± 5.1 years. The mean follow-up of the patients was 5.6 ± 3.2 years. Complete union was observed in all patients, and no device failure was noticed. Pre- and post-operative vertebral tilt below the site of fusion were 11.12° ± 7.92° and 6.21° ± 5.73°, respectively (p < 0.001). The mean post-operative ODI was 16.7 ± 9.8. The mean post-operative VAS was 2.1 ± 0.7. ODI value was positively correlated with follow-up periods (p = 0.04, r = 0.471). New degenerative disc disease (DDD) was observed in 6 out of 37 (16%) patients.ConclusionIn spite of the efficacy and safety of PSF surgery of AIS, it might result in irreversible complications such as DDD. Moreover, the amount of post-operative disability might increase over the time and should be discussed with the patients.

Use of Brace Therapy in Patients with Idiopathic Scoliotic Spine Deformities

Efficacy of brace therapy was studied in 976 patients with idiopathic scoliosis (IS) aged, 5 to 17 years. The principal curvature made up from 18° to 160°. Chкneau braces were used as orthoses. Treatment course was divided into the period of adaptation to brace wearing, period of primary correction, period of brace retention and period of follow up after brace treatment completion. Achieved results showed that in IS brace treatment provided good corrective and stabilizing effect upon scoliotic spine deformity. Clinically it enabled to eliminate completely, diminish or stabilize deformity manifestations of orthopaedic disease. In severe forms of IS it enabled to control the pathologic process conservatively until the spine growth completion.

New disease gene location and high genetic heterogeneity in idiopathic scoliosis

Idiopathic scoliosis (IS) is a spine disorder of unknown origin with 1.5-3% prevalence in the general population. Besides the large multifactorial-form sample of IS, there is a good evidence for the existence of a monogenic subgroup in which the disease is inherited in a dominant manner. However, results from literature suggest a strong heterogeneity in the locations of the mutated genes. Using a high-resolution genome-wide scan, we performed linkage analyses in three large multigenerational IS families compatible with dominant inheritance including 9-12 affected members or obligate carriers. In two of these families, our results suggested intra-familial genetic heterogeneity, whereas, in the other, we observed a perfect marker disease co-segregation in two regions at 3q12.1 and 5q13.3. We can state that one of these two locations is a novel IS disease gene locus, as the probability of having this perfect co-segregation twice by chance in the genome is very low (P=0.001). Lastly, in all three families studied, linkage to the previously mapped dominant IS loci on chromosomes 19p13.3, 17p11.2, 9q34, 17q25 and 18q is unlikely, confirming that there is a high genetic heterogeneity within the subgroup of dominant forms of IS.

On Reliability of М.н. Mehta Prognostic Test

Objective. Validation of the Mehta sign reliability on dynamic spine radiographs of patients with progressive idiopathic scoliosis. Material and Methods. Radiographs of 65 patients with progressive idiopathic right-side thoracic scoliosis examined in dynamics were analyzed. The rib-vertebra angle difference (RVAD) was assessed in accordance with Mehta techniques, and scoliosis evolution was followed up. Results. Initial RVAD in 35 patients was less than 20°. Deformity progressed with time in all patients, and in 71 % of them it evolved into a severe form. Almost half of these patients (43 %) have a curve of 30° to 63° even at initial examination. Equality of rib-vertebra angles (RVA-L and RVA-R) does not indicate the absence of scoliosis. Nine patients (26 %) with equal RVA had the Cobb angle of deformity of 6° to 28°. Conclusion. Our findings raise doubt on reliability of the Mehta sign. Further research is necessary including series of patients with non-progressive forms of idiopathic scoliosis.

ON ETIOPATHOGENESIS OF IDIOPATHIC SCOLIOSIS

Objectives. To study a role of the central nervous system (CNS) in development of idiopathic scoliosis (IS) and to reveal potential neurophysiologic mechanisms participating in this process. Material and Methods. Electroencephalography (EEG) has been applied to examine patients with IS. For the first time the received data were processed by a mathematical method which allowed to establish the temporal organization of basic brain rhythm formation (α, β, θ). Results. Variants of deviations in functioning of basal structures of the brain and its trunk distinctive for sluggish and rapid progressing forms of IS are revealed. Theoretical description of pathogenetic links of idiopathic three-plane spine deformity formation is suggested. It is proved that a basic condition for its development is a disturbance in longitudinal growth conjugation of the spine bone structures and the spinal cord, which demands certain compensating reactions. Conclusion. Long-term uncontrolled asymmetric change in paravertebral muscle tone is a key link in a clinical formation of IS.

[Analysis of polymorphism of the number of tandem repeats in the aggrecan gene exon G3 in the families with idiopathic scoliosis].

In our previous study we showed that the inheritance of pronounced forms of idiopathic scoliosis was described by an autosomal-dominant major gene model assuming incomplete sex- and age-dependent penetrance. In the present study a search for the major gene was carried out by means of testing candidate genes. The aggrecan gene with known polymorphism of the number of tandem repeats in exon G3 was considered to be one of these candidate genes. Various alleles of this gene provide attachment of different number of chondroitin sulfate chains to a proteoglycan core protein, thereby changing functional properties of cartilage. Using the TDT analysis of 33 unrelated families consisting of a proband and his parents, we examined the existence of associations between the aggrecan alleles and the disease. Among nine alleles identified, three alleles with tandem repeats numbers of 25, 26, and 27 prevailed. We did not reveal preferable transmission of any of these alleles to the proband (TDT-statistics for different alleles varied from 0 to 0.71). There was also no correlation between the number of tandem repeats and the disease severity. Thus, either the polymorphism of the number of tandem repeats is not the direct reason for development of idiopathic scoliosis in the families tested, or its effect is too low to be detected using the samples examined.