Lateral Curvature Research Articles

A REVIEW ON UNDERSTANDING OF SCOLIOSIS AND ITS AYURVEDIC ASPECTS

The spinal curvatures are important for balancing the body and it help us to stand upright. If any one of the curves become too large or small, our posture may appear abnormal. There are three main types of spinal curvature disor- ders, viz: scoliosis, kyphosis and lordosis. Among these, scoliosis is the common one. Scoliosis is a lateral curvature of the spine that occurs most often during the growth spurt just before puberty. In 80% of scoliosis patients, the cause is unknown. In most of the cases the curve is mild, but in some children the curve continues to worsen as the child grows. Children who have mild scoliosis need to be monitored closely. In such cases, no treatment is usually necessary. Some of them will need to wear a brace. The ultimate treatment for a progressive curve in children is surgery. While going through Ayurveda literature, we see the word Kubja, and is a common term used by Acharyas to describe a hump like appearance. This article is intended to review scoliosis, its classification, symptoms, diag- nosis and treatment and its Ayurvedic aspects. Keywords: Scoliosis, Brace, Kubja

Three-dimensional morphometric differences of resected distal femurs and proximal tibias in osteoarthritic and normal knees

BackgroundThere is a paucity of data concerning the morphological differences of resected distal femurs and proximal tibias in osteoarthritic (OA) and normal knees. The objective of this study was to determine whether morphometric differences in the surfaces of resected distal femurs and proximal tibias exist between OA and normal knees in a Chinese population.MethodsNinety-four OA knees and ninety-five normal knees were evaluated in Chinese individuals. Computed tomography was used to measure the femoral mediolateral (fML), medial anteroposterior (fMAP), lateral anteroposterior (fLAP), medial condylar width (fMCW), lateral condylar width (fLCW), medial posterior condylar curvature radii (fMCR), lateral posterior condyle curvature radii (fLCR), fML/fMAP aspect ratio, tibial mediolateral (tML), middle anteroposterior (tAP), medial anteroposterior (tMAP), and lateral anteroposterior (tLAP) tML/tMAP aspect ratio to determine the morphologic differences between OA and normal knees.ResultsThe average fMCW and tMAP dimensions of OA knees were larger than those of normal knees in both male and female (p <0.05). The fMAP/fML aspect ratio and tMAP/tML aspect ratio were also significantly different in both sexs (p <0.05). OA knees have an oval-shaped distal femur with a wider ML length and more spherical-shaped proximal tibiae with relatively narrow ML dimensions.ConclusionsThe study revealed the morphological differences in fMCW, tMAP, fMAP/fML and tMAP/tML between OA and normal knees in both males and females. These findings may provide guidelines that can be used to design better knee implants that are more size-matched for OA knees.

Upper Eyelid Contour Changes After Orbital Decompression in Graves Orbitopathy.

To evaluate the effect of orbital decompression on the upper eyelid contour. A paired cross-sectional analysis of the upper eyelid contour was performed for 103 eyes of 66 patients who underwent orbital decompression. A control group of 26 normal subjects was also included. The eyelid contour of all participants were measured with Bézier lines adjusted to the eyelid contour and 9 midpupil eyelid margin (MPD) distances from a horizontal line bisecting the pupil. One central, corresponding to the margin reflex distance (MRD 1), and 8 equally distributed medially and laterally at 20% of the interval between the lines. Patients were classified as with flare if the height of the most lateral MPD relative to the MRD 1 was above the upper limit of the controls. Preoperatively 63 of the 103 contours were classified as flare + (F+). After decompression MRD1 showed a mean decrease of 0.4 mm and the location of the contour shifted 0.8 mm medially. These changes were not correlated with proptosis reduction. Orbital decompression decreased the lateral curvature of the contours especially for the F+ lids. In 40% of the F+ eyelids the flare sign disappeared after decompression. Orbital decompression affects the lateral eyelid contour and diminishes the amount of lateral eyelid retraction surgery necessary to correct the flare sign. In 40% of the patients, the eyelid contour is normalized with proptosis reduction only.

The Type of Conservative Management Could Be Related to the Strength of the Inspiratory Muscles of Adolescents with Idiopathic Scoliosis—A Case Series

Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine with a Cobb angle of at least 10° with an unknown etiology. It is recognized that AIS may affect respiratory function. This study aims to describe and compare respiratory function in a case series of patients with scoliosis who underwent different types of therapeutic management: no intervention, orthotic brace, and global postural reeducation (GPR). Fifteen AIS patients were included in this study (seven no intervention, four orthotic brace and four GPR). Lung function and inspiratory muscle strength were measured and analyzed, as well as sociodemographic, clinical, and anthropometric variables. Significant correlations were observed between height (cm) and maximum inspiratory pressure (MIP) reference (cmH2O) and forced vital capacity (FVC) (liters) (r = 0.650 and r = 0.673, respectively; p < 0.01); weight (Kg) and MIP reference (cmH2O) (r = 0.727; p < 0.01); and Main curve degrees (Cobb angle) and FVC% (r = −0.648; p < 0.01). The AIS cases that underwent GPR treatment presented a greater MIP (% predictive) compared to the no intervention and brace cases (201.1% versus 126.1% and 78.4%, respectively; p < 0.05). The results of this case series show a possible relation whereby patients undergoing treatment with the GPR method have greater inspiratory muscle strength compared to the no intervention and brace cases. Studies with larger samples and prospective designs must be performed to corroborate these results.

RETRACTED ARTICLE: Analysis of risk factors related to the re-fracture of adjacent vertebral body after PKP

BackgroundThis study aims to investigate the risk factors of vertebral re-fracture after percutaneous kyphoplasty (PKP) for osteoporosis vertebral compression fracture (OVCF), and to provide reference for clinical prevention.Material and methodsA retrospective analysis was performed on 228 OVCF patients admitted on November 6, 2013, solstice, December 14, 2018, which met the inclusion criteria. There were 35 males and 193 females, with a male-to-female ratio of 3:20, and an age of 61–89 years. All patients were treated with PKP surgery with complete clinical data, and the rate of re-fracture was calculated according to whether re-fracture occurred after surgery, divided into the re-fracture group (24 cases) and the non-refracture group (204 cases). May be associated with subsequent fracture factors (gender, age, number of surgical segment vertebral body, whether with degenerative scoliosis, whether to fight osteoporosis) into a single-factor research, then the single-factor analysis was statistically significant risk factors for multiple logistic regression analysis, further defined after PKP holds the vertebral body fracture independent risk factors. Survival analysis was performed using the time of vertebral re-fracture after PKP as the end time of follow-up, the occurrence of re-fracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor.ResultsAll 228 vertebroplasty patients were followed up for a period of 1.8 to 63.6 months. The mean follow-up time was (28.8 ± 15.6) months, and the re-fracture rate was 10.5%. There were statistically significant differences between the re-fracture group and the non-refracture group in age, number of operative vertebral bodies, whether there was a combination of degenerative scoliosis and whether there was anti-osteoporosis treatment (P < 0.05). The results of univariate logistic regression analysis after excluding the mutual influence of various factors showed that the number of vertebral bodies and the group with lateral curvature might be the risk factors for PKP re-fracture after surgery. The above possible risk factors were included in multiple logistic regression analysis to show whether there were independent risk factors for scoliosis and vertebral re-fracture. Survival analysis showed that the mean survival time was 42.1 months, the P value was 0.00, and the mean 95% confidence interval was (34.4–49.7 months), indicating that the combination of degenerative lateral bending might be related to the occurrence of re-fracture.ConclusionsCombined scoliosis is an independent risk factor for re-fracture after OVCF laminoplasty and a possible risk factor for re-fracture after surgery.

The structure of a highly decelerated axisymmetric turbulent boundary layer

Experiments were performed over a body of revolution at a length-based Reynolds number of 1.9 million. While the lateral curvature parameters are moderate ( $\delta /r_s &lt; 2, r_s^+&gt;500$ , where $\delta$ is the boundary layer thickness and r s is the radius of curvature), the pressure gradient is increasingly adverse ( $\beta _{C} \in [5 \text {--} 18]$ where $\beta_{C}$ is Clauser’s pressure gradient parameter), representative of vehicle-relevant conditions. The mean flow in the outer regions of this fully attached boundary layer displays some properties of a free-shear layer, with the mean-velocity and turbulence intensity profiles attaining self-similarity with the ‘embedded shear layer’ scaling (Schatzman &amp; Thomas, J. Fluid Mech., vol. 815, 2017, pp. 592–642). Spectral analysis of the streamwise turbulence revealed that, as the mean flow decelerates, the large-scale motions energize across the boundary layer, growing proportionally with the boundary layer thickness. When scaled with the shear layer parameters, the distribution of the energy in the low-frequency region is approximately self-similar, emphasizing the role of the embedded shear layer in the large-scale motions. The correlation structure of the boundary layer is discussed at length to supply information towards the development of turbulence and aeroacoustic models. One major finding is that the estimation of integral turbulence length scales from single-point measurements, via Taylor's hypothesis, requires significant corrections to the convection velocity in the inner 50 % of the boundary layer. The apparent convection velocity (estimated from the ratio of integral length scale to the time scale), is approximately 40 % greater than the local mean velocity, suggesting the turbulence is convected much faster than previously thought. Closer to the wall even higher corrections are required.

Experimental study on the seismic behavior of seawater sea sand concrete beams reinforced with steel-FRP composite bars

This study offers a new solution to improve the durability of steel-reinforced seawater sea sand concrete (SWSSC) beams without reducing their energy-dissipation capacity under seismic loads. Thus, an investigation of beams reinforced with steel-FRP composite bars (SFCBs), hybrid reinforced with SFCB bars and basalt fiber reinforced polymer (BFRP) bars was conducted. The effects of incorporating 1% minibar in concrete on the seismic behavior of reinforced concrete (RC) beams were also studied. These behaviors included the failure mode, hysteretic response, stiffness degradation, energy-dissipation capacity, strain variation, and curvature of the pedestal. Results showed that chloride ions in seawater and sea sand concrete caused steel bars to corrode and adversely affected the seismic response of RC beams. In addition, the SFCB bars and hybrid RC beams exhibited a more pronounced pinching effect and smaller residual displacement as compared with the steel RC beams. The total cumulative dissipated energy of the SFCB RC beams was approximately the same as that of the steel bar RC beams due to increased deformation. The seismic behaviors of the SFCB bar reinforced minibar-concrete beams were significantly improved under low cyclic loads due to a stable confinement of minibar on concrete. Their load-carrying capacity and energy consumption increased by 27.0% and 36.5%, respectively, as compared with those of the steel RC beams. Similar improvements could be observed in the response of the lateral load versus curvature in the pedestal relationship. Based on these seismic behaviors, structures reinforced by SFCB bars and hybrid reinforced by SFCB and BFRP bars are recommended as means of reinforcement for seawater and sea sand concrete structures.

PD48-10 MULTIPLE TRANSVERSE INCISIONS PATCHED WITH TACHOSIL® IN PEYRONIE’S DISEASE: PRELIMINARY DATA OF AN ONGOING, PROSPECTIVE, NON-RANDOMIZED STUDY

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie's Disease (PD48)1 Sep 2021PD48-10 MULTIPLE TRANSVERSE INCISIONS PATCHED WITH TACHOSIL® IN PEYRONIE’S DISEASE: PRELIMINARY DATA OF AN ONGOING, PROSPECTIVE, NON-RANDOMIZED STUDY Afonso Castro, Miguel Fernandes, Miguel Miranda, Pedro Simões Oliveira, Natalia Martins, José Palma dos Reis, and Francisco E. Martins Afonso CastroAfonso Castro More articles by this author , Miguel FernandesMiguel Fernandes More articles by this author , Miguel MirandaMiguel Miranda More articles by this author , Pedro Simões OliveiraPedro Simões Oliveira More articles by this author , Natalia MartinsNatalia Martins More articles by this author , José Palma dos ReisJosé Palma dos Reis More articles by this author , and Francisco E. MartinsFrancisco E. Martins More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002070.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s disease (PD) can be both physically and psychologically distressing to the patient. Although invasive, surgery remains the most reliable and effective treatment option. However, complications are not negligible. We present our preliminary data of an ongoing, prospective, non-randomized study of potent patients with PD who underwent multiple transverse incisions (MTI) covered with Tachosil®. Severe dorsal/dorsolateral deformity and/or further penile shortening were the primary therapeutic endpoints. METHODS: Between January 2018 and February 2020, patients with dorsal/dorsolateral deformity and stable PD were included in this analysis. All patients underwent a penile duplex ultrasound study (PDUSS) and SHIM-5 (Sexual Health Inventory for Males) questionnaire to assess erectile function both objectively and subjectively before and after surgery. PGI-I (Patient Global Impression of Improvement) was used to assess patient satisfaction. RESULTS: 23 patients underwent MTI+Tachosil® (median 4 incisions; range 3-6) after ≥12 months of deformity duration and without evidence of progression. Median age was 66 years (range 49 - 76). Median preoperative compound curvature was 60 degrees (range 30-90), 19 (83%) had dorsal curvature, 3 patients (13%) had dorsolateral deformity and 1 had lateral curvature (4%). Total straightness was achieved in 20 patients (87%) and residual curvature was evidenced in 3 (13%). Erectile rigidity sufficient for penetrative intercourse was maintained in all patients at last follow-up, not displaying erectile dysfunction progression. There were no significant changes in PDUSS scores post-operatively. SHIM-5 scores improved from 13 (range 12-16) pre-operatively, to 19 (range 18-21) post-operatively. Median postoperative PGI-I scores were 2 (much better). No penile length reduction was observed. One patient experienced self-resolution of penile hematoma, 5 patients noted transient glandular hypoesthesia with only 1 developing prolonged sensation impairment. CONCLUSIONS: MTI with Tachosil grafting is feasible, well tolerated, easy and quick to perform surgical technique for the treatment of PD. It avoids creation of large tunical defects with subsequent veno-occlusive dysfunction, and provides additional hemostasis, while preserving erectile function. Most complications were minor and transient (Clavien-Dindo I or II). Source of Funding: The authors received no specific funding for this work © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e842-e842 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Afonso Castro More articles by this author Miguel Fernandes More articles by this author Miguel Miranda More articles by this author Pedro Simões Oliveira More articles by this author Natalia Martins More articles by this author José Palma dos Reis More articles by this author Francisco E. Martins More articles by this author Expand All Advertisement Loading ...

MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS Nicol Bush, and Warren Snodgrass Nicol BushNicol Bush More articles by this author , and Warren SnodgrassWarren Snodgrass More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The benefit of distal hypospadias repair has been questioned by studies of unoperated adults suggesting most adapt with few functional or aesthetic complaints (Fichtner 1995, Dodds 2008). Nearly all presented for unrelated urologic complaints and many were not aware of their anomaly. However, men self-identifying with uncorrected hypospadias in an on-line survey (Schlomer 2014) reported more difficulty with voiding and sexual function than unaffected men. We reviewed complaints in consecutive men with unoperated distal hypospadias to determine functional and aesthetic concerns. METHODS: Men with unoperated hypospadias were identified from a prospectively maintained database. Each was queried at presentation about his urinary stream, straightness of erections, sexual dysfunction and aesthetic concerns. RESULTS: From 2017-2020 a total of 25 men, mean age 42 years (18-63), presented with nonoperated distal hypospadias classified as MIP (8), coronal (6), subcoronal (8) and distal shaft (3). 14 (64%) were circumcised. Representative photos are shown. Of these, 20 (80%) had urine spraying. 9 (36%) had ventral or lateral (2) curvature, causing difficult penetration (1) and discomfort to their sexual partner (3). Altogether 8 (32%) reported painful sexual activity, including 3 with irritation of the exposed urethral mucosa and 1 whose scrotal web irritated his wife. 15 men (40%) were bothered by their appearance. Of all 25 men, 23 complained of an abnormal stream and/or appearance, and the other 2 experienced sexual dysfunction. CONCLUSIONS: Rather than adapting to their condition, all 25 men reported functional problems with voiding and/or sexual activity their entire adult life, and nearly half stated their different appearance currently bothered them. The denominator of men with uncorrected hypospadias is unknown, but the internet survey identified 52 with untreated hypospadias from 736 respondents, and they also reported significantly greater voiding concerns, penile curvature, and sexual disturbances. Even if our patients do not represent the entire population of men with uncorrected distal hypospadias, the adverse impact causing them to request repair even in middle age supports the conclusion that it cannot be dismissed as only a “cosmetic” problem or something men ultimately become accustomed to. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e826 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicol Bush More articles by this author Warren Snodgrass More articles by this author Expand All Advertisement Loading ...

MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE Mei Tuong, Anthony Herndon, Carlos Villanueva, Patricio Gargollo, Andrew Winkelman, and Nora Kern Mei TuongMei Tuong More articles by this author , Anthony Herndon Anthony Herndon More articles by this author , Carlos VillanuevaCarlos Villanueva More articles by this author , Patricio GargolloPatricio Gargollo More articles by this author , Andrew WinkelmanAndrew Winkelman More articles by this author , and Nora KernNora Kern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Method for correction of pediatric penile curvature (PC) usually is dependent on degree of PC which is reliant on how degree is assessed. We sought to assess the confidence and accuracy of measuring PC and hence management using case-based examples. METHODS: An email survey was sent to 355 active members of the Societies of Pediatric Urology. The survey consisted of case scenarios and assessed the management technique and confidence in ability to measure PC. RESULTS: The response rate was 30% (108/355); 97% were fellowship trained. 75% worked in an academic institution, and 50% had greater than 20 years of experience. A Likert scale from 1-5 measured provider confidence on estimating PC; the mean confidence score was 3.6±0.8 (3-fairly confident; 4-very confident). In clinic, 89% of providers used eyeball estimates to assess PC; 5% used both eyeball and goniometer. In the operating room, 71% used eyeball estimates, 8% used goniometer, and 16% used both. If sole decision-maker, providers recommend surgical correction of PC over observation at median 30° (IQR 21-30°). At a median of 45°, there was a shift in corrective surgical preference from dorsal plication (DP) (IQR 30-54°) to ventral lengthening (VL) (IQR 34-60°). See Table 1. Providers underestimated PC degree for all cases. In case 1, only 24% of providers would correct a mean estimate of 23° PC; those who would correct had a higher mean PC estimate vs those who would not (28° vs 21°, p<0.001). Case 2 and 4 had similar estimations and correction methods. In case 2, those who chose VL had a higher mean PC estimate vs those who did not (43° vs 37°, p<0.01), but no estimate difference was seen for DP (p=0.52). In case 4 with lateral PC, those who chose DP had a higher mean PC estimate vs those who did not (41° vs 33°, p=0.049). Yet in case 3, there was no difference in PC estimate in providers who chose VL vs not (57° vs 53°, p=0.16). For all cases, there was no association between provider years in practice or confidence level on estimated PC degree. CONCLUSIONS: A uniform underestimation of PC exists despite provider reported confidence in the ability to measure PC. An increasing willingness to perform surgical correction was demonstrated with a shift towards VL for ventral curvature and less so for lateral curvature as PC worsens. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e827 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mei Tuong More articles by this author Anthony Herndon More articles by this author Carlos Villanueva More articles by this author Patricio Gargollo More articles by this author Andrew Winkelman More articles by this author Nora Kern More articles by this author Expand All Advertisement Loading ...

V07-09 PENILE PROSTHESIS IMPLANTATION AND PEYRONIE'S DISEASE: HOW TO APPROACH THE RESIDUAL CURVATURE; A DETAILED DEMONSTRATION OF MOULDING TECHNIQUE AND GRAFTING PROCEDURE

You have accessJournal of UrologySexual Dysfunction & Transgender (V07)1 Sep 2021V07-09 PENILE PROSTHESIS IMPLANTATION AND PEYRONIE'S DISEASE: HOW TO APPROACH THE RESIDUAL CURVATURE; A DETAILED DEMONSTRATION OF MOULDING TECHNIQUE AND GRAFTING PROCEDURE Giovanni Chiriaco, Enya Maher, Wai Gin Lee, and David Ralph Giovanni ChiriacoGiovanni Chiriaco More articles by this author , Enya MaherEnya Maher More articles by this author , Wai Gin LeeWai Gin Lee More articles by this author , and David RalphDavid Ralph More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002034.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Insertion of a penile prosthesis is the treatment of choice in men with Peyronie’s disease and concomitant erectile dysfunction. The aim of surgery is to straighten the penis and allow adequate rigidity for sexual intercourse. A conundrum arises when there is residual curvature during device testing. This video highlights strategies that will aid the implanter when faced with these intraoperative challenges. METHODS: This video illustrates three different scenarios and suggests strategies that can be used when there is a residual penile curvature following inflatable penile prosthesis insertion: 1) Manual moulding – In this scenario, a persistent left lateral curvature is successfully straightened by moulding the plaque following device insertion. The cylinders are fully inflated and the tubes to the pump are double clamped. One hand is positioned distal to the apex of the curvature while the other is proximal. The penis is manipulated in the opposite direction to the curvature. 2) Residual curvature after manual moulding – The plaque can be incised at the point of maximal curvature and grafted If there is a significant persistent curvature (>30°) following moulding. TachoSil sealant matrix was used in this patient and it offers a quick and effective choice for grafting the tunical defect. 3) Upfront plaque incision and grafting - Some patients are not suitable for moulding following penile prosthesis insertion. Examples include ventral penile curvature and ossified plaques. In this patient with a ventral curvature, the plaque was incised and the tunical defect grafted with bovine pericardial graft prior to corporal dilatation. RESULTS: All three patients had an uneventful post-operative outcome. They were encouraged to cycle the device from 3 weeks and allowed to commence sexual intercourse after 6 weeks post-surgery. CONCLUSIONS: Manual moulding is a safe and effective first line option for residual penile curvature following inflatable penile prosthesis insertion. Plaque incision and grafting can be considered if moulding fails or where manual moulding is contraindicated. There are several choices for graft material including TachoSil or bovine pericardium. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e553-e553 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Chiriaco More articles by this author Enya Maher More articles by this author Wai Gin Lee More articles by this author David Ralph More articles by this author Expand All Advertisement Loading ...

Analysis of related risk factors for the refracture of adjacent vertebral body after percutaneous kyphoplasty

To investigate the risk factors of vertebral refracture after percutaneous kyphoplasty (PKP) for osteoprotic vertebral compression fractures (OVCFs), and to provide reference for clinical prevention. A retrospective analysis of 228 OVCFs patients who met the inclusion criteria admitted from November 6, 2013 to December 14, 2018. There were 35 males and 193 females, with a male-to-female ratio of 3∶20, and aged 58 to 91 years with an average of (69.70±7.03) years. All patients were treated with PKP and had complete clinical data. According to whether refracture occurred after operation, they were divided into refracture group (24 cases) and non refracture group (204 cases). Factors that may be related to refracture (including gender, age, surgical segment, number of vertebral bodies in the surgical segment, whether combined with degenerative scoliosis, whether anti-osteoporosis treatment) were included in the univariate analyses, and the single factor analysis of statistically significant risk factors was carried out with multiple Logistic regression analysis to further clarify the independent risk factors for vertebral body refracture after PKP. Survival analysis was performed using the time of vertebral refracture after PKP as the end time of follow up, the occurrence of refracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor. All 228 patients were followed up for 1.8 to 63.6 months with an average of (28.8±15.6) months, and the refracture rate was 10.5%(24/228). There were statistically significant differences between two groups in age, number of operative vertebral bodies, whether combinedwith degenerative scoliosis and whether anti osteoporosis treatment (P<0.05). Univariate Logistic regression analysis showed that the number of vertebral bodies in the surgical segment and whether combined with degenerative scoliosis may be risk factors for refracture after PKP. Multiple Logistic regression analysis of the above possible risk factors showed that combined scoliosis was an independent risk factor for vertebral refracture of the vertebral body. Survival analysis showed that the mean survival time was 42.1 months, the P value was 0.00, and the mean 95% confidence interval was 34.4-49.7 months, indicating that the combination of degenerative lateral bending might be related to the occurrence of refracture. Combined scoliosis is an independent risk factor for refracture after OVCFs vertebroplasty, and it is also a possible high-risk factor for refracture after surgery.

Evaluation of the Dynamic Trunk Motion of Scoliotic Patients Using Ultrasound-based Motion Analysis System

This study was investigated the effects of the adolescent idiopathic scoliosis on dynamic trunk motion using ultrasound-based motion analysis system. 15 subjects were participated in this study and divided into three groups according to the curve direction. Experimental procedure was divided into two sections: initial position, and left/right lateral bending position. To analyze the alteration of the trunk motion, ultrasound markers was represented the segments. There were significant differences in angle variation between left and right side during lateral bending for the scoliotic groups. In addition, angle differences between left and right side were decreased gradually according to the regions of scoliotic curvature. From these results, it was concluded that the direction and region of the abnormal lateral curvature can influence on dynamic trunk movement and postural balance. Furthermore, ultrasound-based motion analysis system can be utilized to detect asymmetrical balance and dynamic postural change of idiopathic scoliosis patients in adolescence.

The Role of Digital X-Ray in Curative Effect and Nursing Evaluation of Cervical Spondylotic Radiculopathy.

The present study attempted to analyze the features of atlanto-occipital radiograph in patients with cervical spondylotic radiculopathy or vertebral artery type. In order to reduce the interference of human factors and the measurement error as much as possible, this experiment adopts the blind design and analyzes the digital format X-ray films by using the computer software ImageJ. Because the tangent line between the outer plates of the anterior and posterior margin of the foramen magnum was not accurately located on the X-ray film, the angle formed by the line between the saddle dorsal slope and the center point of the anterior and posterior nodule with a clear display was selected as the measurement method of the angle between the atlanto-occipital joints. The results showed that the lateral cervical curvature of the VCS group was 0.43 ± 0.51, and the lateral cervical curvature of the CSR group was 0.46 ± 0.49, both of which were significantly lower than the normal value (1.2 ± 0.5 cm). Patients in both groups had the characteristic of cervical curvature straightening. The changes of cervical curvature in overflexion and overextension positions can indirectly reflect the state of cervical motion. The anterior flexion neck curve of the VCS group was less than that of the CSR group (P < 0.05). Compared with the CSR group, VCS showed limited cervical anterior flexion movement. In this study, X-ray films of both CSR and VCS showed occipitocervical flexion and extension disorders, cervical curvature straightening, and lower cervical instability. In VCS, occipitocervical flexion and extension disorders were mainly manifested in atlantoaxial flexion disorders, while in CSR, atlanto-occipitocervical flexion and extension disorders were mainly manifested in atlantoaxial flexion disorders.

P9. A distraction-based bench top protocol for the evaluation of growing rod concepatients

P9. A distraction-based bench top protocol for the evaluation of growing rod concepatients

Segmentation of dental X-ray in endodontic treatment

Background: The basis of successful endodontic treatment is the correct determination of the working length of the root canal (the distance between the external landmark on the crown of the tooth to the apical border). An apical constriction zone is recommended as a border for root canal treatment and filling. Intraoral radiograph allows you to obtain information about the direction of bending of the root canals, as well as to determine the working length. However, the radiograph is a two-dimensional total image and does not reproduce the entire anatomy of the apical part of the root therefore there are often layers and distortions of the image. When interpreting radiographs, there is a probability of error associated with the subjectivity of the evaluation result of the specialist. Thus, it is impractical to be guided exclusively by this method of determining the working length. The method of apexlocation is based on the difference of electrical resistance of tissues. The hard tissues of the tooth have a higher resistance than the mucous membrane of the mouth and periodontal tissue. Devices for electrometric determination of the working length of the root canal determine the impedance using alternating currents of different frequencies and apply the method of ratio. This measurement is stable and accurate even when working in wet channels and provides smooth visualization of all process of penetration of a top of the channel tool and high accuracy of definition of a place of physiological top of a root (over 80%). Modern algorithms for electrometric determination of the working length of the root canal do not combine the data obtained from the radiograph. In this regard, it is important to develop new methods and means of displaying electrometric data on the radiograph to more accurately determine the location of the physiological apex of the root. Objectives: Development of a method of segmentation of the dental radiograph to determine the area of apical narrowing. Materials and methods: principles of endodontic tooth preparation; methods for determining the working length of the root canal (radiological, electrometric); threshold segmentation method; method of segmentation of bone structures on tomographic images. Results: As a result of the performed work, the structures of the root canals of the tooth were segmented and their length was determined. Comparison of electronic determination of working length with radiological led to the fact that in some cases, X-ray and electronic length do not match. With lateral curvature of the canal, the X-ray may show a shorter working length than apexlocation devices, so the electronic working length is usually more accurate than the length determined by X-ray. Conclusions: The advantage of measuring the length of the root canal with an apex locator is much greater accuracy (about 0.5 mm) compared to the method of radiography, but the combination of these two methods is more reliable, which requires further statistical studies. Particular attention should be to the peculiarities of processing and segmentation methodsof the obtained diagnostic images to ensure the maximum quality of visualization of the contours of the root canals.

Identification of Copy Number Variants in a Southern Chinese Cohort of Patients with Congenital Scoliosis.

Congenital scoliosis (CS) is a lateral curvature of the spine resulting from congenital vertebral malformations (CVMs) and affects 0.5–1/1000 live births. The copy number variant (CNV) at chromosome 16p11.2 has been implicated in CVMs and recent studies identified a compound heterozygosity of 16p11.2 microdeletion and TBX6 variant/haplotype causing CS in multiple cohorts, which explains about 5–10% of the affected cases. Here, we studied the genetic etiology of CS by analyzing CNVs in a cohort of 67 patients with congenital hemivertebrae and 125 family controls. We employed both candidate gene and family-based approaches to filter CNVs called from whole exome sequencing data. This identified 12 CNVs in four scoliosis-associated genes (TBX6, NOTCH2, DSCAM, and SNTG1) as well as eight recessive and 64 novel rare CNVs in 15 additional genes. Some candidates, such as DHX40, NBPF20, RASA2, and MYSM1, have been found to be associated with syndromes with scoliosis or implicated in bone/spine development. In particular, the MYSM1 mutant mouse showed spinal deformities. Our findings suggest that, in addition to the 16p11.2 microdeletion, other CNVs are potentially important in predisposing to CS.

Visual and Vestibular Impairment and Idiopathic Scoliosis – are They Related?

Abstract Scoliosis is a tri-dimensional lateral curvature of the spine of 10° or more, with a rotational component. The most common form of scoliosis in the population is adolescent idiopathic scoliosis (AIS). As its name states, it has no known direct cause, even if, over time some evidence for multiple linked causes has been provided There is some evidence accumulated pointing to an association between AIS and posture control, where vision and vestibular systems are both involved We analysed the links between the curvature of the spine, its evolution and possible visual and vestibular impairment on 44 children with scoliosis. A postural aetiology of scoliosis in the visually and vestibular impaired population could be implied, since all the cases that could be defined as scoliosis and not as a scoliotic attitude (Cobb &gt; 10º) were positive for the Fukuda Stepping Test and more than 60% of the patients that had a Cobb angle value higher than 15º had a type of visual impairment (myopia).

Risk factors for screw loosening in patients with adult degenerative scoliosis: the importance of paraspinal muscle degeneration

BackgroundParaspinal muscle is an important component to maintain spinal stability. But the relationship between the degeneration of paraspinal muscle and postoperative screw loosening in patients with adult degenerative scoliosis has not been studied. The objective of this study was to investigate risk factors for screw loosening in patients with adult degenerative scoliosis, including paraspinal muscle degeneration.MethodsWe investigated 93 patients with adult degenerative scoliosis who underwent spinal interbody fusion and pedicle screw fixation surgery. The lateral curvature was located in the lumbar spine and the follow-up time was ≥ 2 years. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a 1-mm or wider circumferential radiolucent line around the pedicle screw. We checked the cross-sectional area of paraspinal muscles, spinopelvic parameters, bone mineral density, number of fusion segment, and other factors. The potential risk factors for screw loosening were investigated by using binary logistical regression analysis.ResultsFifty-seven patients showed screw loosening, which is 63.4% of total. Compared with patients in the non-loosening group, the cross-sectional area of erector spinae and psoas major muscle at L5 level were significantly smaller in patients with screw loosening (P < 0.05). Among these factors, the number of fused segments and relative erector spinae total cross-sectional area were independent risk factors for screw loosening.ConclusionsThe degeneration of paraspinal muscle and the increase of fusion segment were independent factors for screw loosening in patients with adult degenerative scoliosis.

Effect of 8 weeks of stretching, strength and central stability exercises on scoliosis of boy students

This study was conducted to determine the effect of 8 weeks of stretching, strength, and central stability exercises on scoliosis in boy aged 9 to 13 years. The study includes a comparative model. The statistical population of the present study was boy scoliosis, of whom 60 were scoliosis voluntarily participated in this study &amp; were randomly divided into three groups of 20 people: Experimental Group 1 (EG 1): Tensile, strength; Experimental Group 2 (EG 2): Tensile, strength training and central stability, Control Group CG). Scoliosis was used to measure scoliosis between the first to the 12th breast (C7 to S1) and the photogrammetric method. The results showed that the mean lateral curvature angle of EG 1 and EG 2 decreased significantly after participating in the correctional exercise program. There was no significant difference between EG 1 and EG 2. The results of the ANOVA test showed that EG 1 and EG 2 were significantly different from CG. The results of this study showed that the corrective exercises used in this study might have an effective effect on reducing the lateral curvature of the spinal column of students with scoliosis.