Lateral Curvature Of Spine Research Articles

Sagittal counter forces (SCF) in the treatment of idiopathic scoliosis: A preliminary report

In patients with idiopathic scoliosis (IS), reduced thoracic kyphosis and reduced lumbar lordosis frequently occur in correlation with the lateral spinal curvature. Normalization of the sagittal profile and hyper-correction of the deviation in frontal and coronal plane are the main issues of the latest concept of bracing. The purpose of this study was to investigate the influence of of sagittal counter forces (SCF) on the scoliotic deformity. A case series of four patients with IS treated with two braces designed to improve the sagittal profile (Rigo-System-Chêneau-brace and with a sagittal counter force brace, SCF-brace). The short-term effect (30 min) of both braces was evaluated using surface topography (Formetric surface topography system, Diers International, Wiesbaden). One patient (Cobb angle 92 degrees ) showed no short-term correction in the frontal and coronal planes; others (Cobb angles between 39 and 48 degrees ) exhibited valuable correction in frontal and coronal planes. There was no short-term correction in the sagittal plane for either brace. The application of sagittal counter forces (SCF) seems to have similar short-term effects as 3D correction and should be addressed more in future concepts of scoliosis bracing.

Pinealectomy induces malformation of the spine and reduces the mechanical strength of the vertebrae in Atlantic salmon, Salmo salar.

This study describes the long-term effects of surgical ablation of the pineal gland on the spine of 3-yr-old Atlantic salmon (Salmo salar L.) with a mean weight of 3.2 kg. Radiographic examinations showed that 82% of the pinealectomized fish developed marked lateral (scoliosis) and dorso-ventral spinal curvatures. The proportions of the individual vertebral bodies and their mechanical properties were also altered. The stiffness, yield limit and resilience of the vertebral bodies, as measured by compression in the cranio-caudal direction, were significantly lower in the pinealectomized than in the sham-pinealectomized group. Calcium, phosphorous and total mineral content of the vertebral bodies were also significantly lower in the pinealectomized fish, while these parameters were similar in scales in the two groups. Alterations of the spinal curve accompanied by changes in the proportions, mechanical strength and mineral content of the vertebral bodies of the pinealectomized salmon indicate that melatonin has several functions related to vertebral bone growth. As the lesions found in salmon are similar to the spinal malformations observed in avian species and mammals after pinealectomy, this study strengthens the hypothesis of a phylogenetically conserved function of the pineal gland related to skeletal development.

Management of scoliosis with special seating for the non-ambulant spastic cerebral palsy population––a biomechanical study

Objective. To investigate the effects of special seating on lateral spinal curvature in the non-ambulant spastic cerebral palsy population with scoliosis. Design. Prospective study with matched pairs (same subject pre- and post-intervention). Background. It is thought that special seating can improve the sitting posture of individuals with spastic cerebral palsy. However, there is little known about how the seating can affect a scoliosis. Method. The shape of the spine was measured with subjects sitting in an assessment chair with a clear backrest. The measurement recorded was the “spinous process angle”, an approximation to the Cobb angle. The forces exerted on the subject by the chair were measured by electrical resistance strain gauged transducers attached to the lateral support pads and seat base. Measurements were taken with three alternative arrangements of lateral support pads: upper body unsupported in configuration 1; two lateral pads at the same height in configuration 2; body supported by a 3-point force system in configuration 3. Results. Configuration 3 gave a mean correction of +35% in the spinous process angle compared to configuration 1 ( P=0.000) and the forces applied through the two lateral thoracic pads were, on average, of similar magnitude (mean values of 51 and 47 N). In comparison, for configuration 2 the mean correction was only +18.7% ( P=0.004) and on average the pad on the concave side of the scoliosis applied a much larger force to the chest wall than the pad on the convex side (mean values of 36 and 17 N respectively). Conclusions. Significant static correction of the scoliotic spine can be achieved with an arrangement of lateral pads on a seating system that applies a 3-point force system to the sides of the body. Relevance The results suggest that the position of the lateral pads on a special seating system is important and, by the careful configuration of these supports, significant correction of a scoliosis can be obtained for a person with spastic cerebral palsy. Also the methodology and equipment from this study are potentially useful for the assessment and fitting of special seating for individuals with scoliosis.

The Natural History of Untreated Adolescent Idiopathic Scoliosis

Orthopedics| May 01 2003 The Natural History of Untreated Adolescent Idiopathic Scoliosis AAP Grand Rounds (2003) 9 (5): 57–58. https://doi.org/10.1542/gr.9-5-57 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation The Natural History of Untreated Adolescent Idiopathic Scoliosis. AAP Grand Rounds May 2003; 9 (5): 57–58. https://doi.org/10.1542/gr.9-5-57 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: adolescent idiopathic scoliosis, idiopathic scoliosis Source: Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis. JAMA. 2003;289:559–567. The authors from the Universities of Iowa and Southern California report a 50-year prospective study of a cohort of untreated patients with late-onset idiopathic scoliosis (LIS), defined as a structural lateral spinal curvature occurring during puberty in otherwise healthy adolescents. The diagnosis of LIS was made at the University of Iowa between 1932 and 1948. One hundred seventeen of 314 eligible patients comprised the study group. Their mean age was 66 years. Follow-up studies of this cohort were reported at 30 and 40 years. For this study, 62 age- and sex-matched controls were included. Outcome measures were mortality, pulmonary symptoms, general function, depression, and body image. Data from the 30- and 40-year follow-up studies were used for longitudinal comparisons. Radiographic and physical examinations were performed.... You do not currently have access to this content.

Natural History of Untreated Scoliosis in beta-Thalassemia.

A prospective study was performed. To investigate the natural history of untreated scoliosis in beta-thalassemia patients in a 10-year period. Several previous studies have demonstrated the bone deformities, particularly the high incidence of scoliosis, that is associated with beta-thalassemia. However, little is known about the evolution of scoliosis curvatures, and almost nothing is known about the natural history of this type of scoliosis and its associated lateral spinal curvatures. From a group of 115 patients with beta-thalassemia who were evaluated for scoliosis 10 years ago, 43 patients (37%) were re-evaluated 10 years later to study the evolution of the untreated scoliosis and lateral spinal curvatures. Scoliosis, thoracic kyphosis, thoracolumbar kyphosis, and lumbar lordosis were measured both in the initial and last observation and were compared with each other. All changes in scoliosis curve location, direction, and rate of resolving, as well as the changes in the magnitude of the lateral spine curves, were recorded. Scoliosis curves of more than 5 degrees were present in 34 (79%) of the 43 patients who were followed. Scoliosis progressed but was not statistically significant in 12% of the patients with thalassemia in a 10-year span. Ten years ago, 12 patients (28%) showed scoliosis of 10 degrees to 14 degrees, whereas in the last evaluation, 15 patients (35%) had scoliosis of 10 degrees to 19 degrees. The S-shaped scoliosis curve pattern was the most common (29%). In 10 years, the scoliosis curve pattern remained unchanged in 38% of the patients, and it changed in 38%, whereas 24% of the minor curves (5-9 degrees ) showed spontaneous "self-resolving" character. In the last evaluation, there were seven patients (16%) with new cases of scoliosis de novo. There was no sex-related predominance in prevalence of scoliosis in this series. There was a significant skeletal mature retardation in the patients with beta-thalassemia. There was a significant increase of thoracic and thoracolumbar kyphosis and a decrease of lumbar lordosis. The changes in the sagittal profile were not correlated to scoliosis in this group of patients. Scoliosis in beta-thalassemia appeared with increased prevalence but with small curves of 5 degrees to 19 degrees that did not need active orthopedic treatment. However, a few cases progressed to curves less than 20 degrees, and only one patient (2.9%) showed a severe curve that showed much progression. The behavior of scoliosis in beta-thalassemia differs significantly from that in idiopathic scoliosis. The skeletal disorders that are caused by this hematologic dysfunction seem to be responsible for the spinal deformities and their evolution.

Cerebral aneurysm associated with von Recklinghausen’s neurofibromatosis: a case report

BACKGROUND von Recklinghausen’s neurofibromatosis is a hereditary disease that may affect any organ or system of the body primarily or secondarily, including the vascular system. Among the rare cerebrovascular abnormalities, the most common is stenosis or occlusion of the cerebral artery. Intracranial aneurysms are uncommon. CASE DESCRIPTION A case of an intracranial cerebral aneurysm associated with von Recklinghausen’s neurofibromatosis is reported. A 55-year-old woman presented with a history of intermittent headache for 2 months and right oculomotor nerve palsy for 1 month. Widespread cutaneous neurofibromas and angiomas were found over her trunk and limbs with prominent cafe-au-lait spots. X-ray showed that her left lung was compressed by a large mass in the left chest with rib defects and lateral spinal curvature. Right internal carotid angiography revealed a saccular aneurysm between C1 and C2. Craniotomy to clip the aneurysm could not be performed because the mass in her chest made intubation for general anaesthesia almost impossible. CONCLUSION The clinical features of this case are discussed together with a review of 15 similar cases in the literature. There are different theories about this disorder. We agree that the malformations are derived not only from ectodermal, but also from mesodermal pathology. In terms of our case, we consider the progression of this disease to be slow.

Analysis of symmetry of vertebral body loading consequent to lateral spinal curvature.

A biomechanical model was used to calculate muscle and intervertebral forces in a spine with and without a lumbar scoliosis. To quantify the loading of the motion segments in a lumbar scoliosis. Scoliosis is thought to cause asymmetric loading of vertebral physes, causing asymmetric growth according to the Hueter-Volkmann principle. The magnitude of vertebral loading asymmetry as a function of scoliosis magnitude is unknown, however, as is the sensitivity of growth to asymmetric loading. The analysis included five lumbar vertebrae, the thorax, and the sacrum/pelvis and 90 pairs of multijoint muscles. Five spinal geometries were analyzed: the mean spinal shape of 15 patients with left lumbar scoliosis (38 degrees Cobb angle, apex at L1-L2, the reference or "100%" geometry), and the geometry scaled to 0%, 33%, 67%, and 132% of the asymmetry of the reference shape. The muscle and intervertebral forces for maximum efforts opposing moments applied to the T12 vertebra in each of the three principal directions were calculated. The loading at each intervertebral level was expressed as the resultant force (P), the axial torque, the lateral and anteroposterior offset of P from the disc center, and the angle of P from the axial direction. With increasing scoliosis, there was a weak trend of increasing lateral offset of P, but not consistently to either the convex or concave direction. There was a much stronger trend of increasing angle between the force P and the motion segment longitudinal axis with increasing Cobb angle. Typically, this angle was 10-30 degrees for the largest scoliosis (51 degrees Cobb) and in a direction tending to increase the scoliosis. This angulation of the force results from shear loading of the disc. Axial torques tending to increase the transverse plane deformity increased with scoliosis for extension efforts. These analyses indicate that lumbar scoliosis produces asymmetric spinal loading characterized by shear forces tending to increase the scoliosis, but with little increase in the asymmetric compression of motion segments. If scoliosis progression results from asymmetric loading, it appears that the shear force component is responsible.

The relationship between surface and radiological deformity in adolescent idiopathic scoliosis: effect of change in body position.

Three-dimensional (3D) surface deformity of the trunk in adolescent idiopathic scoliosis (AIS) is affected by changes in patient position. Initial quantification of the curve and its associated deformity, as well as subsequent monitoring, relies on both radiological and surface measurements. However, there is often a discrepancy between radiological and apparent surface deformity. The present investigation studied the dynamics of the 3D deformity associated with changes in patient position on 27 patients with AIS. The trunk deformity was quantified in three positions by measuring the angle of thoracic inclination at each vertebral level using a scoliometer. The patients all had full spine radiography in the antero-posterior erect position. Vertebral rotation and lateral spinal curvature were measured from the radiographs. Body position altered the magnitude of the surface deformity over the whole trunk, with the prone position offering the optimum relationship between 3D trunk shape and radiological deformity. This could be attributed to the ease and standardisation of positioning for prone measurements, together with increased patient comfort. It is suggested that adoption of standardised positioning and measurement of surface and radiological deformity will permit consistency of clinical judgement based on these parameters.

STATURE AND ITS COMPONENTS IN ADOLESCENT IDIOPATHIC SCOLIOSIS. CEPHALO-CAUDAL DISPROPORTION IN THE TRUNK OF GIRLS

Stature and its components were examined in 143 girls aged 11 to 15 years with adolescent idiopathic scoliosis. Correction was made for loss of height due to the lateral spinal curvature, and the findings were compared with those from 202 healthy girls of similar age. Using three components of stature (suprapelvic, pelvic and subischial heights) we were able to show that the relatively greater stature of girls with adolescent idiopathic scoliosis was due to changes in the pelvis and lower limbs but not significantly in the spine. Suprapelvic height was reduced relative to subischial height; this probably represents the growth pattern of predominantly ectomorphic individuals, reflecting the physique of many of these girls. Pelvic height was disproportionately increased, and this is considered to be a true rather than an apparent difference. Cephalocaudal disproportion involving two segments suggests a common mechanism of causation which is unlikely to be secondary to the scoliosis. These physical features may in some way be associated with a predisposition to progression of the scoliosis.

Stature and its components in adolescent idiopathic scoliosis. Cephalo-caudal disproportion in the trunk of girls

Stature and its components were examined in 143 girls aged 11 to 15 years with adolescent idiopathic scoliosis. Correction was made for loss of height due to the lateral spinal curvature, and the findings were compared with those from 202 healthy girls of similar age. Using three components of stature (suprapelvic, pelvic and subischial heights) we were able to show that the relatively greater stature of girls with adolescent idiopathic scoliosis was due to changes in the pelvis and lower limbs but not significantly in the spine. Suprapelvic height was reduced relative to subischial height; this probably represents the growth pattern of predominantly ectomorphic individuals, reflecting the physique of many of these girls. Pelvic height was disproportionately increased, and this is considered to be a true rather than an apparent difference. Cephalocaudal disproportion involving two segments suggests a common mechanism of causation which is unlikely to be secondary to the scoliosis. These physical features may in some way be associated with a predisposition to progression of the scoliosis.

Combined idiopathic kyphosis and scoliosis. An analysis of the lateral spinal curvatures associated with Scheuermann's disease.

A radiological study of 50 patients with thoracic Scheuermann's disease revealed two types of lateral spinal curvature. A total of 43 lateral curves was present in 35 of the patients. Thirteen were apical at the same level as the Scheuermann's kyphosis and were due to vertebral-body wedging in the coronal plane; these curves had a mean Cobb angle of 15 degrees, occurred with equal prevalence in boys and girls and were directed equally to right and left. Thirty curves occurred in regions of compensatory lordosis (mean 5.6 degrees) situated above or, more commonly, below the Scheuermann's kyphosis. These scolioses had a mean Cobb angle of 16 degrees, were more often convex to the right than to the left and were significantly more prevalent in girls than in boys. The presence of these kyphoses and scolioses in the same spine, separated by only a few vertebrae, emphasises the importance of the sagittal plane in idiopathic spinal deformities and strongly suggests that idiopathic scoliosis and Scheuermann's disease share a common pathological process.

Effects of the duration of exposure to mercuric chloride on the embryogenesis of the estuarine teleost, Fundulus heteroclitus

Embryos of Fundulus heteroclitus in the 4–8 cell stage were exposed nine Hg ++ (as mercuric chloride) concentrations from 0 to 100 μg/litre (ppb) for 32 days, 5 days, 2 days and 1 day. All but the chronically (32-day) exposed embryos were allowed to continue development in mercury-free water (20% S) after the exposure period to determine the effect of duration of exposure on three parameters of development. Ninety-six hour survival, total hatching success and per cent incidence of lateral spinal curvature were measured. Only embryos exposed to mercury for a single day showed a significant increase in survival in comparison with embryos exposed for a longer period of time after four days of development. Under all conditions of exposure, survival was reduced at concentrations greater than 40 ppb Hg ++. Hatching success of chronically exposed embryos was significantly reduced at concentrations greater than 10 ppb Hg ++. Significant increases in total hatchability were effected by reducing the duration of exposure to five days and one day. Of eleutheroembryos emerging following chronic exposure to mercury, increases in the incidence of lateral spinal curvature were noted at all concentrations above 20 ppb Hg ++. Significant reductions of this disorder were observed among eleutheroembryos exposed to mercury for 5 days, 2 days or 1 day. Of the three parameters measured, the incidence of lateral spinal curvature and the resulting VH 50 value gave a more sensitive evaluation of the embryotoxic effects of Hg ++ as mercuric chloride on the estuarine teleost, Fundulus heteroclitus.

Braces in Spinal Curvature.

Chicago, Sept. 12, 1898. To the Editor: —In theJournalof Sept. 10, 1898, there appears an editorial entitled Braces in Spinal Curvature which contains so many half truths, to put it gently, that it should not pass without comment. editorial writer says: The two conditions of tubercular caries and spinal curvature differ so widely in their causation, symptomatology and treatment that each must have a clearcut picture in our mind when examining soinal caries. This is true in so far as causation and treatment go, but it is not true in all cases in so far as symptomatology is concerned. It is true that there are cases that distinctly differ, and there are other cases where those having the greatest experience can not at once differentiate. Lateral spinal curvature may not simulate tubercular caries, indeed there would be no serious harm done to the patient by the treatment