Prevalence Of Scoliosis Research Articles

Effects of 8 years of growth hormone treatment on scoliosis in children with Prader-Willi syndrome.

Scoliosis is frequently seen in children with Prader-Willi syndrome (PWS). There is still concern that growth hormone (GH) treatment might increase the risk of onset or progression of scoliosis. Short-term data suggested no adverse effects of GH on scoliosis, but long-term effects of GH treatment on development of scoliosis in PWS are unknown. This study investigated the effects of 8 years of GH treatment on scoliosis in children with PWS. Open-label, prospective cohort study in 103 children with PWS receiving GH for 8 years was analyzed. Prevalence and severity of scoliosis were compared to a group of 23 age-matched GH-untreated children with PWS. Spine X-rays and DEXA-scans were performed, and Cobb angel was measured by two independent observers. After 8 years of GH treatment, at median age of 10.8 years, prevalence of scoliosis was 77.7%. No difference in prevalence or severity of scoliosis was found between GH-treated and age-matched untreated children with PWS (P = 0.409 and P = 0.709, respectively). Height SDS and trunkLBM were significantly higher in GH-treated children. Higher bone mineral density of the lumbar spine was found in children without scoliosis after 8 years of GH. Bone mineral apparent density of lumbar spine (BMADLS) SDS was associated with lower Cobb angle (r = -0.270, P = 0.008). Eight years of GH treatment has no adverse effects on the prevalence and severity of scoliosis in children with PWS until 11 years of age. As BMADLS SDS is inversely associated with Cobb angle, it is pivotal to optimize the BMD status in children with PWS.

The effectiveness and safety of Chuna manual therapy on scoliosis: A protocol for systematic review and meta-analysis.

Background:Scoliosis is a spinal deformity and is diagnosed as Cobb angle being greater than 10°. Because it is accompanied with structural dysfunction, it can cause pain, worsen the patient's general health and quality of life. The prevalence of scoliosis has been increasing and many treatments, including surgical treatment and conservative treatment, such as observation, bracing, physiotherapy, and Chuna manual therapy (CMT), have been suggested. CMT is a manual therapy in Korean medicine that provides effective stimulation to the patient's body structure to treat structural dysfunction. After Korean national health insurance's coverage of CMT in 2019, the application of CMT for scoliosis has increased, and many studies have been reported. There have been attempts to elucidate the effectiveness of CMT on scoliosis; however, its effectiveness still remains unconfirmed. Therefore, the aim of this study is to evaluate the effectiveness and safety of CMT on scoliosis.Methods:The published randomized controlled trials that evaluated the effectiveness and safety of CMT for scoliosis will be searched for in multiple electronic databases without the limitation of country and language. Data on characteristics of studies, interventions, comparators, outcome measures, results, and information for assessment of study quality will be extracted. The primary outcome will be the Cobb angle and the secondary outcomes will be the scales of pain, function, quality of life and disability, and adverse events. Data synthesis and analysis will be conducted using the Review Manager software for Windows (RevMan ver. 5.3.; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Subgroup analysis to identify the differences between different CMT maneuvers will also be performed. For risk of bias assessment, the “risk of bias” tool from Cochrane Collaboration will be used.Results:This study will present the clinical evidence on the effectiveness and safety of CMT on scoliosis.Conclusion:This study will propose useful evidence for treatment, further research, and health policies in the future.

Prevalence of congenital scoliosis in infants based on chest–abdomen X-ray films detected in the emergency department

To investigate the prevalence of congenital scoliosis (CS) in infants based on chest-abdomen radiographs. A retrospective review was conducted on infants in the emergency department (ED) of a tertiary children's hospital between February 2008 and September 2019. Patients who had undergone chest-abdomen X-rays were included. All films from the enrolled patients were screened for CS. Their demographic characteristics, type, and location of the vertebral and rib anomalies, and concomitant defects of other systems were analyzed. In total, 50,426 infants were enrolled; 89 (1.8‰) were diagnosed with CS, including 56 males and 33 females. There was no gender difference in CS prevalence. The visiting age of the CS patients (70 ± 98days) was significantly younger than that of the non-CS group (P < 0.05), with CS patients mainly visiting for digestive (53.9%) and respiratory symptoms (41.6%). Sixty-eight (76.4%) CS patients had main thoracic (T6-T11) vertebral malformations. Rib anomalies were documented in 27 (30.3%) patients, of which 14 had complex rib anomalies. Forty (44.9%) patients had concomitant defects of other organs, of which eight patients had two systemic abnormalities mixed. The most common extraspinal defects were imperforate anus (21, 23.6%) and congenital cardiac defects (17, 19.1%). The prevalence of CS in infants based on chest-abdomen X-rays in the ED was 1.8‰. Both the vertebral and rib anomalies mainly affected the main thoracic region. The spine deformities in infants with concomitant defects of other organs could be identified earlier because of early-onset symptoms, which also bring out a selection bias in our analysis.

Lumbar Scoliosis in Postmenopausal Women Increases with Age but is not Associated with Osteoporosis.

ContextThe contribution of lumbar scoliosis to osteoporosis is unknown.ObjectiveThis work aimed to determine the prevalence and relationship of lumbar scoliosis to osteoporosis in aging women.MethodsA cross-sectional analysis used dual-energy x-ray absorptiometry (DXA) scans of randomly selected groups of postmenopausal women (64-68, 74-78, and 84-88 years; N = 300 each) in a university teaching hospital from 2014 to 2019. Lumbar Cobb angle was tested for an association to femoral neck (FN), total hip (TH), and spine T score, age, weight, and ethnicity. Logistic regression tested an association between scoliosis (Cobb angle > 10°) and osteoporosis (T score ≤ –2.5). Available sequential DXA scans (N = 51) were analyzed for changes in Cobb angle using a linear mixed model of these longitudinal data.ResultsOsteoporosis and Cobb angle both increased with age: from 22% and 4.4 (SD = 7.8) respectively in 64- to 68-year-olds to 32.9% and to 9.7 (SD = 9.2) in women age 84 to 88 years. The prevalence of clinically significant scoliosis rose from 11.5% in the youngest group, to 27.3% and 39.4% in the age 74 to 78 and 84 to 88 cohorts, respectively. Cobb angle increased 0.7° per year of follow-up. After adjusting for covariates, there was no significant association between T scores at any site (TH, FN, or spine) and Cobb angle.ConclusionBased on screening DXAs, the incidence and degree of lumbar scoliosis increases significantly in women between age 65 and 85 years. There was no association between the incidence of lumbar scoliosis and FN bone density.

Generalized joint hypermobility, scoliosis, patellofemoral pain, and physical abilities in young dancers

BackgroundMany young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies.MethodsOne hundred thirty-two female dancers, aged 12–14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP.ResultsGJH was identified in 54 dancers (40.9%) and scoliosis in 38 dancers (28.8%). Significant differences were found in the proportion of dancers with no anomalies (74 dancers, 56.1%) and dancers with both anomalies (34 dancers, 25.8%) (p < .001). Dancers with both anomalies had reduced dynamic postural balance in the anterior direction (p = .023), reduced proprioception ability (p < .001), and weaker knee extensors (p = .036) and flexors (p = .040) compared with dancers with no anomalies. Among dancers with both anomalies, 73.5% suffered bilateral PFP, 17.6% suffered unilateral PFP, and 8.8% had no PFP (p < .001).ConclusionsA high prevalence of young girls participating in dance classes had GJH, as the increased joint flexibility probably provides them with some esthetic advantages. The high prevalence of scoliosis found in these young dancers might be attributed to their relatively low body mass, their delayed maturation, and the selection process of dancers. Dancers with both GJH and scoliosis had decreased muscle strength, reduced postural balance, reduced proprioception, with higher risk of PFP. The main clinical implications are the need to reduce the risk of PFP among dancers by developing appropriate strength and stabilizing exercises combined with proprioceptive and postural balance training, to improve the correct alignment of the hyperextended and hypermobile joints, and to improve their supporting muscle strength.

Prevalence of Scoliosis in Cerebral Palsy

Background: Significant structural deformity of the spine often accompanies cerebral palsy. Progression of curve will eventually lead to pain, loss of ambulation, sitting balance. The aetiology of scoliosis in CP has yet to be well defined. Objective: The objective of this study was to find incidence of scoliosis in different sub-types of cerebral palsy. Method: A total population of 30 children with cerebral palsy aged 5 to 20 years followed with examination and assessment for scoliosis in a health care setting was analysed. GMFCS level, CP subtype, age at diagnosis, gender dominance of the condition were correlates registered. Effect of 5 factors on progression of the curve and type of scoliosis dominant in cerebral palsy was studied. Results: Of the 30 subjects initially enrolled in the study, 19 of them with scoliosis in which incidence of 28% was found among spastic quadriplegia followed by 24% in diplegia. The risk of scoliosis increased with GMFCS level and age. 22% of children showed moderate scoliosis with respect to scoliosis appearance questionnaire. Conclusions: Scoliosis was most common in the spastic group with the highest incidence in the spastic quadriplegics. There was a definite inverse relationship between the level of ambulation and scoliosis: the higher the level of ambulation the lower the incidence of scoliosis. Moderate scoliosis was found because progression of curve is expected to continue until skeletal maturity.

The prevalence of scoliosis within Belgian myelomeningocele population and the correlation with ambulatory status and neurological comorbidities: a chart audit.

Retrospective chart audit. Firstly determining the prevalence of scoliosis in myelomeningocele (MMC) patients of the University Hospitals Leuven. Secondly analyzing whether there are differences concerning distribution of radiological level, ambulatory status, hydrocephalus, tethered cord, and syringomyelia in MMC patients with/without scoliosis. University Hospitals Leuven, spina bifida convention. The following data were collected: age, gender, radiograph type, age at the time of the radiograph, position during radiograph, presence of fusion, age at the time of fusion, diagnosis of hydrocephalus, tethered cord, or syringomyelia, radiological level of MMC, ambulatory status, main Cobb angle, main curve convexity, and main curve location. Correlation between prevalence of scoliosis and ambulatory status, neurological comorbidities, and radiological level were investigated. There were 116 patients remaining, after excluding patients without MMC or useful images. The scoliosis prevalence in MMC patients was 78.4% (95% CI, 71.0-85.8) for Cobb angle ≥10°; 60.3% (95% CI, 51.4-69.2) for ≥20°, 52.6% (95% CI, 43.5-61.7) for ≥30°, and 36.6% (95% CI, 27.7-45.5) for an angle ≥40°. Wheelchair users had 4 to 8 times more chance of having scoliosis than patients able to walk on all surfaces without aid. Thoracolumbar and lumbar radiological levels had a slightly higher prevalence of scoliosis than sacral levels. The high prevalence of scoliosis warrants a thorough screening and follow-up for MMC. There was no statistically significant difference between hydrocephalus, tethered cord, or syringomyelia regarding scoliosis. Future studies should focus on the interactions of the neurological comorbidities associated with MMC and scoliosis.

Sagittal curvature of the spine as a predictor of the pediatric spinal deformity development.

The sagittal curvature of the spine is hypothesized to play an important role in induction of spinal deformities in adolescent idiopathic scoliosis. We previously showed an S shaped flexible rod, with the same curvature as the pediatric sagittal spinal curve, produces scoliotic-like deformities under physiologic loading. Yet, detailed characteristics of the pediatric sagittal spinal curves associated with higher risk of scoliosis are not well defined. A total of 32 patients in a population with a high prevalence of idiopathic-like scoliosis, 22q11.2 deletion syndrome (22q), were included and followed up for at least two-years. We developed a reduced order finite element model (FEM) of the sagittal profile of these 32 patients where the spine was modeled as an S shaped elastic rod. We related the geometrical parameters of the sagittal curves and the deformed FEM of the corresponding S shaped rods to the risk of scoliosis development at two-year follow-up in this cohort. Variations in the sagittal curvature in the cohort of 22q patients resulted in five different deformity patterns shown by finite element analyses. Two sagittal plane deformity pattern groups had high rate of scoliosis development (86% and 100%) whereas the other 3 groups had less than 50% rate of scoliosis development (40%, 33%, and 0%). The pre-scoliotic position of the inflection point (where lordosis turns into kyphosis), the ratio of the spinal curvatures above and below the inflection point, and the length of the spinal curve above and below the inflection point were significantly different between the five deformity patterns groups, p < 0.05. Combination of geometrical parameters of the sagittal profile prior to onset of scoliosis can relate to the development of spinal deformity in pediatric population.

Proper positioning of mice for Cobb angle radiographic measurements

BackgroundThere is no recommended standard for positioning of a mouse for radiographic assessment of the spine. This is necessary to have reproducible radiographic data and avoid false positive results. The objective of this study was to investigate the impact of various postures on Cobb angle measurements and to set up a positioning standard for imaging mouse spines.MethodsThis study was conducted in three parts. Firstly, we identified the problem of lack of posture standardization for radiographs. We collected 77 C57BL/6 J mice for spine radiographs and found a scoliosis prevalence of 28.6% with large variations in curve magnitude. Secondly, 24 C57BL/6 J mice underwent 4 consecutive weekly radiographs and observed high variations (relative standard deviation: 125.3%) between radiographs. Thirdly, we collected another 82 C57BL/6 J mice and designed 14 different postures that could take place during imaging. These postures were related to curling of the limbs, and head, pelvic and tail tilting.ResultsThe results showed that head and pelvic tilting significantly affects the curve magnitude with effect size (Glass’s delta) over 1.50. Avoiding these incorrect positions during radiographs is warranted. The standard recommended posture for mouse imaging entails positioning the snout, interorbital space, neck and whole spine in one line, and with the limbs placed symmetrical to the trunk, whilst avoiding stretching the body of the mouse.ConclusionsOur work exemplified the importance of standard protocol during imaging when using an animal model in the scoliosis study. We recommend utilizing this standard in studying various disorders of the spine to avoid technical causes for the appearance of a curve.

Smith-Magenis syndrome: Clinical and behavioral characteristics in a large retrospective cohort.

Smith-Magenis syndrome (SMS), characterized by dysmorphic features, neurodevelopmental disorder, and sleep disturbance, is due to an interstitial deletion of chromosome 17p11.2 (90%) or to point mutations in the RAI1 gene. In this retrospective cohort, we studied the clinical, cognitive, and behavioral profile of 47 European patients with SMS caused by a 17p11.2 deletion. We update the clinical and neurobehavioral profile of SMS. Intrauterine growth was normal in most patients. Prenatal anomalies were reported in 15%. 60% of our patients older than 10 years were overweight. Prevalence of heart defects (6.5% tetralogy of Fallot, 6.5% pulmonary stenosis), ophthalmological problems (89%), scoliosis (43%), or deafness (32%) were consistent with previous reports. Epilepsy was uncommon (2%). We identified a high prevalence of obstipation (45%). All patients had learning difficulties and developmental delay, but ID range was wide and 10% of patients had IQ in the normal range. Behavioral problems included temper tantrums and other difficult behaviors (84%) and night-time awakenings (86%). Optimal care of SMS children is multidisciplinary and requires important parental involvement. In our series, half of patients were able to follow adapted schooling, but 70% of parents had to adapt their working time, illustrating the medical, social, educative, and familial impact of having a child with SMS.

ASSESSMENT OF THE DYNAMICS OF SCOLIOSIS LEVELS OF CHILDREN IN THE CHERNIHIV REGION AS A DIRECTION IN THE ORGANIZATION OF REHABILITATION MEASURES

The aim: analysis of the dynamics of scoliosis levels among children aged 0-17 years of Chernihiv region and Ukraine, establishing the age category of children with the highest levels of this pathology.Materials and methods: the source of information was the data of the Center for Medical Statistics of the Ministry of Health of Ukraine and the State Statistics Service.Sanitary and statistical surveys cover Ukraine and Chernihiv region. The analysis of the structure of morbidity by age groups for the specified period is carried out. Statistical processing was performed using Excel.Results. In the period 2016-2020, both in Ukraine as a whole and in the Chernihiv region, the prevalence of this pathology decreased slightly (by 17.7% and 14.8%, respectively). There was a 2.5% increase in scoliosis among boys and a 2.5% decrease among girls.There was an increase in the levels of scoliosis among children at the end of the preschool period: six-year-olds 1.2 times, seven-year-olds – 1.9 times, which indicates the earlier development of pathology in modern conditions of insufficient physical activity of the younger generation.Conclusions. During the five-year observation period (2016-2020), the prevalence of scoliosis among children aged 0-17 years in the Chernihiv region decreased by 14.8% and at the end of the reporting period was 43% lower than the national average. During the analyzed period, the predominance of this pathology among girls is noted. Invariably, the highest levels of pathology are observed among school-age children with a tendency to increase the incidence of scoliosis in schoolchildren.

Role of Body Cast Application for Scoliosis Associated With Prader-Willi Syndrome.

Prader-Willi syndrome (PWS) is a rare genetic syndrome, with a prevalence of infantile scoliosis of ~23%. These curves are likely related to severe hypotonia. Approximately 15% of children with PWS will need surgical intervention for their scoliosis. The purpose of this study was to evaluate the effectiveness of curing or controlling moderate and severe infantile scoliosis curves in children with PWS. This single institution, retrospective study of patients with PWS and infantile scoliosis reviewed 34 consecutive children with >24 months follow-up from initiation of serial spinal casting. Cobb angle comparison measurements of radiographs taken precasting, during treatment, and at follow-up were performed. Rib-vertebral angle difference, Nash-Moe rotation, and space available for lung measurements were followed. Outcomes were stratified as "Cured," "Braced," and "Surgery." Average age for first cast for the entire study was 32 months (range, 14 to 64), undergoing 8 casts (range, 3 to 18) over 25 months (range, 9 to 57) for an initial curve of 54 degrees (range, 27 to 106 degrees), which improved to 27 degrees (range, 11 to 78 degrees). In total, 12 patients (35%) were in the Cured group, following 6 casts over 17 months, with an initial curve of 44±14 degrees improving to 17±5 degrees at the end of treatment, and 20±18 degrees at 68-month follow-up. In total, 18 patients were in the Braced group, with curves initially improving from 55±14 degrees to 35±14 degrees, but at 47±20 degrees at 51-month follow-up. Four patients needed surgery, with initial curves 85 degrees (range, 54 to 106 degrees), but surgery could be postponed 56 months (range, 40 to 73) by casting. Rib-vertebral angle difference was not prognostic. Serial spinal casting is effective in for treating infantile scoliosis in children with PWS. One third of patients had their curve resolved, at least temporarily, where they were braced and cast free. The others were able to delay surgery for a number of years. Initial curves <50 degrees in children <3 years of age seem to have the best prognosis. Level IV.

A long-term follow-up study of spinal abnormalities and pain in adults with cerebral palsy and spastic diplegia more than 25 years after selective dorsal rhizotomy.

The main purpose of selective dorsal rhizotomy (SDR) is to reduce spasticity in the lower extremities of children diagnosed with cerebral palsy (CP) and spastic diplegia. The potential for developing spinal abnormalities and pain is a concern, especially in the aging CP population. Therefore, the aim of this study was to evaluate spinal abnormalities, level of pain, and disability (due to back or leg pain) in adults with CP, and associations with participant characteristics, more than 25 years after SDR. This is a 9-year follow-up study with data collection conducted in 2008 and 2017. Radiographs were assessed for the degree of scoliosis, thoracic kyphosis and lumbar lordosis curvatures, and prevalence of spondylolysis and spondylolisthesis, while level of pain and disability was determined with a self-developed questionnaire and the Oswestry Disability Index (ODI) questionnaire, respectively. Twenty-five participants were included (15 males; median age 35.9 years, IQR 34.3-41.5 years), with a follow-up time after SDR ranging from 25 to 35 years. No clinically relevant changes were found for spinal curvatures, spondylolysis and spondylolisthesis, perceived pain frequency, and ODI scores between 2008 and 2017. While the prevalence of spondylolysis was 44%, spondylolisthesis was found in 20% (of whom 15% were grade I and 5% grade II), lumbar hyperlordosis was found in 32%, thoracic hyperkyphosis in 4%, and scoliosis in 20%. The Cobb angle was < 25°, and no patient required surgery for scoliosis. In addition, the low back was reported as the most common site of pain, with 28% of the adults with CP having daily pain. This resulted in 80% of the cohort indicating none or minimal disability due to pain based on the ODI. The only correlation found was between hyperkyphosis and female gender. At follow-up more than 25 years after SDR, no progression in spinal abnormalities, level of pain, and disability was found when compared with findings 15 years after SDR. The prevalence of scoliosis, thoracic hyperkyphosis, and lumbar hyperlordosis was within the range reported for adults with CP, while spondylolysis and spondylolisthesis occurred more often than would be expected. It is difficult, however, to establish the role of SDR in this finding, given the limited data on the natural history of CP. Despite the encouraging outcome of this long-term follow-up study after SDR, it is important to continue monitoring adults with CP during the aging process.

Geometric morphometrics of adolescent idiopathic scoliosis: a prospective observational study.

Adolescent idiopathic scoliosis is the most prevalent type of scoliosis, and its consequences on the human torso have not been deeply studied. In spite of being a 3D condition, clinical management is circumscribed to 2D images among health-care professionals. GMM is a well-recognized tool in the study of 3D shape and symmetry. Twenty-four subjects with AIS and 24 controls were subjected to surface scan. Digitization and shape data were extracted and submitted to GMM analysis. 3D shape and asymmetry were correlated with Cobb angle in subjects with X-ray availability. Comparisons of mean shapes were done between each group and its symmetric average shape and between each group at two states: initial and 6months after. AIS and controls show similar areas of asymmetry, being significantly higher in quantity in AIS (PD = 0.045; PD 0.037; p < 0.001). Significant correlation was observed between Cobb angle and Procrustes asymmetry (r = 0.38; p = 0.01) as happened with 3D shape (r = 0.11; p < 0.001). No significant changes were observed in the 3D shape of both groups 6months after (AIS, p = 0.51; control, p = 0.304). The greater asymmetry observed in AIS was expectable, but the similarity of areas of asymmetry in both groups made us suspect of directional asymmetry in the human torso that could explain the high prevalence of right scoliosis observed in nature. The shape of the torso and the asymmetry should be considered as variables to study in AIS due to its correlation with Cobb angle. Progression of the deformities was not observed in our study, maybe due to short-term follow-up.

The Prevalence of Scoliosis in Adolescent Swimmers and the Effect of Swimming on Adolescent Idiopathic Scoliosis

The Prevalence of Scoliosis in Adolescent Swimmers and the Effect of Swimming on Adolescent Idiopathic Scoliosis

Postural phenotype assessment in pupils: a new clinic approach

Introduction: Most of the postural problems originate during puberty, when the body structure is in the process of development and the hormonal release predisposes the differentiated growth between the gender, which can interfere in the posture and balance of the individual. Objective: To analyze the postural phenotypic parameters in school adolescents. Method: A cross-sectional study was carried out in 72 adolescents with age between 10 and 15 years from a public school in the city of Lagarto, Sergipe. The subjects were divided into two groups according to gender (G1: female group; G2: male group) and age subgroups (SB1: adolescents with 10-12 years; SB2: adolescents with 13-15 years), homogeneous in relation to BMI. The research consisted of the collection of anthropometric and clinical data, backpack weighing, static postural evaluation through biophotogrammetry and measurement of stabilometric parameters through a force platform. Results: The individuals presented reduced mobility of the spine and did not overload the school backpack. The prevalence of scoliosis and scoliotic attitudes was 33.32% and more frequentily in the G2. As for the postural angles, the G1 presented knee valgus, hyperextension of the knee and lumbar hyperlordosis, differently, the G2 was characterized with forward inclination of the body, knee flexion, cervical hyperlordosis and thoracic hyperkyphosis. There was no difference in body balance variables between gender, besides the correlation between postural alignment and balance. Conclusion: The study suggests that the phase of corporal development in the school period favors postural phenotypic differentiations.

Do rheumatoid arthritis patients have low back pain or radiological lumbar lesions more frequently than the healthy population? – Cross-sectional analysis in a cohort study with age and sex-matched healthy volunteers

BACKGROUND CONTEXTRheumatoid arthritis (RA) can affect the spine; however, the epidemiology of lumbar lesions and/or low back pain (LBP) in RA patients has not been well-studied. PURPOSEThe purpose of this study was to compare the prevalence of lumbar lesions and LBP in RA patients with that in healthy volunteers, and to elucidate the influence of RA on lumbar disease. STUDY DESIGNCross-sectional analysis in a cohort study with age- and sex-matched healthy volunteers. PATIENT SAMPLEThis study included 185 patients with RA and 188 gender/age-matched healthy volunteers without RA. OUTCOME MEASURESLumbar spondylolisthesis and prevalent vertebral fractures were evaluated using plain lateral X-ray images. Thoraco-lumbar scoliosis was evaluated using dual-energy X-ray absorptiometric images. LBP was assessed using the visual analogue scale (VAS) and Rolland-Morris disability questionnaire (RDQ). METHODSThe prevalence of radiological lumbar lesion and LBP was compared between the RA and control groups. In the RA group, factors associated with lumbar lesion and LBP were analyzed using a multiple logistic regression model. RESULTSThe prevalence rates of spondylolisthesis and prevalent vertebral fracture were significantly higher in the RA group than in the control group; the prevalence of thoraco-lumbar scoliosis tended to be higher in the RA group. There was no significant difference in the average LBP-VAS between the groups. However, the percentage of analgesic drug use was significantly higher, and RDQ scores tended to be worse in the RA group than the control group. Multivariate analysis revealed that age and disease activity score were both related to LBP in the RA group. CONCLUSIONSRA patients are more likely to have radiological lumbar lesions. LBP in RA patients is well controlled, similar to the level in the healthy population; however, disease activity was related to LBP in RA patients. These results suggest that disease control is important for lumbar care in RA patients.

Investigation On The Prevalence Of Scoliosis In Primary And Secondary School Students In Changzhou

Investigation On The Prevalence Of Scoliosis In Primary And Secondary School Students In Changzhou

Prevalence of idiopathic scoliosis in girls with central precocious puberty: effect of a gonadotropin-releasing hormone agonist.

PurposeAdolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and occurs in children between 10 to 18 years old, during periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), due to early growth spurt, AIS is expected to develop before 10 years of age. Both AIS and CPP are more common in girls than in boys. The aim of this study was to determine the prevalence of AIS in girls with CPP and to evaluate the effect of treatment with gonadotropin-releasing hormone (GnRH) agonists on progression of scoliosis in these patients.MethodsWe retrospectively reviewed medical records of 553 girls, 338 with CPP and 215 without CPP. Scoliosis angle was measured on the standing frontal radiograph of each patient according to the Cobb method. Patients with a Cobb angle of 10° or more were diagnosed with scoliosis. For girls with CPP, follow-up spine radiographs were collected 1 year after treatment with GnRH agonists. Progression of scoliosis before and after treatment was compared in terms of Cobb angle changes.ResultsAIS was more prevalent in girls that were affected by CPP compared tocontrols without CPP (11.5% vs. 6.0%, CPP girls vs. non-CPP girls, respectively, P=0.031). The peak serum luteinizing hormone level positively correlated with Cobb angle (R2=0.015, P=0.023) in the CPP group. No progression of scoliosis was observed in CPP girls after one year of GnRH agonist treatment. Additionally, the prevalence of scoliosis decreased in CPP girls after 1 year of the treatment.ConclusionsWe report that the prevalence of AIS is higher in girls with CPP than in non-CPP patients. A regular follow-up schedule for spine radiographs should be considered to reduce the risk of progression. Furthermore, GnRH agonist treatment for CPP may have a suppressive effect on progression of AIS.

Can Tissue Expansion Reconstruction in the Trunk of Children Increase the Risk of Scoliosis?

We hypothesize that treatment of significant truncal lesions with truncal tissue expanders and subsequent flap surgery in pediatric patients may increase the risk of scoliosis. This study aims to investigate any relationship between tissue expansion (TE) and scoliosis and to compare the prevalence of scoliosis in our tissue expander population to the general population. Health records of patients who underwent truncal TE at BC Children's Hospital between 1997 and 2017 were retrospectively reviewed and analyzed. The cross-sectional component of the study consisted of radiological imaging to establish the presence or absence of scoliosis. We identified 28 patients who underwent truncal TE over the study period. Ten had a scoliosis X-ray on their chart or as a part of the study. Three (10.7%) patients were identified as having developed scoliosis after TE. We recommend that pediatric TE patients be made aware of the potential complication of scoliosis and be followed closely in the years during and after their treatment, in order to allow for preventative measures, early diagnosis and early management (if required).