Classification Of Scoliosis Research Articles

Selection of fusion levels in scoliosis surgery.

Fusion levels are selected with the goal of having a balanced physiologic spine on the postoperative films. We have proposed an algorithm for selecting fusion levels based on the King-Moe scoliosis classification scheme and the flexibility of a compensatory curve. We propose the acronym TEAMS as a pneumonic. Curve type defines the region of the spine to be fused. The ends of the Cobb measurement around the region are the temporary endpoints. The endpoints are extended to avoid an apex due to the sagittal or frontal planes. The mobile disc is defined at the caudal end of the fusion area. Finally, the bending films, traction films, or intraoperative films are used to define the stable zone of Harrington that must contain the ends of the fusion mass. This scheme yields a simple, easily taught algorithm that results in reproducible endpoints for scoliosis fusion.

Identifying sources of variability in scoliosis classification using a rule-based automated algorithm.

Use of a rule-based automated algorithm to determine sources of variability in radiographic classification. To determine whether unambiguous rules encoded in a computer program would ensure reliable classification. Reliability problems have been identified in classifications used in surgical planning for patients with thoracic idiopathic scoliosis, but the sources of unreliability are not understood. Objective classification methodology was tested on the King et al (1983) scheme. There were two novel components: 1) positions of the corners of vertebrae in radiographs were digitized relative to a defined axis system and used in automated evaluation of spinal shape parameters required for classification; and 2) the assignment of a classification was done with a rule-based algorithm. The algorithm was implemented after some ambiguities and absence of precise definitions in the King et al classification scheme had been resolved. The algorithm was tested with radiographs of patients having adolescent idiopathic scoliosis. The automated procedure could encounter reliability problems in cases in which a lumbar curve was very close to crossing the midline, thoracic and lumbar curves were of approximately equal value, when the apex level in the thoracolumbar region was ambiguous, when a Cobb angle was close to 10 degrees, or when the flexibility index was close to unity. Objective measurements and rule-based algorithms can eliminate some sources of interobserver and intraobserver errors in classification of spinal deformity. When classification parameters fall close to the boundaries for classification, reliability problems will persist.

4:31 Classification of heterotopic ossification in artificial disc replacement

Purpose of study: Total disc replacement is currently the only method of restoring mobility to the degenerative lumbar disc. In order to evaluate clinical patients undergoing total disc replacement, it is critical to develop and validate a comprehensive reproducible classification of heterotopic ossification (HO), both for the Food and Drug Administration and other prospective randomized evaluations.Methods used: In the current study, 101 radiographs from patients (n=84) and histologic microradiographs from baboons (n=17) containing different types of disc replacements were evaluated according to a new classification analogous to the Brooker et al. [1] classification for HO with total hip replacement. Seven reviewers independently graded the radiographs using the following scale: Class Zero, no HO present; Class I, HO present as islands of bone within soft tissue but not influencing segmental motion. Bone is not between the planes formed by the two vertebral end plates. Class II, HO present between the two planes formed by the vertebral end plates but not blocking motion; Class III, the range of motion of the vertebral end plates is blocked by the formation of HO and/or postoperative osteophytes on flexion-extension or lateral bending radiographs; Class IV, HO causing inadvertent bony ankylosis.of findings: The interobserver reliability correlation coefficient for seven independent raters (three physicians, two basic scientists and two technicians) calculated using the Intraclass kappa correlation coefficient and Kish's rho was r=.9683 (p<.0001). The intraobserver reliability based on readings at two time intervals is r=0.8949 (p<.01). This is more reproducible than the Cobb method, Meyerding's grading of spondylolisthesis or King's classification of thoracic scoliosis. It approximates the reliability of the Lenke classification when used by its originators.Relationship between findings and existing knowledge: To date, there are seven major reports of SB III Charité, ProDisk, AcroFlex and Ray PDN style prosthetic disk replacements in a total of 474 patients. The incidence of reported HO ranges from 1.4% to 15.2%. The significance of this classification system is that it allows for a prospective and time-independent method of assessing postoperative development of periannular calcification, ectopic ossification or “spontaneous” fusion secondary to spinal prostheses designed to restore motion.Overall significance of findings: This is the first paper describing a validated classification system for HO associated with total disc replacement. The intraobserver reliability of r=.89 and interobserver reliability of r=.96 establishes this classification as extremely valid and reproducible. This validated classification system should facilitate investigating the etiology of HO as well as the effectiveness of treatment options: indomethacin, diphosphonate (EHDP) or radiation therapy.Disclosures: Device or drug: SB Charite Prosthesis. Status: investigational. Device or drug: AcroFlex Prosthesis. Status: investigational.Conflict of interest: Paul C. Mc Afee, grant research support, Waldemar Link; Linge Spine Group.

Interobserver and intraobserver reliability of Lenke's new scoliosis classification system.

The assignment of idiopathic scoliosis curves to the curve types,1-6 to the lumbar spine modifier (A, B, or C), and to the sagittal thoracic modifier (-, N, +), as recently described by Lenke et al, was evaluated by five observers on two occasions. To determine the intraobserver and interobserver reliabilities of Lenke's new system for classifying idiopathic scoliosis. Lenke et al recently introduced a new system for classifying idiopathic scoliosis. Preoperative standing long cassette coronal and sagittal radiographs as well as side-bending radiographs of 51 consecutive patients who underwent surgery for idiopathic scoliosis were labeled with the Cobb angles for all the curves. The center sacral vertical line was marked as the bisection of the proximal sacrum perpendicular to the true horizontal line. Five observers independently assigned a curve type, a lumbar spine modifier, and a sagittal thoracic modifier to each curve following the guidelines as described by Lenke et al. Assignment of the curves was repeated 3 weeks later, with the curves presented in a different order. Kappa coefficients were used to determine the interobserver and intraobserver reliabilities. All five reviewers agreed on the overall classification in 21 (41%) of the 51 patients. A mean kappa value of 0.62 was determined for interobserver reliability, and a mean kappa of 0.73 for intraobserver reliability. Determination of an upper thoracic curve as structural or nonstructural and assignment of a lumbar spine modifier were the main reasons for disagreement. Lenke's new classification system is more reliable than the older King classification, but proper classification of high thoracic and lumbar curves seems to be difficult.

Classification of Thoracic Adolescent Idiopathic Scoliosis

To Editor: We read Intraobserver and Interobserver Reliability of the Classification of Thoracic Adolescent Idiopathic Scoliosis (80-A, 1097-1106, Aug. 1998), by Lenke et al. purpose of that study was to determine the interobserver and intraobserver reliability of the King classification of thoracic adolescent idiopathic scoliosis. King et al.3 classified thoracic curves in a paper entitled The Selection of Fusion Levels in Thoracic Idiopathic Scoliosis. Since the King classification system deals solely with thoracic scoliosis, we fail to understand why, in order to consider the reliability of the King classification, parameters such as the lumbar curve, the thoracolumbar curve, the double-major curve, and others were introduced in the trial. In our opinion, only thoracic curves should have been examined. Furthermore, on the basis of the work by Barr et al.1, Ibrahim et al.2, Lenke et al.6, Lonstein7, and Richards8, there is great terminological confusion between a double-major curve and the King type-I curve, and we believe that the term double-major curve should not have been included in the study. Finally, in the 1994 study by King5 …

Discovering knowledge from medical databases using evolutionary algorithms.

Discusses learning roles and causal structures for capturing patterns and causality relationships. The authors present their approach for knowledge discovery from two specific medical databases. First, rules are learned to represent the interesting patterns of the data. Second, Bayesian networks are induced to act as causality relationship models among the attributes. The Bayesian network learning process is divided into two phases. In the first phase, a discretization policy is learned to discretize the continuous variables, and then Bayesian network structures are induced in the second phase. The authors employ advanced evolutionary algorithms such as generic genetic programming, evolutionary programming, and genetic algorithms to conduct the learning tasks. From the fracture database, they discovered knowledge about the patterns of child fractures. From the scoliosis database, they discovered knowledge about the classification of scoliosis. They also found unexpected rules that led to discovery of errors in the database. These results demonstrate that the knowledge discovery process can find interesting knowledge about the data, which can provide novel clinical knowledge as well as suggest refinements of the existing knowledge.

Intraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis.

The system described by King et al. is the standard method for the classification of thoracic adolescent idiopathic scoliosis. Although it is widely used and referenced, its reliability and reproducibility among scoliosis surgeons are unknown. We used a scoliosis case-presentation format to examine the interobserver and intraobserver reliability of the classification of thoracic adolescent idiopathic scoliosis with the system of King et al. Eight active, current members of the Scoliosis Research Society reviewed twenty-seven full-length radiographs that had been made before operative correction of the scoliotic deformity. On the basis of these images, which included posteroanterior and lateral radiographs made with the patient standing as well as right and left forced-side-bending radiographs made with the patient supine, the reviewers assigned a type to each curve according to the classification system of King et al. Kappa coefficients were used to test statistical reliability. The mean interobserver reliability of the classification was only 64 per cent (range, 54 to 77 per cent) when the responses of seven of the reviewers were compared with those of one of the originators of the classification. The mean kappa coefficient was 0.49 (range, 0.27 to 0.73), which indicates poor reliability. When each reviewer's responses were compared with those of the other reviewers, the reliability was similarly poor (interobserver reliability, 55 per cent [range, 33 to 81 per cent] and mean kappa coefficient, 0.40 [range, 0.21 to 0.63]). Intraobserver reliability was evaluated in a trial in which five reviewers in a group setting were shown the same radiographs in a different order at two different viewings. Comparison of the results at the two viewings revealed a mean intraobserver reliability of 69 per cent (range, 56 to 85 per cent) and a mean kappa coefficient of 0.62 (range, 0.34 to 0.95), which indicates fair reliability. The current method of classification of adolescent idiopathic scoliosis does not appear to have sufficient intraobserver or interobserver reliability among scoliosis surgeons to portray curve types accurately. Thus, it may not help to guide treatment with use of modern spinal fixation methods.

A Logical Coronal Pattern Classification of 2,000 Consecutive Idiopathic Scoliosis Cases Based on the Scoliosis Research Society-Defined Apical Vertebra

Two thousand consecutive idiopathic scoliosis records and radiographs were reviewed for coronal pattern typing and categorization, based on Scoliosis Research Society definitions of the apical vertebra. Apical frequency was determined for each of the patterns identified, and represents a database from a large series of cases for the already accepted Scoliosis Research Society definitions. To identify and numerically pattern-type a large series of idiopathic coronal curves, for the basic purpose of written and oral communication. Some pattern types were not described previously. Although spinal deformity must be considered three dimensional for treatment in 1998, no comprehensive, databased, and user friendly coronal or sagittal classification of idiopathic scoliosis has been reported. Two thousand idiopathic curve patterns from charts and radiographs were reviewed and the coronal patterns categorized by the apical vertebra. The resulting classification was tested for inter- and intraobserver reliability by 12 spine surgeons and 6 orthopedic residents. Apical frequencies were determined for each pattern type. Twenty-one pattern categories were identified, and all were right or left mirror image patterns (except for a quadruple pattern) that permitted separation into 11 types. Incorporating the widely recognized five numbered King types mad pattern recognition simple. Interobserver reliability testing was 98.2%. The left single thoracic curve pattern was included in this classification because only 9 (20.4%) of 44 patients with left thoracic curves had intraspinal pathology. Two thousand consecutive idiopathic coronal curve patterns separated into eleven readily identifiable types, and incorporating the widely referenced five King types, makes recognition simple for purposes of identification and communication. Sagittal and 3D factors excluded from this classification are equally important in the process of treatment decisions. Apical frequency data determined in this study lends credence to Scoliosis Research Society definitions for idiopathic curve patterns.

ORTHOPAEDICS IN CHINA:ITS PAST AND PRESENT

Orthopaedics in china originated chinese medicine and Western medicine. In the first half of twentieth century , Dr. meng chimao(Beijing),New Way Sung (Shanghai),Fang Hsienchi, and others contributed a great deal to development of modern orthopaedics in china. The orthopaedic group was organized under the auspecies of Chinese Medical Association in 1937. The chinese Medical Association Orthopaedic Society was wstablished in 1980. The main achievements of Orthopaedics in China include replantation of severed limb or fingres,toe teansplantation for thumb and fonger reconstruction, nerve teansfer for brachial plexus avulsion, resrarch and manufacturing of domestic prostheses and the techniques of artifival joint replacement, surgical treatment of severe scoliosis and classification of idiopathic scoliosis, operative tireatment of bone tumor, and basic research on giant cell tumor of bone. Key words: Orthopaedics in China ; Achievement ; Trends ;

Adolescent idiopathic scoliosis in identical twins

The Journal of Bone and Joint Surgery. British volumeVol. 72-B, No. 6 ArticlesFree AccessAdolescent idiopathic scoliosis in identical twinsAJ CarrAJ CarrSearch for more papers by this authorPublished Online:1 Nov 1990https://doi.org/10.1302/0301-620X.72B6.2246294AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited ByAberrant interaction between mutated ADAMTSL2 and LTBP4 is associated with adolescent idiopathic scoliosisGene, Vol. 814Idiopathic scoliosis: general characteristics and analysis of etiological theories (literature review)17 August 2021 | Acta Biomedica Scientifica, Vol. 6, No. 3Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key eventMedical Hypotheses, Vol. 151Escoliosis idiopática: evidencias científicas e implicaciones clínicasEMC - Kinesiterapia - Medicina Física, Vol. 41, No. 1An N -Ethyl- N -Nitrosourea (ENU) Mutagenized Mouse Model for Autosomal Dominant Nonsyndromic Kyphoscoliosis Due to Vertebral Fusion8 March 2018 | JBMR Plus, Vol. 2, No. 3Scoliosis severity does not impact the risk of scoliosis in family membersJournal of Pediatric Orthopaedics B, Vol. 27, No. 2Genetics and Functional Pathology of Idiopathic Scoliosis13 June 2018Etiological Theories of Adolescent Idiopathic Scoliosis: Past and PresentThe Open Orthopaedics Journal, Vol. 11, No. 1Concordance for curve type in idiopathic scoliosis among family membersActa Ortopédica Brasileira, Vol. 25, No. 3Understanding the Basis of Genetic Studies: Adolescent Idiopathic Scoliosis as an ExampleSpine Deformity, Vol. 2, No. 1CHD7 Gene Polymorphisms and Familial Idiopathic ScoliosisSpine, Vol. 38, No. 22Adolescent Scoliosis Classification and TreatmentNeurosurgery Clinics of North America, Vol. 24, No. 2Current concepts and controversies on adolescent idiopathic scoliosis: Part IIndian Journal of Orthopaedics, Vol. 47, No. 2Genetic epidemiology and heritability of AIS: A study of 415 Chinese female patients23 February 2012 | Journal of Orthopaedic Research, Vol. 30, No. 9Pediatric scoliosis8 October 2011 | Current Reviews in Musculoskeletal Medicine, Vol. 4, No. 4Lumbar ScoliosisIdiopathic ScoliosisPolygenic inheritance of adolescent idiopathic scoliosis: A study of extended families in UtahAmerican Journal of Medical Genetics Part A, Vol. 152A, No. 5Identification of susceptibility loci for scoliosis in FIS families with triple curvesAmerican Journal of Medical Genetics Part A, Vol. 152A, No. 4Variações na apresentação fenotípica da escoliose idiopática do adolescenteColuna/Columna, Vol. 9, No. 1Genetics and Functional Pathology of Idiopathic Scoliosis30 November 2009Etiopatogenia e historia natural de la escoliosis idiopáticaRehabilitación, Vol. 43, No. 6Estrogen receptor polymorphism, estrogen content and idiopathic scoliosis in human: A possible genetic linkageThe Journal of Steroid Biochemistry and Molecular Biology, Vol. 116, No. 1-2Recent advances in the aetiology of adolescent idiopathic scoliosis16 June 2007 | International Orthopaedics, Vol. 32, No. 6Estrogen cross-talk with the melatonin signaling pathway in human osteoblasts derived from adolescent idiopathic scoliosis patientsJournal of Pineal Research, Vol. 45, No. 4Genetics of Familial Idiopathic ScoliosisContemporary Spine Surgery, Vol. 9, No. 9GENETICS OF SCOLIOSISNeurosurgery, Vol. 63, No. suppl_3The Role of Exercising in a Pair of Female Monozygotic (High-Class Athletes) Twins Discordant for Adolescent Idiopathic ScoliosisSpine, Vol. 33, No. 17Idiopathic Scoliosis and Pineal Lesions in Australian Children4 December 2016 | Journal of Orthopaedic Surgery, Vol. 15, No. 3Récents progrès dans l’étiopathogénie de la scoliose idiopathique de l’adolescent et nouveaux concepts moléculaires15 November 2007 | médecine/sciences, Vol. 23, No. 11Genetics of Familial Idiopathic ScoliosisClinical Orthopaedics & Related Research, Vol. 462Idiopathic Scoliosis: Identification of Candidate Regions on Chromosome 19p13Spine, Vol. 31, No. 16Lack of Association Between the Aggrecan Gene and Familial Idiopathic ScoliosisSpine, Vol. 31, No. 13Linkage analysis of genetic loci for kyphoscoliosis on chromosomes 5p13, 13q13.3, and 13q321 January 2006 | American Journal of Medical Genetics Part A, Vol. 140A, No. 10Identification of Candidate Regions for Familial Idiopathic ScoliosisSpine, Vol. 30, No. 10Familial Idiopathic ScoliosisSpine, Vol. 28, No. 6Genetics of Familial Idiopathic ScoliosisClinical Orthopaedics and Related Research, Vol. 401Characterization of Idiopathic Scoliosis in a Clinically Well-Defined PopulationClinical Orthopaedics and Related Research, Vol. 392Osteopenia in Adolescent Idiopathic ScoliosisSpine, Vol. 26, No. 3Curve characteristics in monozygotic twins with adolescent idiopathic scoliosis: 3 new twin pairs and a review of the literature8 July 2009 | Acta Orthopaedica Scandinavica, Vol. 72, No. 6CAUSE AND NATURAL HISTORY OF ADOLESCENT IDIOPATHIC SCOLIOSISOrthopedic Clinics of North America, Vol. 30, No. 3Scoliosis in TwinsSpine, Vol. 22, No. 17Genetic analysis of structural elastic fiber and collagen genes in familial adolescent idiopathic scoliosisJournal of Orthopaedic Research, Vol. 14, No. 6 Vol. 72-B, No. 6 Metrics Downloaded 61 times History Published online 1 November 1990 Published in print 1 November 1990 InformationCopyright © 1990, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

Curve patterns in idiopathic scoliosis. A clinical and radiographic study.

We have developed a simple technique for demonstrating the sagittal profile of each rotated level of a scoliotic spine and used it to determine the patterns of lordosis and kyphosis in each of six clinical types of idiopathic scoliosis. The currently accepted classification of scoliosis is inaccurate and a modification is proposed. The three main types of scoliosis were shown to have sagittal profiles distinctly different from each other and from normal. Single structural curves had short lordotic sections at their apices, limited above and below by kyphosis. Double curves showed longer lordotic sections limited only by one area of kyphosis. Lordosis throughout the thoracic and lumbar spine was associated with triple curve patterns. The biomechanical effects of the abnormal sagittal profiles provide a simple explanation for the genesis and progression of the different types of scoliosis, and the recognition of the pattern of the sagittal abnormalities permits treatment to be designed on a sound anatomical basis for individual cases.

Scoliosis and Other Spinal Deformities

Scoliosis is a complicated deformity, and the literature dealing with it is often obscure and confusing. Consequently, this book by Moe and his associates is welcome. Eased on 28 years of experience with scoliosis and other deformities of the spine, the authors' views unquestionably carry the weight of authority. The subject is presented clearly in a well-organized sequence of chapters each profusely illustrated from the authors' abundant clinical material. The initial chapters deal with the terminology, classification, diagnosis, and natural history of scoliosis. A thorough discussion of the different varieties of scoliosis follows. These initial chapters should be of particular value to pediatricians and family physicians. For the orthopedic surgeon, the presentation of the technical aspects and the complications of treatment in the later chapters is excellent. There are chapters dealing with juvenile kyphosis, tuberculosis, and injuries of the spine. For a clear exposition of a difficult subject, this monograph

Amino-oxidase and dermal connective tissue in scoliosis.

The amino-oxidase and collagen content of dermal tissue was evaluated in 10 patients with severe idiopathic scoliosis and in a control group of 7 patients with poliomyelitic scoliosis, that were to undergo surgical correction of their skeletal deformity. A greater dermal content of neutral salt souble collagen was found in the patients with idiopathic scoliosis, compared with the control group. Statistically the difference was highly significant. Mono-amino-oxidase activity, however, was found to be significantly decreased in dermal extracts obtained from patients affected by idiopathic scoliosis in comparison with controls. The involvement of mono-amino-oxidase in the crosslinking of collagen and the possible classification of idiopathic scoliosis as a systemic disease of connective tissue are discussed.

Classification and terminology of scoliosis.

Classification and terminology of scoliosis.

O-13. “A Classification of Scoliosis on a Neurological and Equilibrium-functional Basis”

o-13. “A Classification of Scoliosis on a Neurological and Equilibrium-functional Basis”