Morphological differences in scoliosis curvatures as a cause of difficulties in its early detection based on angle of trunk inclination (original) (raw)
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BMC Musculoskeletal Disorders, 2022
Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, signific...
Morphological differences in scoliosis curvatures
BMC musculoskeletal disorders, 2022
Introduction The three dimensional deformation of the spine in scoliosis is specific for a given child with regard to the number and length of curvatures, their degree of rotation and the size of the curvature angle. Early diagnosis of scoliosis in a clinical examination according to the Adams test depends on the correlation between the angle of trunk inclination (ATI) and the Cobb angle and the adopted diagnosis criterion. The aim of the study was to demonstrate the need to adopt different diagnostic criteria for ATI depending on the age and location of scoliosis. Moreover, the observed differences in the ATI/Cobb correlation became the basis for the proposal to introduce the concept of low, medium and high-rotated of curvature to the clinical description of scoliosis. found in the 6-9-and 10-12-year-old groups and in the lumbar and thoracolumbar section. To increase the rate of early diagnosis of scoliosis, the results suggest the need to adopt two ATI criteria for the diagnosis of scoliosis at screening, 5° for age of 6-12 years, and when asymmetry affects the lumbar and thoracolumbar section, and 7° for the remaining children. Keywords Scoliosis, Early detection of scoliosis, Adams test, Vertebral rotation Content courtesy of Springer Nature, terms of use apply. Rights reserved.
2020
Background This research analysed discrepancies between the angle of trunk rotation (ATR) and the Cobb angle, in order to study if the commonly used 7° cut-off threshold for ATR helps diagnose scoliosis. In early stadia of scoliosis in children, ATR and the Cobb angle often disagree, increasing the risk of a false diagnosis: while the former does not suggest scoliosis, the latter does. Methods The study analysed ATR clinical parameters and the Cobb angle in the X-ray pictures of 117 (23 boys and 94 girls, aged 6–17 years) children who had not yet started treatment and whose X-ray pictures showed the Cobb angle of at least 10°, indicating idiopathic scoliosis. The degrees of lumbar lordosis and thoracic kyphosis were measured using the Saunders inclinometer, and back asymmetry was measured with Adam’s forward bend test using the Bunnell scoliometer. In the X-ray pictures, the curvature angle was plotted according to the Cobb method. The patients were stratified based on their age, an...
International Journal of Environmental Research and Public Health, 2019
(1) Background: Idiopathic scoliosis is a deformity of the growing spine. It affects 2-3% of adolescents; yet its cause is still unknown. At the early stage of idiopathic scoliosis (IS), the signs are not very noticeable. That is why the primarily school-based screening for scoliosis is so important. (2) Methods: This was a cross-sectional analysis of 6850 respondents. Participants were elementary school students in the metropolitan area of Poland. The suspicion of IS was based on detection of three-dimensional deformity of the spine using scoliometer. (3) Results: Respondents were divided into two groups: Angle of trunk rotation (ATR) = 0-3
Coll. Antropol, 2009
The relationship between trunk and spine deformity has yet not been well defined. The purpose of this study was to identify the relationship between clinical (contourometric) and radiographic methods of scoliotic deformity evaluation. Our second objective was to create mathematical formulas for calculating radiographic parameters based on defined correlations of multiple parameters. We did a study of 136 preoperatively analysed patients with idiopathic scoliosis. Altogether, 189 lateral curvatures were assessed. Based on Lenke's classification, curves were divided into three groups: a thoracic, a thoracolumbar and a lumbar curve group. Each group was analyzed separately to determine relationships between clinical contourometric (scoliometer value, humpometer values) and radiographic measurement (apical vertebral rotation (AVR) according to Drerup). On the grounds of statistically significant correlation coefficients of most clinical parameters and Drerup rotation we found good relationships between trunk and spine deformity. Using the best correlated clinical parameters and multiple regression statistical analysis we created mathematical formulas for prediction of scoliotic AVR in higher degree curves.
Periodica Polytechnica Civil Engineering, 2018
The oldest and most precise way to determine the curvatures of the spine is two directional X-ray measurement from the sagittal and coronal planes. By using X-ray, patients are exposed to radiation, which limits the repeatability of the measurements even in serious deformities, thus X-ray is not applicable for frequent monitoring. Therefore new alternative non-invasive radiation-free measurement systems appeared, which measure the external shape of the spine on the back surface. The goal of the present study is to validate the new tangential calculation method by Cobb method based radiographic analysis and by two other alternative calculation methods. In the study 22 young patients suffering from scoliotic deformities are examined. Thoracic kyphosis, lumbar lordosis and scoliotic deformity, as the three characterizing angles of spinal curvatures, are calculated by four different methods. The results show that the newly developed tangent line method could be applicable for the evalua...
New Method of Scoliosis Assessment
Spine, 2011
Study Design. A new method for nonradiographic evaluation of scoliosis was independently compared with the Cobb radiographic method, for the quantifi cation of scoliotic curvature. Objective. To develop a protocol for computerized photogrammetry, as a nonradiographic method, for the quantifi cation of scoliosis, and to mathematically relate this proposed method with the Cobb radiographic method. Summary of Background Data. Repeated exposure to radiation of children can be harmful to their health. Nevertheless, no nonradiographic method until now proposed has gained popularity as a routine method for evaluation, mainly due to a low correspondence to the Cobb radiographic method. Methods. Patients undergoing standing posteroanterior full-length spine radiographs, who were willing to participate in this study, were submitted to dorsal digital photography in the orthostatic position with special surface markers over the spinous process, specifi cally the vertebrae C7 to L5. The radiographic and photographic images were sent separately for independent analysis to two examiners, trained in quantifi cation of scoliosis for the types of images received. The scoliosis curvature angles obtained through computerized photogrammetry (the new method) were compared to those obtained through the Cobb radiographic method. Results. Sixteen individuals were evaluated (14 female and 2 male). All presented idiopathic scoliosis, and were between 21.4 ± 6.1 years of age; 52.9 ± 5.8 kg in weight; 1.63 ± 0.05 m in height, with a body mass index of 19.8 ± 0.2. There was no statistically signifi cant difference between the scoliosis angle measurements obtained in the comparative analysis of both methods, and a mathematical relationship was formulated between both methods.
Scoliosis, 2009
Background: Comprehensive evaluation of the morphology of the spine and of the whole body is essential in order to correctly manage patients suffering from progressive idiopathic scoliosis. Although methodology of clinical and radiological examination is well described in manuals of orthopaedics, there is deficit of data which clinical and radiological parameters are considered in everyday practise. Recently, an increasing tendency to extend scoliosis examination beyond the measure of the Cobb angle can be observed, reflecting a more patient-oriented approach. Such evaluation often involves surface parameters, aesthetics, function and quality of life.
The Spine Journal, 2014
BACKGROUND CONTEXT: Adolescent idiopathic scoliosis (AIS) is a complex threedimensional (3D) deformity of the spine involving deviations in the frontal plane, modifications of the sagittal profile, and rotations in the transverse plane. Although Lenke classification system is based on 2D radiographs and includes sagittal thoracic and coronal lumbar modifiers, Lenke et al. suggested inclusion of axial thoracic and lumbar modifiers in the analysis. PURPOSE: To analyze axial plane of Lenke 1A curves to identify curve characteristics. STUDY DESIGN: Retrospective study. PATIENT SAMPLE: Seventy patients (49 women, 21 men) with Lenke Type 1A idiopathic scoliosis were analyzed. OUTCOME MEASURES: Coronal, sagittal, and axial parameters were measured from plain radiographs that were obtained at initial medical examination of the patients. METHODS: Coronal and sagittal plane and whole spine segmental vertebra rotations from thoracic 1 to lumbar 5 were evaluated in 70 AIS patients with Lenke 1A curves by using Drerup method. Three different subgroups were identified according to magnitude and direction of lower end vertebra (LEV) rotation. RESULTS: In Group 1 (Lenke 1A1), the direction of LEV rotation was same with other vertebrae in the main curve and the magnitude of the LEV rotation was less than À0.5. In Group 2 (Lenke 1A2), the rotation of LEV was between À0.5 and 0.5 and so was accepted as neutral. In Group 3 (Lenke 1A3), the rotation of LEV had opposite direction with vertebrae in the main curve and the magnitude of LEV rotation was more than 0.5. The mean thoracic Cobb angle of patients with Lenke 1A idiopathic scoliosis was 51.1 (range 37-80), whereas the mean lumbar Cobb angle was 16.4 (range 0-32). The mean angle of trunk rotation of the patients was 5.7 (range 1-16). In terms of maximum thoracic vertebra rotation, the mean rotation angle of Lenke 1A idiopathic curves was À18.9 (range À(9.8-44.7)). The mean maximum lumbar vertebra rotation was 4.5 (range À7.2 to 15.1). CONCLUSIONS: Addition of axial plane analysis to conventional coronal and sagittal evaluations in patients with Lenke 1A curves may reveal inherent structural differences that are not apparent in single planar radiographic assessments and may necessitate a different surgical strategy.
Trends in Medicine, 2019
Study design: A cross-sectional study Summary and background data: Both Scoliometer and Debrunner's Kyphometer are validated and widely accepted as surface non-invasive, non-radiating measurement instruments for school screening programs for detection and measurement of scoliosis, thoracic kyphosis and lumbar lordosis. Objectives of the study: The authors have questioned if the prevalence of scoliosis and its distribution among gender and spinal levels has changed in the last 20 years; and if the additional measurement of sagittal spinal curvatures is of great importance just like the scoliosis is. Methods: This cross-sectional observational study was conducted in 2016 in a randomly selected school population in a metropolitan town in the southwestern Europe. In 897 adolescents, aged 12-14 years the authors measured both coronal and sagittal spinal curvatures using the scoliometer to measure scoliosis and the Debrunner kyphometer to measure thoracic kyphosis and lumbar lordosis. Previously validated mathematical formulae were used to estimate with high accuracy the predicted Cobb angle. Leg discrepancy was evaluated and correlated with scoliosis. Results: The reliability of measurement with the Debrunner's kyphometer and Scoliometer was high. There were 124 (13.8%) subjects with scoliosis curve-ATR/ value of ≥2 o. The 99.94% were single-level curves, and 0.06% double curves. The right thoracic curve was the most frequent (49%), followed by the right thoracolumbar (19%); left lumbar (12%); left thoracic (8%); right lumbar (6%) and left thoracolumbar (6%). Girls showed higher prevalence than boys in right thoracic (P=0.009) and right thoracolumbar (P= 0.014) curves. In contrary, in 53 subjects (40 girls, 13 boys) with ATR>5 o : no significant gender-related difference and right to left side localization of scoliosis was disclosed; there were 4 (7.5%) individuals with right thoracic ATR: 9 (17%) with left thoracic; 13 (25%) right thoracolumbar; 4 (7.5%) left thoracolumbar; 2 (4%) right lumbar and 10 (19%) left lumbar. There was a statistically significant positive correlation between right lumbar ATR and ipsilateral leg shortening (P=0.000). These findings are within previous similar school screening reports in this country in the last 20 years. Thoracic kyphosis increases linearly with lumbar lordosis. Boys showed greater thoracic kyphosis and less lumbar lordosis than girls. Fourteen (0.15%) individuals with Kyphometer values ≥55 o were sent for radiological examination. Fifty three (5.9%) subjects (3.2% boys and 8.2% girls) with ATR ≥5° were sent for radiological examination. Conclusions: The authors recommend to physicians engaged in scoliosis screening programs to use the Debrunner Kyphometer and Scoliometer together with the mathematic formulas for accurate Cobb angle measurement. We believe that this method will reduce the cost of school screening programs, the over diagnosis, and the unnecessary exposure to radiation of young population in the future.