A segmental radiological study of resolving idiopathic scoliosis with aetiological implications (original) (raw)
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Biomedical Journal of Scientific & Technical Research, 2019
The biomechanical etiology of the so-called idiopathic scoliosis [adolescent idiopathic scoliosis (AIS)] was the subject of the author's research from 1984 to 2009 in the Pediatric Orthopedic and Rehabilitation Department of Medical University in Lublin, Poland, and in years 2009-2018 in OutPatient Orthopedic Clinic in Lublin. The basic observation about etiology, new classification and the rules of the new therapy and causal prophylaxis comes from the years 1995-2007. Spine-Scoliosis (Literature 1-23): The etiology of idiopathic scoliosis was a secret over two thousand years. The biomechanical etiology of scoliosis has been found and described in years 1995-2007 (T. Karski, Lublin). The first observations was in program of research of authors in 1984, during the scholarship stay in Invalid Foundation Hospital in Helsinki, Finland. Over there the first "new clinical symptoms of scoliosis" in the region of pelvis and hips were observed. Next Observations Were in Years 1984 to 1995 and till 2018 in Lublin. There are following observations: 1/ All children with scoliosis have asymmetrical hip movements and it is one of the symptoms of the "Syndrome of Contracture and Deformities" according to Prof. Hans Mau. In all children with scoliosis adduction of the right hip is limited. This limitation of adduction we observe in straight positing of this joint. Here I explainthis position of examination is equal to "standing" and to "stance phase "during gait. 2/ In some patients with scoliosis, limited internal rotation and extension of the right hip are also observed. 3/ All children with scoliosis have the habit to stand 'at ease' on the right leg. The right hip is more stable and because of this, it is more convenient for permanent standing.
The Journal of medical research, 2014
The article describes the biomechanical aetiology of the so-called idiopathic scoliosis (1995 – 2007), known as an adolescent idiopathic scoliosis (AIS). The first lecture dealing with the issue was delivered in Hungary in 1995. The first publication was made in Germany in 1996 (Orthopadische Praxis). Biomechanical development of scoliosis. The scoliosis appears as the secondary deformity originating in the asymmetry of hips’ position and movement described by Prof. Hans Mau in articles about Syndrome of Contractures (Fig. 1, 2a, 2b, 3, 4a, 4b, 4c). Next - while walking and while standing ‘at ease’ on the right leg (T. Karski). The research proves that the right leg is the preferred one over the years for standing. This phenomenon is because of better stability of right leg in region of right hip during standing and this is because of smaller adduction in straight position of joint. Every type of scoliosis starts to develop at the time when the child starts to stand and walk. Depend...
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.
Analysis of the interaction between vertebral lateral deviation and axial rotation in scoliosis
Journal of Biomechanics, 1991
There is a lack of clear biomechanical analyses to explain the interaction of the lateral and axial deformity of the spine in idiopathic scoliosis. A finite element model which represented an isolated ligamentous spine with realistic elastic properties and idealized geometry was used to analyse this interaction. Three variations of this model were used to investigate two different hypotheses about the etiology of scoliosis and to define the forces required to produce a scoliosis deformity. The first hypothesis is that coupling within a motion segment produces the interaction between lateral deviation and axial rotation. The second hypothesis is that posterior tethering by soft tissues in the growing spine produces the observed interaction. Modeling of both hypotheses failed to produce the clinically observed pattern of interaction.
Progression of Vertebral and Spinal Three-Dimensional Deformities in Adolescent Idiopathic Scoliosis
Spine, 2001
Study Design. The evolution of scoliotic descriptors was analyzed from three-dimensionally reconstructed spines and assessed statistically in a group of adolescents with progressive idiopathic scoliosis. Objectives. To conduct an intrasubject longitudinal study quantifying evolution of two-and three-dimensional geometrical descriptors characterizing the scoliotic spine and vertebral deformities. Summary of Background Data. The data available on geometric descriptors usually are based on cross-sectional studies comparing scoliotic configurations of different individuals. The literature reports very few longitudinal studies that evaluated different phases of scoliotic progression in the same patients. Methods. The evolution of regional and local descriptors between two scoliotic visits was analyzed in 28 adolescents with scoliosis. Several statistical analyses were performed to determine how spinal curvatures and vertebral deformities change during scoliosis progression. Results. At the thoracic level, vertebral wedging increases with curve severity in a relatively consistent pattern for most patients with scoliosis. Axial rotation mainly increases toward curve convexity with scoliosis severity, worsening the progression of vertebral body deformities. No consistent evolution is associated with the angular orientation of the maximum wedging. Thoracic kyphosis varies considerably among subjects. Both increasing and decreasing kyphosis are observed in nonnegligible proportions. A decrease in kyphosis is associated with a shift in the plane of maximum deformity toward the frontal plane, which worsens the three-dimensional shape of the spine. Conclusions. The results of this study challenge the existence of a typical scoliotic evolution pattern and suggest that scoliotic evolution is quite variable and patient specific.
Journal of Clinical Medicine, 2021
Introduction and aim of the study: We aim to determine whether the changes in the spine in scoliogenesis of idiopathic scoliosis (IS), are primary/inherent or secondary. There is limited information on this issue in the literature. We studied the sagittal profile of the spine in IS using surface topography. Material and methods: After approval of the ethics committee of the hospital, we studied 45 children, 4 boys and 41 girls, with an average age of 12.5 years (range 7.5–16.4 years), referred to the scoliosis clinic by our school screening program. These children were divided in two groups: A and B. Group A included 17 children with IS, 15 girls and 2 boys. All of them had a trunk asymmetry, measured with a scoliometer, greater than or equal to 5 degrees. Group B, (control group) included 26 children, 15 girls and 11 boys, with no trunk asymmetry and scoliometer measurement less than 2 degrees. The height and weight of children were measured. The Prujis scoliometer was used in stan...
The three-dimensional coupling mechanism in scoliosis and its consequences for correction
Spine Deformity
Introduction In idiopathic scoliosis, the anterior spinal column has rotated away from the midline and has become longer through unloading and expansion of the intervertebral discs. Theoretically, extension of the spine in the sagittal plane should provide room for this longer anterior spinal column, allowing it to swing back towards the midline in the coronal and axial plane, thus reducing both the Cobb angle and the apical vertebral rotation. Methods In this prospective experimental study, ten patients with primary thoracic adolescent idiopathic scoliosis (AIS) underwent MRI (BoneMRI and cVISTA sequences) in supine as well as in an extended position by placing a broad bolster, supporting both hemi-thoraces, under the scoliotic apex. Differences in T4–T12 kyphosis angle, coronal Cobb angle, vertebral rotation, as well as shape of the intervertebral disc and shape and position of the nucleus pulposus, were analysed and compared between the two positions. Results Extension reduced T4...