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PubMed1997

Direct spinal curvature digitization in scoliosis screening--a comparative study with Moiré contourgraphy.

The forward bending test, widely used in scoliosis screening, is associated with high false-positive rates. We postulate that direct surface measurement of the spinal curvature by digitization of the spinous processes used in combination with the forward bending test could increase the predictive value of detecting scoliosis without sacrificing sensitivity. Sixty consecutive patients referred from a school screening program were included in this study. All had moiré contourgraphy, spinous process digitization, and erect frontal radiographs of the spine. The number of false positives from the forward bending test was 35. Moiré contourgraphy did not reduce the number of false positives significantly. A posterior spinal deformity of 10 degrees or more predicted scoliosis in all patients, with 15 false-positive readings. Direct measurement of the spinal curvature by spinous process digitization can be an effective second-stage screening tool for scoliosis in centers where all the screened positives are referred to a single center.

Adolescent↗
PubMed2002

Evaluation of spinal curvatures after a recent osteoporotic vertebral fracture.

OBJECTIVES: To evaluate spinal curvature changes over a 3-year period in postmenopausal women who had had an osteoporotic vertebral fracture within the last 3 months. METHODS: Thoracic kyphosis and lumbar lordosis were measured using a curviscope at baseline and after 1, 3, 6, 12, and 36 months. Anteroposterior and lateral radiographs of the thoracolumbar spine were obtained after 1 and 3 years. RESULTS: Sixty-one patients were included. At baseline, a significant increase in thoracic curvature was found in the subgroup with thoracic fractures as compared to the subgroups with thoracolumbar or lumbar fractures (64 degrees +/- 9 degrees, 56 degrees +/- 10, and 56 degrees +/- 13, respectively; P < 0.05). No lumbar curvature differences were found. Thoracic curvature was significantly correlated with age (r = -0.48, P < 0.001) and with the vertebral deformity index (r = 0.6, P < 0.001). A significant increase in thoracic curvature was apparent 3 months into the study; after 3 years, the increase was 5.6 degrees +/- 0.7 (P < 0.01). A moderate increase in lumbar curvature was found after 3 years (P < 0.01). Five of 13 patients and five of 10 patients had at least one incident fracture after 1 and 3 years, respectively. Mean thoracic curvature was greater among the patients with than without incident fractures after 1 and 3 years, although the difference was not statistically significant. CONCLUSION: Thoracic compression fractures significantly increase thoracic kyphosis as compared to dorsolumbar and lumbar fractures. Thoracic kyphosis worsens overtime in patients with prevalent vertebral fractures. These data invite an evaluation of techniques capable of providing early correction of alignment disorders, such as widespread use of bracing or kyphoplasty.

Absorptiometry, Photon↗
PubMed2004

Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents.

This cross-sectional study was carried out to investigate any correlation between backpack carrying, spinal curvatures, and athletic activities on schoolchildren's dorsal (DP) and low back pain (LBP). Three thousand four hundred forty-one students aged from 9 to 15 years who carried backpacks to school were included in this study and asked for DP and LBP experiences in the school period while carrying the backpack. Nonradiating methods (surface back contour analysis) were used to indirectly measure frontal spinal curve (scoliosis) with the scoliometer and lateral curves (thoracic kyphosis and lumbar lordosis) with the kyphometer. All data analyses were undertaken regarding school year level, age, gender, sports participation, backpack weight, and way of carrying (one versus both shoulder) in relation to magnitude of scoliosis, thoracic kyphosis, lumbar lordosis, and DP and LBP while carrying the backpack. DP increased with increasing backpack weight (P < 0.05). The way (one versus both shoulder) of backpack carrying did not correlate either with DP or with LBP. Girls experienced much more LBP and DP than boys (P < 0.001). There was no difference in the prevalence of LBP and DP between adolescents and children. Students' age, height, and body weight as well as magnitude of kyphosis, lordosis, and scoliosis did not correlate with either LBP or DP. At the age of 11 years, girls and boys showed the highest prevalence for DP (72% and 38.5%, respectively), while at the age of 14 years, girls reported significantly (P < 0.05) more DP than boys. Girls showed the highest prevalence of LBP (71%) at the age of 11 years, while for the boys, it was at the age of 15 years (21%). Girls showed at the age of 11 years significantly more LBP (P < 0.05) than boys. Sports exposure seemed to increase LBP in girls (P < 0.001). The results of this study suggest a differential DP and LBP prevalence in schoolchildren and adolescents carrying backpacks with regard to gender and age. The peak in pain prevalence was immediately before puberty as well as immediately after its onset. Girls who participated in sports activities seem to experience more often DP and LBP than boys. Short children who carry backpacks as heavy as do tall children at the same age are more prone to LBP.

Adolescent↗
PubMed2005

Spinal curvature of cultured Japanese mackerel Scomber japonicus associated with a brain myxosporean, Myxobolus acanthogobii.

Skeletal deformities were found in the cultured Japanese mackerel Scomber japonicus. External and radiographical observations showed the deformed fish to exhibit a dorso-ventral spinal curvature (kyphosis) without fracture or dislocation of the vertebrae. Numerous myxosporean cysts, ca. 0.3 to 1.0 mm in diameter, formed in the 4th ventricle, the cavity of the optic tectum, the surface of the olfactory lobe and bulb, the optic lobe and the inferior lobe of the brain. Spore morphology and molecular analysis of the small subunit ribosomal RNA gene sequence identified the myxosporean parasite as Myxobolus acanthogobii, a parasite which also causes scoliosis in yellowtail Seriola quinqeradiata. Histopathological observation showed that the myxosporean cysts were encapsulated within the host's collagenous layer although some had disintegrated to disperse mature spores into the cranial cavity. Occasionally, lymphocytic infiltration and local granulomatous inflammation were found to be associated with spore dispersion.

Animals↗
PubMed1985

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.

Adolescent↗
PubMed2004

Loss of cervical spinal curvature during radiotherapy for head-and-neck cancers: the neck moves, too.

PURPOSE: We became concerned about our observation of the loss of the normal lordotic cervical spinal curvature during the course of radiotherapy (RT) for head-and-neck tumors. Our goal was to evaluate formally the cervical lordotic curve in 50 random patients by comparing the cervical spinal angles (CSAs) measured at the initiation of RT with the CSAs measured during the last week of RT. METHODS AND MATERIALS: Fifty patients treated mono-isocentrically for head-and-neck cancer were selected randomly for review. All patients had custom-made masks, shoulder pulls, and multiple tattoos to ensure reproducibility. The CSA was defined as the angle formed by the line projected parallel to the posterior surface of C2 and the line projected parallel to C6. The measurements were done on the simulation film and the first and last port films. RESULTS: The average decrease in the CSA was 2.26 degrees (SD +/-2.19 degrees ). In patients with the isocenter placed as low as possible, the change was significantly more compared with the remaining population. (3.8 degrees vs. 1.7 degrees, p = 0.004). CONCLUSION: Despite customized immobilization, the neck position changes during the course of RT for head-and-neck tumors. Patients with the isocenter placed very low have the least long-term reproducibility and a comfortable position may be best suited to intensity-modulated RT for such head-and-neck cancer patients.

Cervical Vertebrae↗
PubMed1993

Sagittal configuration of spinal curvature line in sportsmen using Moire technique.

A separate moire photograph of 380 men's back was taken. Using a micro-computer the sagittal configuration of the spinal curvature line was reconstructed based on the moire fringe on the back. Then the sagittal configuration of this line was compared among groups according to their sports: rugby, soccer, kendo, swimming, yachting, four track and field events (sprinting, distance running, jumping, and throwing), body-building as well as non-athletic men. Distance runners and sprinters had a greater degree of thoracic kyphosis and greater degree of lumbar lordosis, while non-athletes had a smaller degree of both kyphosis and lordosis. Swimmers, bodybuilders, rugby and soccer players had partial lordosis. The degree of lumbar lordosis of swimmers and bodybuilders was less than average while the degree of thoracic kyphosis was ordinary and the degree of thoracic kyphosis of rugby and soccer players was less than average while the degree of lumbar lordosis was ordinary.

Adult↗
PubMed1987

Three-dimensional spinal curvature in idiopathic scoliosis.

Scoliosis is usually considered as a deformity of the spine in the frontal plane, without reference to curvatures in other planes. In this study, the three-dimensional shape of the spine of 104 patients with untreated idiopathic scoliosis (5-55 degrees Cobb) was studied by means of stereo radiographs to determine relationships between curvature of the spine in the frontal plane view, in the lateral view, and in the intermediate views. There was a weak but statistically significant correlation (r = 0.2) relating greater scoliosis with lesser kyphosis or greater lordosis. In the thoracic region, the sagittal plane spinal curvature was less than that measured in a population without scoliosis (mean difference, 7.72 +/- 9.9 degrees). Seventy-four of 76 scolioses in the upper region of the spine with lateral curvature greater than 5 degrees Cobb were kyphotic. Sixty-four of 84 curves greater than 5 degrees Cobb in the lower region were lordotic. Measuring curvatures in the plane of symmetry of the rotated apical vertebra altered these ratios to 69 of 76 kyphotic in the upper region and 68 of 84 lordotic in the lower region. The plane of maximum curvature of sections of the spine with scoliosis was not related to the plane of symmetry of the rotated apical vertebra, for in kyphotic regions of the spine the rotations of these two planes were in opposite directions. In all cases, the magnitudes of the rotations were quite different, i.e., by a factor of -0.22 for curves in thoracic region and by a factor of 0.24 for curves in the lumbar region. This implies that mechanical measures to correct this spinal deformity or to prevent progression should apply different rotations to the apex from those applied to the curve as a whole and, in opposite senses, in curves in kyphotic regions. There was no evidence of an abnormality of sagittal curvature of a magnitude to implicate it in the etiology or in the treatment.

Adolescent↗
PubMedDate not supplied

Correction of spinal curvatures by transcutaneous electrical muscle stimulation.

Transcutaneous electrical neuromuscular stimulation was used to induce acute scoliosis of up to 56 degrees in straight cat spines. Conversely in humans, surface muscle stimulation was able to acutely correct 35 idiopathic scoliosis curves an average of 44%. The amount of correction obtained increased linearly with the length of the skeletal lever arms (ribs, pelvis) interconnecting the stimulated musculature with the vertebrae of the spinal curve. When the electrodes were placed over the lateral trunk musculature rather than on the paraspinals, the scoliosis reduction improved threefold. Similar results were found in a group of seven neuromuscular scoliotics. Muscle groups stimulated were detected with thermography. In 18 kyphosis patients, an average of 13 degrees correction was accomplished with stimulation of the paraspinal musculature. The foundation for clinical use of surface muscle stimulation in the management of excessive spinal curvatures was established, with guidelines for electrode placement in scoliosis, kyphosis, lordosis, and curvature combinations.

Adolescent↗
PubMed2002

Atrophy of kidney following extra corporeal shock wave lithotripsy of renal calculus in a paraplegic patient with marked spinal curvature.

OBJECTIVES: To discuss a rare complication of extra corporeal shock wave lithotripsy (ESWL) of renal calculus in a paraplegic patient, who had marked curvature of thoracic and lumbar spine. DESIGN: A case report of a paraplegic patient, who developed renal atrophy and hypertension after undergoing ESWL of staghorn calculus. SETTING: Regional Spinal Injuries Centre, Southport and Mersey Regional Lithotripsy Unit, Royal Liverpool University Hospital, Liverpool, UK. PARTICIPANT: A 28-year-old male with spina bifida, paraplegia at L-1 level and considerable curvature of spine and tilting of pelvis. METHOD: ESWL was carried out in three sessions by delivering 1934, 1876, and 2025 shock waves respectively. Localisation of the staghorn calculus was difficult because of spinal curvature and pelvic tilt. RESULTS: A follow-up IVU, performed 3 months after last ESWL treatment, revealed no residual stone in the left kidney, apart from a little low-density calcification in the renal parenchyma adjacent to the lower pole calyx. There were no calculi in the left ureter. The left kidney had become small, though still functioning. MAG-3 isotope renogram showed the left kidney to be markedly atrophic. Relative renal function: right kidney, 94%; and left kidney, 6%. He developed hypertension and a laparoscopic left nephrectomy was performed at another hospital. CONCLUSION: Difficulty in localisation of renal calculi for ESWL must be anticipated in spinal bifida and spinal cord injury patients, who have significant spinal curvature. Because of problems in the positioning of a patient with marked curvature of spine and pelvic tilt, and consequent difficulties in accurate localisation of renal calculi for lithotripsy, these patients may be at increased risk of developing renal parenchymal and vascular damage following ESWL.

Adult↗