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PubMed1984

Scoliosis and trunk muscles.

This study examines the role of muscular deficiencies in the origin and development of paralytic scoliosis. We studied spine films of 108 scoliotic curves of poliomyelitic children and results of muscle tests made during the growth phase. We investigated the relationship between spinal and abdominal muscle test values, determined 2 years after the child had experienced the acute phase of anterior polioimyelitis, and the convexity, evolution rate, effects of gravity, and reducibility of the scoliotic deformity. Although paralysis certainly is responsible for triggering scoliosis, it plays no role in determining convexity for thoracic and lumbar patterns, and has little bearing on thoracolumbar curves. It is not at all correlated with the evolution rate, reducibility, or degree of collapse with gravity. The general laws governing the evolution of scoliosis, whatever its origin, are outlined, and several possible pathogenic factors are suggested.

Acute Disease↗
PubMedDate not supplied

Platelet aggregation abnormalities in idiopathic scoliosis.

Platelet aggregation studies were performed in 22 adolescent girls with idiopathic scoliosis. Impaired ADP-induced platelet aggregation was found in washed platelets of the 22 patients with idiopathic scoliosis when compared with the controls (76.5% of control values; p less than 0.01). Furthermore, platelets from patients with progressive curves showed a greater degree of abnormality than platelets from those with nonprogressive curves, e.g., 57.6 +/- 22% of control values (p less than 0.001). No significant differences in aggregation could be detected when platelets were aggregated with the ionophore A-23187 in either the absence or the presence of calcium. Platelet aggregation studies in patients with other spinal deformities did not differ from the healthy controls. Because platelets share similar contractile proteins as muscles, the present study suggests that a muscle disorder may play an important pathogenic role in idiopathic scoliosis.

Adenosine Diphosphate↗
PubMedDate not supplied

School screening for adolescent idiopathic scoliosis.

Two school examination schemes for scoliosis were compared in a defined population of 13,757 children. During the first period, there was no screening program. During the second period, all children in grades 4-8 were examined yearly by forward-bending tests. Brace treatments were started in 0.39%. The two periods did not differ significantly with respect to frequency of children regularly observed for scoliosis by orthopedic surgeons, frequency of brace treatment, age at detection, or mean scoliotic curve at the start of treatment. A single forward-bending test in grade 4 appears to be sufficient for detection of scoliosis requiring treatment.

Adolescent↗
PubMedDate not supplied

Vibratory hypersensitivity in idiopathic scoliosis.

This study determined whether a significant difference in response to vibratory stimuli was consistently present in a large group of children with idiopathic scoliosis as compared with age-matched controls. Fifty-eight unselected adolescent females with documented progressive idiopathic scoliosis were studied along with age-matched controls. Threshold to detection of a vibratory stimulus was measured in both the right and left upper and lower extremities. Results indicated that highly significant differences existed between scoliotic children and controls at all sites tested (p less than 0.01), with scoliotic children being more sensitive than controls. The results support the presence of a central aberration in posterior column function that may be a primary etiology of idiopathic scoliosis.

Adolescent↗
PubMedDate not supplied

Scoliosis in children with pectus excavatum and pectus carinatum.

Between 1974 and 1985, 461 patients with pectus excavatum and 135 patients with pectus carinatum underwent operative repair of their anterior chest wall deformities. Twenty-one percent of patients with anterior chest wall deformity had mild scoliosis by clinical and radiographic examination. The average lateral spinal deformity was 15 degrees (range 6-78 degrees) for pectus excavatum patients and 16 degrees (range 5-57 degrees) for pectus carinatum patients. Eighteen percent of the pectus excavatum patients with scoliosis and 14% of the pectus carinatum patients with scoliosis required therapeutic intervention of bracing and/or arthrodesis.

Adolescent↗
PubMedDate not supplied

Management of scoliosis due to syringomyelia in childhood and adolescence.

To determine the effect of syringomyelia treatment (drainage) on the efficacy of orthotic management and safety of operative management of an associated scoliosis, the records of four boys with scoliosis due to syringomyelia were reviewed. The average follow-up was 8 years. On presentation, all had an abnormal neurologic examination. Each syrinx was treated by laminectomy and insertion of a syringosubarachnoid shunt. After drainage, three of four improved neurologically. Two older patients underwent uneventful posterior spinal fusion with Harrington distraction instrumentation after their drainage procedures. One boy developed kyphosis at the site of his laminectomy. Two young patients, whose curves were initially well controlled with bracing, developed continued curve progression over time. Drainage of the syrinx delayed but did not prevent curve progression in immature patients, but did allow use of distraction instrumentation without complication for operative management of the associated scoliosis.

Adolescent↗
PubMedDate not supplied

Simultaneous correction of pelvic obliquity, frontal plane, and sagittal plane deformities in neuromuscular scoliosis using a unit rod with segmental sublaminar wires: a preliminary report.

Ten patients with neuromuscular scoliosis and pelvic obliquity had segmental spinal instrumentation using a unit Luque rod with sublaminar wires and fixation into the pelvis. Nine of the 10 patients also had anterior spinal fusion without instrumentation before the posterior procedure. Average preoperative pelvic obliquity was 42 degrees which was corrected to 6 degrees (82% correction). Average preoperative scoliosis was 92 degrees, which was corrected to 16 degrees (81% correction). Complications included a wound hematoma in one patient and a superficial wound dehiscence in another. There have been no pseudarthroses or hardware failures to date. Excellent correction of the pelvic obliquity and the spinal curve in neuromuscular scoliosis can be obtained with use of a unit rod and without use of anterior instrumentation.

Adolescent↗
PubMedDate not supplied

Allograft versus autograft bone in idiopathic scoliosis surgery: a multivariate statistical analysis.

The use of autograft versus allograft bone in scoliosis surgery is critically evaluated by a multivariate statistical analysis. Two groups of patients matched for age, angle of curve, and length of fusion, forming a consecutive series of posterior arthrodesis for idiopathic scoliosis, were evaluated. Group A consisted of 83 patients receiving autografts, and group B consisted of 99 patients receiving allografts. There was a significant reduction in operation time in the allograft group, and blood loss also decreased. After 1 year there was no significant difference in correction of the curve. Given the problems of discomfort at the donor site scar, we recommend the use of allograft bone in scoliosis surgery.

Adolescent↗
PubMed2005

Managing scoliosis in a young child with Rett syndrome: a case study.

Rett syndrome is a genetic disorder primarily affecting females. One of its most disabling features is the severe and rapid progression of scoliosis. So far, only surgical intervention has succeeded in reversing the development of scoliosis in Rett syndrome. The present study describes a new management approach implemented with a girl with Rett syndrome. The core of the management regime was intensive: asymmetrical activation of trunk muscles through equilibrium reactions. The X-rays accompanying the article (evaluated by four experienced orthopedic surgeons blinded to the intervention process) suggested that the intervention was successful in reversing the progress of the scoliosis for the above-mentioned child. Discontinuation of treatment led to severe and rapid deterioration of the spinal curve. Due to the fact that this was a case study, generalization is limited, but we suggest further investigation and studies with this method.

Child↗
PubMed2001

Automatic scoliosis detection based on local centroids evaluation on moiré topographic images of human backs.

This paper presents a technique for automating human scoliosis detection by computer based on moiré topographic images of human backs. Scoliosis is a serious disease often suffered by teenagers. For prevention, screening is performed at schools in Japan employing a moiré method in which doctors inspect moiré images of subjects' backs visually. The inspection of a large number of moiré images collected by the school screening causes exhaustion of doctors and leads to misjudgment. Computer-aided diagnosis of scoliosis has, therefore, been requested eagerly by orthopedists. To automate the inspection process, unlike existent three-dimensional techniques, displacement of local centroids is evaluated two-dimensionally between the left-hand side and the right-hand side of the moiré images in the present technique. The technique was applied to real moiré images to draw a distinction between normal and abnormal cases. According to the leave-out method, the entire 120 image data (60 normal and 60 abnormal) were separated into three data sets. The linear discriminant function based on Mahalanobis distance was defined on the two-dimensional feature space employing one of the data sets containing 40 moiré images and classified 80 images in the remaining two sets. The technique finally achieved the average classification rate of 88.3%.

Algorithms↗
PubMed1985

Postoperative respiratory complications in non-idiopathic scoliosis.

The medical records of 303 patients undergoing fusions for scoliosis correction were retrospectively reviewed. The frequency and type of postoperative respiratory complications were compared in idiopathic versus non-idiopathic scoliosis patients in relation to age, type of spinal fusion procedure, pulmonary function test (PFT) results and preoperative diagnoses. The following factors were found to increase the incidence of problems in the postoperative period: a non-idiopathic type of scoliosis, mental retardation, anterior spinal fusion procedures, age of 20 or more years, a relative arterial hypoxemia and an obstructive component to the PFT's. Topics for further investigation are suggested.

Adolescent↗
PubMed1993

Transient scoliosis in a child with juvenile rheumatoid arthritis.

An 8 year old girl was admitted to hospital complaining of arthralgia in a few large joints. According to the clinical course and serological tests, a diagnosis of a polyarticular type of juvenile rheumatoid arthritis was made. About 6 weeks after the onset, scoliosis was observed. The curvature regressed spontaneously over the following 6 months. Generally, scoliosis associated with juvenile rheumatoid arthritis has been noted a few years after the onset. A transient scoliosis in the early phase of this disease is rare.

Arthritis, Juvenile↗
PubMed1976

Myelodysplasia: the natural history of kyphosis and scoliosis. A preliminary report.

The results of this study support the concept that the levels of the bifid vertebral arch and of functional motor activity are significant influences on the development of scoliosis and kyphosis in patients born with myelodysplasia. 'Significant' degrees of scoliosis and kyphosis may appear at any time during life, but most frequently occur during late childhood or adolescence. Not all 'significant' curvatures require treatment, nor do all children with myelodysplasia and factors predisposing to kyphosis and scoliosis develop these complications. It is believed that the preliminary cumulative percentage curves presented in this study will be of value in counselling parents of afflicted newborn infants, and in planning the management of patients born with myelodysplasia.

Adolescent↗
PubMed1993

Trunk asymmetry and screening for scoliosis: a longitudinal cohort study of pubertal schoolchildren.

A cohort of children was followed-up annually from an average age of 10.8-13.8 years to assess various measures of trunk asymmetry for their predictive value in the screening of scoliosis. Of 1060 children, 855 (80.7%) participated in the final examination. Trunk asymmetry was measured by the forward bending test and moiré topography. A posteroanterior standing radiograph of the spine was taken of those 250 (29.2%) children who had a trunk hump > or = 8 mm. Only 8.3% of the children were found to be symmetric (hump 0-2 mm) in the forward bending test: 65.5% had a hump of 3-7 mm and 26.2% had a hump > or = 8 mm at 13.8 years. Also, moiré fringe asymmetry proved to be common (prevalence of asymmetry > 1 fringe 47.3%), but its correlations with rib hump (r = 0.16) and Cobb angle (r = 0.12) were low. At the final examination, the prevalence of scoliosis (Cobb angle > or = 10 degrees) was 9.2%. Two girls (0.2%) needed brace treatment. The forward bending test is preferable to moiré topography in screening for scoliosis, and a hump size of 6 mm at an average age of 10.8 years is the nearest to optimal as a screening threshold.

Adolescent↗
PubMed1977

Results of school screening for scoliosis in the San Juan Unified School District, Sacramento, California.

Annual routine school examination for scoliosis has been established in the San Juan Unified School District. Additionally, several parochial schools and other schools in the county or nearby towns have expressed interest in such a program. A rapid, effective method, taking no more than 30 seconds per child, has been used to detect spinal curvature. The program is beneficial for those identified with scoliosis, because early detection, followed by proper treatment, can prevent major surgery. The need for careful school nurse follow-up must be emphasized. A standing x-ray and evaluation by a qualified physician are imperative. If scoliosis is diagnosed, the school nurse can be a very effective contact in assisting the students by discussing exercise or brace care and by providing encouragement and general supportive help.

Adolescent↗
PubMed2002

Genetic algorithm-neural network estimation of cobb angle from torso asymmetry in scoliosis.

Scoliosis severity, measured by the Cobb angle, was estimated by artificial neural network from indices of torso surface asymmetry using a genetic algorithm to select the optimal set of input torso indices. Estimates of the Cobb angle were accurate within 5 degrees in two-thirds, and within 10 degrees in six-sevenths, of a test set of 115 scans of 48 scoliosis patients, showing promise for future longitudinal studies to detect scoliosis progression without use of X-rays.

Abdomen↗
PubMed1982

Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis).

The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Register control group of 692 normal infants born over the same period, giving a unique opportunity to obtain more accurate antenatal data than has previously been possible. The principal associations were: talipes equinovarus with antepartum haemorrhage and maternal hypertension; metatarsus varus with twin pregnancies; congenital dislocation of the hip with first born children, older than average fathers, breech presentation, a significant lack of menstrual problems in the mother, and maternal upper respiratory infection during pregnancy; infantile idiopathic scoliosis with breech presentation, prematurity, and the onset of the curve in the winter months. No significant association with raised intrauterine pressure (hydramnios or oligohydramnios) was found among these simple idiopathic deformities. It is concluded that the multifactorial genetic background in likely to be similar in all, but that the additional environmental element is variable.

Adult↗
PubMed1990

Scoliosis in rats with experimentally-induced hemiparkinsonism: dependence upon striatal dopamine denervation.

Rats suffering from experimental hemiparkinsonism induced by a unilateral injection of 6-hydroxydopamine into the left area ventralis tegmenti showed a strong ipsilateral deviation and scoliosis-like skeletal deformity. The rats often showed single rotatory curves affecting the thoracic and lumbar regions, although cases with multiple curves were also found. The severity of the scoliosis was closely related to a decrease in extracellular striatal dopamine measured with microdialysis and to the development of postsynaptic dopamine receptor supersensitivity, functionally evaluated with rotational behaviour elicited with apomorphine. Indeed, rats with the strongest dopamine depletion (greater than 95%) and the strongest rotational responses showed the sharpest spinal deviation and skeletal deformity. These findings agree with the clinical observations that scoliosis occurs in patients with Parkinson's disease and its direction is correlated with the side of the major signs and symptoms of parkinsonism.

Afferent Pathways↗