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At least 127 records · Page 7Linked to original sources
PubMed1997

Progression of vertebral wedging in an asymmetrically loaded rat tail model.

STUDY DESIGN: A rat tail model was used to test the hypothesis that angulation and asymmetric axial compressive loading would lead to vertebral wedging because of asymmetric longitudinal growth in the physes. OBJECTIVES: To study the effect of angulation and asymmetric loading on the progression of spinal curvature in a rat tail model. SUMMARY OF BACKGROUND DATA: Large idiopathic scoliotic curves in children with significant growth remaining are the curves most likely to progress. The mechanism of progression of skeletal deformities is thought to be controlled by the Hueter-Volkmann law, whereby additional axial compression decelerates growth, and reduced axial compression accelerates growth. It has been hypothesized that spinal curvature leads to asymmetric loading transversely along the vertebral growth plate, causing progressive vertebral wedging by means of a vicious cycle. METHODS: Two 32-mm diameter external ring fixators were glued to 0.7-mm pins that had been inserted percutaneously through the eighth and 10th caudal vertebra of 10 6-week-old Sprague-Dawley rats. Calibrated springs and 15 degrees wedges, mounted on stainless steel threaded rods passing through holes distributed around the rings, imposed a 30 degrees Cobb angle and axially compressed the instrumented vertebrae. Fluorochrome labels and radiographs were used to document the progression of vertebral wedging. RESULTS: The wedging initially was entirely in the intervertebral discs, but by 6 weeks the wedging of the discs and vertebrae were approximately equal. Fluorochrome labeling confirmed that the vertebral wedging resulted from asymmetric growth in the physes. CONCLUSIONS: This study shows that vertebrae, when asymmetrically loaded, become wedged. This is consistent with the concept of mechanically provoked progression of scoliotic deformities according to the Hueter-Volkmann law.

Animals↗
PubMed1984

Pulmonary function in adolescents with mild idiopathic scoliosis.

Spirometric indices, lung volumes, maximum voluntary ventilation, and maximum inspiratory and expiratory pressures were measured in 44 adolescents with mild idiopathic scoliosis (spinal curvature less than 30 degrees). All were symptom free, but six (13.6%) showed a restrictive defect with forced vital capacity less than 80% of predicted. In 12 subjects (27.3%) maximum voluntary ventilation was reduced to less than 80% of predicted normal. Forced vital capacity was significantly correlated with maximum inspiratory pressure and with maximum expiratory pressure, measures of respiratory muscle strength, but was not related to the degree of thoracic curvature. When maximum inspiratory pressure and forced vital capacity were corrected for differences in body size these variables remained positively correlated, most significantly in the girls. These data indicate that ventilatory function may be impaired in mild, idiopathic scoliosis and that the force developed by the respiratory muscles is a more important determinant of this impairment than the radiologically determined degree of spinal curvature.

Adolescent↗
PubMed2025

Comparative Genomic Screening Identifies Developmental Constraint Loci Underscoring the Phenotypic Evolution of Syngnathids.

Seahorses and their relatives (syngnathids) exhibit remarkable diversity in morphology and function, characterized by their distinctive body shapes and specialized feeding mechanisms. Despite recent advances in uncovering the genetic basis of some traits, the genotype-phenotype map in syngnathids remains incomplete. In this study, we employed forward-genomic approaches and developed a method to enrich for human disease amino acid loci at a genomic scale. Our aim was to identify genetic loci associated with fin size reduction, tooth loss, and spinal curvature in syngnathids. Intriguingly, we identified a convergent amino acid change in the lat4a gene shared by syngnathids and some flying fishes, with in vitro analysis confirming its role in fin size evolution in both lineages. While genes critical for tooth development are conserved in syngnathids, the absence of key regulatory elements, such as pitx2, likely contributes to tooth loss. Additionally, we implicated col6a3 in spinal curvature development in seadragons. These findings reveal novel genetic signatures and developmental constraints underlying syngnathid diversity, demonstrating the utility of comparative genomics and targeted gene enrichment in exploring vertebrate evolution.

Animals↗
PubMed2002

[Influence of sports mechanic demands in competitive tennis on the thoracolumbar spinal profile].

The aim of this study was to evaluate the influence of the sports mechanic demands of competitive tennis on the thoracolumbar spinal profile. For that reason the spinal curvature (C7 - S2) of 123 male active gymnasts aged 23,8 +/- 4,5 years with a sporting exposure of 14,4 +/- 3,8 years and of 1347 age and gender matched non- and recreational sportsmen was recorded by means of the non-invasive ultrasonic-controlled contact rod. In the sagittal projection no differences between both groups were found. However, in control and sports group the dominant side of the arms induced statistically significant differences for all parameters describing spinal curvature in the frontal and transversal plane, data evaluated showed a relevant increase in the tennis group. Furthermore, the criterion both-handed hitting technique in fore and backhand caused an additional extension of lateral inclination, pelvic and pelvic-shoulder tilt as well as pelvic-shoulder rotation to the hitting side of the arms. After examining the sports-specific mechanic strain the measuring values are to interpret as a functional adaptation to the tennis-specific demands. But there is only a reduced correlation with the results of epidemiologic studies taking the incidence and prevalence of spinal injuries in competitive tennis into special account. So the tennis-specific modifications of spinal profile are not to characterise a priori as pathogen.

Adult↗
PubMedDate not supplied

[Results of lateral electrical surface stimulation in scoliosis].

A group of 26 out of 32 patients with idiopathic scoliosis treated by lateral external electric stimulation within the last 4 years was examined. In about 80% an arrest of progression or an improvement of the spinal curvature was found within 2 years. The average improvement was 7.6 degrees Cobb. A good effect can be expected in scoliosis with a Cobb angle up to 25 degrees. Analysis showed that good flexibility, low rotation, low Risser sign and Harrington factor seem to be decisive for a successful treatment. Even if the range of electrostimulation can be extended in the future up to higher degrees of spinal curvature it is doubtful that electrostimulation can substitute orthotic treatment in the whole established spectrum.

Adolescent↗
PubMed1996

Thoracic kyphosis and the prevalence of advanced uterine prolapse.

OBJECTIVE: To determine if there is an association between the degree of thoracic kyphosis and the prevalence of advanced uterine prolapse in women. METHODS: A retrospective case-control study compared the degree of thoracic kyphosis among white women with advanced uterine prolapse with that of matched controls. Medical records were reviewed for 412 consecutive women who underwent either abdominal or vaginal hysterectomy. The cases were those with uterine prolapse to or beyond the level of the introitus, and women with no evidence of prolapse served as controls. Spinal curvature was measured preoperatively for each patient using a lateral chest x-ray and the Ferguson method. Forty-eight cases were matched to 48 controls for age, weight, menopausal status, and hormonal status. Results were stratified to analyze the effect of parity on the relationship between uterine prolapse and thoracic kyphosis. RESULTS: The degree of thoracic kyphosis was higher in patients with uterine prolapse than in controls (mean paired difference = 4.9 degrees, 95% confidence interval [CI] 3.1-6.7; P < .001). Patients with uterine prolapse had a mean spinal curvature of 13.0 degrees (95% CI 11.5-14.5), whereas controls had one of 8.1 degrees (95% CI 6.9-9.4). A higher degree of thoracic kyphosis was associated with an incremental higher occurrence of uterine prolapse (odds ratio 1.35, 95% CI 1.11-1.65; P < .01). CONCLUSION: Thoracic kyphosis appears to be associated with uterine prolapse.

Case-Control Studies↗
PubMedDate not supplied

Forced vital capacity and maximal respiratory pressures in patients with mild and moderate scoliosis.

Lung function and maximal respiratory pressures of 24 adolescent females with mild-to-moderate idiopathic scoliosis (spinal curvature 10-60 degrees) were determined and compared with 38 age- and sex-matched controls. Twelve patients with moderate scoliosis (Cobb angle 35-60 degrees) had significantly reduced mean values for FVC (% predicted) and maximal inspiratory pressure (MIP), as compared to the controls. Twelve patients with mild scoliosis (Cobb angle less than 35 degrees) had normal mean values for FVC and maximal respiratory pressures, but five individual patients had FVC values less than 80% predicted. All but one of the patients with mild scoliosis had normal MIP values. FVC (% predicted) was significantly correlated with the degree of spinal curvature (r = -0.466; P less than 0.05) but was not related to MIP. These results indicate that reduced FVC values do occur in patients with mild-to-moderate idiopathic scoliosis and suggest that these low FVC values can be attributed to the rib cage deformity rather than to an inability to generate adequate inspiratory pressures.

Adolescent↗
PubMed2004

Treatment of multilevel cervical fusion with cages.

BACKGROUND: Multilevel cervical discectomy usually requires plate and screw fixation for maintaining the spinal curvature, and increasing the graft fusion rate. However, the use of plate and screw fixation may cause a few complications, such as screw breakage, screw pullout, esophagus perforation, and cord or nerve root injury. In this study, we try to use cages to replace plate function in multilevel cervical fusion. METHODS: From January 1997 to June 2001, there were 180 consecutive cases of multilevel cervical degenerative disease. We randomized them into three groups: Group A (60 patients) underwent anterior discectomy and polyetheretherketone (PEEK) fusion, Group B (50 patients) underwent anterior discectomy, autogenous iliac crest graft (AICG) fusion and plate fixation, and Group C (70 patients) underwent anterior discectomy and AICG only. X-ray of cervical spine was taken every 3 months until fusion was complete. Spinal curvature was measured by lateral view of X-ray. The functional and working status were evaluated by Prolo scale. Blood loss and operation time were recorded, respectively. RESULTS: The total complication rates were 3.3%, 16%, and 54.3% in Groups A, B, and C respectively. The graft complications were evaluated by radiographic findings (graft collapse, nonunion, or dislodged graft). However, only 37.1% of patients (13/35) with graft complications had clinical symptoms (severe neck pain, radicular pain, or neurologic deficits). The fusion rate was better, and the time to fusion was sooner in Groups A and B than Group C, p < 0.001 (chi(2) test). PEEK cage is statistically better than plating group in total complications, p < 0.05. Graft collapse and nonunion were the major graft complications in Group C (AICG without plating). Screw pullout, and screw breakage were the main causes of plating complication. Blood loss was minimum in Group A, p < 0.05. Spinal lordosis increased by a mean of 4.61 +/- 2.93 mm and 1.68 +/- 5.02 mm in Groups A and B, respectively, but spinal kyphosis increased by a mean of -2.09 +/- 4.77 mm in Group C. Group A had a statistically better Prolo scale than Group C, p < 0.0001. CONCLUSIONS: Both PEEK cage without plating and AICG with plating are good methods for interbody fusion in multilevel cervical degenerative diseases. They increase spinal lordosis and graft fusion rate, and cause fewer surgical complications. However, PEEK cage is preferred in our study for multilevel fusion, because it has the fewest complication rates and the least amount of blood loss.

Adult↗
PubMed1988

Analysis of cervical spine curvature in patients with cervical spondylosis.

Computer-aided design techniques were used to analyze the degree of spinal curvature shown on cervical spine radiograms of 28 patients. On films standardized as to size, a geometrical chord was constructed from the 2nd to the 7th cervical vertebrae (C2 to C7), and an arc was drawn along the posterior margin of the vertebrae. The resulting area was used as an index of curvature, and the spinal canal diameter was measured. Severity of myelopathy as well as clinical improvement was related to the geometrical data. There was no clear correlation between severity of the preoperative myelopathy and degree of curvature. Severe myelopathy was seen in association with straight, lordotic, and hyperlordotic spines. Neck pain was most severe in patients with reversed cervical curvature. The degree of curvature, however, seems to relate to the postoperative clinical outcome. Patients with relatively normal curvature showed the greatest improvement in symptoms and signs. Postoperative magnetic resonance scanning confirms that posterior migration of the spinal cord after laminectomy may be inadequate to clear osteophytes in patients with straightened or reversed curvature of the cervical spine. Spinal geometry should be considered in the selection of the best surgical procedure and the extent of laminectomy for patients with spondylotic myelopathy. Significant abnormalities of spinal curvature may account for some instances of poor outcome after laminectomy.

Aged↗
PubMed2002

SpineCor--a non-rigid brace for the treatment of idiopathic scoliosis: post-treatment results.

The objective of this study was to assess the success of treatment during the follow-up of a group of 195 idiopathic scoliosis (IS) patients consecutively treated with the SpineCor system. A survival analysis was performed to estimate the cumulative probability of success during treatment, at follow-up and for the combined treatment and follow-up period. Success was defined as either a correction or stabilization of +/-5 degrees or more, and failure as a worsening of more than 5 degrees. The patient cohort was categorized before treatment into curves less than 30 degrees (group 1), and curves greater than 30 degrees (group 2). The survival analysis indicated a cumulative probability of success that increased during treatment with the patient wearing the brace (Year 1: 0.30, 0.39; Year 2: 0.62, 0.79; Year 3: 0.92, 0.89, for groups 1 and 2 respectively). During the post-treatment follow-up period, there was a stabilization (Year 1 post-treatment: 0.94, 0.89; Year 2 post-treatment: 0.85, 0.81), with an overall probability of success of 0.92 and 0.88 after 4 years of combined treatment and post-treatment follow-up. For the 29 patients who had a minimum follow-up of 2 years (initial Cobb angle: 30 degrees +/-9 degrees ), the trend during treatment was a decrease in spinal curvature at 3 months, with a mean difference of 10 degrees (SD 5 degrees ); at termination of treatment a mean difference of 7 degrees (SD 7 degrees ); and at the time of the 1- and 2-year follow-ups there was a difference of 4 degrees (SD 7 degrees ) and 5 degrees (SD 7 degrees ) respectively, with reference to the initial out of brace condition. At 2 years follow-up there was an overall correction of greater than 5 degrees for 55% of the patients, 38% had a stabilisation and 7% had worsened by more than 5 degrees. This initial cohort of patients demonstrated a general trend of initial decrease in spinal curvature in brace, followed by a correction and/or stabilisation at the end of treatment, which was maintained through 1, and 2 years' follow-up.

Adolescent↗
PubMed2003

Follow-up after cervical laminectomy, with special reference to instability and deformity.

Misalignment and instability after cervical laminectomy, performed to treat spondylotic myelopathy, has been described as possible adverse effects. Forty-six consecutively patients on whom laminectomy had been performed in a 4-year period were identified; 7.7 +/- 0.6 years after operation, 11 patients had died and 27 patients were available for follow-up. Postoperative static subluxation was observed in 26% of the patients with an average slip of 3.7 +/- 3.1 mm; 7% had abnormal intervertebral movement displaying 1-2 mm movement from full flexion to full extension. Seventy-four per cent of the patients showed abnormal spinal curvature as judged from radiographs. However, no correlation with outcome was observed. Seventy-four per cent of the patients thought of the result of the operation as either good or fair; objectively, the best long-term effect of the operation was upon arm function. Although some patients develop postural anomaly, laminectomy remains, in terms of instability, a justifiable procedure in the elderly patient with spondylosis.

Adult↗
PubMed2003

Peak expiratory flow in children and adolescents with idiopathic scoliosis.

Spirometric and plethysmographic examinations were performed in two groups of children with idiopathic scoliosis and healthy children. Group I, 23--children with scoliosis 1 degree by Cobb, spinal curvature 17.2 degree, 12 girls and 11 boys at the age 8-15 years (the mean age was 11.4 +/- 2.4 yr). In Group II were 35 children, 28 girls and 7 boys at the age 12-19 years (the mean age was 14.67 +/- 1.47 yr) with mean angle of curvature 63.35 degree, which is grade II and III scoliosis according to Cobb. The Control Group were 20 children, 13 girls and 7 boys at the age of 8-16 years (the mean age was 13.77 +/- 1.72 yr). The measurements were done using Body--plethysmography with pneumotachograph Jaeger. All subjects had respiratory function examination performed, which included: total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 sec. (FEV1), residual volume (RV) and intrathoracic gas volume (ITGV). At the same time peak expiratory flow--PEF were determined. In children with scoliosis at initial stage, Group I, were found slightly decreased total lung capacity--TLC and statistically significantly decreased intrathoracic gas volume--ITGV as well as residual volume--RV in comparison to the control group. Forced vital capacity--FVC and forced expiratory volume in 1 sec.--FEV1 were normal. But statistically significantly decreased PEF values were found in comparison to the control group (p < 0.05). It means that restrictive and obstructive disturbances of lungs progressing in grade II and III scoliosis were shown manifested by reduced values of TLC, FVC, ITGV and RV. A statistically significant decrease of peak expiratory flow together with the growth of spinal curvature angle was shown in grade II and III scoliosis in comparison with both the control group and the studied Group I (p < 0.001, p < 0.05).

Adolescent↗
PubMedDate not supplied

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature.

The loss of flexibility in a spinal curvature defines it as a structural spinal deformity; a curvature sufficiently mobile to resolve with a change in posture is a non-structural or 'functional' scoliosis which is within the normal limits of movement for a human spine. It, therefore, seems logical that exercise-based therapies designed to improve and/or maintain flexibility and range of motion of the spine and thorax would be useful in the treatment of scoliosis. Recognition of the importance of maintaining flexibility of the thoracic spinal column to avoid scoliosis-associated pulmonary dysfunction made the use of exercise-based therapies a topic of clinical interest in ancient Greece. In recent years, successful prevention of polio epidemics has resulted in a stable change in patient populations such that most individuals diagnosed with scoliosis do not suffer from irreversible central nervous system compromise. As a result, realistic opportunities to examine the role of exercise in treatment of scoliosis are available for the first time in history. A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults.

Adult↗
PubMed2002

Relation between oligohydramnios and spinal flexion in the human fetus.

BACKGROUND: Oligohydramnios, a severe reduction in the volume of amniotic fluid, is associated with fetal lung hypoplasia but underlying processes are unclear. Studies in sheep suggest that oligohydramnios may lead to lung hypoplasia by causing increased flexion of the fetal spine, but this has not been demonstrated in the human, which has a different uterine anatomy. AIMS: Our aims were to quantify spinal flexion in the human fetus and to determine the relationship between oligohydramnios and the degree of spinal flexion. SUBJECTS AND METHODS: In 35 pregnancies, we used ultrasonography to assess amniotic fluid volume and to image the fetal spine so as to provide an index of mean spinal radius between the upper thoracic and lumbar spine. In 17 pregnancies with evidence of oligohydramnios resulting from premature rupture of membranes (mean +/- SEM gestation 28.8 +/-1.4 weeks), the mean radius of fetal spinal curvature between the upper thorax and sacrum was compared with values from 18 control fetuses with normal amounts of amniotic fluid (at 28.9 +/- 1.6 weeks). RESULTS: In each fetus, the spine could be imaged and the mean radius of curvature calculated. Oligohydramnios was associated with a significantly increased degree of fetal spinal flexion compared to controls. CONCLUSION: In human pregnancy, oligohydramnios is associated with increased flexion of the fetal spine, which is likely due to reduced uterine volume. This could contribute to the development of fetal lung hypoplasia, fetal immobility and other fetal anomalies.

Apgar Score↗
PubMed2004

Variability of clinical expression and evolution of spinal deformity in a family with late detection of dopa-responsive dystonia.

This case report documents an unusual presentation of dopa-responsive dystonia (DRD) in three siblings (two females, one male) which simulated cerebral palsy (CP) and describes the evolution of their spinal deformity in relation to growth and responsiveness to levodopa therapy. The siblings were normal at birth with a negative history of neurological disease or spinal imbalance. They showed marked phenotypic variation but all developed progressive scoliosis and neurological impairment with mixed spastic dystonic features, leading to the misdiagnosis of spastic dystonic CP. Age at establishment of the diagnosis of DRD and levodopa trial for the three patients was 12 years, 9 years 6 months, and 3 years 6 months respectively. In patients 1 and 3, spinal deformity responded dramatically to levodopa treatment and neurological symptoms were ameliorated. Patient 2 developed a rigid scoliotic curve and, despite neurological improvement with levodopa, the spinal curvature remained unresponsive necessitating surgical correction. Spinal decompensation is a common manifestation of DRD, which with early diagnosis and initiation of levodopa treatment has an excellent prognosis. This report highlights the variability of clinical expression in DRD and the importance of an adequate trial of levodopa when unexplained dystonic features are documented.

Adolescent↗
PubMed1990

A comparison of radiographic and computer-assisted measurements of thoracic and thoracolumbar sagittal curvature.

Sagittal plane curve characteristics of the thoracolumbar spine were evaluated from 286 lateral chest radiographs comparing the Cobb technique with a computer-aided digitizer. Thoracic kyphosis and curve apex were measured from the T3 to T11 segments, and in 120 cases, the level of the thoracolumbar curve inflexion point was determined. An age-related increase in curve magnitude was similar for both measurements, although computer generated kyphosis angles were generally larger. The apex of thoracic kyphosis was consistently located near T7 for males compared with greater variability with age for females. The thoracolumbar inflexion point shifted caudally with increasing years, being most marked for females. The computer method was more reliable, producing a coefficient of variation of 1.4% on repeated measurement. The ability to describe quantitatively the thoracolumbar curve characteristics, calculate angles between selected segments, determine points of inflexion and maximum curvature, indicates that radiographic evaluation of sagittal spinal curvature is improved with the use of computer-aided measurement.

Adolescent↗
PubMedDate not supplied

The classification of spinal deformities.

Any methods of classification of scoliosis deformity devised should recognise different aetiological and pathological causes of the conditions and their likely impact on the natural history of the spinal curvature. Such classification should aim to aid clinicians in their approach to treatment. Furthermore, any such system must have a high reliability and validity. Several approaches have been reported. Pathological classifications have been devised which relate to the system or tissue affected by the underlying pathology, such as congenital anomalies which affect the skeletal elements of the spine, general neurological problems or muscular disorders. Classification by age of onset has also been adopted, using criteria such as infancy or adolescence. However, most attention has been focussed on structural features of the spine in developing anatomical classifications. Features such as the apex or magnitude of a curvature or its rotation are important clinical signs and are widely used in surgical practice. This paper reviews the different classification reported but make no attempt to justify one as being ideal. However, since the biological processes contributing to the deformity and its subsequent natural history are still unclear, it remains difficult to develop a fully reliable and all embracing system of classification.

Age of Onset↗
PubMed1997

Preliminary assessment of ultrastructural changes in muscle fibres of rabbits after electric stimulation.

Studies were carried out on the effect of lateral electric surface stimulation used to treat lateral idiopathic spinal curvature in children and youth upon ultrastructural changes in the muscles which take part in spine stabilization. The experiment was carried out for 3 months on 10 rabbits. It was found that this stimulation, performed for 9 hours daily for 3 months, resulted in both progressive and regressive changes. Deviations from a norm suggest that the stimulation process destroys the sensory part of the reflex arc and chronic destructure of motoric neuron. In addition to this, overstraining of the muscle fibres with work was reflected in fibre hypertrophy and changes in the mitochondria.

Animals↗