scholarly journals What causes different coronal curve patterns in idiopathic scoliosis?

2020 ◽  
Author(s):  
Saba Pasha
Keyword(s):  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Vertebral Rotation ◽  
Classification Systems ◽  
Axial Plane ◽  
Spinal Curvature ◽  
Group I ◽  
Plane Projection ◽  
Group Ii ◽  
Deformation Patterns

AbstractBackgroundAdolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spinal column in otherwise healthy adolescents. The underlying mechanisms associated with the spinal deformity development have been explored which delineated the role of the sagittal curvature of the spine. The patterns of the spinal deformity vary between the AIS patients as shown in several classification systems. It remains to further investigate how variations in sagittal profiles result in different coronal plane deformities in AIS and how these deformation patterns are intrinsically different.MethodsA total of 71 Lenke 1 and 52 Lenke 5 AIS patients were included retrospectively. The 3D models of the spine were generated from biplanar radiographs to calculate the clinical spinal parameters, vertebral axial rotations, and the 3D centerline of the spinal curvature. A classification based on the centerlines’ axial plane projection was developed. The 3D curvature of the centerline was calculated at each point. A 2D elastic rod finite element model (FEM) of the sagittal spinal curvature for each axial subtype was developed to calculate the 3D deformity of the spine under gravity and axial torsion. Differences in the axial clusters’ clinical parameters, curvature of the spine, and the deformation patterns of the FEM were compared. The characteristics of the sagittal curvature of these axial clusters were determined.ResultsLenke1 was divided into two axial groups (I and II) whereas the Lenke 5 cohort all had the same axial projection pattern (loop shape). T5-T12 kyphosis was significantly different between Lenke1-Group I and the other two groups, p=0.04. The vertebral rotation in both Lenke1-Group I and Lenke 5 had only one maximum value and the FEM deformed in a loop shaped whereas Lenke1-group II showed two maximum values for vertebral rotation and the FEM of the centerline deformed in a lemniscate shape. The ratio of the spinal arc lengths above and below the sagittal inflection points for Lenke1-Groups I and II and Lenke 5 were 0.52, 1.16, and 3.24, respectively.ConclusionVariations in the axial plane projection of the curve were observed within Lenke types. Lenke 1- Group I and Lenke 5 showed similar 3D curve characteristics suggesting one 3D curve whereas Lenke1-Group II, with two 3D curves, behaved differently. The length of the spinal arcs above and below the sagittal inflection point related to the patterns of axial deformity.

scholarly journals Fully automatic measurements of axial vertebral rotation for assessment of spinal deformity in idiopathic scoliosis

2013 ◽  
Vol 58 (6) ◽  
pp. 1775-1787 ◽  
Author(s):  
Daniel Forsberg ◽  
Claes Lundström ◽  
Mats Andersson ◽  
Ludvig Vavruch ◽  
Hans Tropp ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Vertebral Rotation ◽  
Axial Vertebral Rotation ◽  
Fully Automatic

scholarly journals Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

2015 ◽  
Vol 14 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Jean Carlo Frigotto Queruz ◽  
Allan Kato ◽  
Carlos Abreu de Aguiar ◽  
Luiz Muller Avila ◽  
Luis Eduardo Munhoz da Rocha
Keyword(s):  
Idiopathic Scoliosis ◽  
Hospital Stay ◽  
Posterior Approach ◽  
Thoracolumbar Spine ◽  
Average Hospital ◽  
Icu Stay ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group Ii

<sec><title>OBJECTIVE:</title><p> To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.</p></sec><sec><title>METHODS:</title><p> The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.</p></sec><sec><title>RESULTS:</title><p> The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels), and Group II presented an average of 6.36 vertebrae (5-11 levels). Complications did not show statistically significant difference.</p></sec><sec><title>CONCLUSION:</title><p> Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.</p></sec>

scholarly journals The Effect of Smith-Peterson Osteotomy on Blood Loss during Surgical Correction of Adolescent Idiopathic Scoliosis

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 503-508
Author(s):  
Anastasia Ivanova ◽  
Mikhail Mikhaylovskiy ◽  
Vyacheslav Novikov ◽  
Aleksandr Vasyura ◽  
Vitaliy Lukinov ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Surgical Correction ◽  
Intraoperative Blood Loss ◽  
Transpedicular Fixation ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Blood Loss Volume

Introduction: Surgical correction of adolescent idiopathic scoliosis is inevitably accompanied by blood loss. About 37&ndash;85% of patients undergo allogeneic transfusions associated with a risk of serious complications. Prediction of the expected blood loss volume remains a topical problem. In this regard, there is a need to clarify predictors of increased blood loss. Aim: To assess the effect of vertebrectomy on the intraoperative blood loss volume during surgical correction of adolescent idiopathic scoliosis. Materials and methods: A retrospective study included 511 adolescents who underwent posterior correction of spinal deformity. Two groups were allocated: Group I consisted of 303 patients who underwent multilevel transpedicular fixation; Group II included 208 patients who underwent multilevel transpedicular fixation combined with Smith-Peterson osteotomy. Results: Intergroup comparisons revealed significant differences in the number of transpedicular fixation levels and the volume of blood loss, which were higher in Group II. After aligning the groups by the number of transpedicular fixation levels using the Propensity Score Matching method, no statistically significant difference was observed. We derived formulas for calculating the expected blood loss volume in Groups I and II. Comparison of the formulas revealed that the formula for Group II predicted a significantly lower volume of blood loss, by 2.51%, while the formula for Group I predicted a significantly higher volume of blood loss, by 3.27%. In our opinion, application of the formula that overestimates expected intraoperative blood loss is most reasonable due to a possibility of the worst case scenario during surgery; therefore, the formula for Group I approaches a universal model for use. Conclusion: Smith-Peterson osteotomy did not affect the amount of blood loss during surgical correction of adolescent idiopathic scoliosis, considering the number of transpedicular fixation levels.

scholarly journals COSTAL HUMPBACK RESECTION AS A FINAL STAGE OF IDIOPATHIC SCOLIOSIS SURGICAL TREATMENT

2006 ◽  
pp. 022-028
Author(s):  
Elena Vladimirovna Gubina ◽  
Mikhail Vitalyevich Mikhailovsky ◽  
Vladimir Nikolayevich Sarnadsky
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Vital Capacity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Curve Correction ◽  
Correction Loss ◽  
Group I ◽  
Curve Magnitude ◽  
Group Ii

Objective. To analyse results of multistage surgical treatment of idiopathic scoliosis including costal humpback resection. Material and Methods. From 1996 to 2005 twenty girls with idiopathic scoliosis underwent spine deformity correction with Harrington distraction rod with Drummond interspinous wires (Group I) or with Cotrel – Dubousset Horizon Instrumentation (Group II). The final long-dated stage after correction of deformity included the costal humpback resection at the convex side only. Radiologic and topographic examinations were performed, and lung vital capacity parameter was used for lung function assessment. Patients answered the Russian version of SRS-24 questionnaire after correction and at each follow-up examination. Results. In Group I the mean curvature was 81.7° ± 26.7° (range, 55–107°) before correction and 34.5° ± 13.1° after correction (primary curve correction 57.8 ± 14.1 %). Mean correction loss in dynamics before resection was 8°, after resection 4.3°. In Group II the primary curve magnitude before correction was 87.4° ± 27.1° (range, 48–126°), after correction 42.7° ± 16.9° (primary curve correction 51.9 ± 9.6 %). Average correction loss in dynamics before resection was 3.5°, after resection 2.4°. Spirometric findings presented the following dynamics: lung vital capacity before resection was 1980 ml with mean early postoperative decrease by 16.8 % and subsequent reversion to the preoperative level or increase to 2010 ml. According to the questionnaire survey 100 patients gave the consent for surgery. Conclusion. Costal humpback resection as a cosmetic intervention improves the patient’s assessment of spine deformity surgical correction result.

scholarly journals Surgical correction of spinal deformity with the use of transpedicular screw spinal systems in children with idiopathic thoracic scoliosis

2016 ◽  
Vol 4 (2) ◽  
pp. 37-44
Author(s):  
Nurbek N Nadirov ◽  
Sergei M Belyanchikov ◽  
Dmitriy N Kokushin ◽  
Vladislav V Murashko ◽  
Kirill A Kartavenko
Keyword(s):  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Spinal Deformity ◽  
Pedicle Screws ◽  
Surgical Correction ◽  
Spinal Curvature ◽  
Thoracic Scoliosis ◽  
Use Of Data ◽  
Transpedicular Screw ◽  
Metal Construction

Aim.To compare the results of surgical correction of spinal deformity in children with idiopathic thoracic scoliosis with the use of transpedicular screw spinal systems with different pedicle screw placement.Material and methods.Thirty-one patients (14–17 years) with spinal curvature with a Cobb angle from 40° to 79° were operated on. Surgical correction of the deformity was performed using two methods, depending on the possible placement of a pedicle screw. The first group included 16 patients for whom the transpedicular support elements were placed on both sides, throughout the completely deformed spine. The second group included 15 patients for whom the pedicle screws were not placed for two or more vertebrae on the concave side of the curve, at the top of the main curve.Results.The mean percent correction of the spinal deformity for the first and second groups was 92.5% and 82.6%, respectively. The mean percentage of derotation of the apical vertebra for the first and second groups was 73.9% and 23%, respectively.Conclusion.The use of data based on the anatomical and anthropometric features of the vertebral body with scoliosis facilitates selection of the best option for correction of thoracic curve in children with idiopathic scoliosis using pedicle multi-support metal construction. The use of the spinal pedicle system for correction of spinal deformity in children with idiopathic scoliosis enabled a uniform load distribution along the support elements of the metal construction and maintained the correction in the late postoperative follow-up period.

scholarly journals EVALUATING THE EFFECT OF SPINAL DEFORMITY ON PEDIATRIC PATIENT ACTIVITY LEVELS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0019
Author(s):  
Annie Yau ◽  
Madison R. Heath ◽  
Peter D. Fabricant
Keyword(s):  
Physical Activity ◽  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
Functional Limitations ◽  
Spinal Curvature ◽  
Activity Levels ◽  
Benign Condition ◽  
Significant Difference ◽  
Patient Reported

Background: Idiopathic scoliosis has historically been considered a benign condition without significant functional limitations for the patient. However, as curves progress, patients may experience worsening pain, deformity, and quality of life. Patient reported outcome measures (PROMs) help assess functional limitations that may indicate treatment. Purpose: The objective of this study was to compare physical activity related PROM scores in three groups of patients with different severities of spinal curvature. Methods: Pediatric patients diagnosed with adolescent and juvenile idiopathic scoliosis, kyphoscoliosis, or spinal asymmetry completed the SRS-22R, HSS Pedi-FABS activity scale, and Patient-Reported Outcomes Management Information System (PROMIS) Pediatric Computer Adaptive Tests for Mobility and Physical Activity (PA) at a single institution from July 2018 to February 2019. Radiographic images were reviewed, and patients were grouped as Spinal Asymmetry (SA), Mild Deformity (MD), and Severe Deformity (SD) by major Cobb angle measuring less than 10°, between 10° and 40°, and greater than 40° respectively. One-way ANOVA with a Tukey post-hoc correction was used to determine differences between groups. Results: 206 pediatric patients (65% female) with a mean age 13.5 ± 2.2 years were included. The mean Cobb angles by group were 7.1° ± 2.1° in SA (n=51), 19.4° ± 7.8° in MD (n=130), and 50.2° ± 9.1° in SD (n=25). Compared to both SA and MD patients, SD patients scored lower on PROMIS Mobility (p<0.005). Compared to SA patients only, SD patients had lower scores on the HSS Pedi-FABS (p<0.01) and SRS-22R Function (p<0.05). PROMIS PA scores decreased with increasing spinal deformity, but these differences were not statistically significant. There was no significant difference between SA and MD for all PROMs administered. Conclusion: These findings suggest that mobility, function, and physical activity are affected by increasing severity of spinal curvature. Patients with severe spinal deformity reported lower PROMs compared to patients without clinical spinal deformity. Finally, patients with spinal asymmetry and mild deformity do not report significantly different PROMs. Tables: [Table: see text]

scholarly journals 3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Saba Pasha
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Pediatric Population ◽  
Three Dimensional ◽  
Spinal Column ◽  
Sagittal Profile ◽  
Elastic Rods ◽  
3D Deformation ◽  
Deformation Patterns

Abstract Adolescent idiopathic scoliosis (AIS) is a three-dimensional (3D) deformity of the spinal column in pediatric population. The primary cause of scoliosis remains unknown. The lack of such understanding has hampered development of effective preventive methods for management of this disease. A long-held assumption in pathogenesis of AIS is that the upright spine in human plays an important role in induction of scoliosis. Here, the variations in the sagittal curve of the scoliotic and non-scoliotic pediatric spines were used to study whether specific sagittal curves, under physiological loadings, are prone to 3D deformation leading to scoliosis. To this end, finite element models of the S shaped elastic rods, which their curves were derived from the radiographs of 129 sagittal spinal curves of adolescents with and without scoliosis, were generated. Using the mechanics of deformation in elastic rods, this study showed that the 3D deformation patterns of the two-dimensional S shaped slender elastic rods mimics the 3D patterns of the spinal deformity in AIS patients with the same S shaped sagittal spinal curve. On the other hand, the rods representing the non-scoliotic sagittal spinal curves, under the same mechanical loading, did not twist thus did not lead to a 3D deformation. This study provided strong evidence that the shape of the sagittal profile in individuals can be a leading cause of the 3D spinal deformity as is observed in the AIS population.

How different the scoliotic curves are?

2021 ◽  
Author(s):  
S Pasha
Keyword(s):  
Idiopathic Scoliosis ◽  
Plane Deformation ◽  
Sagittal Profile ◽  
Geometrical Parameters ◽  
Deformation Pattern ◽  
Fe Model ◽  
Axial Deformation ◽  
Group Iii ◽  
Group I ◽  
Deformation Patterns

The pathomechanism of spinal deformity development in adolescent idiopathic scoliosis (AIS) has been related to the sagittal curvature of the spine. It is not known how the variations in the sagittal profile relates to the coronal deformity patterns in AIS. A total of 70 Lenke 1 and 50 Lenke 5 AIS patients were included retrospectively. A finite element (FE) model was developed for each spine where the sagittal spinal curvatures were modeled as 2D S shaped elastic rods. Transverse plane deformation patterns of these rods under physiological loading were determined and clustered based on their similarities. The patients’ characteristics, including the Lenke type, and the spinal measurements in these deformation pattern clusters were statistically compared. Three different axial deformation patterns were determined from the FE simulations of the 120 sagittal curves. Two axial groups were looped shaped in opposing directions (Group I and III) and one was lemniscate shaped (Group II). 94% of the patients in Groups I and II were Lenke 1 and 100% of Group III was Lenke 5. The position of the sagittal inflection point moved downward from Group I-III resulting in significantly different ratio of the arc lengths above and below the sagittal inflection points for Groups I, II and III (0.49±0.59, 1.15±0.44, and 3.22±1.8). A classification of idiopathic scoliosis, based on the biomechanics of S-shaped flexible rods deformation could distinguish between different coronal curve types. The geometrical parameters of the sagittal profiles in the axial deformation pattern groups were significantly different.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  
Keyword(s):  
Fluid Phase ◽  
Anticardiolipin Antibodies ◽  
Dual Reactivity ◽  
Group Iii ◽  
Important Group ◽  
Epitope Specificity ◽  
Glycoprotein I ◽  
Group I ◽  
Group Ii ◽  
Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

Sign in / Sign up

Export Citation Format

Share Document