ROLE OF DIFFERENT HORMONES IN THE PATHOGENESIS AND SEVERITY OF ADOLESCENT IDIOPATHIC SCOLIOSIS

Abstract Background: Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods: A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10-20°; moderate: >20-40°; severe: >40°) and PI (low: <35°; average: 35-50°; high: >50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results: Low PI had smaller SS (30.1±8.3° vs 44.8±7.7°; p<0.001), PT (-0.3±8.1° vs 14.4±7.5°; p<0.001), and LL (42.0±13.2° vs 55.1±10.6°; p<0.001), negative PI-LL mismatch (-12.1±13.1° vs 4.1±10.5°; p<0.001) as compared to large PI. There were no significant relationships with PI and TK (p=0.905) or curve magnitude (p=0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions: The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those >40°.

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Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03937-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Trixie Mak ◽

Prudence Wing Hang Cheung ◽

Teng Zhang ◽

Jason Pui Yin Cheung

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Sagittal Profile ◽

Sacral Slope ◽

Pelvic Parameters ◽

Curve Magnitude ◽

Sagittal Parameters

Abstract Background Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10–20°; moderate: > 20–40°; severe: > 40°) and PI (low: < 35°; average: 35–50°; high: > 50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results Low PI had smaller SS (30.1 ± 8.3° vs 44.8 ± 7.7°; p < 0.001), PT (− 0.3 ± 8.1° vs 14.4 ± 7.5°; p < 0.001), and LL (42.0 ± 13.2° vs 55.1 ± 10.6°; p < 0.001), negative PI-LL mismatch (− 12.1 ± 13.1° vs 4.1 ± 10.5°; p < 0.001) as compared to large PI. There were no significant relationships with PI and TK (p = 0.905) or curve magnitude (p = 0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those > 40°.

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Novel questionnaire to enhance brace wear adherence in patients with adolescent idiopathic scoliosis and the relationship of the quality of life

Orthopedic Reviews ◽

10.4081/or.2021.8840 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Thamrong Lertudomphonwanit ◽

Nachapan Pengrung ◽

Chaiwat Kriwattanapong ◽

Chanika Angsanuntsukh ◽

Pittavat Leelapattana ◽

...

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Included Patient ◽

Nested Case Control ◽

The Relationship

Bracing is an effective non-operative treatment, in patients with adolescent idiopathic scoliosis (AIS). The relationship between patients’ quality of life (QOL) and brace wear adherence has been reported. This study aims to determine brace wear adherence for AIS patients with novel questionnaire. A nested case-control study was conducted, included patient age 10-18 years, coronal Cobb angle 20-50°, and Risser grade 0-3. Correlation between patients’ QOL and the average hours of daily brace-wear were determined. Patients were divided into 3 groups based on brace wear adherence and were compared. QOL domains associated with the incompleteness of brace-wearing were determined by Cox proportional-hazards regression. Mean age of patients was 13.3 years (range 11-17.3 years) with initial Cobb angle of 33.5° (range 20-48°). There were significant negative correlations between total QOL scores and brace wearing time. Increased social domain scores was significantly associated with less brace wearing time (HR 1.5, 95% CI 1.12-2.04). Significant correlations between patients’ QOL and the average hours per day of brace wear. Poor social QOL have a significant impact on brace wear adherence.

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Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis

10.21203/rs.3.rs-42561/v2 ◽

2020 ◽

Author(s):

Trixie Mak ◽

Prudence Wing Hang Cheung ◽

Teng Zhang ◽

Jason Pui Yin Cheung

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Sagittal Profile ◽

Sacral Slope ◽

Pelvic Parameters ◽

Curve Magnitude ◽

Sagittal Parameters

Abstract Background: Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods: A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10-20°; moderate: >20-40°; severe: >40°) and PI (low: <35°; average: 35-50°; high: >50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results: Low PI had smaller SS (30.1±8.3° vs 44.8±7.7°; p<0.001), PT (-0.3±8.1° vs 14.4±7.5°; p<0.001), and LL (42.0±13.2° vs 55.1±10.6°; p<0.001), negative PI-LL mismatch (-12.1±13.1° vs 4.1±10.5°; p<0.001) as compared to large PI. There were no significant relationships with PI and TK (p=0.905) or curve magnitude (p=0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions: The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those >40°.

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Patterns of Coronal and Sagittal Deformities in Adolescent Idiopathic Scoliosis

10.21203/rs.3.rs-42561/v1 ◽

2020 ◽

Author(s):

Trixie Mak ◽

Prudence Wing Hang Cheung ◽

Teng Zhang ◽

Jason Pui Yin Cheung

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Sagittal Profile ◽

Sacral Slope ◽

Pelvic Parameters ◽

Curve Magnitude ◽

Sagittal Parameters

Abstract Background: Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods: A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10-20°; moderate: >20-40°; severe: >40°) and PI (low: <35°; average: 35-50°; high: >50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results: Low PI had smaller SS (30.1±8.3° vs 44.8±7.7°; p<0.001), PT (-0.3±8.1° vs 14.4±7.5°; p<0.001), and LL (42.0±13.2° vs 55.1±10.6°; p<0.001), negative PI-LL mismatch (-12.1±13.1° vs 4.1±10.5°; p<0.001) as compared to large PI. There were no significant relationships with PI and TK (p=0.905) or curve magnitude (p=0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions: The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those >40°.

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What Is the Effect of Surgery on the Quality of Life of the Adolescent With Adolescent Idiopathic Scoliosis?

Spine ◽

10.1097/brs.0b013e3182837c95 ◽

2013 ◽

Vol 38 (9) ◽

pp. 786-794 ◽

Cited By ~ 21

Author(s):

Paul R. P. Rushton ◽

Michael P. Grevitt

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis

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Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment

Prosthetics and Orthotics International ◽

10.1177/0309364618820144 ◽

2019 ◽

Vol 43 (3) ◽

pp. 301-308 ◽

Cited By ~ 7

Author(s):

Gozde Yagci ◽

Yavuz Yakut

Keyword(s):

Quality Of Life ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Exercise Therapy ◽

Trunk Rotation ◽

Stabilization Exercise ◽

Core Stabilization ◽

Trunk Deformity ◽

Core Stabilization Exercise

Background: There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis. Objectives: Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis. Methods: Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°–45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life. Results: Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only. Conclusion: Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis. Clinical relevance This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

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Adolescent idiopathic scoliosis detection and referral trends: impact treatment options

Spine Deformity ◽

10.1007/s43390-020-00182-6 ◽

2020 ◽

Vol 9 (1) ◽

pp. 75-84

Author(s):

Alison Anthony ◽

Reinhard Zeller ◽

Cathy Evans ◽

Jennifer A. Dermott

Keyword(s):

Family History ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Geographic Location ◽

Initial Assessment ◽

Brace Treatment ◽

Level Of Evidence ◽

Cross Sectional ◽

Curve Magnitude

Abstract Study design Retrospective cross-sectional study. Objective To analyze the patient demographic referred for scoliosis to the Hospital for Sick Children to determine the proportion of patients suitable for brace treatment, as per the Scoliosis Research Society guidelines. Summary of background data There is level 1 evidence that bracing in adolescent idiopathic scoliosis (AIS) decreases the risk of curve progression and need for surgery, but optimal brace treatment requires early curve detection. Methods We performed a retrospective review of 618 consecutive patients who underwent initial assessment in our Spine Clinic between Jan. 1 and Dec. 31, 2014. We included children 10–18 years, with scoliosis greater than 10°, excluding those diagnosed with non-idiopathic curves. Primary outcomes were Cobb angle, menarchal status, and Risser score. We analyzed the effect of specific referral variables (family history, the person who first noticed the curve, and geographic location of residence) on presenting curve magnitude. Results During the study period, 335 children met the inclusion criteria, with an average age of 14.1 ± 1.8 years and a mean Cobb angle of 36.8 ± 14.5°. Brace treatment was indicated in 17% of patients; 18% had curves beyond optimal curve range for bracing (> 40°), and 55% were skeletally mature, therefore not brace candidates. The majority of curves (54%) were first detected by the patient or family member and averaged 7° more than curves first detected by a physician. A family history of scoliosis made no difference to curve magnitude, nor did geographic location of residence. Conclusion The majority of AIS patients present too late for effective management with bracing. Level of evidence III.

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