The Effects of Manipulation Therapy on Lumbar Lordosis and Thoracic Kyphosis in Individuals with Flat Back: Pilot Study

2020 ◽  
Vol 16 (2) ◽  
pp. 1-7
Author(s):  
Yeonsung Choi ◽  
◽  
Jintae Han
Keyword(s):  
Pilot Study ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Manipulation Therapy ◽  
Flat Back

Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome

2007 ◽  
Vol 7 (4) ◽  
pp. 387-392 ◽  
Author(s):  
Jee-Soo Jang ◽  
Sang-Ho Lee ◽  
Jun-Hong Min ◽  
Dae Hyeon Maeng
Keyword(s):  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Sagittal Alignment ◽  
Plumb Line ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Spontaneous Correction ◽  
Flat Back ◽  
Lower Lumbar

Object The authors investigate the correlation between thoracic and lumbar curves in patients with degenerative flat back syndrome, and demonstrate the predictability of spontaneous correction of the thoracic curve and sacral angle after surgical restoration of lower lumbar lordosis. Methods The cases of 28 patients treated with combined anterior and posterior spinal arthrodesis were retrospectively reviewed. Inclusion criteria included loss of lower lumbar lordosis resulting in sagittal imbalance. Total lumbar lordosis, thoracic kyphosis, sacral slope, and C-7 plumb line length were measured on pre- and postoperative lateral views of the whole spine. Postoperative changes in thoracic kyphosis, sacral slope, and length of the C-7 plumb line were measured and evaluated according to extent of lumbar lordosis restoration. Results The mean (± standard deviation) preoperative sagittal imbalance was 64.6 ± 63.2 mm, which improved to 15.8 ± 20.7 mm after surgery (p < 0.0001). The preoperative mean lumbar lordosis was 15.6 ± 14.1°, which increased to 40.3 ± 14.5° at follow-up (p < 0.0001). The preoperative mean thoracic kyphosis was 1.6 ± 10.5° and increased to 17.2 ± 12.5° at follow-up (p < 0.0001). Significant preoperative correlations existed between kyphosis and lordosis (r = 0.628, p = 0.0003), and between lordosis and sacral slope (r = 0.647, p = 0.0002). Postoperative correlations also existed between kyphosis and lordosis (r = 0.718, p < 0.0001 and r = 0.690, p < 0.0001, respectively). Conclusions Lower lumbar lordosis plays an important role in sagittal alignment and balance. Surgical restoration of lumbar lordosis results in predictable spontaneous correction of the thoracic curve and sacral slope in patients with degenerative flat back syndrome.

scholarly journals Adolescent idiopathic scoliosis: sagital plane and low density pedicle screws

2014 ◽  
Vol 13 (1) ◽  
pp. 13-15
Author(s):  
Rodrigo Augusto do Amaral ◽  
Robert Meves ◽  
Maria Fernanda Silber Caffaro ◽  
Ricardo Shigueaki Galhego Umeta ◽  
Luciano Antônio Nassar Pelegrino ◽  
...  
Keyword(s):  
Medical Records ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Sagittal Plane ◽  
Pedicle Screws ◽  
Low Density ◽  
Kyphosis Correction ◽  
Pearson Coefficient ◽  
Analysis Of Dispersion

OBJECTIVE: To examine the sagittal curves of patients treated with CD instrumentation using exclusively pedicle screws. METHODS: Image analysis of medical records of 27 patients (26 M and 1 F) with a minimum follow-up of 6 months, who underwent surgical treatment in our service between January 2005 and December 2010. The curves were evaluated on coronal and sagittal planes, taking into account the potential correction of the technique. RESULTS: In the coronal plan the following curves were evaluated: proximal thoracic (TPx), main thoracic (TPp), and thoracolumbar; lumbar (TL, L), and the average flexibility was 52%, 52%, and 92% and the capacity of correction was 51%, 72%, and 64%, respectively. In the sagittal plane there was a mean increase in thoracic kyphosis (CT) of 41% and an average reduction of lumbar lordosis (LL) of 17%. Correlation analysis between variables showed Pearson coefficient of correlation of 0.053 and analysis of dispersion of R2 = <0.001. CONCLUSION: The method has shown satisfactory results with maintenance of kyphosis correction in patients with normal and hyper kyphotic deformities.

scholarly journals Normal Age-Adjusted Sagittal Spinal Alignment Is Achieved with Surgical Correction in Adolescent Idiopathic Scoliosis

2017 ◽  
Vol 11 (5) ◽  
pp. 770-779 ◽  
Author(s):  
Subaraman Ramchandran ◽  
Norah Foster ◽  
Akhila Sure ◽  
Thomas J. Errico ◽  
Aaron J. Buckland
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Surgical Correction ◽  
Sagittal Vertical Axis

<sec><title>Study Design</title><p>Retrospective analysis.</p></sec><sec><title>Purpose</title><p>Our hypothesis is that the surgical correction of adolescent idiopathic scoliosis (AIS) maintains normal sagittal alignment as compared to age-matched normative adolescent population.</p></sec><sec><title>Overview of Literature</title><p>Sagittal spino-pelvic alignment in AIS has been reported, however, whether corrective spinal fusion surgery re-establishes normal alignment remains unverified.</p></sec><sec><title>Methods</title><p>Sagittal profiles and spino-pelvic parameters of thirty-eight postsurgical correction AIS patients ≤21 years old without prior fusion from a single institution database were compared to previously published normative age-matched data. Coronal and sagittal measurements including structural coronal Cobb angle, pelvic incidence, pelvic tilt, thoracic kyphosis, lumbar lordosis, sagittal vertical axis, C2–C7 cervical lordosis, C2–C7 sagittal vertical axis, and T1 pelvic angles were measured on standing full-body stereoradiographs using validated software to compare preoperative and 6 months postoperative changes with previously published adolescent norms. A sub-group analysis of patients with type 1 Lenke curves was performed comparing preoperative to postoperative alignment and also comparing this with previously published normative values.</p></sec><sec><title>Results</title><p>The mean coronal curve of the 38 AIS patients (mean age, 16±2.2 years; 76.3% female) was corrected from 53.6° to 9.6° (80.9%, <italic>p</italic>&lt;0.01). None of the thoracic and spino-pelvic sagittal parameters changed significantly after surgery in previously hypo- and normo-kyphotic patients. In hyper-kyphotic patients, thoracic kyphosis decreased (<italic>p</italic>=0.003) with a reciprocal decrease in lumbar lordosis (<italic>p</italic>=0.01), thus lowering pelvic incidence-lumbar lordosis mismatch mismatch (<italic>p</italic>=0.009). Structural thoracic scoliosis patients had slightly more thoracic kyphosis than age-matched patients at baseline and surgical correction of the coronal plane of their scoliosis preserved normal sagittal alignment postoperatively. A sub-analysis of Lenke curve type 1 patients (n=24) demonstrated no statistically significant changes in the sagittal alignment postoperatively despite adequate coronal correction.</p></sec><sec><title>Conclusions</title><p>Surgical correction of the coronal plane in AIS patients preserves sagittal and spino-pelvic alignment as compared to age-matched asymptomatic adolescents.</p></sec>

scholarly journals Posterior-Only Approach with Pedicle Screws for the Correction of Scheuermann's Kyphosis

2017 ◽  
Vol 11 (4) ◽  
pp. 513-519 ◽  
Author(s):  
Adem Cobden ◽  
Akif Albayrak ◽  
Yalkin Camurcu ◽  
Hakan Sofu ◽  
Temel Tacal ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pedicle Screws ◽  
Definitive Treatment ◽  
Sacral Slope ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Radiological Results ◽  
Lower Complication ◽  
Clinical And Radiological Results

<sec><title>Study Design</title><p>Retrospective study (level of evidence: level 3).</p></sec><sec><title>Purpose</title><p>The purpose of this study was to evaluate the clinical and radiological results of the posterior-only approach with pedicle screws for the treatment of Scheuermann's kyphosis (SK).</p></sec><sec><title>Overview of Literature</title><p>The correction of SK with instrumentation can be performed using posterior-only or combined anterior-posterior procedures. With the use of all-pedicle screw constructs in spine surgery, the posterior-only approach has become a popular option for the definitive treatment of SK. In a nationwide study involving 2,796 patients, a trend toward posterior-only fusion with lower complication rates was reported.</p></sec><sec><title>Methods</title><p>We retrospectively reviewed the data of patients who underwent posterior-only correction for SK between January 2005 and May 2013. Patients with a definite diagnosis of SK who fulfilled the minimum follow-up criterion of 24 months were included. The thoracic kyphosis (T5–T12), lumbar lordosis (L1–S1), and thoracolumbar junction (T10–L2) angles were measured from preoperative, postoperative, and last control radiographs. Sagittal balance, thoracic length, thoracic diameter, Voutsinas index and the sacral slope, pelvic tilt, proximal junction kyphosis, and distal junction kyphosis angles were also measured.</p></sec><sec><title>Results</title><p>Forty-five patients underwent surgery for the treatment of SK between 2005 and 2013. After applying the exclusion criteria, 20 patients (18 males and 2 females) with a mean age of 19 years were included. The mean thoracic kyphosis angle was 79.8 degrees preoperatively, 44.6 degrees postoperatively, and 44.9 degrees at the last control. There were statistically significant differences between preoperative and postoperative values in the thoracic kyphosis and lumbar lordosis angles, thoracic length, thoracic diameter, and Voutsinas index (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>The clinical and radiological results of the current study suggest that posterior-only fusion is an efficient technique for the treatment of SK.</p></sec>

scholarly journals Effects of 8-months yoga training on shaping the spine in people over 55

2013 ◽  
Vol 5 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Małgorzata Grabara
Keyword(s):  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Body Posture ◽  
Hatha Yoga ◽  
Spinal Curvatures ◽  
Thoracic Curvature ◽  
The Third ◽  
Before And After ◽  
The University ◽  
Better Than

Summary Study aim: The aim of this study was to evaluate the influence of hatha yoga practices on the shaping of the anteroposterior (AP) spinal curvatures in students of the University of the Third Age, who participated in hatha yoga classes. Material and methods: 20 women and 5 men took part in the study. Hatha yoga classes were held once a week for 90 minutes over a period of 8 months along with additional exercises including basic positions of hatha yoga in home conditions 1-2 times a week for about 30 minutes. The inclination of the AP curvatures of the spine was measured twice, before and after the end of the classes. A Rippstein plurimeter was used for the measurements. R esults: Measurements of the angle of thoracic kyphosis before starting the series of hatha yoga classes and after finishing them showed a decrease in thoracic curvature in female (p < 0.01). In case of the angle of lumbar lordosis, a reduction in this curvature as a result of yoga techniques has been observed in women (p < 0.01) too. Amounts of AP curvatures of the spine, measured after completing the series of hatha yoga classes, fluctuated around correct values better than before taking them up. Conclusion: This study has shown that yoga training leads to an improvement in the habitual body posture in case of aggravating (excessive) AP curvatures of the spine.

CORRELATION OF BACK EXTENSOR STRENGTH WITH THORACIC KYPHOSIS AND LUMBAR LORDOSIS IN ESTROGEN-DEFICIENT WOMEN1

1996 ◽  
Vol 75 (5) ◽  
pp. 370-374 ◽  
Author(s):  
Mehrsheed Sinaki ◽  
Eiji Itoi ◽  
John W. Rogers ◽  
Erik J. Bergstralh ◽  
Heinz W. Wahner
Keyword(s):  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Back Extensor Strength ◽  
Back Extensor

scholarly journals How Sublaminar Bands Affect Postoperative Sagittal Alignment in AIS Patients with Preoperative Hypokyphosis? Results of a Series of 34 Patients with 2-Year Follow-Up

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sébastien Pesenti ◽  
Antoine Chalopin ◽  
Emilie Peltier ◽  
Elie Choufani ◽  
Matthieu Ollivier ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Radiographic Evaluation ◽  
Cervical Lordosis ◽  
Pelvic Parameters ◽  
Sublaminar Bands ◽  
Thoracic Idiopathic Scoliosis

Hypokyphosis is currently observed in thoracic idiopathic scoliosis. The use of sublaminar bands allows a good restoration of sagittal balance of the spine. The aim of the study was to provide a middle-term radiographic analysis of patients with adolescent idiopathic scoliosis with preoperative hypokyphosis treated by posterior arthrodesis with sublaminar bands. This retrospective study included 34 patients with Lenke 1 scoliosis associated with hypokyphosis (TK < 20°). A radiographic evaluation was performed with a 2-year follow-up. Cobb angle, cervical lordosis, thoracic kyphosis, lumbar lordosis, and pelvic parameters were measured preoperatively, postoperatively, and at 6-month and 2-year follow-up. The mean preoperative thoracic kyphosis was 10.5° versus 24.1° postoperatively (p<0.001), representing a mean gain of 13°. Cobb angle ranged from 59.3° to 17.9° postoperatively (mean correction 69%,p<0.001). Cobb angle increased between the immediate postoperative measurement and the 6-month follow-up (17.9 versus 19.9,p=0.03). Cervical curvature changed from a 5.6° kyphosis to a 3.5° lordosis (p=0.001). Concerning lumbar lordosis, preoperative measurement was 39.7° versus 41.3° postoperatively (p=0.27). At 6-month follow-up, lumbar lordosis significantly increased to 43.6° (p=0.03). All parameters were stable at final follow-up. Correction performed by sublaminar bands is efficient for both fontal and sagittal planes. Moreover, the restoration of normal thoracic kyphosis is followed by an adaptation of the adjacent curvatures with improved cervical lordosis and lumbar lordosis.

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