scholarly journals Effect of Cobb angle and BMI on scoliosis surgery recovery in adolescent idiopathic scoliosis patients

2015 ◽  
Vol 7 (2) ◽  
pp. 28-33
Author(s):  
Abdulmonem Alsiddiky ◽  
Abdullatef Alrashoudi ◽  
Ahmed AL Sayed ◽  
Albaraa Aljerian ◽  
Abeer Aljomiah

Aims and Objectives: To assess the effect of Cobb angle and body mass index (BMI) on surgery recovery outcomes in Adolescent Idiopathic Scoliosis (AIS) patients.Materials and Methods: A retrospective study of 79 Adolescent Idiopathic Scoliosis patients who underwent corrective operations, at King Khaled University Hospital, Riyadh, Saudi Arabia was carried out in 2014. The patients were divided according into Cobb’s angle (mild, moderate and severe) and as per weight (healthy weight and overweight). Data of preoperative, intra-operative and postoperative information as well as measures of daily-living activities were collected.Results: The mean age of 79 patients (70females) was 16.6 years. Cobb angle assessment was mild in 41 (51.9%), moderate in 24(30.4%) and 14(17.7%) were severe. Mean surgery and recovery time of patients is statistically significantly different in relation to severity of Cobb’s angle (mild, moderate and severe). There is highly statistically significant difference in mean ranks of days taken for different measures of daily living in relation to severity of Cobb’s angle. The mean values of body mass index have significantly reduced after surgery, when compared with mean values at before surgery. The mean surgery time was statistically significantly higher in over weight patients (5.33 hours).Conclusions: The results show an effect of severity of Cobb angle on recovery measures of patients with AIS, but no effect of BMI. BMI was corrected in these patients after surgery. Prospective studies are required to assess clinical outcomes of post-operative surgery, satisfaction of patients towards their body image and quality of life.Asian Journal of Medical Sciences Vol.7(2) 2015 28-33

2016 ◽  
Vol 7 (04) ◽  
pp. 550-553 ◽  
Author(s):  
Sohail Rafi ◽  
Naseem Munshi ◽  
Asad Abbas ◽  
Rabia Hassan Shaikh ◽  
Imtiaz Hashmi

ABSTRACT Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb’s angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb’s angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.


2014 ◽  
Vol 24 (2) ◽  
pp. 276-280 ◽  
Author(s):  
Daniel Pérez-Prieto ◽  
Juan Francisco Sánchez-Soler ◽  
Juana Martínez-Llorens ◽  
Sergi Mojal ◽  
Joan Bagó ◽  
...  

Author(s):  
V. V. Kucheryavchenko

In recent years, the concept of "metabolic syndrome" has become more spreading, and in parallel with disorders of carbohydrate and lipid metabolism, endothelial dysfunction is no less significant. The aim of our work was to analyze changes in homocysteine (HC) as a marker of metabolic syndrome in patients with an increased body mass index (IBMI) in polytrauma. The study involved 224 patients with polytrauma, who had different initial values of body mass index (BMI) and were treated at the polytrauma department and the intensive care unit for patients with combined injuries for a period from 1 day to 1 year since the moment of injury. All the patients were subjected to identifying the level of serum HC. The patients had the same severity according to the APACHE II scale, 14 ± 5.8, at the admission to the hospital, and were divided into 3 stratified clinical groups depending on the initial values of anthropometric parameters and BMI. The study was conducted on the 1, 3, 7, 14, 30 and 360 days from the date of polytrauma. Assessment of blood serum HC was performed by ELISA. It was found that the overweight patients with BMI ≤ 29.9 demonstrated an increase in the mean values of blood HC on the 7th and 14th days of the treatment, with a further decrease on the 15th day since the date of injury. For the patients with BMI within the range of 30.0 - 39.9, the persistence of the HC index during the first month of the treatment at baseline with an increase on the 360th day was found out. The patients with BMI ˃ 40.0 showed an increase in the level of blood HC through the year since the date of polytrauma. It was revealed that the level of HС directly affects the course of traumatic disease in patients with increased BMI, its severity in terms of uniformity of injuries received and the same range of severity according to the APACHE II scale depends on BMI at the admission to the hospital.


2015 ◽  
Vol 3 (4) ◽  
pp. 318-326 ◽  
Author(s):  
Baron S. Lonner ◽  
Courtney S. Toombs ◽  
Qasim M. Husain ◽  
Paul Sponseller ◽  
Harry Shufflebarger ◽  
...  

2021 ◽  
Author(s):  
Kepeng Li ◽  
Jun Miao ◽  
Jingan Zhang ◽  
Xijie Wang ◽  
Ye Han

Abstract Background: This study aims to evaluate the effects of bracing on the Cobb’s angle (CA) and spinopelvic parameters in adolescent idiopathic scoliosis (AIS) patients. Methods: A total of 51 AIS patients who received bracing treatment between January 2018 and August 2019 were retrospectively analyzed. The pro-bracing and in-bracing radiographs were analyzed with regard to the spinopelvic parameters. The CA, pelvic coronal obliquity angle (PCOA), thoracolumbar kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical angle (SVA) and coronal vertical angle (CVA) were measured. Results: The mean age at the initiation of bracing was 13.6 ± 1.5 years. The mean pro-bracing CA was 24.0° ± 6.3°. There were no statistically significant differences between pro-bracing and in-bracing measurements of SVA and CVA. However, there were statistically significant differences between the pro-bracing and in-bracing measurements of the CA, PCOA, TLK, LL, PT and SS. A significant correlation was observed between PT variation and TLK variation in the sagittal plane. In the coronal plane, the PCOA variation was correlated to pro-bracing PCOA. Conclusion: Bracing effects of AIS can be extended to the pelvis. The pelvis should retro-rotate correspondingly to TLK hypokyphosis on sagittal plane, whereas in coronal plane, pelvic obliquity was improved independently.


2015 ◽  
Vol 14 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Antenor Rafael de Oliveira Mazzuia ◽  
Diógenes Rodrigues Machado ◽  
Denis Kiyoshi Fukumothi ◽  
Luccas Franco Bettencourt Nunes ◽  
Carlos Tucci Neto ◽  
...  

<sec><title>OBJECTIVE:</title><p> To validate a new method of measuring the Cobb angle for scoliosis from the mobile app CobbMeter to facilitate the evaluation and measurement in clinical practice.</p></sec><sec><title>METHODS:</title><p> Five observers with minimum experience of two years in the field performed radiographic measurements of Cobb angle in 24 radiographs of patients with adolescent idiopathic scoliosis through the CobbMeter. Observers performed serial measures on the images with the application, which were repeated after one month. The most experienced appraiser of the group, after measurements were made through the application, determined the Cobb angle in each radiography by the traditional method.</p></sec><sec><title>RESULTS:</title><p> The mean standard deviation by comparing the angles electronically and manually measured had no clinical significance. Although 40% of electronic measurements are outside the confidence interval when compared to manual measurements, this difference was insignificant in clinical practice.</p></sec><sec><title>CONCLUSIONS:</title><p> The CobbMeter is another alternative for measuring Cobb angle in scoliosis.</p></sec>


2000 ◽  
Vol 24 (2) ◽  
pp. 148-162 ◽  
Author(s):  
M. S. Wong ◽  
A. F. T. Mak ◽  
K. D. K. Luk ◽  
J. H. Evans ◽  
B. Brown

In this prospective study, the effectiveness and biomechanical factors of spinal orthoses in the treatment of moderate adolescent idiopathic scoliosis (AIS) patients were investigated. In the first 20 months of orthotic treatment, the values of standing AP Cobb's angle, apical vertebral rotation, lumbar lordosis as well as thoracic kyphosis showed significant reduction (P<0.05), however, the angle of trunk inclination and trunk listing did not. The values of those reducible parameters reached their lowest values within the first 12 months of orthotic treatment and then the values gradually increased but they were still below the prebrace values. The mean pressure of The pressure pads was found to be 7.09±1.77kPa (53.2±13.3mmHg) while the mean tension of the straps was 26.8±5.2N. The standing AP Cobb's angle strongly correlated with the pad pressure (correlation coefficient=0.931, p<0.05) and strap tension (correlation coefficient=0.914, p<0.05). The strap tension and pad pressure strongly correlated and the correlation coefficient was 0.873 (p<0.05). This suggests that in the consideration of biomechanical function of spinal orthoses, the focus may be upon how tightly the orthosis was fastened and if the location and direction of the pressure pads are correct. Therefore, for enhancing the effectiveness of orthotic treatment, an independent standard tension should be set in each strap, and regular and close monitoring is needed.


2021 ◽  
Vol 13 (1) ◽  
pp. 6-9
Author(s):  
Ghanshyam Kakadiya ◽  
Kalpesh Saindane ◽  
Viraj Gandbhir ◽  
Yogesh Soni, ◽  
Kushal Gohil ◽  
...  

Objective: To determine the short term radiological outcomes of Lenke type 5C adolescent idiopathic scoliosis in terms of Cobb angle correction and coronal balance after selective posterior segmental spinal instrumentation with pedicle screws. Methods: This retrospective cohort study was conducted in the department of Orthopaedic at tertiary care public hospital of Mumbai, India. The medical records of patients from 17th April 2015 to 29th October 2019 who underwent a selective spinal fusion with pedicle screws for Lenke type-5C adolescent idiopathic scoliosis were reviewed. Preoperative radiographs were evaluated for Cobb angle of the lumbar or thoracolumbar curve as well as a sagittal and lumbar modifier on anteroposterior and lateral standing films. The curve correction, implant density, number of segment fused and coronal balance was assessed on postoperative radiographs. The pre and postoperative comparison of important study variables was done and P-value was calculated with the help of the chi-square test. P-value <0.05 was considered statistically significant. Results: The total number of patients was 34. Majority (94.1%, n=32) were females while only 2(5.9%) were males. The mean age at the time of operation was 14.35±2.19 years (range 8 to 19 years). Mean pre-operative and post-operative Cobb angles were 61.790±13.120 (range 400 to 850) and 10.550±8.710 (range 00 to 300) respectively (P-value 0.00). The mean percentage of curve correction and percentage of fulcrum flexibility was 83.35±13.07 % (range 55% to 100%) and 59.56%±15.07 (range 28.57% to 84.60%) respectively (P value 0.469). Mean implant density and fusion mass was 66.03±7.94% (range 53 to 79%) and 10.32±2.8 (range 7 to 15%) segments respectively. The coronal balance was achieved in all patients. No major complication was noted. Conclusion: Near normal Cobb angle correction and coronal balance was achieved in all patients of Lenke type 5C adolescent idiopathic scoliosis treated with posterior segmental spinal instrumentation utilizing pedicle screws.


Sign in / Sign up

Export Citation Format

Share Document