Axial loading during supine MRI for improved assessment of lumbar spine: comparison with standing MRI

Background There are no studies comparing the morphologic changes of lumbar spines between supine axial-loaded and 90° standing magnetic resonance imaging (MRI) examinations of patients with spinal stenosis. Purpose To determine whether axial-loaded MRI using a compression device demonstrated similar morphology of intervertebral disc, dural sac, and spinal curvature as those detected by 90° standing MRI in individuals with suspected spinal stenosis. Material and Methods A total of 54 individuals suspected of having spinal stenosis underwent both axial-loaded and standing MRI studies. The outcome measures included seven radiologic parameters of the lumbar spine: measures of the intervertebral disc (i.e. cross-sectional area [DA], disc height [DH], and anteroposterior distance [DAP]), dural sac (cross-sectional area [DCSA]), spinal curvature (i.e. lumbar lordosis [LL] and L1-L3-L5 angle [LA]), and total lumbar spine height (LH). Results For agreement between the two methods, intraclass correlation coefficient (ICC) ≥ 0.8 was found for all seven radiologic parameters. Supine axial-loaded MRI underestimated LL but remained correlated (ICC = 0.83) with standing MRI. Minor differences between the two methods (≤5.0%) were observed in DA, DCSA, DAP, LA, and LH, while a major difference was observed in LL (8.1%). Conclusion Using a compression device with the conventional supine MRI to simulate weight-bearing on the lumbar spine generated MRI morphology, which was strongly correlated with those from a standing MRI.

A REVIEW ON UNDERSTANDING OF SCOLIOSIS AND ITS AYURVEDIC ASPECTS

The spinal curvatures are important for balancing the body and it help us to stand upright. If any one of the curves become too large or small, our posture may appear abnormal. There are three main types of spinal curvature disor- ders, viz: scoliosis, kyphosis and lordosis. Among these, scoliosis is the common one. Scoliosis is a lateral curvature of the spine that occurs most often during the growth spurt just before puberty. In 80% of scoliosis patients, the cause is unknown. In most of the cases the curve is mild, but in some children the curve continues to worsen as the child grows. Children who have mild scoliosis need to be monitored closely. In such cases, no treatment is usually necessary. Some of them will need to wear a brace. The ultimate treatment for a progressive curve in children is surgery. While going through Ayurveda literature, we see the word Kubja, and is a common term used by Acharyas to describe a hump like appearance. This article is intended to review scoliosis, its classification, symptoms, diag- nosis and treatment and its Ayurvedic aspects. Keywords: Scoliosis, Brace, Kubja

Relationship between Muscle Tone of the Erector Spinae and the Concave and Convex Sides of Spinal Curvature in Low-Grade Scoliosis among Children

The objective of the present research was to assess the relationship between muscle tone of the erector spinae and the concave and convex sides of spinal curvature in low-grade scoliosis found among children. The study included 251 children, aged 7–8. Examination of the spine and body posture was carried out using the Diers Formetric III 4D optoelectronic method. Surface electromyography (sEMG) was used to assess erector spinae muscle tone. The trial was carried out using the 14-channel Noraxon TeleMyo DTS apparatus. The highest generalised tone (sEMG amplitude) of the erector spinae occurred in the case of scoliosis. The higher the angle of curvature, the greater the erector spinae muscle tone. Regardless of the position adopted during examination of the thoracic spine, greater erector spinae tone (sEMG amplitude) was exhibited on the convex side of the spinal curvature. However, in the area of the lumbar spine, greater tone (sEMG amplitude) of the erector spinae occurred on the curvature’s concave side. The exception was the test performed in a standing position, during which greater muscle tone was noted on the side of the convex curvature. In therapeutic practice, within the thoracic section, too tense erector spinae muscles should be stretched on the convex side of the scoliosis, while in the lumbar region, this should be performed on the concave side. However, each case of scoliosis requires individually tailored treatment. The current research has applicative value and does fill a research gap with regard to erector spinae muscle tone in young children experiencing low-grade scoliosis. The development of scoliosis is associated with asymmetry and an increase in erector spinae tone. The uneven distribution of its tone, occurring on both sides of the spine and in its various segments, causes destabilisation and its abnormal progression.

Effect of Low Versus High-Heeled Footwear on Spinopelvic Alignment at Different Phases of Menstrual Cycle in Young Adult Women: A Biopsychosocial Perspective

High-heeled shoes adversely affect spinal curvature, increase the risk of low back pain, and disturb the normal gait pattern. The purpose of this study was to examine, from a biopsychosocial point of view, the combined effect of wearing two different heel heights and of hormonal oscillation throughout different phases of the menstrual cycle on spinopelvic alignment. Notably, 70 females with an average age of 20.42 ± 1.51 years participated in this study, wearing each female two different heel heights as follows: low (2.5 cm) and high (7 cm). Spinopelvic alignment was evaluated by rasterstereography formetric 3D analysis during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Statistical analysis showed that there was no significant difference (p > 0.05) on spinopelvic alignment [kyphotic angle (KA), trunk inclination (TI), and pelvic inclination] between wearing low- or high-heeled shoes during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Considering that high-heeled shoes are traditionally associated with femininity, body image, beauty, and charm, this research has important biopsychosocial implications that should be explored in detail in future studies.

Spinal malformations in a naturally isolated Neotropical fish population

Fish populations that reside in completely isolated freshwater ecosystems are rare worldwide. The Vila Velha State Park (VVSP), located in southern Brazil, is recognized for its arenitic formations called sinkholes (furnas), which are completely isolated. Fish populations within, such as those of Psalidodon aff. fasciatus, often develop vertebral malformations due to this isolation from other conspecifics and other species. In this study, we analyzed geometric morphology in digital radiographs to identify congenital deformations of Psalidodon aff. fasciatus in Furna 2 of VVSP. We found many fish with spinal deformities, including wide variation in the number of caudal vertebrae and corporal deformations related to a flattened body and spinal curvature. Females were more affected than males. We also demonstrated that these deformations reflect inbreeding and an absence of gene flow in the population. In conclusion, isolated populations such as fish species in furnas are potential models for evo-devo research.

Can infrared camera images be used for screening in Adolescent Idiopathic Scoliosis?

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis, and affects up to 4% of adolescents in early stages. The deformity can develop during any of the rapid periods of growth in children, and the time of pubertal growth spurt also plays a role in spinal curve progression. Hence it is crucial to detect the disease early, to provide timely intervention. Detection of scoliosis when it is mild or before the growth spurt can be conducted via various screening methods. Adam's forward bend test (FBT) and scoliometer measurement of the angle of trunk rotation (ATR) are commonly used, to observe lateral bending and rotation of the spine, causing a visible rib hump. Moire topography can also be used, but is reserved for second tier due to some degree of ambiguity. X-rays (XR) remain the best way to diagnose scoliosis, as it provides a clear image of the spine and allows measurement of Cobb angle; however it has risks associated including requirement of the use of ionising radiation. Infrared (IR) thermography can be used to measure surface temperature and is performed with an IR camera. The temperature distribution and data matrix can be visualised into a thermal map, which has previously been studied and associated with the thermal asymmetry in paraspinal muscles, as well as significant temperature differences between the convex and concave side of the spinal curvature for idiopathic scoliotic patients. We hypothesize that such asymmetry and temperature differences may produce a detectable pattern on IR thermography, which would prompt further confirmatory investigations to reach a fast and non-radiation screening of AIS.

Semi-Automatic Image Segmentation on X-ray Image of Spine using Active Contour Method

Currently, many image analysis methods have been developed on X-Ray of scoliotic patients. However, segmentation of spinal curvature is still a challenge, and needs to be improved. In this research, we proposed a semi-automatic spinal image segmentation of scoliotic patients from X-Ray images. This method is divided into 2 steps: preprocessing and segmentation process. A conversion process from RGB to grayscale and CLAHE (Contrast Limited Adequate Histogram Equalization) method was used in image preprocessing. The active contour method was used for the segmentation process. The result shows that segmentation of spinal X-ray images of scoliotic patients using active contour method interactively, can give better results. The average of ME and RAE values are 12.98% and 26.75 %. instead of using the interactive region splitting method which gets 21.17% and 89.27%. Keywords: active contour, interactive segmentation, pre-processing, scoliosis.

Effect of Compensatory Mechanisms on Postural Disturbances and Musculoskeletal Pain in Elite Sitting Volleyball Players: Preparation of a Compensatory Intervention

The aim of the study was to identify the effect of compensatory mechanisms on the prevalence of sagittal spinal curvature deformity and musculoskeletal pain and to assess the interrelationships between those components in sitting volleyball players. Twenty-one elite Polish sitting volleyball players (age = 34.1 ± 7.5, BM = 77.9 ± 16.0) participated in the study in which direct participatory systematic observation and a non-invasive method were used. Both objective (anthropometric, spinal curvature–Idiag M360) and subjective (musculoskeletal ailments–NMQ = 7) measurements were performed. The Statistica 13.3 software package was used for statistical analyses. The neck, lower back (43%), and upper back (38%) were the most frequently reported painful areas. Of all participants, 76% reported sagittal spinal deformities. In the habitual position, the results indicated moderate correlations (r = 0.5, p < 0.05) between the lumbar concavity of the back and low back pain (LBP) and between thoracic convexity and LBP (r = 0.4, p < 0.05). Internal and external compensation have an effect on the prevalence of spinal curvature deformities in the sagittal plane, with thoracic hyperkyphosis (38%) and lumbar hyperlordosis (33%) being the most common. More severe lower and upper back pain were correlated with greater angles of thoracic kyphosis and lumbar lordosis in the habitual position.