Adolescent Idiopathic Scoliosis
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Leilei Xu ◽  
Zhenhua Feng ◽  
Zhicheng Dai ◽  
Wayne Y. W. Lee ◽  
Zhichong Wu ◽  

Previous studies have shown that LBX1 is associated with adolescent idiopathic scoliosis (AIS) in multiple populations. For the first time, rs1322330 located in the putative promoter region of LBX1 was found significantly associated with AIS in the Chinese population [p = 6.08 × 10–14, odds ratio (OR) = 1.42, 95% confidence interval of 1.03–1.55]. Moreover, the luciferase assay and electrophoretic mobility shift assay supported that the allele A of rs1322330 could down-regulate the expression of LBX1 in the paraspinal muscles of AIS. In addition, silencing LBX1 in the myosatellite cells resulted in significantly inhibited cell viability and myotube formation, which supported an essential role of LBX1 in muscle development of AIS. To summarize, rs1322330 may be a novel functional SNP regulating the expression of LBX1, which was involved in the etiology of AIS possibly via regulation of myogenesis in the paraspinal muscles.

2021 ◽  
Vol 22 (1) ◽  
Junyu Li ◽  
Kaige Deng ◽  
Yanchao Tang ◽  
Zexi Yang ◽  
Xiaoguang Liu ◽  

Abstract Background This study aims to analyze postoperative changes of cervical sagittal curvature and to identify independent risk factors for cervical kyphosis in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients. Methods A total of 124 AIS patients who received all-pedicle-screw instrumentation were enrolled. All patients were followed up for at least 2 years. The following parameters were measured preoperatively, immediately after the operation, and at the last follow-up: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), global thoracic kyphosis (GTK), proximal thoracic kyphosis (PrTK), T1-slope, cervical lordosis (CL), McGregor slope (McGS), sagittal vertical axis (SVA), C2–7 SVA (cSVA), and main thoracic angle (MTA). Statistical analysis was performed to evaluate postoperative alterations of and correlations between the parameters and to identify risk factors for cervical kyphosis. Statistical significance was set at P < 0.05. Results After the operation, PrTK and T1-slope significantly increased (3.01 ± 11.46, 3.8 ± 10.76, respectively), cervical lordosis improved with an insignificant increase (− 2.11 ± 13.47, P = 0.154), and MTA, SS, and LL decreased significantly (− 33.68 ± 15.35, − 2.98 ± 8.41, 2.82 ± 9.92, respectively). Intergroup comparison and logistic regression revealed that preoperative CK > 2.35° and immediate postoperative GTK < 27.15° were independent risk factors for final cervical kyphosis, and △T1-slope < 4.8° for a kyphotic trend. Conclusions Postoperative restoration of thoracic kyphosis, especially proximal thoracic kyphosis, and T1-slope play a central role in cervical sagittal compensation. Preoperative CK, postoperative small GTK, and insufficient △T1-slope are all independent risk factors for cervical decompensation.

Sachin Allahabadi ◽  
Hao-Hua Wu ◽  
Sameer Allahabadi ◽  
Tiana Woolridge ◽  
Michael A. Kohn ◽  

Purpose The purpose of this study was to determine perspectives of surgeons regarding simultaneous surgery in patients undergoing posterior spine instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS). Methods A survey was administered to orthopaedic trainees and faculty regarding simultaneous surgery for primary PSIF for AIS. A five-point Likert scale (1: ‘Strongly Disagree’ to 5: ‘Strongly Agree’) was used to assess agreement with statements about simultaneous surgery. We divided simultaneous surgery into concurrent, when critical portions of operations occur at the same time, and overlapping, when noncritical portions occur at the same time. Results The 72 respondents (78.3% of 92 surveyed) disagreed with concurrent surgery for ‘one of my patients’ (response mean 1.76 (sd 1.03)) but were more accepting of overlapping surgery (mean 3.94 (sd 0.99); p < 0.0001). The rating difference between concurrent and overlapping surgery was smaller for paediatric and spine surgeons (-1.25) than for residents or those who did not identify a subspecialty (-2.17; p = 0.0246) or other subspecialty surgeons (-2.57; p = 0.0026). Respondents were more likely to agree with explicit informed consent for concurrent surgery compared with overlapping (mean 4.32 (sd 0.91) versus 3.44 (sd 1.14); p < 0.001). Conclusion Orthopaedic surgeons disagreed with concurrent but were more accepting of overlapping surgery and anaesthesia for PSIF for AIS. Respondents were in greater agreement that patients should be explicitly informed of concurrence than of overlap. The surgical community’s evidence and position regarding simultaneous surgery, in particular overlapping, must be more effectively presented to the public in order to bridge the gap in perspectives. Level of Evidence IV

2021 ◽  
Vol 11 (23) ◽  
pp. 11084
José Hurtado-Avilés ◽  
Vicente J. León-Muñoz ◽  
Pilar Andújar-Ortuño ◽  
Fernando Santonja-Renedo ◽  
Mónica Collazo-Diéguez ◽  

Axial vertebral rotation (AVR) and Cobb angles are the essential parameters to analyse different types of scoliosis, including adolescent idiopathic scoliosis. The literature shows significant discrepancies in the validity and reliability of AVR measurements taken in radiographic examinations, according to the type of vertebra. This study’s scope evaluated the validity and absolute reliability of thoracic and lumbar vertebrae AVR measurements, using a validated software based on Raimondi’s method in digital X-rays that allowed measurement with minor error when compared with other traditional, manual methods. Twelve independent evaluators measured AVR on the 74 most rotated vertebrae in 42 X-rays with the software on three separate occasions, with one-month intervals. We have obtained a gold standard for the AVR of vertebrae. The validity and reliability of the measurements of the thoracic and lumbar vertebrae were studied separately. Measurements that were performed on lumbar vertebrae were shown to be 3.6 times more valid than those performed on thoracic, and with almost an equal reliability (1.38° ± 1.88° compared to −0.38° ± 1.83°). We can conclude that AVR measurements of the thoracic vertebrae show a more significant Mean Bias Error and a very similar reliability than those of the lumbar vertebrae.

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