Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications

Abelin-Genevois, Kariman; Sassi, Davide; Verdun, Stéphane; Roussouly, Pierre

doi:10.1007/s00586-018-5613-1

Cited by 62 publications

(50 citation statements)

References 26 publications

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“…(45) Sagittal profiles in children, especially the ones that develop scoliosis, were shown to differ significantly by Abelin-Genevois in her classification system in 2018 and by Pasha in 2019. (46)(47)(48)(49) Schlösser and colleagues found that in nonscoliotic subjects spines of girls are more backwardly inclined than the spines of boys at the moment of maximal growth velocity. (50) Brink and colleagues showed that the pelvic incidence, the determinator of sagittal spinal alignment, is significantly higher in lumbar than in thoracic scoliosis and controls.…”

Section: Consequences Of the Human Fully Upright Sagittal Spinal Profilementioning

confidence: 99%

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Castelein

Pasha

Cheng

et al. 2020

Journal of Bone and Mineral Research

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Many years of dedicated research into the etiology of idiopathic scoliosis have not led to one unified theory. We propose that scoliosis is a mechanical, rotatory decompensation of the human spine that starts in the transverse, or horizontal, plane. The human spine is prone to this type of decompensation because of its unique and individually different, fully upright sagittal shape with some preexistent transverse plane rotation. Spinal stability depends on the integrity of a delicate system of stabilizers, in which intervertebral disc stiffness is crucial. There are two phases in life when important changes occur in the precarious balance between spinal loading and the disc's stabilizing properties: (i) during puberty, when loads and moment arms increase rapidly, while the disc's "anchor," the ring apophysis, matures from purely cartilaginous to mineralized to ultimately fused to the vertebral body, and (ii) in older age, when the torsional stiffness of the spinal segments decreases, due to disc degeneration and subsequent laxity of the fibers of the annulus fibrosus. During these crucial periods, transverse plane vertebral rotation can increase during a relatively brief window in time, either as adolescent idiopathic or degenerative de novo scoliosis. Much more is known of the biomechanical changes that occur during disc aging and degeneration than of the changing properties of the disc during maturation.

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Section: Consequences Of the Human Fully Upright Sagittal Spinal Profilementioning

confidence: 99%

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Castelein

Pasha

Cheng

et al. 2020

Journal of Bone and Mineral Research

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“…In adolescent idiopathic scoliosis (AIS), the spinal curve in the coronal plane is associated with changes in sagittal shape [1] and axial rotation [2] of the vertebral column. There is often an associated asymmetry of the posterior torso, otherwise known as the rib hump, best observed in the Adams forward bend position.…”

Section: Introductionmentioning

confidence: 99%

A cluster analysis describing spine and torso shape in Lenke type 1 adolescent idiopathic scoliosis

2020

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Purpose The purpose of this work is to identify the variability and subtypes of the combined shape of the spine and torso in Lenke type 1 adolescent idiopathic scoliosis (AIS). Methods Using ISIS2 surface topography, measures of coronal deformity, kyphosis and skin angulation (as a measure of torso asymmetry) in a series of children with Lenke 1 convex to the right AIS were analyzed using k-means clustering techniques to describe the combined variability of shape in the spine and torso. Following this, a k-nearest neighbor algorithm was used to measure the ability to automatically identify the correct cluster for any particular datum. Results There were 1399 ISIS2 images from 691 individuals available for analysis. There were 5 clusters identified in the data representing the variability of the 3 measured parameters which included mild, moderate and marked coronal deformity, mild, moderate and marked asymmetry alongside normal and hypokyphosis. The k-nearest neighbor identification of the correct cluster had an accuracy of 93%. Conclusion These clusters represent a new description of Lenke 1 AIS that comprises both coronal and sagittal measures of the spine combined with a measure of torso asymmetry. Automated identification of the clusters is accurate. The ability to identify subtypes of deformity, based on parameters that affect both the spine and the torso in AIS, leads to as better understanding of the totality of the deformity seen.

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“…It is widely accepted that explicit description of sagittal spine alignment assists in determination of aetiology and the orientation of the surgical plan, both of which are achieved using two incisive tools (spinopelvic parameters and curvatures) in both degenerative spine disease and spine deformity [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…However, these descriptions are overemphasized on spinopelvic parameters, and this process is sometimes tedious due to the lack of a direct view of spine curvatures. Furthermore, the sagittal pro le may be affected by complex compensatory mechanisms, especially in spine deformity patients, which may not be interpret in radiographic parameters [6]. Addressing these de ciencies, Albelin-Genovois et al…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

Gao

Wang

et al. 2020

Preprint

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Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH)The aim of study is to investigate sagittal alignment in TLDH, and analyze sagittal profile with radiographic parameters.Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameters values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The apex of the thoracic kyphotic curve located in the middle thoracic spine in type I, and the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I patients (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In view of the different curvatures, different aetiologies were discovered in each subtype. Mismatch between shape and SS value was observed, and better agreement was found in Type II patients.

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Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications

Cited by 62 publications

References 26 publications

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

A cluster analysis describing spine and torso shape in Lenke type 1 adolescent idiopathic scoliosis

Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

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