The effect of direct vertebral rotation on the spine parameters (coronal and sagittal) in adolescent idiopathic scoliosis

Abstract

BACKGROUND: Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves. METHODS: A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. RESULTS: The Cobb angle averaged 51.3∘± 14.9∘. Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p= 0.003); Cobb angle thoracic distal (p= 0.001); Cobb angle lumbar (p= 0.001); kyphosis (T5-T12, p= 0.012); and kyphosis (T1-T12, p= 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery. CONCLUSION: The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process.

Effect of traditional rehabilitation programme versus telerehabilitation in adolescents with idiopathic scoliosis during the COVID-19 pandemic: a cohort study

“…The radiographs were centred on T12 during inspiration, with a 2-m distance between the film and the focus. All images were transferred to a computer as digital images and evaluated using the image software Surgimap Spine (Nemaris Inc., New York, USA) ( 23 , 24 ).…”

“…Conservative treatment with specific exercises for AIS is based on the recommendations of the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) and an indication for the use of orthopaedic braces, when necessary (20)(21)(22). In general, the recommendation is for scoliotic curvatures between 25° and 45° to be treated with exercise and brace on spine, with highly positive clinical evidence to support progressive reduction and control of the Cobb angle due growth potential of the skeletal maturity phase in adolescents (23).…”

Effect of Progression of Adolescent Idiopathic Scoliosis on Gait Parameters

“…A cross-sectional observational type study was conducted with 40 participants with AIS, who were divided into three groups: 13 with mild AIS (Cobb angle <20˚), 13 with moderate AIS (Cobb angle of 20˚ to 39˚), and 14 with severe AIS (>40˚ or 45˚). 15,26 Recruitment was carried out through the Public Hospital of the State of São Paulo/SP, Brazil, and the Instituto Científico Especializado em Reabilitação-REAB, Campinas/SP, Brazil. The study was reviewed and approved by the Research Ethics Committee under number: 2,729,155, under the ethical regulations of the Declaration of Helsinki.…”

“…The magnitude of AIS severity is determined based on the Cobb angle as follows: mild scoliosis, Cobb angle <20˚; moderate scoliosis, Cobb angle of 20˚ to 39˚; and severe scoliosis with Cobb angle >40˚ or 45˚. 15,25,26 None of these studies linked differences in plantar pressure distribution and gait to different levels of AIS severity, and the relationship between AIS severity levels and walking performance needs to be investigated. Thus, this study aimed to evaluate the influence of the degree of severity (mild, moderate, and severe) of adolescent idiopathic scoliosis (AIS) on the plantar foot load distribution during gait.…”