The radiographic parameter risk factors of rapid curve progression in Lenke 5 and 6 adolescent idiopathic scoliosis

Li, Zhikun; Li, Gengwu; Chen, Chao; Li, Yifan; Yang, Chen; Li, Ming; Xu, Wei; Zhu, Xiaodong

doi:10.1097/md.0000000000009425

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…This was supported by a recent study on the radiographic parameter risk factors of rapid progression in adolescents with Lenke V and VI idiopathic scoliosis [12]. The study showed that apical vertebral rotation ≥ III (according to the Nash-Moe classification), deviation of the apical vertebra ≥40 mm from the central sacral line in the lumbar curve, and a L5 tilt angle ≥10° (Figure 1) are associated with an increased risk of curve progression in adolescents [12].…”

Section: Introductionmentioning

confidence: 52%

Physical Rehabilitation in the Management of Symptomatic Adult Scoliosis

Ng¹,

Ho²,

Ng³

2019

Different Areas of Physiotherapy

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Scoliosis is prevalent in elderlies over the age of 60. Of the different curve types, the thoracolumbar curve is the most common curve type operated upon, as it is associated with marked trunk shift and disability. Current physiotherapy treatments consist of electrotherapy, aquatic exercises, core-strengthening exercises, and dry needling. Outcome of these treatments has not been satisfactory. Longterm successful rate of conservative treatment of symptomatic adult scoliosis is low, as the treatment addresses symptoms but not the biomechanics involved in adult scoliosis. Recent studies have shown that physiotherapeutic scoliosis-specific exercises (PSSE) and bracing stabilized the curves in 80% of the subjects. Thus PSSE and bracing should be added to the standard physiotherapy care in the management of symptomatic adult scoliosis. For asymptomatic patients with thoracolumbar curve that has an increased risk of progression, PSSE should be considered as preventative exercises. Patients who do not respond to conservative treatments and have significant spinal stenosis should be referred for surgery.curves progressed 3° per year [13] and that apical vertebral rotation ≥ III (according to the Nash-Moe classification), a Cobb angle >30°, lateral vertebral translation >6 mm, and L5 above the intercristal line predict curve progression [13,14]. Osteoporosis, a coronal Cobb angle <30°, lumbar lordosis, and degenerative spondylolisthesis are not risk factors for curve progression [14].With increase in life expectancy of the population [2,15], it follows that the prevalence of adult scoliosis increases [2,15] and with it the morbidity.

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Section: Introductionmentioning

confidence: 52%

Physical Rehabilitation in the Management of Symptomatic Adult Scoliosis

Ng¹,

Ho²,

Ng³

2019

Different Areas of Physiotherapy

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“…However, this also means that despite the proven effectiveness of brace treatment, the failure rate ranges between 12 and 39% [3]. Besides patients' compliance in wearing the brace, the known factors influencing the success of conservative treatment are location (main thoracic vs. lumbar), flexibility, symmetry and magnitude of the curve, degree of apical rotation, lateral deviation of the apex from the midline, and the magnitude of the initial correction of the rotation and curve [4][5][6][7][8]. The latter is mainly dependent either on curve flexibility or on the brace's ability to address these parameters, which is strongly related to brace design.…”

Section: Introductionmentioning

confidence: 99%

Improvement of Adolescent Idiopathic Scoliosis Primary Correction by Brace Design Optimization

et al. 2022

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(1) Background: Primary in-brace correction has been shown to be related to conservative adolescent idiopathic scoliosis (AIS) treatment outcome. The purpose of the study was to evaluate TLSO brace design changes over eight years regarding primary Cobb correction and de-rotation of the (major) curve. (2) Methods: This retrospective analysis included AIS patients treated with a full-time TLSO-brace in a single Orthopedic University hospital in 2012–2014 and 2017–2019. Brace design changes resulted from an evolutionary process, from a 3-point bending to a 3D TLSO. The brace parameters (presence of an anterior shoulder pad, posterior high-thoracic pad, thoracic space, and angle of the lumbar and thoracic pressure points) were analyzed regarding the primary (major) Cobb angle and apex rotation correction with a multivariate analysis. (3) Results: A total of 74 (63 female) patients were included in the study. The Cobb angle primary correction was significantly improved over the timeframe. The primary correction was significantly influenced by all design parameters and partially by its interactions with (curve specific) different effects on the Cobb correction and apex de-rotation. (4) Conclusions: Knowledge about the effects of brace design parameters on the curve’s angle and rotation correction enables improvements in individualized brace design and the brace optimization process.

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“…1 Adolescent idiopathic scoliosis(AIS) accounts for about 85% of idiopathic scoliosis. 2 Lenke type 5C is characterized by a single major structural curve in the thoracolumbar or lumbar spine accompanied by two non-structural minor curves. 3 It has been reported that more than 50% of patients with Lenke type 5 AIS with a curve of more than 40 degrees showed progression after the age of 20years.…”

Section: Introductionmentioning

confidence: 99%

Radiological outcomes of the selective spinal fusion for lenke type 5C adolescent idiopathic scoliosis

Kakadiya¹,

Saindane²,

Gandbhir³

et al. 2021

MOJOR

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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.

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The radiographic parameter risk factors of rapid curve progression in Lenke 5 and 6 adolescent idiopathic scoliosis

Cited by 6 publications

References 27 publications

Physical Rehabilitation in the Management of Symptomatic Adult Scoliosis

Physical Rehabilitation in the Management of Symptomatic Adult Scoliosis

Improvement of Adolescent Idiopathic Scoliosis Primary Correction by Brace Design Optimization

Radiological outcomes of the selective spinal fusion for lenke type 5C adolescent idiopathic scoliosis

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