Thoracic Idiopathic Scoliosis Curve Evolution and Prognosis

Perdriolle, R; Vidal, J

doi:10.1097/00007632-198511000-00001

Cited by 197 publications

(99 citation statements)

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“…The most rotated lumbar vertebra was documented only in Lenke three curves. Vertebral rotation was measured on posteroanterior standing radiographs according to Perdriolle [14] and on CT reconstructions of each vertebra from T1 to L5, passing through the plane parallel to the cranial endplate at the pedicles' level. The angle was built between the longitudinal vertebral body axis passing through the middle of the posterior wall and the vertical axis of the CT image [15].…”

Section: Methodsmentioning

confidence: 99%

Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

et al. 2012

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Purpose Idiopathic scoliosis can lead to sagittal imbalance. The relationship between thoracic hyper-and hypokyphotic segments, vertebral rotation and coronal curve was determined. The effect of segmental sagittal correction by in situ contouring was analyzed. Methods Pre-and post-operative radiographs of 54 scoliosis patients (Lenke 1 and 3) were analyzed at 8 years follow-up. Cobb angles and vertebral rotation were determined. Sagittal measurements were: kyphosis T4-T12, T4-T8 and T9-T12, lordosis L1-S1, T12-L2 and L3-S1, pelvic incidence, pelvic tilt, sacral slope, T1 and T9 tilt. Results Thoracic and lumbar curves were significantly reduced (p = 0.0001). Spino-pelvic parameters, T1 and T9 tilt were not modified. The global T4-T12 kyphosis decreased by 2.1°on average (p = 0.066). Segmental analysis evidenced a significant decrease of T4-T8 hyperkyphosis by 6.6°(p = 0.0001) and an increase of segmental hypokyphosis T9-T12 by 5.0°(p = 0.0001). Maximal vertebral rotation was located at T7, T8 or T9 and correlated (r = 0.422) with the cranial level of the hypokyphotic zone (p = 0.003). This vertebra or its adjacent levels corresponded to the coronal apex in 79.6 % of thoracic curves.Conclusions Lenke 1 and 3 curves can show normal global kyphosis, divided in cranial hyperkyphosis and caudal hypokyphosis. The cranial end of hypokyphosis corresponds to maximal rotation. These vertebrae have most migrated anteriorly and laterally. The sagittal apex between segmental hypo-and hyper-kyphosis corresponds to the coronal thoracic apex. A segmental sagittal imbalance correction is achieved by in situ contouring. The concept of segmental imbalance is useful when determining the levels on which surgical detorsion may be focused.

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Section: Methodsmentioning

confidence: 99%

Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

et al. 2012

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“…As a measure of internal control, patients with two measurable apical screws were analyzed separately. For the purposes of this, we study defined crankshaft as AVR more than 5° [32].…”

Section: Measurement Of Apical Rotationmentioning

confidence: 99%

Maintenance of Derotation in Adolescent Idiopathic Scoliosis: A Novel Technique Measuring Postoperative Vertebral Rotation by Pedicle Screw Position

Bjerke

Cheung

Shifflett

et al. 2016

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Current methods of measuring vertebral rotation by plain radiographs rely on anatomic landmarks that are not present in the postoperative spine or require advanced imaging. Furthermore, there are few studies on the incidence of crankshaft with modern pedicle instrumentation. Questions/Purposes: We sought to (1) describe and validate a method of vertebral rotation measurement using plain radiographs and (2) measure postoperative rotation in a series of patients treated for adolescent idiopathic scoliosis. Methods: Patients with adolescent idiopathic scoliosis treated with surgery over a 6-year period were reviewed. Patients with computed tomography (CT) scans and radiographs within 60 days of another were included. Vertebral rotation was calculated by radiographic measurements and measured directly by CT scan. As an internal control, patients with two apical pedicle screws on all radiographs were analyzed. Rotation was measured for all patients with at least 1 year of radiographic follow-up. Results: Three thousand five hundred fifty-two instrumented spinal levels in 308 consecutive patients were reviewed. Ten patients with 93 screws were analyzed by CT and radiographs. The average discrepancy between computed tomography (CT) and radiographs was 3.3±1.9°, with 81.7% (76/93) within 5°. Intra-and inter-rater reliabilities for measured axial rotation were excellent (intra-class correlation coefficient (ICC)=0.879 and 0.900, respectively). One hundred swventy-eight patients were eligible with an average followup of 2.3±1.2 years; 84.8% (151/178) had screw(s) visible on all images at the major curve apex. The average postsurgical rotation was 3.5±2.9°; 19.2% (29/151) were measured to have a rotation over 5°, and 4.0% (6/151) demonstrated a rotation over 10°. Only 4.6% (7/151) of patients demonstrated a postoperative Cobb angle change over 10°. Conclusions: Most major curves have apical pedicle screw instrumentation that can be followed by radiographs alone to measure rotation. Vertebral rotation measurement requires only plain radiographs and is a more sensitive determination for subtle postoperative crankshaft than change in Cobb angle.

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“…A standard anteroposterior standing full spine and a left hand X-ray assessment were performed. On digital photographs, some parameters were evaluated: the main Cobb angle curve [8], the frontal body balance [21], the Risser sign [35] and the apical vertebral rotation (with the Perdriolle technique) [33]. The bone age was assessed on the left hand X-ray with the Greulich and Pyle table [33,35].…”

Section: Demographic and Radiological Assessmentmentioning

confidence: 99%

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

et al. 2009

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Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. Consequently, AIS can modify human locomotion. Very few studies have investigated a simple activity like walking in a cohort of well-defined untreated patients with scoliosis. The first goal of this study is to evaluate the effects of scoliosis and scoliosis severity on kinematic and electromyographic (EMG) gait variables compared to an able-bodied population. The second goal is to look for any asymmetry in these parameters during walking. Thirteen healthy girls and 41 females with untreated AIS, with left thoracolumbar or lumbar primary structural curves were assessed. AIS patients were divided into three clinical subgroups (group 1 \ 20°, group 2 between 20 and 40°, and group 3 [ 40°). Gait analysis included synchronous bilateral kinematic and EMG measurements. The subjects walked on a treadmill at 4 km/h (comfortable speed). The tridimensional (3D) shoulder, pelvis, and lower limb motions were measured using 22 reflective markers tracked by four infrared cameras. The EMG timing activity was measured using bipolar surface electrodes on quadratus lumborum, erector spinae, gluteus medius, rectus femoris, semitendinosus, tibialis anterior, and gastrocnemius muscles. Statistical comparisons (ANOVA) were performed across groups and sides for kinematic and EMG parameters. The step length was reduced in AIS compared to normal subjects (7% less). Frontal shoulder, pelvis, and hip motion and transversal hip motion were reduced in scoliosis patients (respectively, 21, 27, 28, and 22% less). The EMG recording during walking showed that the quadratus lumborum, erector spinae, gluteus medius, and semitendinosus muscles contracted during a longer part of the stride in scoliotic patients (46% of the stride) compared with normal subjects (35% of the stride). There was no significant difference between scoliosis groups 1, 2, and 3 for any of the kinematic and EMG parameters, meaning that severe scoliosis was not associated with increased differences in gait parameters compared to mild scoliosis. Scoliosis was not associated with any kinematic or EMG left-right asymmetry. In conclusion, scoliosis patients showed significant but slight modifications in gait, even in cases of mild scoliosis. With the naked eye, one could not see any difference from controls, but with powerful gait analysis technology, the pelvic frontal motion (right-left tilting) was reduced, as was the motion in the hips and shoulder. Surprisingly, no asymmetry was noted but the spine seemed dynamically stiffened by the longer contraction time of major spinal and pelvic muscles. Further studies are needed to evaluate the origin and consequences of these observations.

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Thoracic Idiopathic Scoliosis Curve Evolution and Prognosis

Cited by 197 publications

References 0 publications

Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

Maintenance of Derotation in Adolescent Idiopathic Scoliosis: A Novel Technique Measuring Postoperative Vertebral Rotation by Pedicle Screw Position

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

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