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Anaesthetic Management of Early-Onset Scoliosis
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Damarla Haritha, Souvik Maitra
The scoliotic curves are generally named with the side facing the convexity as left-sided and right-sided curves. The left-sided curves are more frequently associated with congenital anomalies [2]. The most commonly used parameter for grading the severity is the Cobb angle [5]. It is measured by a plain radiograph of the spine, marking the most cephalic end of the curve and the caudal of the curve. A parallel line is drawn along the upper border of the most tilted upper vertebra and the lower border of the lower vertebra, and perpendiculars are dropped along these two parallel lines. The angle made by these two perpendicular lines is defined as the Cobb angle. A Cobb angle of less than 10° is considered normal. Curves less than 30° rarely progress over time, but the progression also depends on factors such as the age of onset of the deformity, the bone age, etc. A retrospective study by Yin et al. [6] reported that a Cobb angle >77° was associated with postoperative pulmonary complications. The main disadvantage of using Cobb angle is that it only quantifies the deformity in two-dimensions (2D) and does not give any information on the rotational deformity [7] and definition of end vertebra causes a source of error [8].
Orthopaedics and Fractures
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
The majority of curves are defined as adolescent idiopathic scoliosis (AIS). It is most common in girls and there may be a family history. Recent developments suggest that there is a genetic link to the likelihood for curve progression: if the curve starts earlier in infancy or childhood, the prognosis is worse, mainly because there is more time to grow and hence more time for the curve to progress. Curves are usually pain free so that a painful scoliosis should raise an alarm and may provoke further investigation. Scoliosis curves are measured on an AP x-ray and assessed in terms of the Cobb angle.
Impairment of functions in the neuromusculoskeletal system
Published in Ramar Sabapathi Vinayagam, Integrated Evaluation of Disability, 2019
The mobility of joint function refers to a free and full movement of an individual joint. The examiner uses a goniometer or inclinometer to measure a passive range of motion of a joint. Evaluation of mobility of the joint requires a minimum of two measurements to obtain a reliable range without error. It considered the neutral position of the joint as zero position and extended anatomic position of the joint as 0° rather than 180°. The Cobb angle measures the degree of scoliosis in the anteroposterior view of a plain X-ray of the dorsolumbar spine, and the degree of kyphosis in a lateral view of the dorsolumbar spine. It is the angle formed between the parallel lines drawn along the superior endplate of the normal upper vertebra and inferior endplate of the normal lower vertebra (Figure 7.1).
The efficacy of Schroth exercises combined with the Chêneau brace for the treatment of adolescent idiopathic scoliosis: a retrospective controlled study
Published in Disability and Rehabilitation, 2022
Ming-Qiao Fang, Xiao-Li Huang, Wei Wang, Yu-An Li, Guang-Heng Xiang, Guang-Kui Yan, Chen-Rong Ke, Cheng-Huang Mao, Zong-Yi Wu, Tian-Long Pan, Rui-Bo Zhu, Jian Xiao, Xian-Hong Yi
The Chêneau brace showed a high percentage of correction with brace-wearing in both groups (53.6% vs. 50.2%). After treatment, 21 patients whose Cobb angle increased by more than 5° in the Brace group and only one patient in the Brace + SBP group. Schreiber et al. observed 12% participants in the Schroth exercises + brace group and 40% in the brace group whose largest Cobb angle deteriorated by >5° [29]. Otman et al. reported that Schroth’s technique positively influenced muscle strength and postural defects in AIS. Schroth exercises may relieve muscle stiffness caused by brace-wearing [30]. However, De Giorgi et al. showed that the average correction was 59.3% of the initial values of scoliosis at the end of treatment with Chêneau bracing. The correction rate was significantly higher than we showed in the present study [5]. We speculate that the discrepancy is due to differences in brace production technology and the different types of curves. In the present study, our findings suggest that Schroth exercises improve the efficacy of bracing. Zaina et al. reported that physiotherapy could help reduce the correction loss in brace weaning for AIS [31]. Hence, we recommend that patients undergoing brace treatment continue Schroth exercises until the completion of brace weaning.
Postural Stability in Children with High Sacral Level Spina Bifida: Deviations from a Control Group
Published in Journal of Motor Behavior, 2020
Kardelen Gencer-Atalay, Evrim Karadag-Saygi, Samaya Mirzayeva, Ibrahim Gokce, Adnan Dagcinar
Scoliosis was detected by measuring the Cobb angle on anteroposterior scoliosis graphs. A Cobb angle >10° was considered as scoliosis (Kittleson & Lim, 1970). Acetabular dysplasia, hip subluxation, and dislocation were evaluated using the acetabular index (AI), Reimer’s migration index (RMI), and the Shenton line on anteroposterior pelvic radiograph. An AI >30° and an RMI >33% were considered as acetabular dysplasia and hip dislocation, respectively (Donnelly, 2009; Hägglund, Lauge-Pedersen, & Persson, 2007). Foot deformities were examined by measuring the talocalcaneal angle (TCA) and talus first metatarsal angles (T1MA) on both anteroposterior and lateral graphs for each foot. The normal values were established as TCA 20°–40°, T1MA –20° to –15° on the anteroposterior graph and TCA 35°–55°, T1MA –20° to –15° on the lateral graph (Simons, 1977). All radiographic measurements were performed by two different physicians on recent radiographs.
Innovative decision support for scoliosis brace therapy based on statistical modelling of markerless 3D trunk surface data
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Stephan Rothstock, Hans-Rudolf Weiss, Daniel Krueger, Victoria Kleban, Lothar Paul
One of the most common three dimensional spine deformities is adolescent idiopathic scoliosis (AIS) with a prevalence of 2–4% of the population, predominantly affecting females (Rogala et al. 1978). Due to the natural progression but also to treatment there is a need for repeated follow-up investigations (Roach 2008). Brace treatment for example following the Chêneau principles has become a popular option for the conservative treatment of patients with scoliosis (Moramarco and Borysov 2017; Weiss 2017a, 2017b; 2019; Weiss and Moramarco 2017). Currently radiographic assessment of the spine is performed in order to measure the Cobb angle (Cobb 1948) between the two most tilted vertebrae of each curve. The Cobb angle measurement as the ‘Gold’ standard has certain limitations. The measurement is in frontal plane only, while scoliosis is a three dimensional deformity and for younger patients repeated X-ray exposures are a possible source for adverse effects (Thulbourne and Gillespie 1976; Nash et al. 1979; Hoffman et al. 1989; Doody et al. 2000; Ronckers et al. 2008; Ronckers et al. 2010).