European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Randomized Controlled Trial
A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria.
SpineCor is a relatively innovative brace for non-operative treatment of adolescent idiopathic scoliosis (AIS). However, the effectiveness of SpineCor still remains controversial. The objective of the current study was to compare the treatment outcomes of SpineCor brace with that of rigid brace following the standardized Scoliosis Research Society (SRS) criteria on AIS brace study. ⋯ Curve progression rate was found to be significantly higher in the SpineCor group when compared with the rigid brace group. Changing to rigid bracing could control further curve progression for majority of patients who previously failed with SpineCor bracing. For both SpineCor and rigid brace treatments, 30-40% of patients who were originally successfully treated by bracing would exhibit further curve progression beyond skeletal maturity. The post-maturity progression rate was found to be 1.5° per year in the current study, which was relatively greater than those reported before.
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To analyze the changes in the curve extent, pattern and the fusion level in adolescent idiopathic scoliosis (AIS) patients who undergo delayed surgery instead of early surgery. ⋯ Delay of surgery in immature AIS patients whose Cobb's angle exceed 40° initially and showing subsequent progression of the curve, of more than 10° can lead to alterations in the curve pattern and the need for increase in fusion levels.
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Idiopathic scoliosis (IS) is a frequent 3D structural deformity of the spine with a multi-factorial aetiology which remains largely unclear. In the last decade, human magnetic resonance imaging (MRI) morphometry studies (e.g. cortical thickness, 2D shape of the corpus callosum) have aimed to investigate the potential contribution of the central nervous system in the etiopathogenesis of IS. Recent developments in diffusion tensor imaging (DTI) allow us to extend the previous work to the study of white matter microstructure. Here, we hypothesized that part of the corpus callosum could show a difference in white matter microstructure in IS patients as compared to healthy controls. ⋯ This first diffusion magnetic resonance imaging brain study in IS patients, suggests that differences in white matter development, such as synchronization of axonal myelination and pruning could be involved in the etiopathogenesis of IS.
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Comparative Study
Effect of vertebroplasty with bone filler device and comparison with balloon kyphoplasty.
To evaluate the effect of vertebroplasty with a bone filler device compared with balloon kyphoplasty. ⋯ Vertebroplasty with a bone filler device could achieve equivalent compression reduction and bone cement leakage rate, as well as greater sponge-type bone cement distribution, which were advantages over balloon kyphoplasty.
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The sagittal vertical axis (SVA) is a meaningful measurement and widely used for evaluating sagittal balance, and is considered a design standard for surgery, including most ankylosing spondylitis (AS) kyphotic deformity planning. However, recent research indicates that the C7 plumb line is actually not the center of gravity (CG) line. Therefore, whether there is a better radiological marker as the CG of the trunk for AS thoracolumbar kyphosis remains unknown. This research is to investigate a radiological marker for the CG of the trunk in lateral radiographs for AS thoracolumbar kyphosis. ⋯ The hilus pulmonis fell approximately on the hip axis both pre- and post-operatively. It was a better marker as the center of gravity of the trunk for deformity planning for AS thoracolumbar kyphosis.