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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To investigate coronal plane trunk asymmetry (TA) and its association with sagittal postural alignment in healthy subjects before pubertal peak growth. ⋯ In immature spines without known scoliosis, coronal plane TA is associated with whole-body sagittal alignment. It is more often seen in non-neutral than neutral sagittal posture types. Whether adolescent idiopathic scoliosis is related with postural characteristics before pubertal growth peak, should be addressed in future prospective studies.
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Preoperative directionality of shoulder tilting seems to be independent of the radiographic features of proximal thoracic (PT) curve in adolescent idiopathic scoliosis (AIS) patients. To date, no study had investigated the mechanisms underlying the variety of preoperative directionalities of shoulder tilting in AIS patients. The purpose of this study was to evaluate the differences of radiographic features between Lenke type 2 (double thoracic curve) AIS patients with different preoperative directionalities of shoulder tilting. ⋯ The directionality of shoulder tilting is diverse in Lenke type 2 AIS patients. The preoperative directionality of shoulder mainly depends on the profile of MT curve rather than that of PT curve. The RSH should be carefully evaluated before making a surgical plan in these patients.
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The cartilage oligomeric matrix protein (COMP) was reported to be down-regulated in adolescent idiopathic scoliosis (AIS). The purposes of the study were to evaluate the roles of COMP promoter methylation on the abnormal gene expression and the epigenetic phenotype in AIS. ⋯ AIS patients had significantly high COMP promoter methylation and low gene expression. Positive and high COMP promoter methylation was correlated with young age and high Cobb angle of main curve. Therefore, COMP gene promoter methylation may provide significant prognostic information in predicting the susceptibility and curve progression of AIS.
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Observational Study
Description of the sagittal alignment of the degenerative human spine.
To present the description of sagittal alignment of the degenerative human spine and its possible evolution. ⋯ Level IV cross sectional observational study.
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Case Reports
Tailor-made management of thoracic scoliosis with cervical hyperextension in muscular dystrophy.
We report the case of a 13-year-old boy managed for fixed cervical hyperextension due to congenital muscular dystrophy with partial merosin deficiency. He presented a right decompensated thoracic scoliosis (T6-L1 Cobb angle 72°) associated with cervical and lumbar lordosis. The spinal extension was accompanied by major flexion of the hip resulting in the trunk being bent forward. This posture caused daily severe back pain responsible for significant loss of quality of life. This led to the decision to perform surgery. ⋯ There is no gold standard treatment for cervical hyperextension, but approaches have to be tailor-made to the patient's needs and the team's experience.