Showing papers on "Cobb angle published in 1987"
TL;DR: Correcting the lateral curve in adolescent idiopathic scoliosis may have no effect on vertebral rotation and cannot be guaranteed to effect a permanent reduction of the rib hump.
Abstract: A prospective study to investigate changes in the rib hump or rib deformity after correction of the lateral curvature in adolescent idiopathic scoliosis is reported. The operative treatment for 47 patients was by a Harrington distraction rod and posterior fusion. Before operation and at follow-up, measurements of the Cobb angle, of vertebral rotation, and of the rib deformity were taken. Despite operative correction of the lateral curve, there was a progression of the rib deformity in 64% of the cases after four years. Correction of the lateral curve may thus have no effect on vertebral rotation and cannot be guaranteed to effect a permanent reduction of the rib hump.
45 citations
TL;DR: The Leeds procedure, which consists of segmental wiring to a kyphotically-contoured square-ended Harrington rod, not only derotates the spine but restores the natural thoracic kyphosis, thus avoiding subsequent buckling.
Abstract: Late-onset idiopathic scoliosis is associated with a rib hump in the thoracic region, and surgery is indicated when this deformity becomes unacceptable. Fifty patients with this deformity were treated by the Leeds procedure, which consists of segmental wiring to a kyphotically-contoured square-ended Harrington rod; this procedure not only derotates the spine but restores the natural thoracic kyphosis, thus avoiding subsequent buckling. All patients were followed up for a minimum of two years. Forty-two of these, who had a pre-operative Cobb angle of less than 60 degrees, were treated by one-stage instrumentation and fusion, while the remaining eight with greater curves underwent preliminary anterior multiple discectomy to provide flexibility with shortening. Postoperative loss of correction was not observed and there were no neurological complications.
44 citations
TL;DR: There was considerable variation in the progression rate of similar deformities but on average significant deterioration occurred when the Cobb angle was over 55 degrees with a maximum deterioration approaching 1.5 degrees per year in the thoracic curves between 90 degrees and 100 degrees mature Cobb angle.
Abstract: Seventy-eight unfused patients with idiopathic scoliosis were followed from skeletal maturity over a mean period of 17 years (range 10 to 27 years) with a mean age at follow up of 33.7 years. The following aspects were investigated: curve deterioration, back pain incidence, and psychosocial details. There was considerable variation in the progression rate of similar deformities but on average significant deterioration occurred when the Cobb angle was over 55 degrees with a maximum deterioration approaching 1.5 degrees per year in the thoracic curves between 90 degrees and 100 degrees mature Cobb angle. Thoracolumbar and lumbar curves were slightly more benign with a maximum progression rate of about 1 degree when the mature angle was 80 degrees to 90 degrees. The thoracic component of double curves progressed least. Rotation increased in proportion to the Cobb angle progression except in some lumbar curves where lateral subluxation occurred with a disproportionate amount of rotation. The incidence of back pain in relation to pain in the general population and in fused patients remains uncertain. Eighty-two percent of patients had married and 87% had job satisfaction; 10% received treatment for depression.
32 citations
TL;DR: The composite measurement, considering sagittal alignment, is a significantly more valid method of description of the scoliotic deformity and of comparison of treatment methods.
Abstract: A method of calculation of biplanar spinal deformity in which the frontal Cobb angle is added to the deviation from normal sagittal alignment is presented. Three equivalent groups of adolescent idiopathic scoliosis treated by different surgical methods are presented. When only the frontal Cobb method of comparison was used, results were similar. When the composite measurement that takes into account sagittal changes was used, the Harrington instrumentation group showed significantly poorer results than the Luque rod and Cotrel-Dubousset rod groups. The composite measurement, considering sagittal alignment, is a significantly more valid method of description of the scoliotic deformity and of comparison of treatment methods.
24 citations
TL;DR: An epidemiological survey of idiopathic scoliosis derived by school screening in Greece has shown a three-fold rise in prevalence rate from 1% in 6- year-olds to more than 3% in 15-year-olds.
Abstract: An epidemiological survey of idiopathic scoliosis derived by school screening in Greece has shown a three-fold rise in prevalence rate from 1% in 6-year-olds to more than 3% in 15-year-olds. Moderate curves (with a Cobb angle of 10 degrees to 19 degrees) are the most common curve magnitude encountered in both boys and girls. Typical curves (right thoracic, left lumbar, or right thoracic left lumbar double structural configurations) become relatively more prevalent with rising curve magnitude, while atypical curve patterns (left thoracic, right lumbar, or left thoracic right lumbar double structural configurations) reciprocally diminish. Growth is clearly an important environment in which curves progress and peak prevalence rates occur at the ages of 11 years and 13 years. Although it is not possible to prognosticate about the individual case, attention to these characteristics derived from epidemiological surveys is useful in assessing future curve behavior.
19 citations
TL;DR: It is recommended to use, in addition to the Cobb method, an accurate method for measuring the axial rotation, because the Cobb angle is mainly influenced by the lateral deviation and less by the axIAL rotation.
14 citations
TL;DR: The data strongly support the belief that systemic biologic factors are a major variable affecting the quality of the fusion procedure.
Abstract: This retrospective study of 24 patients with adolescent idiopathic scoliosis who underwent L-rod instrumentation, posterior thoracoplasty, and rib-bone grafting analyzed the correlation between the quality of rib regeneration and the host response to the rib-bone grafts. A planimetric technique was used to quantitate the coronal plane area of the resected ribs and of an L1-L2 concave fusion area immediately after surgery and at the end of the first postsurgical year. Using computerized regression analysis, these and other variables such as age, Cobb angle, and grafting technique were studied. Rib regeneration correlated with spinal fusion but not with age or Cobb angle. A better host response with strip vs. morseled graft was suggested, but not statistically proven. The data strongly support the belief that systemic biologic factors are a major variable affecting the quality of the fusion procedure.
5 citations
TL;DR: This Automatic Analytic System of scoliosis is excellent in the medical survey at school, and in seventeen cases screened that had more than 15° of Cobb angle in the thoracic C curve type, the correlation coefficient between the Cobb angle and the difference between the right back pitch and left one at standing was 0.75, which is a pretty good correlation.
Abstract: Automatic Analytic System of scoliosis that employed TV camera, A/D changing apparatus and personal computer, was applied clinically. The results were previously reported by Okamoto.The character of Automatic Analytic System is the following.(1) It analyzes automatically the back deformity of scoliosis by personal computer, and prints out the results.(2) The time for analysis is about thirty seconds for each person.(3) It can screen the spinal deformity without X-rays and contact, objectively, correctly, and directly.(4) It can be carried easily for the light weight.(5) Many analytic apparatuses are not needed in a prefecture, if the system has been perfected.This time we carried out the medical examination of scoliosis at the primary and lower secondary schools in the city of Isahaya by means of the Automatic Analytic System. In seventeen cases screened that had more than 15° of Cobb angle in the thoracic C curve type, the correlation coefficient between the Cobb angle and the difference between the right back pitch and left one at standing was 0.75, which is a pretty good correlation. As a result of this medical examination, we saw that this Automatic Analytic System of scoliosis is excellent in the medical survey at school.
1 citations
01 Jan 1987
TL;DR: Non-invasive and non-ionizing analysis of spinal deformity for large scale screening or repeated controls on the same patients where the need is to avoid X-ray exposures or to reduce them during the course of the disease and its treatment.
Abstract: During the last few years, several studies (1, 2, 3) have been devoted to non-invasive and non-ionizing analysis of spinal deformity. Such approach becomes particularly useful for large scale screening or repeated controls on the same patients where the need is to avoid X-ray exposures or to reduce them during the course of the disease and its treatment.