Showing papers on "Cobb angle published in 1988"
TL;DR: It is found that spinal fusion protects the scoliotic spine from further deterioration during adult life except for those with severe curves and marked rotation.
Abstract: We reviewed 77 unfused and 91 fused patients with idiopathic scoliosis who first attended between 1949 and 1965. Both groups were re-examined at least 10 years after reaching skeletal maturity, with attention to progression of the Cobb angle, increased in vertebral rotation, back pain and psychosocial problems. We found that spinal fusion protects the scoliotic spine from further deterioration during adult life except for those with severe curves and marked rotation. Fusion also significantly reduced the incidence of severe pain and allowed patients to carry out heavy physical work, but did not confer complete immunity from backache. Surgery improved the appearance, but patients were not always completely satisfied with the cosmetic result.
159 citations
TL;DR: The method of analysis of back surface shape is described which was designed to present most of the numerical parameters needed to assess the progress of the disease as it affects body shape and indicates quantitatively and with complete safety both lateral asymmetry and deformity in the transverse plane.
138 citations
TL;DR: In 30 adolescent patients with 36 structural curves undergoing posterior spinal arthrodesis using Cotrel-Dubousset (CD) Instrumentation, computer tomography (CT) was performed to evaluate the change in rotation and in the sagittal plane, CD instrumentation improves both the rotational and Sagittal plane deformities better than that reported for other systems.
Abstract: In 30 adolescent patients with 36 structural curves undergoing posterior spinal arthrodesis using Cotrel-Dubousset (CD) instrumentation, computer tomography (CT) was performed to evaluate the change in rotation and in the sagittal plane. The average preoperative Cobb angle was 51.7 degrees, and improved to 18.7 degrees postoperatively, or 64.9%. The angle of rotation of the apical vertebra relative to the anterior midline of the body (RAML) improved from 27.9 degrees preoperatively to 21.5 degrees postoperatively (23.9%). The angle of rotation relative to the sagittal plane (RAsag) improved from 15.2 degrees preoperatively to 13.4 degrees postoperatively (14.3%). The kyphotic angle increased an average of 10.6 degrees in the 14 patients whose preoperative angle was less than 25 degrees. As measured by CT, CD instrumentation improves both the rotational and sagittal plane deformities better than that reported for other systems.
80 citations
TL;DR: Avoidance of postoperative casting or bracing, maintenance of secondary spinal contours, secure pelvic fixation when needed, and anterior thoracoplasty in a majority of patients were achievable goals with LRI.
Abstract: Eighty patients were treated with L-rod instrumentation (LRI) for adolescent idiopathic scoliosis at the authors' institution from 1978 through 1985 The percentage correction of Cobb angle, the fusion rate, and the neurologic injury rate were similar to that reported for Harrington instrumentation Avoidance of postoperative casting or bracing, maintenance of secondary spinal contours, secure pelvic fixation when needed, and anterior thoracoplasty in a majority of patients were achievable goals with LRI
67 citations
TL;DR: Relationships between skeletal and surface measures were similar for curves in thoracic and lumber regions and for patients with single and double curves and there is potential for clinical application of surface measurement techniques to prescription of orthoses and monitoring of changes due to progression or treatment.
60 citations
TL;DR: The overall success rate was 81%, and onset of menarche and Risser sign were statistically significant prognostic variables, and the Wilmington jacket appears to give similar results for part-time brace wearers.
Abstract: A retrospective study of one hundred female patients treated for idiopathic scoliosis using an underarm plastic thoracolumbar-sacral orthosis (TLSO) jacket was undertaken. The purpose of the study was to evaluate the efficacy of the Wilmington jacket, to search for clinical variables which could statistically predict success, and to evaluate preliminary results of parttime bracing in 25 patients. The following parameters were statistically evaluated by multiple regression analysis: age, sex, curve location, number of vertebrae in curve, Cobb angle, maturity (Risser sign, menarche), curve flexibility, and hours in the jacket. The overall success rate was 81%, and onset of menarche and Risser sign were statistically significant prognostic variables. Ten patients (10%) underwent posterior spinal fusion for curve progression. Bracing with an underarm scoliosis jacket is a successful method of treatment of idiopathic scoliosis in the immature spine. We do not recommend brace treatment for postmenarchal patients or patients with a Risser sign of Grade 1 or greater until curve progression has been observed. Furthermore, the Wilmington jacket appears to give similar results for part-time brace wearers.
40 citations
TL;DR: In the thoracic region, the change from a standing-erect to a sitting-forward-bending position, in contrast, shows a statistically significant reduction of the hump on the convexity of the spinal curve.
Abstract: A detailed study of the effects of forward flexion in the spine on back shape is reported. ISIS and the Scoliometer were used to record angle of trunk inclinations (ATIs) in 13 patients with idiopathic scoliosis. Two standard positions were used: standing erect (for ISIS) and sitting forward bending (for the Scoliometer). In the lumbar region, a positional change in ATI between standing erect and sitting forward is revealed; it is related to the type and side of mainly compensatory spinal curves. It does not correlate with Cobb angle but it does correlate with each of spinous process rotation (Bunnell) and pedicular rotation (Perdriolle). In the thoracic region, the change from a standing-erect to a sitting-forward-bending position, in contrast, shows a statistically significant reduction of the hump on the convexity of the spinal curve. The findings have relevance to screening tests for scoliosis.
36 citations
TL;DR: A retrospective study was conducted in 122 patients with idiopathic scoliosis who were followed for more than 2 years, and only those who did not receive any treatment or who failed to comply with brace treatment were selected to eliminate the effect of treatment.
Abstract: A retrospective study was conducted in 122 patients with idiopathic scoliosis who were followed for more than 2 years. There were 58 patients who showed 5 degrees (Cobb) or more progression, and 41 patients who showed no progression. Only those who did not receive any treatment or who failed to comply with brace treatment were selected, to eliminate the effect of treatment. In the early phase of the study, 12 parameters were put into a multivariate analysis to observe the relative weight of each of them, which led the authors to eliminate the following five parameters: 1) Cobb angle, 2) rotation of the apical vertebra, 3) deviation of the apical vertebra, 4) Risser's expected correction: (standing angle--supine angle) X 3, and 5) maturation index of the iliac apophysis. Through a multiple regression analysis, an equation was obtained to correlate the predictive and the real progression within 10 degrees deviation.
30 citations
TL;DR: It is suggested that low FVC values in patients with mild‐to‐moderate idiopathic scoliosis can be attributed to the rib cage deformity rather than to an inability to generate adequate inspiratory pressures.
Abstract: Lung function and maximal respiratory pressures of 24 adolescent females with mild-to-moderate idiopathic scoliosis (spinal curvature 10-60 degrees) were determined and compared with 38 age- and sex-matched controls. Twelve patients with moderate scoliosis (Cobb angle 35-60 degrees) had significantly reduced mean values for FVC (% predicted) and maximal inspiratory pressure (MIP), as compared to the controls. Twelve patients with mild scoliosis (Cobb angle less than 35 degrees) had normal mean values for FVC and maximal respiratory pressures, but five individual patients had FVC values less than 80% predicted. All but one of the patients with mild scoliosis had normal MIP values. FVC (% predicted) was significantly correlated with the degree of spinal curvature (r = -0.466; P less than 0.05) but was not related to MIP. These results indicate that reduced FVC values do occur in patients with mild-to-moderate idiopathic scoliosis and suggest that these low FVC values can be attributed to the rib cage deformity rather than to an inability to generate adequate inspiratory pressures.
29 citations
TL;DR: The Cobb measurement of scoliosis is the most precise for detecting small changes, but can be improved by a computerized analysis of digitized radiographs.
Abstract: Thirty-five untreated patients with scoliosis were studied by Cobb radiography and back-surface photogrammetry on each of at least two clinic visits. Also, the maximum vertebral axial rotation was measured. Each pair of patient visits was classified as showing either a progression, improvement, or no change in the scoliosis using a threshold of 5 degrees change in the Cobb angle. The computer Cobb measurement was the most precise measurement, and the back-surface measurements were the least precise. The Cobb measurement of scoliosis is the most precise for detecting small changes, but can be improved by a computerized analysis of digitized radiographs.
24 citations
TL;DR: In the opinion the photofluorography method is particularly well-suited for follow-up and screening evaluation of scoliosis, but in tall patients the image field size restricts its usefulness as initial examination.
Abstract: Photofluorography using a large-field image intensifier (Siemens Optilux 57) was applied to scoliosis radiography and compared with a full-size rare-earth screen/film technique. When scoliosis radiography (PA-projection) was performed on 25 adolescent patients, the photofluorographs were found to be of comparable diagnostic quality with full-size films. A close correspondence between the imaging techniques was found in the Cobb angle measurements as well as in the grading of rotation with the pedicle method. The use of photofluorography results in a radiation dose reduction of about one-half and considerable savings in direct imaging costs and archive space. In our opinion the method is particularly well-suited for follow-up and screening evaluation of scoliosis, but in tall patients the image field size of 40 x 40 cm restricts its usefulness as initial examination.
01 Jan 1988
TL;DR: A 23-year-old woman with idiopathic scoliosis was admitted for Harrington rod instrumentation.
Abstract: A 23-year-old woman with idiopathic scoliosis was admitted for Harrington rod instrumentation. The diagnosis of scoliosis was made when she was 13 years old, at which time the curvature was between 20 and 30°. She was initially treated conservatively with application of a Milwaukee brace, which was used for 5 years. The curvature increased, and at time of admission measured 62°.