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3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis
BACKGROUND: Scoliotic braces are the standard of curve for management of moderate spinal deformities in pediatric patients. The effectiveness of this treatment method has been shown; however, the spinal and rib cage parameters, in the three anatomical planes, that are associated with bracing outcome...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706918/ https://www.ncbi.nlm.nih.gov/pubmed/31438927 http://dx.doi.org/10.1186/s12891-019-2754-2 |
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author | Pasha, Saba |
author_facet | Pasha, Saba |
author_sort | Pasha, Saba |
collection | PubMed |
description | BACKGROUND: Scoliotic braces are the standard of curve for management of moderate spinal deformities in pediatric patients. The effectiveness of this treatment method has been shown; however, the spinal and rib cage parameters, in the three anatomical planes, that are associated with bracing outcome in adolescent idiopathic scoliosis (AIS) are not fully identified. METHODS: A total number of 45 right thoracic AIS patients who had received a thoraco-lumbo-scaral brace for the first time were included retrospectively. For each patient, radiographic images at three visits, pre-brace, in-brace, and at least 1 year after the first brace fit were included. Age, sex, Risser sign, and curve type at pre-brace, and thoracic and lumbar frontal and sagittal Cobb angles, thoracic and lumbar apical rotations, sagittal and frontal balances at pre-brace and in-brace were determined. Two sagittal curve types (hypothoracolumbar and normal/hyperthoracolumbar kyphosis), two rib cage types based on the costovertebral joints (drooping and horizontal), and two axial shapes of the spine (S shaped and V shaped) were used to stratify the patients. Feature selection and linear regression with regularization determined the parameters and the interaction terms that predicted the brace effectiveness significantly. RESULTS: Smaller in-brace thoracic Cobb and larger in-brace lordosis predicted brace effectiveness, p < 0.05. Impact of the out of brace lordosis on the brace success increased as the in brace kyphosis angle decreased, p = 0.046. A larger out of brace lordosis in hypothoracolumbar sagittal profile type patients improved the outcomes, p = 0.031. A smaller out of brace thoracic rotation improved the bracing outcomes in patients with horizontal ribs, p = 0.040. CONCLUSION: Both 3D patient specific parameters (lordosis, thoracic rotation, shape of the rib cage, and sagittal profile) and brace design (which allows larger in brace lordosis, better in brace Cobb correction) are important predictors of the brace effectiveness in AIS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2754-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6706918 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67069182019-08-28 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis Pasha, Saba BMC Musculoskelet Disord Research Article BACKGROUND: Scoliotic braces are the standard of curve for management of moderate spinal deformities in pediatric patients. The effectiveness of this treatment method has been shown; however, the spinal and rib cage parameters, in the three anatomical planes, that are associated with bracing outcome in adolescent idiopathic scoliosis (AIS) are not fully identified. METHODS: A total number of 45 right thoracic AIS patients who had received a thoraco-lumbo-scaral brace for the first time were included retrospectively. For each patient, radiographic images at three visits, pre-brace, in-brace, and at least 1 year after the first brace fit were included. Age, sex, Risser sign, and curve type at pre-brace, and thoracic and lumbar frontal and sagittal Cobb angles, thoracic and lumbar apical rotations, sagittal and frontal balances at pre-brace and in-brace were determined. Two sagittal curve types (hypothoracolumbar and normal/hyperthoracolumbar kyphosis), two rib cage types based on the costovertebral joints (drooping and horizontal), and two axial shapes of the spine (S shaped and V shaped) were used to stratify the patients. Feature selection and linear regression with regularization determined the parameters and the interaction terms that predicted the brace effectiveness significantly. RESULTS: Smaller in-brace thoracic Cobb and larger in-brace lordosis predicted brace effectiveness, p < 0.05. Impact of the out of brace lordosis on the brace success increased as the in brace kyphosis angle decreased, p = 0.046. A larger out of brace lordosis in hypothoracolumbar sagittal profile type patients improved the outcomes, p = 0.031. A smaller out of brace thoracic rotation improved the bracing outcomes in patients with horizontal ribs, p = 0.040. CONCLUSION: Both 3D patient specific parameters (lordosis, thoracic rotation, shape of the rib cage, and sagittal profile) and brace design (which allows larger in brace lordosis, better in brace Cobb correction) are important predictors of the brace effectiveness in AIS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-019-2754-2) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-22 /pmc/articles/PMC6706918/ /pubmed/31438927 http://dx.doi.org/10.1186/s12891-019-2754-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Pasha, Saba 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title | 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title_full | 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title_fullStr | 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title_full_unstemmed | 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title_short | 3D spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
title_sort | 3d spinal and rib cage predictors of brace effectiveness in adolescent idiopathic scoliosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706918/ https://www.ncbi.nlm.nih.gov/pubmed/31438927 http://dx.doi.org/10.1186/s12891-019-2754-2 |
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