A Practical Study of Diagnostic Accuracy: Scoliosis Screenings of Middle School Students by a Trained Nurse With a Smartphone Versus a Spine Surgeon With a Scoliometer

This study aimed to assess the accuracy of smartphone-aided diagnosis of scoliosis by a trained nurse compared with scoliometer-based diagnosis by a spine surgeon. Summary of Background Data. Many assessments have been developed to estimate the reliability of smartphone-aided measurements in diagnosing scoliosis. However, clinical studies assessing the accuracy of smartphone-aided diagnosis with radiographs or scoliometers are scarce. Methods. A total of 2702 grade 7 students (mean age 13.56 yrs, range 13–15) at 10 middle schools were first screened with a smartphone by a trained nurse from the orthopedics department. Approximately half a year later, most of the students underwent a chest x-ray examination as part of a compulsory medical examination. Students with suspicious findings in either the first screen or the chest x-ray were recommended to a scoliosis clinic for single-blind tests, such as a forward bending test (FBT) and an analysis of the angle of trunk rotation (ATR) with a scoliometer, performed by an experienced spine surgeon. Finally, the Cobb method was conducted with full-spine radiographs to serve as the gold standard. Results. The agreement between the first screening by the nurse and the second test by the spine surgeon was low in cases with a Cobb angle 10° (κā€Š=ā€Š0.349 [0.19–0.50], Pā€Š
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

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ConclusionsProximal fusion carries the risk of adding-on, but leaving unfused segments in the lower spine increases the potential for compensatory mechanisms to improve spinal and truncal balance. In mature patients with a flexible MT curve, surgeons may consider fusion at or cranial to the LTV.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS: A high index of suspicion is needed to diagnose sacral insufficiency fracture after LS arthrodesis. A trial of conservative management is reasonable for select patients; potential surgical indications include refractory pain, neurological deficit, fracture nonunion with anterolisthesis or kyphotic angulation, L5-S1 pseudarthrosis, and spinopelvic malalignment. Lumbopelvic fixation with iliac screws may be effective salvage treatment to allow fracture healing and symptom improvement. High-risk patients may benefit from prophylactic lumbopelvic fixation at the time of index LS arthrodesis. PMID: 32217798 [P...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
AbstractPurposeTo investigate airway development and airway resistance by computed tomographic three-dimensional (3D) reconstruction of the bronchial tree in patients with adolescent idiopathic scoliosis (AIS). We evaluated factors predicting postoperative respiratory complications to provide timely treatment, prevent complications, and improve operative and anesthetic safety.MethodsFrom August 2015 to August 2017, 53 AIS patients with a mean age of 15.4  years (range 10–20 years) were included in this study. Scoliotic parameters on radiographs were analyzed. Airway resistance was obtained by pulmonary func...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Publication date: Available online 13 March 2020Source: Journal of Clinical NeuroscienceAuthor(s): Masaaki Machino, Noriaki Kawakami, Tetsuya Ohara, Toshiki Saito, Ryoji Tauchi, Shiro Imagama
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Background: Congenital scoliosis due to hemivertebra of the cervicodorsal spine is a rare disorder. It might be accompanied by impaired cosmetic appearances such as head tilt and trunk shift. Little is known about the effect of correction of the major curve on head tilt and trunk shift in children. The purpose of this study was to assess radiographic changes of head tilt and trunk shift following posterior hemivertebra resection (PHVR). Methods: Retrospectively, all children who underwent PHVR at the cervicodorsal spine (C6-Th6) with pedicle screw fixation with a minimum radiographic follow-up of 1 year were identifie...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Online Articles: Cervical Spine Source Type: research
Conclusions: The relationships between component tidal volumes and the spinal curve type are complex and are beyond intuitive reasoning and guessing. TLC has a much greater influence on restricting chest wall and diaphragm tidal volumes than MTC. Major curve angles are not indicative of passive resting volumes or tidal volumes. Level of Evidence: Level II—diagnostic.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research
ConclusionThis is the first study to provide the results of a direct comparison between Lenke 1 and Lenke 5 patients during gait. Curve location influenced coronal and sagittal balance, but abnormalities of transversal trunk motion were the same, wherever the curve was located.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
AbstractPurposeTo investigate whether the rotation of preoperative-presumed lowest instrumented vertebra (LIV) is a risk factor for adding-on (AO) in adolescent idiopathic scoliosis (AIS) treated with selective posterior thoracic fusion (sPTF).MethodsA total of 196 AIS patients of Lenke type 1A or 2A with minimum 2-year follow-up after sPTF with all pedicle screw instrumentation were included. Radiographical parameters were measured as follows: preoperative rotation angle of presumed LIV and LIV  + 1, LIV + 1/LIV rotation difference, postoperative rotation angle of LIV and LIV derotation angle o...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS: Numerous factors previously related to poor outcomes with surgery, such as low mental health, lower socioeconomic status, and high BMI, were not related to outcomes in ASLS in this exploratory analysis. Those patients with higher PI-LL mismatch did improve more with surgery than those with normal alignment. On average, none of the factors considered were associated with a worse outcome with operative treatment versus nonoperative treatment. These findings may guide future prospective analyses of factors related to outcomes in ASLS care. PMID: 32114531 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Conclusion. Dextrocardia shows increased incidence of AIS in both male and female patients. Left-sided thoracic curvature in cases with concurrent dextrocardia may not be associated with intra-spinal pathology as seen in the general population. These data suggest that thoracic organ orientation affects AIS convexity directionality. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
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