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Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal...
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Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 6684

Special Issue Editors

Dr. Theodoros B. Grivas

E-Mail Website
Guest Editor
Former Head of the Department of Orthopaedics and Traumatology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece
Interests: spinal deformity; idiopathic scoliosis; diagnosis; school screening; bracing; physiotheraputic specific scoliosis exercises (PSSE); growth modulation; operative treatment
Special Issues, Collections and Topics in MDPI journals
Dr. Elias Vasiliadis

E-Mail Website
Guest Editor
3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, 14561 Athens, Greece
Interests: orthopedics; epidemiology; public health; trauma
Dr. Angelos Kaspiris

E-Mail Website
Guest Editor
Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, 10679 Athens, Greece
Interests: bone and cartilage; osteoporosis; osteoarthritis; scoliosis; bone metabolism; molecular pathways in orthopaedics; fractures; knee arthroplasty

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled "Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II". This is a new volume; 22 papers were published in the first volume. For more details, please visit: https://www.mdpi.com/journal/jcm/special_issues/scoliosis_spinal_disorders

Scoliosis, a 3-D deformity of the spine and the thorax, mainly affects children, who are the future of any society. The medical societies that specialize in this ailment have recently intensely focused on the study of the epidemiology; etiology; pathobiomechanics; and laboratory, clinical and imaging documentation and treatment, either non-operative or operative. The advent of new technologies is key in the study and advancement of our insight into this disease, with the aim of improving the quality of life of this sensitive group of people. The ultimate goal is to diminish or even eliminate the disease.

It is interesting to note the impressive developments in the implementation of growth modulation for the surgical treatment of early-onset scoliosis. These developments have led to better patient quality of life compared to experiences in the past. However, this topic is still under development, and new instrumentation systems are being introduced.

When proper management is not implemented, spinal disorders may lead to significant social problems and enormous economic losses. Therefore, treatment decisions based on the recent evidence-based literature will result in the optimum outcome. Proper management, including prevention and non-operative or operative treatment, must be tailored and implemented.

Therefore, it is very important to increase awareness and advocacy for a social mission regarding the early detection of scoliosis and the prevention of progressive spinal deformity. It is imperative to raise awareness about scoliosis and to inform the public, healthcare and policy-making communities about the individual, familial and societal burdens of spinal deformity, as well as the benefits of proper detection, diagnosis and optimal care for all patients.

This Special Issue and its series of submitted papers aim to serve the above-mentioned objectives.

Dr. Theodoros B. Grivas
Dr. Elias Vasiliadis
Dr. Angelos Kaspiris
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • spinal deformities
  • idiopathic scoliosis
  • etiology
  • pathobiomechanics
  • pathogenesis
  • diagnosis
  • school screening
  • physiotheraputic scoliosis-specific exercises (PSSEs)
  • bracing
  • surgical treatment
  • growth modulation

Related Special Issue

Published Papers (6 papers)

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Research

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14 pages, 836 KiB  
Article
The Effectiveness of Early Rehabilitation in Limiting the Progression of Idiopathic Scoliosis
by Marek Kluszczyński, Katarzyna Zaborowska-Sapeta, Ireneusz Kowalski and Ilona Karpiel
J. Clin. Med. 2024, 13(5), 1422; https://doi.org/10.3390/jcm13051422 - 29 Feb 2024
Viewed by 648
Abstract
Background: The purpose of this study was to assess specific rehabilitation methods’ effectiveness in early idiopathic scoliosis (IS) development, focusing on lower limb functional inequality’s role in scoliosis progression. Materials and Methods: This study comprised 812 patients aged 6–16 years at risk [...] Read more.
Background: The purpose of this study was to assess specific rehabilitation methods’ effectiveness in early idiopathic scoliosis (IS) development, focusing on lower limb functional inequality’s role in scoliosis progression. Materials and Methods: This study comprised 812 patients aged 6–16 years at risk of developing idiopathic scoliosis (IS). The mean (SD) age was 10.66 (3.16) years. Patients were categorized into high- and medium-risk groups based on the angle of trunk rotation (ATR) size. Specific scoliosis physiotherapy was used, and the average follow-up period was 28.1 ± 14.5 months. Changes in ATR, Cobb angle, and functional length of the lower limbs pre- and post-treatment were statistically analyzed across three age groups (6–9, 10–12, and 13–16 years) and three scoliosis locations. Results: Significant effectiveness of early rehabilitation was observed in the high-risk group of children aged 6–9 years. In the medium-risk group, significant reductions in ATR were observed in both the 6–9 and 10–12 age groups across all three scoliosis locations. Additionally, there was a significant decrease in the Cobb angle in the thoracolumbar region and a significant reduction in lower limb inequality across all age groups and scoliosis locations. Conclusions: The early implementation of specific physiotherapy may enhance the efficacy of idiopathic scoliosis treatment by attenuating factors contributing to its progression. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
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10 pages, 724 KiB  
Article
Clinical Outcomes of 111 Patients with Early Onset Idiopathic Scoliosis (EOIS) Receiving Brace Treatment: A Longitudinal Retrospective Cohort Study
by Rufina Wing-Lum Lau, Alec Lik-Hang Hung, Ho-Man Kee, Leo Chung-Hei Wong, Victor Kin-Wai Chan, Derek Wai-Yin Chung, Jerry Kwok-To Chan, Bosco Kin-Pok Chau, Stanley Ho-Fung Leung, Jack Chun-Yiu Cheng, Tsz-Ping Lam and Adam Yiu-Chung Lau
J. Clin. Med. 2024, 13(3), 767; https://doi.org/10.3390/jcm13030767 - 29 Jan 2024
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Abstract
Introduction: Bracing is one of the first-line treatment for early-onset idiopathic scoliosis (EOIS) to control curves from progression. This study aimed to explore the determinants that govern bracing effectiveness in EOIS. Methods: One hundred and eleven patients with EOIS (mean age [...] Read more.
Introduction: Bracing is one of the first-line treatment for early-onset idiopathic scoliosis (EOIS) to control curves from progression. This study aimed to explore the determinants that govern bracing effectiveness in EOIS. Methods: One hundred and eleven patients with EOIS (mean age of 8.6 ± 1.25 at diagnosis) received bracing treatment and had a final follow-up beyond skeletal maturity were identified from records between 1988 and 2021. Demographic data and clinical features of spinal curvature were obtained for correlation analyses to determine the associations between curve outcomes and clinical features. Results: Most patients were female (85.6%) and had a major curve on the left side (67%). The mean baseline Cobb angle of major curves was 21.73 ± 7.92°, with a mean Cobb angle progression of 18.05 ± 19.11°. The average bracing duration was 5.3 ± 1.9 years. Only 26 (23.4%) of them underwent surgery. The final Cobb angle and curve progression at the final follow-up with a Cobb angle of ≥50° were positively correlated with the initial Cobb angle (r = 0.206 and r = 0.313, respectively) and negatively correlated with maturity parameters. The lumbar curve type was found to correlate with a smaller final Cobb angle. Conclusions: The majority of patients had a final Cobb angle < 50°, which was considered a successful bracing outcome. The final Cobb angle correlated with the initial Cobb angle and curve types observed in EOIS. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
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12 pages, 255 KiB  
Article
Menarche in Scoliotic and Non-Scoliotic Balkan Girls and the Relationship between Menarche and the Laterality of Scoliotic Curves
by Samra Pjanic, Nikola Jevtic and Theodoros B. Grivas
J. Clin. Med. 2024, 13(1), 132; https://doi.org/10.3390/jcm13010132 - 26 Dec 2023
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Abstract
Background: Menarche, as an important parameter in the assessment of scoliosis progression in girls, is proven to be dependent on geographical latitude. The aim of this study was to determine whether the age of menarche differs in scoliotic and non-scoliotic Balkan girls and [...] Read more.
Background: Menarche, as an important parameter in the assessment of scoliosis progression in girls, is proven to be dependent on geographical latitude. The aim of this study was to determine whether the age of menarche differs in scoliotic and non-scoliotic Balkan girls and the relationship between menarche and the laterality of scoliotic curves. Participants and Methods: This is a retrospective study with three groups: scoliotic, non-scoliotic, and control. Patient data collection and analysis were approved by the Ethical Committee of the Institute. Statistical Analysis: The SPSS 24 program was used, and we employed One-way ANOVA, Fisher’s, and Chi-squared tests to compare different groups. Statistical significance was defined as p < 0.05. Results: No statistically significant difference was found in the age of menarche between the three groups (p = 0.168). In the scoliotic postmenarchal group, the primary right curve was dominant in 54.80%, while in the scoliotic premenarchal group, the primary left curve was dominant in 60.09% (p < 0.01). Conclusion: In Balkan girls from Bosnia and Herzegovina and Serbia, there was no significant difference in the age of menarche between scoliotic and non-scoliotic girls. A significant difference was found in the laterality of the primary curve in premenarchal and postmenarchal scoliotic girls. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
13 pages, 2026 KiB  
Article
Reciprocal Change of Cervical Spine after Posterior Spinal Fusion for Lenke Type 1 and 2 Adolescent Idiopathic Scoliosis
by Kanji Mori, Jun Takahashi, Hiroki Oba, Tetsuhiko Mimura and Shinji Imai
J. Clin. Med. 2023, 12(17), 5599; https://doi.org/10.3390/jcm12175599 - 28 Aug 2023
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Abstract
Reciprocal sagittal alignment changes after adolescent idiopathic scoliosis (AIS) posterior corrective surgery have been reported in the cervical spine, but the evidence is not yet sufficient. Furthermore, much remains unknown about the effects of cervical kyphosis on clinical outcomes in AIS. Forty-five consecutive [...] Read more.
Reciprocal sagittal alignment changes after adolescent idiopathic scoliosis (AIS) posterior corrective surgery have been reported in the cervical spine, but the evidence is not yet sufficient. Furthermore, much remains unknown about the effects of cervical kyphosis on clinical outcomes in AIS. Forty-five consecutive patients (4 males and 41 females) with AIS and Lenke type 1 or 2 curves underwent a posterior spinal fusion, and a minimum of 24-month follow-up was collected from our prospective database. We investigated radiographic parameters and SRS-22r. Before surgery, cervical kyphosis (cervical lordosis < 0°) was present in 89% and cervical hyperkyphosis (cervical lordosis < −10°) in 60%. There were no significant differences in age, sex, or Lenke type between the hyperkyphosis and the non-hyperkyphosis groups. Although cervical lordosis increased significantly after surgery, cervical kyphosis was observed in 73% of patients 2 years after surgery. We found a significant correlation between Δthoracic kyphosis (TK) and Δcervical lordosis. Preoperative cervical kyphosis, ΔT1 slope, and ΔTK were independently associated factors for postoperative cervical hyperkyphosis. The cervical hyperkyphosis group had significantly lower SRS-22r domains. In AIS corrective surgery, restoring TK leading to a gain of T1 slope may lead to an improvement of cervical sagittal alignment. Remaining cervical hyperkyphosis after AIS surgery may affect clinical outcomes. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
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Review

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15 pages, 1375 KiB  
Review
The Role of Muscle Biomarkers in Adolescent Idiopathic Scoliosis
by Federico Roggio, Bruno Trovato, Martina Sortino, Maria Pia Onesta, Luca Petrigna and Giuseppe Musumeci
J. Clin. Med. 2023, 12(24), 7616; https://doi.org/10.3390/jcm12247616 - 11 Dec 2023
Cited by 1 | Viewed by 1632
Abstract
Adolescent idiopathic scoliosis (AIS) is the predominant orthopedic disorder in children, affecting 1–3% of the global population. Research in this field has tried to delineate the genetic factors behind scoliosis and its association with heredity since AIS is considered a polygenic disease and [...] Read more.
Adolescent idiopathic scoliosis (AIS) is the predominant orthopedic disorder in children, affecting 1–3% of the global population. Research in this field has tried to delineate the genetic factors behind scoliosis and its association with heredity since AIS is considered a polygenic disease and has different genetic and epigenetic factors. The current study conducted a narrative review of the literature, focusing on biomarkers in the pathophysiology of muscle in AIS patients. Articles were collected from Scopus, Pubmed, and Web of Science. The key screening parameters were scoliosis classification, sampling, and the biomarkers evaluated. This review emphasizes potential key mechanisms and molecular regulators in muscle tissue. While there has been limited focus on the proteins contributing to muscle changes in AIS, significant attention has been given to genomic studies of single-nucleotide polymorphisms, particularly in LBX1. Despite these efforts, the exact causes of AIS remain elusive, with several theories suggesting genetic and hormonal factors. This review identified critical protein biomarkers such as Gi-protein alpha subunits, fibrillin-1 and -2, and various differentially expressed proteins, which may be linked to muscle alterations in AIS. This field of research is still limited due to a lack of homogeneity in the distinction of patients by groups and curve severity. Although the pathophysiology of AIS is still unclear, molecular research is important to guide the treatment of AIS before achieving skeletal maturity, thus avoiding serious problems associated with posture changes and low quality of life. In the future, a more comprehensive synergy between orthopedic and molecular research might ameliorate the diagnosis and treatment of AIS patients. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
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Other

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10 pages, 1445 KiB  
Brief Report
Direct Vertebral Rotation (DVR) Does Not Improve Clinical and Radiological Results Compared to Differential Rod Contouring (DRC) in Patients Treated Surgically for Idiopathic Scoliosis
by Wiktor Urbanski, Piotr Markowski, Rafal Zaluski, Anis Kokaveshi and Piotr Morasiewicz
J. Clin. Med. 2023, 12(12), 4091; https://doi.org/10.3390/jcm12124091 - 16 Jun 2023
Cited by 1 | Viewed by 1391
Abstract
Direct vertebral rotation (DVR) is the most widespread method to correct axial vertebral rotation. Differential rod contouring (DRC) also includes derotation, but not to the same extent as DVR. DVR requires additional surgical effort with potential consequences, which are absent in DRC; moreover, [...] Read more.
Direct vertebral rotation (DVR) is the most widespread method to correct axial vertebral rotation. Differential rod contouring (DRC) also includes derotation, but not to the same extent as DVR. DVR requires additional surgical effort with potential consequences, which are absent in DRC; moreover, the data concerning the clinical benefits of apical derotation are not convincing. In the present study, clinical and radiological outcomes were compared in patients who underwent surgery for adolescent idiopathic scoliosis (AIS), having DVR and DRC vs. DRC only. In total, 73 AIS patients with curves of 40–85°, consecutively operated on by one surgeon, participated in this study and were followed up over 2 years. Scores from the SRS-22 questionnaire were analysed, the angles of trunk rotation (ATR) were measured with an inclinometer and a radiographic assessment of coronal and sagittal spinal profiles was conducted. In 38 cases, only DRC was performed, and in 35 DRC was performed and followed by DVR; the groups did not differ from an epidemiological point of view. Total SRS-22 scores after 2 years were similar in both groups (4.23 (±0.33) in DRC vs. 4.06 (±0.33) in DRC/DVR, p = 0.1). In all components of SRS-22, the differences were minor, with p being way above 0.05. The mean ATR in the DRC/DVR group was slightly smaller (8 ± 4°) than that of the DRC group (10 ± 5°), p = 0.16. Radiographic analysis did not show significant differences. The coronal curve was corrected by 66 ± 12% for DRC and 63 ± 15% for DVR, p = 0.28. Thoracic kyphosis in the DRC/DVR group increased by 1°, whereas in the DRC group the average kyphosis increased by 5° with a p value of 0.07. The complication rates were similar in both groups. This investigation did not show any advantages of the combination of DRC and DVR in scoliosis correction over DRC only, both radiologically and clinically, yet it affected intraoperative parameters, extending the operation time with only a minor increase in blood loss. Full article
(This article belongs to the Special Issue Advances in Scoliogeny, Diagnosis and Management of Scoliosis and Spinal Disorders: Part II)
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