Substantial advances in the treatment of early onset scoliosis (EOS) over the past two to three decades have resulted in significant improvements in health-related quality of life of affected children. In addition to classifications that address the marked heterogeneity of this patient population, increasing understanding of the natural history of the disease, and new implants and treatment techniques have resulted in innovations unlike any other area of pediatric orthopedics. The growing understanding of the interaction between spinal and thoracic growth, as well as dependent lung maturation, has had a lasting impact on the treatment strategy of this potentially life-threatening disease.
View Article and Find Full Text PDFIntroduction: Chronic postsurgical pain (CPSP) is defined as pain that persists after a surgical procedure and has a significant impact on quality of life. Previous studies show the importance of psychological factors in CPSP, yet the majority of studies focused solely on negative emotions. This longitudinal observational study aims to broaden this knowledge base by examining the role of emotional state, emotion variability, emotion regulation and emotion differentiation on the child and the parent level for the development CPSP, and to describe pain and emotion-related trajectories following surgery.
View Article and Find Full Text PDFJ Biomech
February 2024
Whole-body lifting strategies could be derived from conventional video recordings using the Stoop-Squat-Index, which quantifies the ratio between trunk forward lean and lower extremity joint flexion from 0 (full squat) to 100 (full stoop). The purpose of this study was to compare Stoop-Squat-Indices derived from conventional video recordings to those from a three-dimensional marker-based motion capture system and to evaluate interrater and intrarater reliability of the video-based approach. Thirty healthy participants lifted a 5-kg box under different conditions (freestyle, squat, stoop).
View Article and Find Full Text PDFMusculoskeletal (MSK) models offer great potential for predicting the muscle forces required to inform more detailed simulations of vertebral endplate loading in adolescent idiopathic scoliosis (AIS). In this work, simulations based on static optimization were compared with in vivo measurements in two AIS patients to determine whether computational approaches alone are sufficient for accurate prediction of paraspinal muscle activity during functional activities. We used biplanar radiographs and marker-based motion capture, ground reaction force, and electromyography (EMG) data from two patients with mild and moderate thoracolumbar AIS (Cobb angles: 21° and 45°, respectively) during standing while holding two weights in front (reference position), walking, running, and object lifting.
View Article and Find Full Text PDFVirtual reality (VR), coupled with motion tracking, can investigate walking in a controlled setting while applying various walking challenges. The purpose of this review was to summarize the evidence on consequences of VR on biomechanical gait parameters in children with cerebral palsy. MEDLINE, Embase and Web of Science were searched.
View Article and Find Full Text PDFBackground: The T1-S1 distance to evaluate spinal length is traditionally measured as a straight line on an anteroposterior radiograph. However, this method may not reflect the true 3-dimensional (3D) spinal length. The objective of the study was to evaluate the difference between the traditional T1-S1 measurement and a 3D reconstruction from standard x-ray imaging.
View Article and Find Full Text PDFStudy Design: A multicenter retrospective review of consecutive series of patients.
Objective: Long-term experience with using the magnetically controlled growing rods (MCGR) to treat patients with deformity in the growing spine to the conclusion of treatment with posterior spine fusion.
Summary Of Background Data: MCGR treatment for growing spine gained popularity with paucity of long-term follow up data.
The vertical expandable prosthetic titanium rib (VEPTR) device was originally developed for the treatment of thoracic insufficiency syndrome with the aim of improving respiratory function of affected patients. Although clinically obvious, the changes in pulmonary function of VEPTR-treated patients are difficult to assess when using common lung function tests, and newer techniques based on functional magnetic resonance imaging (MRI) are currently being evaluated. The potential of improving lung function and simultaneously controlling the spinal deformity has continuously broadened the spectrum of indications for VEPTR, not least due to the frequent reports of complications with spine-based traditional growing rods (tGR).
View Article and Find Full Text PDFBackground: Structural leg length discrepancy (LLD) is a common phenomenon. However, its effect on spinal gait kinematics remains unclear.
Research Question: How does LLD affect spinal gait kinematics in patients with structural LLD and what is the immediate effect of a shoe lift?.
Background And Objective: The aim of this study was to validate a new program which aims at measuring the three-dimensional length of the spine's midline based on two calibrated orthogonal radiographic images. The traditional uniplanar T1-S1 measurement method is not reflecting the actual three dimensional curvature of a scoliotic spine and is therefore not accurate. The Spinal Measurement Software (SMS) is an alternative to conveniently measure the true spine's length.
View Article and Find Full Text PDFBackground And Purpose: The pathogenesis of adolescent idiopathic scoliosis (AIS) remains poorly understood. Previous research has indicated possible relationships between kinematics of the spine, pelvis and lower extremities during gait and the progression of AIS, but adequate evidence on spinal kinematics is lacking. The aim of this study was to provide a detailed assessment of spinal gait kinematics in AIS patients compared to asymptomatic controls.
View Article and Find Full Text PDFBackground And Purpose: Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated.
View Article and Find Full Text PDFPurpose: Historically, severe spinal and thoracic deformities in children were treated with early long spinal fusions. This prevented further growth of the spine and thorax and often led to small stiff thoraces. Therefore, growth-retaining implants, like vertical expandable titanium ribs (VEPTR), were developed to stimulate thoracic and spinal growth.
View Article and Find Full Text PDFEthylene oxide (EO) is a highly reactive gas widely used for sterilization of medical devices, for example, plastic materials and ventriculoperitoneal shunts. Allergic reactions to EO are rare and have been observed mainly in patients during hemodialysis and myelomeningocele patients. We describe severe anaphylaxis to EO in a patient with myelomeningocele during general anesthesia.
View Article and Find Full Text PDFIn spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.
View Article and Find Full Text PDFAnnu Int Conf IEEE Eng Med Biol Soc
March 2011
Statistical shape models (SSMs) have been used widely as a basis for segmenting and interpreting complex anatomical structures. The robustness of these models are sensitive to the registration procedures, i.e.
View Article and Find Full Text PDFKnowledge about segmental flexibility in adolescent idiopathic scoliosis is crucial for a better biomechanical understanding, particularly for the development of fusionless, growth-guiding techniques. Currently, there is lack of data in this field. The objective of this study was, therefore, to compute segmental flexibility indices (standing angle minus corrected angle/standing angle).
View Article and Find Full Text PDFThis retrospective study analyses 23 children treated with vertical expandable prosthetic titanium rib (VEPTR) for correction of non-congenital early onset spine deformities. After the index procedure (IP), the device was lengthened at 6-month intervals. The average (av) age at the time of IP was 6.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2002
Despite a standardized operative technique and appropriate patient selection for physeal bar resection, a bar size less than 50% of the physis, and a prospective growth period greater than 2 years, failure may result. Limited growth because of poor function of the remaining physis and secondary tethers (incomplete resection or recurrence of the bar) may prevent reestablishment of growth or lead to its premature cessation. The current study investigated patients with insufficient restoration of growth by means of magnetic resonance imaging or computed tomography or both.
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