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1.
Stud Health Technol Inform ; 140: 33-6, 2008.
Article in English | MEDLINE | ID: mdl-18809995

ABSTRACT

Wedging of the scoliotic inter-vertebral disc (IVD) was previously reported as a contributory factor for progression of idiopathic scoliotic (IS) curves. The present study introduces a theoretical model of IVD's role in IS pathogenesis and examines if, by reversing IVD wedging with conservative treatment (full- and night-time braces and exercises) or fusionless IS surgery with staples, we can correct the deformity of the immature spine. The proposed model implies the role of the diurnal variation and the asymmetric water distribution in the scoliotic IVD and the subsequent alteration of the mechanical environment of the adjacent vertebral growth plates. Modulation of the IVD by applying corrective forces on the scoliotic curve restores a close-to-normal force application on the vertebral growth plates through the Hueter-Volkmann principle and consequently prevents curve progression. The forces are now transmitted evenly to the growth plate and increase the rate of proliferation of chondrocytes at the corrected pressure side, the concave. Application of appropriately directed forces, ideally opposite to the apex of the deformity, likely leads to optimal correction. The wedging of the elastic IVD in the immature scoliotic spine could be reversed by application of corrective forces on it. Reversal of IVD wedging is thus amended into a "corrective", rather than "progressive", factor of the deformity. Through the proposed model, treatment of progressive IS with braces, exercises and fusionless surgery by anterior stapling could be effective.


Subject(s)
Intervertebral Disc/pathology , Scoliosis/pathology , Humans , Intervertebral Disc/physiopathology , Intervertebral Disc/surgery , Models, Theoretical , Orthopedic Procedures/instrumentation , Scoliosis/physiopathology , Scoliosis/surgery , Spinal Fusion
2.
Stud Health Technol Inform ; 140: 240-4, 2008.
Article in English | MEDLINE | ID: mdl-18810030

ABSTRACT

The value of school screening as a research tool for Idiopathic Scoliosis (IS) aetiology has not been recognized adequately in the literature. The aim of the present study is to summarize the contribution of school screening in research of IS aetiology. All the relative publications about research of IS aetiology which originated from our scoliosis school screening program were analyzed. Information is provided about a) the influence of environmental factors in IS prevalence, b) the IS prevalence in girls with visual deficiency, c) the role of melatonin in IS pathogenesis, d) the age at menarche in IS girls and its relation to laterality of the curve, e) the role of the brain in trunk asymmetry and IS pathogenesis, f) the role of the thoracic cage in IS pathogenesis, g) the impact of the lateral spinal profile, h) the role of the intervertebral discs in IS pathogenesis, i) the association of cavus foot with IS and j) anthropometric data in IS patients. The present study provides evidence to support that school screening programs should be continued not only for early detection of IS or for health care purposes, but also as a basis for epidemiological surveys until we learn much more about the aetiology of IS.


Subject(s)
School Health Services , Schools , Scoliosis/diagnosis , Students , Adolescent , Age Factors , Anthropometry , Female , Humans , Melatonin , Menarche , Posture , Scoliosis/physiopathology , Time Factors
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