Journal articles on the topic 'Thoracic kyphosis'
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Dulaev, Aleksandr Kaisinovich, Konstantin Alekseyevich Nadulich, Sergey Viktorovich Vasilevich, and Andrey Vasilyevich Teremshonok. "SURGICAL APPROACH TO POSTTRAUMATIC THORACIC KYPHOTIC DEFORMITY." Hirurgiâ pozvonočnika, no. 2 (May 26, 2005): 020–29. http://dx.doi.org/10.14531/ss2005.2.20-29.
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Objective. To define the effective surgical management of posttraumatic kyphotic deformities in the thoracic spine basing on experimental biomechanical and clinical studies Material and Methods. Experimental biomechanical study was performed in 30 spine specimens. Anterior wedge osteotomy and fixation of a specimen in a kyphotic position modeled kyphotic deformity. Deformity correction with various instrumentation systems was firstly performed by maximal extension of segments adjacent to kyphosis-producing block, and carried on after crossing of intervertebral anatomical structures. Clinical study consisted in X-ray and instrumental examinations of 80 patients operated on for thoracic spine trauma. The magnitude of true posttraumatic deformity was defined as a difference between measured Cobb angle and mean physiological kyphosis value in the studied spine level. Results. Deformity rigidity, character of spine mobilization at the level of correction and size of posttraumatic deformity are the most significant factors determining the efficacy of thoracic posttraumatic kyphosis correction. The study resulted in defining rational approach to surgical correction of posttraumatic deformities in the thoracic spine. Conclusion. Minor kyphotic deformities in the thoracic spine are effectively corrected by instrumentation without mobilization of the spine. Large unfixed kyphosis sometimes requires anterior mobilization. Cases with rigid posttraumatic kyphotic deformity should be operated on with combined mobilization of the spine.
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Aizawa, Toshimi, Tetsuro Sato, Hiroshi Ozawa, Naoki Morozumi, Fujio Matsumoto, Hirotoshi Sasaki, Takeshi Hoshikawa, Chikashi Kawahara, Shoichi Kokubun, and Eiji Itoi. "Sagittal alignment changes after thoracic laminectomy in adults." Journal of Neurosurgery: Spine 8, no. 6 (June 2008): 510–16. http://dx.doi.org/10.3171/spi/2008/8/6/510.
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Object The increased kyphosis after thoracic laminectomy in adult patients was retrospectively evaluated and various factors affecting this spinal deformity were analyzed. Methods The authors conducted a retrospective study of 58 cases in which laminectomy was performed and more than half of the facet joints were left intact. The study group included 44 men (mean age 59 years) and 14 women (mean age 61 years) with thoracic myelopathy due to ossifications of the ligamentum flavum and/or the posterior longitudinal ligament or due to posterior bone spurs. Patients were followed up for a minimum of 2 years. Their neurological condition was evaluated using the Japanese Orthopaedic Association (JOA) scale (a full score is 11), and the magnitude of local kyphosis in the laminectomized area was determined using the Cobb angle method. Results The mean preoperative JOA score was 5.4; the mean postoperative score was 8.3. No relationship was found between postoperative JOA score and increased kyphotic angle. The mean preoperative kyphotic angle was 7.0°. The mean postoperative kyphotic angle was 10.8°. Thus local kyphosis in the treated area increased by only 3.8°. The mean increase in kyphosis per spinal segment, calculated by dividing the kyphotic angle of the surgically decompressed area by the number of resected laminae, was 1.9°. Female patients with ≥ 3-level laminectomies showed a significant increase of kyphosis in both the laminectomized area and each spinal segment. Conclusions The increase in kyphosis after thoracic laminectomy is not large and thus spinal fusion is usually not necessary. In cases involving female patients who undergo long-segment laminectomies, however, careful radiographic follow-up is recommended.
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Jung, Sung-hoon, Ui-jae Hwang, Sun-hee Ahn, Jun-hee Kim, and Oh-yun Kwon. "Effects of Manual Therapy and Mechanical Massage on Spinal Alignment, Extension Range of Motion, Back Extensor Electromyographic Activity, and Thoracic Extension Strength in Individuals with Thoracic Hyperkyphosis: A Randomized Controlled Trial." Evidence-Based Complementary and Alternative Medicine 2020 (November 23, 2020): 1–10. http://dx.doi.org/10.1155/2020/6526935.
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Background. Manual therapy has been recommended to reduce and prevent musculoskeletal problems related to thoracic hyperkyphosis. With recent rapid technological developments, manual techniques can now be implemented by mechanical devices; hence, mechanical massage can manipulate the back muscles and mobilize the spine. Purpose. Here, we aimed to 1) determine the effects of mechanical massage and manual therapy and 2) compare their effects on spinal posture, extension range of motion, trunk extensor electromyographic activity, and thoracic extension strength in individuals with thoracic hyperkyphosis. Methods. Participants with thoracic hyperkyphosis were randomly assigned to the manual therapy (n = 16) or mechanical massage (n = 19) group. Each intervention was applied for 8 weeks. The participants’ spinal posture, extension range of motion, trunk extensor electromyographic activity, and thoracic extension strength were measured before and after intervention. Results. Intergroup analyses revealed no significant differences in any variables. However, thoracic kyphosis angle, thoracic extension range of motion, longissimus thoracis electromyographic activity, iliocostalis lumborum pars lumborum activity, and thoracic extension strength differed significantly in intertime analyses. The results of paired t-test analysis showed that thoracic kyphosis angle, thoracic extension range of motion, longissimus thoracis electromyographic activity, and thoracic extension strength were significantly different after intervention in both groups p < 0.05 . Conclusions. Mechanical massage and manual therapy effectively improve thoracic kyphosis angle, thoracic extension range of motion, and thoracic extension strength. Therefore, mechanical massage is an alternative intervention to manual therapy for improving thoracic kyphosis angle, thoracic extension range of motion, and thoracic extension strength in participants with hyperkyphosis. This trail is registered with KCT0004527.
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Dimitrijevic, Vanja, Branka Protic-Gava, Tatjana Vinaji, and Nela Popovic. "Effects of corrective exercises on kyphotic angle reduction: A systematic review and meta-analysis." Medical review 74, no. 5-6 (2021): 167–73. http://dx.doi.org/10.2298/mpns2106167d.
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Introduction. Kyphosis is a deformity of the spine characterized by excessive backward curvature of the thoracic spine. The normal range of thoracic kyphosis in teenagers is 20 - 40 degrees, and the diagnosis of hyper-kyphosis is beyond 45 degrees. The aim of this review was to assess the magnitude of the effects of various corrective exercises on kyphotic angle reduction. Material and Methods. The Web of Science and PubMed were searched to retrieve relevant literature. Ten studies were included in our systematic review and meta-analysis. Results. The magnitude of the effects of corrective exercises on the kyphotic angle correction was estimated and the results showed a statistical significance in standardized mean difference (-0.504, P < 0.001). The analysis of the subgroups regarding the age showed a heterogeneity that was not statistically significant and the magnitude of the effects in different age groups. Conclusion. The results of our meta-analysis may be useful to many physiotherapists and clinicians in solving problems in patients with kyphosis and hyper-kyphosis.
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Zhang, Hao-Xuan, Xin Pan, Yong Hou, Lei Cheng, Yu-Hua Li, Meng Si, Shuai-Shuai Wang, and Lin Nie. "Severe thoracic kyphosis." Spine Journal 16, no. 1 (January 2016): e17-e18. http://dx.doi.org/10.1016/j.spinee.2015.08.012.
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Zeng, Yan, Zhongqiang Chen, Qiang Qi, Zhaoqing Guo, Weishi Li, Chuiguo Sun, and Andrew P. White. "Clinical and radiographic evaluation of posterior surgical correction for the treatment of moderate to severe post-tuberculosis kyphosis in 36 cases with a minimum 2-year follow-up." Journal of Neurosurgery: Spine 16, no. 4 (April 2012): 351–58. http://dx.doi.org/10.3171/2011.12.spine11568.
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Object The object of this study was to compare the clinical and radiographic outcomes of 36 patients with posttuberculosis kyphosis who underwent one of two types of osteotomy. Methods Each patient underwent single-stage correction via a posterior surgical approach. A modified pedicle subtraction osteotomy (mPSO) was performed when the kyphotic deformity was less than 70° (7 cases), whereas a posterior vertebral column resection (VCR) was performed when the kyphotic deformity exceeded 70° (29 cases). Full-length standing radiographs were obtained before surgery and at follow-up visits. These images were used to measure the kyphosis angle; sagittal alignment of the lumbar, thoracic, and cervical regions; and sagittal balance of the spine. Back pain was rated using the visual analog scale (VAS), and neurological function was classified based on the American Spinal Injury Association (ASIA) grading system. Each patient's overall satisfaction with surgical treatment was measured with the Patient Satisfaction Index. For purposes of comparison, patients were studied in 2 groups based on the region of their kyphotic apex. Half of the cohort had apical kyphosis in the lower thoracic spine or thoracolumbar junction (TL group). Using both radiographic and clinical assessments, the authors compared this group with the other half of the patients who had apical kyphosis in the upper to mid thoracic spine (MT group). Results The cohort included 15 males and 21 females, with an average age of 34 years at the time of surgery. The minimum follow-up was 24 months, and the mean follow-up was 31 months. Following surgery, kyphosis across the treated segments was reduced by an average of 60°. Lumbar lordosis also improved by an average of 24°, and thoracic kyphosis improved by an average of 20°. Both back pain and neurological function improved after surgical treatment. There was a 67% improvement in VAS scores, and 13 of the 36 patients had improvement in their ASIA grade. The 2 surgical procedures used for deformity correction (mPSO and VCR) demonstrated comparable radiographic and clinical results. Note, however, that differences were found in both radiographic and clinical outcomes in comparing patients who had lower thoracic or thoracolumbar (TL group) versus upper to midthoracic (MT group) apical kyphosis. Conclusions Posterior tubercular kyphosis can be effectively improved through corrective surgery, and deformity correction can be accompanied by improvement in clinical symptoms. When appropriately selected, both the mPSO and the VCR can be expected to yield satisfactory reduction of post-tuberculosis kyphotic deformities. Differences in radiographic and clinical outcomes should be anticipated, however, when treating such deformities in different regions of the spine.
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Swarup, I., P. Derman, E. Sheha, J. Nguyen, J. Blanco, and R. Widmann. "Relationship between thoracic kyphosis and neural axis abnormalities in patients with adolescent idiopathic scoliosis." Journal of Children's Orthopaedics 12, no. 1 (February 2018): 63–69. http://dx.doi.org/10.1302/1863-2548.12.170163.
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Purpose Previous studies have suggested an association between increased thoracic kyphosis and neural axis abnormalities in patients with adolescent idiopathic scoliosis (AIS). However, the basis for this finding is unclear, and this association has been mainly noted in retrospective studies on a non-consecutive series of patients. The purpose of this study was to assess the relationship between thoracic kyphosis and neural axis abnormalities in patients with AIS. Methods We studied a consecutive series of AIS patients treated with spinal fusion. Thoracic kyphosis (T2 to T12) was measured from preoperative lateral radiographs. All patients underwent a spine magnetic resonance imaging (MRI) prior to surgery, and MRI reports were reviewed to determine the presence of neural axis abnormalities. Statistical analyses included descriptive statistics and chi-squared analysis. Results This study included 210 patients with AIS. There were no significant differences in age or gender between patients with thoracic hypokyphosis (kyphosis < 20°), normal thoracic kyphosis (kyphosis 20° to 40°) and thoracic hyperkyphosis (kyphosis > 40°) (p > 0.05). Neural axis abnormalities were present in 17.9% of patients with thoracic hypokyphosis, 9.8% of patients with normal thoracic kyphosis and 13.6% of patients with thoracic hyperkyphosis (p = 0.60). There were no significant differences in rates of Chiari malformation, syrinx, intra-spinal masses and other central nervous system abnormalities between groups (p > 0.05). Conclusions Thoracic kyphosis was not associated with neural axis abnormalities in our consecutive series of patients with AIS. Increased thoracic kyphosis may not be a reliable indicator for the presence of neural axis abnormalities in patients with AIS. Level of Evidence IV
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Hwang, Steven W., Amer F. Samdani, Mark Tantorski, Patrick Cahill, Jason Nydick, Anthony Fine, Randal R. Betz, and M. Darryl Antonacci. "Cervical sagittal plane decompensation after surgery for adolescent idiopathic scoliosis: an effect imparted by postoperative thoracic hypokyphosis." Journal of Neurosurgery: Spine 15, no. 5 (November 2011): 491–96. http://dx.doi.org/10.3171/2011.6.spine1012.
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Object Several studies have characterized the relationship among postoperative thoracic, lumbar, and pelvic alignment in the sagittal plane. However, little is known of the relationship between postoperative thoracic kyphosis and sagittal cervical alignment in patients with adolescent idiopathic scoliosis (AIS) treated with all pedicle screw constructs. The authors examined this relationship and associated factors. Methods A prospective database of pediatric patients with AIS undergoing spinal fusion between 2003 and 2005 was reviewed for those who received predominantly pedicle screw constructs for Lenke Type 1 or Type 2 curves. Parameters analyzed on pre- and postoperative radiographs were the fusion levels; cervical, thoracic, and lumbar sagittal balance; and C-2 and C-7 plumb lines. Results Preoperatively, 6 (Group A) of the 22 patients included in the study had frank cervical kyphosis (mean angle 13.0°) with mean associated thoracic kyphosis of 27.2° (range 16°–37°). Postoperatively, cervical kyphosis (13.0°) remained in the patients in Group A along with mean thoracic kyphosis of 17.7° (range 4°–26°, p < 0.05). Preoperatively, the remaining 16 of 22 patients had neutral to lordotic cervical alignment (mean −13.8°) with thoracic kyphosis (mean 45°, range 30°–76°). Postoperatively, 8 (Group B) of these 16 patients demonstrated cervical sagittal decompensation (> 5° kyphosis), with 6 showing frank cervical kyphosis (10.5°, p < 0.05). In Group B, the mean postoperative thoracic kyphosis was 25.6° (range 7°–49°, p < 0.05). The other 8 patients (Group C) had mean postoperative thoracic kyphosis of 44.1° (range 32°–65°), and there was no cervical decompensation (p < 0.05). Conclusions The sagittal profile of the thoracic spine is related to that of the cervical spine. The surgical treatment of Lenke Type 1 and 2 curves by using all pedicle screw constructs has a significant hypokyphotic effect on thoracic sagittal plane alignment (19 [86%] of 22 patients). If postoperative thoracic kyphosis is excessively decreased (mean 25.6°, p < 0.05), the cervical spine may decompensate into significant kyphosis.
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Elpeze, Gönül, and Günseli Usgu. "The Effect of a Comprehensive Corrective Exercise Program on Kyphosis Angle and Balance in Kyphotic Adolescents." Healthcare 10, no. 12 (December 8, 2022): 2478. http://dx.doi.org/10.3390/healthcare10122478.
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This study aimed to investigate the effects of a comprehensive corrective exercise program on the kyphosis angle and balance in kyphotic adolescents. A total of 62 male adolescents (between the ages of 10 and 18, mean BMI 21.7 kg/m2) with a thoracic kyphosis (TK) angle of ≥ 50° were divided into three groups using the simple randomization method: CCEP (comprehensive corrective exercise program), TEP (thoracic exercise program) and control group. The CCEP program consisted of corrective exercises plus postural perception training (PPT). Exercise programs were applied for 40–50 min, 3 days a week for 12 weeks. The kyphosis angle was measured using a flexible ruler, and balance was assessed using the Romberg index obtained from pedobarography. After training, a highly significant reduction in the kyphosis angle was observed in the CCEP and TEP groups (p < 0.001). Comparison among the groups showed a greater reduction in the kyphosis angle in the CCEP group (p < 0.020). Postural perception improved in the CCEP group versus other groups (p < 0.001). Improvement of the Romberg index (balance) was found only in the CCEP group upon within-group comparison (p < 0.001), with no difference among the groups (p > 0.05). The use of postural perception in combination with corrective exercise programs for thoracic kyphosis represents a comprehensive approach, and PPT can increase the effectiveness of the intervention.
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Nadulich, K. A., V. M. Shapovalov, A. V. Teremshonok, and S. V. Vasilevich. "EXPERIMENTAL EVALUATION OF CORRECTION FEATURES OF POSTTRAUMATIC KYPHOSIS OF THORACIC AND LUMBAR SPINE." Traumatology and Orthopedics of Russia 16, no. 2 (August 17, 2010): 86–88. http://dx.doi.org/10.21823/2311-2905-2010-0-2-86-88.
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Experimental biomechanical study was performed in 60 spine specimens. Anterior wedge osteotomy and fixation of a specimen in a kyphotic position modeled kyphotic deformity. Deformity correction with various instrumentation systems was firstly performed by maximal extension of segments adjacent to kyphosis-producing block, and carried on after crossing of intervertebral anatomical structures. The study resulted in defining rational approach to surgical correction of posttraumatic deformities in the thoracic and lumbar spine. Minor kyphotic deformities are effectively corrected by instrumentation without mobilization of the spine. Large unfixed kyphosis sometimes requires anterior mobilization. Cases with rigid posttraumatic kyphotic deformity should be operated on with combined mobilization of the spine.
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Fernandes, Fabio Araújo, João Paulo Machado Bergamaschi, Luciano Antonio Nassar Pellegrino, Ricardo Shigueaki Galhego Umeta, Maria Fernanda Silber Caffaro, Robert Meves, and Osmar Avanzi. "Sagittal curve and high metal density in adolescent idiopathic scoliosis." Coluna/Columna 13, no. 2 (2014): 104–7. http://dx.doi.org/10.1590/s1808-18512014130200229.
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Objectives: To analyze radiographically the postoperative kyphosis from patients undergoing surgical treatment for AIS with pedicle screws in all vertebrae included in the arthrodesis. Methods: Retrospective study. The following measurements were evaluated: Cobb angle in anteroposterior radiograph of the three curves (proximal thoracic, main thoracic, and lumbar), Cobb angle in the lateral view of the two curves: thoracic kyphosis (T5-T12) and lumbar lordosis (T12-S1). Results: Of the 25 patients evaluated preoperatively, four (16%) were hypokyphotic, 20 patients (80%) were normokyphotic and only one (4%) was hyperkyphotic. For hypokyphotic and hiperkyphotic patients a satisfactory correction of thoracic kyphosis was obtained in 100% of cases, which was preserved in the final result. The same pattern of thoracic kyphosis was observed for all normokyphotic patients throughout the follow-up. Conclusion: Radiographic evaluation of thoracic kyphosis in patients with AIS treated surgically with pedicle screws in all vertebrae showed satisfactory results with respect to the correction of thoracic kyphosis.
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Schlösser, Tom P. C., René M. Castelein, Pierre Grobost, Suken A. Shah, and Kariman Abelin-Genevois. "Specific sagittal alignment patterns are already present in mild adolescent idiopathic scoliosis." European Spine Journal 30, no. 7 (February 27, 2021): 1881–87. http://dx.doi.org/10.1007/s00586-021-06772-w.
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Abstract Purpose The complex three-dimensional spinal deformity in AIS consists of rotated, lordotic apical areas and neutral junctional zones that modify the spine’s sagittal profile. Recently, three specific patterns of thoracic sagittal ‘malalignment’ were described for severe AIS. The aim of this study is to define whether specific patterns of pathological sagittal alignment are already present in mild AIS. Methods Lateral spinal radiographs of 192 mild (10°–20°) and 253 severe (> 45°) AIS patients and 156 controls were derived from an international consortium. Kyphosis characteristics (T4–T12 thoracic kyphosis, T10–L2 angle, C7 slope, location of the apex of kyphosis and of the inflection point) and sagittal curve types according to Abelin-Genevois were systematically compared between the three cohorts. Results Even in mild thoracic AIS, already 49% of the curves presented sagittal malalignment, mostly thoracic hypokyphosis, whereas only 13% of the (thoraco) lumbar curves and 6% of the nonscoliosis adolescents were hypokyphotic. In severe AIS, 63% had a sagittal malalignment. Hypokyphosis + thoracolumbar kyphosis occurred more frequently in high-PI and primary lumbar curves, whereas cervicothoracic kyphosis occurred more in double thoracic curves. Conclusions Pathological sagittal patterns are often already present in curves 10°–20°, whereas those are rare in non-scoliotic adolescents. This suggests that sagittal ‘malalignment’ patterns are an integral part of the early pathogenesis of AIS.
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Bezalel, Tomer, Eli Carmeli, and Leonid Kalichman. "Introduction of the Novel Radiographic Line (L5-Kyphosis Apex Line) Intended to Evaluate Scheuermann’s Disease and Postural Kyphosis Progression on Standard Lateral X-Rays." Asian Spine Journal 14, no. 3 (June 30, 2020): 350–56. http://dx.doi.org/10.31616/asj.2019.0213.
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Study Design: Cross-sectional and follow-up nested study.Purpose: To assess the reliability of the L5-kyphosis apex line (L5-KAL) evaluation and determine the association between changes in L5-KAL, changes in radiological parameters, and changes in clinical symptoms.Overview of Literature: Scheuermann’s disease is the most common cause of hyperkyphosis of the thoracolumbar and thoracic spine during adolescence. Scheuermann’s disease patients usually show compensatory hyperlordosis of the lumbar spine, which is usually flexible, and express an anterior translation of the lumbar section. The L5-KAL was developed on the basis of our clinical experience, displaying the horizontal distance between the thoracic and lumbar curves.Methods: In the cross-sectional segment, 150 initial lateral X-rays of patients with Scheuermann’s disease and postural kyphosis were analyzed, and 80 additional X-rays were analyzed in the follow-up segment. The data taken from the X-rays of the whole spinal column included the thoracic kyphosis angle, the C7 plumb line, and the L5-KAL. Clinical data included a numerical rating scale of self-perceived body image, pain, and a Scoliosis Research Society-22 questionnaire (SRS-22).Results: Significant positive associations were observed in a cross-sectional study between the L5-KAL and thoracic kyphosis, lumbar lordosis, C7 line, and self-perceived body image. In the follow-up nested study, in a mixed analysis of variance, the main effect of time was significant for the L5-KAL, kyphotic deformity and SRS-22, which indicated a change in these parameters after treatment of Scheuermann’s disease patients. Significant positive associations were observed between the changes in L5-KAL and the changes in thoracic kyphosis.Conclusions: Our evidence suggests that the L5-KAL can serve as an indicator of the thoracic curve change in Scheuermann’s disease and postural kyphosis patients and should be considered in clinical practice.
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Samudrala, Srinath, Shoshanna Vaynman, Ty Thiayananthan, Samer Ghostine, Darren L. Bergey, Neel Anand, Robert S. Pashman, and J. Patrick Johnson. "Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy." Journal of Neurosurgery: Spine 13, no. 6 (December 2010): 695–706. http://dx.doi.org/10.3171/2010.5.spine08608.
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Object Sagittal plane deformities can be subdivided into kyphotic and lordotic forms and further characterized according to their global or regional (focal) presentation. Regional deformities of a significant magnitude constitute a gibbous deformity. Pedicle subtraction osteotomy (PSO) and interlaminar Smith-Petersen osteotomies have been used to correct sagittal plane deformities in the cervical, thoracic, and lumbar spine. By resecting a portion of the vertebral body and closing in the gap of this vertebra, the spine is placed in local lordosis and kyphosis is corrected. These osteotomies have generally been carried out in the lumbar or less frequently in the thoracic area. While PSO has been performed in the mid and lower thoracic spine, there have been no case series of patients undergoing PSO at the CTJ. Specifically, a PSO approach that addresses the challenges of the CTJ is needed. Here, the authors review their case series of PSOs performed in the CTJ. Their goal in the treatment of these patients was to correct the regional CTJ kyphosis, restore forward gaze, and reduce the pain associated with the deformity. Methods Eight patients (5 males and 3 females, mean age 63 years) underwent PSO for the correction of CTJ kyphosis. Pedicle subtraction osteotomy was performed at C-7 or the upper thoracic vertebrae and was facilitated by a computer-guided intraoperative monitoring system. Surgical indications included postlaminectomy kyphosis, spinal cord tumor resection, posttraumatic kyphosis, and degenerative cervical spondylosis. Results The mean follow-up was 15.3 months (range 12–20 months), and the mean preoperative CTJ kyphosis was 38.67° (range 25°–60°). Clinically satisfactory correction of the regional deformity was accomplished in all patients, achieving a mean correction of 35.63° (range 15°–66°) at the CTJ, with restoration of forward gaze and significant reduction in pain. Conclusions A CTJ deformity is a distinctive form of kyphosis that presents as a variable local deformity and requires complex spinal reconstructive techniques to restore sagittal balance and forward gaze. Pedicle subtraction osteotomy allows for significant correction through one spinal segment, and it can be used safely to correct the regional sagittal alignment of the cervical spine and head in relation to the pelvis. Pedicle subtraction osteotomy can be used alone or in combination with other techniques as some patients may require multistage procedures with anterior and posterior spinal reconstruction to obtain stable sagittal correction. All deformities in these patients were kyphotic in nature with only mild elements of scoliosis or coronal plane deformity. This is unlike lumbar and thoracic curves where the kyphosis is frequently associated with scoliosis.
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Gonçalves, Márcia Aparecida, Bruna Estima Leal, Liseane Gonçalves Lisboa, Michelle Gonçalves de Souza Tavares, Wellington Pereira Yamaguti, and Elaine Paulin. "Comparison of diaphragmatic mobility between COPD patients with and without thoracic hyperkyphosis: a cross-sectional study." Jornal Brasileiro de Pneumologia 44, no. 1 (February 2018): 5–11. http://dx.doi.org/10.1590/s1806-37562016000000248.
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ABSTRACT Objective: To compare diaphragmatic mobility, lung function, and respiratory muscle strength between COPD patients with and without thoracic hyperkyphosis; to determine the relationship of thoracic kyphosis angle with diaphragmatic mobility, lung function, and respiratory muscle strength in COPD patients; and to compare diaphragmatic mobility and thoracic kyphosis between male and female patients with COPD. Methods: Participants underwent anthropometry, spirometry, thoracic kyphosis measurement, and evaluation of diaphragmatic mobility. Results: A total of 34 patients with COPD participated in the study. Diaphragmatic mobility was significantly lower in the group of COPD patients with thoracic hyperkyphosis than in that of those without it (p = 0.002). There were no statistically significant differences between the two groups of COPD patients regarding lung function or respiratory muscle strength variables. There was a significant negative correlation between thoracic kyphosis angle and diaphragmatic mobility (r = −0.47; p = 0.005). In the sample as a whole, there were statistically significant differences between males and females regarding body weight (p = 0.011), height (p < 0.001), and thoracic kyphosis angle (p = 0.036); however, there were no significant differences in diaphragmatic mobility between males and females (p = 0.210). Conclusions: Diaphragmatic mobility is lower in COPD patients with thoracic hyperkyphosis than in those without it. There is a negative correlation between thoracic kyphosis angle and diaphragmatic mobility. In comparison with male patients with COPD, female patients with COPD have a significantly increased thoracic kyphosis angle.
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Özerdemoglu, Remzi Arif, Ufuk Aydinli, Cagatay Ozturk, Salim Ersozlu, and Aytun Temiz. "ANALYSIS OF UPPER AND LOWER THORACIC KYPHOSIS IN HEALTHY INDIVIDUALS." Hirurgiâ pozvonočnika, no. 3 (September 12, 2006): 049–51. http://dx.doi.org/10.14531/ss2006.3.49-51.
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The aim of this prospective radiological analysis is to determine the normal values of the kyphosis of the upper and lower thoracic segments, and to analyze their variation with age and sex, as well as to investigate if there is any interaction between them. The study includes 157 healthy individuals without any complaints related to their spine, and a thoracic kyphosis of not more than 50 degrees. Subjects were evaluated by medical history, physical examination, and standing spinal roentgenograms. Age and sex of the patient, together with the degree of upper (T2–T6), lower (T6–T12) and the total (T2–T12) thoracic kyphosis – measured by the Cobb method – were the parameters used for statistical analysis. There were 49 males and 108 females with the mean age of 42 ± 16 years (range, 11–76). Mean values of the upper, lower, and total thoracic kyphosis were found to be 13° ± 6° (range, 2–30°), 21° ± 8° (range, 4–43°), and 34° ± 9° (range, 11–50°), respectively. An older age correlated to a higher degree of kyphosis in the lower thoracic segment (p = 0.007), without an increase in the upper thoracic kyphosis. There was also a negative correlation between the degree of the upper and lower thoracic kyphosis (p = 0.015).
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Laws, Nicola, and Andrew Hoey. "Progression of kyphosis in mdx mice." Journal of Applied Physiology 97, no. 5 (November 2004): 1970–77. http://dx.doi.org/10.1152/japplphysiol.01357.2003.
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Spinal deformity in the form of kyphosis or kyphoscoliosis occurs in most patients with Duchenne muscular dystrophy (DMD), a fatal X-linked disorder caused by an absence of the subsarcolemmal protein dystrophin. Mdx mice, which also lack dystrophin, show thoracolumbar kyphosis that progresses with age. We hypothesize that paraspinal and respiratory muscle weakness and fibrosis are associated with the progression of spinal deformity in this mouse model, and similar to DMD patients there is evidence of altered thoracic conformation and area. We measured kyphosis in mdx and age-matched control mice by monthly radiographs and the application of a novel radiographic index, the kyphotic index, similar to that used in boys with DMD. Kyphotic index became significantly less in mdx at 9 mo of age (3.58 ± 0.12 compared with 4.27 ± 0.04 in the control strain; P ≤ 0.01), indicating more severe kyphosis, and remained less from 10 to 17 mo of age. Thoracic area in 17-mo-old mdx was reduced by 14% compared with control mice ( P ≤ 0.05). Peak tetanic tension was significantly lower in mdx and fell 47% in old mdx latissimus dorsi muscles, 44% in intercostal strips, and 73% in diaphragm strips ( P ≤ 0.05). Fibrosis of these muscles and the longissimus dorsi, measured by hydroxyproline analysis and histological grading of picrosirius red-stained sections, was greater in mdx ( P < 0.05). We conclude that kyphotic index is a useful measure in mdx and other kyphotic mouse strains, and assessment of paralumbar and accessory respiratory muscles enhance understanding of spinal deformity in muscular dystrophy.
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Cheung, Jason P. Y., Christopher H. W. Chong, and Prudence W. H. Cheung. "Underarm bracing for adolescent idiopathic scoliosis leads to flatback deformity." Bone & Joint Journal 101-B, no. 11 (November 2019): 1370–78. http://dx.doi.org/10.1302/0301-620x.101b11.bjj-2019-0515.r1.
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Aims The aim of this study was to determine the influence of pelvic parameters on the tendency of patients with adolescent idiopathic scoliosis (AIS) to develop flatback deformity (thoracic hypokyphosis and lumbar hypolordosis) and its effect on quality-of-life outcomes. Patients and Methods This was a radiological study of 265 patients recruited for Boston bracing between December 2008 and December 2013. Posteroanterior and lateral radiographs were obtained before, immediately after, and two-years after completion of bracing. Measurements of coronal and sagittal Cobb angles, coronal balance, sagittal vertical axis, and pelvic parameters were made. The refined 22-item Scoliosis Research Society (SRS-22r) questionnaire was recorded. Association between independent factors and outcomes of postbracing ≥ 6° kyphotic changes in the thoracic spine and ≥ 6° lordotic changes in the lumbar spine were tested using likelihood ratio chi-squared test and univariable logistic regression. Multivariable logistic regression models were then generated for both outcomes with odds ratios (ORs), and with SRS-22r scores. Results Reduced T5-12 kyphosis (mean -4.3° (sd 8.2); p < 0.001), maximum thoracic kyphosis (mean -4.3° (sd 9.3); p < 0.001), and lumbar lordosis (mean -5.6° (sd 12.0); p < 0.001) were observed after bracing treatment. Increasing prebrace maximum kyphosis (OR 1.133) and lumbar lordosis (OR 0.92) was associated with postbracing hypokyphotic change. Prebrace sagittal vertical axis (OR 0.975), prebrace sacral slope (OR 1.127), prebrace pelvic tilt (OR 0.940), and change in maximum thoracic kyphosis (OR 0.878) were predictors for lumbar hypolordotic changes. There were no relationships between coronal deformity, thoracic kyphosis, or lumbar lordosis with SRS-22r scores. Conclusion Brace treatment leads to flatback deformity with thoracic hypokyphosis and lumbar hypolordosis. Changes in the thoracic spine are associated with similar changes in the lumbar spine. Increased sacral slope, reduced pelvic tilt, and pelvic incidence are associated with reduced lordosis in the lumbar spine after bracing. Nevertheless, these sagittal parameter changes do not appear to be associated with worse quality of life. Cite this article: Bone Joint J 2019;101-B:1370–1378.
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Fujibayashi, Shunsuke, Masashi Neo, and Takashi Nakamura. "Flexion myelopathy of the thoracic spine." Journal of Neurosurgery: Spine 6, no. 1 (January 2007): 68–72. http://dx.doi.org/10.3171/spi.2007.6.1.68.
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✓The authors report a rare case of surgically treated symptomatic thoracic kyphosis caused by dynamic compression in an elderly man. Myelopathy due to thoracic kyphosis has been reported in patients with congenital kyphosis, Scheuermann dorsal kyphosis, and Cushing disease, but to the authors’ knowledge this is the first report of dynamic kyphosis in an elderly person. This otherwise healthy 84-year-old man presented with a 2-year history of progressive difficulty in walking and bilateral leg dysesthesia. Despite several cervical and lumbar surgeries, his symptoms gradually worsened. A radiological examination revealed severe thoracic kyphosis, with a lateral Cobb angle of 59° from T-2 to T-12. On a dynamic computed tomography (CT) myelogram, severe thoracic spinal cord draping and stretching on flexion was demonstrated. On extension, however, imaging studies failed to show draping or stretching. Posterior corrective fusion was performed with instrumentation from T-2 to T-9. Postoperative CT myelography demonstrated no significant spinal cord compression with restoration of the cerebrospinal fluid space anterior to the spinal cord, and the successful correction of the kyphosis to 44°. The patient’s neurological sequelae gradually resolved throughout 6 months of follow up.
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Zaretskov, V. V., and I. A. Artem’eva. "Comparative characteristics of radiologic methods for the evaluation of thoracic kyphosis in children." N.N. Priorov Journal of Traumatology and Orthopedics 4, no. 3 (July 29, 1997): 58–59. http://dx.doi.org/10.17816/vto108558.
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Significance of radiometric methods for the assessment of thoracic kyphosis was studied in 100 children with degenerative-dystrophic spine pathology and in 50 healthy children. It was shown that in disturbances of the vertebral body shape the routine methods of examination had significant errors. Proposed original method for the measurement of kyphotic deformity by the posterior bone structures allows to avoid such mistakes. Results of the evaluation of kyphosis degree using this method do not greatly differ from the data obtained by Fergusons method which is considered to be the more accurate one. The proposed method can be used side by side with the other generally accepted methods as well as for the elaboration of the pathologic kyphosis classification.
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Grabara, Małgorzata. "Spinal curvatures of yoga practitioners compared to control participants—a cross-sectional study." PeerJ 9 (September 16, 2021): e12185. http://dx.doi.org/10.7717/peerj.12185.
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Purpose The angles of thoracic kyphosis and lumbar lordosis determine the spinal alignment in the sagittal plane. The aim of this study was to compare the thoracic kyphosis and lumbar lordosis of male and female yoga practitioners with non-practicing participants and to determine the possible dependencies between sagittal spinal curvatures and somatic parameters, time spent on yoga exercise, and undertaking other physical activities in yoga practitioners. Methods The study involved 576 women and 91 men ages 18–68 years (mean = 38.5 ± 9) who were practicing yoga, and 402 women and 176 men ages 18–30 years (mean = 20.2 ± 1.3) as a control group. The angles of thoracic kyphosis and lumbar lordosis were measured using a Plurimeter-V gravity inclinometer. Results The two-way ANOVA demonstrated the influence of group (p < .0001) and sex (p = .03) on the angle of thoracic kyphosis, as well as the influence of group (p < .0001) and sex (p < .0001) on the angle of lumbar lordosis. It was noted that yoga practitioners had less pronounced thoracic kyphosis and lumbar lordosis and were more often characterized by normal or smaller thoracic kyphosis and lumbar lordosis than students from the control group. In yoga practitioners, the angle of thoracic kyphosis was positively correlated with age, body mass, BMI, and undertaking other forms of physical activity. The angle of lumbar lordosis was negatively correlated with body height and body mass. Conclusions The results suggest that yoga exercises can affect the shape of the anterior-posterior curves of the spine and may be an efficient training method for shaping proper posture in adults.
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Amaricai, Elena. "FUNCTIONAL AND ADHERENCE ASSESSMENT IN CHILDREN AND ADOLESCENTS WITH THORACIC KYPHOSIS." CBU International Conference Proceedings 6 (September 25, 2018): 860–62. http://dx.doi.org/10.12955/cbup.v6.1261.
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Thoracic kyphosis represents a widely spread spinal deviation that affects an increasing number of children and adolescents. It effects not only the development of children but can also have consequences on the ventilatory parameters and on the aerobic functional capacity. The objectives of our study were to assess the respiratory function and functional capacity in children and adolescents with thoracic kyphosis who followed a physical therapy program and to compare these parameters to healthy controls. Another objective was to evaluate the adherence of this category of patients to a supervised exercise program. 20 children and adolescents diagnosed with thoracic kyphosis and 20 gender and age-matched healthy controls were included in the study. Our patients performed a twelve-week supervised exercise program. They were assessed at the beginning and at the end of rehabilitation by spirometry (forced vital capacity-FVC, forced expiratory volume in 1 second-FEV1, peak expiratory flow-PEF and FEV1/FVC ratio) and functional capacity testing (6-minute walk test: 6MWT). A final assessment was conducted with the parents of the children and the adolescents with thoracic kyphosis where they completed an adherence questionnaire. In patients with thoracic kyphosis, their FVC, FEV1, PEF and 6-MWT scores improved significantly after the twelve-week program (p˂0.0001). After rehabilitation there were no differences between the study patients and controls, except for the functional capacity which had lower values in children and adolescents with thoracic kyphosis. Adherence to an exercise-based program could improve the outcomes of the rehabilitation. Besides the respiratory function and functional capacity, assessing adherence to therapy and improving it should be considered when treating pediatric patients suffering from thoracic kyphosis.
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Segi, Naoki, Kei Ando, Hiroaki Nakashima, Masaaki Machino, Sadayuki Ito, Hiroyuki Koshimizu, Hiroyuki Tomita, and Shiro Imagama. "Recurrent ossification of the posterior longitudinal ligament in the upper thoracic region 10 years after initial decompression." Surgical Neurology International 13 (January 12, 2022): 17. http://dx.doi.org/10.25259/sni_1187_2021.
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Background: Posterior decompression surgery consisting of laminoplasty is generally considered be the treatment of choice for upper thoracic OPLL. Here, we describe a patient who, 10 years following a C3–T4 level laminectomy, developed recurrent OPLL at the T2–3 level with kyphosis requiring a posterior fusion. Case Description: A 64-year-old male with CT documented OPLL at the C3–4, C6–7, and T1–4 levels, originally underwent a cervicothoracic laminectomy with good results. However, 10 years later, when T2–3 OPLL recurred along with kyphosis, he warranted an additional posterior fusion. Conclusion: Due to the long-term risks of developing kyphotic deformity/instability, more patients undergoing initial decompressive surgery alone for upper thoracic OPLL should be considered for primary fusions.
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Carr, Andrew J., Rosalind J. Jefferson, Alan R. Turner-smith, Itzhak Weisz, David C. Thomas, Tzanis Stavrakis, and Gregory R. Houghton. "Surface stereophotogrammetry of thoracic kyphosis." Acta Orthopaedica Scandinavica 60, no. 2 (January 1989): 177–80. http://dx.doi.org/10.3109/17453678909149248.
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Yang, Changwei, Mingyuan Yang, Xianzhao Wei, Jie Shao, Yuanyuan Chen, Jian Zhao, Xiaodong Zhu, Dawei He, and Ming Li. "Lumbar Lordosis Minus Thoracic Kyphosis." SPINE 41, no. 5 (March 2016): 399–403. http://dx.doi.org/10.1097/brs.0000000000001231.
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Yang, Mingyuan, Changwei Yang, Ziqiang Chen, Xianzhao Wei, Yuanyuan Chen, Jian Zhao, Jie Shao, Xiaodong Zhu, and Ming Li. "Lumbar Lordosis Minus Thoracic Kyphosis." SPINE 41, no. 6 (March 2016): E359—E363. http://dx.doi.org/10.1097/brs.0000000000001258.
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Briggs, Andrew M., Jaap H. van Dieën, Tim V. Wrigley, Alison M. Greig, Bev Phillips, Sing Kai Lo, and Kim L. Bennell. "Thoracic Kyphosis Affects Spinal Loads and Trunk Muscle Force." Physical Therapy 87, no. 5 (May 1, 2007): 595–607. http://dx.doi.org/10.2522/ptj.20060119.
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Background and Purpose Patients with increased thoracic curvature often come to physical therapists for management of spinal pain and disorders. Although treatment approaches are aimed at normalizing or minimizing progression of kyphosis, the biomechanical rationales remain unsubstantiated. Subjects Forty-four subjects (mean age [±SD]=62.3±7.1 years) were dichotomized into high kyphosis and low kyphosis groups. Methods Lateral standing radiographs and photographs were captured and then digitized. These data were input into biomechanical models to estimate net segmental loading from T2–L5 as well as trunk muscle forces. Results The high kyphosis group demonstrated significantly greater normalized flexion moments and net compression and shear forces. Trunk muscle forces also were significantly greater in the high kyphosis group. A strong relationship existed between thoracic curvature and net segmental loads (r =.85–.93) and between thoracic curvature and muscle forces (r =.70–.82). Discussion and Conclusion This study provides biomechanical evidence that increases in thoracic kyphosis are associated with significantly higher multisegmental spinal loads and trunk muscle forces in upright stance. These factors are likely to accelerate degenerative processes in spinal motion segments and contribute to the development of dysfunction and pain.
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Nadri, Hamed, Bita Rohani, Gholamheidar Teimori, Shahram Vosoughi, and Fatemeh Fasih-Ramandi. "Thoracic Kyphosis Angle in Relation to Low Back Pain among Dentists in Iran." Open Access Macedonian Journal of Medical Sciences 7, no. 21 (November 10, 2019): 3704–9. http://dx.doi.org/10.3889/oamjms.2019.578.
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BACKGROUND: Non-specific low back pain (LBP) has a direct impact on the quality of life, active days at work and health care costs.
AIM: This study was conducted to determine the relationship between LBP and thoracic kyphosis angle among dentists.
MATERIAL AND METHODS: This cross-sectional and descriptive-analytical study carried out in the form of census among 84 dentists employed in a specialised clinic in Iran. Dentists LBP prevalence and intensity and thoracic kyphosis angle were evaluated respectively with the self-administered body map questionnaire, visual analogue scale and flexicurve ruler. Statistical data analysis was done using SPSS software, version 22.
RESULTS: The data showed that the prevalence of LBP in dentists was 44.9% and intensity of LBP was reported about 71.9 ± 19.34. Pearson correlation coefficient between thoracic kyphosis angle and dentist’s characteristics was not significant except for work experience. The single linear regression model showed that 1.3% of thoracic kyphosis angle changes was positively dependent on LBP. Also, the present study proved that thoracic kyphosis angle changes were positively dependent to 2.6%, 10.8% and 5.7 percent of age, work experience and Body Mass Index (BMI), respectively.
CONCLUSION: Despite the lack of significant statistical relation between LBP and thoracic kyphosis angle, there is a high prevalence and intensity of LBP among Dentists. To reduce the risk of work-related LBP among dentists, managing factors such as BMI, work postures and exercises during work should be taken into consideration.
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Pesenti, Sébastien, Renaud Lafage, Brice Henry, Han J. Kim, Manon Bolzinger, Jonathan Elysée, Mathew Cunningham, et al. "Deformity correction in thoracic adolescent idiopathic scoliosis." Bone & Joint Journal 102-B, no. 3 (March 2020): 376–82. http://dx.doi.org/10.1302/0301-620x.102b3.bjj-2019-0993.r1.
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Aims To compare the rates of sagittal and coronal correction for all-pedicle screw instrumentation and hybrid instrumentation using sublaminar bands in the treatment of thoracic adolescent idiopathic scoliosis (AIS). Methods We retrospectively reviewed the medical records of 124 patients who had undergone surgery in two centres for the correction of Lenke 1 or 2 AIS. Radiological evaluation was carried out preoperatively, in the early postoperative phase, and at two-year follow-up. Parameters measured included coronal Cobb angles and thoracic kyphosis. Postoperative alignment was compared after matching the cohorts by preoperative coronal Cobb angle, thoracic kyphosis, lumbar lordosis, and pelvic incidence. Results A total of 179 patients were available for analysis. After matching, 124 patients remained (62 in each cohort). Restoration of thoracic kyphosis was significantly better in the sublaminar band group than in the pedicle screw group (from 23.7° to 27.5° to 34.0° versus 23.9° to 18.7° to 21.5°; all p < 0.001). When the preoperative thoracic kyphosis was less than 20°, sublaminar bands achieved a normal postoperative thoracic kyphosis, whereas pedicle screws did not. In the coronal plane, pedicle screws resulted in a significantly better correction than sublaminar bands at final follow-up (73.0% versus 59.7%; p < 0.001). Conclusion This is the first study to compare sublaminar bands and pedicle screws for the correction of a thoracic AIS. We have shown that pedicle screws give a good coronal correction which is maintained at two-year follow-up. Conversely, sublaminar bands restore the thoracic kyphosis better while pedicle screws are associated with a flattening of the thoracic spine. In patients with preoperative hypokyphosis, sublaminar bands should be used to restore a proper sagittal profile. Cite this article: Bone Joint J 2020;102-B(3):376–382
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Czaprowski, Dariusz, Paulina Pawłowska, Aleksandra Kolwicz-Gańko, Dominik Sitarski, and Agnieszka Kędra. "The Influence of the “Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9724021.
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Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH) instructed with “straighten your back” command (SYB).Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS), lumbar lordosis (LL), global thoracic kyphosis (TK), lower thoracic kyphosis (LK), and upper thoracic kyphosis (UK) were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting) and after the SYB.Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P<0.01), with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5) versus 21.0° (SD 15.5),P<0.001) below the standards proposed in the literature (30–40°) and flattening of its lower part (P<0.001). The same changes were observed in the control group.Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.
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Barsotti, Carlos Eduardo Gonçales, Carlos Augusto Belchior B. Junior, Rodrigo Mantelatto Andrade, Alexandre Penna Torini, and Ana Paula Ribeiro. "The effect of direct vertebral rotation on the spine parameters (coronal and sagittal) in adolescent idiopathic scoliosis." Journal of Back and Musculoskeletal Rehabilitation 34, no. 5 (September 6, 2021): 821–28. http://dx.doi.org/10.3233/bmr-200320.
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BACKGROUND: Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves. METHODS: A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. RESULTS: The Cobb angle averaged 51.3∘± 14.9∘. Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p= 0.003); Cobb angle thoracic distal (p= 0.001); Cobb angle lumbar (p= 0.001); kyphosis (T5-T12, p= 0.012); and kyphosis (T1-T12, p= 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery. CONCLUSION: The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process.
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Islam, Anowarul, Fahad Goni, and Naimur Rahman. "Evaluation of Transpedicular Surgical Decompression withLong Segment Stabilization in Thoracic and Thoracolumbar SpinalTuberculosis." Bangladesh Medical Research Council Bulletin 43, no. 3 (April 16, 2018): 138–42. http://dx.doi.org/10.3329/bmrcb.v43i3.36418.
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Pott’s disease is a common cause of neurological complications and kyphotic deformity.When deformity progressed that may lead to painful costo-pelvic impingement, respiratory distress, risk of paralysis of muscle of lower limb and consequent reduction in quality andlongevity oflife. The treatmentstrategy is to avoid neurological complication and achieve a near normal spine. In tuberculosis, spinal column may become unstable. Pathological fracture or dislocation of a diseased vertebral body may occur due to mechanical insult. Surgical decompression causefurther instability.The insertion of a metallic implant is to provide stability. Pedicle screw fixation in kyphotic correction in old Pott’s disease is a most suitable device.This prospective interventionalstudywas conducted in BanglabandhuSheikh Mujib Medical University (BSMMU) for aperiod of 60 monthsfrom July 2011, with at leasttwo years follow-up period. Twentycases (13 males and 7 females) of thoracolumbar spinal tuberculosis with neurological deficit were operated with a transpedicular decompression and screw fixation along with anti-tubercular drug treatment. All of these patients had varying degrees of neurological deficit and single level involvement with vertebral body destruction and mild kyphosis of 9–28 degrees. Long segment pedicle screw fixation, posterior decompression, and correction of kyphosis were performed in single stage.The mean age of patients was 50.9 and kyphosis improved from 17.85±1.37 degrees to 10.85±2.66 degrees (p=0.0206).Neurological recovery occurred in 18 patients (90%). Bony fusion was achieved in 67.5% cases. At 2-years follow-up mean visual analogue score (VAS) score improved from 5.5 to 0.75 (p=0.0031).So, posterior decompression and transpedicular stabilization with continued chemotherapy is a good treatment option for the management of the thoracic and thoracolumbar TB in patients with vertebral body destruction and <30degree kyphosis.
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Lang-Tapia, Morin, Vanesa España-Romero, Juan Anelo, and Manuel J. Castillo. "Differences on Spinal Curvature in Standing Position by Gender, Age and Weight Status Using a Noninvasive Method." Journal of Applied Biomechanics 27, no. 2 (May 2011): 143–50. http://dx.doi.org/10.1123/jab.27.2.143.
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This aim was to examine differences on lumbar lordosis and thoracic kyphosis in standing position by gender, age and weight status in healthy subjects using a noninvasive method. A total of 297 women (36.6 ± 7.3 years) and 362 men (39.8 ± 7.5 years) participated in this study. Participants were categorized according to the international BMI (kg/m2) cut-off points. Age was stratified by ten years increments starting from 20 y. Men showed smaller lumbar lordosis (17.3 ± 9.3) and larger thoracic kyphosis (42.8 ± 8.8°) than women (29.6 ± 11.3 and 40.4 ± 9.5° respectively; bothp< .001). Older groups presented smaller lumbar lordosis and larger thoracic kyphosis values compared with the 20–29 y group (20.9 ± 10.4, 20.8 ± 11.2 and 23.6 ± 12.6° for ≥50, 40–49 and 30–39 y, respectively vs. 26.7 ± 12.2° for 20–29 y in lumbar lordosis and 42.6 ± 9.8, 42.61 ± 8.7 and 41.8 ± 8.9° for ≥50, 40–49 and 30–39 y, respectively vs. 37.5 ± 10.9° for 20–29 y in thoracic kyphosis; bothp< .05). Finally, overweight and obese groups showed smaller lumbar lordosis (19.4 ± 11.1 and 20.9 ± 11.8° respectively) and larger thoracic kyphosis values (42.7 ± 8.9 and 42.8 ± 9.4° respectively) compared with nonoverweight participants (25.1 ± 12.4 and 40.6 ± 9.2° for lumbar lordosis and thoracic kyphosis respectively; allp< .05). However, when gender, age and weight status were take into account all together only gender seems to influence the lumbar lordosis curvature. The results of this study suggest that gender could be the only determinant factor of lumbar lordosis in healthy people.
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Cho, Jae Hwan, Chang Ju Hwang, Young Hyun Choi, Dong-Ho Lee, and Choon Sung Lee. "Cervical sagittal alignment in patients with adolescent idiopathic scoliosis: is it corrected by surgery?" Journal of Neurosurgery: Pediatrics 21, no. 3 (March 2018): 292–301. http://dx.doi.org/10.3171/2017.8.peds17357.
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OBJECTIVECervical sagittal alignment (CSA) is related to function and quality of life, but it has not been frequently studied in patients with adolescent idiopathic scoliosis. This study aimed to reveal the change in CSA following corrective surgery, compare the cervical sagittal parameters according to curve types, and assess related factors for postoperative aggravation of CSA.METHODSThe authors studied 318 consecutive patients with adolescent idiopathic scoliosis who underwent corrective surgery at a single center. Occiput–C2 and C2–7 lordosis, C2–7 sagittal vertical axis (SVA), T-1 slope, thoracic kyphosis, and lumbar sagittal profiles were measured preoperatively and postoperatively. Scoliosis Research Society Outcomes Questionnaire (SRS-22) scores were used as clinical outcomes. Each radiological parameter was compared preoperatively and postoperatively according to curve types (double major, single thoracic, and double thoracic curves). Patients were grouped based on preoperative CSA: the lordotic group (group L) and the kyphotic group (group K). Each radiological parameter was compared between the groups. Related factors for postoperative aggravation of CSA were assessed using multivariate logistic analysis.RESULTSOf the total number of patients studied, 67.0% (213 of 318) and 54.4% (173 of 318) showed cervical kyphotic alignment preoperatively and postoperatively, respectively. C2–7 lordosis increased (from −5.8° to −1.1°; p < 0.001) and C2–7 SVA decreased (from 24.2 to 20.0 mm; p < 0.001) postoperatively regardless of curve types. Although group K showed improvement in C2–7 lordosis (from −12.7° to −4.8°; p < 0.001), group L showed no difference (from 9.0° to 6.9°; p = 0.115) postoperatively. Clinical outcomes were not related to the degree of cervical kyphosis in this cohort. C2–7 lordosis (p < 0.001) and pelvic tilt (p = 0.019) were related to postoperative aggravation of CSA.CONCLUSIONSRegardless of the trend of improvement in CSA, many patients (54.4%) still showed cervical kyphotic alignment postoperatively. C2–7 lordosis and C2–7 SVA improved postoperatively in all curve types. However, postoperative changes in C2–7 lordosis showed different results based on preoperative CSA, which could be related to T-1 slope and thoracic kyphosis. However, clinical outcomes showed no difference based on CSA in this study cohort. Greater C2–7 lordosis and proximal thoracic curve preoperatively were risk factors for postoperative aggravation of CSA (p < 0.001 and p = 0.019, respectively).
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Amaral, Rodrigo Augusto do, Robert Meves, Maria Fernanda Silber Caffaro, Ricardo Shigueaki Galhego Umeta, Luciano Antônio Nassar Pelegrino, João Paulo Machado Bergamaschi, and Osmar Avanzi. "Adolescent idiopathic scoliosis: sagital plane and low density pedicle screws." Coluna/Columna 13, no. 1 (March 2014): 13–15. http://dx.doi.org/10.1590/s1808-18512014130100210.
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OBJECTIVE: To examine the sagittal curves of patients treated with CD instrumentation using exclusively pedicle screws. METHODS: Image analysis of medical records of 27 patients (26 M and 1 F) with a minimum follow-up of 6 months, who underwent surgical treatment in our service between January 2005 and December 2010. The curves were evaluated on coronal and sagittal planes, taking into account the potential correction of the technique. RESULTS: In the coronal plan the following curves were evaluated: proximal thoracic (TPx), main thoracic (TPp), and thoracolumbar; lumbar (TL, L), and the average flexibility was 52%, 52%, and 92% and the capacity of correction was 51%, 72%, and 64%, respectively. In the sagittal plane there was a mean increase in thoracic kyphosis (CT) of 41% and an average reduction of lumbar lordosis (LL) of 17%. Correlation analysis between variables showed Pearson coefficient of correlation of 0.053 and analysis of dispersion of R2 = <0.001. CONCLUSION: The method has shown satisfactory results with maintenance of kyphosis correction in patients with normal and hyper kyphotic deformities.
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Klineberg, Eric, Frank Schwab, Christopher Ames, Richard Hostin, Shay Bess, Justin S. Smith, Munish C. Gupta, et al. "Acute Reciprocal Changes Distant from the Site of Spinal Osteotomies Affect Global Postoperative Alignment." Advances in Orthopedics 2011 (2011): 1–7. http://dx.doi.org/10.4061/2011/415946.
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Introduction. Three-column vertebral resections are frequently applied to correct sagittal malalignment; their effects on distant unfused levels need to be understood.Methods. 134 consecutive adult PSO patients were included (29 thoracic, 105 lumbar). Radiographic analysis included pre- and postoperative regional curvatures and pelvic parameters, with paired independentt-tests to evaluate changes.Results. A thoracic osteotomy with limited fusion leads to a correction of the kyphosis and to a spontaneous decrease of the unfused lumbar lordosis (−8°). When the fusion was extended, the lumbar lordosis increased (+8°). A lumbar osteotomy with limited fusion leads to a correction of the lumbar lordosis and to a spontaneous increase of the unfused thoracic kyphosis (+13°). When the fusion was extended, the thoracic kyphosis increased by 6°.Conclusion. Data from this study suggest that lumbar and thoracic resection leads to reciprocal changes in unfused segments and requires consideration beyond focal corrections.
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Sharifnezhad, Ali, Gholam Reza Raissi, Bijan Forogh, Hosniyeh Soleymanzadeh, Shadan Mohammadpour, Mina Daliran, and Masumeh Bagherzadeh Cham. "The Validity and Reliability of Kinovea Software in Measuring Thoracic Kyphosis and Lumbar Lordosis." Iranian Rehabilitation Journal 19, no. 2 (June 1, 2021): 129–36. http://dx.doi.org/10.32598/irj.19.2.670.1.
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Objectives: The present study evaluated the inter-rater and intra-rater validity and reliability of posturography by Kinovea software to measure the thoracic kyphosis and lumbar lordosis. Methods: Eighteen subjects (10 females & 8 males) referring for radiographic imaging were included in this cross-sectional study. For evaluating the validity, the thoracic kyphosis and lumbar lordosis were measured according to the Cobb method and Kinovea in standing position. The inter-rater and intra-rater reliability of Kinovea were tested by 3 evaluators and one expert evaluator, respectively. Results: Pearson correlation coefficient data suggested that the validity of measuring the thoracic kyphosis depends on the evaluator’s expertise. Besides, the correlation was not significant in measuring the lumbar lordosis angle (P>0.05). The inter-rater and intra-rater repeatability revealed that the correlation was significant in all angles by the intraclass correlation coefficient (P<0.001). Discussion: Posturography by Kinovea, as a noninvasive method presents an excellent inter-rater and intra-rater repeatability for measuring thoracic kyphosis and lumbar lordosis. This reliable method is simple, efficient, and inexpensive.
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Jang, Jee-Soo, Sang-Ho Lee, Jun-Hong Min, and Dae Hyeon Maeng. "Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome." Journal of Neurosurgery: Spine 7, no. 4 (October 2007): 387–92. http://dx.doi.org/10.3171/spi-07/10/387.
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Object The authors investigate the correlation between thoracic and lumbar curves in patients with degenerative flat back syndrome, and demonstrate the predictability of spontaneous correction of the thoracic curve and sacral angle after surgical restoration of lower lumbar lordosis. Methods The cases of 28 patients treated with combined anterior and posterior spinal arthrodesis were retrospectively reviewed. Inclusion criteria included loss of lower lumbar lordosis resulting in sagittal imbalance. Total lumbar lordosis, thoracic kyphosis, sacral slope, and C-7 plumb line length were measured on pre- and postoperative lateral views of the whole spine. Postoperative changes in thoracic kyphosis, sacral slope, and length of the C-7 plumb line were measured and evaluated according to extent of lumbar lordosis restoration. Results The mean (± standard deviation) preoperative sagittal imbalance was 64.6 ± 63.2 mm, which improved to 15.8 ± 20.7 mm after surgery (p < 0.0001). The preoperative mean lumbar lordosis was 15.6 ± 14.1°, which increased to 40.3 ± 14.5° at follow-up (p < 0.0001). The preoperative mean thoracic kyphosis was 1.6 ± 10.5° and increased to 17.2 ± 12.5° at follow-up (p < 0.0001). Significant preoperative correlations existed between kyphosis and lordosis (r = 0.628, p = 0.0003), and between lordosis and sacral slope (r = 0.647, p = 0.0002). Postoperative correlations also existed between kyphosis and lordosis (r = 0.718, p < 0.0001 and r = 0.690, p < 0.0001, respectively). Conclusions Lower lumbar lordosis plays an important role in sagittal alignment and balance. Surgical restoration of lumbar lordosis results in predictable spontaneous correction of the thoracic curve and sacral slope in patients with degenerative flat back syndrome.
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Zaveri, Gautam. "Posterolateral approach to the thoracic spine for spinal tuberculosis: A Technical Note and an Analysis of Results." Journal of Clinical Orthopaedics 7, no. 1 (2022): 40–46. http://dx.doi.org/10.13107/jcorth.2022.v07i01.465.
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Surgical pathologies in the thoracic spine are principally located anteriorly within the vertebral body resulting in vertebral body destruction, kyphotic deformity, and anterior or anterolateral compression of the spinal cord. Adequate decompression of the neural elements and vertebral body reconstruction requires access to the anterior spinal column. The posterolateral approach through a posterior midline incision allows circumferential spinal cord decompression, anterior column reconstruction, correction of thoracic kyphosis, and posterior spinal stabilization to be safely performed through a single incision, at a single sitting with excellent outcomes.
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Ribeiro, Rafael Paiva, Bárbara Vendramini Marchetti, Eduardo Bojunga de Oliveira, and Claúdia Tarragô Candotti. "Kyphosis index obtained in X-ray and with flexicurve assessment in children and young people." Revista Brasileira de Saúde Materno Infantil 17, no. 1 (March 2017): 79–87. http://dx.doi.org/10.1590/1806-93042017000100005.
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Abstract Objectives: to assess the concurrent validity of kyphosis index measured in the flexicurve from the correlation of X-rays exams, identifying its accuracy and to assess the thoracic spine in children and young people. Methods: 31 young people at an average age of 11.1±3.4 years were evaluated by digital x-rays: (1) Cobb angle (ÂngCobb), (2) Kyphosis index (KIX), and (3) KIX angle (ÂngKIX). These were measured from the flexicurve design on the millimetric graph paper: (1) Kyphosis index (KIFint), obtained from C7 the intersection of kyphosis-lordosis, (2) Kyphosis index (KIFT12), obtained between C7 and T12, and (3) Kyphosis angle (ÂngKIFint and ÂngKIFT12). Statistical analysis: Correlation to Pearson Moment-Product and t test (α<0.05). Results: the angular values (ÂngKIFint, ÂngKIFT12, ÂngKIX) were underestimated in relation to Cobb angle (p<0.05), correlating only to KIX angle and Cobb angle [r=0.698, p<0.001]. The linear values (KIFint, KIFT12, KIX) were similar ( p>0.05) among themselves, correlating only to KIX and Cobb angle [r=0.698, p<0.001] and KIX angle and KIX [r=1; p<0.001]. Conclusions: the KIX and KIX angle presented as an accurate method and valid to be used in the thoracic kyphosis assessment, although KIFint, KIFT12, KIFint angle and KIFT12 angle showed no correlation to the gold standard and not being indicated to assess the thoracic kyphosis in children and young people.
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Janusz, Piotr, Wioleta Ostiak-Tomaszewska, Mateusz Kozinoga, and Tomasz Kotwicki. "Supine fulcrum bending test and in-cast correction of Scheuermann juvenile kyphosis." International Journal of Research in Orthopaedics 5, no. 2 (February 23, 2019): 206. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20190431.
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<p class="abstract"><strong>Background:</strong> Patients with Scheuermann disease often require conservative management with a series of corrective casts, followed by anti-kyphotic brace. Flexibility of the kyphosis can be assessed during a supine fulcrum bending test. The aim of the study was to analyze the radiological flexibility of kyphosis and immediate in-cast correction in a series of patients conservatively treated.</p><p class="abstract"><strong>Methods:</strong> Eighty-six adolescents were conservatively treated for Scheuermann disease of thoracic location. Charts of 55 patients, 39 boys and 16 girls, were accessible. The mean age was 14.6±1.6 years. On the lateral full-cassette standing radiograph, the angle of thoracic and lumbar lordosis were measured. The flexibility of kyphosis was assessed on a supine fulcrum bending lateral radiograph. The in-cast kyphosis angle was measured on a standing lateral radiograph.<strong></strong></p><p class="abstract"><strong>Results:</strong> In 18 patients, a mild non-progressive scoliotic curvature was present; it did not exceed a Cobb angle measurement of 25°. The initial kyphosis angle was 59.2°±9.3°. The lordosis angle was 76.3°±9.3°. The kyphosis angle on supine fulcrum bending test was 30.4°±9.7°. The kyphosis angle in the reclining cast was 44.3°±12.5°. There was no correlation between age and the supine bending correction. There was a correlation between the correction obtained with the supine bending test and the immediate correction in the cast (r=0.64, p=0.0012).</p><p class="abstract"><strong>Conclusions:</strong> The reduction of the kyphosis Cobb angle by supine fulcrum bending was 50% on average, while in the cast in standing position, only half of this correction was maintained.</p>
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Goh, S., R. I. Price, P. J. Leedman, and K. P. Singer. "AGE-INDEPENDENT CORRELATION OF OPTICALLY DETERMINED THORACIC KYPHOSIS WITH LUMBAR SPINE BONE MINERAL DENSITY." Journal of Musculoskeletal Research 03, no. 04 (December 1999): 267–74. http://dx.doi.org/10.1142/s0218957799000294.
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The thoracic spine is susceptible to age-related increases in the sagittal curve, a process which is accentuated in osteoporosis. Previous studies have demonstrated an association between low vertebral bone mineral density (BMD) and accentuation of kyphosis. However, concerns of ionizing radiation associated with radiographic evaluation of osteoporotic fracture risks create a demand for alternative noninvasive detection methods. Back shape, and in particular the thoracic kyphosis, may act as a surrogate for bone density and complement methods of screening individuals for osteoporosis or monitoring progression. The aim of this prospective study is to establish the statistical association of mean lumbar spine BMD and the age-independent BMD Z-score with kyphosis, measured from noninvasive, rasterstereographic analysis of back shape. Back shape imaging of 42 females was performed following routine lumbar bone densitometry using dual energy X-ray absorptiometry. Kyphosis parameters derived from an optical back shape imaging system were correlated, using simple linear regression models, against mean lumbar BMD and BMD Z-scores. Moderate associations were noted between lumbar BMD and thoracic kyphosis (r=0.63 to 0.71, p<0.0001). The trend was still evident when correlating kyphosis against BMD Z-scores (r=0.57 to 0.68, p<0.0001). These data confirm earlier studies comparing radiographic indices of thoracic curvature with vertebral BMD, and suggest potential application of noninvasive back shape imaging to assist in the screening of individuals at risk of spinal osteoporosis, particularly in younger populations.
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Dhiman, Monika, and Maman Paul. "Effectiveness of Selected Exercise Programme on Cervical Range of Motion in Patients with Thoracic Kyphosis & Forward Head Posture." International Journal of Physiotherapy and Research 9, no. 4 (July 11, 2021): 3863–69. http://dx.doi.org/10.16965/ijpr.2021.125.
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Background: Altered postural behaviours result in Forward head posture and thoracic kyphosis making it amenable to correction. The biomechanical strain, in presence of reduced strength of the core stabilizing musculature, in particular, if it is repeated or prolonged, is the predominant explanation for symptoms associated with forward head posture and thoracic kyphosis i.e., neck pain and reduced cervical range of motion. Objective: The aim of the present study was to investigate and compare the effect of postural awareness and conventional exercises on the cervical range of motion in patients with thoracic kyphosis and forward head posture. Methodology: This experimental study was conducted on 60 subjects both male and female of age group 20-35yrs. Subjects were randomly divided into two groups consisting of 30 subjects each. Group A received hot pack and postural advice and Group B received hot pack and stretching and strengthening exercises. All the subjects received a total intervention of 4 days (alternate days) per week for 4 weeks. Results: Intra-group significant differences were obtained between pre- and post-treatment for all evaluated variables (p˂0.01) in both groups. The inter-group comparison showed significant differences (p˂0.01) between post-treatment variables of Group A and Group B where, Group B showed greater improvement than Group A. Conclusion: The treatment given to both the groups together can be used to improve cervical range of motion, thoracic kyphosis, and forward head posture. This study may serve as a guideline for physiotherapists when making decisions regarding possible interventions. KEY WORDS: Cervical range of motion, Craniovertebral angle, Forward head posture, Kyphosis index, Neck disability index, Thoracic kyphosis.
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Filkova, Sylviya. "Approaches for evaluation of thoracic kyphosis." Varna Medical Forum 10, no. 2 (August 19, 2021): 149. http://dx.doi.org/10.14748/vmf.v10i2.7893.
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Lewis, Stephen J., Taylor E. Dear, Michael G. Zywiel, Sam G. Keshen, Y. Raja Rampersaud, and Sofia P. Magana. "T12 Sagittal Tilt Predicts Thoracic Kyphosis." Spine Deformity 4, no. 2 (March 2016): 112–19. http://dx.doi.org/10.1016/j.jspd.2015.10.002.
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Carr, AJ. "Idiopathic thoracic kyphosis in identical twins." Journal of Bone and Joint Surgery. British volume 72-B, no. 1 (January 1990): 144. http://dx.doi.org/10.1302/0301-620x.72b1.2298775.
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Macagno, Angel E., and Michael F. O’Brien. "Thoracic and Thoracolumbar Kyphosis in Adults." Spine 31, Suppl (September 2006): S161—S170. http://dx.doi.org/10.1097/01.brs.0000236909.26123.f8.
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Orel, A. M., and O. K. Semenova. "Kyphosis types of the spine cervical-thoracic junction." Russian Osteopathic Journal, no. 3 (October 5, 2021): 8–18. http://dx.doi.org/10.32885/2220-0975-2021-3-8-18.
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Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior CV–TV axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.
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Orel, A. M., and O. K. Semenova. "Kyphosis types of the spine cervical-thoracic junction." Russian Osteopathic Journal, no. 3 (October 5, 2021): 8–18. http://dx.doi.org/10.32885/2220-0975-2021-3-8-18.
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Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior CV–TV axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.
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Thomas, Diala, Manon Bachy, Aurélien Courvoisier, Arnaud Dubory, Houssam Bouloussa, and Raphaël Vialle. "Progressive restoration of spinal sagittal balance after surgical correction of lumbosacral spondylolisthesis before skeletal maturity." Journal of Neurosurgery: Spine 22, no. 3 (March 2015): 294–300. http://dx.doi.org/10.3171/2014.9.spine1412.
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OBJECT Spinopelvic alignment is crucial in assessing an energy-efficient posture in both normal and disease states, such as high-displacement developmental spondylolisthesis (HDDS). The overall effect in patients with HDDS who have undergone local surgical correction of lumbosacral imbalance for the global correction of spinal balance remains unclear. This paper reports the progressive spontaneous improvement of global sagittal balance following surgical correction of lumbosacral imbalance in patients with HDDS. METHODS The records of 15 patients with HDDS who underwent surgery between 2005 and 2010 were reviewed. The treatment consisted of L4–sacrum reduction and fusion via a posterior approach, resulting in complete correction of lumbosacral kyphosis. Preoperative, 6-month postoperative, and final follow-up postoperative angular measurements were taken from full-spine lateral radiographs obtained with the patient in a standard standing position. Radiographic measurements included pelvic incidence, sacral slope, lumbar lordosis, and thoracic kyphosis. The degree of lumbosacral kyphosis was evaluated by the lumbosacral angle. Because of the small number of patients, nonparametric tests were considered for data analysis. RESULTS Preoperative lumbosacral kyphosis and L-5 anterior slip were corrected by instrumentation. Transient neurological complications were noted in 5 patients. Statistical analysis showed a significant increase of thoracic kyphosis on 6-month postoperative and final follow-up radiographs (p < 0.001). A statistically significant decrease of lumbar lordosis was noted between preoperative and 6-month control radiographs (p < 0.001) and between preoperative and final follow-up radiographs (p < 0.001). CONCLUSIONS Based on the authors' observations, this technique resulted in an effective reduction of L-5 anterior slip and significant reduction of lumbosacral kyphosis (from 69.8° to 105.13°). Due to complete reduction of lumbosacral kyphosis and anterior trunk displacement associated with L-5 anterior slipping, lumbar lordosis progressively decreased and thoracic kyphosis progressively increased postoperatively. Adjusting the sagittal trunk balance produced not only pelvic anteversion, but also reciprocal adjustment of lumbar lordosis and thoracic kyphosis, creating a satisfactory level of compensated global sagittal balance.