Andrey A. Pershin, MD, orthopedist, PhD Med.Sci., the chief of 2nd pediatric orthopedic department of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint- Petersburg, Russian Federation.
Alla B. Koganova, MD, senior orthopedic fellow of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation.
Zoya I. Fedotova, MD, orthopedist, 2nd pediatric orthopedic department of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation. E-mail: firstname.lastname@example.org; fone +79500164287
In the heading: Original researches
Year: 2019 Volume: 1 Journal number: 1
Article type: scientific and practical
Introduction. The ability for self-correction of posture in three planes is recognized by SOSORT experts as an important condition for the conservative treatment of scoliosis. Surgical treatment of scoliosis means that a significant number of vertebral-motion segments are fused, meanwhile the question of how instrumented fusion affects the patient’s ability to change the position of the body is always important for patients and their parents and medical staff.
Aim. To determine the changes in ability of self-correction in three planes after the surgical treatment of scoliosis.
Material and methods. 12 patients (10 girls and 2 boys) aged from 14 to 17 years with scoliosis. All patients underwent surgical treatment – correction of spinal deformity and posterior instrumentеd fusion. The ability of posture self-correction after posterior spinal fusion was evaluated. The trunk surface metric analysis in natural position and self-correction position was performed. We evaluated parameters as follow: PTI – integral posterior trunk index; PTI-F – integral posterior trunk index in frontal plane; PTI-G – integral posterior trunk index in horizontal plane and PTI-S – integral posterior trunk index in sagittal plane. The difference between integral posterior trunk index, integral indexes for each plane in natural and self-correction positions before and after surgical treatment was considered as the ability of posture self-correction.
Results. Before surgery PTI index in the self-correction posture increased on average by 0.05, after surgery – by 0.03 (p≤0.05). Before surgery, PTI-F index in the posture of self-correction decreased on average by 0.04 (improvement), after surgery – by 0.23 (p≤0.05). Before surgery, PTI-G index in the self-correction posture increased on average by 0.004, after surgery – by 0.04 (p≤0.05). Before surgery PTI-S index in the self-correction posture increased on average by 0.5, after surgery – by 0.02 (changes are statistically significant).
Conclusion. Surgical treatment of scoliosis does not significantly limit the mobility of the posture, and, consequently, the patient’s ability to correct themselves in the frontal and horizontal planes; at the same time, it reduces mobility and limits the tendency to a possible deterioration of posture in the sagittal plane. Thus, surgery creates the conditions for harmonious adaptation of the patient’s body to the achieved changes in trunk anatomy.
1. Weiss HR, Negrini S, Hawes MC, Rigo M, Kotwicki T, Grivas TB, et al. Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005. Scoliosis. 2006;1:6. doi: 10.1186/1748-7161-1-6.
2. Michele Romano, Alessandra Negrini, Silvana Parzini1Marta Tavernaro, Fabio Zaina, Sabrina Donzelli1and Stefano Negrini. SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises. Romano et al. Scoliosis (2015) 10:3 Doi 10.1186/ s13013-014-0027-2.
3. Weiss HR. The method of Katharina Schroth – history, principles and current development. Scoliosis. 2011;6:17.
4. Dobosiewicz K, Durmala J, Kotwicki T. Dobosiewicz method physiotherapy for idiopathic scoliosis. Stud Health Technol Inform. 2008; 135:228–36.
5. Maruyama T, Takeshita K, Kitagawa T. Side-shift exercise and hitch exercise. Stud Health Technol Inform. 2008;135:246–9.], FITS [Białek M. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short termradiological and clinical results based on SOSORT and SRS criteria. Scoliosis.2011; 6:25. doi:10.1186/1748-7161-6-25.
6. Christa Lehnert-Schroth, P.T. Three-dimensional treatment for scoliosis. A physiotherapeutic method for deformities of the spine. The Martindale Press Palo Alto, California. Copyright© 2007 by Christa Lehnert-Schroth.
7. Dobosiewicz K, Durmala J, Czernicki K, Jendrzejek H. Pathomechanic basics of conservative treatment of progressive idiopathic scoliosis according to Dobosiewicz method based upon radiologic evaluation. Stud Health Technol Inform. 2002;91:336–41.
8. Lunes DH, Cecilio MB, Dozza MA, Almeida PA. Quantitative photogrammetric analysis of the Klapp method for treating scoliosis. Rev Bras Fisioter, São Carlos. 2010;14(2):133–4.0.
9. Hagit Berdishevsky, Victoria Ashley Lebel, Josette Bettany-Saltikov, Manuel Rigo, Andrea Lebel, Axel Hennes, Michele Romano, Marianna Białek, Andrzej M’hango, Tony Betts, Jean Claude de Mauroy, Jacek Durmala. Scoliosis Spinal Disord., 2016.
10. De Sèze M. Cugy Pathogenesis of idiopathic scoliosis: a review. Ann Phys Rehabil Med. 2012;55(2):128–38. doi:10.1016/j.rehab.2012.01.003. Epub 2012 Jan 27.
11. Takasaki H: Moiré Topography. Applied Optics. 1970, 9: 1457-1492.
12. Berryman F, Pynsent P, Fairbank J, Disney Sm: A new system for measuring 3D back shape in scoliosis. Eur Spine J. 2008, 17: 663-672.
13. Thometz J, Liu X, Lyon R, Harris G: Variability in Three-Dimensional Measurements of Back Contour with Raster Stereography in Normal Subjects. Journal of Pediatric Orthopaedics. 2000, 20 (1): 54.
14. Dickson RA, Weinstein SL: Bracing (and screening)-yes or no?. J Bone Joint Surg Br. 1999, 81: 193.
15. Petit Y, Aubin CE, Labelle H: Three-dimensional imaging for the surgical treatment of idiopathic scoliosis in adolescents. Can J Surg. 2002, 45: 453-458.
16. Grivas T, Karras G, Katrabasas J, Papavasiliou N: Study of posterior trunk surface changes by age and sex using moiré topography. Research into spinal deformities 1. Edited by: Sevastik J, Diab K. 1997, IOS Press, Amsterdam, 331-334.
17. Sahlstrand T: The clinical value of Moiré Topography in the management of scoliosis. Spine. 1986, 11 (5): 409-417.
18. Sarnadskij V.N., Sadovoj M.A., Fomichev N.G. Sposob komp`yuternoj opticheskoj topografii tela cheloveka i ustrojstvo dlya ego osushhestvleniya. Zayavl. 26.08.96. Evrazijskij patent № 000111. (In Russ.) [Sarnadskij V.N., Sadovoj M.A., Fomichev N.G. Way of computer optical topography of a body of the person and the device for its implementation. Zayavl. 26.08.96. Eurasian patent No. 000111. (In Russ.)]
19. Sarnadskij V.N., Fomichev N.G. Monitoring deformacii pozvonochnika metodom komp`yuternoj opticheskoj topografii. – Posobie dlya vrachej Ministerstva zdravooxraneniya Rossijskoj Federacii MZ RF. – Novosibirsk, NIITO, 2001. – 44s. (In Russ) [Sarnadskij V.N., Fomichev N.G. Monitoring of deformation of a backbone by method of computer optical topography. – A grant for doctors of Ministries of Health of the Russian Federation. – Novosibirsk, Nauka Publ. NIITO, 2001. – 44 pages. (In Russ).]
20. P. Patias, Th. B Grivas, A. Kaspiris, C. Aggouris, E. Drakoutos. A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices. – Scoliosis. 2010; 5: 12. doi: 10.1186/1748-7161-5-12.
21. Kotwicki T, Negrini S, Grivas Th, Rigo M, Maruyama T, Durmala J, Zaina F: Methodology of evaluation of morphology of the spine and the trunk in idiopathic scoliosis and other spinal deformities -6thSOSORT consensus paper. Scoliosis. 2009, 4: 26.