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Scoliosis diagnosis and treatment
Research Guide
What is Scoliosis diagnosis and treatment?
Scoliosis diagnosis and treatment encompasses the clinical evaluation, classification systems, biomechanical analysis, and orthopedic interventions including surgical techniques like spinal fusion for managing spinal deformities characterized by lateral curvature of the spine.
Research on scoliosis diagnosis and treatment includes 46,832 works focused on spinal deformities, sagittal alignment, and orthopaedic treatment for adolescent idiopathic scoliosis. Key studies address classification reliability, pelvic parameters for sagittal curve regulation, and the impact of sagittal balance on symptoms in adult spinal deformity. Publications emphasize clinical biomechanics, stability concepts like the neutral zone, and long-term surgical outcomes.
Topic Hierarchy
Research Sub-Topics
Adolescent Idiopathic Scoliosis Treatment
This sub-topic evaluates bracing, posterior fusion, and growing rod techniques for curve correction in AIS patients. RCTs and propensity-matched studies compare progression rates and quality of life outcomes.
Sagittal Balance in Spinal Deformity
Researchers quantify pelvic incidence-lumbar lordosis mismatch and its correction via osteotomies. Radiographic analyses link sagittal parameters to pain and disability post-surgery.
Proximal Junctional Kyphosis
Studies identify risk factors like rod stiffness and fusion levels for PJK after long fusions. Preventive strategies including ligament tethers and softer rods are biomechanically tested.
Pedicle Subtraction Osteotomy Techniques
This area refines PSO for severe kyphosis, assessing closure angles, blood loss, and neurological safety. Finite element models predict stress on instrumentation.
Scoliosis Classification Systems
Development and validation of 3D classification schemes integrate coronal, sagittal, and axial deformities for surgical planning. Reliability studies across raters guide Lenke and SRS-Schwab systems.
Why It Matters
Scoliosis diagnosis and treatment directly affect patient function and survival through management of spinal deformities. Glassman et al. (2005) in "The Impact of Positive Sagittal Balance in Adult Spinal Deformity" demonstrated that positive sagittal imbalance linearly worsens symptoms, with even mild cases showing detriment and severe lower lumbar kyphosis poorly tolerated, guiding surgical corrections like pedicle subtraction osteotomy. Lenke et al. (2001) in "Adolescent Idiopathic Scoliosis" introduced a two-dimensional classification more reliable than the King system, tested by surgeon groups, improving preoperative planning and versatility for vertebral body derotation in adolescent cases. Legaye et al. (1998) in "Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves" established pelvic incidence as a key fixed parameter for sagittal alignment, influencing treatment targets in spinal fusion procedures. White and Panjabi (1978) in "Clinical Biomechanics of the Spine" analyzed spine mechanics including vibration effects, informing orthopedic techniques to restore balance and prevent complications like proximal junctional kyphosis.
Reading Guide
Where to Start
"Clinical Biomechanics of the Spine" by White and Panjabi (1978) provides foundational analysis of spine mechanics, anatomy, and kinematics essential for understanding scoliosis diagnosis and orthopaedic treatment principles.
Key Papers Explained
White and Panjabi (1978) in "Clinical Biomechanics of the Spine" establishes core spine mechanics, which Legaye et al. (1998) in "Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves" builds upon by defining pelvic incidence for sagittal regulation. Glassman et al. (2005) in "The Impact of Positive Sagittal Balance in Adult Spinal Deformity" applies these to show linear symptom worsening with imbalance. Panjabi (1992) in "The Stabilizing System of the Spine. Part II. Neutral Zone and Instability Hypothesis" extends stability concepts from White and Panjabi, while Lenke et al. (2001) in "Adolescent Idiopathic Scoliosis" offers a reliable classification linking biomechanics to adolescent surgical planning.
Paper Timeline
Most-cited paper highlighted in red. Papers ordered chronologically.
Advanced Directions
Current research targets complications like proximal junctional kyphosis and pedicle subtraction osteotomy outcomes in spinal fusion, based on persistent focus in the 46,832 works on sagittal balance and adolescent idiopathic scoliosis treatments.
Papers at a Glance
| # | Paper | Year | Venue | Citations | Open Access |
|---|---|---|---|---|---|
| 1 | Gait Speed and Survival in Older Adults | 2011 | JAMA | 4.2K | ✕ |
| 2 | Unbiased average age-appropriate atlases for pediatric studies | 2010 | NeuroImage | 2.4K | ✓ |
| 3 | Clinical Biomechanics of the Spine | 1978 | — | 2.3K | ✕ |
| 4 | The Impact of Positive Sagittal Balance in Adult Spinal Deformity | 2005 | Spine | 1.9K | ✕ |
| 5 | Measures of postural steadiness: differences between healthy y... | 1996 | IEEE Transactions on B... | 1.8K | ✕ |
| 6 | Pelvic incidence: a fundamental pelvic parameter for three-dim... | 1998 | European Spine Journal | 1.7K | ✓ |
| 7 | Adolescent Idiopathic Scoliosis | 2001 | Journal of Bone and Jo... | 1.7K | ✕ |
| 8 | Predicting the Probability for Falls in Community-Dwelling Old... | 1997 | Physical Therapy | 1.6K | ✓ |
| 9 | Balance in elderly patients: the "get-up and go" test. | 1986 | PubMed | 1.6K | ✕ |
| 10 | The Stabilizing System of the Spine. Part II. Neutral Zone and... | 1992 | Journal of Spinal Diso... | 1.5K | ✕ |
Frequently Asked Questions
What is the role of sagittal balance in scoliosis treatment?
Positive sagittal balance detrimentally impacts symptoms in adult spinal deformity, with severity increasing linearly as imbalance progresses. Glassman et al. (2005) showed kyphosis is better tolerated in the upper thoracic region but poorly in the lower lumbar area. This guides surgical goals to restore alignment and reduce health risks.
How is adolescent idiopathic scoliosis classified?
A two-dimensional classification for adolescent idiopathic scoliosis proved more reliable than the King system when tested by surgeon groups. Lenke et al. (2001) demonstrated its accuracy for defining vertebral body translation and rotation. Further studies confirm its versatility for treatment planning.
What is pelvic incidence in scoliosis diagnosis?
Pelvic incidence serves as a fundamental parameter for three-dimensional regulation of spinal sagittal curves. Legaye et al. (1998) identified it as a morphological constant influencing lumbar lordosis and overall alignment. It is used to assess and correct sagittal balance in deformity treatments.
What defines spinal instability in scoliosis?
The neutral zone is the region of intervertebral motion around neutral posture with minimal passive resistance, correlating with instability. Panjabi (1992) in "The Stabilizing System of the Spine. Part II. Neutral Zone and Instability Hypothesis" validated this through cadaveric, animal, and simulation studies. It informs surgical stabilization techniques like fusion.
How does biomechanics factor into scoliosis treatment?
Clinical biomechanics reviews spine mechanics, anatomy, kinematics, and vibration effects from activities like road driving. White and Panjabi (1978) in "Clinical Biomechanics of the Spine" combined orthopedic and engineering data for analysis. This supports orthopaedic treatments for deformities including scoliosis.
Open Research Questions
- ? How can sagittal imbalance severity be precisely quantified to predict symptom progression beyond linear associations?
- ? What additional validation is needed for the two-dimensional classification of adolescent idiopathic scoliosis to enhance surgical accuracy?
- ? How does pelvic incidence variability across populations affect personalized sagittal curve regulation in treatments?
- ? In what ways can the neutral zone be measured in vivo to better predict post-surgical instability?
- ? Which kinematic factors most influence proximal junctional kyphosis risk after scoliosis correction?
Recent Trends
The field maintains 46,832 works on scoliosis diagnosis and treatment, with sustained emphasis on spinal deformity classification, sagittal alignment via pelvic incidence, and surgical techniques for adolescent idiopathic scoliosis as evidenced by high citations in Lenke et al. and Glassman et al. (2005); no new preprints or news in the last 12 months indicate stable research trajectories without reported shifts.
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