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PURPOSE: The purpose of this review was to evaluate the effectiveness of patient-specific rods for adult spinal deformity. METHODS: A systematic review of the literature was performed through an electronic search of the PubMed, Scopus, and Web of Science databases. Human studies between 2012 and 2023 were included. Sample size, sagittal vertical axis (SVA), pelvic incidence-lumbar lordosis (PI-LL), pelvic tilt (PT), operation time, blood loss, follow-up duration, and complications were recorded for each study when available. RESULTS: Seven studies with a total of 304 adult spinal deformity patients of various etiologies were included. All studies reported SVA, and PT; two studies did not report PI-LL. Four studies reported planned radiographic outcomes. Two found a significant association between preoperative plan and postoperative outcome in all three outcomes. One found a significant association for PI-LL alone. The fourth found no significant associations. SVA improved in six of seven studies, PI-LL improved in all five, and three of seven studies found improved postoperative PT. Significance of these results varied greatly by study. CONCLUSION: Preliminary evidence suggests potential benefits of PSRs in achieving optimal spino-pelvic parameters in ASD surgery. Nevertheless, conclusions regarding the superiority of PSRs over traditional rods must be judiciously drawn, given the heterogeneity of patients and study methodologies, potential confounding variables, and the absence of robust randomized controlled trials. Future investigations should concentrate on enhancing preoperative planning, standardizing surgical methodologies, isolating specific patient subgroups, and head-to-head comparisons with traditional rods to fully elucidate the impact of PSRs in ASD surgery.

Background/purpose: The relationship between a handball player's upper body posture, body weight distribution in relation to body height is poorly understood. So, this study explored the relationship between body height and sagittal spinal curvatures and plantar pressure distribution in handball players. Method: According to handball player's body height, 63 male handball players were divided into two groups; group A (age, 23.54 ± 1.32 years) consisted of 30 handball players with body height above average, and group B (age, 23.40 ± 1.73 years) consisted of 33 handball players with body height below average. The thoracic and lumbar curvatures and trunk height were measured with the Formetric III 4D spine, and the DIERS Pedoscan device was used to assess the plantar pressure distribution for both groups. Results: The thoracic kyphosis of group A was significantly higher than that of group B (p = 0.001), without a significant difference in lumbar lordosis (p = 0.086). Group A showed a significant increase in the forefeet pressure and a significant decrease in the rearfeet pressure compared to group B (p = 0.001). There was a high positive correlation between the body height and trunk length, and body height and kyphosis angle (r = 0.932, r = 0.665, respectively). There was a high positive correlation between the body height and forefoot plantar pressure (r = 0.665, p < 0.01). Conclusion: The taller handball players have an increased thoracic kyphosis angle and forefeet pressure compared to shorter handball players. [ABSTRACT FROM AUTHOR]

The correlation between the Cobb angle and the sagittal spinal curvature (SSC) in adolescent idiopathic scoliosis (AIS) has been reported in some previous studies, but few studies have reported on the relation of coronal wedge deformity (CWD) with sagittal curvature. This study aims to investigate the correlation between CWD and SSC in AIS patients. A retrospective analysis was conducted in 122 AIS patients treated at our hospital from January 2018 to November 2023. Correlation analysis was performed on the Cobb angle, total wedge angle(TW), apical vertebral wedge angle (APW), upper end-vertebral wedge angle (UW), lower end-vertebral wedge angle (LW), total affected structures, average wedge angle(AW), total vertebral wedge angle (TVW), average vertebral wedge angle (AVW), Vertebral Wedge Angle ratio (VWR), total disc wedge angle (TDW), average disc wedge angle (ADW), and disc wedge angle ratio (DWR). Furthermore, out of all cases which underwent lateral spinal radiographs, a correlation analysis between thoracic kyphosis (TK), lumbar lordosis (LL) and CWD was carried out on 102 patients. The Cobb angle exhibited a significant positive correlation with multiple CWD parameters (P < 0.05). TK showed a significant negative correlation with the Cobb angle (r = − 0.221, P = 0.026), TW (r = − 0.199, P = 0.045), AW (r = − 0.262, P = 0.008), TDW (r = − 0.211, P = 0.033), and ADW (r = − 0.278, P = 0.005). LL had no significant correlation with TK and other parameters (P > 0.05). In mild and moderate AIS patients, CWD parameters were positively correlated with the Cobb angle and negatively correlated with thoracic SSC. This may indicate that it's necessary to correct sagittal thoracic curvature when rectifying scoliosis in clinic. This research would not only provide new insights for clinical practice but also offer important evidence for early diagnosis and intervention. [ABSTRACT FROM AUTHOR]

Introduction: With increasing life expectancy, degenerative lumbar spinal stenosis (LSS) has become a common problem in the geriatric population. LSS reduces the quality of life, limits daily activities, and requires therapeutic aids. We share our experiences of treating octogenarian patients with LSS with key lesion percutaneous single portal endoscopic unilateral laminotomy and bilateral decompression (sEndo-ULBD). Materials and methods: Nine octogenarian patients who underwent sEndo-ULBD between January 2021 and July 2022 were prospectively enrolled in this study. Their visual analogue score (VAS), Oswestry Disability Index (ODI), disc height, spondylolisthesis, lumbar lordotic angle, lumbar scoliotic angle, and spinal canal area before and after sEndo-ULBD were followed up for more than six months. Results: The VAS score was significantly reduced three months after the operation (p < 0.05). The postoperative ODI scores of all patients improved relative to their preoperative scores; this difference became significant in the third month after the operation (p < 0.05). Index-level disc height did not significantly change after the operation. Spondylolisthesis, lumbar lordotic angle, and lumbar scoliotic angle showed no significant curve progression. The spinal canal area increased markedly after sEndo-ULBD (p <0.05), with no known surgery-related complications. Conclusions: Key lesion sEndo-ULBD was an appropriate, safe, and effective treatment for octogenarian patients suffering from degenerative LSS. With an average follow-up of over one year, we did not find any significant progression in spinal curvature or instability. sEndo-ULBD is an ideal alternative to aggressive fusion fixation lumbar surgery for managing degenerative LSS in octogenarian patients with functional disability. [ABSTRACT FROM AUTHOR]

Iprodione (IDN) is a broad-spectrum fungicide used to treat various fungal infections in plants. Despite its extensive use, assessment of its toxicity in aquatic organisms remains incomplete. This study investigated the deleterious effects of IDN using zebrafish (ZF) as a model organism. ZF embryos, beginning at 2 h post-fertilization (hpf), were exposed to IDN (3.75–40 mg/L), and both mortality and deformities were assessed. The impact of IDN on mortality was concentration-dependent and significant from 14 mg/L. Importantly, IDN induced several deformities at sublethal concentrations, including abnormal somites, reduced retinal pigment accumulation, yolk sac edema, hatching failure, abnormal swim bladders, and spinal curvature. The EC50 values for IDN-induced deformities were 3.44 ± 0.74 to 21.42 ± 6.00 mg/L. The calculated teratogenic index values for all deformities were above 1, indicating that IDN is teratogenic to ZF. IDN-exposed ZF also displayed abnormalities in touch-evoked escape responses. IDN significantly affected heart rate and blood flow, and induced pericardial edema and hyperemia in a concentration-dependent manner, suggesting its influence on cardiac development and the function of ZF. In conclusion, these results suggest that IDN exerts toxic effects on ZF embryos, affecting mortality, development, and behavior. [ABSTRACT FROM AUTHOR]

The traditional scoliosis examination based on X-ray film is not suitable for large-scale screening, and it is also not suitable for dynamic evaluation during rehabilitation. Therefore, based on computer vision technology, this paper puts forward an evaluation method of scoliosis with different photos of the back taken by mobile phones, which involves three aspects: first, based on the key point detection model of YOLOv8, an algorithm for judging the type of spinal coronal curvature is proposed; second, an algorithm for evaluating the coronal plane of the spine based on the key points of the human back is proposed, aiming at quantifying the deviation degree of the spine in the coronal plane; third, the measurement algorithm of trunk rotation (ATR angle) based on multi-scale automatic peak detection (AMPD) is proposed, aiming at quantifying the deviation degree of the spine in sagittal plane. The public dataset and clinical paired data (mobile phone photo and X-ray) are used to test. The results show that this method has high accuracy and effectiveness in distinguishing the type of spinal curvature and evaluating the degree of deviation, which is higher than other deep learning algorithms. [ABSTRACT FROM AUTHOR]

OBJECTIVES Cases of severe pectus excavatum presenting with worsening cardiopulmonary symptoms in the upright position have been reported. However, the underlying mechanism remains unclear. We evaluated posture-related morphological changes of the thorax in patients with pectus excavatum. METHODS Chest morphology was evaluated preoperatively using upright and supine computed tomography in 21 patients with pectus excavatum and 35 healthy volunteers. The minimum anterior–posterior thoracic diameter, depression depth, and Haller index on horizontal sections, as well as the T6-12 plumb line distance on sagittal sections, were compared between the 2 positions. RESULTS In patients with pectus excavatum (median age, 22 years; 18 males and 3 females), the minimum anterior–posterior diameter was smaller (4.5 vs 5.1 cm, P  < 0.001) and the Haller index was greater (10.1 vs 6.4, P  < 0.001) in the upright position than in the supine position. The T6-T12 plumb line distance was longer in the upright position (2.4 vs 0.8 cm, P  < 0.001), while the depression depth showed no significant difference. Healthy volunteers exhibited similar changes. The degree of spinal curvature increased in the upright position due to the anterior shift of the lower thoracic vertebrae, resulting in a shorter anterior–posterior diameter, irrespective of chest wall deformity. One patient with dyspnoea only in the upright position exhibited compression of the right inferior pulmonary vein only on upright computed tomography. CONCLUSIONS The minimum anterior–posterior diameter is shorter in the upright position. This may explain the worsening of cardiopulmonary symptoms in patients with severe pectus excavatum when in an upright position. Clinical trial registration number: UMIN000036438 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041519 [ABSTRACT FROM AUTHOR]

Summary: Designing appropriate diagnostic and treatment methods to reduce fall risk and improve quality of life, as well as reduce the cost of care in elderlies. Our findings have potential for early diagnosis of those with a high probability of falling based on fairly simple clinical measures of hyperkyphosis, forward head, and lordosis. Introduction: Poor balance is an underlying cause of falling in the elderly, for which a change in the natural curvature of the spine plays a major role. Little is known about the relationship between spinal curvatures and fall incidence in this population. We primarily aimed to investigate the relationship between sagittal plane spinal curvatures and fall incidence over 1 year among nursing facility residents. Secondarily, we aim to determine associations of sagittal plane spinal curvatures with participants' perception of fall risk and balance capability. Methods: Participants (100 residents mean age 70.17 ± 6.01 years) underwent standing measures of sagittal plane spinal curvatures (flexible ruler technique) and forward displacement of the head relative to the cervical spine. The Tinetti Performance Oriented Mobility Assessment (POMA) and Fall Efficacy Scale assessed participants' perception of balance and fear of falling. Incident falls were self-reported monthly and tracked across 1 year. Spearman's correlations and logistic regression evaluated associations between fall incidence and spinal curvature. Predictive performance of spinal curvature and fall risk was determined by the corresponding ROC for defining a cut-off for variables of spinal curvature and fall risk indicators. Results: Predictive performance of spinal curvature and fall risk factors indicated 84% and 77% of participants were correctly classified using models of kyphosis and head angle, respectively. Conclusions: Our study adds new data on spinal curvatures and incident falls among nursing facility residents. Efforts are needed to intervene to counter progression of spinal curvatures and improve fall prevention practices. [ABSTRACT FROM AUTHOR]

Objective To analyze the co-morbidity of spinal curvature abnormality and myopia and the relevant factors in primary and middle school students in Guangzhou from 2019 to 2023, so as to provide references for the establishment of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of common diseases in students. Methods From September 2019 to 2023, used stratified random cluster sampling, 4 248, 4 230, 4 266, 25 476, 25 587 primary and middle school students were selected as subjects for spinal curvature abnormality and myopia screening and questionnaire survey. The SymbolcA@2test was used for comparing the group differences and univariate analysis. The multivariable logistic regression model was used to explore the influencing factors of their co-morbidity. Results the co-morbidity rates of spinal curvature abnormality and myopia were 2.96%-6.00% from 2019 to 2023 in primary and middle school students in Guangzhou. The differences in the co-morbidity rates among students of each phases of studying and the difference of the co-morbidity rate in primary and middle school students over the past 5 years were statistically significant (P＜0.05). Multivariate logistic regression analysis showed that low BMI junior and senior high school students (OR=1.72, 1.89, 95%CI: 1.11-2.67, 1.47-2.41) were more likely to suffer these two diseases. Primary school students in grades 4 to 6 who had menarche or spermatorrhea (OR=1.77, 95%CI: 1.04-3.02), screening time 2-＜3h or≥3h per day (OR=3.06, 2.28, 95%CI: 1.41-6.68, 1.02-5.19), outdoor activities time＜2h per day (OR=2.28, 95%CI: 1.22-4.26), junior high school students with low BMI (OR=1.72, 95%CI: 1.11-2.67), whose teacher "never or occasionally" reminded reading and writing posture (OR=1.50, 95%CI: 1.06-2.12), who were not strict with requiring standing and sitting posture themselves (OR=2.51, 1.99, 95%CI: 1.29-4.86, 1.06-3.74), senior high school students with low BMI (OR=1.89, 95%CI: 1.47-2.41) who had activities in the teaching building during recess (OR=1.33, 95%CI: 1.02-1.75), distance from chest to the edge of table "never or occasionally" more than 1 fist away during reading and writing (OR=1.27, 95%CI: 1.05-1.53) had a higher risk of spinal curvature abnormality and myopiaco-morbidity (P＜0.05). Conclusion The co-morbidity of spinal curvature abnormality and myopia was associated with daytime outdoor exercise and sedentary behavior with bad posture. Early screening and early treatment of spinal curvature abnormality and myopia should be strengthened among adolescent students, especially in urban, female and emaciated students. [ABSTRACT FROM AUTHOR]

Background: Halo-pelvic traction (HPT) is acknowledged for enhancing pulmonary function and reducing neurological complications in severe and rigid scoliosis and kyphoscoliosis. While its role in improving coronal balance is established, its impact on sagittal kyphosis remains under-researched. This study aims to assess HPT's effects on sagittal alignment in these conditions. Methods: A retrospective review of 37 patients with severe and rigid scoliosis or kyphoscoliosis was conducted to evaluate HPT's efficacy. The analysis focused on the impact of HPT on coronal and sagittal parameters, pulmonary function tests (PFTs) and complications. Radiographic assessments included main cobb angle in coronal, sagittal major kyphosis. Results: HPT was applied for an average of 2.9 months, significantly reducing the primary coronal curve from 127.7°±30.3° to 74.9°±28.3° (P < 0.05), achieving a 41.3% correction rate. Sagittal kyphosis correction was more pronounced, with angles decreasing from 80.4°±26.4° to 41.3°±24.4° (P < 0.05), resulting in a 48.6% correction rate. Pulmonary function tests showed improvements in forced vital capacity (FVC) (from 1.32 ± 0.91 to 1.55 ± 0.83) and forced expiratory volume in 1 s (FEV1) (from 1.03 ± 0.76 to 1.28 ± 0.72), with percentage predicted values also increasing (FVC%: 40.4%±24.3–51.4%±23.1%; FEV1%: 37.8%±25.2–48.1%±22.7%; all P < 0.05). Conclusion: HPT effectively reduces spinal deformity severity and improves pulmonary function in patients with severe and rigid scoliosis and kyphoscoliosis. Sagittal kyphosis correction was notably greater than coronal scoliosis correction. The correlation between PFT improvements and coronal curve adjustments suggests that correcting the coronal Cobb angle is pivotal for pulmonary function enhancement. [ABSTRACT FROM AUTHOR]

Introduction: Transcutaneous electrical nerve stimulation (TENS) is commonly used for pain management. Recent studies have shown that TENS can improve the condition of low back pain by influencing the elastic coefficient of the lumbar fascia and the balance status; however, the effect of TENS on the lumbar fascia of healthy people has not been investigated. Accordingly, this study examines the effect of TENS on the lumbar fascia of healthy people. Materials and Methods: A total of 60 healthy participants in two groups, underwent 10 sessions of conventional TENS intervention. The first group (intervention group) received TENS with an intensity at the tolerance level, and the second group (control group) received sham TENS. Ultrasonography and a spinal mouse device were assessed lumbar fascia thickness and lumbar curvature before and after the TENS. Results: Significant changes were observed after TENS in the intervention group in reducing the lumbar fascia thickness (P=0.006) and increasing the lumbar curvature (P=0.000). Between-group changes after the intervention sessions indicated a significant difference between the lumbar fascia thickness and curvature (P≤0.003). Conclusion: TENS in healthy people can lead to a decrease in the thickness of the lumbar fascia and improve lumbar curvature. Also, a strong correlation was found between lumbar fascia thickness reduction and increased lumbar curvature. [ABSTRACT FROM AUTHOR]

Prior reviews investigating the impact of pregnancy on adolescent idiopathic scoliosis (AIS) have reached different conclusions and a meta-analysis of curve progression among pregnant females with AIS and its effects on clinical outcomes has not previously been performed. A comprehensive search of major bibliographic databases (PubMed, Embase, and Scopus) was conducted for articles pertaining to spinal curve progression during pregnancy among patients with AIS. Patient demographics, scoliotic curve outcomes, and patient-reported quality of life measures were extracted. Ten studies, including 857 patients with a mean age of 28.7 years, were included. Before pregnancy, 42.1% had undergone spinal fusion and 59.0% had a thoracic curve. Based on prepregnancy and postpregnancy radiographs, the curve increased from 33.9°–38.5°, and meta-analysis revealed a curve progression of 3.6° (range = −5.85 to 1.25, P = 0.003), primarily arising from loss of correction in the unfused group (Unfused = −5.0, P = 0.040; Fused = −3.0, P = 0.070). At the same time, 45.9% patients reported increased low back pain and many reported a negative body self-image and limitations in sexual function. However, 5 studies noted that pregnancy and number of pregnancies were not associated with curve progression, and multiple studies identified similar quality of life-related changes in non-pregnant patients with AIS. Among unfused pregnant females with AIS, the spinal curvature increased significantly by 5.0° from before to after pregnancy. However, these changes may be independent of pregnancy status and occur with time. Such curve progression can contribute to a negative body self-image, low back pain, and functional limitations irrespective of pregnancy state. [ABSTRACT FROM AUTHOR]

Objective: Injury outcomes for powered two- and three-wheeler (PTW) riders are influenced by the rider posture. To enable analysis of PTW rider accidents and development of protection systems, detailed whole-body posture data is needed. Therefore, the aim of this study is to fill this gap by providing collections of average male whole-body postures, including subpopulation variability, for different PTW types. This will enable future studies to explore the influence of PTW rider posture variation and to support safety system development. Methods: 3D photometric measurements of 51 anatomical landmarks were recorded on 20 (50th percentile male) volunteers in their preferred riding postures across three PTW types (naked, scooter, and touring). Following an outlier removal process, a principal component analysis (PCA) was performed to calculate average postures and principal components (PCs), to describe the observed posture variation, for each PTW. The visualization of the PCs was facilitated through kinematic linkage representations, connecting anatomical landmarks and estimated joint centers to form segments and characteristic joint angles. Results: The first seven PCs explained 80% of the variance in posture for each of the three PTWs. Across PTWs, these PCs frequently described combinations of postural features including variation in fore-aft seat positions, pelvic tilt, spinal curvature, head position, and extremity flexion-extension. Analysis revealed distinct differences in average postures across the three PTWs, on average, 10 ± 9° for the characteristic joint angles within a min-to-max range between the three PTWs. However, for all three PTWs, the variability between volunteers in characteristic joint angles on the same PTW were on average more than twice as large within a ± 2 SD range (26 ± 11°). Conclusions: The results suggest that PTW rider posture variation must be addressed by involving simultaneous adjustments of multiple body parts, as described by each of the first seven PCs, as a direct consequence of the human body interconnectedness. Furthermore, the study's findings challenge conventional assumptions that the relative distance between PTWs' handlebar, seat, and foot support predominantly influences rider postures. Instead, the research demonstrates that individual variability has a substantial influence on rider posture and should be considered in PTW safety development. [ABSTRACT FROM AUTHOR]

A sore neck and back are very common among cyclists and can be caused by a change in spinal curvature and forward head posture during cycling. In addition, elite cyclists were found to have a decreased infrared thermography measurement during incremental exercise, and increased measurements after exhaustion. This study aims to assess the benefits of corrected cycling posture, evaluated by the OpenPose evaluation system and physical therapists, on exercise performance as determined by infrared thermography. We adopt a case–control study design. Thirty participants were divided into the group riding with a natural posture (control group) and the group riding with a corrected posture (experimental group). While both groups had comparable back and neck temperatures before and 10 min after finishing the exercise, the corrected posture group had a statistically lower temperature compared to the control one after riding for 30 min (33.58 ± 0.69°C vs. 35.18 ± 0.89°C; p < 0.001). This observed decrease in skin temperature during exercise implies better heat dissipation mechanisms and hence fatigue avoidance among cyclists with corrected posture. Larger studies with various static and dynamic cycling positions are required to gain better insights about the correlation between those positions, infrared thermography measurements, enhanced athletic performance and injury prevention. [ABSTRACT FROM AUTHOR]

Purpose: Proper posture is essential for maintaining musculoskeletal health. The stability of the spine depends largely on the curvature of the human upright spine, and deviations in sagittal arches may signify a displacement in the body's center of gravity. This study aims to investigate the relationship between spinal curvature and postural... [ABSTRACT FROM AUTHOR]

Background/Objectives: Scoliosis is a condition that involves deformation of the spine in the coronal plane and commonly appears in childhood or adolescence, significantly limiting a person's life. The cause is multifactorial, and treatment aims to improve the spinal curvature, prevent major pathologies, and enhance aesthetics. The objective of this review was to determine whether high-velocity low-amplitude (HVLA) spinal manipulation is more effective than other treatments for children with idiopathic scoliosis (IS). Methods: The PubMed, Web of Science, Scopus and PEDro databases were searched for both clinical trials and cohort studies. Methodological quality was assessed via the PEDro scale (for clinical trials) and the Newcastle–Ottawa scale (for observational studies). The protocol of this systematic review was registered in PROSPERO (CRD42024532442). Results: Five studies were selected for review. The results indicated moderate improvements in pain and the Cobb angle and limited improvements in quality of life. Conclusions: HVLA spinal manipulation does not seem to have significant effects on reducing spinal deformity in IS patients, nor does it significantly impact quality of life. However, this therapy may have significant effects on reducing pain in these patients. [ABSTRACT FROM AUTHOR]

Objective: Idiopathic scoliosis (IS) is a three-dimensional deformity of the spine, defined radiographically as a lateral deviation of more than 10 degrees in the coronal plane, characterized by sagittal and transverse plane changes. Balance and walking are the most common activities of daily living. In our study, we aimed to analyze the effect of the curvature on balance and walking in IS individuals, who have a reduced risk of progression and whose curvatures are generally stable, by analyzing quantitative data. Methods: The study included 34 patients with IS and 34 healthy individuals. All participants were questioned about their socio-demographic and physical characteristics. Balance parameters were recorded using a multi-axis, motorized platform system called Huber 360 with built-in force sensors and handles. The participants' gait analysis was performed using a Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform. Results: When gait parameters were examined, step time and walking cycle duration were significantly higher in the IS group compared to the control group (p=0.007 and p=0.008, respectively). On the contrary, right-foot loading response and walking speed of the control group were significantly higher than the scoliosis group (p=0.006 and p=0.0003, respectively). Stability speed with eyes closed was significantly higher in the IS group compared to controls (14.55±3.5 mm/s and 12.6±4.6 mm/s, respectively, p=0.012). No significant differences were observed between the groups in terms of other balance and gait characteristics. Conclusion: This study revealed that balance and gait were affected in patients with IS, and individuals with scoliosis had poor balance and walking skills compared to healthy individuals. Therefore, in scoliosis rehabilitation, balance and walking problems that may be caused by spinal curvatures should definitely be taken into consideration. [ABSTRACT FROM AUTHOR]

Traditional 3D motion analysis typically considers the spine as a rigid entity. Nevertheless, previous single-joint models have proven inadequate in evaluating the movement across different spinal segments in patients with idiopathic scoliosis (IS). Scoliosis significantly impairs movement functions, especially during activities such as ascending and descending stairs. There is a lack of research on the patterns of stair movement specifically for patients with IS. This study aims to investigate trunk kinematics in college students with IS during stair ascent and descent tasks. A total of 56 participants, 28 with IS and 28 with healthy controls, were recruited for this case-control study. The trunk movements were analyzed using a motion analysis system that incorporated a multisegment spine model. Understanding the multi-segment spine kinematics during stair tasks can contribute to the development of effective rehabilitation programs for individuals with IS. Case-control study. Twenty-eight IS and 28 controls. Cobb angle, spinal curvature, spinal active range of motion (ROM), Kinematics. The Qualisys system (Gothenburg, Sweden) was utilized in this study with a sampling frequency of 150 Hz. It recorded the kinematics in the thoracic, lumbar, thoracic cage, and pelvis while ascending and descending stairs for both the 28 IS individuals and the 28 control participants. Additionally, clinical parameters such as the Cobb angle, curvature of the spine, spinal range of motion (ROM), and other relevant factors were concurrently assessed among the subjects. Project supported by the National Natural Science Foundation of China (Grant No. 82205306). The authors declare no conflict of interest in preparing this article. The findings of this study revealed that IS individuals exhibited reduced kyphotic curvature in the sagittal plane (p<.05) when compared to the control group. In contrast, these IS patients displayed greater coronal curvature (Cobb angle) in the frontal plane and a more substantial difference in thoracic side bending range of motion in comparison to the control group (p.05). Moreover, during the ascending stair activity, IS patients showed reduced thoracic cage flexion-extension range of motion (p<.05), while displaying increased lumbar rotation range of motion and anterior-posterior pelvic tilt range of motion (p<.05) in contrast to the control group. Notably, the kinematic analysis during the descent of stairs indicated that IS patients exhibited a larger range of motion in thoracic flexion-extension, thoracic side bending, thoracic cage side bending, thoracic rotation, and thoracic cage rotation when compared to the control group (p<.05). The results showed significant differences in trunk kinematics between the two groups during both stair ascent and descent tasks. The utilization of the "multisegment spine model" facilitates the acquisition of motion information across multiple segments of the spine in patients diagnosed with IS, effectively enhancing the assessment outcomes derived from imaging information. The three-dimensional structural deformity in the trunk affects both static and dynamic activity patterns. In different activity states, IS patients demonstrate stiff movements in certain segments while experiencing compensatory instability in others. In the future, clinical rehabilitation programs for IS should prioritize stair-related activity training. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective study. Objective: To develop a new MRI scoring system to assess patients' clinical characteristics, outcomes and complications. Methods: A retrospective 1-year follow-up study of 366 patients with cervical spondylosis from 2017 to 2021. The CCCFLS scores (cervical curvature and balance (CC), spinal cord curvature (SC), spinal cord compression ratio (CR), cerebrospinal fluid space (CFS). Spinal cord and lesion location (SL). Increased Signal Intensity (ISI) were divided into Mild group (0-6), Moderate group (6-12), and Severe group (12-18) for comparison, and the Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS), numerical rating scale (NRS), Neck Disability Index (NDI) and Nurick scores were evaluated. Correlation and regression analyses were performed between each variable and the total model in relation to clinical symptoms and C5 palsy. Results: The CCCFLS scoring system was linearly correlated with JOA, NRS, Nurick and NDI scores, with significant differences in JOA scores among patients with different CC, CR, CFS, ISI scores, with a predictive model (R2 = 69.3%), and significant differences in preoperative and final follow-up clinical scores among the 3 groups, with a higher rate of improvement in JOA in the severe group (P <.05), while patients with and without C5 paralysis had significant differences in preoperative SC and SL (P <.05). Conclusion: CCCFLS scoring system can be divided into mild (0-6). moderate (6-12), severe (12-18) groups. It can effectively reflect the severity of clinical symptoms, and the improvement rate of JOA is better in the severe group, while the preoperative SC and SL scores are closely related to C5 palsy. Level of Evidence: III [ABSTRACT FROM AUTHOR]

Objective: This study delves into the implications of adenoidectomy for scoliosis progression, investigating the intricate nexus of hypoxia, spinal curvature, and surgical intervention. With adenoidectomy being a common procedure for addressing pediatric sleep-disordered breathing, this research study explores its potential impact on spinal health. Patients and Methods: Employing a retrospective cohort design, this study gathered data from patients who underwent adenoidectomy, including those with scoliosis, between January 2017 and March 2023. Initial and follow-up evaluations involved clinical and radiological assessments, notably measuring the Cobb angle to quantify spinal curvature. Results: This study enrolled 218 patients under 10 years old. Among them, 18 exhibited Cobb angles of 10° or more, with a mean Cobb angle of 12.8°. In the follow-up evaluation, 83% of patients with initial Cobb angles of 10° or more were reached out to, along with 84.6% of those with Cobb angles below 10°. The postoperative follow-up revealed a notable decrease in Cobb angles for most patients, particularly those with an initial Cobb angle exceeding 10°. Conclusions: This study underscores the potential connection between adenoidectomy, hypoxia, and scoliosis regression, highlighting the importance of early intervention for scoliosis management. Despite certain limitations, this investigation lays the foundation for future research involving larger patient cohorts and multifaceted analyses. The observed interactions between airway function, hypoxia, and spinal health open avenues for refining clinical strategies in scoliosis treatment. [ABSTRACT FROM AUTHOR]

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Aim and background: Diastasis recti abdominis (DRA) is a disorder that can persist in 35–60% of women postpartum, leading to issues like core function issues, urine incontinence, and low back pain (LBP). Diastasis recti abdominis has been associated with modifications in spinal alignment, notably an elevation in lumbar curvature, potentially affecting the distribution of loads. Diastasis recti abdominis is a potential cause of postural abnormalities, and evaluating the relationship between them will be beneficial for the medical professionals to understand the need for abdominal muscle strengthening in the postpartum period and how it affects quality of life. Thus, this study aims to explore the relationship between postural changes and DRA in the postpartum phase. Materials and methods: This cross-sectional study design was conducted to find the relationship between spinal curvature and DRA using a bubble inclinometer, and a caliper respectively. A total of 102 patients underwent screening based on inclusion and exclusion criteria. An independent t-test and Karl Pearson’s correlation method were used to find a comparison and relation of spinal curvature (thoracic kyphosis angle and lumbar lordosis angle) between with and without DRA groups, while a p-value < 0.05 was considered statistically significant. Results: The results of the present study stated that DRA was positively correlated (p < 0.05) with kyphosis angle (r = 0.322) and lordosis angle (r = 0.774). The findings of the current study also indicate a positive correlation between body mass index (BMI) and both DRA and the lordosis angle. Conclusion: This study revealed a strong positive correlation between DRA and lordosis angle and a weak positive correlation between DRA and kyphosis angle in postpartum women. Clinical significance: These findings emphasize the importance of holistic postpartum care to address musculoskeletal changes, providing insights for interventions to improve core muscle function and alleviate chronic spinal pain. [ABSTRACT FROM AUTHOR]

Chest deformities in children with scoliosis may result in cardiopulmonary disorders, lowering cardiopulmonary capacity levels. However, results regarding the dependence of cardiopulmonary capacity on the severity level of scoliosis remain controversial. We aimed to use dynamic cardiopulmonary exercise testing (CPET) to investigate exercise capacity in reference to spinal deformity in patients with mild or moderate idiopathic scoliosis by means of multivariate analyses. Methods: We included 92 children and adolescents aged 10–17 years with mild and moderate idiopathic scoliosis and 94 healthy peers. The study consisted of three parts: (1) medical record analyses; (2) anthropometric measurements; and (3) CPET. Results: Our results revealed that the mean VO2peak and VO2peak/kg values of the participants with scoliosis were 0.27 L/min and 0.37 mL/min/kg lower than their healthy peers, respectively, regardless of age and gender. Furthermore, the occurrence of scoliosis correlates with a mean decrease in minute ventilation volume by 10.10 L/min, tidal volume by 0.11 L, breathing frequency by 3.78 bpm, and breathing reserve by 14.34%, regardless of the age and gender of the participants. Children and adolescents with mild-to-moderate scoliosis during CPET exhibit a lower ventilation capacity and lower VO2 max than healthy adolescents matched in age but their cardiorespiratory fitness parameters do not depend on the Cobb angle value and the angle rotation of the primary spinal curvature. Conclusions: Physical therapy and activity should be recommended to prevent cardiorespiratory failure in later life in patients with scoliosis. This study may also provide CPET reference values for healthy children and adolescents with scoliosis. [ABSTRACT FROM AUTHOR]

Introduction: Ankylosing spondylitis is chronic progressive disease, which decrease functions of musculoskeletal system including chest area. Those changes influences respiratory mechanics, worsen conditions of proper ventilation of lungs. Objectives: Rating of functional and respiratory parameters and dependence between them at patients with ankylosing spondylitis. Materials & methods: The study included 45 patients with diagnosed ankylosing spondylitis. Chest and upper limbs mobility, resting spinal curvature alignment were assessed, and respiratory parameters were measured in a plethysmographic chamber JAGGER MasterScreen Body. Results: Ankylosing spondylitis patients had lower respiratory parameters especially sReff, and FRC. Restriction of chest and upper limbs mobility was also demonstrated. Forward head extension was observed based on the occipital wall test. Correlations between functional parameters and correlations between functional and respiratory parameters were shown, in particular MIP, MEP, sReff, Rtot, TLC, ERV. Conclusions: The study confirmed a decrease in functional and respiratory parameters in the examined patients with ankylosing spondylitis compared to the applicable standards. A significant relationship was found between functional parameters in the upper body and respiratory parameters, which worsen with increasing thoracic dysfunction. The obtained results indicate the directions of therapy that should be taken into account to improve respiratory parameters and reduce respiratory dysfunction in these patients. Chest-focused physiotherapy appears to be an important element in improving function in patients with ankylosing spondylitis. [ABSTRACT FROM AUTHOR]

Thoracic kyphosis is a common postural problem affecting over 20% of adolescents. This condition can contribute to various spinal problems, leading to a decreased ability to perform daily activities, reduced quality of life, and impaired pulmonary function. This review aimed to investigate the effectiveness of exercise programs in adolescents with thoracic kyphosis. We systematically searched the PubMed, Embase, Cochrane Library, and Scopus databases for articles relevant to adolescents with thoracic kyphosis that had been published up to 14 May 2024. Our inclusion criteria focused on studies investigating the effects of exercise on improving thoracic kyphosis. A total of 1883 articles was identified using the search terms. After the titles and abstracts had been screened, 1868 articles were found not to meet our inclusion criteria and were excluded. The remaining 15 articles were then assessed for eligibility. Finally, only seven studies were included in this systematic review. Exercises targeting the entire spinal curvature demonstrated efficacy in enhancing the strength and function of the cervical, thoracic, lumbar, and pelvic muscles, resulting in a corrective effect on thoracic kyphosis in adolescents. Consequently, exercise programs have emerged as potentially beneficial treatment approaches to improve poor posture and reduce adolescent thoracic kyphosis. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionsOverall spinal curvature is evaluated by calculating the difference between the angles of lumbar lordosis (LL) and thoracic kyphosis (TK) and is expressed as LL minus TK (LL-TK). It is unclear whether LL-TK is associated with physical function in community-dwelling older adults and whether it is more relevant than TK or LL alone.This study aimed to identify whether LL-TK is associated with physical function in community-dwelling older adults, and whether it is strongly associated than TK or LL alone.The participants comprised 1,674 community-dwelling older adults who underwent physical assessments (women, n = 1,099; mean age, 67.4 ± 5.3 years). As spinal alignment indices, TK and LL were measured using skin surface methods, and LL-TK was calculated as the difference between them. Decreased LL-TK indicated increased overall spinal curvature. Physical function was determined by measuring single-leg standing, five-times chair-stand, and usual gait speed. Stepwise multiple regression analyses were performed with each physical function as the dependent variable and spinal alignment indices as the independent variables, with adjustments.Multiple regression analyses showed that single-leg standing (β = 0.092, 95% confidence interval [CI] = 0.071 to 0.214, p < .001) and five-times chair-stand (β=-0.142, 95% CI = −0.037 to −0.019, p < .001) were significantly associated with LL-TK, but not LL. Both LL-TK (β = 0.121, 95% CI = 0.001 to 0.004, p < .001) and LL (β = 0.087, 95% CI = 0.001 to 0.003, p = .003) were significant determinants of usual gait speed.This study showed that decreased LL-TK may be associated with poor physical function. This association may be stronger than that observed for TK or LL alone. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective multicenter study. Objective. Our objective was to compare the spline-based measurement of sagittal spinal curvatures to fixed landmarks in a normative population. Summary of Background Data. Recent research has stressed the importance of considering sagittal curvature in its entirety using a spline reconstruction. To date, no data supports the superiority of this method in comparison to classic measurement methods. Patients and Methods. Full-spine biplanar radiographs of subjects over 20 years old who had normal radiographs were analyzed. Thoracic kyphosis (TK) and lumbar lordosis (LL) were measured following two modalities: either using predefined landmarks (TKT1T12, TKT5T12, and LLL1S1) or spline-based measurement (TKSpline and LLspline). Results. A total of 1520 subjects were included (mean 54yo). The mean difference between TKspline and TKT1T12 was 1.4° and between TKspline and TKT5T12 was 11.7° (P<0.001). LLspline was significantly larger than LLL1S1 (55° vs. 54°, P <0.001). LLspline and LLL1S1 were correlated (R=0.950, P<0.001). Pelvic incidence had no influence on the difference between LLspline and LLL1S1 (R= -0.034, P= 0.184). Using LLL1S1 measurements, LL was underestimated in 17% of the cases. The comparison of outlier distributions according to age groups (P=0.175), sex (P= 0.937), or pelvic incidence groups (P= 0.662) found no difference. There were significantly more outliers in Roussouly type 1 compared with other types (56%, P<0.001). Conclusion. Our results suggest that the use of TKT1T12 and LLL1S1 is acceptable to assess spinal sagittal curvatures. However, TKT5T12 is not accurate for the thoracic curve and should be used with caution. LLL1S1 can be used to accurately assess the lumbar curve, except in Roussouly type 1. [ABSTRACT FROM AUTHOR]

When conducting spine-related diagnosis and surgery, the three-dimensional (3D) upright posture of the spine under natural weight bearing is of significant clinical value for physicians to analyze the force on the spine. However, existing medical imaging technologies cannot meet current requirements of medical service. On the one hand, the mainstream 3D volumetric imaging modalities (e.g. CT and MRI) require patients to lie down during the imaging process. On the other hand, the imaging modalities conducted in an upright posture (e.g. radiograph) can only realize 2D projections, which lose the valid information of spinal anatomy and curvature. Developments of deep learning-based 3D reconstruction methods bring potential to overcome the limitations of the existing medical imaging technologies. To deal with the limitations of current medical imaging technologies as is described above, in this paper, we propose a novel deep learning framework, ReVerteR, which can realize automatic 3D Reconstruction of Vertebrae from orthogonal bi-planar Radiographs. With the utilization of self-attention mechanism and specially designed loss function combining Dice, Hausdorff, Focal, and MSE, ReVerteR can alleviate the sample-imbalance problem during the reconstruction process and realize the fusion of the centroid annotation and the focused vertebra. Furthermore, aiming at automatic and customized 3D spinal reconstruction in real-world scenarios, we extend ReVerteR to a clinical deployment-oriented framework, and develop an interactive interface with all functions in the framework integrated so as to enhance human–computer interaction during clinical decision-making. Extensive experiments and visualization conducted on our constructed datasets based on two benchmark datasets of spinal CT, VerSe 2019 and VerSe 2020, demonstrate the effectiveness of our proposed ReVerteR. In this paper, we propose an automatic 3D reconstruction method of vertebrae based on orthogonal bi-planar radiographs. With the 3D upright posture of the spine under natural weight bearing effectively constructed, our proposed method is expected to better support doctors make clinical decision during spine-related diagnosis and surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: The association between changes occurring in the spine and lower body parts is not well understood in adolescent idiopathic scoliosis (AIS). OBJECTIVES: The first aim of the study was to investigate the association of scoliosis with lower extremity (LE) alignments, foot characteristics, and muscle strengths in adolescents. Secondly, comparisons of the data among AIS with single and double curves and control groups were determined. METHODS: Thirty-one participants were recruited and classified into 3 groups; AIS with a single curve (n = 7), AIS with double curves (n = 14), and controls (n = 10). Association of the presence of scoliosis with LE alignments (Q and TC angles), LE muscle strengths (hip, knee, and ankle), and foot characteristics (arch indexes) were examined using the point biserial correlation, and the data among three groups were compared using the ANOVA. RESULTS: Scoliosis was associated with Q angle, arch indexes, and all LE muscle strengths except for hip extensors and ankle plantar flexors strengths. Comparisons among the three groups showed significant increases in LE alignments and foot characteristics in AIS. Almost all LE muscle strengths decreased in AIS, especially for the single curve group. CONCLUSIONS: Apart from spinal deformity, the AIS has changed in LE alignments, muscle strengths, and foot characteristics. Therapists should consider these associations and alterations for designing proper management. [ABSTRACT FROM AUTHOR]

Adolescent idiopathic scoliosis (AIS) necessitates accurate spinal curvature assessment for effective clinical management. Traditional two-dimensional (2D) Cobb angle measurements have been the standard, but the emergence of three-dimensional (3D) automatic measurement techniques, such as those using weight-bearing 3D imaging (WR3D), presents an opportunity to enhance the accuracy and comprehensiveness of AIS evaluation. This study aimed to compare traditional 2D Cobb angle measurements with 3D automatic measurements utilizing the WR3D imaging technique in patients with AIS. A cohort of 53 AIS patients was recruited, encompassing 88 spinal curves, for comparative analysis. The patient sample consisted of 53 individuals diagnosed with AIS. Cobb angles were calculated using the conventional 2D method and three different 3D methods: the Analytical Method (AM), the Plane Intersecting Method (PIM), and the Plane Projection Method (PPM). The 2D cobb angle was manually measured by 3 experienced clinicians with 2D frontal whole-spine radiographs. For 3D cobb angle measurements, the spine and femoral heads were segmented from the WR3D images using a 3D-UNet deep-learning model, and the automatic calculations of the angles were performed with the 3D slicer software. AM and PIM estimates were found to be significantly larger than 2D measurements. Conversely, PPM results showed no statistical difference compared to the 2D method. These findings were consistent in a subgroup analysis based on 2D Cobb angles. Each 3D measurement method provides a unique assessment of spinal curvature, with PPM offering values closely resembling 2D measurements, while AM and PIM yield larger estimations. The utilization of WR3D technology alongside deep learning segmentation ensures accuracy and efficiency in comparative analyses. However, additional studies, particularly involving patients with severe curves, are required to validate and expand on these results. This study emphasizes the importance of selecting an appropriate measurement method considering the imaging modality and clinical context when assessing AIS, and it also underlines the need for continuous refinement of these techniques for optimal use in clinical decision-making and patient management. [ABSTRACT FROM AUTHOR]

Halo gravity traction (HGT) is a preoperative modality for children with severe spinal deformity used to optimize spine flexibility and balance while decreasing the likelihood of neurologic injury. HGT is a dependable solution for these challenging spinal deformities. Aligning treatment guidelines and providing resources, education, and training for staff are key components for a successful HGT program. The HGT program at Children's Mercy Hospital was then developed with a systems approach with the holistic goal of multidisciplinary collaboration with physical/occupational therapy, hospital medicine, pulmonology, psychology, nutrition, child life, and complex care management. Education, research, and national collaboration to standardize this therapy should improve patient safety and support quality improvement. [ABSTRACT FROM AUTHOR]

Background Development of malocclusion can be promptly recognized through an understanding of the optimal position of the bone structures in the orofacial system and their relationship to the cranial base and jaw base. The aim of this study was to assess the relationship between the cranial base, mandible, and hyoid bone in different anteroposterior skeletal malocclusions. Materials and Methods This retrospective study evaluated 120 lateral cephalometric radiographs of individuals aged between 15 and 30 years. The subjects were classified using Burstone's analysis into three groups based on the N perpendicular to point A and N perpendicular to point B. The collected lateral cephalograms of the selected individuals were analyzed using Nemoceph v.12 software (Nemotec, Spain). The nasion-sella-articulare (NSAr), hyoidale angle (C3HyD), sella-articulare-hyoid angle (SArHy), and nasion-sella-hyoid (NSHy) angles were measured and compared among all the three groups. Results In the present study, considering the various angles among the three study groups, a statistically significant difference was observed for the SArHy angle (p < 0.05). However, the saddle angle (NSAr) and hyoidale angle (C3HyD) showed no statistically significant difference between the three study groups. Post hoc Bonferroni test was applied to compare the differences between two groups. A statistically significant difference (p < 0.05) was observed between class I and class II and between class II and class III groups. Conclusion Though the findings of the present study concluded that there is no variation in saddle angle among the three groups, the significant association of SArHy angle among class I, class II, and class III skeletal relationships, suggests an adaptation of the hyoid bone position in various skeletal patterns. We also suggest that the posterior positioning of the hyoid bone is related to skeletal class II malocclusion, whereas a forward positioning of the hyoid bone is related to skeletal class III malocclusion. [ABSTRACT FROM AUTHOR]

Background: The study of the angles between the vertebrae and the curvatures of the spine plays an important role in the pathogenesis of spinal disorders. The nature of the cervical region makes it susceptible to various cervical disorders, many of which can be caused by imbalanced alignment. Methods: In the present study, patients with chronic neck pain were compared with the normal population for cervical indexes. Results: One hundred subjects were selected, including 57 males (57%) and 43 females (43%). Neck tilting was significantly lower in the case group than control (41.5 vs. 45.8) (p=0.01). The mean of C0-C2 angle did not differ between groups (p=0.503), however, a significant increase was found for C2-C7 and C0-C7 angles (p=0.012) and (p=0.05), respectively. Further analysis revealed that cranial offset (21.9 vs. 8.6) and cranial tilting (21.3 vs. 10.1) significantly increased in patients with chronic neck pain (p<0.001) and (p=0.004), respectively. Also, cervical Sagittal Vertical Axis (SVA) has shown a significant increase in patients than control (24.8 vs. 9.7) (p<0.001). Conclusion: The data have indicated that cervical indexes. Thus, spine surgeons should obtain standing cervical radiographs and evaluate the relationship between T1 slope, Spino Cranial Angle (SCA), and cSVA in all cases affected by cervical pathogenesis, even without obvious deformity. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. Methods: In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture. Results: A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups. Conclusions: There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5–6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity. [ABSTRACT FROM AUTHOR]

Complex mixtures of chemicals present in groundwater at legacy-contaminated industrial sites can pose significant risks to adjacent surface waters. The combination of short-term molecular and chronic apical effect assessments is a promising approach to characterize the potential hazard of such complex mixtures. The objectives of this study were to: (1) assess the apical effects (survival, growth, development, and liver histopathology) after chronic exposure of early life stages (ELSs) of fathead minnows (FHM; Pimephales promelas) to contaminated groundwater from a legacy-contaminated pesticide manufacturing and packaging plant, and (2) identify possible molecular mechanisms responsible for these effects by comparing results to mechanistic outcomes previously determined by a short-term reduced transcriptome assay (EcoToxChips). This study revealed a significant increase in mortality and prevalence of spinal curvatures, as well as a significant reduction in the length of FHMs exposed to the groundwater mixtures in a concentration-dependent manner. There was an increasing trend in the prevalence of edema in FHMs, though not significantly different from controls. Additionally, no histopathological effects were observed in the liver of FHMs exposed to the groundwater mixtures. Short-term molecular outcomes determined in a parallel study were found to be informative of chronic apical outcomes, including cardiotoxicity, spinal deformities, and liver toxicity. Overall, the results observed in this study demonstrated that short-term transcriptomics analyses could support the hazard assessment of complex contaminated sites. Molecular outcomes were reflective of mortality and deformities, but uncertainties remained in the prediction of hepatotoxic effects at apical level. [ABSTRACT FROM AUTHOR]

Introduction. To investigate the outcomes of Pilates exercise compared to traditional treatment for the management of upper cross syndrome (UCS). Methods. Forty female participants with UCS were randomly divided into two equal groups: group A (control group) and group B (experimental group). Both groups received two sessions per week for four consecutive weeks. Group A received a traditional physical therapy program consisting of stretching, strengthening, and postural correction exercises, while group B received a Pilates exercise program. Primary outcome measures were balance, spinal curvature, craniovertebral (CV) angle, and rounded shoulders, while the Neck Disability Index and Visual Analogue Scale served as secondary outcome measures. Measurements were recorded before and after treatment. Results. A comparison of pre- and post-treatment test results showed that all dependent variables significantly improved for both groups (p > 0.001). However, Pilates exercise resulted in greater improvement in terms of balance, spinal curvature, CV angle, and pain (p > 0.001). Conclusions. The Pilates exercise program proved more effective than the traditional physical therapy program in improving spinal curvature, balance, and function, and in reducing pain in UCS. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: Evaluate and compare sagittal parameters of the spine in different morphological types of cervical curves. Method: ten lateral radiographs of the cervical spine of each morphological type of cervical curvature (lordotic, straightened, sigmoid and kyphotic) were used to measure the C1-C2 angle, C2-C7 angle using the Cobb method, T1 inclination, T1-lordosis inclination C2-C7 cervical and axial sagittal cervical axis. Parameter measurements were compared in the different morphological types of cervical spine curvature. Results: a statistical difference was observed in the C2-C7 angle, T1 inclination and T1 inclination-C2-C7 cervical lordosis in the different morphological types of cervical curvature. No statistical difference was observed in the C1-C2 angle and axial sagittal cervical axis in the different morphological types of cervical curvature.Conclusion: sagittal parameters (C2-C7 angle by Cobb method, T1 inclination, T1 inclination-C2-C7 cervical lordosis) present differences in the different morphological types of cervical curvatures and must be considered in the evaluation and therapeutic development. Evidence level III, retrospective comparative study.

ABSTRACT Objectives: Compare three methods for evaluating the curvature of the cervical spine (Cobb, Jackson and Harrison method) considering the morphological types of cervical curvature (lordotic, straightened, sigmoid and kyphotic). Method: Ten lateral radiographs of each type of cervical curvature (lordotic, rectified, sigmoid and kyphotic) were used to measure the curvature of the cervical spine using the Cobb, Jackson and Harrison methods. The results were compared. Results: he methods for assessing cervical curvature showed statistical differences in the assessment of the group of individuals and in the individualized assessment of each morphological type of cervical spine curvature. Conclusion: he methods for assessing cervical spine curvature present differences in relation to angular measurement and the difference in measurement was also observed in the different morphological types of cervical spine curvature. Evidence level III, retrospective comparative study.

Introduction: Transcutaneous electrical nerve stimulation (TENS) is commonly used for pain management. Recent studies have shown that TENS can improve the condition of low back pain by influencing the elastic coefficient of the lumbar fascia and the balance status; however, the effect of TENS on the lumbar fascia of healthy people has not been investigated. Accordingly, this study examines the effect of TENS on the lumbar fascia of healthy people. Materials and Methods: A total of 60 healthy participants in two groups, underwent 10 sessions of conventional TENS intervention. The first group (intervention group) received TENS with an intensity at the tolerance level, and the second group (control group) received sham TENS. Ultrasonography and a spinal mouse device were assessed lumbar fascia thickness and lumbar curvature before and after the TENS. Results: Significant changes were observed after TENS in the intervention group in reducing the lumbar fascia thickness (P=0.006) and increasing the lumbar curvature (P=0.000). Between-group changes after the intervention sessions indicated a significant difference between the lumbar fascia thickness and curvature (P≤0.003). Conclusion: TENS in healthy people can lead to a decrease in the thickness of the lumbar fascia and improve lumbar curvature. Also, a strong correlation was found between lumbar fascia thickness reduction and increased lumbar curvature.

Airborne fine particulate matter (PM2.5) in air pollution has become a significant global public health concern related to allergic diseases. Previous research indicates that PM2.5 not only affects the respiratory system but may also induce systemic inflammation in various tissues. Moreover, its impact may vary among different populations, with potential consequences during pregnancy and in newborns. However, the precise mechanisms through which PM2.5 induces inflammatory reactions remain unclear. This study aims to explore potential pathways of inflammatory responses induced by PM2.5 through animal models and zebrafish embryo experiments. In this study, zebrafish embryo experiments were conducted to analyze the effects of PM2.5 on embryo development and survival, and mouse experimental models were employed to assess the impact of PM2.5 stimulation on various aspects of mice. Wild-type zebrafish embryos were exposed to a PM2.5 environment of 25–400 μg/mL starting at 6 h after fertilization (6 hpf). At 6 days post-fertilization, the survival rates of the 25, 50, 100, and 200 µg/mL groups were 100%, 80, 40%, and 40%, respectively. Zebrafish embryos stimulated with 25 μg/mL of PM2.5 still exhibited successful development and hatching. Additionally, zebrafish subjected to doses of 25–200 μg/mL displayed abnormalities such as spinal curvature and internal swelling after hatching, indicating a significant impact of PM2.5 stimulation on embryo development. In the mouse model, mice exposed to PM2.5 exhibited apparent respiratory overreaction, infiltration of inflammatory cells into the lungs, elevated levels of inflammatory response-related cytokines, and inflammation in various organs, including the liver, lungs, and uterus. Blood tests on experimental mice revealed increased expression of inflammatory and chemotactic cytokines, and GSEA indicated the induction of various inflammatory responses and an upregulation of the TNF-α/NFκB pathway by PM2.5. Our results provide insights into the harmful effects of PM2.5 on embryos and organs. The induced inflammatory responses by PM2.5 may be mediated through the TNF-α/NFκB pathway, leading to systemic organ inflammation. However, whether PM2.5-induced inflammatory responses in various organs and abnormal embryo development are generated through different pathways requires further study to comprehensively clarify and identify potential treatment and prevention methods. [ABSTRACT FROM AUTHOR]

Background: Limited research has examined the impact of lower limb length discrepancy (LLLD) alteration on spinopelvic compensation in individuals with developmental dysplasia of the hip (DDH). This study aimed to investigate the effects of LLLD on spinopelvic compensation following total hip arthroplasty (THA) and elucidate the complex biomechanical adaptations in the spinopelvic structures. Methods: A retrospective review of DDH patients undergoing THA from January 2014 to December 2021 categorized individuals with Crowe type I and II into the low dislocation group (LDG, n = 94) and those with Crowe type III and IV into the high dislocation group (HDG, n = 43). Demographic data, as well as preoperative, postoperative, and last follow-up imaging data, including lower limb length (LLL), sacral obliquity (SO), iliac obliquity (IO), hip obliquity (HO), Cobb angle, apical vertebral translation (AVT), and coronal decompensation (CD), were collected for analysis. Results: Patients in the LDG had a significantly higher surgical age and shorter disease duration (P<0.05). In LDG, patients exhibited substantial postoperative reductions in LLLD, SO, IO, and HO (P<0.05), while Cobb Angle, AVT, and CD showed no statistically significant changes (P>0.05). The variation in LLLD correlated significantly with the variations in SO, IO, and HO (P<0.05). Postoperative outcomes in the HDG demonstrated marked decreases in LLLD, SO, IO, HO, and CD (P<0.05), with no significant change in Cobb angle and AVT (P>0.05). The variation in LLLD correlated significantly with the variations in SO, IO, HO, and CD (P<0.05). Conclusions: THA effectively reduces LLLD in patients with DDH, and the variation in LLLD correlates meaningfully with the recovery of spinopelvic compensatory mechanisms. [ABSTRACT FROM AUTHOR]

To propose a novel surgical strategy-thoracic anterior controllable antedisplacement fusion (TACAF) to treat multilevel thoracic ossification of the posterior longitudinal ligament (mT-OPLL), and investigate its safety and efficacy. Between January 2019 and December 2021, a total of 49 patients with thoracic myelopathy due to mT-OPLL surgically treated with TACAF were retrospectively reviewed. Patients' demographic data, radiologic parameters, and surgery-related complications, modified Japanese Orthopedic Association (mJOA) and visual analog scale (VAS) scores, thoracic kyphosis (TK), kyphosis angle in fusion area (FSK), thoracic curvature, spinal cord curvature, and curvature of curved rod in surgical region, diameter, and area of the spinal cord at the most compressed level were included. All patients acquired satisfactory recovery of neurologic function and overall complication rate was low at the final follow up. The mean mJOA of the laminectomy+TACAF and Full Lamina Preservation +TACAF groups, respectively, was 3.74 ± 2.05, 3.67 ± 1.95 before surgery, and 9.97 ± 0.83, 9.80 ± 0.68 at the final followed up, with the recovery rate of 84.26% ± 14.20%, 82.79% ± 10.35%, as to VAS Scores. The mean FSK was 34.50 ± 4.46,35.33 ± 3.44 before surgery, and was restored to 20.97 ± 5.70, 22.93 ± 6.34 at the final followed up respectively, as to mean TK (P < 0.05). Spinal cord curvature was improved from 34.12 ± 3.59, 33.93 ± 3.45 before surgery to 19.47 ± 3.53, 18.80 ± 3.17 at the final follow-up respectively, as to thoracic curvature (P < 0.05). In addition, the area and diameter of the spinal cord was also significantly improved at the final follow up (all P < 0.05). The curvature of the thoracic pulp and thoracic vertebra is closely related to the curvature of the rod. There was no statistically significant difference in the incidence of the pelvis and the slope value of the sacrum. This strategy provides a novel solution for the treatment of mT-OPLL with favorable recovery of neurological function, the tension of spinal cord, and fewer complications. [ABSTRACT FROM AUTHOR]

Knowledge of the relationship between the hip and spine is essential in the effort to minimize instability and improve outcomes following total hip arthroplasty (THA). A detailed yet straightforward preoperative imaging workup can provide valuable information on pelvic positioning, which may be helpful for optimum placement of the acetabular cup. For a streamlined preoperative assessment of THA candidates, classification systems with a capacity for providing a more personalized approach to performance of THA have been introduced. Familiarity with these systems and their clinical application is important in the effort to optimize component placement and reduce the risk of instability. Looking ahead, the principles of the hip-spine relationship are being integrated using emerging innovative technologies, promising further streamlining of the evaluation process. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is transforming spinal imaging and patient care through automated analysis and enhanced decision-making. This review presents a clinical task-based evaluation, highlighting the specific impact of AI techniques on different aspects of spinal imaging and patient care. We first discuss how AI can potentially improve image quality through techniques like denoising or artifact reduction. We then explore how AI enables efficient quantification of anatomical measurements, spinal curvature parameters, vertebral segmentation, and disc grading. This facilitates objective, accurate interpretation and diagnosis. AI models now reliably detect key spinal pathologies, achieving expert-level performance in tasks like identifying fractures, stenosis, infections, and tumors. Beyond diagnosis, AI also assists surgical planning via synthetic computed tomography generation, augmented reality systems, and robotic guidance. Furthermore, AI image analysis combined with clinical data enables personalized predictions to guide treatment decisions, such as forecasting spine surgery outcomes. However, challenges still need to be addressed in implementing AI clinically, including model interpretability, generalizability, and data limitations. Multicenter collaboration using large, diverse datasets is critical to advance the field further. While adoption barriers persist, AI presents a transformative opportunity to revolutionize spinal imaging workflows, empowering clinicians to translate data into actionable insights for improved patient care. [ABSTRACT FROM AUTHOR]

Background: Congenital kyphosis is a spinal deformity that arises from the inadequate anterior development or segmentation of the vertebrae in the sagittal plane during the initial embryonic stage. Consequently, this condition triggers atypical spinal growth, leading to the manifestation of deformity. Concurrently, other congenital abnormalities like renal or cardiac defects within the gastrointestinal tract may co-occur with spinal deformities due to their shared formation timeline. In light of the specific characteristics of the deformity, the age range of the patient, deformity sizes, and neurological conditions, surgical intervention emerges as the optimal course of action for such cases. The selection of the appropriate surgical approach is contingent upon the specific characteristics of the anomaly. Case Presentation: This investigation illustrates the utilization of a surgical posterior-only strategy for correcting pediatric congenital kyphoscoliosis through the implementation of a vertebral column resection method along with spine reconstruction employing a mesh cage. The individual in question, a 16-year-old female, exhibited symptoms such as a progressive rib hump, shoulder asymmetry, and back discomfort. Non-invasive interventions like bracing proved ineffective, leading to the progression of the spinal curvature. After the surgical procedure, diagnostic imaging displayed a marked enhancement across all three spatial dimensions. After a postoperative physical assessment, it was noted that the patient experienced significant enhancements in shoulder alignment and rib hump prominence, with no discernible neurological or other adverse effects. Conclusions: Surgical intervention is considered the optimal approach for addressing such congenital anomalies. Typically, timely surgical intervention leads to favorable results and has the potential to halt the advancement of deformity and curvature enlargement. [ABSTRACT FROM AUTHOR]

Background: Surgical treatment of adolescent idiopathic scoliosis (AIS) is very complex and modern instrumentation techniques offer multiple possibilities. Despite numerous publications, there is no clear consensus on the optimal strategy for the correction of scoliotic deformities. The goal of this study was to summarize the current surgical strategies for specific AIS cases within various countries. Method: Thirty‐two experienced scoliosis surgeons from 15 countries were asked to plan surgeries on 12 representative AIS cases. All AIS cases had an indication for surgery. A questionnaire was provided to document surgical planning. The surgeons were provided with the patients' age and sex, together with radiographs in the lateral and sagittal planes during upright standing and in lateral bending to the left and right, as well as with clinical images. The angles of the main spinal curvatures were specified in the questionnaire. The surgeons were asked to specify their preferred classification system, their surgical approach, the planned fusion length, the type of implants, the rod type, and the resection steps. The data were analyzed with respect to the inter‐rater variability, which was quantified using the Fleiss‐Kappa Method. Results: There was a good agreement (k = 0.61) between the surgeons in choosing the Lenke curve type, and a moderate agreement for the lumbar (0.41) and sagittal (0.56) modifiers. The most frequently planned resection procedure was complete facetectomy (67%). The posterior approach was the most commonly (91%) selected strategy to treat AIS. Anterior approaches were chosen most for Lenke 5 type with a rate of 20%. The upper instrumented vertebra (UIV) varied most for Lenke 1, 5, and 6 cases, with a vertebral level discrepancy of up to 10 levels at Lenke 6. The lowest instrumented vertebra varied most for Lenke 1 and 4 by up to five levels. Polyaxial screws were chosen most (56%), followed by monoaxial (20%) and uniplanar (19%) screws and hooks (5%). Conclusions: The results highlight the commonalities and discrepancy in the surgical treatment of AIS in between surgeons. The selected LIV and UIV can vary depending on the curve type and surgeon. Hook constructs appear to be generally replaced by transpedicular screws. The survey indicates open questions in the AIS treatment and in the understanding of scoliosis biomechanics. [ABSTRACT FROM AUTHOR]

Background: Severe and rigid scoliosis represents a type of spinal deformity characterized by a Cobb angle exceeding 90° and a flexibility of less than 30%. Halo spinal traction remains the established standard for managing severe scoliosis, although alternative approaches such as temporary internal distraction rods and staged surgical correction exist. The primary objective of this investigation was to compare two cohorts of patients treated using these distinct methods to ascertain any divergences in terms of surgical and radiological outcomes, pulmonary function (PF), and quality of life (QoL). Methods: This study encompassed a total of 62 pediatric patients meeting the specified criteria, which included severe idiopathic scoliosis (major Cobb curve >90) and flexibility <30%. Group 1 (G1) underwent surgical intervention involving preoperative Halo gravity traction (HGT) succeeded by posterior spinal fusion (PSF). On the other hand, Group 2 (G2) underwent a two-stage procedure starting with a less invasive temporary internal distraction technique (LITID) prior to PSF. The radiological outcomes, PF, and QoL were documented and assessed over a monitoring period ranging from 2 to 5 years. Results: The average preoperative major curves (MCs) measured 124° and 122° in G1 and G2, respectively (p < 0.426). Initial flexibility, as observed in preoperative bending films, ranged from 18% in G1 to 21% in G2 (p < 0.001). Following the ultimate surgical intervention, the MCs were corrected to 45° and 37.4° in G1 and G2, respectively (p < 0.001). The percentage correction of the MCs was higher in G2 (63% vs. 70% in G1 and G2, respectively), with significant between-group disparities (p < 0.001). The mean preoperative thoracic kyphoses (TKs) were 96.5° in G1 and 92° in G2 (p = 0.782), which were rectified to 45.8° in G1 and 36.2° in G2 (p < 0.001), equating to correction rates of 55% and 60% in the respective groups. Initially, G2 exhibited lower values for the percentage of predicted lung volume (FVC) and predicted FEV1 compared with G1 (49% and 58% vs. 54.5% and 60.8%; N.S.). Nonetheless, both groups demonstrated enhancements in their FVC and FEV1 values over the follow-up period. Conclusions: The surgical management of severe and untreated spinal curvatures in the pediatric and adolescent population can be considered safe, with a tolerable incidence of minor complications. LITID emerges as a method offering improved QoL and pulmonary function, achieving notably substantial average corrections in deformity by 70% in the coronal plane and 60% in the sagittal plane, alongside a mean increase in trunk height of 10.8 cm. Furthermore, a typical reduction of 76% in rib humps and enhancements in respiratory function, as indicated by improvements in 1 s predicted forced expiratory volume (by 25–56%) and forced vital capacity (by 35–65%), were achieved, leading to a clinically and statistically significant enhancement in QoL when evaluated using SRS-22r, without resorting to more radical, high-risk procedures. [ABSTRACT FROM AUTHOR]

Background: The surgical treatment of severe and complex adult spinal deformity (ASD) commonly required three-column osteotomy (3-CO), which was technically demanding with high risk of neurological deficit. Personalized three dimensional (3D)-printed guide template based on preoperative planning has been gradually applied in 3-CO procedure. The purpose of this study was to compare the efficacy, safety, and precision of 3D-printed osteotomy guide template and free-hand technique in the treatment of severe and complex ASD patients requiring 3-CO. Methods: This was a single-centre retrospective comparative cohort study of patients with severe and complex ASD (Cobb angle of scoliosis > 80° with flexibility < 25% or focal kyphosis > 90°) who underwent posterior spinal fusion and 3-CO between January 2020 to January 2023, with a minimum 12 months follow-up. Personalized computer-assisted three-dimensional osteotomy simulation was performed for all recruited patients, who were further divided into template and non-template groups based on the application of 3D-printed osteotomy guide template according to the surgical planning. Patients in the two groups were age- and gender- propensity-matched. The radiographic parameters, postoperative neurological deficit, and precision of osteotomy execution were compared between groups. Results: A total of 40 patients (age 36.53 ± 11.98 years) were retrospectively recruited, with 20 patients in each group. The preoperative focal kyphosis (FK) was 92.72° ± 36.77° in the template group and 93.47° ± 33.91° in the non-template group, with a main curve Cobb angle of 63.35° (15.00°, 92.25°) and 64.00° (20.25°, 99.20°), respectively. Following the correction surgery, there were no significant differences in postoperative FK, postoperative main curve Cobb angle, correction rate of FK (54.20% vs. 51.94%, P = 0.738), and correction rate of main curve Cobb angle (72.41% vs. 61.33%, P = 0.101) between the groups. However, the match ratio of execution to simulation osteotomy angle was significantly greater in the template group than the non-template group (coronal: 89.90% vs. 74.50%, P < 0.001; sagittal: 90.45% vs. 80.35%, P < 0.001). The operating time (ORT) was significantly shorter (359.25 ± 57.79 min vs. 398.90 ± 59.48 min, P = 0.039) and the incidence of postoperative neurological deficit (5.0% vs. 35.0%, P = 0.018) was significantly lower in the template group than the non-template group. Conclusion: Performing 3-CO with the assistance of personalized 3D-printed guide template could increase the precision of execution, decrease the risk of postoperative neurological deficit, and shorten the ORT in the correction surgery for severe and complex ASD. The personalized osteotomy guide had the advantages of 3D insight of the case-specific anatomy, identification of osteotomy location, and translation of the surgical planning or simulation to the real surgical site. [ABSTRACT FROM AUTHOR]