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- Abul-Kasim, Kasim, et al.
(författare)
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Increased rod stiffness improves the degree of deformity correction by segmental pedicle screw fixation in adolescent idiopathic scoliosis.
- 2011
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Ingår i: Scoliosis. - : Springer Science and Business Media LLC. - 1748-7161. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are limited reports in literature studying the impact of rod diameter and stiffness on the degree of deformity correction in patients with AIS. AIMS: The aims of this study were to evaluate the 3-dimentional deformity correction achieved by segmental pedicle screw fixation in patients with adolescent idiopathic scoliosis, and to find out if learning or the change to stiffer rods had any positive impact on deformity correction. STUDY DESIGN: Retrospective study. METHODS: Plain radiographs and low-dose spine CTs of 116 consecutive patients (aged 15.9 ± 2.8 years) operated during the period 2005-2009 (group 1: patients operated autumn 2005-2006; group 2: 2007; group 3: 2008; group 4: 2009) were retrospectively evaluated. RESULTS: There was no statistically significant difference between the correction of the Cobb angle (P = 0.425) or lower end vertebra tilt (P = 0.298) in patients operated during the first versus the remaining periods of the study. No restoration of the sagittal kyphosis was reported in the first period compared with 5.9° in the last study period (P < 0.001). The correction of vertebral rotation was also improved from 4.2° to 7.8° (P < 0.001) for the same periods. For the whole study population, there was statistically significant correlation between the order of the operation (patient number) and the restoration of sagittal kyphosis (r = -0.344, P = 0.001), and the correction of vertebral rotation (r = 0.370, P < 0.001), but not for the Cobb angle or LEVT. However, there was no significant difference in restoration of sagittal kyphosis and the vertebral rotation in the first 17 patients compared with the last 17 patients operated with rods of 5.5 mm diameter (P = 0.621, and 0.941, respectively), indicating that rod stiffness had more impact on the deformity correction than did learning. CONCLUSIONS: This study showed that rod stiffness had more impact on the deformity correction than did learning.
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- Abul-Kasim, Kasim, et al.
(författare)
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Measurement of vertebral rotation in adolescent idiopathic scoliosis with low-dose CT in prone position - method description and reliability analysis
- 2010
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Ingår i: Scoliosis. - : Springer Science and Business Media LLC. - 1748-7161. ; 5, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: To our knowledge there is no report in the literature on measurements of vertebral rotation with low-dose computed tomography (CT) in prone position.Aims: To describe and test the reliability of this new method, compare it with other methods in use and evaluate the influence of body position on the degree of vertebral rotation measured by different radiological methods.Study design: Retrospective study.Methods: 25 consecutive patients with adolescent idiopathic scoliosis scheduled for surgery (17 girls, 8 boys) aged 15 ± 2 years (mean ± SD) were included in the analysis of this study. The degree of the vertebral rotation was in all patients measured according to the method of Perdriolle on standing plain radiographs and on supine CT scanogram, and according to the method of Aaro and Dahlborn on axial CT images in prone position and on magnetic resonance imaging (MRI) in supine position. The measurements were done by one neuroradiologist at two different occasions. Bland and Altman statistical approach was used in the reliability assessment.Results: The reliability of measuring vertebral rotation by axial CT images in prone position was almost perfect with an intraclass correlation coefficient of 0.95, a random error of the intraobserver differences of 2.3°, a repeatability coefficient of 3.2° and a coefficient of variation of 18.4%. Corresponding values for measurements on CT scanogram were 0.83, 5.1°, 7.2°, and 32.8%, respectively, indicating lower reliability of the latter modality and method. The degree of vertebral rotation measured on standing plain radiographs, prone CT scanogram, axial images on CT in prone position and on MRI in supine position were 25.7 ± 9.8°, 21.9 ± 8.3°, 17.4 ± 7.1°, and 16.1 ± 6.5°, respectively. The vertebral rotation measured on axial CT images in prone position was in average 7.5% larger than that measured on axial MRI in supine position.Conclusions: This study has shown that measurements of vertebral rotation in prone position were more reliable on axial CT images than on CT scanogram. The measurement of vertebral rotation on CT (corrected to the pelvic tilt) in prone position imposes lower impact of the recumbent position on the vertebral rotation than did MRI in supine position. However, the magnitude of differences is of doubtful clinical significance.
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| 4. |
- Abul-Kasim, Kasim, et al.
(författare)
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Tonsillar ectopia in idiopathic scoliosis: does it play a role in the pathogenesis and prognosis or is it only an incidental finding?
- 2009
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Ingår i: Scoliosis. - : Springer Science and Business Media LLC. - 1748-7161. ; 4, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: There is an ongoing controversy about the significance of tonsillar ectopia among patients with idiopathic scoliosis (IS). AIM: To find out if tonsillar ectopia occurs more frequently among patients with IS and if it plays any etiological or prognostic role in IS. STUDY DESIGN: Retrospective study. METHODS: Retrospective analysis of 155 consecutive spine MRIs (79 patients with IS and 76 controls; aged 7-25 years; 55% were female) with regard to the position of the cerebellar tonsils in relation to foramen magnum and the sagittal diameter of foramen magnum. All images were evaluated independently by two neuroradiologists. Interobserver and intraobserver reliability analysis was performed by calculation of kappa-value, intraclass correlation coefficient, and systematic and random errors. The occurrence of tonsillar ectopia among patients with IS and controls was estimated and the association of tonsillar ectopia with different predictors has been tested. Statistical significance was set to P
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