The effect of coronal decompensation on the biomechanical parameters in lower limbs in adolescent idiopathic scoliosis
| Autor: | Péter Than, Miklós Tunyogi-Csapó, Máté Burkus, István Márkus, Kristóf József, Ádám Tibor Schlégl, Bálint Niklai |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Scoliosis Young Adult 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Decompensation Femur Tibia Child Pelvic Bones Retrospective Studies Balance (ability) Orthodontics 030222 orthopedics Bone Development Cobb angle business.industry Reproducibility of Results medicine.disease Spine Biomechanical Phenomena Surgery Lower Extremity Case-Control Studies Coronal plane Bone maturation Female business 030217 neurology & neurosurgery |
| Zdroj: | Orthopaedics & Traumatology: Surgery & Research. 104:609-616 |
| ISSN: | 1877-0568 |
| DOI: | 10.1016/j.otsr.2018.06.002 |
| Popis: | Study hypothesis We hypothesized that altered coronal balance in adolescent scoliosis leads to asymmetric stress on the lower limbs, with subsequent effects on bone maturation and later morphology. We aimed to assess the correlation between the biomechanical parameters of the lower limbs and coronal balance in idiopathic scoliosis. Materials and methods In this study, EOS images of 280 patients and 56 controls were randomly selected from our clinics’ database. The average age of AIS patients was 14.5 years and average Cobb angle 33.48°. Three D reconstructions of the pelvis and lower limbs were performed and coronal balance assessed. Reliability of measurements was ensured by intra- and inter-observer agreement. During statistical analysis the Kolmogorov-Smirnov test, t-test and linear regression analysis were performed. A p value Results Of the 15 examined lower limb parameters, a significant difference between sides was found in those with AIS for femur length, total length, collodiaphyseal angle, angle between the femoral mechanical and anatomical axis and tibial torsion. In addition, the tibial length and the mechanical tibiofemoral angle were significantly higher than those of the controls. The coronal balance was found to be the strongest predictive factor showing a significant correlation with all of the previous parameters, except tibial torsion. With patients grouped based on coronal balance (compensated, right and left decompensated) the paired t-test also supported these findings. Conclusion The biomechanical parameters of the lower limbs are affected in cases of scoliosis with an altered coronal balance. It was thought that a shift in balance in the coronal plane accounted for the small but significant changes seen in our study, with the lower limb on the side of decompensation becoming shorter in comparison to its’ counterpart, with a lower collodiaphyseal angle and increased varus at the knee joint. Level of evidence III, case-control study. |
| Databáze: | OpenAIRE |
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