• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.228-236
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• 2020

Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.230-237
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• 2020

Objective: To investigate the physical appearance and therapeutic changes that occur with the performance of Schroth exercise in patients with scoliosis. Design: Randomized controlled trial. Methods: Fifteen subjects with maximum curvature of the lumbar who were diagnosed with idiopathic scoliosis had volunteered to participate in the study. Eight subjects were included in the experimental group where they performed the Schroth Therapeutic Exercise and the other seven were included in the control group. The experimental group underwent 2 hours of weekly treatment for 12 weeks, while the control group did not during the same period based on the decisions of patients or guardians. The Mann-Whitney rank test was carried out to compare the treatment results of the two groups, and the comparison within the group was done by Wilcoxon signed-rank test. The vertebral rotation angle (VRA) was by Scoliometer, and difference of rotated and curved portion volume (DV) between both sides on the major curvature portion measured by 3D human body scanning system. Results: In the experimental group, 12 weeks of Schroth exercise therapy has significant improved in correction rate (CR) in Cobb's angle (CA), VRA, and DV between both sides on the major curvature portion (p<0.05), while significant differences were not found between the groups regarding weight bearing difference in both feet (WD) and DV (p<0.05). Conclusions: Schroth exercise performance showed significant changes in the patient's therapeutic changes (CA, VRA), but the physical appearance (DV, WD) was not significant, indicating that external changes in the treatment goal setting are more difficult goals to achieve.

• 산업융합연구
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• 제20권1호
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• pp.107-114
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• 2022

척추측만증은 척추가 관상면에서 10도 이상 굽은 상태입니다. 하지만 관상면 뿐만 아니라 횡단면, 시상면에서의 변형도 포함되기 때문에 단순하지 않은 문제입니다. 측만증의 만곡은 성장기 어린이에게 상당히 진행되면 문제를 일으킵니다. 척추측만증의 치료는 관찰을 포함해서 기브스, 보조기, 물리치료, 운동 및 수술 등이 있습니다. 관리의 목표는 낮은 측만각을 유지하여 비대칭을 최소화하는 것이지만, 학업과 시간 부족으로 청소년들은 지속적인 치료를 받기 어려운 형편입니다. 이에 가정용 온열-마사지를 통해 측만각의 유지 또는 개선을 경험한 척추측만증 사례를 보고합니다.

• Clinical and Experimental Pediatrics
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• 제45권11호
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• pp.1417-1421
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• 2002

저자들은 척추 측만증과 보행장애를 주소로 입원한 9세된 남아에서 단순 방사선 검사 및 복부 CT 검사에서 13 cm 길이의 나무연필에 의한 2차적인 척추 측만증 증례를 경험하였으며 아울러 요즘 사회적인 문제로 대두되는 학교집단폭행이나 학대에 의한 가능성이 높은 것으로 추정되어 이에 대한 심각성을 실감하게 되어 문헌 고찰과 함께 보고하는 바이다.

• Physical Therapy Rehabilitation Science
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• 제6권3호
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• pp.113-119
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• 2017

Objective: The objective of this study was to investigate the effects of Schroth's three-dimensional exercises in combination with respiratory muscle exercise (SERME) on Cobb's angle and functional movement screen (FMS). Design: Randomized controlled trial. Methods: Fifteen subjects with scoliosis were randomly assigned to two groups. Eight subjects were assigned to the experimental group and seven subjects were assigned to the control group. The experimental group underwent SERME using SpiroTiger (Idiag, Switzerland), while the control group performed only the Schroth's three-dimensional exercises (SE). Both groups performed exercises for one hour per day, three times a week for eight weeks. Cobb's angle, pulmonary function (forced vital capacity, forced expiratory volume at one second, and peak expiratory flow) and FMS were measured before and after the experiment. Results: After intervention, the SERME group showed a significant difference in Cobb's angle, FMS scores, and pulmonary function as compared to before intervention (p<0.05). In the SE group, there was a statistically significant difference in Cobb's angle, pulmonary function, and FMS scores compared to before intervention (p<0.05). The SERME group showed a significant difference in Cobb's angle and peak expiratory flow in pulmonary function compared to the SE group (p<0.05). Conclusions: The results suggest that SERME could be a more effective intervention for improvement of the Cobb's angle and pulmonary function for scoliosis patients.

• Experimental and Molecular Medicine
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• 제50권11호
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• pp.3.1-3.11
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• 2018

This study aimed to verify the effects of estrogen on the onset and development of adolescent idiopathic scoliosis and the mechanisms associated with these effects by constructing a pubescent bipedal rat model. Experiments were conducted to investigate whether scoliosis progression was prevented by a Triptorelin treatment. One hundred twenty bipedal rats were divided into female, OVX (ovariectomy), OVX + E2, Triptorelin, sham, and male groups. According to a spinal radiographic analysis, the scoliosis rates and curve severity of the female and OVX + E2 groups were higher than those in the OVX, Triptorelin, and male groups. The measurements obtained from the sagittal plane of thoracic vertebrae CT confirmed a relatively slower growth of the anterior elements and a faster growth of the posterior elements between T11 and T13 in the female and OVX + E2 groups than in the OVX and Triptorelin groups. Histomorphometry and immunohistochemistry revealed a significantly longer hypertrophic zone of the vertebral cartilage growth plates that expressed more type X collagen and less type II collagen in the OVX and Triptorelin groups than in the female and OVX + E2 groups. Ki67 immunostaining confirmed an increase in the proliferation of vertebral growth plate chondrocytes in the OVX group compared with the female and OVX + E2 groups. In conclusion, estrogen obviously increased the incidence of scoliosis and curve severity in pubescent bipedal rats. The underlying mechanism may be a loss of coupling of the endochondral ossification between the anterior and posterior columns. Triptorelin decreased the incidence of scoliosis and curve magnitudes in bipedal female rats.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.776-783
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• 2021

Objective : The purpose of this study was to identify risk factors for distal adding on (AO) or distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) treated by posterior spinal fusion (PSF) to L3 with a minimum 2-year follow-up. Methods : AIS patients undergoing PSF to L3 by two senior surgeons from 2000-2010 were analyzed. Distal AO and DJK were deemed poor radiographic results and defined as >3 cm of deviation from L3 to the center sacral vertical line (CSVL), or >10° angle at L3-4 on the posterior anterior- or lateral X-ray at ultimate follow-up. New stable vertebra (SV) and neutral vertebra (NV) scores were defined for this study. The total stability (TS) score was the sum of the SV and NV scores. Results : Ten of 76 patients (13.1%) were included in the poor radiographic outcome group. The other 66 patients were included in the good radiographic outcome group. Lower Risser grade, more SV-3 (CSVL doesn't touch the lowest instrumented vertebra [LIV]) on standing and side bending films, lesser NV and TS score, rigid L3-4 disc, more rotation and deviation of L3 were identified risk factors for AO or DJK. Age, number of fused vertebrae, curve correction, preoperative coronal/sagittal L3-4 disc angle did not differ significantly between the two groups. Multiple logistic regression results indicated that preoperative Risser grade 0, 1 (odds ratio [OR], 1.8), SV-3 at L3 in standing and side benders (OR, 2.1 and 2.8, respectively), TS score -5, -6 at L3 (OR, 4.4), rigid disc at L3-4 (OR, 3.1), LIV rotation >15° (OR, 2.9), and LIV deviation >2 cm from CSVL (OR, 2.2) were independent predictive factors. Although there was significant improvement of the of Scoliosis Research Society-22 average scores only in the good radiographic outcome group, there was no significant difference in the scores between the groups. Conclusion : The prevalence of AO or DJK at ultimate follow-up for AIS with LIV at L3 was 13.1%. To prevent AO or DJK following fusion to L3, we recommend that the CSVL touch L3 in both standing and side bending, TS score is -4 or less, the L3/4 disc is flexible, L3 is neutral (<15°) and ≤2 cm from the midline and the patient is ≥ Risser 2.

• 한국전문물리치료학회지
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• 제13권4호
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• pp.47-55
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• 2006

The purpose of this study was to compare the static balance of standing position between adolescent idiopathic scoliosis (AIS) and a normal group that were aged-matched. There were forty subjects included in this study. Twenty-seven healthy subjects (age, $13.9{\pm}1.2$ yrs; height, $161.9{\pm}7.5$ cm; weight, $52.2{\pm}7.7$ kg) and thirteen AIS subjects (age, $14.2{\pm}2.2$ yrs; height, $161.5{\pm}8.7$ cm; weight, $48.1{\pm}8.1$ kg) were participated in the study. The thirteen subjects in the AIS group had a major Cobb angle between $20.1^{\circ}$ and $49^{\circ}$. Each group was tested with the Balance Performance Monitor (BPM). The parameters for static balance were sway area, sway path, max velocity, mean balance, anterior-posterior angle, and left-right angle of each group with their eyes opened and again with their eyes closed. Both sides of the forward reach test and the lateral reach test were also performed on each group. Results from the BPM tested showed significantly increases in all parameters of static balance with those patients with AIS under the conditions where eyes were opened and closed. In the right and left forward reach test, there was no significant difference between normal and AIS groups. However, in the lateral reach test with right and left direction, there were significant differences between normal and AIS groups. For the normal subjects, there were significant differences in the parameters with sway path and anterior-posterior sway angle between the eyes opened and closed. However, there were no significant differences in the all parameters between eyes opened and closed for the AIS subjects. These results suggest that, balance programs could be used in the rehabilitation setting for intervention of AIS and evaluation of AIS. Further study is needed to measure many patients with AIS and other functional balance scales for clinical application.

• 임상간호연구
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• 제22권3호
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• pp.345-351
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• 2016

Purpose: The specific aims of this study were to investigate the incidence, time of occurrence, intervention methods and related causes of abdominal discomfort after scoliosis corrective surgery. Methods: A retrospective review was carried out on all patients with diagnosis of adolescent idiopathic scoliosis (n=420) who received a posterior spinal fusion between January 2012 and December 2014. Logistic regression analysis was used to identify significant related factors. Results: One hundred eighty five of the patients in the study (44.0%) reported abdominal discomfort (AD group). The discomfort was worst on 2nd days after operation (31.4%), and 3rd days (27.0%). Ninety seven patients (52.4%) in the AD group received enema treatment. Significant related factors for developing abdominal discomfort were distal fusion levels (OR=2.43, p<.006) and increased operative blood loss (OR=1.03, p<.001). Conclusion: The incidence of abdominal discomfort after scoliosis corrective surgery in this study was 44%. Abdominal discomfort, therefore, is a main concern in reference to scoliosis corrective surgery, and solutions need to be searched and reported in future research.

• 대한물리의학회지
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• 제7권1호
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• pp.59-67
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• 2012

Purpose : This study was somatosensory less in patients with idiopathic scoliosis somatosensory input to the lumbar stabilization exercises carried out to determine the most effective treatment method to be stable and unstable in terms of supporting the lumbar stabilization exercises the patient's torso length and postural sway by comparing the distance from a standing position and looked for differences in effect on the balance. Methods : The subjects of the study were 18 patients who showed the symptom of scoliosis. The study classified the patients into two experimental groups, one using an unstable surface and one a fixed surface, and the patients were required to do a lumbar stabilization exercise a total of 12 times for 60 minutes per session, three times a week for four weeks. The study carried out a paired comparison t-test so as to compare differences between measurement values in each experimental group before and after the exercise. Results : Superior iliac spine on the left, there was a significant reduction in the group doing the lumbar stabilization exercise on an unstable surface (p<0.05). Regarding change in sway distance to the left and right directions in the group doing the lumbar stabilization exercise on the unstable surface, there was a significant decrease in both the condition of closed eyes or open eyes (p<0.05). As for change in sway distance in forward-and-backward direction, there was a significant reduction in the condition of either closed eyes or open eyes (p<0.05). Conclusion : The lumbar stabilization exercise on an unstable surface improved the trunk posture of patients with scoliosis symmetrically, and the static balance ability in a standing posture was discovered to be improved. In the future, the lumbar stabilization exercise on an unstable surface may be used as a posture correction and balance increase exercise for patients with scoliosis.