Idiopathic scoliosis : radiographic, neurophysiologic and psychologic aspects
Author: Yngvi Ólafsson, .
Date: 1999-12-17
Location: Medicinhistoriska museet, Leksellsalen
Time: 9.00
Department: - / -
Abstract
The aim of this thesis was to study brace treatment outcome, the brace
effect on electromyographic muscle responses and self image, possible
occurrence of somatosensory dysfunction and the descriptive power of
surface topography contra radiography, in idiopathic scoliosis.
There were 64 patients in a retrospective 4.8 years brace treatment
follow-up, and 39 patients in a retrospective surgically treated group,
in which somatosensory evoked potentials (SEP) were studied. 74 patients
were included in four prospective studies including interview
questionnaire on brace effect on self image; analyses on
electromyographic muscle responses on balance perturbation with and
without brace; comparisons of Jenoptik-Formetric-videorasterstereography
(VRS), Myrininclinometry, Bunnell-scoliometry and radiography; as well as
neurophysiological tests including SEP, detailed neurological status with
sensibility screening, examination of dystonia, muscle function, thermal
and vibration thresholds.
Brace treatment results were good if the patient was compliant. The
primary brace induced correction was the most important prognostic
factor. The primary correction was equal for prefabricated braces with 0
and 15 degrees lumbar lordosis. The self-image of scoliosis patients
before treatment was equal to that of a normal age-matched control group.
Bracing had no negative effect on self-image.
VRS could not provide an equivalent to the radiographic Cobb angle but
correlation between radiographic apex translation and VRS lateral
deviation was statistically significant. Right convex thoracic curves
were adequately demonstrated by VRS. Using VRS rotation(max) breakpoint
of 8.5 degrees, curves larger than 25 degrees Cobb could be diagnosed
with more than 95% security.
Signs of segmental muscle dystony were not found. SEP pathology,
indicated in the retrospective study, could not be verified in the
prospective study. The only neurophysiologic pathology was found in
vibration thresholds as a side asymmetry, which however, was not
correlated to the curve side. There was also an asymmetry in
electromyography recordings in sternocleidomastoid, rectus abdominis and
neck extensor muscles. The brace did not affect this asymmetry nor
paravertebral muscle responses otherwise.
List of papers:
I. Ólafsson Y, Saraste H, Söderlund V, Hoffsten M (1995). "Boston brace in the treatment of idiopathic scoliosis" J Pediatr Orthop 15(4): 524-527
Pubmed
II. Ólafsson Y, Saraste H, Ahlgren RM (1970). "Does bracing affect self-image: a prospective study on 54 patients with adolescent idiopathic scoliosis" (Accepted)
III. Ólafsson Y,Saraste H (1970). "Muscle responses to balance perturbations in sitting in idopathic scoliosis without and with brace" (Submitted)
IV. Ólafsson Y, Saraste H (1970). "Comparision of radiography, back surface topography and inclinometry in idopathic scoliosis" (Submitted)
V. Ólafsson Y, Saraste H, Persson HE (1995). "Spinal cord monitoring during scoliosis surgery" Orthop internat 3: 510-515
VI. Ólafsson Y, Saraste H, Persson HE, Odengren T (1970). "Somatosensory testing in idiopathic scoliosis" (Submitted)
I. Ólafsson Y, Saraste H, Söderlund V, Hoffsten M (1995). "Boston brace in the treatment of idiopathic scoliosis" J Pediatr Orthop 15(4): 524-527
Pubmed
II. Ólafsson Y, Saraste H, Ahlgren RM (1970). "Does bracing affect self-image: a prospective study on 54 patients with adolescent idiopathic scoliosis" (Accepted)
III. Ólafsson Y,Saraste H (1970). "Muscle responses to balance perturbations in sitting in idopathic scoliosis without and with brace" (Submitted)
IV. Ólafsson Y, Saraste H (1970). "Comparision of radiography, back surface topography and inclinometry in idopathic scoliosis" (Submitted)
V. Ólafsson Y, Saraste H, Persson HE (1995). "Spinal cord monitoring during scoliosis surgery" Orthop internat 3: 510-515
VI. Ólafsson Y, Saraste H, Persson HE, Odengren T (1970). "Somatosensory testing in idiopathic scoliosis" (Submitted)
Issue date: 1999-11-26
Publication year: 1999
ISBN: 9979-60-507-3
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