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*In general, patients whose scoliosis surgery does not involve disruption of their chest wall can be expected to experience improved post-operative pulmonary function. | *In general, patients whose scoliosis surgery does not involve disruption of their chest wall can be expected to experience improved post-operative pulmonary function. | ||
*However, in few cases impairment in respiratory mechanics may persist after successful scoliosis surgery. | *However, in few cases impairment in respiratory mechanics may persist after successful scoliosis surgery. | ||
===Peak Height Velocity=== | |||
*Curve progression in idiopathic scoliosis is related to growth.<ref name="pmid10819279">{{cite journal| author=Little DG, Song KM, Katz D, Herring JA| title=Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls. | journal=J Bone Joint Surg Am | year= 2000 | volume= 82 | issue= 5 | pages= 685-93 | pmid=10819279 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10819279 }} </ref> | |||
*Peak height velocity is a maturity scale directly related to growth and the adolescent growth spurt. | |||
*Recommendations for bracing and operative intervention rely on the ability to assess the growth potential of these patients. | |||
*Once peak height velocity is identified, the timing of cessation of growth can be reliably predicted, so that patients can be told well in advance how long they will need to wear an orthosis. | |||
===Computerized Photogrammetry=== | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
Electromyography, somatosensory evoked potential, pulmonary function studies, peak height velocity, and computerized photogrammetry may be helpful in the diagnosis of scoliosis.
Other Diagnostic Studies
Other diagnostic studies for scoliosis include electromyography (EMG), somatosensory evoked potential (SSEP), pulmonary function test (PFT), peak height velocity, and computerized photogrammetry.
Electromyography (EMG)
- In literature, it has been demonstrated that changes in the EMG activity of the paraspinal muscles during the development and progression of the scoliotic curve.[1][2][3][4][5]
- EMG of the paraspinal muscles are of value for predicting the progression in idiopathic scoliosis.
- Increased EMG activity has been noted on the convex side of the scoliotic curve.
- Higher amplitude of Motor unit Action potential (MUP) on the convexity side was the most prominent abnormal findings in our adolescent idiopathic scoliosis (AIS) patients.
- The amplitude of MUPs correlates to the degree of scoliosis with no significant effect on progression of AIS curve according to the Cobb angle.
Somatosensory Evoked Potential (SSEP)
- Preserving the integrity of the spinal cord during a surgical maneuver is vital.[6][7][8][9][10][11][12]
- Intraoperative neurophysiologic monitoring (IOM) provides guidance to surgeons and reduces the risk of permanent neurologic complications.
- A somatosensory evoked potential study determines whether the spinal nerves can send and receive sensory messages, and how quickly these messages are transmitted between the nerve and brain.
- SSEP amplitude recorded before skin incision is used as the reference baseline.
- A 50% decrease in the amplitude from baseline is set as the alarm threshold for intra-operative neural damage.
- SSEP can be affected by anesthesia and hypotension.
Pulmonary Function Test (PFT)
- Pulmonary function studies have been used extensively in the evaluation of patients with idiopathic scoliosis.[13][14][15][16]
- The pre-operative values serve as a reference baseline as well as they determine the impact of large curves on pulmonary function.
- Patients with large curves have low volume, flow, and lung capacity parameters.
- In general, patients whose scoliosis surgery does not involve disruption of their chest wall can be expected to experience improved post-operative pulmonary function.
- However, in few cases impairment in respiratory mechanics may persist after successful scoliosis surgery.
Peak Height Velocity
- Curve progression in idiopathic scoliosis is related to growth.[17]
- Peak height velocity is a maturity scale directly related to growth and the adolescent growth spurt.
- Recommendations for bracing and operative intervention rely on the ability to assess the growth potential of these patients.
- Once peak height velocity is identified, the timing of cessation of growth can be reliably predicted, so that patients can be told well in advance how long they will need to wear an orthosis.
Computerized Photogrammetry
References
- ↑ Bos RR, Boering G, Rozema FR, Leenslag JW (1987). "Resorbable poly(L-lactide) plates and screws for the fixation of zygomatic fractures". J Oral Maxillofac Surg. 45 (9): 751–3. PMID 3476698.
- ↑ de Oliveira AS, Gianini PE, Camarini PM, Bevilaqua-Grossi D (2011). "Electromyographic analysis of paravertebral muscles in patients with idiopathic scoliosis". Spine (Phila Pa 1976). 36 (5): E334–9. doi:10.1097/BRS.0b013e3181f516cd. PMID 21325929.
- ↑ Zetterberg C, Björk R, Ortengren R, Andersson GB (1984). "Electromyography of the paravertebral muscles in idiopathic scoliosis. Measurements of amplitude and spectral changes under load". Acta Orthop Scand. 55 (3): 304–9. PMID 6741480.
- ↑ Cheung J, Veldhuizen AG, Halbertsma JP, Maurits NM, Sluiter WJ, Cool JC; et al. (2004). "The relation between electromyography and growth velocity of the spine in the evaluation of curve progression in idiopathic scoliosis". Spine (Phila Pa 1976). 29 (9): 1011–6. PMID 15105674.
- ↑ Farahpour N, Ghasemi S, Allard P, Saba MS (2014). "Electromyographic responses of erector spinae and lower limb's muscles to dynamic postural perturbations in patients with adolescent idiopathic scoliosis". J Electromyogr Kinesiol. 24 (5): 645–51. doi:10.1016/j.jelekin.2014.05.014. PMID 25008019.
- ↑ Dawson EG, Sherman JE, Kanim LE, Nuwer MR (1991). "Spinal cord monitoring. Results of the Scoliosis Research Society and the European Spinal Deformity Society survey". Spine (Phila Pa 1976). 16 (8 Suppl): S361–4. PMID 1785088.
- ↑ Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE (1995). "Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey". Electroencephalogr Clin Neurophysiol. 96 (1): 6–11. PMID 7530190.
- ↑ Cheng JS, Ivan ME, Stapleton CJ, Quinones-Hinojosa A, Gupta N, Auguste KI (2014). "Intraoperative changes in transcranial motor evoked potentials and somatosensory evoked potentials predicting outcome in children with intramedullary spinal cord tumors". J Neurosurg Pediatr. 13 (6): 591–9. doi:10.3171/2014.2.PEDS1392. PMC 4322892. PMID 24702615.
- ↑ Kundnani VK, Zhu L, Tak H, Wong H (2010). "Multimodal intraoperative neuromonitoring in corrective surgery for adolescent idiopathic scoliosis: Evaluation of 354 consecutive cases". Indian J Orthop. 44 (1): 64–72. doi:10.4103/0019-5413.58608. PMC 2822422. PMID 20165679.
- ↑ Owen JH (1999). "The application of intraoperative monitoring during surgery for spinal deformity". Spine (Phila Pa 1976). 24 (24): 2649–62. PMID 10635528.
- ↑ Pajewski TN, Arlet V, Phillips LH (2007). "Current approach on spinal cord monitoring: the point of view of the neurologist, the anesthesiologist and the spine surgeon". Eur Spine J. 16 Suppl 2: S115–29. doi:10.1007/s00586-007-0419-6. PMC 2072895. PMID 17619913.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMC 5922622. PMID https://doi.org/10.1016/j.wneu.2016.05.054 Check
|pmid=value (help). - ↑ Vedantam R, Lenke LG, Bridwell KH, Linville DL (2000). "Comparison of push-prone and lateral-bending radiographs for predicting postoperative coronal alignment in thoracolumbar and lumbar scoliotic curves". Spine (Phila Pa 1976). 25 (1): 76–81. PMID 10647164.
- ↑ Yaszay B, Jazayeri R, Lonner B (2009). "The effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis". J Spinal Disord Tech. 22 (4): 278–83. doi:10.1097/BSD.0b013e31816d2530. PMID 19494748.
- ↑ Smith RM, Dickson RA (1994). "Changes in residual volume relative to vital capacity and total lung capacity after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis". J Bone Joint Surg Am. 76 (1): 153. PMID 8288659.
- ↑ Winter RB, Lovell WW, Moe JH (1975). "Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis". J Bone Joint Surg Am. 57 (7): 972–7. PMID 1184646.
- ↑ Little DG, Song KM, Katz D, Herring JA (2000). "Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls". J Bone Joint Surg Am. 82 (5): 685–93. PMID 10819279.