May 8, 2014 - He, Xiaohua (Palmer College of Chiropractic Florida, Port Orange, USA) ...... technician, during the course of treatment, (named A and B group of LRs). ..... (AIS) patients and controls using quantitative ultrasound examination,.
The International Congress on Scoliosis Orthopaedic and Rehabilitation Treatment
MAY 08 - 10, 2014
Educational Courses: May 06 - 07
WIESBADEN Germany
www.sosort2014.com
Welcome. 9th Annual Meeting of the SOSORT May 08 -10, 2014 Wiesbaden 11th International Conference on Conservative Management of Spinal Deformities
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On behalf of the SOSORT 2014 Local Organizing and International 6FLHQWLÀF&RPPLWWHHV,KDYHWKHSOHDVXUHRILQYLWLQJ\RXWRSDUWLFLSDWH LQWKHWK,QWHUQDWLRQDO&RQIHUHQFHRQ&RQVHUYDWLYH0DQDJHPHQW RI6SLQDO'HIRUPLWLHV)ROORZLQJWKHVXFFHVVIXOSUHYLRXVPHHWLQJVKHOG LQGLIIHUHQWFRXQWULHVLQ(XURSHDQG$PHULFD WKLV\HDUWKH626257 LVFRPLQJWR:LHVEDGHQ*HUPDQ\IRUWKHÀUVWWLPH:LHVEDGHQLVD FLW\UHNQRZQIRUUHKDELOLWDWLRQ KHDOWKDQGPHGLFDOH[KLELWLRQV DQG ZKLFKEHORQJVWRWKH5KHLQJDXUHJLRQ IDPRXVIRUWKHULHVOLQJZLQH 7KH PDLQ SXUSRVH RI WKLV FRQIHUHQFH LV WR SURYLGH D IRUXP WR SUHVHQW DQG GLVFXVV GHYHORSPHQWV LQ WKH ÀHOG RI QRQVXUJLFDO PDQDJHPHQW RI VSLQDO GHIRUPLWLHV ZLWK DWWHQGHHV FRPLQJ IURP DOORYHUWKHZRUOG7KHPHHWLQJLVDVKRZZLQGRZ ZKHUHWKHODWHVW VWDWXVRIFOLQLFDODQGWHFKQLFDOUHVHDUFKZLOOEHSUHVHQWHG6FLHQWLÀF HGXFDWLRQDO FRQWURYHUVLDO DQG FRQVHQVXDO VHVVLRQV ZLOO SURYLGH DOO SDUWLFLSDQWV ZLWK LQIRUPDWLRQ DERXW WKH PRVW UHFHQW DGYDQFHV LQ WKH PHGLFDO ÀHOG DOO IRFXVHG RQ WKH SDWLHQWV DQG WKHLU IDPLOLHV 7KHVSLULWRI626257LVWRSURPRWHDQGVXSSRUWDPXOWLGLVFLSOLQDU\ DSSURDFK DQG ZH EHOLHYH WKDW WKH DPELHQFH RI:LHVEDGHQ ZLOO VWLPXODWHDQDWPRVSKHUHSURPRWLQJVXFFHVVIXOZRUNDQGZLOOFUHDWH UHODWLRQVKLSVEHWZHHQVFLHQWLVWVSK\VLFDOPHGLFLQHDQGUHKDELOLWDWLRQ GRFWRUV VSLQDO VXUJHRQV SK\VLRWKHUDSLVWV SV\FKRORJLVWV &32V DQG SDWLHQWV %\ DWWHQGLQJ WKH FRQIHUHQFH DQG SUREDEO\ DGGLQJ VRPH H[WUDGD\VIRUVLJKWVHHLQJDQGUHFUHDWLRQ\RXZLOOEHDEOHWRH[FKDQJH VFLHQWLÀF LGHDV REWDLQ LQIRUPDWLRQ DERXW QHZ GHYHORSPHQWV DQG LQQRYDWLRQV DQGFRQÀUPLQWHUQDWLRQDOIULHQGVKLSLQDQLQYLWLQJDQG SOHDVDQWHQYLURQPHQW ,WLVDJUHDWSOHDVXUHIRUXVWRKDYHDOORI\RXZLWKXVIRUVHYHUDOGD\V LQRXUORYHO\FLW\MRLQLQJWKLV,QWHUQDWLRQDO&RQIHUHQFH DQGZHWUXVW \RXZLOOKDYHDQHQMR\DEOHDQGSURGXFWLYHVWD\ :HZHOFRPH\RXWR:LHVEDGHQ
1 years after weaning of the brace. Compliance was estimated by our own compliance score (Lit. 1). All braces are made by one orthotist. Results: First examination: At the initial presentation Cobb angle changed from 31° (range 20°-56°) to 27° (range 20°-46°) in cases Risser 50° decreased from 12% to 5%. Summary : Now scoliosis is diagnosed earlier, but the number of unskilled pretreatment and rejection of treatment increased. Our experience lowers the number of idiopathic scoliosis. We have learned to make bracing more effective in primary correction and at follow up despite of a lower wearing time per day. We could not influence compliance significantly.
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Conclusion: Patients increasingly influence therapeutic regime. Part time bracing becomes the main option in outpatient treatment. There is still potential to improve brace-management . In outpatient treatment “compliance of the staff” seems to be a problem. An experienced orthopedic technician leads to a good standard, but it lacks on comparison and competition. Literature: Pediatr Rehabil. 2003 Jul-Dec;6(3-4):201-7. Estimating the final outcome of brace treatment for idiopathic thoracic scoliosis at 6-month follow-up. Landauer F, Wimmer C, Behensky H. SS4-I/006
TO BRACE OR NOT? THE ANSWER IS „IT DEPENDS.“ PRELIMINARY RESULTS FROM BRAIST. Dolan Lori, Weinstein Stuart and the BrAIST Study Group University of Iowa, Iowa City, IA, USA Background: Recent research suggests current indications for bracing in AIS result in significant overtreatment. Many patients are actually at low risk for significant progression. Others present at higher risk will benefit little from bracing. Aim: This study developed a simple, yet accurate, model of the risk of significant curve progression in AIS and the risk reduction associated with bracing. Methods: Data from 238 BrAIST subjects were used (91 observed, 147 braced). All met current indications for bracing (Cobb 20-40Ƞ, Risser 50Ƞ 10 degrees or more) was 2.52% (172 of 6824 schoolchildren). There was a positive but very weak correlation between scoliosis and age. The prevalence rate was significantly higher in girls than in boys (girls vs. boys: 3.11% vs. 1.96%, ratio 1.5:1). Most of the curves were minor (from 10 to 19 degrees). The right curve was the most common type in the thoracic region (60.3% of all thoracic curves), while it was left in thoracolumbar (75.5%) and lumbar regions (64.7%). Conclusions:The prevalence of scoliosis in the Island of Chongming was 2.52%. The percentage of curve magnitude and type were comparable, while gender, curve side and the correlation between scoliosis and age in the Island of Chongming differed from that in other countries. According to these results, epidemiological regional variability, possibly with genetic basis, can be considered. Key words: school scoliosis screening; scoliosis; prevalence; China SS7-Etio/004
A LINE OF ZEBRAFISH WITH DEVELOPMENT OF ABNORMAL SPINAL CURVATURES Tomasiewicz Henry1, Thometz John2, Liu XueCheng2, Tassone Channing2, North Paula2 1
University of Wisconsin-Milwaukee, Milwaukee, USA
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Medical College of WI, Milwaukee, USA
BACKGROUND: The lack of a good animal model system has hindered studying the etiology of idiopathic scoliosis. Recently, it has become clear that several fish species appear to exhibit spinal curvatures. AIMS: To determine if the affected tissue in a line of zebrafish with spinal deformities resembles the pathology observed in pediatric populations with scoliosis. DESIGN: This case series study was approved by IACUC. METHODS: Potential founder fish with spinal curvatures were outcrossed with a wild type zebrafish line (AB) and the resulting siblings (F1 generation) crossed and the offspring (F2 generation) examined for signs of spinal curvature beginning at 14 days post fertilization (dpf). Spinal curvatures of the affected fish were visualized using either a Faxitron or by Alizarian red staining of the skeletons and the curvature measured from the resulting images in the thoracic, thoracolumbar, or lumbar regions. Affected and normal zebrafish were fixed, embedded, section and stained with hemotoxylin and eosin. RESULTS: The degrees of curvatures ranged from 18° to 40° Histological data demonstrated structural changes as compared to normal fish spine. Out of 212 individuals in the F2 generation 28, or 13.2%, were observed to have spinal deformities at 21 dpf. Importantly, we did not observe spinal deformities in the F1 generation fish and similar age wild type fish, indicating the observed spinal deformities were due to a recessive mutation(s). CONCLUSION: An increase of scoliosis in family members and the occurrence of abnormal spinal curvatures in twins suggest a polygenetic inheritance pattern. We have noticed several fish in our zebrafish colony with spinal curvatures reminiscent of human idiopathic scoliosis. We suspect that “scoliosis” in these zebrafish results from mutation(s) in the zebrafish genome. And these fish can be the source of a zebrafish line in which the offspring exhibit a predictable frequency of scoliosis which can be used to study the etiology and progression of scoliosis.
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SS7-Etio/005
ASSOCIATION BETWEEN VITAMIN D SERUM LEVELS AND ADOLESCENT IDIOPATHIC SCOLIOSIS BATISTA Rodrigo, MARTINS Delio E, HAYASHI Lilian F, LAZARETTI-CASTRO Marise, PUERTAS Eduardo B, WAJCHENBERG Marcelo Federal University of Sao Paulo, Sao Paulo, Brazil Background: Idiopathic scoliosis (IS) is a deformity of the spine that occurs in up to 4% of children during childhood and adolescence. Idiopathic scoliosis is considered multifactorial, and family history may present several individuals affected. We still cannot determine which curves will worsen and at what rate, but some factors, such as age, growth potential and skeletal maturity have been associated with a higher risk of progression. Studies have suggested that a decrease in bone mineral density may be responsible for the appearance and progression of the disease, and some have tried to link vitamin D receptor gene (VDRG) polymorphism to adolescent idiopathic scoliosis (AIS). Aim: The goal of this study was to establish an association between serum levels of 25-OH-VitD and the presence of AIS. Design: Cross-sectional study Methods: The patients were recruited from the outpatient clinic of our institution during the year of 2013. Children younger than 10 or older than 18, and those carrying neurologic or muscular disorders, congenital deformities or genetic syndromes were excluded. Calcium, phosphorus, creatine, urea and human parathyroid hormone dosage was taken to rule out renal or parathyroid dysfunctions. Patient’s were measured and weighted, and 25-OHVitD levels were determined through electrochemioluminescence by an automated test after an eight-hour fast, during Brazilian spring. The results were compared to a second group composed of healthy individuals. Results: The majority of the patients in both groups are non-black females. On group 1 (controls), 63,3% showed abnormal vitamin D levels, while 91% of AIS patients presented low vitamin D level. The mean BMI were 19,6 kg/m2 for controls and 20,3 kg/m2 on group 2. Statistical analysis through unpaired t tests found relevant difference (p
