Compensation treatment of scoliosis - the use of parameters evaluating a global trunk rotation value

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Scoliosis is a generic term covering a group of disorders involving a change in shape and position of the spine [18]. Scoliosis Research Society defines it as an abnormal curve of the spine for which the measured Cobb angle in a radiogram is at least 10° [25.30]. Also referred to as an abnormal lateralcurvature of the spine, it is, in fact, a three-dimensional deformity [6]. Parameters characterising idiopathic scoliosis include: unknown aetiology, three-dimensional nature of changes, appearance in the period of development, a tendency for progression in the period of fast growth of the spine, and more frequent occurrence in girls [6,30]. They represent 80% to 90% of all types of scolioses, regardless of classifications used in the literature [10,24,26,28]. Prevalence of juvenile idiopathic scoliosis corresponds to 2-3 % of the general population [20,22,27].

SUMMING PARAMETERS - COMPENSATION MECHANISM.

The vertebral axial rotation is a characteristic of the spine deformation in idiopathic scoliosis [8]. It is evaluated by the Adam’s test using the Bunnell’s scoliometer, which is a simple and easy to use measuring device characterised by high sensitivity and repeatability, and its availability makes it useful for screen tests [2,3,4,19]. A reduction in costal hump during treatment indicates that a three-dimensional correction was achieved, and represents an important part of the treatment result assessment by a patient [1].  The scoliometer can be used to evaluate an angle of rotation of individual arches and a global trunk rotation.

The angle of trunk rotation (ATR) is measured at a level of the scoliosis apex, both for the primary and the secondary scoliosis.
 

Figure 4.11.  Measurements of the angle of trunk rotation using a scoliometer, for cervical (A), thoracic (B) and lumbar (C) spine. Own material.


The global trunk rotation can be measured by using summing parameters. The sum of rotation (SR) represents a sum of angles of trunk rotation at a level of 12 thoracic and 5 lumbar vertebrae, with a correction for pelvis rotation.  A shorter method for evaluation of the global scoliotic deformation is the Hump Sum parameter, also known as the Suzuki Hump Sum. It is...

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