MRI reveals individual level deformities in the growing scoliotic spine that clinically are masked by the Cobb angle

Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured using sequential MRI scans to investigate coronal plane deformity progression with growth. Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in overall Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.

Sequential MRI reveals individual level deformities in the growing scoliotic spine that are clinically masked by the Cobb angle

Introduction Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. Methods A 0.49mm isotropic 3D MRI technique was developed to investigate the level-by-level changes that occur in the growing spine of a group of Adolescent Idiopathic Scoliosis (AIS) patients, who received two to four sequential scans (spaced 3-12 months apart). The coronal plane wedge angles of each vertebra and disc in the major curve were measured to capture any changes that occurred during their adolescent growth phase. Results Seventeen patients had at least two scans. Mean patient age was 12.9 years (SD 1.5 years). Sixteen were classified as right-sided major thoracic Lenke Type 1 (one left sided). Mean standing Cobb angle at initial presentation was 31° (SD 12°). Six received two scans, nine three scans and two four scans, with 65% showing a Cobb angle progression of 5° or more between scans. Overall, there was no clear pattern of deformity progression of individual vertebrae and discs, nor between patients who progressed and those who didn’t. There were measurable changes in the wedging of the vertebrae and discs in all patients. In sequential scans, change in direction of wedging was also seen. In several patients there was reverse wedging in the discs that counteracted increased wedging of the vertebrae such that no change in overall Cobb angle was seen. Conclusion Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.

Sequential MRI of growing scoliotic spines reveals individual level deformities that are clinically masked by the cobb angle

INTRODUCTION. Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. METHODS. A 0.49mm isotropic 3D MRI technique was developed to investigate the level-by-level changes that occur in the growing spine of a group of Adolescent Idiopathic Scoliosis (AIS) patients, who received two to four sequential scans (spaced 3-12 months apart). The coronal plane wedge angles of each vertebra and disc in the major curve were measured to capture any changes that occurred during their adolescent growth phase. RESULTS. Seventeen patients had at least two scans. Mean patient age was 12.9 years (SD 1.5 years). Sixteen were classified as right-sided major thoracic Lenke Type 1 (one left sided). Mean standing Cobb angle at initial presentation was 31° (SD 12°). Six received two scans, nine three scans and two four scans, with 65% showing a Cobb angle progression of 5° or more between scans. Overall, there was no clear pattern of deformity progression of individual vertebrae and discs, nor between patients who progressed and those who didn’t. There were measurable changes in the wedging of the vertebrae and discs in all patients. In sequential scans, change in direction of wedging was also seen. In several patients there was reverse wedging in the discs that counteracted increased wedging of the vertebrae such that no change in overall Cobb angle was seen. CONCLUSION. Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.

Sequential MRI reveals individual level deformities in the growing scoliotic spine that are not seen clinically by the cobb angle

Clinically, the Cobb angle method measures the overall scoliotic curve in the coronal plane but does not measure individual vertebra and disc wedging. The contributions of the vertebrae and discs in the growing scoliotic spine were measured to investigate coronal plane deformity progression with growth. Sequential MRI data in this project showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle measure; the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.

Sediment genotoxicity and its relationship to the frequency of chironomid labial plate deformities

Sediment samples were taken from seven locations in the WeIland River in December 1986 and April 1987. The DMSO extracts of these sediment samples showed a significant (pdeformities (over 1000 individual specimens were observed) . The samples from station D-l showed the highest frequency of chironomid labial plate deformities (10 . 9% ± 3.2%), while samples from the upstream control (station A) displayed t,he lowest frequency of deformities (3.8% ± 1.3%). All samples were coded to avoid unconscious biases . The results of the genotoxicity study indicated that station D-l in the WeIland River was contaminated with genotoxic materials. The genotoxic materials may have induced the observed increased frequency in chironomid labial plate deformities . Samples from stations C and D-l, located in a downstream portion of the river bounded by an industrialized area were slightly toxic according to -the alkaline phosphatase inhib_ii~ion component of the 50S chromotest analyses. The toxicity of these samples was only evident once they had been activated by the 59 (liver extract) mixture.

Analysis of scoliosis trunk deformities using ICA

This paper describes a method for analyzing scoliosis trunk deformities using Independent Component Analysis (ICA). Our hypothesis is that ICA can capture the scoliosis deformities visible on the trunk. Unlike Principal Component Analysis (PCA), ICA gives local shape variation and assumes that the data distribution is not normal. 3D torso images of 56 subjects including 28 patients with adolescent idiopathic scoliosis and 28 healthy subjects are analyzed using ICA. First, we remark that the independent components capture the local scoliosis deformities as the shoulder variation, the scapula asymmetry and the waist deformation. Second, we note that the different scoliosis curve types are characterized by different combinations of specific independent components.

Personalized 3D reconstruction of the rib cage for clinical assessment of trunk deformities

Scoliosis is a 3D deformity of the spine and rib cage. Extensive validation of 3D reconstruction methods of the spine from biplanar radiography has already been published. In this article, we propose a novel method to reconstruct the rib cage, using the same biplanar views as for the 3D reconstruction of the spine, to allow clinical assessment of whole trunk deformities. This technique uses a semi-automatic segmentation of the ribs in the postero-anterior X-ray view and an interactive segmentation of partial rib edges in the lateral view. The rib midlines are automatically extracted in 2D and reconstructed in 3D using the epipolar geometry. For the ribs not visible in the lateral view, the method predicts their 3D shape. The accuracy of the proposed method has been assessed using data obtained from a synthetic bone model as a gold standard and has also been evaluated using data of real patients with scoliotic deformities. Results show that the reconstructed ribs enable a reliable evaluation of the rib axial rotation, which will allow a 3D clinical assessment of the spine and rib cage deformities.

Multilevel Analysis of Trunk Surface Measurements for Noninvasive Assessment of Scoliosis Deformities.

Study Design. Reliability study. Objectives. To assess between-acquisition reliability of new multilevel trunk cross sections measurements, in order to define what is a real change when comparing 2 trunk surface acquisitions of a same patient, before and after surgery or throughout the clinical monitoring. Summary of Background Data. Several cross-sectional surface measurements have been proposed in the literature for noninvasive assessment of trunk deformity in patients with adolescent idiopathic scoliosis (AIS). However, only the maximum values along the trunk are evaluated and used for monitoring progression and assessing treatment outcome. Methods. Back surface rotation (BSR), trunk rotation (TR), and coronal and sagittal trunk deviation are computed on 300 cross sections of the trunk. Each set of 300 measures is represented as a single functional data, using a set of basis functions. To evaluate between-acquisition variability at all trunk levels, a test-retest reliability study is conducted on 35 patients with AIS. A functional correlation analysis is also carried out to evaluate any redundancy between the measurements. Results. Each set of 300 measures was successfully described using only 10 basis functions. The test-retest reliability of the functional measurements is good to very good all over the trunk, except above the shoulders level. The typical errors of measurement are between 1.20° and 2.2° for the rotational measures and between 2 and 6 mm for deviation measures. There is a very strong correlation between BSR and TR all over the trunk, a moderate correlation between coronal trunk deviation and both BSR and TR, and no correlation between sagittal trunk deviation and any other measurement. Conclusion. This novel representation of trunk surface measurements allows for a global assessment of trunk surface deformity. Multilevel trunk measurements provide a broader perspective of the trunk deformity and allow a reliable multilevel monitoring during clinical follow-up of patients with AIS and a reliable assessment of the esthetic outcome after surgery.

Noninvasive Clinical Assessment of Trunk Deformities Associated With Scoliosis

Besides the spinal deformity, scoliosis modifies notably the general appearance of the trunk resulting in trunk rotation, imbalance, and asymmetries that constitutes patients' major concern. Existing classifications of scoliosis, based on the type of spinal curve as depicted on radiographs, are currently used to guide treatment strategies. Unfortunately, even though a perfect correction of the spinal curve is achieved, some trunk deformities remain, making patients dissatisfied with the treatment received. The purpose of this study is to identify possible shape patterns of trunk surface deformity associated with scoliosis. First, trunk surface is represented by a multivariate functional trunk shape descriptor based on 3-D clinical measurements computed on cross sections of the trunk. Then, the classical formulation of hierarchical clustering is adapted to the case of multivariate functional data and applied to a set of 236 trunk surface 3-D reconstructions. The highest internal validity is obtained when considering 11 clusters that explain up to 65% of the variance in our dataset. Our clustering result shows a concordance with the radiographic classification of spinal curves in 68% of the cases. As opposed to radiographic evaluation, the trunk descriptor is 3-D and its functional nature offers a compact and elegant description of not only the type, but also the severity and extent of the trunk surface deformity along the trunk length. In future work, new management strategies based on the resulting trunk shape patterns could be thought of in order to improve the esthetic outcome after treatment, and thus patients satisfaction.

Social disadvantage, bone mineral density and vertebral wedge deformities in the Tasmanian Older Adult Cohort

Summary The relationship between social disadvantage and bone mineral density (BMD) is complex and remains unclear; furthermore, little is known of the relationship with vertebral deformities. We observed social disadvantage to be associated with BMD for females, independent of body mass index (BMI). A lower prevalence of vertebral deformities was observed for disadvantaged males.

Introduction The relationship between social disadvantage and BMD appears complex and remains unclear, and little is known about the association between social disadvantage and vertebral wedge deformities. We examined the relationship between social disadvantage, BMD and wedge deformities in older adults from the Tasmanian Older Adult Cohort.

Methods BMD and wedge deformities were measured by dual-energy X-ray absorptiometry and associations with extreme social disadvantage was examined in 1,074 randomly recruited population-based adults (51 % female). Socioeconomic status was assessed by Socio-economic Indexes for Areas values derived from residential addresses using Australian Bureau of Statistics 2001 census data. Lifestyle variables were collected by self-report. Regression models were adjusted for age, BMI, dietary calcium, serum vitamin D (25(OH)D), smoking, alcohol, physical inactivity, calcium/vitamin D supplements, glucocorticoids and hormone therapy (females only).

Results Compared with other males, socially disadvantaged males were older (65.9 years versus 61.9 years, p = 0.008) and consumed lower dietary calcium and alcohol (both p ≤ 0.03). Socially disadvantaged females had greater BMI (29.9 ± 5.9 versus 27.6 ± 5.3, p = 0.002) and consumed less alcohol (p = 0.003) compared with other females. Socially disadvantaged males had fewer wedge deformities compared with other males (33.3 % versus 45.4 %, p = 0.05). After adjustment, social disadvantage was negatively associated with hip BMD for females (p = 0.02), but not for males (p = 0.70), and showed a trend for fewer wedge deformities for males (p = 0.06) but no association for females (p = 0.85).

Conclusions Social disadvantage appears to be associated with BMD for females, independent of BMI and other osteoporosis risk factors. A lower prevalence of vertebral deformities was observed for males of extreme social disadvantage. Further research is required to elucidate potential mechanisms for these associations.

Morphological deformities in the osseous structure in spotted sorubim Pseudoplatystoma coruscans (agassiz & spix, 1829) with vitamin c deficiency

A vitamina C é essencial para dietas de peixe porque muitas espécies não conseguem sintetizá-la. Esta vitamina é necessária par a formação de cartilagem e matriz óssea. Além disso, age como antioxidante e melhora as resposta do sistema imunológico. O presente trabalho investigou os efeitos da suplementação de vitamina C em dietas para alevinos de pintado (Pseudoplatystoma corruscans) pela incidência de deformidades na estrutura óssea e cartilaginosa. O ascorbil polifosfato (AP) foi utilizado como fonte de vitamina C em dietas para alevinos de pintado durante o período de três meses. Seis dietas foram formuladas: uma dieta controle (0 mg de vitamina C / kg) e cinco dietas 500, 1.000, 1.500, 2.000 e 2.500 mg de AP / kg. Os peixes alimentados sem suplementação de vitamina C apresentaram deformidades óssea na cabeça e mandíbula e fragilidade de nadadeiras. Assim, a dieta de 500 mg de AP/kg foi suficiente para prevenir a ocorrência de deformidades, e a ausência desta vitamina prejudica o desenvolvimento ósseo de juvenis de pintados.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Morphological deformities in the osseous structure in spotted sorubim Pseudoplatystoma coruscans (agassiz & spix, 1829) with vitamin c deficiency

A vitamina C é essencial para dietas de peixe porque muitas espécies não conseguem sintetizá-la. Esta vitamina é necessária par a formação de cartilagem e matriz óssea. Além disso, age como antioxidante e melhora as resposta do sistema imunológico. O presente trabalho investigou os efeitos da suplementação de vitamina C em dietas para alevinos de pintado (Pseudoplatystoma corruscans) pela incidência de deformidades na estrutura óssea e cartilaginosa. O ascorbil polifosfato (AP) foi utilizado como fonte de vitamina C em dietas para alevinos de pintado durante o período de três meses. Seis dietas foram formuladas: uma dieta controle (0 mg de vitamina C / kg) e cinco dietas 500, 1.000, 1.500, 2.000 e 2.500 mg de AP / kg. Os peixes alimentados sem suplementação de vitamina C apresentaram deformidades óssea na cabeça e mandíbula e fragilidade de nadadeiras. Assim, a dieta de 500 mg de AP/kg foi suficiente para prevenir a ocorrência de deformidades, e a ausência desta vitamina prejudica o desenvolvimento ósseo de juvenis de pintados.

Hatching, survival and deformities of piracanjuba (Brycon orbignyanus) embryos subjected to different cooling protocols

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)