• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.473-485
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• 2021

Adolescent idiopathic scoliosis (AIS), which is associated with an extensive range of clinical and radiological presentations, is the one of the most challenging spinal disorders. The goals of surgery are to correct the deformity in 3 dimensions and to preserve motion segments while avoiding complications. Despite the ongoing evolution of classification systems and algorithms for the surgical treatment of AIS, there has been considerable debate regarding the selection of an appropriate fusion level in AIS. In addition, there is no consensus regarding the exact description, relationship, and risk factors of coronal decompensation following selective fusion. In this review, we summarize the current concepts of selection of the fusion level for AIS and review the available information about postoperative coronal decompensation.

• 척추신경추나의학회지
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• 제5권2호
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• pp.181-191
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• 2010

Current treatment for adolescent idiopathic scoliosis(AIS) consists of three phases: observation, bracing, and surgery. Although there are many nonsurgical treatment(bracing, electrical stimulation, exercise, manipulation, acupuncture, etc), their effect is still controversial. In many paper, Schroth method was reported good immediate response to conservative care, which could be considered a sign of good prognosis. Schroth method became effective thai specialists in physiotherapy for spinal deformities teach the patient how to perform a routine of 'curve pattern' specific exercises with the purpose to facilitate the correction of the asymmetric posture and to teach the patient to maintain the corrected posture in dally activities. This Principles of correction exercise treatment are based on those developed by the German physiotherepist K. Schroth.

• Asian Spine Journal
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• 제12권6호
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• pp.1127-1145
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• 2018

Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.

• PNF and Movement
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• 제8권3호
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• pp.39-47
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• 2010

Purpose : The purpose of this study was to investigate the correlations between clinical balance scales and Balance Performance Monitor parameters in patient with adolescent idiopathic scoliosis (AIS). Methods : Twenty AIS subjects (age, $14.26{\pm}1.93yrs$; height, $160.56{\pm}7.98cm$; weight, $47.54{\pm}6.94kg$)were participated in this study. Postural sway(mean balance, sway angle, sway area, sway path, maximal sway velocity) were were evaluated by balance performance monitor. Measurements for clinical balance scales were Functional reach test (both side), the Lateral reach test (both side) and One leg standing test (both legs). Results : The results were as follows. There were positive strong correlation between major curve direction and left-right sway angle, sway path, maximal sway velocity. There were negative strong correlation between the functional reach and left-right sway angle, sway area, sway path, maximal sway velocity. And the lateral reach were also showed negative strong correlation parameters of balance performance monitor. One leg standing were negatively correlated with left-right sway angle, sway path, maximal sway velocity. Conclusion : The clinical balance scales will be useful tools for balance measurements, and basic tools for clinical setting for patient with AIS.

• 한국전문물리치료학회지
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• 제14권4호
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• pp.35-43
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• 2007

The purpose of this study was to compare the static balance in a sitting position between a group with adolescent idiopathic scoliosis (AIS) and a normal aged-matched group. Forty-nine subjects were included in this study. Thirty-one healthy subjects and eighteen AIS subjects were participated. Each group was tested with the Lumbar Trunk Muscle Endurance Test (LTMET) and Balance Performance Monitor (BPM). The parameters for static balance were sway area, sway path, mean balance, maximum velocity, anterior-posterior angle, and left-right angle of each group with eyes opened and closed. Results from the LTMET showed significantly more increase in the normal group than in the AIS group in the flexor and extensor endurance. The BPM tested showed significantly difference beteen the groups in parameters of sitting balance such as maximum velocity and anterior-posterior sway angle. For the AIS subjects, there were no significant differences in all parameters of sitting balance between eyes opened and eyes closed. In comparisons of the groups with eyes opened there were no significant differences in all parameters of sitting balance. In comparisons of the groups with eyes closed there were significant differences in the sway area, maximum velocity, anterior-posterior sway angle and left-right sway angle. These results suggest that the AIS group relies much more on proprioception than on vision, and develops compensatory passive postures of the spine. Further study is needed to measure many AIS patients with morphologic and electromyographic data for clinical application.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.13-18
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• 2013

Objective : There are few published studies which have documented psychopathological abnormalities in patients with of adolescent idiopathic scoliosis (AIS) The aim of this study was to evaluate the psychopathological influence of AIS in Korean 19-year-old males. Methods : The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 105 AIS cases (more than 10 degrees of Cobb's angle without surgical treatment) with the KMPI profiles of 108 normal controls. The AIS group was split depending on Cobb's angle to further evaluate this relation by the severity of AIS. Results : A significantly decreased result on the faking-good response scale and an significantly increased result on the faking-bad response were observed in the AIS group compared to the control (p<0.012). The neurosis scale results, including anxiety, depression and somatization symptoms, were significantly increased in the AIS group compared to the control (p<0.010). The severity level of personality disorder and schizophrenia were also significantly increased in the AIS group (p<0.010). Differences in KMPI scale scores were not related to the severity of AIS. Conclusion : Young males with AIS tend to have abnormal results on the multiphasic personal inventory test compared to normal volunteers, suggesting that AIS may be related to psychopathology in the young male group in Korea. Although these psychopathology in AIS were differently observed compared to normal controls, but not interfered with military life. Clinicians are recommended to pay attention the psychopathological traits of patients with AIS.

• 국제물리치료학회지
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• 제11권4호
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• pp.2191-2196
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• 2020

Background: Incorrect postures of adolescents caused by the use of smart devices have been noted as a factor causing spinal diseases. Objectives: To examine the effect of joint mobilization and stretching on Cobb's angle and respiratory function in adolescent idiopathic scoliosis (AIS). Design: Cluster-randomized controlled trial. Methods: A total of 22 subjects with AIS were enrolled. They were allocated to two groups: the joint mobilization (n=11) and the stretching (n=11). All interventions were conducted for 30 minutes, three times a week for six weeks. Outcome measures were the Cobb's angle and respiratory function. The Cobb's angle and respiratory function measured using the X-ray and Micro-Quark. Results: Joint mobilization group showed significant differences in Cobb's angle and respiratory function, but stretching group showed significant differences Cobb's angle. The differences in peak expiratory flow (PEF) between the two groups were significant. Conclusion: This study proved that joint mobilization is a more effective intervention for AIS to improve Cobb's angle and respiratory function, when compared to stretching.

• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.136-139
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• 2014

Purpose: The purpose of this study will demonstrate that relationship between scoliosis and gait factor and foot weight bearing in ambulation. Methods: Subjects were 40 elementary students. A normal control group consisted of a total of 20 children without any known musculoskeletal disorders and an AIS group of 20 children with mild AIS (defined by a Cobb angle between 10 and $25^{\circ}$) were recruited. Measurements were scoliometer screening test, Cobb angle, gait parameter (rate of swing/stance phase, gait velosity), foot weight bearing (entire, fore, hind). Results: Scoliometer screening test (P = 0.000) and X-ray Cobb angle (P = 0.000) significant difference of group which was significantly higher in the AIS group. Gait parameter not showed significant difference. Forefoot weight bearing was significantly higher in the AIS group than more normal group. Conclusion: It seems that the results of weight bearing analysis in ambulation may be used in modifying rehabilitation programs for individual needs of patients with idiopathic scoliosis.

• 한국운동역학회지
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• 제24권3호
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• pp.269-275
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• 2014

The purpose of this study is to develop functional garment wear for patients with adolescent idiopathic scoliosis (AIS) and to analyze changes in Cobb's angle and the COM of the body and the pelvis during gaits in order to identify the effects of the functional garment wear. The subjects of the study were 9 patients with adolescent idiopathic scoliosis, who wore the functional garment wear for 12 weeks 12 hours a day. As for the research methods, the scoliotic angle was measured using Cobb's angle, and the shoulder angle and the COM of the body and the pelvis during gaits for the AIS patients were calculated using five high speed infrared cameras. As a result of the study, it was found that the scoliotic angle (Cobb's angle) was reduced significantly and that the smaller the original scoliotic angle, the greater the effects. As for the shoulder motion angle, a significantly larger angle was found 12 weeks after wearing the functional garment wear, and particularly, larger shoulder motion (activity) was observed at the phase of right heel contact. As for the motion of the body and the pelvis, the moving ranges were significantly reduced after wearing the functional garment wear for 12 weeks, which stabilized gait in the patients with adolescent idiopathic scoliosis.

• Journal of Korean Neurosurgical Society
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• 제58권6호
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• pp.534-538
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• 2015

Objective : To correct apical vertebral rotation for adolescent idiopathic scoliosis (AIS), direct vertebral derotation (DVD) or simple rod rotation (SRR) might be considered. The aim of the present study is to introduce the surgical experiences of AIS by a Korean neurosurgeon and to evaluate the effectiveness of SRR for apical vertebral rotation. Methods : A total of 9 patients (1 male and 8 females) underwent scoliosis surgery by a neurosurgeon of our hospital. The Lenke classifications of the patients were 1 of 1B, 2 of 1C, 1 of 2A, 1 of 2C, 3 of 5C and 1 of 6C. Surgery was done by manner of simple rod rotation on the concave side and in situ coronal bending. Coronal Cobb's angles, vertebral rotation angles and SRS-22 were measured on a plain standing X-ray and CT before and after surgery. Results : The mean follow up period was 25.7 months (range : 5-52). The mean number of screw positioning level was nine (6-12). The mean age was 16.4 years (range : 13-25) at surgery. The mean Risser grade was $3.7{\pm}0.9$. The apical vertebral rotation measured from the CT scans was $25.8{\pm}8.5^{\circ}$ vs. $9.3{\pm}6.7^{\circ}$ (p<0.001) and the Coronal Cobb's angle was $53.7{\pm}10.4^{\circ}$ vs. $15.4{\pm}6.5^{\circ}$ (p<0.001) preoperatively and postoperative, respectively. The SRS-22 improved from 71.9 preoperatively to 90.3 postoperatively. There were no complications related with the operations. Conclusion : SRR with pedicle screw instrumentation could be corrected successfully by axial rotation without complications. SRR might serve as a good option to correct AIS deformed curves of AIS.