[Early diagnosis (non-invasive and dynamic) of postural disequilibria in adolescent scoliosis].
This paper focuses on peri-adolescent, mild idiopathic scoliosis. The AA present an noninvasive, non hazardous, and dynamical method for photographically individualizing the subject's back discrepancies which manifest themselves between the first and second photos (interval-15 min). After a few minutes in the erect posture, under the subject's fatigue it may be possible to notice and record significant displacement of certain bone prominences. For measuring purposes, the AA utilize a plumb-line, the superior end being applied to the 7th cervical vertebra prominence and the inferior heavy and the level of the line extending between the two posterior--superior iliac spines as indicate by cutaneous landmarks. The subject adaptation and standardized photographic examination are very simple and not expensive. It deals with many medical requirements of pediatric, preventive, rehabilitative and sport medicine. The case is relevant in its postural distortion and orthopedic and rehabilitation specialists are involved. The entity of postural discrepancies was assessed by the AA by means of the case- studies of peri-adolescent subjects. The first case-study (1st group) represents subjects who were submitted to a regular program based on trunk brace and exercises, the second one (2nd group) who were not. The first group showed a better curvature evolution as the x-ray have confirmed in a 24 months follow up. By means of our dynamical study the subject's back postural discrepancies were considered of relevance being the dislocation of the plumb-line distal end with respect to the PSISs' line besides an arbitrarily chosen threshold value. This value is 1/5 of the distance between the two PSISs. The above described dislocation was assessed both in inferior and lateral direction. A relevant descent of the heavy plumb-line is characteristic of a vertebral axial failure (the spine shortens for increase of its curves both in the frontal and in the antero-posterior planes) with a major back trunk inherent distortion. A relevant tilting of the heavy end of the plumb-line means lateral entire subject imbalance (the spine tilts laterally). Of course, combinations of both unfavorable features were frequently possible. Summarizing, the postural imbalance becomes worse together with the curvature seriousness deterioration, i.e. chiefly in the non-compliant patients. Therefore it is to be noticed the entire spine tilting as relevant both in the 1st group and in the 2nd group of patients (24% versus 25%).(ABSTRACT TRUNCATED AT 400 WORDS)
Romano
M
M
Bonaccorsi
S
S
Cama
V
V
D000293:Adolescent; D001915:Braces; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010781:Photography; D010808:Physical Examination / Q000379:methods*; D011187:Posture; D012600:Scoliosis / Q000175:diagnosis* / Q000628:therapy
Diagnostica precoce (non invasiva e dinamica) degli squilibri posturali nella scoliosi adolescenziale.