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Thread: Definitions of structural and nonstructural curves

  1. #1
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    Definitions of structural and nonstructural curves

    Here are some rigorous definitions I found for these terms from reliable sources:

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    http://eradiology.bidmc.harvard.edu/...o/Sabatini.pdf

    Non-structural - has no structural component; it corrects on supine side-bending films

    Non-structural scoliosis - reversible lateral curvature without rotation

    Structural - lacks normal flexibility

    Structural scoliosis - irreversible lateral curvature of the spine with rotation of the vertebral bodies in the area of the major curve
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    http://www.espine.com/adolescent-scoliosis.htm

    Structural curves are defined as those curves that incompletely straighten on side-bending. Compensatory curves straighten significantly on side bending and function to produce spinal balance.
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    http://www.mccc.edu/~petroskw/outlin..._Scoliosis.pdf (emphasis added)

    Scoliosis can be classified in several ways. First, scoliosis can be classified into 2 groups: functional (nonstructural) and structural.8,9,12,13,18 Functional scoliosis means that the spine is structurally normal, but a lateral curve has developed as a secondary response to a problem occurring elsewhere in the body.13 Nonstructural scoliosis also is known as compensatory or postural scoliosis and can occur due to differing leg lengths or a tilt to the pelvis, as well as flexion deformities at the hip or knee.9,13,18 In nonstructural scoliosis, the lateral curve to the spine resolves when the patient is seated or recumbent.13,18 Several other types of nonstructural scoliosis have been identified, including sciatic scoliosis, hysterical scoliosis and inflammatory scoliosis.18 Sometimes these types are classified as transient structural scoliosis.9 Sciatic scoliosis results when patients experience a painful sciatic nerve and try to position themselves to lessen the pain, creating a compensatory spinal curve.18 Inflammatory scoliosis results from an infective process such as appendicitis, while hysterical scoliosis develops from an underlying psychological disorder.18 In nonstructural scoliosis, the abnormal curve of the spine is usually temporary and disappears when the underlying cause has been addressed.3

    Structural scoliosis is the type of scoliosis most people are familiar with. The spine not only has a lateral curve, but also has a rotational element to the vertebrae.18 Structural scoliosis directly involves the structural aspect of the spine and does not go away when the patient lies down or sits upright.9,13,18
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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  2. #2
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    Colleen Sabatini is at UCSF now. She spoke at the last meeting....

    Thx for digging these up, these are great articles. I didnít know that non-structural curves had no vert rotation, very interesting.

    School screening is mandatory in California, usually in the 7th and 8th grade. I first noticed something was wrong in the 5th grade having trouble doing sit ups at age 10. I guess I could have said something.....???? I think about this quite a bit.

    Could there be any harm in instructing gym teachers to line up the kids and performing an Adamís and taking a peek? Maybe do this a little earlier like in the 4th and 5th grades? Iím always looking at my friends kids, like a seeing eye dog.
    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
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    I think there should be school screening for the purpose of catching surgical curves early enough to keep the fusion as short as possible. Not in your case because you already had a double major but it seems like most adults with untreated scoliosis have longer fusions than most kids who are treated. There is something going on here and it is not working in favor of waiting years and years. We hear a lot of people who have scoliosis who never need fusion. I'd like to see some proof of large numbers in that category. So far, all I have seen is arm waving.

    The need to rigorously identify structural and non-structural curves would seem to be limited to surgical planning and designing studies. For the average patient out there not in one of those categories, it might be neither here nor there. That said, I don't think surgeons should be entirely blowing off the issue to patients and parents as we have seen. Facts don't fail to be facts when not in context.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #4
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    Well, looking at my latest x-rays, both curves have quite a bit of rotation by looking at the spinous processes. I actually have vertebral rotation all the way down to L4 (L5 is deformed due to spina bifida occulta). That's a scary thought. I've never had bending x-rays, so I wouldn't know how much could be bent out of the lower curve.
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