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Thread: Some articles from Spine this year (that might be false)

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    Join Date
    Jan 2008

    Some articles from Spine this year (that might be false)

    Concordance for Curve Type in Familial Idiopathic Scoliosis: A Survey of One Hundred Families
    Sales de Gauzy, Jérôme MD; Ballouhey, Quentin MD; Arnaud, Catherine MD; Grandjean, Hélène MD; Accadbled, Franck MD, PhD

    Results. Familial concordance rate for curve pattern and side was 66% (95% confidence interval, 57-75), whereas the expected random concordance rate was 26% (95% confidence interval, 17-34). The affected relative was in 27 cases a sibling, in 32 cases a parent, in 1 case an uncle, in 2 cases a cousin, in 2 cases a half sister, in 2 cases a grandmother. Concordance rate was 65% (27/42) in siblings' pairs and 67% (32/48) in parents/child's pairs.

    Conclusion. We report a high concordance rate for curve pattern and side between relatives with idiopathic scoliosis. Curve shape is likely to be genetically determined in familial scoliosis. It seems important that curve type is documented and considered in future genetic studies.

    Braces for Idiopathic Scoliosis in Adolescents
    Negrini, Stefano MD; Minozzi, Silvia MD; Bettany-Saltikov, Josette PhD, MSc, MCSP; Zaina, Fabio MD; Chockalingam, Nachiappan PhD; Grivas, Theodoros B. MD; Kotwicki, Tomasz MD; Maruyama, Toru MD; Romano, Michele PT; Vasiliadis, Elias S. MD

    Results. We included 2 studies. There was very low quality evidence from 1 prospective cohort study with 286 girls that a brace curbed curve progression at the end of growth (success rate, 74% [95% confidence interval {CI}: 52%–84%]), better than observation (success rate, 34% [95% CI: 16%–49%]) and electrical stimulation (success rate, 33% [95% CI: 12%–60%]). There is low-quality evidence from 1 RCT with 43 girls that a rigid brace is more successful than an elastic one (SpineCor) at curbing curve progression when measured in Cobb degrees, but there were no significant differences between the 2 groups in the subjective perception of daily difficulties associated with wearing the brace.

    Conclusion. There is very low quality evidence in favor of using braces, making generalization very difficult. Further research could change the actual results and our confidence in them; in the meantime, patients' choices should be informed by multidisciplinary discussion. Future research should focus on short- and long-term patient-centered outcomes, in addition to measures such as Cobb angles. RCTs and prospective cohort studies should follow both the Scoliosis Research Society and Society on Scoliosis Orthopedic and Rehabilitation Treatment criteria for bracing studies.

    Males With Familial Idiopathic Scoliosis: A Distinct Phenotypic Subgroup
    Clough, Mark MD; Justice, Cristina M. PhD; Marosy, Beth MS; Miller, Nancy H. MD

    Results. The initial study population had significant results at markers d17s975 and d17s2196. Analyses of a subgroup of families with males having undergone surgery using a customized single nucleotide polymorphism panel resulted in increased significance of this region.

    Conclusion. The data confirm a previously reported genetic locus on chromosome 17 as statistically significant in the etiology of FIS within a subgroup of families in which an affected male had spinal surgery.

    Vertebral Body Stapling: A Fusionless Treatment Option for a Growing Child With Moderate Idiopathic Scoliosis
    Betz, Randal R. MD; Ranade, Ashish MD; Samdani, Amer F. MD; Chafetz, Ross DPT; D'Andrea, Linda P. MD; Gaughan, John P. PhD; Asghar, Jahangir MD; Grewal, Harsh MD; Mulcahey, Mary Jane PhD

    Results. There were 26 thoracic and 15 lumbar curves. Average follow-up was 3.2 years. The procedure was considered a success if curves corrected to within 10° of preoperative measurement or decreased >10°. Thoracic curves measuring <35° had a success rate of 77.7%. Curves which reached ≤20° on first erect radiograph had a success rate of 85.7%. Flexible curves >50% correction on bend film had a success rate of 71.4%. Of the 26 curves, 4 (15%) showed correction >10°. Kyphosis improved in 7 patients with preoperative hypokyphosis (<10° of kyphosis T5–T12). Of the patients, 83.5% had remaining normal thoracic kyphosis of 10° to 40°. Lumbar curves demonstrated a success rate of 86.7%. Four of the 15 lumbar curves (27%) showed correction >10°. Major complications include rupture of a unrecognized congenital diaphragmatic hernia and curve overcorrection in 1 patient. Two minor complications included superior mesenteric artery syndrome and atelectasis due to a mucous plug. There were no instances of staple dislodgement or neurovascular injury.

    Conclusion. Analysis of patients with idiopathic scoliosis (IS) with high-risk progression treated with vertebral body stapling (VBS) and minimum 2-year follow-up shows a success rate of 87% in all lumbar curves and in 79% of thoracic curves <35°. Thoracic curves >35° were not successful and require alternative treatments.
    Last edited by Pooka1; 09-12-2010 at 09:31 PM.
    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."

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