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Scoliosis  2006 

A segmental radiological study of the spine and rib – cage in children with progressive Infantile Idiopathic Scoliosis

DOI: 10.1186/1748-7161-1-17

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Abstract:

In the posteroanterior (PA) spinal radiographs of 24 patients with progressive IIS, with a mean age of 4.1 years old, the Thoracic Ratios (TRs) (segmental convex and concave TRs), the Cobb angle, the segmental vertebral rotation and vertebral tilt were measured. In 233 subjects, with a mean age of 5.1 years old, who were used as a control group, the segmental left and right TRs and the total width of the chest (left plus right TRs) were measured in PA chest radiographs. Statistical analysis included Mann-Whitney, Spearman correlation coefficient, multiple linear regression analysis and ANOVA.The comparison shows that the scoliotic thorax is significantly narrower than that of the controls at all spinal levels. The upper chest in IIS is funnel-shaped and the vertebral rotation at T4 early in management correlates significantly with the apical vertebral rotation at follow up.The IIS thorax is narrower than that of the controls, the upper chest is funnel-shaped and there is a predictive value of vertebral rotation at the upper limit of the thoracic curve of IIS, which reflects, impaired rib control of spinal rotation possibly due to neuromuscular factors, which contribute also to the funnel-shaped chest.A study of children aged 1–5 years with progressive infantile idiopathic scoliosis (IIS) shows that a two stage anterior and posterior surgical procedure leads to deterioration of the spine during follow up [1-3].By reviewing the literature, no publication was found on rib growth in children with IIS. Dansereau et al [4] examined rib length asymmetry by using a stereoradiographic method in children with adolescent idiopathic scoliosis.These findings caused us to undertake a segmental radiological study of the spine and rib – cage in children with progressive IIS.The effect of upper thoracic cage on pulmonary function in IIS is an additional interesting issue. A report on diminished pulmonary function following arthrodesis of the thoracic spine before age 5 noted strong

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