Explore the vast range of titles available.

Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH) instructed with “straighten your back” command (SYB). Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS), lumbar lordosis (LL), global thoracic kyphosis (TK), lower thoracic kyphosis (LK), and upper thoracic kyphosis (UK) were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting) and after the SYB. Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P<0.01), with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5) versus 21.0° (SD 15.5), P<0.001) below the standards proposed in the literature (30–40°) and flattening of its lower part (P<0.001). The same changes were observed in the control group. Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.

Height loss and vertebral deformity had independent effects on health-related quality of life evaluated by the European quality-of-life five-domain questionnaire (EQ-5D) in a cohort of 2,021 elderly Japanese men and women. Height loss aggravated EQ-5D more strongly than vertebral deformity in all domains, with different patterns. Vertebral deformity reduces the activities of daily living and quality of life, and elevates mortality. Height loss is taken to be a sign of vertebral deformity, although other factors could also cause height loss. In this study, we examined the difference in EQ-5D between elderly with height loss and with vertebral deformity. The subjects were 2,021 men and women aged 57-101 years from the Hiroshima Cohort who underwent health examinations in 2002-03 and responded to the EQ-5D. Vertebral deformity was assessed semi-quantitative methods using lateral chest and spine radiographs. Height was measured during the routine biennial examinations, which have been conducted since 1958. We used linear regression analyses, ordered polytomous logistic regression analyses, and Bonferroni tests. Eighty three men and 314 women had prevalent vertebral deformity. The mean height loss was 2.2 cm for men and 3.9 cm for women. Height loss > or =4 cm (P < 0.01) and vertebral deformity (P = 0.04) were independent risk factors for low EQ-5D scores, after adjustment for sex and age. The present study showed that height loss and vertebral deformity affected EQ-5D significantly and independently in the elderly.

Study design: Experimental trial based on the analytical study of radiographic standards of the sagittal spinal alignment in paraplegics in upright position under surface neuromuscular electrical stimulation (NMES). Objectives: To evaluate changes in radiographic standards of the sagittal spinal alignment of paraplegics under three different models of NMES used to optimize the global bipedal posture. Setting: The University Hospital Ambulatory (UNICAMP), Campinas, SP, Brazil. Methods: Ten paraplegic patients were selected. Each patient underwent three different models of NMES. The influence that each NMES model exerted over the sagittal balance of the spine was evaluated by lateral panoramic X-rays. Wilcoxon's test was used to compare the modifications observed in each NMES model in the group studied. Results: Using the femoral quadriceps muscles' NMES as the starting point, the inclusion of the gluteus maximus' NMES generated an increase of the lumbar lordosis and a decrease of the spinal tilt angle. These alterations resulted in partial improvement of the anterior sagittal imbalance. NMES of the paralyzed paravertebral lumbar muscles resulted in a more expressive increase on the lumbar lordosis, with no significant change on the spinal tilt. On the latter model, however, an improvement of 20% was observed in the global sagittal imbalance due to a posterior translation of the spine as pointed out by the decrease in the C7–HA horizontal distance. Conclusions: The proposed NMES models were able to partially amend the anterior sagittal imbalance of the paraplegic patients in bipedal posture.

Background This study aimed to evaluate the association between spinopelvic alignment parameters and hip osteoarthritis progression after spinal alignment correction surgery for adult spinal deformity, focusing on the preoperative to postoperative change in spinopelvic alignment. Methods This retrospective study enrolled 100 adult spinal deformity patients (196 hip joints) who underwent spinal fusion surgery, after excluding four joints with previous total hip arthroplasty. Acetabular roof obliquity (ARO), center edge angle (CE) and Kellgren and Lawrence (KL) grade were measured in the hip joint. Spinopelvic alignment parameters were measured preoperatively and 1-month postoperatively and the changes (Δ) during this period were calculated. Patients were followed-up for ≥ 5 years and factors associated with KL grade progression at 5-years postoperatively were determined by logistic regression analysis. Results In the analysis with all cases, KL grade progressed in 23 joints. Logistic regression analysis revealed age (OR: 1.098, 95% CI: 1.007–1.198, p  = 0.019), ARO (OR: 1.176, 95% CI: 1.01–1.37, p  = 0.026), and Δ PI (OR: 0.791, 95% CI: 0.688–0.997, p  < 0.001) as parameters significantly associated with KL grade progression. On the other hand, in the analysis limited to 185 cases with 1-month postoperative KL grade of 0, KL grade progressed in 13 joints. Logistic regression analysis revealed PI-LL (OR: 1.058, 95% CI: 1.001–1.117, p  = 0.04), ΔPI (OR: 0.785, 95% CI: 0.649–0.951, p  < 0.001), and ΔCobb (OR: 1.127, 95% CI: 1.012–1.253, p  = 0.009) as parameters significantly associated with progression. Conclusions Both the overall and limited analyzes of this study identified preoperative to postoperative change in PI as parameters affecting the hip osteoarthritis progression after spinal fusion surgery. Decrease in PI might represent preexisting sacroiliac joint laxity. Patients with this risk factor should be carefully followed for possible hip osteoarthritis progression.