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Ali MS, Usama M. Association Between Two Methods of Spinal and Pelvic Analysis Among Children With Cerebral Palsy. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2024; 24:67-72. [PMID: 38427370 PMCID: PMC10910198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Children with cerebral palsy have weak muscles, which may impair postural adjustments. These postural adjustments are required for gait and dynamic balance during the daily living activities. The aim of this study was to investigate the association between Cobb's angle and Formetric 4D surface topography system in evaluating spinal and pelvic deformity in children with cerebral palsy. METHODS One hundred children with spastic diplegia (6 to 8 years old) diagnosed as cerebral palsy participated in this study and selected from the Outpatient Clinic of Faculty of Physical Therapy. Digital x- ray and formetric analysis were used to measure spinal deformities and pelvic deviation in children with cerebral palsy. RESULTS There were positive correlations between Cobb's angle and formetric parameters, including trunk imbalance, lateral deviation, and pelvic tilt. Also, Formetric parameters were significant predictors of Cobb's angle, including trunk imbalance (for a one-degree increase, Cobb's angle increases by 0.227, lateral deviation (for a one-degree increase, Cobb's angle increases by 0.665), and pelvic tilt (for a one-degree increase, Cobb's angle increases by 0.252). CONCLUSION Formetric 4D surface topography system was effective in evaluating spinal and pelvic deformity in children with cerebral palsy when compared with Digital x-ray.
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Affiliation(s)
- Mostafa S. Ali
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, October 6 University, Egypt
| | - Mahmoud Usama
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
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Singh H, Shipra, Gupta M, Gupta N, Gupta G, Pandita AK, Sharma R, Pandita S, Singh V, Garg B, Rai E, Sharma S. SOX9 gene shows association with adolescent idiopathic scoliosis predisposition in Northwest Indians. Eur J Med Res 2024; 29:66. [PMID: 38245767 PMCID: PMC10799485 DOI: 10.1186/s40001-024-01635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common structural deformity of the spine affecting adolescent individuals globally. The disorder is polygenic and is accompanied by the association of various genetic loci. Genetic studies in Chinese and Japanese populations have shown the association of genetic variants of SOX9 with AIS curve severity. However, no genetic study evaluating the association of SRY-Box Transcription Factor 9 (SOX9) variants with AIS predisposition has been conducted in any Indian population. Thus, we aimed to investigate the association of the genetic variants of the SOX9 along with 0.88 Mb upstream region with AIS susceptibility in the population of Northwest India. METHODS In total, 113 AIS cases and 500 non-AIS controls were recruited from the population of Northwest India in the study and screened for 155 genetic variants across the SOX9 gene and 0.88 Mb upstream region of the gene using Global Screening Array-24 v3.0 chip (Illumina). The statistical significance of the Bonferroni threshold was set at 0.000322. RESULT The results showed the association of 11 newly identified variants; rs9302936, rs7210997, rs77736349, rs12940821, rs9302937, rs77447012, rs8071904, rs74898711, rs9900249, rs2430514, and rs1042667 with the AIS susceptibility in the studied population. Only one variant, rs2430514, was inversely associated with AIS in the population, while the ten variants were associated with the AIS risk. Moreover, 47 variants clustered in the gene desert region of the SOX9 gene were associated at a p-value ≤ 0.05. CONCLUSION The present study is the first to demonstrate the association of SOX9 enhancer locus variants with AIS in any South Asian Indian population. The results are interesting as rs1042667, a 3' untranslated region (UTR) variant in the exon 3 and upstream variants of the SOX9 gene, were associated with AIS susceptibility in the Northwest Indian population. This provides evidence that the variants in the enhancer region of SOX9 might regulate its gene expression, thus leading to AIS pathology and might act as an important gene for AIS susceptibility.
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Affiliation(s)
- Hemender Singh
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Shipra
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Manish Gupta
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Nital Gupta
- District Hospital Poonch, Poonch, Jammu and Kashmir, India
| | - Geetanjali Gupta
- Department of Radiology, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, Jammu and Kashmir, India
| | - Ajay K Pandita
- Accidental Hospital, Chowki Choura, Jammu, Jammu and Kashmir, India
| | - Rajesh Sharma
- Government Medical College, Jammu, Jammu and Kashmir, India
| | - Sarla Pandita
- Chest Disease Hospital, Bakshi Nagar, Jammu, Jammu and Kashmir, India
| | - Vinod Singh
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Bhavuk Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Rai
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India.
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India.
| | - Swarkar Sharma
- Human Genetics Research Lab, Centre for Molecular Biology, Central University of Jammu, Jammu, India.
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Maaliw RR. SCOLIONET: An Automated Scoliosis Cobb Angle Quantification Using Enhanced X-ray Images and Deep Learning Models. J Imaging 2023; 9:265. [PMID: 38132683 PMCID: PMC10743962 DOI: 10.3390/jimaging9120265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
The advancement of medical prognoses hinges on the delivery of timely and reliable assessments. Conventional methods of assessments and diagnosis, often reliant on human expertise, lead to inconsistencies due to professionals' subjectivity, knowledge, and experience. To address these problems head-on, we harnessed artificial intelligence's power to introduce a transformative solution. We leveraged convolutional neural networks to engineer our SCOLIONET architecture, which can accurately identify Cobb angle measurements. Empirical testing on our pipeline demonstrated a mean segmentation accuracy of 97.50% (Sorensen-Dice coefficient) and 96.30% (Intersection over Union), indicating the model's proficiency in outlining vertebrae. The level of quantification accuracy was attributed to the state-of-the-art design of the atrous spatial pyramid pooling to better segment images. We also compared physician's manual evaluations against our machine driven measurements to validate our approach's practicality and reliability further. The results were remarkable, with a p-value (t-test) of 0.1713 and an average acceptable deviation of 2.86 degrees, suggesting insignificant difference between the two methods. Our work holds the premise of enabling medical practitioners to expedite scoliosis examination swiftly and consistently in improving and advancing the quality of patient care.
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Affiliation(s)
- Renato R Maaliw
- College of Engineering, Southern Luzon State University, Lucban 4328, Quezon, Philippines
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Li Z, Zhou L, Wu M, Lv Y, Lin X, Huang Y, Xie H, Chen F. A new method for measuring penile curvature based on digital images. J Pediatr Urol 2023:S1477-5131(23)00129-8. [PMID: 37121816 DOI: 10.1016/j.jpurol.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/25/2023] [Accepted: 04/02/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION AND OBJECTIVE Accurate and objective assessment of penile curvature is considered a critical evaluation in patients with hypospadias, as it often determines if a 1 or 2-stage procedure should be done. Due to the ease of acquisition and reusability of digital images, more research is focused on digital images; however, the current method based on digital images is not an easily accurate and objective evaluation of penile curvature amongst surgeons. In scoliosis, the Cobb method is a standard method to quantify spinal curvature. Therefore, this study introduces a new accurate, and standardized method for measuring penile curvature based on the digital image concerning the Cobb method. METHODS Twenty-two subjects were randomly selected, including 11 pediatric urologists with experience in goniometry(professional group)and 11 non-pediatric urologists without experience in goniometry (non-professional group). A total of 9 two-dimensional images of penile curvatures from 10° to 90°were obtained and stored in the research project notebook. Subjects measured 9 digital images using the new method (fixed anatomical position method) and classical method (the angle created by the interception of two ideal lines, one passing along the proximal portion of the corpora and a second passing through the tip of the penis), respectively. Measurement error was calculated as the absolute difference between the true curvature and the subject estimation. A t-test was used to evaluate the significant differences between the methods. RESULTS A total of 22 subject measurement data were obtained. Mean errors using the new method ranged from 1.06° to 3.50°, compared to 3.84°to 11.83°for classical method. Mean errors were significantly lower (p < 0.05) when using the new method compared to the classical method. A subgroup comparing subjects with and without prior experience with goniometry showed a statistically significant difference only for the classical method when the penis curvature is 10-40°, the mean error range of the professional group was 7.8°-9.56°, compared to 10.34°-13.02°for nonprofessional group. DISCUSSION We emphasize the importance of penile curvature measurement and urgent need for an accurate measurement method, and then we focus on the new method compare with the previously described methods looking at mean errors and explain the reason that the new method why is accurate. Subsequently, we focus on explain the impact of experience measurement methods. Finally, the shortcomings of this paper and the prospective points are discussed:1) how to obtain more photos in practical situations; 2) using artificial intelligence methods for automatic marking of key points to achieve efficient measurement of penile curvature. CONCLUSIONS In this preliminary study, we demonstrated better penile curvature estimations using the new method compared to the classical methods currently used by pediatric urologists.
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Affiliation(s)
- Zhanchi Li
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Zhou
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Min Wu
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiqing Lv
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoling Lin
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yichen Huang
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Xie
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Fang Chen
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Joarder I, Taniguchi S, Mendoza A, Snow ME. Defining "successful" treatment outcomes in adolescent idiopathic scoliosis: a scoping review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:1204-1244. [PMID: 36847911 DOI: 10.1007/s00586-023-07592-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/07/2023] [Accepted: 02/07/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis that affects children aged 10-18 years old, manifesting in a three-dimensional spinal deformity. This study aimed to explore outcome measures used in defining AIS treatment success. Particularly, analyzing the extent of qualitative and quantitative (radiographic and quality of life domains) measures to evaluate AIS and whether AIS treatment approaches (surgical, bracing and physiotherapy) influences outcomes used as proxies of treatment success. METHODS EMBASE and MEDLINE databases were used to conduct a systematic scoping review with 654 search queries. 158 papers met the inclusion criteria and were screened for data extraction. Extractable variables included: study characteristics, study participant characteristics, type of study, type of intervention approach and outcome measures. RESULTS All 158 studies measured quantitative outcomes. 61.38% of papers used radiographic outcomes whilst 38.62% of papers used quantitative quality of life outcomes to evaluate treatment success. Irrespective of treatment intervention utilized, the type of quantitative outcome measure recorded were similar in proportion. Moreover, of the radiographic outcome measures, the subcategory Cobb angle was predominantly used across all intervention approaches. For quantitative quality of life measures, questionnaires investigating multiple domains such as SRS were primarily used as proxies of AIS treatment success across all intervention approaches. CONCLUSION This study identified that no articles employed qualitative measures of describing the psychosocial implications of AIS in defining treatment success. Although quantitative measures have merit in clinical diagnoses and management, there is increasing value in using qualitative methods such as thematic analysis in guiding clinicians to develop a biopsychosocial approach for patient care.
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Affiliation(s)
- Ishraq Joarder
- Faculty of Medicine, University of British Columbia, #908 - 2233 Allison Road, Vancouver, BC, V6T 1T7, Canada.
| | - Seika Taniguchi
- Faculty of Medicine, University of British Columbia, #908 - 2233 Allison Road, Vancouver, BC, V6T 1T7, Canada
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Galbusera F, Bassani T, Panico M, Sconfienza LM, Cina A. A fresh look at spinal alignment and deformities: Automated analysis of a large database of 9832 biplanar radiographs. Front Bioeng Biotechnol 2022; 10:863054. [PMID: 35910028 PMCID: PMC9335010 DOI: 10.3389/fbioe.2022.863054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
We developed and used a deep learning tool to process biplanar radiographs of 9,832 non-surgical patients suffering from spinal deformities, with the aim of reporting the statistical distribution of radiological parameters describing the spinal shape and the correlations and interdependencies between them. An existing tool able to automatically perform a three-dimensional reconstruction of the thoracolumbar spine has been improved and used to analyze a large set of biplanar radiographs of the trunk. For all patients, the following parameters were calculated: spinopelvic parameters; lumbar lordosis; mismatch between pelvic incidence and lumbar lordosis; thoracic kyphosis; maximal coronal Cobb angle; sagittal vertical axis; T1-pelvic angle; maximal vertebral rotation in the transverse plane. The radiological parameters describing the sagittal alignment were found to be highly interrelated with each other, as well as dependent on age, while sex had relatively minor but statistically significant importance. Lumbar lordosis was associated with thoracic kyphosis, pelvic incidence and sagittal vertical axis. The pelvic incidence-lumbar lordosis mismatch was found to be dependent on the pelvic incidence and on age. Scoliosis had a distinct association with the sagittal alignment in adolescent and adult subjects. The deep learning-based tool allowed for the analysis of a large imaging database which would not be reasonably feasible if performed by human operators. The large set of results will be valuable to trigger new research questions in the field of spinal deformities, as well as to challenge the current knowledge.
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Affiliation(s)
- Fabio Galbusera
- Spine Center, Schulthess Clinic, Zurich, Switzerland
- *Correspondence: Fabio Galbusera,
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Matteo Panico
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Andrea Cina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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