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Chehrassan M, Nikouei F, Shakeri M, Moeini J, Jafari B, Mahabadi EA, Ghandhari H. Factors Related to Proximal Junctional Kyphosis and Device Failure in Patients with Early-Onset Scoliosis Treated with a Traditional Dual Growing Rod: A Single Institution Study. Asian Spine J 2024; 18:236-243. [PMID: 38454749 PMCID: PMC11065516 DOI: 10.31616/asj.2023.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/25/2023] [Accepted: 11/26/2023] [Indexed: 03/09/2024] Open
Abstract
STUDY DESIGN Observational study. PURPOSE Investigation of factors related to proximal junctional kyphosis (PJK) and device failure in patients with early-onset scoliosis. OVERVIEW OF LITERATURE The use of growth-friendly devices, such as traditional dual growing rod (TDGR) for the treatment of earlyonset scoliosis (EOS), may be associated with important complications, including PJK and device failure. METHODS Thirty-five patients with EOS and treated with TDGR from 2014 to 2021 with a minimum follow-up of 2 years were retrospectively evaluated. Potential risk factors, including demographic factors, disease etiology, radiological measurements, and surgical characteristics, were assessed. RESULTS PJK was observed in 19 patients (54.3%), and seven patients (20%) had device failure. PJK was significantly associated with global final kyphosis change (p=0.012). No significant correlation was found between the rod angle contour, type of implant, connector design, and the risk of PJK or device failure. CONCLUSIONS Treatment of EOS with TDGR is associated with high rates of complications, particularly PJK and device failure. The device type may not correlate with the risk of PJK and device failure. The progression of thoracic kyphosis during multiple distractions is an important risk factor for PJK.
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Affiliation(s)
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | - Mohammadreza Shakeri
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | | | - Behnam Jafari
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | - Ebrahim Ameri Mahabadi
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
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Chehrassan M, Nikouei F, Shakeri M, Behnamnia A, Mahabadi EA, Ghandhari H. The role of environmental and seasonal factors in spine deep surgical site infection: the air pollution, a factor that may be underestimated. Eur Spine J 2024:10.1007/s00586-024-08183-z. [PMID: 38461454 DOI: 10.1007/s00586-024-08183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 02/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Different strategies have been described in order to reduce spine deep surgical site infection (SSI); however, non-intervenable items such as environmental factors remain as one of the main concerns for spine surgeons. METHODS A retrospective cohort study was designed in order to evaluate the effect of environmental factors such as temperature, humidity and particularly the air pollution index (PM 2.5) on spine surgical site infection. The files of 3609 patients who underwent spinal surgery from April 2019 to March 2022 were reviewed, and 121 patients with spine SSI were detected. RESULTS There was no significant relationship between mean temperature and humidity of each month with infection and type of bacteria. However, there was a significant relation between warmer season periods and infection. The rate of infection among patients was 3.25% ranged from 2.5% to 4% in colder and warmer seasons accordingly. It was determined that air pollution had a significant relationship with the infection and the type of bacteria. (p value < 0.05, R-Squared = 0.249). CONCLUSIONS Our study revealed a 60% increase in spine SSI during warmer seasons. There was a significant correlation between air pollution and the rate of infection. These may suggest the necessity to reduce the number of elective spine surgeries during warmer seasons and when the level of air pollutant is high.
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Affiliation(s)
- Mohammadreza Chehrassan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shakeri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Behnamnia
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri Mahabadi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Chehrassan M, Nikouei F, Shakeri M, Jafari B, Ameri Mahabadi E, Ghandhari H. Perioperative complications of symptomatic congenital kyphosis: a retrospective cohort study. Spine Deform 2024; 12:181-187. [PMID: 37605093 DOI: 10.1007/s43390-023-00751-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/05/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Despite the recent improvements in the surgical treatment of congenital kyphosis, this surgery may be associated with high rate of complications "particularly when patients are symptomatic preoperatively". MATERIALS AND METHODS Medical profiles of 40 patients with symptomatic congenital kyphosis were retrospectively reviewed. Perioperative complications were recorded and divided in two groups including catastrophic complications (neurologic deficit, pulmonary thromboembolic events, and death) and major complications (infection, deep vein thrombosis, device failure, and dural injury). RESULTS Catastrophic surgical complications occurred in nine (22.5%) patients including seven neurological deficits and two death. A significant association was observed between the incidence of major complications and type III of congenital kyphosis (P = 0.021). Major complications occurred in 14 (30%) patients. CONCLUSION Surgical treatment significantly improve symptomatic congenital kyphosis deformity; however, surgery of symptomatic patient may be associated with higher rate of complications and even death.
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Affiliation(s)
- Mohammadreza Chehrassan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shakeri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behnam Jafari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri Mahabadi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Depatment of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Chehrassan M, Nikouei F, Shakeri M, Moeini J, Hosseini F, Mahabadi EA, Ghandhari H. The effect of cage type on local and total cervical lordosis restoration and global spine alignment in single-level anterior cervical discectomy and fusion based on EOS ® imaging: A comparison between standalone conventional interbody polyether ether ketone cage and integrated cage and plate (Perfect-C ®). J Craniovertebr Junction Spine 2023; 14:399-403. [PMID: 38268682 PMCID: PMC10805155 DOI: 10.4103/jcvjs.jcvjs_108_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 01/26/2024] Open
Abstract
Background There is a small level of evidence regarding the alterations in global spine alignment following the restoration of cervical lordosis using anterior cervical discectomy and fusion (ACDF). Different cage types are available to restore cervical lordosis through ACDF. In this study, we evaluate the impact of two types of these cages on local and global spine alignments. Patients and Methods Thirty-two patients with a mean age of 46 ± 10 who underwent ACDF for cervical disc herniation were included in this retrospective study. Patients were divided according to their cage type into two groups, 17 patients with standalone conventional polyether ether ketone cages and 15 patients with integrated cage and plate (ICP) (Perfect-C®). Cervical alignment and global spine alignment were evaluated on the pre- and post-operative EOS® images. Results Three months after the ACDF, total cervical lordosis correction was higher in patients with ICP (P = 0.001), while the local cervical lordosis correction was not significantly different between conventional cages and prefect-C cages (P = 0.067). Lumbar lordosis and pelvic tilt change were significantly higher among patients with Perfect-c cages (P = 0.043). Conclusion In patients undergoing ACDF, alignment of the global spine changes along with the restoration of the cervical spine. Cage type affects this association, mainly through the compensatory alteration of pelvic tilt.
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Affiliation(s)
- Mohammadreza Chehrassan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shakeri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Moeini
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farrokhlagha Hosseini
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri Mahabadi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
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Ghandhari H, Ameri E, Nikouei F, Mahdavi SM, Chehrassan M, Motalebi M. Selective Thoracolumbar/Lumbar Fusion in Adolescent Idiopathic Scoliosis: A Comprehensive Review of the Literature. Arch Bone Jt Surg 2023; 11:313-320. [PMID: 37265523 PMCID: PMC10231918 DOI: 10.22038/abjs.2022.61439.3014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/05/2022] [Indexed: 06/03/2023]
Abstract
In Adolescent Idiopathic Scoliosis (AIS), correction surgery can correct the maximum movement and balance of the spine. Under certain conditions for two simultaneous curvatures, the procedure, in which correcting one of the curvatures can result in the automatic correction of another curvature, is called selective fusion, attracting spine surgeons' interest because of more movement in the spine. However, the majority of surgeons have not used this technique due to the lack of sufficient information. The current study aimed to totally investigate selective thoracolumbar/lumbar fusion and to provide accurate information on outcomes and complications of surgery for spinal surgeons. This technique can also help spinal surgeons have a better selection of patients' surgical procedures.
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Affiliation(s)
- Hasan Ghandhari
- Bone and Joint reconstruction research center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint reconstruction research center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint reconstruction research center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mani Mahdavi
- Orthopedic Spine Surgery Department, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Mohammadreza Chehrassan
- Bone and Joint reconstruction research center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Motalebi
- Bone and Joint reconstruction research center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Shakeri M, Mahdavi SM, Nikouei F, Ameri E, Eslami A, Habibollahzadeh A, Ghandhari H. Reliability and Validity of the Persian Version of the Body Image Disturbance Questionnaire-Scoliosis in Patients with Adolescent Idiopathic Scoliosis Who Did Not Have Surgical Indication. Arch Bone Jt Surg 2023; 11:130-135. [PMID: 37168827 PMCID: PMC10165678 DOI: 10.22038/abjs.2022.66298.3170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/22/2022] [Indexed: 05/13/2023]
Abstract
Background Adolescent Idiopathic Scoliosis (AIS) is the most common spinal deformity disorder associated with bad posture and reduced quality of life. The Body Image Disturbance Questionnaire-Scoliosis (BIDQ-S) is a self-report instrument that assesses the concerns of scoliotic patients. This study aimed to translate and evaluate the reproducibility and internal consistency of the BIDQ-S in the Persian-speaking population worldwide suffering from AIS. Methods The BIDQ-S was translated into Persian by two native-speaking Iranian translators and back-translated into English by two native-English translators. The resulting back-translated English BIDQ-S was then sent to the authors of the English BIDQ-S questionnaire for validation. After translation, it was provided for 41 AIS patients from those who referred to the outpatient clinics of Shafa Yahyaian Hospital from January 2020 to January 2021. Patients were asked to complete the Persian BIDQ-S and Persian Scoliosis Research Society-22 (SRS-22) inventories. Internal consistency and reproducibility were assessed using Cronbach's alpha and interclass correlation coefficients (ICC), respectively. The validity of the questionnaire was evaluated by comparing the scores obtained on the Persian BIDQ-S (P-BIDQ-S) inventory with those obtained on the SRS-22 subscales. Results The consistency and reliability of the P- BIDQ-S inventory were confirmed by Cronbach's alpha of 0.856 and interclass correlation coefficients of 0.882. The P-BIDQ-S scores directly correlated with the level of education of patients (r=0.21, P=0.041). The correlation coefficient between the P-BIDQ-S inventory and the SRS-22 questionnaire was -0.56 (P=0.001). A significant correlation was also observed between the P-BIDQ-S items and all of the SRS-22 subscales (P<0.05). Conclusion The P-BIDQ-S inventory maintains adequate reliability, internal consistency, and reproducibility for the evaluation of Persian-speaking AIS patients.
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Affiliation(s)
- Mohammadreza Shakeri
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mani Mahdavi
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Arvin Eslami
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Habibollahzadeh
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran
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Nikouei F, Ghandhari H, Ameri E, Mokarami F. Shoulder Imbalance in Adolescent Idiopathic Scoliosis: A Systematic Review of the Current State of the Art. Arch Bone Jt Surg 2022; 10:992-1003. [PMID: 36721654 PMCID: PMC9846726 DOI: 10.22038/abjs.2022.64282.3086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/02/2022] [Indexed: 02/02/2023]
Abstract
Background Shoulder imbalance (SI) is among the most rated manifestations of adolescent idiopathic scoliosis (AIS) pointed to by patients and spine surgeons. It serves as a criterion to assess the outcome of scoliosis surgery and is also a cause of dissatisfaction for the patients postoperatively. Despite the availability of multiple studies on this issue, a comprehensive survey of the risk factors and preventive measures has yet to be elucidated. The present study aimed to highlight the most recent approach to the evaluation and management of SI, as well as medical counseling about the expectations and limitations of the surgery. Methods A systematic literature review using electric databases was conducted, including PubMed, Embase, the Cochrane Library, and Google Scholar, with a well-defined search strategy on SI definition, risk factors, and preventive and surgical recommendations. Results A total of 69 articles were identified; SI > 2 cm was the most used cut-off, and its risk factors included the main thoracic Cobb angle > 80˚, preoperative level shoulder, high left shoulder, and higher Risser grade. The most stated strategies to preclude SI were the sufficient correction of the proximal thoracic curve, and moderate correction of the main thoracic and lumbar curve (LC). Conclusion Shoulder imbalance should be prevented not only for appearance or satisfaction but also for possible complications such as distal adding-on, new LC progression, or trunk shift postoperatively in AIS patients.
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Affiliation(s)
- Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farzam Mokarami
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
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Mousavi L, Seidi F, Minoonejad H, Nikouei F. Prevalence of idiopathic scoliosis in athletes: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2022; 8:e001312. [PMID: 35999823 PMCID: PMC9362835 DOI: 10.1136/bmjsem-2022-001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study aimed to determine the prevalence of idiopathic scoliosis (IS) in child, adolescent and adult athletes of all sports activity levels. Design Systematic review with meta-analysis. Data sources Electronic databases (PubMed, Scopus, ProQuest, Sage journals, ScienceDirect, Google Scholar and Springer) were systematically searched up from inception to 28 September 2021. Eligibility criteria for selecting studies Observational investigations were included to evaluate the prevalence of IS in athletes (engaged in any type of individual and team sports). Congenital scoliosis, neuromuscular scoliosis, Scheuermann’s kyphosis and de novo scoliosis were not included. The risk of bias was assessed using the tool developed by Hoy et al. Results Twenty-two studies were included (N=57 470, range 15–46544, participants), thirteen studies were of high-quality. The estimated prevalence of IS in athletes was 27% (95% CI 20% to 35%, I2=98%), with a 95% prediction interval (1% to 69%). The prevalence of IS was significantly higher in female athletes (35%, 95% CI 27% to 34%, I2=98%). Ballet dancers showed a high IS prevalence (35%, 95% CI 24% to 47%, I2=98%). Recreational athletes showed a higher IS prevalence (33%, 95% CI 24% to 43%, I2=98%) than at competitive-level athletes (0.05%, 95% CI 0.03% to 0.08%, I2=98%), followed by elite (20%, 95% CI 13% to 27%, I2=98%). Conclusions The prevalence of IS in athletes was similar or higher to that as seen in other studies of the general population. IS prevalence may have a U-shaped relationship relative to level of competition. Further studies are required to determine which sports have the highest IS prevalence.
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Affiliation(s)
- Leila Mousavi
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Foad Seidi
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Hooman Minoonejad
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
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Ghandhari H, Ameri E, Mahmoudi A, Nikouei F, Sabbaghan S, Mirzamohammadi E. Validity and Reliability of an Adapted Persian Version of the Scoliosis Research Society-30 Questionnaire. Arch Bone Jt Surg 2021; 9:708-713. [PMID: 35106337 PMCID: PMC8765195 DOI: 10.22038/abjs.2021.47205.2305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common type of spinal deformity confronting surgeons. The Scoliosis Research Society Health-Related Quality of Life (SRS-30) Questionnaire has been translated into Persian to evaluate its internal consistency, reliability, validity, and cross-cultural adaptability in the Persian population. METHODS The translation and cultural adaptation process was based on the American Academy of Orthopaedic Surgeons guidelines. A total of 102 AIS patients referring to our institution were enrolled in this study within March 2014-March 2016. The 36-item Short Form (SF-36) was used for adapting the Persian SRS-30 questionnaire. The convergent validity of the Persian SRS-30 was examined using the Pearson correlation coefficient. Furthermore, its internal consistency and validity were tested using Cronbach α with bootstrapped 95% confidence interval. Interclass Correlation Coefficient (ICC) was used to test and retest reliability. RESULTS The total correlation coefficient between the Persian SRS-30 and SF-36 was obtained at 0.74 (0.67-0.80), which was statistically significant (P=0.001). The total Cronbach α for the Persian SRS-30 was estimated at 0.84, ranging from 0.51 in satisfaction with management domains to 0.88 in mental health domains. The Persian SRS-30r domains indicated satisfactory test-retest reliability with ICC rage of 0.79-0.87. CONCLUSION The Persian SRS-30 translation was reliable and valid for the AIS Iranian patients. The internal consistency of this instrument was found to be good and excellent in all domains except satisfaction with management, which was moderate. The authors believe that the Persian version of SRS-30 is simple and easy to use and now it can be applied in clinical settings for future outcome studies in Iran.
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Affiliation(s)
- Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mahmoudi
- Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Sabbaghan
- Bone and Joint Reconstruction Research Center, Shafa orthopedic hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Mirzamohammadi
- Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Nikouei F, Nabizadeh N, Mirzamohammadi E, Ameri M, Sabbaghan S, Givehchian B, Safdari F. Application of Oscillating Saw for Lumbar en Bloc Laminectomy: A Case Series. Arch Bone Jt Surg 2020; 8:407-412. [PMID: 32766400 DOI: 10.22038/abjs.2019.14126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background An oscillating bone saw is rarely used to perform laminectomy. The purpose of this study was to describe a relatively quick and harmless technique for multilevel laminectomy in patients with lumbar spinal stenosis (LSS) using an oscillating bone saw to find out how this instrument affects the time of surgery and rate of complications. Methods This prospective study was conducted on 45 patients with LSS who required multilevel laminectomy. The bones were cut using an oscillating sagittal saw equipped with a fine 1-cm blade. Posterolateral fusion was performed if any evidence of spinal instability occurred, or the correction of deformity was addressed. The time spent for laminectomy from initial cutting to the whole bone removal (T1) and the duration of laminectomy (i.e., from initiation to the end of decompression; T2) were recorded for the corresponding level. The volume of harvested autograft was also measured, and any dural injuries were reported. Results Posterolateral fusion was performed on 32 (71.1%) patients. The mean T1 and T2 per level were estimated at 70.5±5.4 and 157.5±12.1 sec, respectively. In addition, the mean volume of harvested autograft per level was obtained as 3.5±1.2 cc. No durotomy was observed during laminectomy using an oscillating bone saw. However, a dural tear occurred in one patient when a Kerisson punch was utilized for ligamentum flavum removal and foraminotomy. Conclusion Based on the findings, it can be concluded that laminectomy by means of the oscillating bone saw is a safe procedure that provides a sufficient volume of harvested autograft for fusion. This technique could also induce a remarkable reduction in the time of surgery.
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Affiliation(s)
- Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Naveed Nabizadeh
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Ameri
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Sabbaghan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Behrooz Givehchian
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Safdari
- Bone and Joint Related Tissue Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sabbaghan S, Mirzamohammadi E, Ameri Mahabadi M, Nikouei F, Rahbarian F, Ahmadichaboki S, Eftekhari S, Zamankhani M, Aghaie Aghdam A. Short-Term Efficacy of Epidural Injection of Triamcinolone Through Translaminar Approach for the Treatment of Lumbar Canal Stenosis. Anesth Pain Med 2020; 10:e99764. [PMID: 32337171 PMCID: PMC7158243 DOI: 10.5812/aapm.99764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 12/20/2022] Open
Abstract
Background Epidural steroid injection is a non-operative minimally invasive procedure for pain relief in spinal canal stenosis. However, there is no significant consensus regarding its efficacy. Objectives In this study, we aimed to evaluate the effectiveness of translaminar injection of triamcinolone in lumbar canal stenosis. Methods In a retrospective study, we included 111 patients with MRI-confirmed spinal canal stenosis who were irresponsive to 12 weeks of conservative treatment and underwent epidural injection of triamcinolone through the translaminar approach. Outcome measures were routinely checked before the intervention and four weeks after the intervention, which included the Visual Analog scale (VAS) for low back pain, VAS for lower-limb pain, and Oswestry Disability index (ODI). Results The study population included 32 (28.8%) males and 79 (71.2%) females with the mean age of 61 ± 13.4 years. The mean ODI, VAS for low back pain, and VAS for lower-limb pain significantly improved at the final evaluation session (P < 0.001, P = 0.001, and P < 0.001, respectively). The levels of improvement in ODI, VAS for low back pain, and VAS for lower-limb pain were considerably more in patients with single-level involvement (P < 0.001, P = 0.04, and P < 0.001, respectively). Improvement of lower-limb VAS was negatively correlated with age (r = -0.400, P < 0.001) and BMI (r = -0.525, P < 0.001). The ODI improvement was also negatively correlated with BMI (r = -0.569, P < 0.001). Conclusions Epidural injection of triamcinolone through the translaminar approach could be regarded as an efficacious method for the alleviation of pain and disability in patients with spinal canal stenosis.
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Affiliation(s)
- Saeed Sabbaghan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Mirzamohammadi
- Occupational Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Ameri Mahabadi
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Rahbarian
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Susan Ahmadichaboki
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Eftekhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Zamankhani
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Aghaie Aghdam
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Nikouei F, Ghandhari H, Haghbin M, Momen O, Aghaie Aghdam A. Sagittal Alignment Following the Kyphoplasty of Acute Versus Chronic Osteoporotic Vertebral Compression Fracture. ACTA ACUST UNITED AC 2019. [DOI: 10.32598/jrosj.6.3.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ameri E, Nikouei F, Ghandhari H, Sabbaghan S, Givehchian B. Osteoid Osteoma of Odontoid: Case Report and Literature Review. Arch Bone Jt Surg 2019; 7:566-570. [PMID: 31970263 PMCID: PMC6935530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/14/2018] [Indexed: 06/10/2023]
Abstract
Osteoid osteoma (OO) is a small tumor of bone that affects the spine in 10% of the cases. The tumor has a tendency to neural arc, and the lumbar spine is the most common site of presentation. Lesions of the odontoid process are very rare. We presented the case of a 20-year-old man who had cervical pain for 8 months. The pain responded to medical therapy. After investigation, there was a lytic lesion at the odontoid process with the characteristic features of OO in computed tomography scan and magnetic resonance imaging. Firstly, medical treatment was initiated with the administration of nonsteroidal anti-inflammatory drugs; however, due to adverse effects and worsening of his pain, the patient underwent surgical treatment with intralesional curettage from the transoral approach. In addition, the posterior fusion of the first and second cervical vertebrae was performed. The pain disappeared, and the patient was symptom-free after one year of follow-up.
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Affiliation(s)
- Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran
- Research performed at Bone and Joint reconstruction research center, Shafa orthopedic hospital, Iran University of medical science, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran
- Research performed at Bone and Joint reconstruction research center, Shafa orthopedic hospital, Iran University of medical science, Tehran, Iran
| | - Hassan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran
- Research performed at Bone and Joint reconstruction research center, Shafa orthopedic hospital, Iran University of medical science, Tehran, Iran
| | - Saeed Sabbaghan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran
- Research performed at Bone and Joint reconstruction research center, Shafa orthopedic hospital, Iran University of medical science, Tehran, Iran
| | - Behrooz Givehchian
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran
- Research performed at Bone and Joint reconstruction research center, Shafa orthopedic hospital, Iran University of medical science, Tehran, Iran
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Nikouei F, Ghandhari H, Ameri E, Mahdavi SM, Ameri M, Safdari F. Complications of Fusionless Correction of Early Onset Scoliosis Using Dual Growing Rods. Arch Iran Med 2018; 21:595-599. [PMID: 30634858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Growing rods are increasingly used for treatment of early onset scoliosis (EOS) worldwide. Beside promising outcomes, some authors are concerned about high rates of complications. In the current clinical trial, complications of EOS surgery using dual growing rods were investigated. METHODS Between June 2006 and February 2017, twenty-two consecutive patients with a coronal curve >45 degrees underwent serial surgical correction using dual growing rods at Shafa Orthopedic hospital, Tehran, I.R. Iran. The rods were secured using hooks or screws or both. The patients were followed for 5.2 ± 1.7 years on average. Wilcoxon test was utilized to compare the pre- and post-operative values. P < 0.05 was considered significant. RESULTS The scoliotic and kyphotic curves decreased significantly from 52 ± 24° to 38 ± 19° and from 78 ± 22° to 60 ± 17°, respectively (P < 0.001). Total rate of implant-related complications (IRCs) and surgical site complications (SSCs) were 54.5% (12 patients) and 22.7% (5 patients), respectively. Malpositioned pedicular screw was found in 2 patients. CONCLUSION EOS can be effectively corrected using dual growing rods, however, considerable rates of IRC are of concern (54.5%). It seems necessary to compare the efficacy and complication rate of newer devices with those of growing rods in future studies.
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Affiliation(s)
- Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mani Mahdavi
- Orthopedic Spine Surgery Department, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Safdari
- Bone Joint and Related Tissue Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ghandhari H, Ameri E, Nikouei F, Haji Agha Bozorgi M, Majdi S, Salehpour M. Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis. Scoliosis Spinal Disord 2018; 13:14. [PMID: 30123840 PMCID: PMC6090875 DOI: 10.1186/s13013-018-0157-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/17/2018] [Indexed: 12/18/2022]
Abstract
Background Adolescent idiopathic scoliosis (AIS) is the most common form of idiopathic scoliosis, and surgery is considered as one of the therapeutic options. However, it is associated with a variety of irreversible complications, in spite of the benefits it provides. Here, we evaluated the long-term outcome of posterior spinal fusion (PSF) of AIS to shed more light on the consequences of this surgery. Methods In a cross-sectional study, a total of 42 AIS patients who underwent PSF surgery were radiographically and clinically inspected for the potential post-operative complications. Radiographic assessments included the device failure, union status, and vertebral tilt below the site of fusion. Clinical outcomes were evaluated using the Oswestry disability index (ODI) and visual analogue scale (VAS). Results The mean age of the surgery was 14.4 ± 5.1 years. The mean follow-up of the patients was 5.6 ± 3.2 years. Complete union was observed in all patients, and no device failure was noticed. Pre- and post-operative vertebral tilt below the site of fusion were 11.12° ± 7.92° and 6.21° ± 5.73°, respectively (p < 0.001). The mean post-operative ODI was 16.7 ± 9.8. The mean post-operative VAS was 2.1 ± 0.7. ODI value was positively correlated with follow-up periods (p = 0.04, r = 0.471). New degenerative disc disease (DDD) was observed in 6 out of 37 (16%) patients. Conclusion In spite of the efficacy and safety of PSF surgery of AIS, it might result in irreversible complications such as DDD. Moreover, the amount of post-operative disability might increase over the time and should be discussed with the patients.
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Affiliation(s)
- Hasan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Ameri
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Haji Agha Bozorgi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shoeib Majdi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Salehpour
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
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Ghandhari H, Ameri Mahabadi M, Nikouei F, Sabbaghan S, Azizi A, Mirzaei A, Givehchian B. The Role of Spinopelvic Parameters in Clinical Outcomes of Spinal Osteotomies in Patients with Sagittal Imbalance. Arch Bone Jt Surg 2018; 6:324-330. [PMID: 30175181 PMCID: PMC6110429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/03/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sagittal imbalance is known as the main radiographic driver of disability in adult spinal deformity (ASD). In this study, the association of radiological spinopelvic parameters and clinical outcomes was evaluated following the corrective surgery of sagittal imbalance, in order to explore the predictive ability of each parameter. METHODS A total of 23 patients, who underwent corrective osteotomy for restoration of sagittal balance, were included in this study. The mean follow-up period of the patients was 15.5±2.1, ranging from 12 to 18 months. Pre- and postoperative radiological parameters including pelvic tilt (PT), sagittal vertical axis (SVA) and pelvic incidence minus lumbar lordosis (PI-LL) were assessed for each patient. Clinical outcomes were evaluated using Oswestry disability Index (ODI). RESULTS The mean ODI improved 32% following the corrective osteotomy of sagittal imbalance. Postoperative ODI was significantly correlated with all preoperative radiological parameters (r=0.608, P=0.002 for PI-LL; r=0.483, P=0.01 for PT; and r=0.464, P=0.02 for SVA). ODI improvement was significantly correlated with PI-LL and SVA change (r=536, P=0.008 and r=416, P=0.04, respectively), but not with PT change (r=247, P=0.25). The outcome was better in pedicle subtraction osteotomy (PSO) compared to Smith-Petersen Osteotomy (SPO). CONCLUSION Surgical correction of sagittal imbalance could limit the amount of disability caused by this misalignment. According to our results, while all the spinopelvic parameters could be used in the prediction of the outcomes of corrective surgery of sagittal imbalance, PI-LL was the most informative parameter and more attention should be devoted to this parameter.
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Affiliation(s)
- Hassan Ghandhari
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Ameri Mahabadi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Sabbaghan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Abouzar Azizi
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Mirzaei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
| | - Behrooz Givehchian
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran
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Hesarikia H, Azma K, Kousari A, Nikouei F. Magnetic resonance imaging investigations of position of conus medullaris in adolescent idiopathic scoliosis as a peripheral neuropathy. Int J Clin Exp Med 2015; 8:5918-5924. [PMID: 26131185 PMCID: PMC4483850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 03/31/2015] [Indexed: 06/04/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a structural 3-dimensional deformity the spine, which is occurring between 10 years of age and skeletal maturity and it mostly affects prepuberbal girls. The etiology of AIS remains unknown and seems should be multifactorial. According to the theories, there could be a shorter spinal cord or a higher location of the conus medullaris and disproportionate growth in neuro-osseous system. This study wants to investigate the position of the conus medullaris in AIS patients with a large curve magnitude in comparison with healthy adolescents. 94 AIS patients consisting of 25 males and 69 females between 11 and 25 years old, based on physical examination and standing posteroanterior roentgenography of the total spine with a Cobb angle more than 40 degrees was chosen. The main curve magnitude of every AIS patient was measured by the Cobb method. Apex of deformity was determined based on SRS definition. Patients' deformity were calcified based on Lenke classification. Magnetic resonance imaging examinations of the total spine were performed in the AIS group, by means of a 1.5-T magnetic resonance imaging system. The position of conus medullaris was defined according to the method by saffiudin et al and was assessed based on the age, sex, type of deformity, severity of deformity, kyphosis, lordosis, flexibility, apical vertebra, stable vertebra. The mean age of patients were 16.34 with 6.77 of conus medullaris position in mean, which was lower one-third of L1. Our study showed no significant correlation between the position of conus medullaris with age, weight, preoperative curve, flexibility, types of deformity based on Lenke classification and degree of kyphosis and lordisis. In conclusion, there is the same mean and the distribution of the conus medullaris locations for AIS patients and normal populations.
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Affiliation(s)
- Hamid Hesarikia
- Department of Orthopedics, Baqiyatallah Hospital, Baqiyatallah University of Medical SciencesTehran, Iran
| | - Kamran Azma
- Department of Physical Medicine and Rehabilitation, AJA University of Medical SciencesTehran, Iran
| | - Aliasghar Kousari
- Department of Orthopedics, Baqiyatallah Hospital, Baqiyatallah University of Medical SciencesTehran, Iran
| | - Farshad Nikouei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical SciencesTehran, Iran
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