Traction versus supine side-bending radiographs in determining flexibility: What factors influence these techniques?

Koota Watanabe, Noriaki Kawakami, Yuji Nishiwaki, Manabu Goto, Taichi Tsuji, Tetsuya Obara, Shiro Imagama, Morio Matsumoto

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

STUDY DESIGN. Prospective clinical, radiologic study of adolescent idiopathic scoliosis (AIS). OBJECTIVE. We evaluated a Cobb angle in standing position, patient age, the level of the apex, and the number of involved vertebrae in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. SUMMARY OF BACKGROUND DATA. Side-bending and traction radiographs are used to evaluate curve flexibility during corrective surgery for AIS despite notable differences in the flexibilities of identical curves. Thus, interpretation for the differences among these techniques should be investigated. METHODS. A total of 229 consecutive patients with AIS who were surgically treated were evaluated. Standing, supine side-bending, and traction radiographs were obtained before surgery. Curves were divided into main thoracic (MT) or thoracolumbar/lumbar (TL/L) curves, and proximal thoracic (PT) curves. We evaluated the Cobb angle in standing position, the level of the apex, the number of involved vertebrae, kyphosis angle of main thoracic curve, and patient age in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. RESULTS. A total of 219 curves were observed in MT lesions. The traction flexibility rate (FR) was higher than the side-bending FR at angle of ≥60° (P = 0.02), in patients younger than 15 years (P = 0.02), in curves whose apex was located at T4-T8/T9(P = 0.01), in curves whose involved vertebrae were 6 or 7 (P = 0.02), and at kyphosis angle between 10° and 39° (P = 0.02). In 96 TL/L curves, side-bending FR was higher at angle of <60° (P < 0.01). In 163 PT curves, traction FR was higher at angles of ≥40° (P = 0.02). CONCLUSION. In addition to a Cobb angle, patient age, the level of the apex, and the number of involved vertebrae also influence the conditions under which the corrective ability of traction radiographs is superior to that of side-bending radiographs.

Original languageEnglish
Pages (from-to)2604-2609
Number of pages6
JournalSpine
Volume32
Issue number23
DOIs
Publication statusPublished - 2007 Nov

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Traction
Scoliosis
Thorax
Spine
Kyphosis
Posture

Keywords

  • Adolescent idiopathic scoliosis
  • Flexibility
  • Side-bending radiograph
  • Traction radiograph

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Traction versus supine side-bending radiographs in determining flexibility : What factors influence these techniques? / Watanabe, Koota; Kawakami, Noriaki; Nishiwaki, Yuji; Goto, Manabu; Tsuji, Taichi; Obara, Tetsuya; Imagama, Shiro; Matsumoto, Morio.

In: Spine, Vol. 32, No. 23, 11.2007, p. 2604-2609.

Research output: Contribution to journalArticle

Watanabe, Koota ; Kawakami, Noriaki ; Nishiwaki, Yuji ; Goto, Manabu ; Tsuji, Taichi ; Obara, Tetsuya ; Imagama, Shiro ; Matsumoto, Morio. / Traction versus supine side-bending radiographs in determining flexibility : What factors influence these techniques?. In: Spine. 2007 ; Vol. 32, No. 23. pp. 2604-2609.
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abstract = "STUDY DESIGN. Prospective clinical, radiologic study of adolescent idiopathic scoliosis (AIS). OBJECTIVE. We evaluated a Cobb angle in standing position, patient age, the level of the apex, and the number of involved vertebrae in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. SUMMARY OF BACKGROUND DATA. Side-bending and traction radiographs are used to evaluate curve flexibility during corrective surgery for AIS despite notable differences in the flexibilities of identical curves. Thus, interpretation for the differences among these techniques should be investigated. METHODS. A total of 229 consecutive patients with AIS who were surgically treated were evaluated. Standing, supine side-bending, and traction radiographs were obtained before surgery. Curves were divided into main thoracic (MT) or thoracolumbar/lumbar (TL/L) curves, and proximal thoracic (PT) curves. We evaluated the Cobb angle in standing position, the level of the apex, the number of involved vertebrae, kyphosis angle of main thoracic curve, and patient age in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. RESULTS. A total of 219 curves were observed in MT lesions. The traction flexibility rate (FR) was higher than the side-bending FR at angle of ≥60° (P = 0.02), in patients younger than 15 years (P = 0.02), in curves whose apex was located at T4-T8/T9(P = 0.01), in curves whose involved vertebrae were 6 or 7 (P = 0.02), and at kyphosis angle between 10° and 39° (P = 0.02). In 96 TL/L curves, side-bending FR was higher at angle of <60° (P < 0.01). In 163 PT curves, traction FR was higher at angles of ≥40° (P = 0.02). CONCLUSION. In addition to a Cobb angle, patient age, the level of the apex, and the number of involved vertebrae also influence the conditions under which the corrective ability of traction radiographs is superior to that of side-bending radiographs.",
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T2 - What factors influence these techniques?

AU - Watanabe, Koota

AU - Kawakami, Noriaki

AU - Nishiwaki, Yuji

AU - Goto, Manabu

AU - Tsuji, Taichi

AU - Obara, Tetsuya

AU - Imagama, Shiro

AU - Matsumoto, Morio

PY - 2007/11

Y1 - 2007/11

N2 - STUDY DESIGN. Prospective clinical, radiologic study of adolescent idiopathic scoliosis (AIS). OBJECTIVE. We evaluated a Cobb angle in standing position, patient age, the level of the apex, and the number of involved vertebrae in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. SUMMARY OF BACKGROUND DATA. Side-bending and traction radiographs are used to evaluate curve flexibility during corrective surgery for AIS despite notable differences in the flexibilities of identical curves. Thus, interpretation for the differences among these techniques should be investigated. METHODS. A total of 229 consecutive patients with AIS who were surgically treated were evaluated. Standing, supine side-bending, and traction radiographs were obtained before surgery. Curves were divided into main thoracic (MT) or thoracolumbar/lumbar (TL/L) curves, and proximal thoracic (PT) curves. We evaluated the Cobb angle in standing position, the level of the apex, the number of involved vertebrae, kyphosis angle of main thoracic curve, and patient age in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. RESULTS. A total of 219 curves were observed in MT lesions. The traction flexibility rate (FR) was higher than the side-bending FR at angle of ≥60° (P = 0.02), in patients younger than 15 years (P = 0.02), in curves whose apex was located at T4-T8/T9(P = 0.01), in curves whose involved vertebrae were 6 or 7 (P = 0.02), and at kyphosis angle between 10° and 39° (P = 0.02). In 96 TL/L curves, side-bending FR was higher at angle of <60° (P < 0.01). In 163 PT curves, traction FR was higher at angles of ≥40° (P = 0.02). CONCLUSION. In addition to a Cobb angle, patient age, the level of the apex, and the number of involved vertebrae also influence the conditions under which the corrective ability of traction radiographs is superior to that of side-bending radiographs.

AB - STUDY DESIGN. Prospective clinical, radiologic study of adolescent idiopathic scoliosis (AIS). OBJECTIVE. We evaluated a Cobb angle in standing position, patient age, the level of the apex, and the number of involved vertebrae in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. SUMMARY OF BACKGROUND DATA. Side-bending and traction radiographs are used to evaluate curve flexibility during corrective surgery for AIS despite notable differences in the flexibilities of identical curves. Thus, interpretation for the differences among these techniques should be investigated. METHODS. A total of 229 consecutive patients with AIS who were surgically treated were evaluated. Standing, supine side-bending, and traction radiographs were obtained before surgery. Curves were divided into main thoracic (MT) or thoracolumbar/lumbar (TL/L) curves, and proximal thoracic (PT) curves. We evaluated the Cobb angle in standing position, the level of the apex, the number of involved vertebrae, kyphosis angle of main thoracic curve, and patient age in patients with AIS to determine whether the corrective ability of traction or side-bending radiographs was superior. RESULTS. A total of 219 curves were observed in MT lesions. The traction flexibility rate (FR) was higher than the side-bending FR at angle of ≥60° (P = 0.02), in patients younger than 15 years (P = 0.02), in curves whose apex was located at T4-T8/T9(P = 0.01), in curves whose involved vertebrae were 6 or 7 (P = 0.02), and at kyphosis angle between 10° and 39° (P = 0.02). In 96 TL/L curves, side-bending FR was higher at angle of <60° (P < 0.01). In 163 PT curves, traction FR was higher at angles of ≥40° (P = 0.02). CONCLUSION. In addition to a Cobb angle, patient age, the level of the apex, and the number of involved vertebrae also influence the conditions under which the corrective ability of traction radiographs is superior to that of side-bending radiographs.

KW - Adolescent idiopathic scoliosis

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KW - Traction radiograph

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