Clinical Evaluation of the Anterior Chest Wall Deformity in Thoracic Adolescent Idiopathic Scoliosis
Notice bibliographique
Résumé
STUDY DESIGN: A retrospective radiographical study of pre- and postoperative anterior chest wall shape in thoracic adolescent idiopathic scoliosis. OBJECTIVE: To assess the anterior chest wall deformity and define its relationship with other deformed components in adolescent idiopathic scoliosis. The surgical influence on the deformed chest wall contour was also evaluated to improve the clinical recognition of the risk factors associated with aggravated chest wall shape postoperatively. SUMMARY OF BACKGROUND DATA: Anterior chest wall deformity is one of the major cosmetic concerns that may be attributable to rotational coupling in adolescent idiopathic scoliosis. Patients could be quite different in their anterior chest wall appearance with similar spinal angulation. The surgical improvement of this deformed chest wall shape is also quite elusive and the reverse could also happen despite excellent correction in Cobb angle. We investigated whether or not the anterior chest wall deformity was independent in the severity from the codevelopment of spinal curvature, translation, and vertebral rotation. METHODS: In this retrospective study, 110 sets of computed tomographic scans, 70 of which had both pre- and postoperative images, were retrieved and analyzed. The ImageJ software (National Institutes of Health, Bethesda, MD) was used to manipulate formatted computed tomographic scans into 3-dimensional anterior chest wall reconstructions. Multiple anterior and posterior deformity parameters were evaluated, correlated, and compared. RESULTS: The preoperative Cobb angle of major thoracic curve, chest wall angle (CWA), rib hump (RH), angle of the sternum relative to the apical vertebral body (α), sternum-rib ratio (S-R ratio), apical vertebral rotation (AVR), and angle of trunk rotation (ATR) averaged 54.4° ± 15.2°, 5.4° ± 3.9°, 14.7° ± 5.4°, 80.5° ± 7.8°, 1.3° ± 0.2, 12.3° ± 6.5°, and 8.8° ± 4.6°, respectively. The thoracic Cobb angle demonstrated moderate correlation with CWA, RH, α, S-R ratio, AVR, and ATR (r = 0.377, 0.604, -0.401, 0.514, 0.530, and 0.517, respectively, P < 0.001). The RH demonstrated moderate correlation with AVR (r = 0.546, P < 0.001). No statistically significant relationships between CWA and RH, AVR, and ATR were detected (r = 0.129, 0.043, -0.039, P > 0.05). The AVR demonstrated significant correlation with α and S-R ratio (r = -0.757, P < 0.001; r = 0.213, P < 0.05). Averaged CWA with different curve apex showed a normal distribution shape, with the highest at T9 level. The postoperative thoracic Cobb angle, S-R ratio, AVR, and ATR improved significantly (P < 0.05), with the exception of the postoperative CWA and α (P > 0.05). Postoperative |CWA| aggravated in 52.8% of the patients, with 38.6% beyond 5°, which showed a significantly lower average preoperative CWA (3.0° ± 2.8°) compared with the rest of patients with decreased CWA (7.9° ± 3.1°) (P < 0.001). CONCLUSION: Idiopathic scoliosis is associated with distinctive anterior chest wall deformity, with its variations partially attributable to Cobb angle and apex location, but not directly correlated with AVR. Incidence of aggravated postoperative anterior chest wall shape is notable in our study, and patients should be informed of this risk beforehand. Small preoperative CWA and apical vertebra located above T9 were associated with relatively higher risk of postoperative chest wall shape aggravation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».