By Peter O. Newton, Michael F. O'Brien, Harry L. Shufflebarger, Randal R. Betz, Robert A. Dickson, Jürgen Harms
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Additional resources for Idiopathic Scoliosis: The Harms Study Group Treatment Guide
Qxd 4/23/10 12:06 PM Page 29 3 Pathogenesis of Idiopathic Scoliosis A B Fig. 1 (A) Axial MRI scan through the apex of an idiopathic thoracic scoliosis, showing that the spinal cord lies close to the posterolateral elements on the concave side. (B) Sagittal MRI scan of a post-traumatic kyphosis, showing the spinal cord applied to, and indeed stretched over, the back of the kyphosis. 35 Since MRI scanning first became available, the Leeds Group has looked at patients with idiopathic spinal deformities.
With the development of a thoracic lordosis, however (Fig. qxd 4/23/10 12:06 PM Page 35 3 Pathogenesis of Idiopathic Scoliosis Fig. 10 The axis of spinal column rotation. This is determined by the orientation of the posterior facet joints at each level. this axis of rotation, making them very vulnerable to buckling and explaining the increased rotational prominence seen on forward bending in idiopathic scoliosis (Fig. 65 If one compares the true lateral view of the apex of the idiopathic thoracic scoliotic curve with a lateral view of Scheuermann’s kyphosis, they would appear to be opposite directional deformities in the sagittal plane (Fig.
End-vertebra, and the protractor dial is set to zero. When the upper border of the instrument is then aligned with the lower surface of the lower end-vertebra, the needle gives the Cobb angle. qxd 20 4/22/10 3:38 PM Page 20 Idiopathic Scoliosis It should be remembered that these measurements are made on an anteroposterior (AP) radiograph of the patient, and that the vertebrae within the curve are rotated out of the frontal plane of the patient, the apical vertebra being the most rotated. Accordingly, bigger curves are progressively rotated further away from the plane of the patient and thus, for example, a curve of 60 degrees is much more than twice as big as a curve of 30 degrees because the 60 degree curve is seen less en face (Fig.