ud7-basic radiology i - bspts.net
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ScoliosisBasicRadiologicEvaluationI
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Characteristics of IS (AIS)
Trunk Deformity and imbalance Spinal Deformity
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Scoliosis:TheConceptofCurveMagnitude
TheCOBBAngle:
=UEV
=LEV
=AV
31º
31º
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Curvemagnitude
SpinalDeformity
RS
MajorThoracic>40ºMajorLumbarorTL>30º
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Limitations:Intra-andinter-observervariations,positioning,andposture
1)Intra-observerandinter-observervariation(5º-10º)(selectingEndVertebrae)
2)Positioning:arotatedpositioncanproducesignificantchangesmeasurements
3)Variabilityofwhatwemeasure:diurnalvariabilityandpostureCopyright by BSPTS-Concept by Rigo
AxialRotation
ÑÑ
10º
Perdriolle
Raimondi
Nash&Moe
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30º
Raimondi
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T1Spinalimbalanceinthefrontalplane
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Rissersign(Europeanscale)
1
2 34
American
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Sanders(1-8)
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ScoliosisBasicRadiologicEvaluationII
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SacralSlopeSS
PelvicIncidencePI
PelvicTiltPT
MTK
MLL
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SacralSlopeSS
PelvicIncidencePI
PelvicTiltPT
MTK
MLL
Sub-RegionswithPredefinedLevels
ProximalThoracicT2-T5MainThoracicT5-T12ThoracolumbarT10-L2LumbarT12-S1LumbarL1-S1LowLumbarL4-S1
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�4
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DansereauJed.InternationalSymposiumon3DScolioticDeformitiesjoinedwiththeVIIInternationalSymposiumonSpinalDeformitiesandSurfaceTopography.EdGermany,GustavFisherVerlag1992
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50%40%11%
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Classification: The curve pattern (X-Ray)
• Ponseti and Friedman 1950 • Moe and Kettleson 1970 (Lonstein) • King et al 1983 • Coonrad et al 1998 • Lenke et al 2001 (indirect 3D) • Poncet et al 2001 (3D) • Thong et al 2016 (3D)
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OperativeTreatment
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Non-OperativeTreatment
• (1)Singleanddouble• (2)Thoracic,lumbar,thoracolumbaranddouble(PonsetiandFriedman1950)
• (3)3singleand4combinedtypes(MoeandKettleson(1970)• (4)4singleand4combinedtypes(Lee,Denis,WinterandLonsteinmodification1993)
• (5)Kingclassification(King,Moe,WinterandBradford,1983)Copyright by BSPTS-Concept by Rigo
Ponseti(I.V.)Friedman(B.).-Prognosisinidiopathicscoliosis.J.BoneJt.Surg.,1950,32-A,381-395
J.I.PJames(Edinburgh)Scoliosis©1967S.LivingstoneLtd
LumbarThoracolumbarThoracicDoubleApexTh11-12
PStagnara(Lyon)LesdéformationsdurachisMassonS.A.Deformacionesdelraquis©1987
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RigoClassificationisaclinicalclassificationwithradiologicalcorrespondenceStructuralCurveisdefinedclinicallyattheMainThoracic,LumbarorTLandProximalThoracicRegionsGLOBALFrontalPlaneBalance/Imbalance/StructuralCurvatureattheProximalThRegion=Dmodifier
N3N4/C3C/A4C/B E
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AB
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RigoClassificationforNon-operativeTreatment(PhysiotherapyandBracing)
• Single Major High Thoracic (upper or proximal) • Single Major Thoracic • Single Major Thoracolumbar • Single Major Lumbar • Major Thoracic and Minor Lumbar • Double Major Thoracic and Lumbar • Double Major Thoracic and Thoracolumbar • Double Major Thoracic • Multiple /Triple structural
Lonstein’s Revision of the Moe & Ketleson (1970)
• Thoracic:T2-T11(DiscT11-12)• ProximalThoracic:T3-4-5• MainTh=T8;HighTh:T6-7• LowThT9-11(Rigo)• Thoracolumbar:T12-L1• Lumbar:L2-L4(DiscL1-2)• Lumbosacral:L5-S1(DiscL4-5)
SingleComposite
Doublemajor=2structuralcurveswithaCobbanglenot≠5º
MajorlumbarorTL/MinorThoracicDoubleThoracic(notalwaysdoublemajor,sometimesmajor-minor)(Rigo)
+
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