Advertisement

Elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis after posterior selective fusion surgery

      Highlights

      • Elasticity of paraspinal fascia and muscle is assessed in adolescent idiopathic scoliosis.
      • Elasticity of the concave muscle increases after posterior fusion surgery.
      • Variation of elastic asymmetry after surgery is different in each part of curve.

      Abstract

      Background

      We sought to assess the elasticity change of the paravertebral fascia and muscle in adolescent idiopathic scoliosis patients with Lenke Type 1, 2, or 3 curves after posterior selective fusion surgery.

      Methods

      The shear wave elasticity imaging system was used to assess the elasticity of the thoracic paravertebral muscles and fascia both on the concave and convex sides. Three regions of interest, including the apex, upper end, and lower end of the main curve, were tested.

      Findings

      Ten female patients, with an average age of 16.6 ± 2.7 years old, were included. The average post-operation follow-up period was 9.0 ± 2.4 months. The Cobb angle was significantly corrected from 63.6 ± 12.0° to 10.7 ± 5.4° (p < 0.05). The length of the trunk increased from 40.4 ± 2.5 cm to 46.0 ± 2.8 cm (p < 0.05). The elasticity of deep fascia didn't show a significant change post-operation (p > 0.05). The elasticity of the paravertebral muscle on the concave side had a significant increase at the final follow-up (p < 0.05). The elasticity of the paravertebral muscle on the convex side also increased at the upper end (p < 0.05). The elasticity asymmetry of the deep fascia decreased, but the elasticity asymmetry of the paravertebral muscle increased at the upper end of the curve (p < 0.05).

      Interpretation

      The paravertebral muscle on the concave side is stiffer after surgery. Elastic asymmetry of paravertebral muscle increased and elastic asymmetry of the deep fascia decreased at the upper end of the curvature. Further study is needed to elucidate the mechanism by which the paravertebral soft tissue responds after surgery.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Burwell Richard Geoffrey
        • Dangerfield Peter Hugh
        Pathogenesis of progressive adolescent idiopathic scoliosis. Platelet activation and vascular biology in immature vertebrae: an alternative molecular hypothesis.
        Acta Orthop. Belg. 2006; 72: 247-260
        • Chan Suk-Tak
        • Fung Po-Kwan
        • Ng Nim-Yu
        • et al.
        Dynamic changes of elasticity, cross-sectional area, and fat infiltration of multifidus at different postures in men with chronic low back pain.
        Spine J. 2012; 12: 381-388
        • Curtin Maurice
        • Lowery Madeleine M.
        Musculoskeletal modeling of muscle activation and applied external forces for the correction of scoliosis.
        J. Neuroeng. Rehabil. 2014; 11: 52
        • Ferguson L.W.
        Adolescent idiopathic scoliosis: the tethered spine III: is fascial spiral the key?.
        J. Bodyw. Mov. Ther. 2017; 21: 948-971
        • Fidler M.W.
        • Jowett R.L.
        Muscle imbalance in the aetiology of scoliosis.
        J. Bone Joint Surg. (Br.). 1976; 58: 200-201
        • Kim Hong Jin
        • Yang Jae Hyuk
        • Chang Dong-Gune
        • et al.
        Long-term influence of paraspinal muscle quantity in adolescent idiopathic scoliosis following deformity correction by posterior approach.
        J. Clin. Med. 2021; 10: 4790
        • Landman Zachary
        • Oswald Timothy
        • Sanders James
        • et al.
        Prevalence and predictors of pain in surgical treatment of adolescent idiopathic scoliosis.
        Spine (Phila Pa 1976). 2011; 36: 825-829
        • Lee Sin Ying
        • Ch'ng Pei Ying
        • Wong Tat Seng
        • et al.
        Patients' perception and satisfaction on neck and shoulder imbalance in adolescent idiopathic scoliosis.
        Global Spine J. 2021; https://doi.org/10.1177/21925682211007795
        • Linek Pawel
        • Wolny Tomasz
        • Sikora Damian
        • et al.
        Intrarater reliability of shear wave elastography for the quantification of lateral abdominal muscle elasticity in idiopathic scoliosis patient.
        J. Manipulative Physiol. Ther. 2020; 43: 303-310
        • López-Torres Olga
        • Mon-López Daniel
        • Gomis-Marzá Carlos
        • et al.
        Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: a systematic review.
        J. Bodyw. Mov. Ther. 2021; 27: 16-25
        • Oliva-Pascual-Vaca Ángel
        • Heredia-Rizo Alberto Marcos
        • Barbosa-Romero Alejandro
        • et al.
        Assessment of paraspinal muscle hardness in subjects with a mild single scoliosis curve: a preliminary myotonometer study.
        J. Manipulative Physiol. Ther. 2014; 37: 326-333
        • Rigo M.
        Patient evaluation in idiopathic scoliosis: radiographic assessment, trunk deformity and back asymmetry.
        Physiother. Theory Pract. 2011; 27: 7-25
        • Roberts S.B.
        • Tsirikos A.I.
        • Subramanian A.S.
        Posterior spinal fusion for adolescent idiopathic thoracolumbar/lumbar scoliosis: clinical outcomes and predictive radiological factors for extension of fusion distal to caudal end vertebra.
        Bone Joint J. 2014; 96-B(8): 1082-1089
        • Shuo Y.
        • Ning F.
        • Yong H.
        • et al.
        What is the impact of scoliotic correction on postoperative shoulder imbalance in severe and rigid scoliosis?.
        BMC Musculoskelet. Disord. 2021; 22: 868
        • Stokes I.A.F.
        Mechanical effects on skeletal growth.
        J. Musculoskelet. Neuronal Interact. 2002; 2: 277-280
        • Tan Jun-Hao
        • Hey Hwee Weng Dennis
        • Wong Gordon
        • et al.
        Lumbar adding-on of the thoracic spine after selective fusion in adolescent idiopathic scoliosis Lenke types 1 and 2 patients: a critical appraisal.
        Spine (Phila Pa 1976). 2021; 46: E167-E173
        • Upasani Vidyadhar
        • Caltoum Christine
        • Petcharaporn Maty
        • et al.
        Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.
        Spine (Phila Pa 1976). 2008; 33: 1107-1112
        • Wajchenberg Marcelo
        • Martins Delio Eulalio
        • de Paiva Luciano Rafael
        • et al.
        Histochemical analysis of paraspinal rotator muscles from patients with adolescent idiopathic scoliosis: a cross-sectional study.
        Medicine. 2015; 94e598
        • Weiner Debra K.
        • Sakamoto Sara
        • Perera Subashan
        • et al.
        Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings.
        J. Am. Geriatr. Soc. 2006; 54: 11-20
        • Wilke H.J.
        • Wolf S.
        • Claes L.E.
        • et al.
        Influence of varying muscle forces on lumbar intradiscal pressure: an in vitro study.
        J. Biomech. 1996; 29: 549-555
        • William W. Lu
        • Hu Yong
        • Luk Keith D.K.
        • et al.
        Paraspinal muscle activities of patients with scoliosis after spine fusion: an electromyographic study.
        Spine (Phila Pa 1976). 2002; 27: 1180-1185
        • Yagi M.
        • Machida M.
        • Asazuma T.
        Pathogenesis of adolescent idiopathic scoliosis.
        JBJS Rev. 2014; 2e4
        • Yagi M.
        • Hosogane N.
        • Watanabe K.
        • et al.
        The paravertebral muscle and psoas for the maintenance of global spinal alignment in patient with degenerative lumbar scoliosis.
        Spine J.: Off. J. North Am. Spine Soc. 2016; 16: 451-458
        • Yang Mingyuan
        • Zhao Yuechao
        • Yin Xin
        • et al.
        Prevalence, risk factors, and characteristics of the “adding-on” phenomenon in idiopathic scoliosis after correction surgery: a systematic review and Meta-analysis.
        Spine (Phila Pa 1976). 2018; 43: 780-790
        • Yuzeng L.
        • Aixing P.
        • Yong H.
        • et al.
        Asymmetric biomechanical characteristics of the paravertebral muscle in adolescent idiopathic scoliosis.
        Clin. Biomech. 2019; 65: 81-86