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A S Wojcik

Publications and source records attributed to A S Wojcik.

7 recordsLinked to original sources
PubMed2002

3D back shape in normal young adults.

In today's climate of evidence based medicine, there is an increasing emphasis on objective assessment to monitor treatment effectiveness. Although spinal posture and back shape are commonly assessed by clinicians, current practice is based on subjective findings and unreliable objective tools. Numerous management protocols aim to improve both posture and shape, however data related to normal back shape is quite scarce. The aim of this study was to investigate normal back shape in young adults, in order to produce normative values against which deformity could be defined. The Integrated Shape Imaging System (ISIS) was used to measure the three-dimensional back shape. A convenience sample of 48 normal adults, aged 18-28 volunteered to participate in this study. A small minority of individuals showed no curve (8%), 55% showed a single curve and the rest showed a double one. Right spinal asymmetry was more frequent than the left (77% to 52%). Mean values and 95% confidence intervals were 14.1 degrees (11.7 degrees-16.5 degrees) for upper Lateral asymmetry, 5.6 degrees (3.3 degrees - 7.9 degrees) for lower lateral asymmetry, 24.9mm (20.6mm -29.2mm) for thoracic kyphosis and 14.9mm (12.5mm -17.2mm) for lumbar lordosis. Increasing upper lateral asymmetry correlated with decreasing thoracic kyphosis (p=0.01). Maximum skin surface angle correlated positively with only upper lateral asymmetry (p<0.0001). Similar topographical interrelationships have been demonstrated in scoliosis. It is important that clinicians in relevant disciplines objectively assess all three dimensions of back shape, as our research shows that changes in one plane are associated with changes in the other two planes.

Adolescent↗
PubMed1992

Segmental evaluation of the surface and radiological deformity after Cotrel-Dubousset (CD) instrumentation for King type II and III. adolescent idiopathic scoliosis (AIS): surgical and etiological implications.

In this paper we report the segmental effects of CD in each of the three planes of deformity (frontal, transverse and sagittal) in 35 children with AIS (King types II and III) treated by Cotrel-Dubousset instrumentation. Patients were examined preoperatively and in follow-up at 8 weeks and one year, and 15 patients were also examined at two years. Back shape was appraised segmentally as angle of trunk inclination (ATI) at each of ten levels by ISIS and the Scoliometer. The radiographs were measured nonsegmentally for Cobb angle, apical vertebral rotation and spinal balance, and segmentally for both vertebral rotation and tilt (frontal and sagittal plane), and in the rib cage for rib-vertebra angles (RVAs).

Adolescent↗
PubMed1990

An analysis of the effect of the Zielke operation on the rib cage of S-shaped curves in idiopathic scoliosis.

This report evaluates the rib cage in 16 patients with S-shaped idiopathic scoliosis having the Zielke operation and followed-up for an average period of 30 months. Methods used include Cobb angle and a segmental evaluation (T7-T12) of each of convex and concave rib-vertebra angles (RVAs), rib-vertebra angle differences (RVADs), vertebral rotation, tilt and displacement. Preoperatively, the apical convex ribs droop more than the concave ribs, but the most striking difference is an asymmetry of RVAs, with increasing droop of the concave RVAs from T7-T12. The effect of the Zielke operation (on the lower curve) is: (a) to correct the Cobb angle, vertebral tilt, and displacement of the upper (thoracic) curve; (b) to derotate the spine; (c) to elevate the mobile concave ribs; (d) to have little or no effect on the stiff apical convex ribs; and (e) to increase the droop of the mobile lower convex ribs. During follow-up, six of the upper (thoracic) curves progressed. The apical RVAD and apical convex RVA are not prognostic. The concave RVAs maintain their position while convex RVAs elevate relative to the concave ribs.

Adolescent↗
PubMed1990

Harrington-Luque and Cotrel-Dubousset instrumentation for idiopathic thoracic scoliosis. A postoperative comparison using segmental radiologic analysis.

This article reports a comparison of the Cotrel-Dubousset (CD) operation with the Harrington-Luque (HL) procedure for the treatment of adolescent idiopathic thoracic scoliosis. Thirty-nine patients were studied preoperatively and postoperatively using segmental radiologic measurements including Cobb angle, end-vertebra angles (EVAs), surgical flexibility index, vertebral rotation, displacement and tilt, convex and concave rib-vertebra angles (RVAs), and kyphosis and lordosis. Cotrel-Dubousset is not significantly different from HL with respect to Cobb angle (%), surgical flexibility index, apical vertebral displacement, apical vertebral rotation, apical rib-vertebra angles, kyphosis, and lordosis. It is significantly better than the HL with respect to the correction of vertebral displacement at T10-11; lower EVA of the thoracic curve; vertebral rotation mainly above the apex; convex RVAs above the apex; and concave RVAs at T10. The surgical correction of vertebral tilt above and below the apex of the thoracic curve is significantly related to the correction of convex and concave RVAs. The view that persistent deformity of ribs is a factor needing surgical correction in some patients with adolescent idiopathic thoracic scoliosis having posterior instrumentation and fusion needs further evaluation.

Adolescent↗
PubMed1990

An analysis of the effect of the Zielke operation on S-shaped curves in idiopathic scoliosis. A follow-up study revealing some skeletal and soft tissue factors involved in curve progression.

This article analyzes the fate of S-shaped idiopathic spinal curves during follow-up in 18 patients having the Zielke VDS operation. The spinal radiographs were evaluated by Cobb angle, end-vertebra angles (EVAs), vertebral rotation, and by a new method using the tilt of the surgically fused spinal block in the frontal plane. Spinal growth was measured. Using the conventional criterion for Cobb angle progression, 83% of the lower curves and 50% of the upper curves progress. The use of EVAs shows that progression occurs mainly in the middle (thoracolumbar) segment of the spine. Curve progression occurs in the frontal plane without any significant change in vertebral rotation. The progression of the upper curve Cobb angle is not related to the progression of the Cobb angle of the lower curve; but it is related to 1) tilt of the spinal block, 2) growth of the spine below the block and 3) overall linear spinal growth (T1-S1). Progression of the upper EVA of the upper curve is associated with skeletal immaturity. The key features leading to curve progression after the Zielke operation appear to be spinal asymmetry in the frontal plane, linear spinal growth, and concave lumbar muscle tether (myostatic contracture). The surgical implications of the findings are outlined.

Adolescent↗
PubMed1989

An analysis of the effect of the Zielke operation on S-shaped curves in idiopathic scoliosis. The use of EVAs showing that correction of the thoracic curve occurs in its lower part: significance of the thoracolumbar spinal segment.

This paper analyzes the initial effect of the Zielke VDS operation on S-shaped idiopathic spinal curves in 17 patients with particular reference to the thoracic spine. The curves are evaluated by conventional methods (Cobb angle, apical vertebral rotation, kyphosis, and lordosis) and by a new method using end vertebra angles (EVAs). Three new surgical correction indices are used. In the lower curve, the surgical correction averaged 81%, and it is usually larger than that induced in the thoracic curve by about 48% (surgical correctability index). The lower curve correction is asymmetric, occurring more in its lower part (lower EVA) than in its upper part (upper EVA), a difference that the authors attribute to the restraint imposed by the rib cage on the upper EVA of the lower curve. In the upper (thoracic) curve, the surgically induced correction is variable and averages 33% (range, 6-69%). It is related significantly to preoperative bending film flexibility. The thoracic curve correction also is asymmetric, occurring more in its lower part (lower EVA) than in its upper part (upper EVA), which usually remains stable. The kyphosis angle decreases by an average of 7 degrees. The thoracic apical vertebral rotation shows variable changes. The findings show that the correction of the upper curve occurs mainly in the thoracolumbar spinal segment. It is suggested that this junctional segment of the spine is of importance in determining the limits of both instrumentation and fusion for idiopathic scoliosis.

Adolescent↗