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Clayton J Adam

Publications and source records attributed to Clayton J Adam.

6 recordsLinked to original sources

The role of quadratus lumborum asymmetry in the occurrence of lesions in the lumbar vertebrae of cricket fast bowlers.

In cricket fast bowlers an increased incidence of stress fractures or lesions in the L4 pars interarticularis is observed, which shows a strong statistical correlation with the presence of hypertrophy in the contralateral Quadratus Lumborum (QL) muscle. This study aims to find a physical explanation for this correlation. A mathematical model was used to estimate the forces and moments on the L3 and L4 vertebrae in six postures attained during fast bowling. These forces and moments were used in finite element models to estimate the stresses in the pars interarticularis. Two scenarios were examined per posture: symmetric QL muscles, and right QL muscle volume 30% enlarged. Influence of muscle activation was also investigated. QL asymmetry only correlates with significant stress increases when stress levels are relatively low. When stress levels are high, due to extreme posture or muscle activation, asymmetry only causes small stress changes, suggesting that asymmetry is not the cause of stress fractures in the pars. There are even indications that asymmetry might help to reduce stresses, but more detailed knowledge of the size and activation of the lumbar muscles is needed to confirm this.

Athletic Injuries↗

Recovery of pulmonary function following endoscopic anterior scoliosis correction: evaluation at 3, 6, 12, and 24 months after surgery.

STUDY DESIGN: A series of patients with scoliosis undergoing endoscopic anterior instrumentation and fusion undertaking repeated pulmonary function assessments. OBJECTIVE: To assess recovery of pulmonary function in the 2 years following endoscopic anterior scoliosis correction. SUMMARY OF BACKGROUND DATA: Recent studies have found that pulmonary function returns to preoperative levels 12-24 months following endoscopic anterior scoliosis correction, and a small improvement in forced expiratory volume (FEV1) has also been reported. METHODS: A series of 44 patients with endoscopic anterior scoliosis correction had pulmonary function tests before surgery, and at 3, 6, 12, and 24 months after surgery. Forced vital capacity (FVC), FEV1, and total lung capacity (TLC) were measured. Nonparametric statistical analysis was used to investigate changes in pulmonary function between successive assessments. RESULTS: Pulmonary function decreased by approximately 10% at 3 months after surgery. At 24 months after surgery, FVC and FEV1 recovered to 5% to 8% higher than preoperative levels, while TLC returned to preoperative levels. Statistically significant improvements in most pulmonary function values occurred between 3 and 6, and 6-12 months. Improvements in mean FVC, FEV1, and TLC continue between 12 and 24 months, although only the increase in absolute FVC for this time is statistically significant. CONCLUSIONS: Endoscopic anterior scoliosis surgery has no lasting negative effect on pulmonary function, and with prolonged follow-up, pulmonary capacity improves beyond preoperative levels.

Adolescent↗

A prospective assessment of SRS-24 scores after endoscopic anterior instrumentation for scoliosis.

STUDY DESIGN: Prospective clinical case series. OBJECTIVE: To evaluate the clinical outcome of anterior endoscopic instrumention for scoliosis using the SRS-24 questionnaire and to examine how these scores change over a 2-year follow-up period. SUMMARY OF BACKGROUND DATA: Anterior endoscopic instrumentation correction has several advantages compared with open procedures. However, the clinical results of this technique using a validated outcome measure have rarely been reported in the literature. METHODS: A total of 83 consecutive patients underwent endoscopic anterior instrumentation performed at a single unit. Patients completed the SRS-24 questionnaire before surgery and at 3, 6, 12, and 24 months after surgery. The SRS-24 scores were compared between each of the follow-up intervals. RESULTS: The pain, general self-image, and function from back condition domains improved after surgery (P < 0.05). Activity level significantly improved between 3 and 6 months, and both function domains improved between 6 and 12 months (P < 0.05). None of the domains increased significantly after 1 year. CONCLUSIONS: Endoscopic anterior instrumentation for scoliosis significantly improved pain, self-image, and function. The greatest improvement in function occurred between 6 and 12 months after surgery. The SRS-24 scores at 1 year from surgery may provide a good indicator of patient outcome in the long-term.

Adolescent↗

Automatic measurement of vertebral rotation in idiopathic scoliosis.

STUDY DESIGN: Development of an automatic measurement algorithm and comparison with manual measurement methods. OBJECTIVES: To develop a new computer-based method for automatic measurement of vertebral rotation in idiopathic scoliosis from computed tomography images and to compare the automatic method with two manual measurement techniques. SUMMARY OF BACKGROUND DATA: Techniques have been developed for vertebral rotation measurement in idiopathic scoliosis using plain radiographs, computed tomography, or magnetic resonance images. All of these techniques require manual selection of landmark points and are therefore subject to interobserver and intraobserver error. METHODS: We developed a new method for automatic measurement of vertebral rotation in idiopathic scoliosis using a symmetry ratio algorithm. The automatic method provided values comparable with Aaro and Ho's manual measurement methods for a set of 19 transverse computed tomography slices through apical vertebrae, and with Aaro's method for a set of 204 reformatted computed tomography images through vertebral endplates. RESULTS: Confidence intervals (95%) for intraobserver and interobserver variability using manual methods were in the range 5.5 degrees to 7.2 degrees . The mean (+/-SD) difference between automatic and manual rotation measurements for the 19 apical images was -0.5 degrees +/- 3.3 degrees for Aaro's method and 0.7 degrees +/- 3.4 degrees for Ho's method. The mean (+/-SD) difference between automatic and manual rotation measurements for the 204 endplate images was 0.25 degrees +/- 3.8 degrees . CONCLUSIONS: The symmetry ratio algorithm allows automatic measurement of vertebral rotation in idiopathic scoliosis without intraobserver or interobserver error due to landmark point selection.

Algorithms↗

Variability in Cobb angle measurements using reformatted computerized tomography scans.

STUDY DESIGN: Survey of intraobserver and interobserver measurement variability. OBJECTIVE: To assess the use of reformatted computerized tomography (CT) images for manual measurement of coronal Cobb angles in idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Cobb angle measurements in idiopathic scoliosis are traditionally made from standing radiographs, whereas CT is often used for assessment of vertebral rotation. Correlating Cobb angles from standing radiographs with vertebral rotations from supine CT is problematic because the geometry of the spine changes significantly from standing to supine positions, and 2 different imaging methods are involved. METHODS: We assessed the use of reformatted thoracolumbar CT images for Cobb angle measurement. Preoperative CT of 12 patients with idiopathic scoliosis were used to generate reformatted coronal images. Five observers measured coronal Cobb angles on 3 occasions from each of the images. Intraobserver and interobserver variability associated with Cobb measurement from reformatted CT scans was assessed and compared with previous studies of measurement variability using plain radiographs. RESULTS: For major curves, 95% confidence intervals for intraobserver and interobserver variability were +/-6.6 degrees and +/-7.7 degrees, respectively. For minor curves, the intervals were +/-7.5 degrees and +/-8.2 degrees, respectively. Intraobserver and interobserver technical error of measurement was 2.4 degrees and 2.7 degrees, with reliability coefficients of 88% and 84%, respectively. There was no correlation between measurement variability and curve severity. CONCLUSIONS: Reformatted CT images may be used for manual measurement of coronal Cobb angles in idiopathic scoliosis with similar variability to manual measurement of plain radiographs.

Adolescent↗