摘要：Background concept: The severity and progression of adolescent idiopathic scoliosis is evaluatd radiologically by measuring Cobbs angle on AP radiographs. Spinal radiographs although invaluable in diagnosis and follow-up evaluation, carry the risk of exposure to ionizing radiation. Development of a valid non-radiologic test for measuring the curve will prevent such exposures.
Study Design: Cross sectional study.
Objective: To evaluate whether the difference in right and left lateral flexion in patients with adolescent idiopathic scoliosis is significantly greater than normal patients and whether it is a valid measure of the magnitude of the scoliotic curve.
Patient Sample: Thirty patients (25 females and 5 males) without any clinical evidence of scoliosis (controls) and 10 patients (9 females and 1 male) with adolescent idiopathic scoliosis formed the study population.
Method: All patients and controls underwent coronal range of motion tests. For the test, the subjects were instructed to start from an upright position and move to full extent of lateral flexion on each side. The distance of the tip of the middle fingers to the floor was measured for both sides. Radiographic measurement of Cobbs angle on an AP radiograph in cases of scoliosis was done.
Statistical Method: In the first part difference in the lateral bending were analyzed for both cases and control group of patients and the mean and standard deviation was calculated for both the groups. The data was analysed using two paired student t test. The next part involved using Pearson’s product - moment correlation coefficients (Pearson’s r) to find out the correlation between the Cobbs angle and difference in lateral bending in the scoliotic group.
Results: Results indicated that the asymmetry in left and right lateral bendings of the scoliosis group was significantly higher than the control group (p=0.000055). The degree of asymmetry was in almost linear correlation with the degree of Cobbs angle as measured on Radiographs with a Pearson’s correlation coefficient (r) of 0.933239.
Conclusion: The asymmetry in coronal range of motion can be used as a valid guide to assess the severity of curves and lacks the usual disadvantage of ionizing radiation exposure and high cost of radiographic measures. The pilot study may be extended to include a longer number and a longer follow-up to evaluate if asymmetry in lateral flexion progresses with progression of the curve and if it does, whether performing this simple test during serial follow ups may potentially obviate the need of serial radiographic follow up of the patient.
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