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"Spinal fusion"

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"Spinal fusion"

Review Article

Pediatric rehabilitation

Assessment and Management of Adolescent Idiopathic Scoliosis: From the Perspective of a Physiatrist
Yang-Chin Su, Chi-Kuang Feng, Tsui-Fen Yang
Ann Rehabil Med 2025;49(5):263-278.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250097
Adolescent idiopathic scoliosis (AIS) is the most encountered spinal deformity in growing children, which may bring significant impacts on patients’ physical function, appearance, and overall quality of life. A physiatrist plays a crucial role in the early diagnosis of AIS and longitudinal management through continuous care. Contemporary management for AIS is according to the skeletal maturity, the magnitude of the spinal curves, and the risk of progression. For mild curves, therapeutic exercises, particularly physiotherapeutic scoliosis-specific exercises (PSSE), are employed as a conservative approach to improve postural symmetry and reduce the risk of curve progression. Bracing is required for moderate curves from 25 to 45 degrees in skeletally immature cases. Strict compliance with bracing is critical for therapeutic success. In cases that are rapidly progressive or in severe curves exceeding 40 to 45 degrees, spinal fusion surgery is considered the definitive treatment. Recent advancements in non-fusion and motion-preserving techniques provide alternative options to traditional fusion surgery. To protect maximal neurological function, intraoperative neurophysiological monitoring (IONM) is currently the trend for spinal deformity correction surgery. The care for AIS patients is an individualized, multidisciplinary, patient-centered, growth-sensitive approach, aiming to optimize outcomes and minimize long-term complications. This review outlines a comprehensive rehabilitation-oriented strategy for AIS patients from the perspective of a physiatrist, encompassing clinical assessment, conservative management with observation, therapeutic exercises, bracing, and further considerations in referral to spinal surgery.

Citations

Citations to this article as recorded by  
  • Evaluating the Effectiveness of sEMG Biofeedback for Posture Training and Scoliosis Management
    Yiu-Hong Wong, Mei-chun Cheung, Qi-Wen Emma Lei, Joanne Yip, Yoel A. Klug
    BioMed Research International.2026;[Epub]     CrossRef
  • Interrelationships among 3D spinal alignment variables during active self-correction in adolescents with idiopathic scoliosis
    Arkadiusz Żurawski, Sun-Young Ha
    European Spine Journal.2026;[Epub]     CrossRef
  • Three-Dimensional Surface Topography for the Assessment of Spinal Alignment: A Cross-Sectional Study of Biomechanical Correlates
    Brigitte Osser, Csongor Toth, Gyongyi Osser, Laura Ioana Bondar, Liliana-Oana Pobirci, Florin Mihai Marcu, Ramona Nicoleta Suciu, Nicoleta Anamaria Pascalau, Adina Mincic, Corina Dalia Toderescu
    Diagnostics.2026; 16(10): 1445.     CrossRef
  • Economic evaluation of school scoliosis screening in Gannan Tibetan autonomous prefecture, Gansu Province: a cost-utility analysis based on decision tree-Markov model
    Shaobo Yang, Juan Wang, Peiji Miao, Chen Zhang, Jin Huang, Xiaoyun Yuan, Yanxiang Zhang, Xiaohui Dou, Zhenheng Zhang, Zhe Liu, Jianjun Duan, Xueting Xu, Jiantao Wen, Shunjun Cui, Xiaole Zhu
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Comment on “Automatic radiation-free evaluation of Cobb angle for spinal curvature based on fringe projection profilometry and deep learning technology”
    Y. M. Manu, Suresha Devaraju, B. M. Praveen
    Spine Deformity.2026;[Epub]     CrossRef
  • 5,562 View
  • 105 Download
  • 4 Web of Science
  • 5 Crossref
Original Article
Static and Dynamic Parameters in Patients With Degenerative Flat Back and Change After Corrective Fusion Surgery
Jung Hwan Lee, Sang-Ho Lee
Ann Rehabil Med 2016;40(4):682-691.   Published online August 24, 2016
DOI: https://doi.org/10.5535/arm.2016.40.4.682
Objective

To evaluate characteristics of static and dynamic parameters in patients with degenerative flat back (DFB) and to compare degree of their improvement between successful and unsuccessful surgical outcome groups

Methods

Forty-seven patients with DFB were included who took whole spine X-ray and three-dimensional motion analysis before and 6 months after corrective surgery. Forty-four subjects were selected as a control group. As static parameters, thoracic kyphosis (TK), thoracolumbar junction (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured. As dynamic parameters, maximal and minimal angle of pelvic tilt, lower limb joints, and thoracic and lumbar vertebrae column (dynamic TK and LL) in sagittal plane were obtained.

Results

The DFB group showed smaller TK and larger LL, pelvic posterior tilt, hip flexion, knee flexion, and ankle dorsiflexion than the control group. Most of these parameters were significantly corrected by fusion surgery. Dynamic spinal parameters correlated with static spinal parameters. The successful group obtained significant improvement in maximal and minimal dynamic LL than the unsuccessful group.

Conclusion

The DFB group showed characteristic lower limb and spinal angles in dynamic and static parameters. Correlation between static and dynamic parameters was found in spinal segment. Dynamic LL was good predictor of successful surgical outcomes.

Citations

Citations to this article as recorded by  
  • Spinal fusion limits trunk movement, but improves gait in patients with adult spinal deformity
    Stephanie M.D. Huysmans, Rachel Senden, Eva Jacobs, Annemarijn Weber, Paul J.B. Willems, Rik G.J. Marcellis, Mark van den Boogaart, Kenneth Meijer, Paul C. Willems
    Gait & Posture.2026; 128: 110178.     CrossRef
  • Personalized Hip Joint Replacement with Large Diameter Head: Current Concepts
    Pascal-André Vendittoli, Sagi Martinov, Mina Wahba Morcos, Sivan Sivaloganathan, William G. Blakeney
    Journal of Clinical Medicine.2022; 11(7): 1918.     CrossRef
  • Thoracic kyphosis and pelvic anteversion in patients with adult spinal deformity increase while walking: analyses of dynamic alignment change using a three-dimensional gait motion analysis system
    Kousei Miura, Hideki Kadone, Masao Koda, Tetsuya Abe, Toru Funayama, Hiroshi Noguchi, Kentaro Mataki, Katsuya Nagashima, Hiroshi Kumagai, Yosuke Shibao, Kenji Suzuki, Masashi Yamazaki
    European Spine Journal.2020; 29(4): 840.     CrossRef
  • Successful detection of postoperative improvement of dynamic sagittal balance with a newly developed three-dimensional gait motion analysis system in a patient with iatrogenic flatback syndrome: A case report
    Kousei Miura, Masao Koda, Hideki Kadone, Tetsuya Abe, Hiroshi Kumagai, Katsuya Nagashima, Kentaro Mataki, Kengo Fujii, Hiroshi Noguchi, Toru Funayama, Kenji Suzuki, Masashi Yamazaki
    Journal of Clinical Neuroscience.2018; 53: 241.     CrossRef
  • Visualization of walking speed variation-induced synchronized dynamic changes in lower limb joint angles and activity of trunk and lower limb muscles with a newly developed gait analysis system
    Kousei Miura, Hideki Kadone, Masao Koda, Keita Nakayama, Hiroshi Kumagai, Katsuya Nagashima, Kentaro Mataki, Kengo Fujii, Hiroshi Noguchi, Toru Funayama, Tetsuya Abe, Kenji Suzuki, Masashi Yamazaki
    Journal of Orthopaedic Surgery.2018;[Epub]     CrossRef
  • 6,768 View
  • 52 Download
  • 5 Web of Science
  • 5 Crossref
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