Document Detail

Biomechanical factors affecting progression of structural scoliotic curves of the spine.
MedLine Citation:
PMID:  15457699     Owner:  NLM     Status:  MEDLINE    
The development of the spine is affected by both biological and mechanical factors. As the geometry of the motion segment changes throughout growth, so does the mechanical behaviour of the spine owing to changing vectors acting on a variable geometry system. The biomechanical analysis of the growing spine enables the assessment of the role played by biological and mechanical factors in the pathogenesis of progressive scoliosis to be assessed and its comparison with factors acting on an adult scoliotic spine. The knowledge of these principles is instrumental to setting the right parameters for treatment and to design braces that may be capable of obtaining correction of the deformity. The elastic behaviour of child and adult spine differs because of both physiologic and pathologic conditions. In child scoliosis an abnormal geometry causes a persistent stress concentration in crucial areas of the motion segment. This induces a progressive elasto-plastic strain which modifies the geometry of the motion segment, thus worsening the stress concentration and the excessive strain through a vicious cycle. In adult scoliosis, on the other hand, deformation primarily affects the viscous-elastic structures, namely the intervertebral disc and the capsulo-ligamentous structures. This produces instabilty of the motion segments and slow deformation of the vertebrae through remodelling. It therefore ensues that the aim of the treatment differs in both conditions. In the child spine the aim is to prevent the motion segment deformity by means of braces which adequately modifies the stress distribution acting on the spine, thus enabling the spine to grow according to a quasi-physiological model. In adult scoliosis a stable equilibrium is required in order to prevent further deformation of the motion segment.
S Lupparelli; E Pola; L Pitta; O Mazza; V De Santis; L Aulisa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Studies in health technology and informatics     Volume:  91     ISSN:  0926-9630     ISO Abbreviation:  Stud Health Technol Inform     Publication Date:  2002  
Date Detail:
Created Date:  2004-10-01     Completed Date:  2005-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214582     Medline TA:  Stud Health Technol Inform     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  81-5     Citation Subset:  T    
Clin. Orthop. Pol. A. Gemelli - Universit_ Cattolica del Sacro Cuore, Roma, ITALY.
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MeSH Terms
Age Factors
Bone Remodeling / physiology
Child, Preschool
Disease Progression
Intervertebral Disk / physiopathology
Ligaments / physiopathology
Lumbar Vertebrae / physiopathology
Scoliosis / physiopathology*,  therapy
Thoracic Vertebrae / physiopathology

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