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La escoliosis idiopática del Adolescente (EIA) es una deformidad tridimensional de la columna vertebral que aqueja de diversas formas la condición de vida de quien la padece, afectando el desarrollo físico y psicológico del paciente. Proponemos evaluar el resultado clínico, radiológico y el componente de calidad de vida de pacientes tratados quirúrgicamente con EIA, en el servicio de Neurocirugía, Hospital Jesús Yerena del Lídice. Se evaluó patrón de la curva, clasificación según Lenke, ángulo de Cobb pre y postquirúrgico, edad de tratamiento quirúrgico, gradode corrección, calidad de vida según cuestionario SRS-22 pre y postquirúrgica, valoración funcional mediante la escala de discapacidad de Oswestry (ODI) y complicaciones postoperatorias. Se estudiaron 22 casos (95 % femenino), el principal grupo etario fue de 11-14 años (55 %), la escoliosis tipo 1 fue la predominante (60 %), el ángulo de Cobb inicial fue mayor a 50° (50 %) y la madurez esquelética principal fue Risser 3 (55 %). La edad de resolución quirúrgica predominante fue entre 15-18 años (60 %), el grado de corrección postoperatorio fue de 75-100 % (73 %) y la densidad de los tornillos pediculares fue de 1.4-1.7 (64 %). En el cuestionario SRS-22, hubo mayor afectación en las dimensiones de autoimagen con una media de 1.8 y la valoración por ODI mostró un índice de incapacidad mínima, que fue mejorando en los controles sucesivos. Nuestra principal complicación fueron las infecciones (36 %). Concluimos que la cirugía correctiva temprana en la EIA ofrece a una mejoría clínica, radiológica y de la calidadde vida de estos paciente(AU)

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine that affects the living condition of those who suffer from it in various ways, affecting the physical and psychological development of the patient. We propose to evaluate the clinical and radiological outcome and the quality-of-life component of patients treated surgically with EIA, in the Neurosurgery Service, Hospital Jesús Yerena del Lídice. Curve pattern, Lenke classification, pre-and post-surgical Cobb angle, age at surgical treatment, degree of correction, quality of life according to pre-and post-surgical SRS-22 questionnaire, functional assessment using the Oswestry Disability Scale (ODI) and postoperative complications were evaluated. 22 cases were studied (95% female), the main age group was 11-14 years (55%), type 1 scoliosis was predominant (60%), the initial Cobb angle was greater than 50° (50%) and the main skeletal maturity was Risser 3 (55%). The predominant age of surgical resolution was between 15-18 years (60%), the degree of postoperative correction was 75-100% (73%) and the density of pedicle screws was 1.4-1.7 (64%). In the SRS-22 questionnaire, there was greater impairment in the self-image dimensions with a mean of 1.8 and the ODI assessment showed aminimal disability index, which improved in successive controls. Our main complication was infections (36%). We conclude that early corrective surgery in AIS offers clinical, radiological and quality of life improvement for these patient(AU)

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Introducción: La fotografía digital de radiografías puede generar distorsiones angulares en las imágenes. No está publicado si estas alteraciones pueden afectar las mediciones de los ángulos de Cobb. Objetivo: Evaluar la reproducibilidad del ángulo de Cobb con la fotografía digital de espinogramas de 30 x 90 cm en escoliosis del adulto. Materiales y Métodos: Se eligieron al azar 20 espinogramas preoperatorios de pacientes con escoliosis del adulto para evaluar prospectivamente. Los espinogramas fueron escaneados y sus imágenes digitales se consideraron como controles. Se analizó la discrepancia intraobservador, interobservador, intercámara e intracámara, con tres cámaras digitales y dos observadores que realizaron ocho sesiones fotográficas a cada espinograma. Se midieron los ángulos con Adobe Photoshop« sobre las imágenes digitales y se los analizó con el coeficiente de correlación de Pearson. Resultados: El promedio de los ángulos de Cobb torácicos y lumbares del escáner, las cámaras 1, 2 y 3 fue de 37,9; 37,8; 37,7; 37,5; 53,2; 53,1; 53,3; 52,9, respectivamente. La correlación interobservador e intraobservador fue extremadamente alta, así como entre las cámaras y el escáner. Conclusión: El ángulo de Cobb se puede medir luego de la fotografía digital de espinogramas de 30 x 90 cm, con alta reproducibilidad entre diferentes cámaras y observadores.(AU)

Background: Digital photography to radiographs can generate angular distortions to the images. It is not published if these distortions can affect the lines used for Cobb measurements in routine practice. Objective: To analyze reliability for coronal Cobb angle measurements of digitally acquired photograph to the 30 x 90 cm plain films in adult scoliosis. Methods: Twenty anteroposterior long-cassette scoliosis radiographs from adult patients who were operated on in one institution were randomly selected and prospectively studied. The endplates of the curves were selected and marked by one observer. The radiographs were scanned and the digital images were used as controls. The variability of the measurements was evaluated with three digital cameras and two observers making eight photographic sessions to each long-film. Over the digital images the Cobb angles were measured using Adobe Photoshop« and they were analyzed with the Pearson correlation coefficient. Results: The overall mean thoracic and lumbar Cobb angles for the scanned, camera 1, 2 and 3 were 37.9, 37.8, 37.7, 37.5, 53.2, 53.1, 53.3, 52.9, respectively. The interobserver and intraobserver agreement was extremely high, as well as across cameras and scanner. Conclusion: The Cobb angle can be measured after digitally photographed films with high reliability among different cameras and observers.(AU)

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O objetivo deste estudo é analisar a variabilidade intra e interobservador do método de Cobb em indivíduos escolióticos. Foram avaliadas trinta e quatro radiografias de sujeitos com escoliose para mensuração do ângulo de Cobb. A avaliação intraobservador foi realizada por um avaliador, enquanto a avaliação interobservador foi realizada por três avaliadores. Foram controlados possíveis erros intrínsecos e extrínsecos de mensuração, mas não houve a pré-seleção das vértebras que caracterizam a escoliose. A concordância intra e interobservador foi avaliada pelo coeficiente de correlação de Pearson (p < 0,05). Não houve diferenças significativas de julgamento na condição intra e interobservadores. A magnitude dos coeficientes de correlação oscilou de bom até excelente nos níveis torácico e tóraco-lombar. Na coluna lombar não houve correlação em ambas as condições

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o objetivo deste estudo é analisar a variabilidade intra e interobservador do método de Cobb em indivíduos escolióticos. Foram avaliadas trinta e quatro radiografias de sujeitos com escoliose para mensuração do ângulo de Cobb. A avaliação intraobservador foi realizada por um avaliador, enquanto a avaliação interobservador foi realizada por três avaliadores. Foram controlados possíveis erros intrínsecos e extrínsecos de mensuração, mas não houve a pré-seleção das vértebras que caracterizam a escoliose. A concordância intra e interobservador foi avaliada pelo coeficiente de correlação de Pearson (p < 0,05). Não houve diferenças significativas de julgamento na condição intra e interobservadores. A magnitude dos coeficientes de correlação oscilou de bom até excelente nos níveis torácico e tóraco-lombar. Na coluna lombar não houve correlação em ambas as condições.(AU)

the aim of this study is to assess intra and interobserver variability of the Cobb method in subjects who have scoliosis. Thirty four scoliosis radiographs were evaluated for measure of the angle of Cobb. The intra-observer assessment was carried out by an observer, while the inter-observer evaluation was carried out by three observers. It was controlled intrinsic and extrinsic errors of measurement, but there was no pre-selection of the vertebrae that characterized the scoliosis. Both intraobserver and interobserver reliabilities were assessed by calculating the Pearson correlation coefficient (p d"0.05). No significant differences were observed between intra-and interobservers. The magnitude of correlation coefficients ranged from very high to unreasonable in chest and thoracolumbar level. Lumbar spine did not correlate in both conditions.(AU)

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INTRODUÇÃO: A dor lombar vem sendo um achado comum em atletas e indivíduos adultos jovens. Das diversas causas deste sintoma, as alterações mecânico-posturais estão entre as mais comuns na população. OBJETIVO: Este estudo foi realizado com o intuito de correlacionar a intensidade e os aspectos da lombalgia com as medidas angulares da curvatura lombar em praticantes de voleibol. MÉTODOS: Participaram desta pesquisa 42 jovens atletas, de ambos os sexos, com idade entre 14 e 18 anos, divididos em dois grupos, o grupo sem dor e o grupo com dor lombar. Ambos responderam a uma ficha de avaliação inicial, porém a escala analógica visual de dor foi aplicada apenas nos indivíduos do grupo com dor. A seguir, todos os participantes foram submetidos ao exame radiológico da coluna lombar e o ângulo de Cobb foi obtido sobre as radiografias no plano sagital. RESULTADOS: Os resultados foram analisados através da estatística descritiva e inferencial, demonstrando que, para p < 0,05, os valores médios dos ãngulos entre os dois grupos analisados não diferem significativamente. CONCLUSÃO: Conclui-se que não houve correlação entre a curvatura da coluna lombar e a lombalgia em jovens praticantes de voleibol.

INTRODUCTION: Although not frequent, lately there have been cases of young adults and athletes complaining of lumbar pain, this being one of the most common causes of mechanical postural alterations. OBJECTIVE: In view of this, it was decided to carry out this study correlating the intensity of lumbar pain with its anatomical/physiological characteristics, using the measurements of the angles of lumbar curvature in volleyball players. METHODS: 42 athletes including males and females from 14 to 18 years of age took part. These volunteers were divided into two groups according to the symptoms of their lumbar pain: one group with lumbar pain and the other with no lumbar pain. The initial procedure for both groups was to complete a structured functional assessment form. Only the group with lumbar pain then had the visual analogical scale of pain applied. After this stage, both groups were submitted to a radiological examination of the lumbar region of the spine, which was used to calculate the Cobb angle examining the x-rays on the sagital plane. RESULTS: The results were analysed using descriptive and inferential statistics, regarding as statistically significant p<0.05 the difference of the mean values of the angles found in the measurements taken in the two groups. Statistical analysis using the qui-square test, the likeli hood ratio test and Student's t-test showed no statistically significant difference. CONCLUSION: this study concluded that the differences found through the measurement of curvature of the lumbar region of the spine have no influence on the appearance and the intensity of lumbar pain in young volleyball players.

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