Early‐onset scoliosis in children aged 4–7 years in Nanjing,China:A cross‐sectional study

Background:This study aimed to investigate the potential variance in the prevalence of early‐onset scoliosis among children aged 4–7 years and analyze the influencing factors.The goal was to establish a crucial reference point for monitoring and evaluating spinal curvature development in preschoolers,ultimately to reduce the occurrence of adverse health outcomes.Methods:Children aged 4–7 years within the main urban area of Nanjing were selected using a stratified random sampling method.A team of four senior therapists conducted screenings for spinal curvature among children using visual inspection,the Adams forward bending test,and an electronic scoliometer to measure the angle of trunk rotation(ATR)and identify children displaying signs of scoliosis.Children with suspected scoliosis in the initial screening underwent X‐ray Cobb angle assessment for confirmation.The prevalence of early‐onset scoliosis was then determined from the screening results.R version 4.2.0 software was used to analyze the factors associated with scoliosis among children using partial least squares structural equation modeling.Results:A total of 2281 children were included in this study,consisting of 1211 boys and 1070 girls,with a mean age of 5.44±0.81 years(ranging from 4 to 7 years).Among them,7.58%exhibited positive signs of scoliosis,5.87%had early‐onset scoliosis,and the positive predictive value was 77.5%.Significant differences in ATR were observed among children in different age groups(Kruskal–Wallis=15,p=0.0104)and by sex(t=3.17,p=0.00153).Significant variations in ATR were noted in children with scoliosis(t=−22.7,p<0.001),with a cutoff at ATR=4.5°,and auxiliary values of 0.947 and 0.990.Children diagnosed with early‐onset scoliosis generally exhibited lower body mass index values,with a statistically significant difference(t=2.99,p=0.003).Conclusions:Using visual inspection,the Adams test,and an electronic scoliometer to measure the ATR,the present triad method is more sensitive for early scoliosis screening in children with abnormal posture aged 4–7 years.A full spine X‐ray is advised in children with an ATR over 4.5°and poor posture.

Muscle Strength, Lumbar Curve, Fear of Movement and Functional Disability among Patients with Lumbar Disc Herniation: A Review

Introduction: Lumbar disc herniation (LDH) refers to the rupture of the fibrous annulus of the intervertebral discs. Lumbar curvature may lead to the occurrence of lumbar disc degeneration. Fear of movement may worsen their disc herniation and cause further pain and injury. LDH conditions impact the individuals’ quality of life, to explore the relationship between lumbar curve, muscle strength, fear of movement and functional disability among patients with LDH. Methods: An electronic search was conducted on PubMed, Medline, Science Direct, Springerlink, Google Scholar and a hand search from reference lists was reviewed. Publications were included in human studies, patients 25 - 85 years of age, original studies and published in English language journals from January 2002 to December 2023. Result: In total, 64 articles were researched through the online search engines, and 9 papers were found through manual searches of reference lists. As a result, a total of 11 articles were included for the purpose of this review. The comprehensive analysis revealed the presence of eight cross-sectional studies, two retrospective studies and one experimental study. A minimum of 25 participants and a maximum of 360 participants were included. Ten studies included both genders, only one studies included healthy adults and patients with LDH but these studies didn’t mention gender. Results showed that the factors influencing LDH can be categorized into non-modifiable factors, such as gender, age, height or others. Modifiable factors included increased BMI, DM, smoking, alcohol, employment status, lifestyle and health problems or psychology. Conclusion: Females with greater VASC may be at risk of LDH. The lumbar extensor muscles indicated a localized disc herniation or nerve root pathology in patients with LDH. The fear of movement may lead to psychological consequences and reduce functional disability among patients with LDH.