Irina Adomaitienė, Romualdas Sinkevičius, Eglė Stašienė, Artūras Samuilis, Juozas Raistenskis, Vaiva Strukčinskaitė
Role of fasciae in the pathogenesis of chronic myofascial pain of lumbar and neck region is radiologically proven and morphological changes are described. Conventional physiotherapy results in symptomatic improvement and normalization of structure of fasciae . The etiology of adolescent idiopathic scoliosis remains unclear, but most likely it is multifactorial. The role of thoracolumbar fascia in development of idiopathic scoliosis is unknown and wasn’t examined radiologically. Common pathophysiology mechanisms could be involved in chronic myofascial pain and fasciae injury in idiopathic scoliosis. Aim of the study. The aim of this pilot study was to investigate radiological characteristics (thickness, layering) of thoracolumbar fascia in the group of healthy adolescents and adolescents with idiopathic scoliosis. Materials and Methods. A pilot study was performed in Children’s Hospital, Affiliate of Vilnius University Santariskiu Clinics during the period from November 2015 till January 2016. Nine patients with adolescent idiopathic scoliosis and 9 healthy adolescents in control group were examined. Langevin`s methodic was used for thoracolumbar fascia ultrasound examination and evaluation. Results. Adolescents with idiopathic scoliosis have thicker thoracolumbar fascia compared with healthy controls. In the group of adolescents with idiopathic scoliosis the average thickness of thoracolumbar fascia was 0.96 cm on the left side and 0,91 cm on the right side of the spine. In healthy control group the average thickness of thoracolumbar fascia was 0.73 cm on the left side and 0.77 cm on the right side of the spine. In adolescents with idiopathic scoliosis thoracolumbar fascia was thickened due to increase in the supramuscular part: on the left side the average thickness – 0.44 cm; in the control group – 0.26 cm (p = 0.001); similar difference has been observed on the right side in the target group: the average thickness of supramuscular part – 0.46 cm; in the control group – 0.24 cm (p <0.001). The fascia is multilayered in supramuscular part in the group of idiopatic scoliosis. The layering of supramuscular part of fascia is more prevalent in adolescent with idiopatic scoliosis compared to control group: on the right side of – 88.9% and 22.2% (p = 0.015); on the left – 88.9% and 11.1% (p = 0.003). There was no significant difference of the thickness of thoracolumbar fascia in left and right anatomical sides of the spine in any group. Conclusions. Thoracolumbar fascia in adolescents with idiopathic scoliosis could be evaluated by ultrasound examination and morphological modification (thickening and multilayered appearance) is clealy observed compared to healthy controls. Prospective clinical study evaluating changes in thoracolumbar fascia and paravertebral muscles with ultrasound examination before and after complex rehabilitation treatment in adolescents with idiopathic scoliosis is relevant and feasible.
Keyword(s): thoracolumbar fascia; adolescent idiopathic scoliosis; ultrasound examination.
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