Yoshihiro Kohashi

A New Method Using Top Views of the Spine to Predict the Progression of Curves in Idiopathic Scoliosis During Growth

Study Design A prospective longitudinal study of 51 patients with idiopathic scoliosis using spinal stereoradiographs was performed. The top view, which was obtained from stereoscopic anteroposterior and lateral radiographs, was analyzed for predicting the progression of spinal deformity. Objectives To show that the top view facilitates prediction of curve progression in idiopathic scoliosis at the initial examination. Summary of Background Data Four progression factors were set up using the top view and were analyzed statistically for predicting progression. No previous study has assessed this concept. Methods Fifty-one patients with idiopathic thoracic scoliosis or combined thoracic and lumbar scoliosis were studied longitudinally. There were 24 untreated patients and 27 patients treated with braces. Four potential progression factors were evaluated using the top view: 1) the ratio of the frontal size and the sagittal size in the top view, 2) the magnitude and direction of the vector describing the plane of maximum curvature in the thoracic spine, 3) the magnitude and direction of the vector describing the plane of maximum curvature in the lumbar spine, and 4) the balance of these vectors between the thoracic and lumbar curve. All cases were classified into five groups according to these four factors. The probability of the progression was evaluated statistically, and the prevalence of curve progression was found in each group. Results The probability of progression of a scoliosis curve increased according to the increase of these four factors. No significant difference was found between Cobb angle at the initial examination and that at skeletal maturity in untreated patients with a small risk of progression. The patients with a large risk of progression and who were treated with braces showed progression of curvature despite brace treatment. Conclusion The present study has evaluated factors relating to progression in scoliosis using the top view. These results may help predict the risk of progression in idiopathic scoliosis.

Evaluation of Rotator Cuff Strength in Healthy Volunteers

【目的】健常人において，各種の肩関節筋力テスト結果を検討して，その特徴を示すことである．次に，利き手―非利き手間に筋力差があるかどうかを確認することである．【対象及び方法】肩の愁訴のないボランティア30例（男性が15例，女性が15例）を対象とした．平均年齢は36歳であった．両肩の筋力測定は徒手筋力測定器（MICROFET）を用いて測定した．各テストを3回計測して，平均値をもとめた．臨床筋力テストは外転筋力テストが40度テスト，Jobeテスト，90度テストの3種類とした．外旋筋力テストはISPテストとER IIテストの2種類，内旋筋力テストはBelly pressテストとSSCテストの2種類とした．【結果】外転筋力を100とすると外旋筋力は115，内旋筋力は160となった．利き手―非利き手間の筋力差は内外旋筋力テストではなく，外転筋力テストの中でJobeテストと90°テストにて有意差を認めた．女性の筋力は男性の60～70％であった．