Analyzing isolated degeneration of lumbar facet joints: implications for degenerative instability and lumbar biomechanics using finite element analysis.

The facet joint contributes to lumbar spine stability as it supports the weight of body along with the intervertebral discs. However, most studies on the causes of degenerative lumbar diseases focus on the intervertebral discs and often overlook the facet joints. This study aimed to investigate the impact of facet joint degeneration on the degenerative changes and diseases of the lumbar spine. A finite element model of the lumbar spine (L1-S1) was fabricated and validated to study the biomechanical characteristics of the facet joints. To simulate degeneration of the facet joint, the model was divided into four grades based on the number of degenerative segments (L4-L5 or L4-S1) and the contact condition between the facet joint surfaces. Finite element analysis was performed on four spine motions: flexion, extension, lateral bending, and axial torsion, by applying a pure moment to the upper surface of L1. Important parameters that could be used to confirm the effect of facet joint degeneration on the lumbar spine were calculated, including the range of motion (ROM) of the lumbar segments, maximum von Mises stress on the intervertebral discs, and reaction force at the facet joint. Facet joint degeneration affected the biomechanical characteristics of the lumbar spine depending on the movements of the spine. When analyzed by dividing it into degenerative onset and onset-adjacent segments, lumbar ROM and the maximum von Mises stress of the intervertebral discs decreased as the degree of degeneration increased in the degenerative onset segments. The reaction force at the facet joint decreased with flexion and increased with lateral bending and axial torsion. In contrast, lumbar ROM of the onset-adjacent segments remained almost unchanged despite severe degeneration of the facet joint, and the maximum von Mises stress of the intervertebral discs increased with flexion and extension but decreased with lateral bending and axial torsion. Additionally, the facet joint reaction force increased with extension, lateral bending, and axial rotation. This analysis, which combined the ROM of the lumbar segment, maximum von Mises stress on the intervertebral disc, and facet joint reaction force, confirmed the biomechanical changes in the lumbar spine due to the degeneration of isolated facet joints under the load of spinal motion. In the degenerative onset segment, spinal instability decreased, whereas in the onset-adjacent segment, a greater load was applied than in the intact state. When conducting biomechanical studies on the lumbar spine, considering facet joint degeneration is important since it can lead to degenerative spinal diseases, including adjacent segment diseases.

Socioeconomic and Other Risk Factors for Retear after Arthroscopic Surgery for Nontraumatic Rotator Cuff Tear.

Background and Objectives: Few studies have investigated the socioeconomic factors associated with retear after rotator cuff repair. This study aimed to identify the risk factors, including socioeconomic factors, for rotator cuff retear in patients who underwent arthroscopic rotator cuff repair. Materials and Methods: This retrospective study included 723 patients diagnosed with full-thickness rotator cuff tears who underwent arthroscopic rotator cuff repair from March 2010 to March 2021. The outcome variable was rotator cuff retear observed on postoperative magnetic resonance imaging or ultrasonography. Sex, age, obesity, diabetes, symptom duration, and tear size were the independent variables. Socioeconomic variables included occupation, educational level, type of medical insurance, and area of residence. We compared patients with and without retear and estimated the effects of the independent factors on retear risk. Results: The mean age of the patients, symptom duration, and tear size were 62.4 ± 8.0 years, 1.8 ± 1.7 years, and 21.8 ± 12.5 mm, respectively. The age, type of medical insurance, diabetes, tear size, and symptom duration differed significantly between patients with and without retearing (p < 0.05). Age, occupation, type of medical insurance, diabetes, initial tear size, and symptom duration significantly affected the risk of retear. Patients who performed manual labor had a significantly higher retear rate (p = 0.005; OR, 1.95; 95% CI, 1.23-3.11). The highest retear risk was seen in patients with Medicaid insurance (p < 0.001; OR, 4.34; 95% CI, 2.09-9.02). Conclusions: Age, initial tear size, and symptom duration significantly affect retear risk after arthroscopic rotator cuff repair. Occupation and type of medical insurance were also risk factors for retear. Socioeconomically vulnerable patients may be at a greater risk of retear. Proactive efforts are required to expand early access to medical care.

Nanomaterials for detection of biomolecules and delivering therapeutic agents in theragnosis: A review.

Nanomaterials are emerging facts used to deliver therapeutic agents in living systems. Nanotechnology is used as a compliment by implementing different kinds of nanotechnological applications such as nano-porous structures, functionalized nanomaterials, quantum dots, carbon nanomaterials, and polymeric nanostructures. The applications are in the initial stage, which led to achieving several diagnoses and therapy in clinical practice. This review conveys the importance of nanomaterials in post-genomic employment, which includes the design of immunosensors, immune assays, and drug delivery. In this view, genomics is a molecular tool containing large databases that are useful in choosing an apt molecular inhibitor such as drug, ligand and antibody target in the drug delivery process. This study identifies the expression of genes and proteins in analysis and classification of diseases. Experimentally, the study analyses the design of a disease model. In particular, drug delivery is a boon area to treat cancer. The identified drugs enter different phase trails (Trails I, II, and III). The genomic information conveys more essential entities to the phase I trials and helps to move further for other trails such as trails-II and III. In such cases, the biomarkers play a crucial role by monitoring the unique pathological process. Genetic engineering with recombinant DNA techniques can be employed to develop genetically engineered disease models. Delivering drugs in a specific area is one of the challenging issues achieved using nanoparticles. Therefore, genomics is considered as a vast molecular tool to identify drugs in personalized medicine for cancer therapy.

Validation of the Korean Ankylosing Spondylitis Quality of Life Questionnaire.

Background: Measuring accurate and reliable scores of quality of life in patients with ankylosing spondylitis (AS) is important in both decision-making and treatment planning for the disease. Questionnaire, The ankylosing spondylitis quality of life (ASQoL), is one of the representative tools for assessing how seriously AS patients view their disease severity, activity, as well as their overall health. To make these types of questionnaires readable and understandable, local language translation of surveys should be required. A Korean version of the ASQoL questionnaire has accordingly been developed. This study assessed the Korean version of the ASQoL survey to evaluate the reliability and validity of it. Methods: Translation and reverse translation of the English ASQoL survey were conducted. A total of 120 consecutive AS patients received a mail including the Korean-translated 36-Item Short Form Survey (SF-36), the ASQoL survey, and the visual analog scale (pain). The coefficient of intraclass correlation and Cronbach's alpha were computed, and factor analysis, as well as reliability assessments utilizing the kappa agreement statistics for each item, was undertaken. By analyzing the responses to SF-36 and ASQoL questionnaire utilizing Pearson's correlation coefficient, construct validity was calculated. Results: Factor analysis was performed regarding pain, physical function, and mental function. The kappa statistic of agreement was larger than 0.6 for all items. The ASQoL questionnaire had adequate test and re-test reliability (0.814). Furthermore, Cronbach'sα, the internal consistency, was very good (0.877). The Korean-translated ASQoL questionnaire demonstrated a significantly strong correlation between the single domain and total SF-36 scores. Conclusions: The Korean version of the ASQoL questionnaire showed acceptable properties of measurement and successful translation. Thus, it can be said that the questionnaire is appropriate for evaluating the outcomes of Korean patients with AS.

A novel computer modeling and simulation technique for bronchi motion tracking in human lungs under respiration.

In this work, we proposed a novel computer modeling and simulation technique for motion tracking of lung bronchi (or tumors) under respiration using 9 cases of computed tomography (CT)-based patient-specific finite element (FE) models and Ogden's hyperelastic model. In the fabrication of patient-specific FE models for the respiratory system, various organs such as the mediastinum, diaphragm, and thorax that could affect the lung motions during breathing were considered. To describe the nonlinear material behavior of lung parenchyma, the comparative simulation for biaxial tension-compression of lung parenchyma was carried out using several hyperelastic models in ABAQUS, and then, Ogden's model was adopted as an optimal model. Based on the aforementioned FE models and Ogden's material model, the 9 cases of respiration simulation were carried out from exhalation to inhalation, and the motion of lung bronchi (or tumors) was tracked. In addition, the changes in lung volume, lung cross-sectional area on the axial plane during breathing were calculated. Finally, the simulation results were quantitatively compared to the inhalation/exhalation CT images of 9 subjects to validate the proposed technique. Through the simulation, it was confirmed that the average relative errors of simulation to clinical data regarding to the displacement of 258 landmarks in the lung bronchi branches of total subjects were 1.10%~2.67%. In addition, the average relative errors of those with respect to the lung cross-sectional area changes and the volume changes in the superior-inferior direction were 0.20%~5.00% and 1.29 ~ 9.23%, respectively. Hence, it was considered that the simulation results were coincided well with the clinical data. The novelty of the present study is as follows: (1) The framework from fabrication of the human respiratory system to validation of the bronchi motion tracking is provided step by step. (2) The comparative simulation study for nonlinear material behavior of lung parenchyma was carried out to describe the realistic lung motion. (3) Various organs surrounding the lung parenchyma and restricting its motion were considered in respiration simulation. (4) The simulation results such as landmark displacement, lung cross-sectional area/volume changes were quantitatively compared to the clinical data of 9 subjects.

Mitochondrial glutamate transporter SLC25A22 uni-directionally export glutamate for metabolic rewiring in radioresistant glioblastoma.

Glioblastoma Multiforme (GBM) is a malignant primary brain tumor. Radiotherapy, one of the standard treatments for GBM patients, could induce GBM radioresistance via rewiring cellular metabolism. However, the precise mechanism attributing to GBM radioresistance or targeting strategies to overcome GBM radioresistance are lacking. Here, we demonstrate that SLC25A22, a mitochondrial bi-directional glutamate transporter, is upregulated and showed uni-directionality from mitochondria to cytosol in radioresistant GBM cells, resulting in accumulating cytosolic glutamate. However, mitochondrial glutaminolysis-mediated TCA cycle metabolites and OCR are maintained constantly. The accumulated cytosolic glutamate enhances the glutathione (GSH) production and proline synthesis in radioresistant GBM cells. Increased GSH protects cells against ionizing radiation (IR)-induced reactive oxygen species (ROS) whereas increased proline, a rate-limiting substrate for collagen biosynthesis, induces extracellular matrix (ECM) remodeling, leading to GBM invasive phenotypes. Finally, we discover that genetic inhibition of SLC25A22 using miR-184 mimic decreases GBM radioresistance and aggressiveness both in vitro and in vivo. Collectively, our study suggests that SLC25A22 upregulation confers GBM radioresistance by rewiring glutamate metabolism, and SLC25A22 could be a significant therapeutic target to overcome GBM radioresistance.

Vitamin D in adolescent idiopathic scoliosis: a meta-analysis.

OBJECTIVE: The aim of this study was to compare serum vitamin D levels in girls with adolescent idiopathic scoliosis (AIS) and controls using meta-analysis methods. We searched Medline (via PubMed), Cochrane, Scopus, and Embase databases for studies evaluating outcomes in AIS, including patient age, body mass index, bone mineral density (BMD), and serum levels of parathyroid hormone (PTH), calcium, and phosphate, published between January 2000 and June 2020. We searched for studies that were limited to humans only. The inclusion criteria were a scoliosis study that measured vitamin D levels. We excluded duplicate publications such as review articles, case reports, and letters without original data. Two authors extracted data independently and resolved any discrepancies by consensus. RESULTS: Eight comparative studies were identified. Demographic characteristics, bone density, serum levels of vitamin D, parathyroid hormone, and phosphate levels were not significantly different between AIS group and controls, except for serum calcium levels. The serum calcium levels were lower in AIS group than in the controls. CONCLUSIONS: This review includes eight comparative studies reporting serum vitamin D and/or parathyroid hormone levels in AIS. Due to heterogeneity, a limited number of meta-analyses have shown a weak correlation between serum vitamin D levels and the incidence of AIS. Larger, multicenter studies are therefore needed to validate the results.

Effect of adipokine and ghrelin levels on BMD and fracture risk: an updated systematic review and meta-analysis.

Context: Circulating adipokines and ghrelin affect bone remodeling by regulating the activation and differentiation of osteoblasts and osteoclasts. Although the correlation between adipokines, ghrelin, and bone mineral density (BMD) has been studied over the decades, its correlations are still controversial. Accordingly, an updated meta-analysis with new findings is needed. Objective: This study aimed to explore the impact of serum adipokine and ghrelin levels on BMD and osteoporotic fractures through a meta-analysis. Data sources: Studies published till October 2020 in Medline, Embase, and the Cochrane Library were reviewed. Study selection: We included studies that measured at least one serum adipokine level and BMD or fracture risk in healthy individuals. We excluded studies with one or more of the following: patients less than 18 years old, patients with comorbidities, who had undergone metabolic treatment, obese patients, patients with high physical activities, and a study that did not distinguish sex or menopausal status. Data extraction: We extracted the data that include the correlation coefficient between adipokines (leptin, adiponectin, and resistin) and ghrelin and BMD, fracture risk by osteoporotic status from eligible studies. Data synthesis: A meta-analysis of the pooled correlations between adipokines and BMD was performed, demonstrating that the correlation between leptin and BMD was prominent in postmenopausal women. In most cases, adiponectin levels were inversely correlated with BMD. A meta-analysis was conducted by pooling the mean differences in adipokine levels according to the osteoporotic status. In postmenopausal women, significantly lower leptin (SMD = -0.88) and higher adiponectin (SMD = 0.94) levels were seen in the osteoporosis group than in the control group. By predicting fracture risk, higher leptin levels were associated with lower fracture risk (HR = 0.68), whereas higher adiponectin levels were associated with an increased fracture risk in men (HR = 1.94) and incident vertebral fracture in postmenopausal women (HR = 1.18). Conclusions: Serum adipokines levels can utilize to predict osteoporotic status and fracture risk of patients. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021224855, identifier CRD42021224855.

Relationships between Clinical Status and Gait Parameters in Ankylosing Spondylitis.

Background: This study aimed to identify the relationship between gait parameters and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS). Methods: The study group comprised 134 patients with AS and 124 patients were enrolled as controls. All study participants underwent instrumented gait analysis and completed clinical questionnaires. The kinematic parameters of gait were walking speed, step length, cadence, stance phase, single support, double support, phase coordination index (PCI), and gait asymmetry (GA). For each patient, a visual analog scale (VAS; 0-10) score was used to assess back pain, 36-item short form survey (SF-36) questionnaire was administered to evaluate the HRQOL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was calculated. Using kinematic parameters and questionnaires, statistical analyses were done to investigate significant differences between the groups. Relationship of gait kinematic data and questionnaires of clinical outcome was also evaluated. Results: Among the 134 patients with AS, 34 were women and 100 were men. In the control group, 26 were women and 98 were men. The patients with AS and control group patients had significant differences in terms of walking speed, step length, single support, PCI, and GA. However, such differences were not observed in cadence, stance phase, and double support (p > 0.05). In correlation analyses, gait kinematic parameters and clinical outcomes were significantly related with each other. In multiple regression analysis performed to identify predictive factors for clinical outcome, walking speed was found to predict VAS, and walking speed and step length were found to predict the BASDAI and SF-36 scores. Conclusions: Patients with and without AS had significant differences in the gait parameters. Correlation analysis showed significant correlation between the gait kinematic data and clinical outcomes. In particular, walking speed and step length successfully predicted clinical outcomes in patients with AS.

Transfer learning-based ensemble convolutional neural network for accelerated diagnosis of foot fractures.

The complex shape of the foot, consisting of 26 bones, variable ligaments, tendons, and muscles leads to misdiagnosis of foot fractures. Despite the introduction of artificial intelligence (AI) to diagnose fractures, the accuracy of foot fracture diagnosis is lower than that of conventional methods. We developed an AI assistant system that assists with consistent diagnosis and helps interns or non-experts improve their diagnosis of foot fractures, and compared the effectiveness of the AI assistance on various groups with different proficiency. Contrast-limited adaptive histogram equalization was used to improve the visibility of original radiographs and data augmentation was applied to prevent overfitting. Preprocessed radiographs were fed to an ensemble model of a transfer learning-based convolutional neural network (CNN) that was developed for foot fracture detection with three models: InceptionResNetV2, MobilenetV1, and ResNet152V2. After training the model, score class activation mapping was applied to visualize the fracture based on the model prediction. The prediction result was evaluated by the receiver operating characteristic (ROC) curve and its area under the curve (AUC), and the F1-Score. Regarding the test set, the ensemble model exhibited better classification ability (F1-Score: 0.837, AUC: 0.95, Accuracy: 86.1%) than other single models that showed an accuracy of 82.4%. With AI assistance for the orthopedic fellow, resident, intern, and student group, the accuracy of each group improved by 3.75%, 7.25%, 6.25%, and 7% respectively and diagnosis time was reduced by 21.9%, 14.7%, 24.4%, and 34.6% respectively.

DGKB mediates radioresistance by regulating DGAT1-dependent lipotoxicity in glioblastoma.

Glioblastoma (GBM) currently has a dismal prognosis. GBM cells that survive radiotherapy contribute to tumor progression and recurrence with metabolic advantages. Here, we show that diacylglycerol kinase B (DGKB), a regulator of the intracellular concentration of diacylglycerol (DAG), is significantly downregulated in radioresistant GBM cells. The downregulation of DGKB increases DAG accumulation and decreases fatty acid oxidation, contributing to radioresistance by reducing mitochondrial lipotoxicity. Diacylglycerol acyltransferase 1 (DGAT1), which catalyzes the formation of triglycerides from DAG, is increased after ionizing radiation. Genetic inhibition of DGAT1 using short hairpin RNA (shRNA) or microRNA-3918 (miR-3918) mimic suppresses radioresistance. We discover that cladribine, a clinical drug, activates DGKB, inhibits DGAT1, and sensitizes GBM cells to radiotherapy in vitro and in vivo. Together, our study demonstrates that DGKB downregulation and DGAT1 upregulation confer radioresistance by reducing mitochondrial lipotoxicity and suggests DGKB and DGAT1 as therapeutic targets to overcome GBM radioresistance.

Comparison of Korean Body Image Questionnaires in Adolescent Idiopathic Scoliosis.

STUDY DESIGN: A prospective study. PURPOSE: To obtain the results of four body image questionnaires analyzed for validity in Korean and compare them to radiographic findings and quality of life scores. OVERVIEW OF LITERATURE: Each of the four body image questionnaires has been studied, but comparative studies of each other are rare. METHODS: Adolescent idiopathic scoliosis (AIS) patients ages 10 to 19 years completed the Korean version of the Quality of Life Profile for Spinal Deformities (K-QLPSD), the Scoliosis Research Society-22 self-image subscale (K-SRS-22-si), Korean version of the Spinal Appearance Questionnaire (K-SAQ), Korean version of the Body Image Disturbance Questionnaire-Scoliosis (K-BIDQ-S), and Korean version of the Italian Spine Youth Quality of Life (K-ISYQOL). Four body image questionnaires were compared with K-ISYQOL and radiographic major curve magnitude, coronal balance, and sagittal balance. Spearman's correlation was performed to compare the four body image questionnaires. RESULTS: The study included 84 AIS patients, with a mean age of 12.6 years and a major Cobb angle of 29.4°. The four surveys were correlated with major curve magnitude and K-ISYQOL. K-SAQ and K-BIDQ-S were correlated better than K-QLPSD, and K-SRS-22-si was correlated with K-ISYQOL. The four surveys were moderately correlated with major curve magnitude, but there was no correlation with age, coronal balance, and sagittal balance. CONCLUSIONS: K-SAQ and K-BIDQ-S correlate better with K-ISYQOL than K-QLPSD and K-SRS-22-si.

Fibromyalgia in Axial Spondyloarthritis: A Meta-analysis.

OBJECTIVES: This study aimed to compare the demographic characteristics, disease activity, functional status, and quality of life between patients with axial spondyloarthritis and fibromyalgia and patients with axial spondyloarthritis without fibromyalgia. METHODS: We searched MEDLINE via PubMed, Cochrane, Scopus, and Embase databases, from the earliest available indexing date to March 30, 2019, for comparative studies evaluating fibromyalgia in patients with axial spondyloarthritis. Two authors extracted data independently, and all discrepancies were resolved through consensus. RESULTS: Seven comparative studies were identified. No statistically significant differences were observed in terms of age, levels of inflammatory markers, and prevalence of extra-articular manifestations such as uveitis, psoriasis, and inflammatory bowel disease between patients with Axial spondyloarthritis fibromyalgia and those without it. Sex ratios (female to male) were approximately 3:2 and 1:3 in patients with and without fibromyalgia, respectively. The ratios concerning human leukocyte antigen B27-positive patients with and without fibromyalgia were 45.1% and 65.6%, respectively. Patients with fibromyalgia had significantly higher Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Ankylosing Spondylitis Quality of Life scores. CONCLUSIONS: Our meta-analysis showed that patients with Axial spondyloarthritis fibromyalgia had considerably higher pain severity, disease activity, and worse quality of life than patients without fibromyalgia. The sex ratios (female to male) were approximately 3:2 and 1:3, and ratios for human leukocyte antigen B27-positive patients were 45.1% and 65.6% in patients with and without fibromyalgia, respectively. Further well-designed studies are needed to substantiate our results.

Reproducibility and Accuracy of Pelvic Tilt in Predicting the Difference Between Pelvic Incidence and Lumbar Lordosis Value.

OBJECTIVE: We investigated the pelvic morphologic factors that determine the degree of pelvic incidence (PI)-lumbar lordosis (LL) mismatch. METHODS: Overall, 306 patients were included. The regional and global sagittal parameters were measured. Linear regression analyses were performed for 4 pelvic parameters and PI-LL mismatch. E1 and E2 were defined as linear regression equations between pelvic tilt (PT) and PI-LL mismatch and PI and PI-LL mismatch, respectively. The patients were categorized by cluster analysis using the hierarchal method for the 4 pelvic parameters. RESULTS: E1 and E2 showed statistical significance; however, the coefficient of determination of E1 was higher than that of E2 (R2 = 0.675 vs. 0.238; P < 0.01). Sex, LL, E1, and E2 showed significant differences in the regional parameters. The T1 pelvic angle (TPA), spinosacral angle (SSA), and incidence angle of inflection points (IAIPs) showed significant differences in global parameters (P < 0.01). The IAIPs and TPA were low in the anteverted pelvis group and high in the retroverted pelvis group (P < 0.001). The SSA was low in the small pelvis group and high in the large pelvis group (P < 0.001). The proportion of women in the large pelvis group (93%) was significantly higher than that in the other groups (P < 0.01). CONCLUSIONS: The individual differences between the PI and LL values can be more accurately determined using the individual PT, and the optimal PT amount will differ depending on the pelvis shape. The increase in the TPA and IAIPs corresponded to the PT, and the SSA increased in accordance with the pelvic size.

Effect of bisphosphonates on ankylosing spondylitis: A meta-analysis.

This study aimed to compare outcomes between ankylosing spondylitis (AS) treated with and without bisphosphonate (BP; non-BP) through a meta-analysis. The Medline (via PubMed), Cochrane, Scopus, and Embase databases were searched for studies that evaluated the outcomes of AS, including patient age, disease duration, disease activity, and bone mineral density (BMD), published between January 2000 and March 2020. Two authors extracted the data independently. Any discrepancies were resolved by a consensus. Six comparative studies were identified. No significant differences were found between the BP and non-BP groups in terms of demographic characteristics, disease activity, and BMD, except for follow-up erythrocyte sedimentation rate (ESR). The follow-up ESR was higher in the BP than in the non-BP group. A literature review identified six comparative studies reporting the outcomes of BP and non-BP treatments for AS. Despite the heterogeneity, a limited number of meta-analyses reported that BP treatment was not clearly better than non-BP treatment. Hence, further large-scale multicenter studies are required to validate our results.

Validation of the Italian spine youth quality of life (ISYQOL) in Korean population.

We aimed to evaluate the reliability and validity of the adapted Korean version of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire. Translation/retranslation of the English version of ISYQOL was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the ISYQOL and the previously validated Scoliosis Research Society-22 (SRS-22) questionnaire were mailed to 120 consecutive idiopathic scoliosis patients wearing brace. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient (ICC) and Cronbach's α were conducted. Construct validity was also evaluated by comparing the responses of ISYQOL with the responses of SRS-22 by using Pearson's correlation coefficient. Factor analysis extracted 2 factors. All items had a kappa statistics of agreement greater than 0.6. The ISYQOL showed good test/re-test reliability (ICC = 0.812). Internal consistency of Cronbach's α was found to be very good (α = 0.873). The Korean version of ISYQOL showed good significant correlation with SRS-22 total score and with single SRS-22 domains scores. The adapted Korean version of the ISYQOL was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with idiopathic scoliosis.

Radiographic predictive findings of neck pain in patients with ankylosing spondylitis.

OBJECTIVE: The aim of this study was to investigate the relationship between neck pain and radiological findings in ankylosing spondylitis (AS) patients. METHODS: The study groups comprised 257 AS and 50 normal patients. Of the AS patients, 91 had axial neck pain (group 1) and 166 did not (group 2). Full-length radiographs of the spine in the anteroposterior and lateral planes were taken. Radiographic parameters such as the chin brow vertical angle (CBVA), McGregor slope (McGS), slope of the Line of Sight (SLS), C2 slope, C2-C7 lordosis (CL), C2-C7 sagittal vertical axis (C2-C7 SVA), and T1 slope were measured. Statistical analysis was performed. RESULTS: The AS and normal patients were found to have significantly different CBVA, McGS, C2 slope, C2-C7 SVA, and T1 slope. However, no significant difference was observed for SLS and CL. Between groups 1 and 2, there were significant differences in the McGS, CL, and T1 slope. However, no significant difference between these two groups was observed for CBVA, SLS, C2 slope, and C2-C7 SVA. Logistic regression analysis was performed to identify statistically significant predictors of neck pain in AS patients and it revealed that the T1 slope and McGS were two such predictors. The T1 slope showed superior discriminatory power to McGS and CL in the receiver operating characteristic curve analysis. CONCLUSIONS: This study shows that a high T1 slope and McGS are independent radiological predictors of neck pain in AS. Further well-designed studies would be necessary to substantiate our results.