Influence of connective tissue dysplasia on the formation of idiopathic scoliosis in preschool and school-age children
- Authors: Pertseva M.1
-
Affiliations:
- Воронежский государственный медицинский университет им. Н.Н.Бурденко
- Issue: Vol 9 (2020): Материалы XVI Международной Бурденковской научной конференции 23-25 апреля 2020 года
- Pages: 246-247
- Section: Педиатрия
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/5945
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Abstract
Currently, there is a tendency to increase the number of children of preschool and school age with a specified diagnosis of idiopathic scoliosis. The very wording of the diagnosis indicates that at the moment there are no known causes of the development of this pathology. The disease mainly occurs during the period of intensive growth of the skeleton, and, in most cases, has unknown causes. Statistics of recent years indicate that there is a tendency to increase the prevalence of the disease in childhood. An urgent problem of Pediatrics is to identify specific causes that contribute to the formation of this frequently occurring disorder of the musculoskeletal system.
Goal. To determine the frequency of phenotypic signs of connective tissue dysplasia in children with spinal deformity.
Material and methods. The study included 40 patients of preschool and school age (from 5 to 16 years) with an established diagnosis of idiopathic scoliosis.
By means of anonymous questionnaires, using patient medical records, as well as interviewing patients and their parents for the period of their stay in the Department of medical rehabilitation in the CSTO No. 2 and receiving treatment at Healthy child LLC, information was collected and analyzed, including: the nature of spinal deformity (scoliosis), age of patients, neuropsychic development, and physical development of patients. Obstetric and hereditary anamnesis was collected from the parents ' words.
Results: on examination, signs of connective tissue dysplasia were detected in 70% of patients in the observation group. It was found that such factors as fatigue (in 42.5% of children), frequent respiratory viral infections (65% children), flat feet (62,5%), muscle loss (from 17.5% of children), poor sleep (40% children) were found in two age pahrumph and their frequency did not differ significantly, but the gender differences: most often, these symptoms were recorded among girls in the age group of 12-16 years (80%). It was also determined that 65% of cases were diagnosed with DST in the mother/father.
Conclusion. Statistical analysis of anonymous questionnaires, interviews and examinations of patients allowed us to determine the high frequency of clinical signs of connective tissue dysplasia in 70% of patients with idiopathic scoliosis, which allows us to confirm the causal relationship of this pathology with persistent spinal deformity in childhood.
Full Text
Relevance. Currently, there is a tendency to increase the number of children of preschool and school age with a specified diagnosis of idiopathic scoliosis. The very wording of the diagnosis indicates that at the moment there are no known causes of the development of this pathology. The disease mainly occurs during the period of intensive growth of the skeleton, and, in most cases, has unknown causes. Statistics of recent years indicate that there is a tendency to increase the prevalence of the disease in childhood. An urgent problem of Pediatrics is to identify specific causes that contribute to the formation of this frequently occurring disorder of the musculoskeletal system. Connective tissue dysplasia (DST) accompanies a number of diseases in childhood and, in many ways, determines the treatment tactics and prognosis of polymorbid pathology in Pediatrics. The concept of connective tissue dysplasia is caused by hereditary and congenital defects in collagen synthesis and includes a number of changes in the musculoskeletal system associated with a violation of the structure of cartilage, such as spinal deformity, flat feet, changes in body proportions, malocclusion, joint pathology, specifically - their tendency to dislocations, hypermobility. There is also increased trauma, bronchopulmonary pathologies, valvular heart defects, weight loss, which leads to violations of the function of the gastrointestinal tract.
An informational analysis of existing works devoted to the study of idiopathic scoliosis showed that there is no information about concomitant connective tissue dysplasia in this disease. In this paper, a study was conducted that studied the effect of connective tissue dysplasia on the formation of scoliosis in childhood.
OBJECTIVE: to Determine the frequency of phenotypic signs of connective tissue dysplasia in children with spinal deformity.
METHODS. 1. research Design
The study design included a retrospective analysis of medical records, an anonymous questionnaire, and a survey of 40 preschool and school-age patients (from 5 to 16 years) and their parents during their stay in the Department of medical rehabilitation in the CSTO No. 2 and who were treated at Healthy child LLC with an established diagnosis of idiopathic scoliosis.
2. Eligibility criteria
The study included patients admitted to a medical institution by random sampling. The age of the patients ranged from 5 to 16 years, who were diagnosed with the disease. Inclusion criteria: established diagnosis of idiopathic scoliosis.
3. Modalities
The study was conducted on the basis of the Voronezh regional children's clinical hospital No. 2, as well as LLC "Healthy child". Children with idiopathic scoliosis from Voronezh and districts of the Voronezh region are admitted to the Department of medical rehabilitation on a planned basis.
4. The duration of the study
The analysis of medical records with the established diagnosis took place within 4 months.
5. Description of medical intervention
The nature of spinal deformity (scoliosis), age of patients, neuropsychic development, and physical development of patients were taken into account. Obstetric and hereditary anamnesis was collected from the words of parents
6. Main outcome of the study
To determine the degree of influence of connective tissue dysplasia on the possibility of idiopathic scoliosis in preschool and school-age children.
7. Additional outcomes of the study
Additional outcomes of the study have not been studied.
8. Analysis in subgroups
The analysis was performed in a General group of children and in subgroups of patients distributed by age and characterized by the presence or absence of connective tissue dysplasia.
9. Registration methods outcomes
Data from anonymous questionnaires, the use of patient histories, and interviews with patients and their parents were taken into account.
10. Statistical analysis
The sample size was not calculated beforehand. Statistical analysis was performed using Microsoft Excel programs.
Qualitative nominal and ordinal data are indicated with the frequency of occurrence, represented as an absolute value and relative (%). For comparison of quality indicators used the χ2 criterion, in cases of small sample sizes (when the number of observations in one cell of a fourfold table is <5) Fisher's exact test and the χ2 with the Yates correction for 2x2 tables.
RESULTS. When collecting anamnesis in all patients included in the study, conditions were identified that can be considered as signs of the presence of connective tissue dysplasia syndrome.
Patients were divided into groups: by age: 5-7 years (25%) and 12-16 years (75%), and gender (male – 15%, female – 85%).
On examination, signs of connective tissue dysplasia were detected in 70% of patients in the observation group.
It was found that such factors as fatigue (in 42.5% of children), frequent respiratory viral infections (65% children), flat feet (62,5%), muscle loss (from 17.5% of children), poor sleep (40% children) were found in two age pahrumph and their frequency did not differ significantly, but the gender differences: most often, these symptoms were recorded among girls in the age group of 12-16 years (80%). It was also determined that 65% of cases were diagnosed with DST in the mother/father.
At the same time, 40% of patients had joint hypermobility, which is the leading sign of undifferentiated connective tissue dysplasia and a marker of the risk of orthopedic pathology, as well as an abnormal ability to bend the fingers 90 degrees towards the wrist or bend the elbow joints in the opposite direction (in 60% of patients).
DISCUSSION
Scoliosis is a pathology that is currently not fully understood. There are a large number of theories on which the formation of this disease is based, and connective tissue dysplasia is no exception. In this study, information about patients and their condition is analyzed in sufficient detail, which can prove the existence of a relationship between the manifestations of connective tissue dysplasia and the development of this pathology. It also provides a detailed distribution of patients by age and gender, which also allows us to identify the relationship of these characteristics with deformities of the musculoskeletal system in children of preschool and school age.
CONCLUSION
Statistical analysis of anonymous questionnaires, interviews and examinations of patients allowed us to determine the high frequency of clinical signs of connective tissue dysplasia in 70% of patients with idiopathic scoliosis, which allows us to confirm the causal relationship of this pathology with persistent spinal deformity in childhood.
About the authors
Maria Pertseva
Воронежский государственный медицинский университет им. Н.Н.Бурденко
Author for correspondence.
Email: MariaPertceva@yandex.ru
ORCID iD: 0000-0001-8478-5244
SPIN-code: 1150-4668
Russian Federation, 394622, Россия, г. Воронеж, ул. Студенческая, 10.
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