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Theoretically, extension of the spine in the sagittal plane should provide room for this longer anterior spinal column, allowing it to swing back towards the midline in the coronal and axial plane, thus reducing both the Cobb angle and the apical vertebral rotation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this prospective experimental study, ten patients with primary thoracic adolescent idiopathic scoliosis (AIS) underwent MRI (BoneMRI and cVISTA sequences) in supine as well as in an extended position by placing a broad bolster, supporting both hemi-thoraces, under the scoliotic apex. Differences in T4\u2013T12 kyphosis angle, coronal Cobb angle, vertebral rotation, as well as shape of the intervertebral disc and shape and position of the nucleus pulposus, were analysed and compared between the two positions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Extension reduced T4\u2013T12 thoracic kyphosis by 10\u00b0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), the coronal Cobb angle decreased by 9\u00b0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and vertebral rotation by 4\u00b0 (<jats:italic>p<\/jats:italic>\u2009=\u20090.036). The coronal wedge shape of the disc significantly normalized and the wedged and lateralized nucleus pulposus partially reduced to a more symmetrical position.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Simple extension of the scoliotic spine leads to a reduction of the deformity in the coronal and axial plane. The shape of the disc normalizes and the eccentric nucleus pulposus partially moves back to the midline.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-023-00732-8","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T16:02:01Z","timestamp":1691596921000},"page":"1509-1516","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The three-dimensional coupling mechanism in scoliosis and its consequences for correction"],"prefix":"10.1007","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-5186","authenticated-orcid":false,"given":"Lorenzo","family":"Costa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom P. 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Curie cofound RESCUE grant agreement No 801540. Peter Seevinck: Cofounder and minority shareholder of MRIGuidance BV. Moyo C. Kruyt: None related to this study. Tom P. C. Schlosser: None related to this study. Ren\u00e9 M. Castelein: None related to this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Bioethics Committee of the Medical University of Utrecht (No. 21\/569). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}