This study aims to investigate potential alterations in hemorheological parameters in adolescents with idiopathic scoliosis (AIS) compared to healthy controls. A total of 30 AIS patients and 30 age- and sex-matched healthy individuals will be evaluated through clinical, radiological, and laboratory assessments. Hematocrit, plasma and whole blood viscosity, erythrocyte deformability, and aggregation will be measured. The goal is to determine whether structural spinal deformities in AIS are associated with changes in microcirculatory blood flow properties.
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis in children and adolescents. Although extensively studied from orthopedic and biomechanical perspectives, its potential systemic effects remain poorly understood. This study is designed to investigate whether AIS is associated with alterations in blood rheology-specifically, changes in viscosity, erythrocyte deformability, and aggregation-which may reflect underlying microcirculatory dysfunction. Hemorheology refers to the study of blood flow and its mechanical properties. In this study, key hemorheological parameters-including hematocrit (Hct), whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte deformability (ED), and erythrocyte aggregation (EA)-will be assessed in AIS patients and healthy controls. A total of 30 AIS patients and 30 age- and sex-matched healthy participants will be enrolled. Blood samples will be collected for rheological analysis, and measurements will be performed using a rotational cone-plate viscometer and a laser-optical erythrocyte analyzer under standardized shear conditions. Clinical and radiological data, such as Cobb angle, vertebral rotation, and sagittal alignment, will also be collected. Statistical comparisons between groups and correlation analyses will be conducted to evaluate the relationships between hemorheological variables and scoliosis severity or type. This study will provide the first controlled assessment of hemorheological behavior in adolescents with idiopathic scoliosis. Results may offer novel insights into whether spinal deformity has systemic circulatory implications and may help identify early markers of microvascular dysfunction associated with AIS.
Study Type
OBSERVATIONAL
Enrollment
60
University of Health Sciences
Istanbul, Turkey (Türkiye)
Plasma viscosity (PV)
Measurement of plasma viscosity (mPa·s) using cone-plate viscometry at a shear rate of 450 s-¹.
Time frame: At baseline (single time point)
Whole blood viscosity (WBV)
Measurement of whole blood viscosity (mPa·s) using cone-plate viscometer at multiple shear rates (37.5 to 450 s-¹).
Time frame: At baseline (single time point)
Erythrocyte deformability (EImax)
Evaluation of erythrocyte elongation index (EImax) using laser-assisted ektacytometry (Lorrca MaxSis).
Time frame: At baseline (single time point)
Erythrocyte deformability (SS1/2)
Evaluation of shear stress at half EImax (SS1/2) using laser-assisted ektacytometry (Lorrca MaxSis).
Time frame: At baseline (single time point)
Erythrocyte aggregation (AI and Tr)
Measurement of aggregation index (AI) using Lorrca MaxSis at 37°C under standardized conditions.
Time frame: At baseline (single time point)
Erythrocyte aggregation (Tr)
Measurement of relaxation time (Tr) using Lorrca MaxSis at 37°C under standardized conditions.
Time frame: At baseline (single time point)
Correlation between Cobb angle and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
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Correlation between cervical lordosis angle and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and the Plasma viscosity (mPa·s)
Plasma viscosity (mPa·s), measured using a cone-plate rotational viscometer at 450 s-¹, and Joint hypermobility will be measured using the Beighton score (0-9 scale), a standardized clinical examination evaluating passive dorsiflexion of the fifth finger, thumb apposition, elbow hyperextension, knee hyperextension, and forward flexion of the trunk. Scores ≥5 will be considered indicative of generalized joint hypermobility.
Time frame: At baseline (single time point)
Correlation between Cobb angle and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹) and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
Correlation between cervical lordosis angle and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹) and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹) and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹), and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹), and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹), and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and the Whole blood viscosity (mPa·s)
Whole blood viscosity (mPa·s), measured at multiple shear rates (37.5 to 450 s-¹), and Joint hypermobility will be measured using the Beighton score (0-9 scale), a standardized clinical examination evaluating passive dorsiflexion of the fifth finger, thumb apposition, elbow hyperextension, knee hyperextension, and forward flexion of the trunk. Scores ≥5 will be considered indicative of generalized joint hypermobility.
Time frame: At baseline (single time point)
Correlation between Cobb angle and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
Correlation between cervical lordosis angle and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and Erythrocyte deformability (EImax)
Erythrocyte deformability (EImax), measured using laser-optical ektacytometry (Lorrca MaxSis) and Joint hypermobility will be measured using the Beighton score (0-9 scale), a standardized clinical examination evaluating passive dorsiflexion of the fifth finger, thumb apposition, elbow hyperextension, knee hyperextension, and forward flexion of the trunk. Scores ≥5 will be considered indicative of generalized joint hypermobility.
Time frame: At baseline (single time point)
Correlation between Cobb angle and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
Correlation between cervical lordosis angle and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and Erythrocyte deformability (SS1/2)
Erythrocyte deformability (SS1/2), measured using laser-optical ektacytometry (Lorrca MaxSis) and Joint hypermobility will be measured using the Beighton score (0-9 scale), a standardized clinical examination evaluating passive dorsiflexion of the fifth finger, thumb apposition, elbow hyperextension, knee hyperextension, and forward flexion of the trunk. Scores ≥5 will be considered indicative of generalized joint hypermobility.
Time frame: At baseline (single time point)
Correlation between Cobb angle and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
Correlation between cervical lordosis angle and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and Erythrocyte aggregation (AI)
Erythrocyte aggregation (AI), measured using Lorrca MaxSis under standardized conditions at 37°C and joint hypermobility (Beighton score).
Time frame: At baseline (single time point)
Correlation between Cobb angle and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and Cobb angle measured in degrees on standing posteroanterior spinal radiographs
Time frame: At baseline (single time point)
Correlation between cervical lordosis angle and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and cervical lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between thoracic kyphosis angle and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and thoracic kyphosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between lumbar lordosis angle and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and lumbar lordosis angle measured in degrees on standing lateral spinal radiographs
Time frame: At baseline (single time point)
Correlation between angle of trunk rotation (ATR) and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and angle of trunk rotation (ATR) measured with a scoliometer
Time frame: At baseline (single time point)
Correlation between vertebral rotation (Nash-Moe grade) and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and Vertebral rotation will be assessed using the Nash-Moe grading system on standing posteroanterior spinal radiographs. The Nash-Moe method classifies pedicle asymmetry into 5 grades (Grade 0 to Grade 4), where higher grades indicate increased vertebral rotation.
Time frame: At baseline (single time point)
Correlation between joint hypermobility (Beighton score) and Erythrocyte aggregation (Tr)
Erythrocyte aggregation (Tr), measured using Lorrca MaxSis under standardized conditions at 37°C and joint hypermobility (Beighton score)
Time frame: At baseline (single time point)