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Symmetry/Asymmetry in Musculoskeletal Science

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A special issue of Symmetry (ISSN 2073-8994). This special issue belongs to the section "Life Sciences".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 21644

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Prof. Dr. Grzegorz Miękisiak

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Institute of Medicine, University of Opole, 45-052 Opole, Poland
Interests: disability; meta analysis; scoliosis; aging; spine; clinical microbiology
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Lukasz Kubaszewski

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Department of Orthopedics and Traumatology, W. Dega University Hospital, Poznan University of Medical Sciences, 61-545 Poznan, Poland
Interests: elements; metalloproteinase; femoral bone; hip osteoarthritis stages; grades; α-phenyl-N-tert-butyl muscle-derived stem/progenitor cells; Myoblasts; Apoptosis; oxidative stress; regenerative medicine; trace

Prof. Dr. Tomasz Szmuda

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Neurosurgery Department, Medical University of Gdansk, Marii Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
Interests: medicine; neurosurgery; neuroscience; health information seeking; spinal cord stimulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

According to the WHO, approximately 1.71 billion people live with musculoskeletal disorders worldwide. These conditions are the leading cause of disability across the globe, and as the population ages, the burden of these ailments is growing rapidly. This trend propels advances in research, and new technologies are continuously being brought into the field. With these new advances, we are now able to monitor the functions of the musculoskeletal system in ways unprecedented in history. This allows us to shed new light on many key concepts, including the role of symmetry in the ability to maintain function. The lack of symmetry can be a cause and an effect of various dysfunctions of the locomotor system. A better understanding of this concept can help physicians, physiotherapists and patients themselves guide treatment to improve outcomes.

In this Special Issue, we invite manuscripts concerned with the role of symmetry in the musculoskeletal system and how it affects locomotor function and human well-being in general. We are seeking papers investigating the prevalence of asymmetries in different organs, systems and disease units, associations between different asymmetries (e.g., local or global; asymmetries in structure, strength, power, stability, flexibility, movement kinematics or other aspects), relationships between asymmetries and general human health, quality of life, treatment outcomes, quality of gait and other aspects of human biomechanics and methodological as well as interventional studies concerning human body (a)symmetries.

Prof. Dr. Grzegorz Miękisiak
Prof. Dr. Lukasz Kubaszewski
Prof. Dr. Tomasz Szmuda
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Symmetry is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

symmetry
asymmetry
biomechanics
gait
musculoskeletal system
locomotion
spine
quality of life
anatomy

Published Papers (10 papers)

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Research

8 pages, 955 KiB

Open AccessArticle

Gravitational Acceleration Test Results According to Functional Movement Screen and Morphological Symmetry Results of Air Force Cadets

by Deok-Hwa Jeong, Dong-Ryul Lee, Kyu-Lim Lee and Jun-Young Sung

Symmetry 2023, 15(4), 804; https://doi.org/10.3390/sym15040804 - 26 Mar 2023

Cited by 1 | Viewed by 1084

Abstract

Objectives: Strong physical abilities and morphological symmetry are important factors for pilots to withstand aerial G-tolerance. Therefore, this study aimed to determine the symmetry difference between cadets by measuring functional movement screen (FMS) and functional leg length of Korea Air Force cadets for the first time and to understand the pass–fail relationship of the G-test by variable. Methods: Altogether, 72 fourth-year cadets (male, 72; mean age, 23.8 ± 0.6) were included in the study, and their body composition, FMS, functional leg length, and G-test results were measured. Results: The G-test results according to the FMS score revealed that the G-test passed (GP) group scored significantly higher than the G-test failed (GF) group in terms of the following: hurdle step (p =0.000), inline lunge (p = 0.006), active straight leg raise (p = 0.001), and T = trunk stability push-ups (p = 0.001). Conclusions The G-test results according to leg length demonstrated a significant difference between both groups. Morphological symmetry of leg length is an important factor in the functional aspect of exercise and exercise persistence. Moreover, a high G-test success rate can be expected if a follow-up study is conducted to improve the symmetry and balance of the body of air force cadets. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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9 pages, 1386 KiB

Open AccessArticle

Kinematic Analysis of the Forward Head Posture Associated with Smartphone Use

by Justyna Fercho, Michał Krakowiak, Rami Yuser, Tomasz Szmuda, Piotr Zieliński, Dariusz Szarek and Grzegorz Miękisiak

Symmetry 2023, 15(3), 667; https://doi.org/10.3390/sym15030667 - 07 Mar 2023

Cited by 2 | Viewed by 3189

Abstract

Background: Frequent use of mobile devices has a known association with musculoskeletal neck pain. This study sought out to localize the region with greatest flexion in the cervical spine and explored the role of symmetry in maintaining the pose during texting. Methods: Three inertial measuring units (IMUs) superficially attached along the cervical spine divided the cervical spine into two measurable segments. Twenty-five subjects participated in the study and performed three tasks when using smartphones: sitting, standing, and walking. Data from each IMU were used to calculate the flexion of cervical divided into two segments: craniocervical junction (C0–C1) and subaxial (C1–C7). Results: The greatest flexion by far occurred at C0–C1. While sitting, standing, and walking, the mean flexion angles were 33.33 ± 13.56°, 27.50 ± 14.05°, and 32.03 ± 10.03° for the C0–C1 joint and −3.30 ± 10.10°, 2.50 ± 9.99°, and −1.05 ± 11.88° for the C2–C7 segment, respectively. There is a noticeable pattern of yaw movement of the head, with a slow rotation toward symmetry and a fast corrective movement toward the smartphone held in one hand. Conclusions: This study identified the region of greatest contribution toward forward flexion along the cervical parameters during various tasks involving smartphone use. With each task, the greatest contributor to head flexion was the C0–C1 joint. There is involuntary rotation of the cervical spine toward symmetry when texting. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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10 pages, 1551 KiB

Open AccessArticle

The Effect of Spinal Asymmetries on Physical Fitness Parameters in Young Elite Soccer Players

by Eleni Theodorou, Marios Christou, Andreas Apostolidis, Marios Tryfonidis, Nikolaos Zaras and Marios Hadjicharalambous

Symmetry 2022, 14(12), 2497; https://doi.org/10.3390/sym14122497 - 25 Nov 2022

Cited by 2 | Viewed by 1044

Abstract

The purpose of the study was to examine the effect of spinal asymmetries on specific physical fitness parameters in young elite soccer players. Fifty male soccer players, all members of the under 17 (U17) and 15 (U15) National teams of Cyprus, were initially evaluated for thoracic kyphosis, lumbar lordosis and scoliosis asymmetries. Based on the spinal asymmetries’ initial evaluation, soccer players were categorized into the asymmetry group (AG) and normal group (NG) per spinal asymmetry. Hamstring and lower-back flexibility, countermovement jump (CMJ) and lower body isokinetic maximum force were evaluated between AG and NG. CMJ with arm swing was lower in kyphotic posture AG compared with the NG (AG: 41.70 ± 3.59 cm, NG: 44.40 ± 4.34 cm; p = 0.028). Single leg CMJ was lower in both legs in scoliotic posture AG compared with the NG (right: AG: 17.42 ± 1.86 cm, NG: 19.16 ± 2.42 cm, p = 0.008, left: AG: 17.54 ± 1.33 cm, NG: 19.97 ± 2.91 cm; p = 0.002). Sit-and-reach flexibility was lower in scoliotic posture AG (AG: 20.44 ± 5.76 cm, NG: 24.82 ± 6.83 cm; p = 0.024) and higher in lordotic posture AG (AG: 25.95 ± 6.59 cm, NG: 21.73 ± 6.45 cm; p = 0.04) both compared with the NG. No significant difference was found for quadriceps and hamstrings concentric peak torque between the AG and NG (p > 0.05). The current study revealed that kyphotic and scoliotic posture asymmetries deteriorate neuromuscular explosiveness performance and diminish lower limbs’ flexibility in young International-level soccer players. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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14 pages, 717 KiB

Open AccessArticle

The Effect of Vibration Massage on Fatigue of the Upper Trapezius Muscle during Different Tasks

by Lingyu Wang, Mingzhu Fang and Jie Hu

Symmetry 2022, 14(10), 2158; https://doi.org/10.3390/sym14102158 - 15 Oct 2022

Cited by 3 | Viewed by 3919

Abstract

Background: Vibratory massage is now widely used to alleviate muscle fatigue. The effects of different vibration massage intensities on left and right upper trapezius (UT) fatigue have not been examined. Therefore, the present study first examined whether a vibration massage intervention had an effect on UT muscles and second compared the effects of 2 different levels (36 Hz and 46 Hz) of vibratory massage on the right and left oblique muscles under 3 different fatigue conditions. Methods: A total of 23 participants (12 female, 11 male; age: 26.5 ± 3.9 year, height: 170.5 ± 1.6 cm, mass: 57.5 ± 1.5 kg, BMI: 24.3 ± 1.6 kg/m²) were randomly divided into intervention and control groups. The 2 groups of subjects completed isometric contraction fatigue tasks of 30 s of fatigue, 60 s of fatigue and 90 s of fatigue in turn. The specific task of isotonic contraction was performed by subjects holding a 1 kg dumbbell in each hand and performing a straight arm weighted lateral supination exercise. After each exercise, the intervention group was randomized to apply a massage device with a vibration intensity of 36 Hz or 46 Hz on the left and right UT muscles for 5 min each. The control group did not receive any treatment. Both groups then repeated the same fatigue task as before. Then, the effects of different vibration massage interventions on UT muscles were derived by analyzing the changes in maximal voluntary contraction percentage (MVC%) of surface electromyography (sEMG) signals before and after the intervention, and the most effective vibration massage program for relieving left and right UT fatigue was summarized. Then, four classification algorithms were used to label and classify the collected sEMG data, and finally a UT muscle fatigue identification and vibration massage model was constructed. Results: After using the vibration massage level 1 (36 Hz) intervention, the MVC% of the right UT muscle showed significant reductions in the 30 s fatigue task, the 60 s fatigue task and the 90 s fatigue task (R1: p = 0.022, R2: p = 0.005, R3: p = 0.049). After using the vibration massage level 3 (46 Hz) intervention, the MVC% of the right UT muscle showed a significant decrease in both the 60 s fatigue task and the 90 s fatigue task (R2: p = 0.033, R3: p = 0.028). Significant decreases in MVC% for the left UT muscle were found only in the 90 s fatigue task (L3: p = 0.040). Then, by comparing the different performances of four commonly used classification algorithms, it was found that the bagging (accuracy = 0.860) algorithm had higher accuracy. Therefore, the bagging algorithm was used for the UT fatigue identification and vibration massage models. Conclusions: This was the first study to show the impacts of different levels of vibration massage on fatigue alleviation in the left and right UT muscles. Furthermore, the bilateral UT fatigue identification and vibration massage model developed in this study can help people to choose the most appropriate massage protocol for quick relief and relaxation of the UT muscles under three different fatigue tasks. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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13 pages, 315 KiB

Open AccessArticle

Asymmetries of the Muscle Mechanical Properties of the Pelvic Floor in Nulliparous and Multiparous Women, and Men: A Cross-Sectional Study

by Daiana Priscila Rodrigues-de-Souza, Ana Carolina Sartorato Beleza, Lourdes García-Luque, Sandra Alcaraz-Clariana, Cristina Carmona-Pérez, Amaranta De Miguel-Rubio, María Teresa Garzón-Alfaro, Inés Cruz-Medel, Juan Luis Garrido-Castro and Francisco Alburquerque-Sendín

Symmetry 2022, 14(10), 2124; https://doi.org/10.3390/sym14102124 - 12 Oct 2022

Cited by 3 | Viewed by 1584

Abstract

This study aimed to identify if the muscle mechanical properties (MMPs) of both sides of pelvic floor muscles (PFMs) are symmetrical in different populations of both sexes. Between-sides comparisons of MMPs of PFMs, assessed with manual myotonometry, were performed in three groups, with 31 subjects each, composed of healthy nulliparous women (without any type of delivery or pregnancy), multiparous women (with at least two vaginal deliveries), and healthy adult men. Intra-group correlations between MMPs and age, body mass index (BMI), or clinical state of pelvic floor were also obtained. The nulliparous women and the men showed no between-sides differences in any MMP of PFMs. However, the multiparous women showed that the right side displayed less frequency (−0.65 Hz, 95% CI = −1.01, −0.20) and decrement (0.5, 95% CI = 0.11, 0.01), and more relaxation (1.00 ms, 95% CI = 0.47, 1.54) and creep (0.07 De, 95% CI = 0.03, 0.11), than the left side. Further, MMPs were related to age, sex, and BMI, also depending on the population, with the multiparous women being the only group with some between-sides asymmetries, which in this case were positive and of fair intensity for the left side of the PFMs, between BMI, and frequency and stiffness (rho Spearman coefficient: 0.365 and 0.366, respectively). The symmetry of MMPs of the PFMs could depend on the subject’s condition. Multiparous women show a higher tendency to asymmetries than nulliparous women and men, which should be considered in research and clinical settings. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

13 pages, 14396 KiB

Open AccessArticle

Assessment of the Asymmetry of the Intervertebral Foramina within the Lower Motion Segments of the Lumbar Spine on the Computer Tomography Sections

by Piotr Nowak and Łukasz Kubaszewski

Symmetry 2022, 14(10), 1967; https://doi.org/10.3390/sym14101967 - 20 Sep 2022

Cited by 1 | Viewed by 1160

Abstract

Asymmetry in the degenerative lumbar spine may eventually evolve to debilitating scoliosis. The point where it starts to accelerate in some individuals is obscure. Discreet preclinical asymmetry may be a prognostic feature of the condition. The aim of this study was to assess the asymmetry of the intervertebral foramina of lower lumbar motion segments of the spine based on morphometric measurements using novel techniques of three-dimensional imaging. Computed tomography scans of 19 subjects with axial low back pain aged 50 to 78 of both sexes were digitally processed, and 3D reconstruction of L4/L5 and L5/S1 motion segments were obtained. The planes of intervertebral foramina were defined in reference to the axis of the pedicles bordering the intervertebral canal and the measurements were performed yielding absolute values in millimeters. The circumference ranged from 33.4 mm to 63.86 mm on the left side and from 33.01 mm to 73.54 mm on the right side. The horizontal dimension ranged from 6.86 mm to 17.84 mm on the left side and from 5.41 mm to 17.63 mm on the right side. The vertical dimension ranged from 10.17 mm to 23.65 mm on the left side and from 9.04 mm to 29.69 mm on the right side. All the measurements were combined to assess the asymmetry. Only in three cases (15%), symmetry in both segments was confirmed. No defined lateralization of asymmetry was found, as well as no significant link between the sex and age could be confirmed. This is the first study confirming the asymmetry among the intervertebral foramina. It seems that it is the dominant phenotype for intervertebral foramina. As the observed asymmetry lacks the dominant lateralization, it may be linked with the same trait of degenerative scoliosis. Though no direct link between the age and sex was confirmed in this study, it suggests other factors should be considered in prediction of the progress and magnitude of the deformity. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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9 pages, 1007 KiB

Open AccessArticle

The Impact of Piano Styles on Muscle Force in Pianist Students

by Iulia Toma, Elena Amaricai, Roxana Ramona Onofrei and Mihai Popean

Symmetry 2022, 14(9), 1927; https://doi.org/10.3390/sym14091927 - 15 Sep 2022

Cited by 1 | Viewed by 1427

Abstract

The study of the consequences of different sonata styles (baroque, classical and romantic piano repertoire) on pianists’ upper limbs represents a research topic for both the musical and medical fields. Twenty piano students were examined using a MicroFet2 dynamometer after playing three sonatas (Scarlatti K. 1 Sonata as a representative of the baroque style, Haydn Sonata no. 60 for the classical style and Chopin second Sonata for the romantic style). The phase sequence was randomised for each subject: firstly, continuous interpretation of 10 bars of a sonata was conducted 10 times, with the metronome tempo set by the investigator; secondly, the subject interpreted 10 bars of a different sonata continuously, standardised by tempo, which was carried out 10 times; finally, the continuous interpretation of 10 bars of the remaining third sonata, standardised by tempo, was carried out 10 times. After each performance of the 10 bars, the elbow extensor’s isometric muscle force was measured. Significant differences were found between the elbow extensor’s isometric muscle force assessed after playing Scarlatti’s sonata and Haydn’s sonata (p = 0.005 for left arm, p = 0.03 for right arm), between Scarlatti’s sonata and Chopin’s sonata (p < 0.0001 for both left and right arms) and between Haydn’s sonata and Chopin’s sonata (p = 0.01 for left arm, p < 0.0001 for right arm). In healthy piano students, the dynamometric assessment of elbow extensors’ isometric muscle force after playing three different sonatas (baroque, classical and romantic) showed that the lowest values were recorded after playing the baroque style. Our results showed bilateral symmetry in the elbow extensor’s isometric muscle force for all three piano styles. The testing of arm muscles, besides that of the fingers, should be considered as a regular evaluation for future professional pianists with regard to the prevention of musculoskeletal complaints. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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14 pages, 4128 KiB

Open AccessArticle

Clinical and Demographic Factors Influencing the Asymmetry of Gait in Lower-Limb Prosthetic Users

by Mikołaj Dąbrowski, Katarzyna Łysakowska, Adam Gramala and Łukasz Kubaszewski

Symmetry 2022, 14(9), 1910; https://doi.org/10.3390/sym14091910 - 13 Sep 2022

Cited by 1 | Viewed by 1673

Abstract

(1) Background: A lower limb prosthesis replaces a lost body part with a differential representation of gait function and its symmetry. Many physical, personal, and specific factors in amputees influence gait asymmetry. The aim of this study was to determine the factors influencing the asymmetry of gait in amputated patients. (2) Methods: The study group consisted of 12 people. Gait quality was assessed using the MoCap OptiTrack^® Motion Capture System and the results were correlated with demographic factors (age, gender), morphological features (height, weight), amputation-related factors (cause and side of amputation, prosthesis time, and prosthesis fixation), and ailment pain. The control group consisted of 12 people. (3) Results: In the study group, a positive correlation between the mean walking speed and height in the study group was demonstrated, as well as a positive correlation between the difference in ROM and height, and a negative correlation between the mean walking speed and age. A negative correlation between the difference in ROM and age was found in both groups. A positive correlation was found between the width of the support and the weight in the control group. No other statistical relationship with the parameters describing gait asymmetry was found. (4) Conclusions: Statistical analysis showed that mean walking speed and ROM difference in the study group were positively related to height and negatively to age. No other statistical relationship with the parameters describing gait asymmetry was found. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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14 pages, 2777 KiB

Open AccessArticle

Vertebral Slip Morphology in Dysplastic Spondylolisthesis as a Criterion for the Choice of the L5/S1 Support (ALIF, PLIF, Fibular Graft) in Surgical Treatment

by Robert Vyskocil, Martin Prymek, Ludek Ryba, Jan Sklensky, Jan Kocanda, Michael Lujc, Petr Vosynek and Martin Repko

Symmetry 2022, 14(7), 1466; https://doi.org/10.3390/sym14071466 - 18 Jul 2022

Cited by 1 | Viewed by 3475

Abstract

Dysplastic spondylolisthesis is a severe pathological condition, based on dysplastic changes in the lumbosacral part of the spine, that causes the asymmetry of the lumbosacral junction. The appropriate therapeutic algorithm remains controversial. As the gold standard, the surgical reposition of the slipped vertebra and 360° fusion of the affected spinal segment is preferred. Thirty-two patients were operated on between the years 2005 and 2018. Different techniques of 360° fusion, based on the severity of the displacement of the affected vertebral segment, were used. Herein, the advantages and disadvantages of different techniques of interbody fusion are discussed. The slippage and retention after reduction in the vertebrae are evaluated prior to the operation, postoperatively, one year after the surgery, and during follow-up, which was 7 years on average (minimum 2 years for a follow-up). Complications associated with the surgery are evaluated, in addition to the operation time, blood loss, spinopelvic parameters, and patient satisfaction with the surgery. All surgical techniques improved the slippage compared to preoperative conditions. The retention of the reposition was not changed significantly in postoperative controls. The incidence of neurological complications reached 12.5%. Surgical treatment is the only treatment option that successfully addressed the pathological principle of dysplastic spondylolisthesis. All of the surgical methods used led to restoring the symmetry of the lumbar spine, and to the improvement in both radiological parameters and the alleviation of subjective difficulties. The aim of this article is to summarize surgical methods in patients having dysplastic spondylolisthesis with a slip of more than 25%, who were operated on, and to determine the optimal treatment algorithm according to the severity of the slip. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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12 pages, 3006 KiB

Open AccessArticle

The Role of Bending Films in the Lowest Instrumented Vertebra Selection in Adolescent Idiopathic Scoliosis Lenke Type 1A,B Based on Asymmetrical Disc Loading and Decompensation

by Martin Prymek, Robert Vyskocil, Jan Sklensky, Jan Kocanda, Andrea Sprlakova-Pukova, Milan Filipovic and Martin Repko

Symmetry 2022, 14(7), 1386; https://doi.org/10.3390/sym14071386 - 06 Jul 2022

Viewed by 1835

Abstract

Patients with severe adolescent idiopathic scoliosis (AIS) require instrumented spinal fusion surgery. The range of instrumented vertebra is still questioned, especially the selection of the lowest instrumented vertebra (LIV). This single institution retrospective consecutive study is to provide real-world data on outcomes. The study aims to assess whether bending films can determine the LIV. The method of determination of the lower tilted vertebra (LTV) is presented. The selection of the LTV was identified on standing PA (LTVs) and on bending X-rays (LTVb). Group A is a reference group, with less flexible curves. Groups B and C contained patients with more flexible curves. Group B covered patients with instrumentation ending at the LTVs and group C with shorter instrumentation ending at LTVb. The disc angle below the LIV was monitored for postoperative decompensation. Sixty-eight subjects with AIS Lenke 1A and 1B types underwent selective fusion. The decompensation criteria of the unfused disc below the fusion were determined as a wedging disk of >5° of the Cobb angle. The patients were monitored during the postoperative period with 5.8 years average followup (minimum of 2 years). The rate of decompensation was comparable in groups A and B (31% and 33%, respectively). In contrast, the rate of decompensation was doubled in group C (60%). Caudal fusion shortening in more flexible curves according to bending films is associated with the first free disc asymmetry, which leads to decompensation below the fusion. This method should be considered in addition to other LIV selection criteria. Full article

(This article belongs to the Special Issue Symmetry/Asymmetry in Musculoskeletal Science)

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