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BackgroundRadiographic evaluation for patients with scoliosis using Cobb method is the current gold standard, but radiography has radiation hazards. Several groups have recently demonstrated the feasibility of using 3D ultrasound for the evaluation of scoliosis. Ultrasound imaging is radiation-free, comparatively more accessible, and inexpensive. However, a reliable and valid 3D ultrasound system ready for clinical scoliosis assessment has not yet been reported. Scolioscan is a newly developed system targeted for scoliosis assessment in clinics by using coronal images of spine generated by a 3D ultrasound volume projection imaging method. The aim of this study is to test the reliability of spine deformity measurement of Scolioscan and its validity compared to the gold standard Cobb angle measurements from radiography in adolescent idiopathic scoliosis (AIS) patients.MethodsProspective study divided into two stages: 1) Investigation of intra- and inter- reliability between two operators for acquiring images using Scolioscan and among three raters for measuring spinal curves from those images; 2) Correlation between the Cobb angle obtained from radiography by a medical doctor and the spine curve angle obtained using Scolioscan (Scolioscan angle). The raters for ultrasound images and the doctors for evaluating radiographic images were mutually blinded. The two stages of tests involved 20 (80 % females, total of 26 angles, age of 16.4 ± 2.7 years, and Cobb angle of 27.6 ± 11.8°) and 49 (69 % female, 73 angles, 15.8 ± 2.7 years and 24.8 ± 9.7°) AIS patients, respectively. Intra-class correlation coefficients (ICC) and Bland-Altman plots and root-mean-square differences (RMS) were employed to determine correlations, which interpreted based on defined criteria.ResultsWe demonstrated a very good intra-rater and intra-operator reliability for Scolioscan angle measurement with ICC larger than 0.94 and 0.88, respectively. Very good inter-rater and inter-operator reliability was also demonstrated, with both ICC larger than 0.87. For the thoracic deformity measurement, the RMS were 2.5 and 3.3° in the intra- and inter-operator tests, and 1.5 and 3.6° in the intra- and inter-rater tests, respectively. The RMS differences were 3.1, 3.1, 1.6, 3.7° in the intra- and inter-operator and intra- and inter-rater tests, respectively, for the lumbar angle measurement. Moderate to strong correlations (R2 > 0.72) were observed between the Scolioscan angles and Cobb angles for both the thoracic and lumbar regions. It was noted that the Scolioscan angle slightly underestimated the spinal deformity in comparison with Cobb angle, and an overall regression equation y = 1.1797x (R2 = 0.76) could be used to translate the Scolioscan angle (x) to Cobb angle (y) for this group of patients. The RMS difference between Scolioscan angle and Cobb angle was 4.7 and 6.2°, with and without the correlation using the overall regression equation.ConclusionsWe showed that Scolioscan is reliable for measuring coronal deformity for patients with AIS and appears ...

The current study showed that the failure rate of the SpineCor was significantly higher than that of the rigid spinal orthosis, and the patients' acceptance to the SpineCor was comparable to the conventional rigid spinal orthosis.

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In this study, SpinoMed® could not provide additional treatment benefits to patients with osteoporotic vertebral fracture regarding pain relief and functional independence improvement at the subacute stage. The effects of SpinoMed® in muscle-strengthening and thoracic kyphotic angle reduction for patients with osteoporotic vertebral fracture need to be further verified in a more intensive and longer-term training program.

The treatment effectiveness of the CAD/CAM method and the manual method in managing adolescent idiopathic scoliosis (AIS) was compared. Forty subjects were recruited with twenty subjects for each method. The clinical parameters namely Cobb's angle and apical vertebral rotation were evaluated at the pre-brace and the immediate in-brace visits. The results demonstrated that orthotic treatments rendered by the CAD/CAM method and the conventional manual method were effective in providing initial control of Cobb's angle. Significant decreases (p 5 0.05) were found between the pre-brace and immediate in-brace visits for both methods. The mean reductions of Cobb's angle were 12.88 (41.9%) for the CAD/CAM method and 9.88 (32.1%) for the manual method. An initial control of the apical vertebral rotation was not shown in this study. In the comparison between the CAD/CAM method and the manual method, no significant difference was found in the control of Cobb's angle and apical vertebral rotation. The current study demonstrated that the CAD/CAM method can provide similar result in the initial stage of treatment as compared with the manual method.

In this prospective study, the effectiveness and biomechanical factors of spinal orthoses in the treatment of moderate adolescent idiopathic scoliosis (AIS) patients were investigated. In the first 20 months of orthotic treatment, the values of standing AP Cobb's angle, apical vertebral rotation, lumbar lordosis as well as thoracic kyphosis showed significant reduction (P<0.05), however, the angle of trunk inclination and trunk listing did not. The values of those reducible parameters reached their lowest values within the first 12 months of orthotic treatment and then the values gradually increased but they were still below the pre-brace values. The mean pressure of The pressure pads was found to be 7.09 +/- 1.77 kPa (53.2 +/- 13.3 mmHg) while the mean tension of the straps was 26.8 +/- 5.2N. The standing AP Cobb's angle strongly correlated with the pad pressure (correlation coefficient=0.931, p<(.05) and strap tension (correlation coefficient=0.914, p<0.05). The strap tension and pad pressure strongly correlated and the correlation coefficient was 0.873 (p<0.05). This suggests that in the consideration of biomechanical function of spinal orthoses, the focus may be upon how tightly the orthosis was fastened and if the location and direction of the pressure pads are the correct. Therefore, for enhancing independent standard tension should be set in each strap, and regular and close monitoring is needed.