X-ray study to verify clinical findings in patients with scoliosis and other deformities of the spine is associated with considerable radiation exposure as well as a variety of other problems, particularly as regards assessing disease progression. Hence, in the course of the past few years a number of alternative, supplementary spinal diagnostic procedures have been developed which are based on analysis of the surface of the back: Moiré topography, photogrammetry/raster stereometry, opTRImetric system, ISIS system, video raster stereometry (formetrics), ultrasound-guided spine analysis (Zebris) and ultrasound topometry. To assess the effectiveness of screening, diagnosis, and progression of scoliosis the formetric system of video raster stereometry and the Zebris system for ultrasound-guided spine analysis were tested. It was shown that the results of screening tests, diagnostic study, and progression evaluation of scoliosis and sagittal deformities were exact enough using these systems. Furthermore, the ultrasound-guided Zebris system offers the option of dynamic analysis of spinal movement. Limitations in measurement precision were found in obese patients, asymmetric muscle surfaces, and in patients who had undergone surgery, although in the latter group progression could be reliably monitored if the radiological angle was known. We can assume that surface analysis procedures will gain in importance clinically and in practice.
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