A Comparative Study of Computed Tomographic and Plain Radiographic Methods to Measure Vertebral Rotation in Adolescent Idiopathic Scoliosis

Ho, Eric K.; Upadhyay, Sachin; Ferris, Lauren A.; Chan, F. L.; Bacon‐Shone, John; Hsu, L. C. S.; Leong, Jcy

doi:10.1097/00007632-199207000-00008

Cited by 52 publications

(33 citation statements)

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“…They reported a tolerance of ± 1.2° [8]. The method we describe gives similar results to Ho's, which shows its reliability in clinical use.…”

Section: Discussionsupporting

confidence: 76%

“…CT measurement methods are known to be more precise and more reliable than the conventional methods [7,8,10]. There are contradictory reports on the results and reliability of the defined conventional graphic assessments [3,5,12,16].…”

Section: Discussionmentioning

confidence: 99%

“…There are contradictory reports on the results and reliability of the defined conventional graphic assessments [3,5,12,16]. Today, many authors accept that methods like the Cobb method, which are based on the spinous process, are not reliable, as the end of the spinous process is deformed extensively [8,12,18].…”

Section: Discussionmentioning

confidence: 99%

“…The first method described for measuring vertebral rotation, and used as gold standard for years, was the Aaro and Dahlborn method, but its lack of inter-observer reliability restricts its clinical application [7,8]. In this method, the junction of the inner surfaces of the lamina is constant and easily identifiable, but the other datum point, i.e.…”

Section: Discussionmentioning

confidence: 99%

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A new method to measure vertebral rotation from CT scans

Göçen

Havıtçıoğlu

Alıcı

1999

European Spine Journal

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IntroductionThe importance of vertebral rotation in the etiology and management of scoliosis is well recognized. Evaluation of transverse plane deformity in idiopathic scoliosis is still controversial.Displacement of the spinous process from the midline was used to measure rotation by Cobb [16]. Later, Nash and Moe introduced their own method, in which the displacement of the convex-side pedicle toward the midline was considered to be in direct proportion to the degree of rotation [13]. Perdriolle quantitatively measured pedicle shift using a specific template [14]. Some authors have also described analytic methods based on trigonometric and geometric measurements on plain radiographs [4,5,16,18].Because of the high rate of error, application difficulties and performer variation of these conventional radiography measurement methods, authors have looked for more sensitive methods [3]. The use of CT to measure vertebral rotation was introduced by Aaro and Dahlborn in 1981, in a study of five patients [1]. Subsequently, they used the method to assess rotational deformity of spine and rib cage and the derotation effect of the Boston brace, and to study the relation between lateral curvature and rotation of the apical vertebra [2]. Recently, Ecker et al. used the CT method to evaluate the effect of CotrelDubousset instrumentation in idiopathic scoliosis [6]. In this method, the sagittal angle (RA sag) was taken to be the angle between the sagittal plane and the line between the correct posterior mid-point of the vertebral canal and the center point of the corpus vertebrae.A second method was described by Ho et al. in 1993 [9]. The vertebral rotation angle was taken to be the angle between the sagittal plane and mid-angle line of connecting lines of three points. These three reference points Abstract CT measurement methods have good reliability for idiopathic scoliosis transverse plane deformity evaluation. However, because of application difficulties and variations in how these methods are applied, more sensitive methods are needed. This paper presents a new method for measurement of vertebral rotation from tomographic scans. First, the method was subject to clinical, intraobserver and inter-observer analysis. Twenty-three patients with adolescent idiopathic scoliosis were studied to test the clinical reliability of this method. There were no statistical differences between the results of the new method and Ho's method (P = 0.3380) in the clinical study. Intraobserver and inter-observer analysis showed that this method was reliable. An experimental study was then conducted to show the confidence limits of our new method, which were found to be ± 1.6°, and there was no significant difference between the mean rotation value obtained from CT scans using our new method and that obtained using the mechanical method. These results suggest that our new method is a simple, practical and reliable method for measurement of vertebral rotation from CT scans.

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“…They reported a tolerance of ± 1.2° [8]. The method we describe gives similar results to Ho's, which shows its reliability in clinical use.…”

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A new method to measure vertebral rotation from CT scans

Göçen

Havıtçıoğlu

Alıcı

1999

European Spine Journal

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“…Indeed, the concept of axial rotation of the scoliotic curve vertebrae requires a single referential system for all the vertebrae. The accuracy of these methods has been assessed [14,28,29,32,35] and the shadows of the anatomical features were found to be distorted [9, 25, 31 35]. These evaluations have also been compared to those drawn from CT scans and ultrasound images [1, 2,12,16,17,18,28], and it has been shown that the measurement technique must be standardized to allow the comparative assessment of findings [29].…”

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confidence: 99%

Access to a three-dimensional measure of vertebral axial rotation

1998

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IntroductionThe spinal distortion that gives rise to a scoliotic curve includes both a rib hump and an axial rotation of the apical vertebra. The location and extent of axial rotation can provide considerable information on the nature of the deformity. The earliest method of detecting an axial rotation was from the lateral displacement of the shadow of the spinal process with respect to that of the vertebral body on coronal plain radiographs. Subsequently, Grossiord et al. [12] and Nash and Moe [21] showed that the position of the pedicle shadow with respect to those of the vertebral body wedges and the posterior arch provided a more sensitive index. They also showed that accurate calibration of the X-ray machine was most important, as the coronal view of the spine provides only a frontal projection of the vertebrae, and hence a qualitative evaluation of the axial rotation.Several authors [4, 5,7,8,19,20,24,32] have used a variety of geometrical formulae that take into account the diverse anatomical frames of the vertebrae as projected in coronal radiographs to develop a quantitative measurement of axial rotation, implicitly referred to the global referential system. Indeed, the concept of axial rotation of the scoliotic curve vertebrae requires a single referential system for all the vertebrae. The accuracy of these methods has been assessed [14,28,29,32,35] and the shadows of the anatomical features were found to be distorted [9, 25, 31 35]. These evaluations have also been compared to those drawn from CT scans and ultrasound images [1, 2,12,16,17,18,28], and it has been shown that the measurement technique must be standardized to allow the comparative assessment of findings [29].However, none of the above methods use sagittal data, consequently they do not produce a true three-dimensional (3D) measurement of the axial rotation of each vertebra. The 2D data provide what is referred to in this paper as "apparent rotation". True 3D measurements must also take into account the sagittal tilt of the vertebrae. This report analyses the concept of introduced rotation and its implications, and then describes a method of obtaining a true 3D evaluation of vertebral axial rotation.Abstract Scoliotic curvatures can only be assessed through three-dimensional (3D) procedures. Measurement of the axial vertebral rotation appears to be of primary importance for such techniques. Nevertheless, traditional methods are based only on 2D data, obtained through antero-posterior radiographic projections of the spine. A 3D method is described in this study, taking into account the sagittal tilt of the vertebrae. Only such a measurement provides a real 3D method for a true appraisal of the scoliotic spine. The practical implications are developed.

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Applications of Medical Image Processing in the Diagnosis and Treatment of Spinal Deformity

Adam

Dougherty

2011

Medical Image Processing

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A Comparative Study of Computed Tomographic and Plain Radiographic Methods to Measure Vertebral Rotation in Adolescent Idiopathic Scoliosis

Cited by 52 publications

References 0 publications

A new method to measure vertebral rotation from CT scans

A new method to measure vertebral rotation from CT scans

Access to a three-dimensional measure of vertebral axial rotation

Applications of Medical Image Processing in the Diagnosis and Treatment of Spinal Deformity

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