Angle Measurement Reproducibility Using EOSThree-Dimensional Reconstructions in Adolescent Idiopathic Scoliosis Treated by Posterior Instrumentation

Ilharreborde, Brice; Steffen, Jean Sebastien; Nectoux, Éric; Vital, J. M.; Mazda, Keyvan; Skalli, Wafa; Obeid, Ibrahim

doi:10.1097/brs.0b013e3182293548

Cited by 148 publications

(101 citation statements)

References 21 publications

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“…Mean follow-up was 34 ± 6 months. The mean number of levels fused was 13.5 ± 1 (11)(12)(13)(14)(15). The number of UCs used for thoracic correction averaged 6.8 (5-10).…”

Section: Demographic Data and Operative Proceduresmentioning

confidence: 99%

“…Low dose biplanar radiographs (EOS imaging, Paris, France) were obtained preoperatively, postoperatively and at the latest patient visit as part of the routine work-up and follow-up [12]. Patients were in the weight-bearing standing position, arms folded at 45°in order to avoid superposition with the spine.…”

Section: Biplanar Radiographic Systemmentioning

confidence: 99%

“…As previously described, full 3D images of the spine were reconstructed by an independent senior radiologist, experienced with the method (total 147 reconstructions) [12,18,19]. The preliminary step was the identification of a segment on the sacral endplate and two spheres around the femoral heads in the acetabuli, which permitted the creation of a 'patient frame' that is compatible with the reference axis used by the SRS for classification of AIS [20].…”

Section: Reconstruction Processmentioning

confidence: 99%

“…Computer scanning can be used for this type of analysis, but at the expense of high radiation exposure, and with the limitation of being performed in the supine position. These drawbacks can now be avoided by the use of low-dose stereoradiography in standing AIS patients to obtain 3D reconstructions, the validity of which in routine preoperative and postoperative use has been recently confirmed [12]. Therefore, in surgical units that dispose of this imaging system, the efficacy of AIS treatment procedures can now be accurately measured in all three planes, routinely, without a trade-off in safety [13].…”

Section: Introductionmentioning

confidence: 99%

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Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system

et al. 2013

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Purpose Computed tomography can be used for threedimensional (3D) evaluation of adolescent idiopathic scoliosis (AIS) patients, but at the expense of high radiation exposure, and with the limitation of being performed in the supine position. These drawbacks can now be avoided with low-dose stereoradiography, even in routine clinical use. The purpose of this study was to determine the 3D postoperative correction of AIS patients treated by posteromedial translation. Methods Forty-nine consecutive patients operated for AIS (Lenke 1-4) using posteromedial translation were included. Corrections were evaluated preoperatively, postoperatively and after at least 2 years using the EOS imaging system. 3D angles were measured in the plane of maximum deformity. Results Mean number of levels fused and operative time were 13.5 ± 1 and 215 ± 25 min, respectively. Main thoracic, proximal thoracic, and lumbar curves corrections averaged 64.4 ± 18, 31 ± 10 and 69 ± 20 %, respectively. Mean T4-T12 kyphosis increased 18.8°± 9°in the subgroup of hypokyphotic patients. Mean apical vertebral rotation reduction was 48.3 ± 20 %. Trunk height gain averaged 27.8 ± 14 mm. There was no pseudarthrosis or significant loss of correction in any plane during follow-up. Two patients (4 %) developed asymptomatic proximal junctional kyphosis, despite having normal thoracic kyphosis. Their sagittal balance was shifted posteriorly by 36 and 47 mm, respectively, by the operation, but revision surgery was not performed. Conclusions Low-dose stereoradiography provided 3D reconstructions of the fused and unfused spine in routine clinical use. Postoperative 3D analysis showed that posteromedial translation enhanced sagittal balance correction, without sacrificing frontal or axial correction of the deformity.

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“…Mean follow-up was 34 ± 6 months. The mean number of levels fused was 13.5 ± 1 (11)(12)(13)(14)(15). The number of UCs used for thoracic correction averaged 6.8 (5-10).…”

Section: Demographic Data and Operative Proceduresmentioning

confidence: 99%

Section: Biplanar Radiographic Systemmentioning

confidence: 99%

Section: Reconstruction Processmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system

et al. 2013

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“…Use of synthetic antifibrinolytic drugs (tranexamic and epsilon-aminocapronic acid) may reduce the perioperative blood transfusion requirement [48,49]. Pre-and postoperative 3D low dose whole body radiographic imaging (e.g., sterEOS) enhances the biomechanical understanding and supports preoperative planning [50,51]. Intraoperative use of navigation to place pedicle screws steepens the learning curve and aids instrumenting in difficult anatomic situations [22,[52][53][54].…”

Section: Additional Improvements Over Timementioning

confidence: 99%

A brief overview of 100 years of history of surgical treatment for adolescent idiopathic scoliosis

Hasler

2013

Journal of Children's Orthopaedics

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The history of surgical correction for adolescent idiopathic scoliosis reaches back about 100 years: the natural course of progressive, crippling and sometimes even lifethreatening deformities which could not be controlled by external means called for effectual, invasive procedures. Hibbs 1911 aimed at halting progression by long, uninstrumented fusions. However, the lack of true correction, long rehabilitation times, high pseudarthrosis and infection rates, and a fusion mass which bent further once exposed to gravity again were not satisfying. The transition from slowing progression to halting progression and truly correcting the deformity lasted almost another half a century: Paul Harrington, confronted with many scoliotic polio patients, successfully introduced a hook-rod system for concavedistraction and convex-compression at the end of the 1950s. Many implant failures, a still-considerable pseudarthrosis rate, flattening of the sagittal profile and the lack of true threedimensional (3D) correction were the shortcomings. In the 1970s the Frenchmen Cotrel and Dubousset took scoliosis surgery to the next level by introducing a versatile hook system and curve-pattern-adapted correction modes. The basics of the so-called derotation-manoeuvre consists in strategic distribution of the anchors along the curve, bending the rod accordingly, and rotating it back into the sagittal plane. The overall correction, stability and the fusion rates improved significantly. However, the effect on the sagittal and transverse plane were still limited. Lately, a better biomechanical understanding and bilateral, polysegmental strong three-column fixation with pedicle screw has become the benchmark method: in conjunction with posterior release techniques, osteotomies or even vertebral column resections for severe cases, it allows better 3D control (vertebral column manipulation), faster rehabilitation and better patient satisfaction.

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Institution‐wide shape analysis of 3D spinal curvature and global alignment parameters

Iriondo

Mehany

Shah

et al. 2021

Journal Orthopaedic Research

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The spine is an articulated, 3D structure with 6 degrees of translational and rotational freedom. Clinical studies have shown spinal deformities are associated with pain and functional disability in both adult and pediatric populations. Clinical decision making relies on accurate characterization of the spinal deformity and monitoring of its progression over time. However, Cobb angle measurements are time‐consuming, are limited by interobserver variability, and represent a simplified 2D view of a 3D structure. Instead, spine deformities can be described by 3D shape parameters, addressing the limitations of current measurement methods. To this end, we develop and validate a deep learning algorithm to automatically extract the vertebral midline (from the upper endplate of S1 to the lower endplate of C7) for frontal and lateral radiographs. Our results demonstrate robust performance across datasets and patient populations. Approximations of 3D spines are reconstructed from the unit normalized midline curves of 20,118 pairs of full spine radiographs belonging to 15,378 patients acquired at our institution between 2008 and 2020. The resulting 3D dataset is used to describe global imbalance parameters in the patient population and to build a statistical shape model to describe global spine shape variations in preoperative deformity patients via eight interpretable shape parameters. The developed method can identify patient subgroups with similar shape characteristics without relying on an existing shape classification system.

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Angle Measurement Reproducibility Using EOSThree-Dimensional Reconstructions in Adolescent Idiopathic Scoliosis Treated by Posterior Instrumentation

Cited by 148 publications

References 21 publications

Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system

Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system

A brief overview of 100 years of history of surgical treatment for adolescent idiopathic scoliosis

Institution‐wide shape analysis of 3D spinal curvature and global alignment parameters

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