Are we simplifying balance evaluation in adolescent idiopathic scoliosis?

Pasha, Saba; Baldwin, Keith

doi:10.1016/j.clinbiomech.2017.11.011

Cited by 19 publications

(7 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 3D analysis of the spine has shown promising results in terms of determining subgroups of patients pre-operatively 33 , 34 . Given the importance of the 3D spinal curvature in postural assessment of the AIS patient 35 , 36 , a low-dimensional model that facilitates comparison between the 3D spinal shapes can improve the curve classification in AIS patients. The spinal evaluation in the three anatomical planes has underlined the parameters associated with the surgical outcome in AIS, which were not evident via the 2D evaluation of the spine 9 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Data-driven Classification of the 3D Spinal Curve in Adolescent Idiopathic Scoliosis with an Applications in Surgical Outcome Prediction

Pasha

Flynn

2018

Sci Rep

Self Cite

View full text Add to dashboard Cite

Adolescent idiopathic scoliosis (AIS) is a three-dimensional (3D) deformity of the spinal column. For progressive deformities in AIS, the spinal fusion surgery aims to correct and stabilize the deformity; however, common surgical planning approaches based on the 2D X-rays and subjective surgical decision-making have been challenged by poor clinical outcomes. As the suboptimal surgical outcomes can significantly impact the cost, risk of revision surgery, and long-term rehabilitation of adolescent patients, objective patient-specific models that predict the outcome of different treatment scenarios are in high demand. 3D classification of the spinal curvature and identifying the key surgical parameters influencing the outcomes are required for such models. Here, we show that K-means clustering of the isotropically scaled 3D spinal curves provides an effective, data-driven method for classification of patients. We further propose, and evaluate in 67 right thoracic AIS patients, that by knowing the patients’ pre-operative and early post-operation clusters and the vertebral levels which were instrumented during the surgery, the two-year outcome cluster can be determined. This framework, once applied to a larger heterogeneous patient dataset, can further isolate the key surgeon-modifiable parameters and eventually lead to a patient-specific predictive model based on a limited number of factors determinable prior to surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Data-driven Classification of the 3D Spinal Curve in Adolescent Idiopathic Scoliosis with an Applications in Surgical Outcome Prediction

Pasha

Flynn

2018

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Considering the importance of the 3D alignment of the spine on the postural balance and surgical outcome [ 15 , 16 ], the current study aimed to develop a 3D classification of the spinal curve in right thoracic AIS patients, the most common scoliotic curve type. A hierarchical classification that allows identifying the differentiating features of the spinal curve in an orderly fashion was investigated.…”

Section: Introductionmentioning

confidence: 99%

A hierarchical classification of adolescent idiopathic scoliosis: Identifying the distinguishing features in 3D spinal deformities

et al. 2019

Self Cite

View full text Add to dashboard Cite

This study aimed to identify the differentiating parameters of the spinal curves’ 2D projections through a hierarchical classification of the 3D spinal curve in adolescent idiopathic scoliosis (AIS). A total number of 103 right thoracic left lumbar pre-operative AIS patients were included retrospectively and consecutively. A total number of 20 non-scoliotic adolescents were included as the control group. All patients had biplanar X-rays and 3D reconstructions of the spine. The 3D spinal curve was calculated by interpolating the center of vertebrae and was isotropically normalized. A hierarchical classification of the normalized spinal curves was developed to group the patients based on the similarity of their 3D spinal curve. The spinal curves’ 2D projections and clinical spinal measurements in the three anatomical planes were then statistically compared between these groups and between the scoliotic subtypes and the non-scoliotic controls. A total of 5 patient groups of right thoracic left lumbar AIS patients were identified. The characteristics of the posterior-anterior and sagittal views of the spines were: Type 1: Normal sagittal profile and S shape axial view. T1 is leveled or tilted to the right in the posterior view. Type 2: Hypokyphotic and a V shape axial view. T1 is tilted to the left in the posterior view. Type 3: Hypokyphotic (only T5-T10) and frontal imbalance, S shape axial view. T1 is leveled or tilted to the right, and 3 frontal curves. Type 4: Flat sagittal profile (T1-L2), slight frontal imbalance with a V shape axial view, T1 tilted to the left. Type 5: flat sagittal profile and forward trunk shift with a proximal kyphosis and S shape axial view. T1 is leveled or tilted to the right. In conclusion, a hierarchical classification of the 3D scoliotic spine allowed identifying various distinguishing features of the spinal curves in patients with a right thoracic curve in an orderly fashion. The subtypes’ characteristics resulting from this 3D classification can be identified from the pairs of the frontal and sagittal spinal curves i.e. X-rays in right thoracic AIS patients.

show abstract

“…Adolescent idiopathic scoliosis (AIS) manifests as a three-dimensional (3D) deformity of the spinal column that occurs around puberty. Several factors such as genetics 1,2 , biomechanics 3 , morphology of the vertebral bones, intervertebral disc, and muscle physiology 4–9 , hormones 10,11 , environmental factors 12,13 , and neural system deficiencies 14,15 are considered as the underlying cause of the spinal deformity in AIS. While each of these factors explained part of the pathogenesis of this disease, none have proved to be its main or primary cause.…”

Section: Introductionmentioning

confidence: 99%

3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

Pasha

2019

Sci Rep

Self Cite

View full text Add to dashboard Cite

Adolescent idiopathic scoliosis (AIS) is a three-dimensional (3D) deformity of the spinal column in pediatric population. The primary cause of scoliosis remains unknown. The lack of such understanding has hampered development of effective preventive methods for management of this disease. A long-held assumption in pathogenesis of AIS is that the upright spine in human plays an important role in induction of scoliosis. Here, the variations in the sagittal curve of the scoliotic and non-scoliotic pediatric spines were used to study whether specific sagittal curves, under physiological loadings, are prone to 3D deformation leading to scoliosis. To this end, finite element models of the S shaped elastic rods, which their curves were derived from the radiographs of 129 sagittal spinal curves of adolescents with and without scoliosis, were generated. Using the mechanics of deformation in elastic rods, this study showed that the 3D deformation patterns of the two-dimensional S shaped slender elastic rods mimics the 3D patterns of the spinal deformity in AIS patients with the same S shaped sagittal spinal curve. On the other hand, the rods representing the non-scoliotic sagittal spinal curves, under the same mechanical loading, did not twist thus did not lead to a 3D deformation. This study provided strong evidence that the shape of the sagittal profile in individuals can be a leading cause of the 3D spinal deformity as is observed in the AIS population.

show abstract

Are we simplifying balance evaluation in adolescent idiopathic scoliosis?

Cited by 19 publications

References 36 publications

Data-driven Classification of the 3D Spinal Curve in Adolescent Idiopathic Scoliosis with an Applications in Surgical Outcome Prediction

Data-driven Classification of the 3D Spinal Curve in Adolescent Idiopathic Scoliosis with an Applications in Surgical Outcome Prediction

A hierarchical classification of adolescent idiopathic scoliosis: Identifying the distinguishing features in 3D spinal deformities

3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

Contact Info

Product

Resources

About