Computer-Generated, Three-Dimensional Spine Model From Biplanar Radiographs: A Validity Study in Idiopathic Scoliosis Curves Greater Than 50 Degrees

Carreau, Joseph H.; Bastrom, Tracey P.; Petcharaporn, Maty; Schulte, Caitlin; Marks, Michelle; Illés, Tamás; Somoskeőy, Szabolcs; Newton, Peter O.

doi:10.1016/j.jspd.2013.10.003

Cited by 39 publications

(13 citation statements)

References 9 publications

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“…Here the used specimen with a moderate scoliosis of 47°and a rotation of the apical vertebra of -14°revealed no clinically relevant change of the Cobb angle at rotational misalignments of ±20°in relation to a neutral plane. This model confirmed the reasonable reliability of Cobb angle and vertebral rotation measurements even with a rotational positioning error of ±20°within CR, BLR, and 3D model measurements based on BLR using CT as the reference standard [4,5,[15][16][17][18][19]. The error for Cobb angle measurements in this study between the different modalities at the neutral plane was 3°, which lies within the known intra-observer variation of ±5° [6][7][8][9].…”

Section: Discussionsupporting

confidence: 78%

Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve

et al. 2015

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Background The Cobb angle measurement is well established for the measurement of coronal deformity aspect of scoliotic curves. The effect of positional differences in relation to the apex side of the scoliosis is not yet fully quantified. While theoretically plausible that positioning error with rotation toward the apex of the scoliosis would decrease the Cobb angle, the relations are not investigated yet and were object of this study. Materials and methods Multiple measurements of the Cobb angle were performed, while turning a spine-pelvic cadaveric specimen with a right-sided thoracic scoliosis of 47°(in neutral position) from 45°to -45°in steps of 5°u sing biplanar radiography. Statistical methods were applied to find the critical position, in which measurement errors potentially become clinically relevant (Cobb angle deviation [5°). Results Turning the specimen to the right (toward the apex of the scoliosis) produced during the first -15°of rotation, a Cobb angle ranging from 47°to 45°. At -20°, the Cobb angle was 42°, at -25°rotation 37°and at -30°r otation 36°. Above -30°rotation, the measured Cobb angle decreased to 36°(77 % of the original Cobb angle). No relevant differences were found by rotating the specimen to the left (away from the apex) (47°at neutral rotation and 44°at maximal error rotation of ?45°). Conclusion The influence of rotational misplacement of the patient at the time of image acquisition on Cobb angle measurements is negligible for a rotational misplacement of ±20°of rotation for a idiopathic right-sided thoracic scoliosis of 47°. Over 20°of rotational misplacement of the patient toward the apex of the scoliosis falsely decreases the Cobb angle.

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Section: Discussionsupporting

confidence: 78%

Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve

et al. 2015

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“…In the present study, we investigated sagittal whole body skeletal alignment and standing balance used a scanning X-ray imager with a biplanar upright scanning imaging modality to achieve reduced X-ray particle scatter, improved image quality, and significantly reduced radiation to the patient [10,11,14]. While artifacts in the images due to body sway during scanning may affect the measurements, these are minimized by the rapid scan rate (7.6 cm/s) and X-ray detection time (every 0.8333 ms).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, subtle artifacts in the images can occur due to body sway during scanning, but the artifacts are minimized because of the rapid X-ray detection time (0.8333 ms) with no blurring of the images. The radiographs [10,14] were completed routinely and the track of the center of gravity was simultaneously recorded using a force plate as follows:…”

Section: Alignment and Balance Measurementsmentioning

confidence: 99%

Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects

Hara¹,

Okamoto²,

et al. 2016

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Purpose To elucidate the normative values of whole body sagittal alignment and balance of a healthy population in the standing position; and to clarify the relationship among the alignment, balance, health-related quality of life (HRQOL), and age. Methods Healthy Japanese adult volunteers [n = 126, mean age 39.4 years (20-69), M/F = 30/96] with no history of spinal disease were enrolled in a cross-sectional cohort study. The Oswestry Disability Index (ODI) questionnaire was administered and subjects were scanned from the center of the acoustic meati (CAM) to the feet while standing on a force plate to determine the gravity line (GL), and the distance between CAM and GL (CAM-GL) was measured in the sagittal plane. Standard X-ray parameters were measured from the head to the lower extremities. ODI was compared among age groups stratified by decade. Correlations were investigated by simple linear regression analysis. Ideal lumbar lordosis was investigated using the least squares method. Results The present study yielded normative values for whole standing sagittal alignment including head and lower extremities in a cohort of 126 healthy adult volunteers, comparable to previous reports and thus a formula for ideal lumbar lordosis was deduced: LL = 32.9 ? 0.60 9 PI -0.23 9 age. There was a tendency of positive correlation between McGregor slope, thoracic kyphosis, PT, and age. SVA, T1 pelvic angle, sacrofemoral angle, knee flexion angle, and ankle flexion angle, but not CAM-GL, increased with age, suggesting that the spinopelvic alignment changes with age, but standing whole body alignment is compensated for to preserve a horizontal gaze. ODI tended to increase from the 40s in the domain of pain intensity, personal care, traveling, and total score. ODI weakly, but significantly positively correlated with age and PI-LL. Conclusion Whole body standing alignment even in healthy subjects gradually deteriorates with age, but is compensated to preserve a horizontal gaze. HRQOL is also affected by aging and spinopelvic malalignment.

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“…Routine radiographs were obtained using the EOS system (Dubousset et al 2005;Carreau et al 2014), and tracking of the centre of gravity using a force plate was simultaneously recorded as follows.…”

Section: Radiological Measurementmentioning

confidence: 99%

Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans

Hara¹,

Okamoto²,

et al. 2017

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Human beings stand upright with the chain of balance beginning at the feet, progressing to the lower limbs (ankles, knees, hip joints, pelvis), each of the spinal segments, and then ending at the cranium to achieve horizontal gaze and balance using minimum muscle activity. The details of the alignment and balance of the chain, however, are not clearly understood, due to the lack of information regarding the three‐dimensional (3D) orientation of all bony elements in relation to the gravity line (GL). We performed a clinical study to clarify the standing sagittal alignment of whole axial skeletons in reference to the GL using the EOS slot‐scanning 3D X‐ray imaging system with simultaneous force plate measurement in a healthy human population. The GL was defined as a vertical line drawn through the centre of vertical pressure measured by the force plate. The present study yielded a complete set of physiological alignment measurements of the standing axial skeleton from the database of 136 healthy subjects (a mean age of 39.7 years, 20–69 years; men: 40, women: 96). The mean offset of centre of the acoustic meati from the GL was 0.0 cm. The offset of the cervical and thoracic vertebrae was posterior to the GL with the apex of thoracic kyphosis at T7, 5.0 cm posterior to the GL. The sagittal alignment changed to lordosis at the level of L2. The apex of the lumbar lordosis was L4, 0.6 cm anterior to the GL, and the centre of the base of the sacrum (CBS) was just posterior to the GL. The hip axis (HA) was 1.4 cm anterior to the GL. The knee joint was 2.4 cm posterior and the ankle joint was 4.8 cm posterior to the GL. L4‐, L5‐ and the CBS‐offset in subjects in the age decades of 40s, 50s and 60s were significantly posterior to those of subjects in their 20s. The L5‐ and CBS‐offset in subjects in their 50s and 60s were also significantly posterior to those in subjects in their 30s. HA was never posterior to the GL. In the global alignment, there was a positive correlation between offset of C7 vertebra from the sagittal vertical axis (a vertical line drawn through the posterior superior corner of the sacrum in the sagittal plane) and age, but no correlation was detected between the centre of the acoustic meati‐GL offset and age. Cervical lordosis (CL), pelvic tilt (PT), pelvic incidence, hip extension, knee flexion and ankle dorsiflexion increased significantly with age. Our results revealed that aging induces trunk stooping, but the global alignment is compensated for by an increase in the CL, PT and knee flexion, with the main function of CL and PT to maintain a horizontal gaze in a healthy population.

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Computer-Generated, Three-Dimensional Spine Model From Biplanar Radiographs: A Validity Study in Idiopathic Scoliosis Curves Greater Than 50 Degrees

Abstract: SterEOS 3D reconstruction spine software creates reproducible measurements in all 3 planes of deformity in curves greater than 50°. Advancements in 3D scoliosis imaging are expected to improve our understanding and treatment of idiopathic scoliosis.

Cited by 39 publications

References 9 publications

Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve

Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve

Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects

Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans

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