Defining the “Three-Dimensional Sagittal Plane” in Thoracic Adolescent Idiopathic Scoliosis

Newton, Peter O.; Fujimori, Takahito; Doan, Joshua D.; Reighard, Fredrick G.; Bastrom, Tracey P.; Misaghi, Amirhossein

doi:10.2106/jbjs.o.00148

Cited by 94 publications

(59 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These authors also showed that routine 2D measurements of deformities underestimate the amount of Cobb angle because of the axial plane rotation. These techniques have the advantage that a software calculates a 3D reconstruction of the spine based on radiographs of the standing patient [20,21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis

Lechner

Putzer

Dammerer

et al. 2016

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The Cobb angle as an objective measure is used to determine the progression of deformity, and is the basis in the planning of conservative and surgical treatment. However, studies have shown that the Cobb angle has two limitations: an inter-and intraobserver variability of the measurement is approximately 3-5 degrees, and high variability regarding the definition of the end vertebra. Scoliosis is a three-dimensional (3D) pathology, and 3D pathologies cannot be completely assessed by two-dimensional (2D) methods, like 2D radiography. The objective of this study was to determine the intraobserver and interobserver reliability of end vertebra definition and Cobb angle measurement using X-rays and 3D computer tomography (CT) reconstructions in scoliotic spines. Methods To assess interoberver variation the Cobb angle and the end vertebra were assessed by five observers in 55 patients using X-rays and 3D CT reconstructions. Definition of end vertebra and measurement of the Cobb angle was repeated two times with a three-week interval. Intraclass correlation coefficients (ICC) were used to determine the interobserver and intraobserver reliabilities. 95% prediction limits were provided for measurement errors. Results Intraclass correlation coefficient (ICC) showed excellent reliability for both methods. The measured Cobb angle was on average 9.2 degrees larger in the 3D CT group (72.8°, range 30-144) than on 2D radiography (63.6°, range 24-152). Conclusions In scoliosis treatment it is very essential to determine the curve magnitude, which is larger in a 3D measurement compared to 2D radiography.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis

Lechner

Putzer

Dammerer

et al. 2016

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…3-D printing of spine models allows surgeons to more completely understand the anatomy of complex spinal deformities; facilitates better preparation for an operative intervention; and potentially minimizes operative time, blood loss, and the overall risk of neurologic injury. 10,11 We report our experience with additive manufacturing, specifically highlighting 3 complex cases in which our 3-D models were used for preoperative planning and for patient education.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Printed Patient Models for Complex Pediatric Spinal Surgery

Coote¹,

Nguyen²,

Tholen

et al. 2019

TOJ

View full text Add to dashboard Cite

Background: Pediatric spinal deformity surgeries are challenging operations that require considerable expertise and resources. The unique anatomy and rarity of these cases present challenges in surgical training and preparation. We present a case series illustrating how 3-dimensional (3-D) printed models were used in preoperative planning for 3 cases of pediatric spinal deformity surgery. Case Series: Patient 1 was a 6-year-old male with scoliosis secondary to an L3 hemivertebra and severe congenital heart disease who underwent excision of the L3 hemivertebra and L2-L4 spinal fusion. Patient 2 was an 11-year-old male with an L2 hemivertebra and lumbar kyphosis who underwent excision of the L2 hemivertebra and T12-L4 spinal fusion. Patient 3 was a 6-year-old female with Down syndrome who presented with atlantoaxial instability and acute lymphoblastic leukemia. She underwent occipitalcervical spinal fusion and decompression. Prior to surgery, 3-D printed models of the patients' spines were created based on computed tomography (CT) imaging. Conclusion: The anatomic complexity and risk of devastating neurologic consequences in spine surgery call for careful preparations. 3-D models enable more efficient and precise surgical planning compared to the use of 2-dimensional CT/magnetic resonance images. The 3-D models also make it easier to visualize patient anatomy, allowing patients and their families who lack medical training to interpret and understand cross-sectional anatomy, which in our experience, enhanced the consultations.

show abstract

“…19 This was partially demonstrated by Newton et al,20 who evaluated the angulation between each segment using EOS and observed segmental kyphosis in the curve that is underestimated by the standard radiographic technique. This shows that we have Iittle capacity to produce kyphosis using current posterior techniques, probably because of the conformation of the vertebrae in the structured curves (greater height of the vertebral body in the anterior region and in the convexity in relation to the posterior region and the concavity).…”

Section: Discussionmentioning

confidence: 90%

Evaluation of Cervical Alignment and Its Relationship With Thoracic Kyphosis and Spinopelvic Parameters After Scoliosis Correction Surgery

Daher

Pereira²,

Nascimento³

et al. 2017

Coluna/Columna

View full text Add to dashboard Cite

Objectives: To evaluate the cervical alignment after the correction of idiopathic scoliosis using high screw density and direct vertebral derotation (DVD) and to correlate it with thoracic kyphosis, spinopelvic parameters, and quality of life. Methods: Retrospective cohort study. We assessed the medical records and radiographs of patients submitted to idiopathic scoliosis surgery using high density of pedicular screws (80%) and DVD with at least 6 months of follow-up. All the radiographic parameters were evaluated in the preoperative period and in the last postoperative visit. Results: A total of 43 patients were evaluated, of which 35 (81%) were female. The mean age was 15 years (11 to 30 years) with a mean follow-up of one year and four months. Regarding Lenke's classification, 14 were of group 1, five of group 2, 10 of group 3, eight of group 4, four of group 5 and two of group 6. Only four patients had sagittal modifier (+) and two sagittal modifier (-).There was no significant difference between pre and postoperative thoracic kyphosis. When we evaluated the groups with +, N and -thoracic modifiers, we observed hypokyphotic and normokyphotic patients (-and N) had an increase in kyphosis, whereas hyperkyphotic patients (+)had a decrease. There was no statistical difference in relation to the radiographic parameters of the cervical spine in the pre and postoperative periods. There was a significant improvement in most of the parameters of the quality of life questionnaires, but no correlation with the cervical radiographic parameters. Conclusion: Correction of idiopathic scoliosis using a high density of pedicular screws and a direct vertebral derotation technique failed to improve thoracic kyphosis or change the cervical sagittal alignment, despite promoting a significant improvement in the parameters of quality of life questionnaires.Keywords: Scoliosis; Treatment outcome; Quality of life; Orthopedic fixation devices. RESUMO Objetivos: Avaliar o alinhamento cervical após a correção da escoliose idiopática utilizando alta densidade de parafusos e derrotação vertebral direta (DVD) e correlacionar com a cifose torácica, parâmetros espinopélvicos e qualidade de vida. Métodos: Estudo retrospectivo de coorte. Foram avaliados prontuários e radiografias de pacientes submetidos à cirurgia de escoliose idiopática utilizando alta densidade de parafusos pediculares (80%) e DVD com pelo menos seis meses de seguimento. Todos os parâmetros radiográficos foram avaliados no pré-operatório RESUMEN Objetivos: Evaluar la alineación cervical después de la corrección de la escoliosis idiopática utilizando alta densidad de tornillos y desrotación vertebral directa (DVD) y correlacionar con la cifosis torácica, parámetros espinopélvicos y calidad de vida. Métodos: Estudio retrospectivo de cohorte. Se evaluaron los historiales médicos y radiografías de pacientes sometidos a la cirugía de escoliosis idiopática utilizando alta densidad de tornillos pediculares (80%) y DVD con al menos seis meses de seguimiento. Todos los pará...

show abstract

Defining the “Three-Dimensional Sagittal Plane” in Thoracic Adolescent Idiopathic Scoliosis

Abstract: Routine 2-D measurements of thoracic kyphosis erroneously underestimate the preoperative loss of kyphosis in AIS because of errors associated with axial plane rotation, an inherent component of thoracic scoliosis.

Cited by 94 publications

References 20 publications

Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis

Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis

Three-Dimensional Printed Patient Models for Complex Pediatric Spinal Surgery

Evaluation of Cervical Alignment and Its Relationship With Thoracic Kyphosis and Spinopelvic Parameters After Scoliosis Correction Surgery

Contact Info

Product

Resources

About