Demonstration of vertebral and disc mechanical torsion in adolescent idiopathic scoliosis using three-dimensional MR imaging

Birchall, Daniel; Hughes, David G.; Gregson, Barbara; Williamson, Brad

doi:10.1007/s00586-004-0705-5

Cited by 36 publications

(20 citation statements)

References 24 publications

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“…Birchall et al [4] manually identified the landmarks according to the method of Ho et al and reported surprisingly low intra-and inter-observer variability of 0.4°SD (2.6°MAD) and 0.3°SD (3.0°MAD), respectively. In a later study [5], a total variability of 1.3°S D (0.8°MAD) was reported for the rotation of vertebral endplates. To obtain the rotation between two neighboring lumbar vertebrae, Haughton et al [10] matched two axial MR cross sections with a precision of around 0.5°.…”

Section: 0°1mentioning

confidence: 89%

“…1) were used to measure the AVR in 3D MR images. Although these methods were originally developed for orthogonal axial computed tomography (CT) cross sections, their application to MR cross sections is straightforward, as they are based on specific anatomical landmarks that can be identified in both CT and MR images [4,5]. As the sagittal and/or coronal vertebral tilt may introduce errors in the determination of AVR [13,18], the manual measurements were not performed in orthogonal, but in oblique, 2D axial MR cross sections.…”

Section: Manual Methodsmentioning

confidence: 99%

“…When compared to manual methods, computerized methods were reported to increase the accuracy and precision of the measurements [5,10,12,17,20], although still requiring some observer interaction. To the best of our knowledge, the intra-and inter-observer reliabilities of manual and/or computerized methods for measuring AVR in images acquired by magnetic resonance (MR) imaging have not been investigated yet.…”

Section: Introductionmentioning

confidence: 99%

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Determination of axial vertebral rotation in MR images: comparison of four manual and a computerized method

2010

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Axial vertebral rotation (AVR) of 14 normal and 14 scoliotic vertebrae from magnetic resonance (MR) images was determined by three observers using four manual methods and a computerized method, which were based on the evaluation of vertebral symmetry in two dimensions (2D) and in three dimensions (3D). The method of Aaro and Dahlborn proved to be the manual method with the highest intra-observer (1.7°SD) and inter-observer (1.2°SD) reliabilities, and was also most in agreement with the computerized method (1.3°SD, 1.0°MAD). The computerized method yielded higher intra-observer (1.3°S D) and inter-observer (1.4°SD) reliabilities than the manual methods, indicating it to be an efficient alternative for repeatable and reliable AVR measurements.

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Section: 0°1mentioning

confidence: 89%

Section: Manual Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determination of axial vertebral rotation in MR images: comparison of four manual and a computerized method

2010

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“…Therefore, alternative non-invasive, radiationfree, and reliable methods to study scoliosis are urgently sought. Magnetic resonance imaging (MRI) could reconstruct high-quality tomographic images of spinal vertebrae [17,18]. However, the use of MRI is costly and time consuming; therefore, its use to evaluate AIS still remains very limited.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Imaging of Spinal Vertebrae to Study Scoliosis

Chen

Lou

2012

OJA

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Scoliosis is a musculoskeletal disorder manifested as a three-dimensional spinal deformity. It affects 2% -3% of the adolescent population. The conventional method to diagnose scoliosis is to measure the Cobb angle from posteroanterior radiograph. Since radiation exposure is not desirable for patients, other non-ionizing methods have been explored. Among all the non-ionization methods, ultrasound (US) is a potential cost-effective method. However, our understanding of US interaction with the vertebrae or the spine is limited. The purpose of this study was to demonstrate the ability of US to identify bony landmarks for measuring spinal deformity. This study used a phased array US system with a 5 MHz transducer and a position encoder. In-vitro experiment on a cadaver vertebra and a pilot clinical study were carried out. The in-vitro experimental results showed that the lamina and spinous process were strong reflectors from the single vertebra. Less than 4% of error occurred on the dimension measurements. The pilot study was performed on a healthy subject and a scoliotic patient. The results indicated the lamina and spinous process could be identified and the curvature of the spine could be estimated using the reflectors. The difference of the curvature angle of the spine measured from the radiograph and the US images was 2˚. These results have illustrated that US is a promising tool to measure curvature of spinal deformity and study scoliosis.

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“…3, 4). Given a good match of the preoperative and operative variables between the N-and A-groups (the normal and the pelvic rotational patients), our interpretation of the postoperative coronal decompensation could be the instability of the spine foundation (i.e., the pelvis) outside the areas of instrumentation [35]. From a biomechanical point of view, the spine and pelvis linking the head to the lower extremities could be regarded as a chain [36].…”

Section: Pelvic Axial Rotation (Par)mentioning

confidence: 99%

Preoperative pelvic axial rotation: a possible predictor for postoperative coronal decompensation in thoracolumbar/lumbar adolescent idiopathic scoliosis

et al. 2013

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Background The pelvis as the biomechanical foundation of spine, plays an important role in the balance of the stance and gait through the multi-link spinal-pelvic system. If the pelvic axial rotation (PAR) exists in adolescent idiopathic scoliosis (AIS) patients, it should theoretically have some effects on the body balance. Purpose To explore the probable effects of preoperative PAR on the spinal balance in coronal plane in AIS patients with main thoracolumbar/lumbar (TL/L) curve after posterior spinal instrumentation. Methods Thirty-eight AIS patients (age: 15 ± 1.5 years) with main TL/L curve (51°± 6.2°) were recruited retrospectively into this study. The mean follow-up period was 27 months (24-36 months). Standing full spine posteroanterior radiographs were taken preoperatively, 3 month and 1 year postoperatively, and at last follow-up. The convex/concave ratio (CV/CC ratio) of the anterior superior iliac spine laterally and the inferior ilium at the sacroiliac joint medially was measured on posteroanterior radiographs. According to the preoperative CV/CC ratios, the patients were divided into two groups: normal group (N-group: 0.95 B CV/CC B 1.05); and the asymmetrical group (A-group: CV/CC \ 0.95, or [1.05). Results In all the patients, the 3-month-postoperative CV/ CC ratio (1.026 ± 0.087) was significantly different from the preoperative CV/CC ratio (0.969 ± 0.095, P \ 0.001), indicating that the pelvis had rotated in the opposite direction of the corrective derotation load applied to the TL/L spine after surgery. No significant change was found in the CV/CC ratio from 3-month-postoperative to the last follow-up (1.013 ± 0.103, P [ 0.05). There was no significant difference in the demographic, phenotypic, and treatment variables between the N-(n = 16) and A-groups (n = 22) (P [ 0.05). However, more coronal decompensation occurred in the A-group after surgery (36.4 vs. 0.0 %, P = 0.013): two patients having trunk translation, three having lower instrumented vertebra (LIV) translation, and one having LIV tilt; meanwhile, one patient having both LIV translation and LIV tilt, and one having both trunk translation and LIV tilt. Conclusions The present study confirmed the existence of PAR in AIS patients, and indicated that the pelvis would experience an active rebalancing in the transverse plane within 3 months after spinal correction, and since then, its position would remain stable. Moreover, TL/L-AIS patients with preoperative asymmetrical PAR probably had greater risk of coronal decompensation postoperatively.

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Demonstration of vertebral and disc mechanical torsion in adolescent idiopathic scoliosis using three-dimensional MR imaging

Cited by 36 publications

References 24 publications

Determination of axial vertebral rotation in MR images: comparison of four manual and a computerized method

Determination of axial vertebral rotation in MR images: comparison of four manual and a computerized method

Ultrasound Imaging of Spinal Vertebrae to Study Scoliosis

Preoperative pelvic axial rotation: a possible predictor for postoperative coronal decompensation in thoracolumbar/lumbar adolescent idiopathic scoliosis

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