How well do Radiologic Assessments of Truncal and Shoulder Balance Correlate With Cosmetic Assessment Indices in Lenke 1C Adolescent Idiopathic Scoliosis?

Sharma, Shallu; Andersen, Thomas; Wu, Chunsen; Sun, Haolin; Wang, Yu; Hansen, Ebbe Stender; Bünger, Cody

doi:10.1097/bsd.0000000000000134

Cited by 16 publications

(7 citation statements)

References 28 publications

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“…This suggests that the shoulder girdle is compensating for an asymmetry of the underlying torso (demonstrated by the difference in position of the right and left axillae). The independence of movement of the shoulder girdle relative to the torso may well explain why there is moderate to poor correlation of the intraoperative radiographic features of shoulder position to the post-operative shoulder position [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

The effects of scoliosis and subsequent surgery on the shape of the torso

2017

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BackgroundAdolescent idiopathic scoliosis (AIS) causes asymmetry of the torso, and this is often the primary concern of patients. Surgery aims to minimise the visual asymmetry. It is not clear how scoliosis makes the torso asymmetric or how scoliosis surgery changes that asymmetry when compared to the distribution of asymmetries seen in a non-scoliotic group of normal controls.MethodsSurface topography images were captured for a group with AIS both pre-operatively and post-operatively. Identifiable points were compared between the images to identify the effects of AIS on the shape of the torso by looking at the relative heights and distances from the midline of the shoulders, axillae and waist in a two-dimensional coronal view. This was then compared to a previously reported group of normal non-scoliotic children to analyse whether surgery recreated normality.ResultsThere were 172 pairs of images with 164 females and 8 males, mean age at pre-operative scan of 13.7 years. The normal group was 642 images (237 females and 405 males) from 116 males and 79 females, mean age of 12.5 years.The curve patterns seen in the scoliotic group matched the patterns of a main thoracic curve (n = 146) and main thoracolumbar curve (n = 26). The asymmetries seen in both shoulders, axillae and waist were different between the two different types of curve. Across both groups, the shoulder asymmetry was less than that of the corresponding axillae.There was a statistically significant reduction in all asymmetries following surgery in the main thoracic group (p < 0.001). This was not seen in the main thoracolumbar group, thought to be due to the small sample size. In the main thoracic group, there were statistically significant differences in the asymmetries between the post-operative and normal groups in the shoulders and axillae (p < 0.001) but not the waist.ConclusionsThis paper demonstrates quantitatively the range of asymmetries seen in the AIS torso and the degree to which surgery alters them. Surgery does not recreate normality but does cause a statistically significant change in torso shape towards that seen in a non-scoliotic group.

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Section: Discussionmentioning

confidence: 99%

The effects of scoliosis and subsequent surgery on the shape of the torso

2017

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“…Achieving shoulder balance after spinal scoliosis correction surgery is the goal of many surgeons and is also pursued by patients and their families. Shallu Sharma once pointed out in his research that in addition to influencing clinical and functional outcomes, trunk/shoulder deformity contributes substantially to negative self-image, psychological distress and concerns over body development ( 15 ). There have been many studies on shoulder imbalance after spinal scoliosis correction surgery, such as studies that determined the appropriate T1 tilt angle ( 14 , 16 , 17 ), studies that determined the appropriate correction of the MT curve ( 18 , 19 ), studies that evaluated the corresponding measures for different preoperative shoulder level differences ( 20 ) and studies that evaluated the selection of the UIV for upper fixation vertebra ( 18 , 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis and clinical significance of changes in upper thoracic vertebra tilt and clavicle angle pre- and post-operation

Jiang,

Wang,

Cui

et al. 2024

Front. Surg.

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The imbalance of the lateral shoulder is reflected by the clavicle angle (CA) in radiology. It remains unclear how to achieve postoperative lateral shoulder balance (LSB) after spinal deformity correction surgery. A retrospective analysis was conducted on AIS patients who underwent surgery by the same spine surgeon at our hospital from 2016 to 2020. A total of 110 patients with spinal deformity were included in the study to verify the correlation between the T1–T5 tilt angle and CA before and after surgery, as well as the relation-ship between the change in T1–T5 tilt angle before and after surgery and the change in CA before and after surgery. By comparing the correlation coefficients, it was found that there may not be a direct relationship between the pre- and postoperative tilt angles of T1–5 and CA, but their changes were closely related to the changes in CA. The change in T1 tilt angle after orthopaedic surgery was significantly correlated with the change in CA, with a correlation coefficient of 0.976, indicating a close relationship between T1 and the clavicle. As the vertebrae moved down, the correlation gradually decreased. In summary, this study suggests that there is a close relationship between T1–T5 and the clavicle and that the change in T1 tilt angle after spinal scoliosis correction surgery is significantly correlated with CA, which decreases as the vertebra moves down.

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“…Clinical photographs have shown consistency in image analysis and correlations with body self-perception, radiographic angular measurements, and quantifiable image scales (such as TAPS) [20,21]. The current limitation for its universal use is the lack of automatic software that can reliably measure these photographs [18,22].…”

Section: Introductionmentioning

confidence: 99%

Reliability of a New Digital Tool for Photographic Analysis in Quantifying Body Asymmetry in Scoliosis

Pizones,

Moreno-Manzanaro,

Pupak

et al. 2024

JCM

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Background: Advancements in non-ionizing methods for quantifying spinal deformities are crucial for assessing and monitoring scoliosis. In this study, we analyzed the observer variability of a newly developed digital tool for quantifying body asymmetry from clinical photographs. Methods: Prospective observational multicenter study. Initially, a digital tool was developed using image analysis software, calculating quantitative measures of body asymmetry. This tool was integrated into an online platform that exports data to a database. The tool calculated 10 parameters, including angles (shoulder height, axilla height, waist height, right and left waistline angles, and their difference) and surfaces of the left and right hemitrunks (shoulders, waists, pelvises, and total). Subsequently, an online training course on the tool was conducted for twelve observers not involved in its development (six research coordinators and six spine surgeons). Finally, 15 standardized back photographs of adolescent idiopathic scoliosis patients were selected from a multicenter image bank, representing various clinical scenarios (different age, gender, curve type, BMI, and pre- and postoperative images). The 12 observers measured the photographs at two different times with a three-week interval. For the second round, the images were randomly mixed. Inter- and intra-observer variabilities of the measurements were analyzed using intraclass correlation coefficients (ICCs), and reliability was measured by the standard error of measurement (SEM). Group comparisons were made using Student’s t-test. Results: The mean inter-observer ICC for the ten measurements was 0.981, the mean intra-observer ICC was 0.937, and SEM was 0.3–1.3°. The parameter with the strongest inter- and intra-observer validity was the difference in waistline angles 0.994 and 0.974, respectively, while the highest variability was found with the waist height angle 0.963 and 0.845, respectively. No test–retest differences (p > 0.05) were observed between researchers (0.948 ± 0.04) and surgeons (0.925 ± 0.05). Conclusion: We developed a new digital tool integrated into an online platform demonstrating excellent reliability and inter- and intra-observer variabilities for quantifying body asymmetry in scoliosis patients from a simple clinical photograph. The method could be used for assessing and monitoring scoliosis and body asymmetry without radiation.

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How well do Radiologic Assessments of Truncal and Shoulder Balance Correlate With Cosmetic Assessment Indices in Lenke 1C Adolescent Idiopathic Scoliosis?

Cited by 16 publications

References 28 publications

The effects of scoliosis and subsequent surgery on the shape of the torso

The effects of scoliosis and subsequent surgery on the shape of the torso

Correlation analysis and clinical significance of changes in upper thoracic vertebra tilt and clavicle angle pre- and post-operation

Reliability of a New Digital Tool for Photographic Analysis in Quantifying Body Asymmetry in Scoliosis

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