In vivo three-dimensional segmental analysis of adolescent idiopathic scoliosis

Abstract

Introduction An accurate assessment of three-dimensional (3D) intervertebral deviation is crucial to the better surgical correction of adolescent idiopathic scoliosis (AIS).However, a precise 3D study of intervertebral deviation has not been previously reported. Objective The purpose of the present study is to evaluate the intervertebral coronal inclination, axial rotation and sagittal angulation of AIS using 3D bone models and a local coordinate system. Materials and methods 3D bone models of the thoracic and lumbar spine of ten AIS patients were constructed using computed tomography. The local coordinate axis was determined semi-automatically for each vertebra. By using these local coordinates, the intervertebral deviation angles were calculated in the coronal, axial and sagittal planes and projected to subjacent local coordinates. Result The intervertebral deformity in the coronal plane was larger near the apical region and smaller near the junctional region. Conversely, the intervertebral rotation in the axial plane was smaller near the apical region, and larger near the junctional region. Concerning the sagittal plane deformity, the constant tendency was not recognized. Conclusion Using a local coordinate system for the vertebra of AIS, we measured the 3D intervertebral coronal, axial and sagittal deviation of the thoracolumbar spine and found that the change in the intervertebral inclination angle in the coronal plane increased toward the apical region and decreased toward the junctional region, and that the converse tendency was noted for the axial intervertebral rotational angle. This analysis provides an improved 3D guide for the surgical correction of AIS.

Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system

“…Preliminary 3D assessment of intervertebral deviation has already been performed by Hattori et al [26] using bone models, but stereoradiography allows a routine clinical use. The images of scoliosis patients in the standing position, provided by the new EOS imaging device and its 3D reconstruction software (SterEOS, EOS imaging, Paris, France), contribute substantially to understanding of both preoperative scoliotic deformities and postoperative correction.…”

Effect of three-dimensional rotational deformity correction in surgery for adult degenerative scoliosis using lumbar lateral interbody fusion and posterior pedicle screw fixation

“…Effect of three-dimensional rotational deformity correction in surgery for adult degenerative scoliosis using lumbar lateral interbody fusion and posterior pedicle screw fixation Ryota Takatori 1) , Taku Ogura 2) , Wataru Narita 3) , Tatsuro Hayashida 2) , Kazuya Tanaka 2) , Hitoshi Tonomura 1) , Masateru Nagae 1)…”

“…In radiological evaluation, rotational deformities in the frontal plane can be assessed as scoliosis, typified by a large Cobb angle, and rotational deformities in the sagittal plane are evaluated as kyphosis; however, it is difficult to quantitatively evaluate rotational deformities in the axial plane using a radiograph. These deformities can be evaluated using CT axial images or the EOS ® 2D/3D X-ray imaging system [2][3][4][5][6] . The utility of three-dimensional (3D) image analysis for adolescent idiopathic scoliosis has been recently reported 2,5,6) .…”

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

“…Adolescent idiopathic scoliosis is typically defined as a structural, lateral, rotated curvature of the spine that arises in otherwise healthy children at or around puberty [1,2,27]. However, other extra-spinal skeletal asymmetries [7,[28][29][30] such as a relative lengthening upper limb on the convexity have been reported.…”