Radiographic Estimation of Vertebral Rotation in Scoliosis

Mehta, M. H.

doi:10.1302/0301-620x.55b3.513

Cited by 64 publications

(29 citation statements)

References 3 publications

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“…The search for a precise analysis of vertebral rotation associated with scoliosis is hardly new: various methods have been described by Cobb [5], Nash and Moe [11], Perdriolle [12] or Mehta [13], all of which are based on evaluation of the relative position of posterior vertebral elements. Although Perdriolle's torsiometer became the most widely used in clinical practice, its reproducibility and accuracy are very limited [14].…”

Section: Introductionmentioning

confidence: 99%

Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results

Illés

Somoskeőy

2013

Eur Spine J

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Purpose A new concept of vertebra vectors based on spinal three-dimensional (3D) reconstructions of images from the EOS system, a new low-dose X-ray imaging device, was recently proposed to facilitate interpretation of EOS 3D data, especially with regard to horizontal plane images. This retrospective study was aimed at the evaluation of the spinal layout visualized by EOS 3D and vertebra vectors before and after surgical correction, the comparison of scoliotic spine measurement values based on 3D vertebra vectors with measurements using conventional twodimensional (2D) methods, and an evaluation of horizontal plane vector parameters for their relationship with the magnitude of scoliotic deformity. Methods 95 patients with adolescent idiopathic scoliosis operated according to the Cotrel-Dubousset principle were subjected to EOS X-ray examinations pre-and postoperatively, followed by 3D reconstructions and generation of vertebra vectors in a calibrated coordinate system to calculate vector coordinates and parameters, as published earlier. Conclusions Vertebra vectors provide a key opportunity to visualize spinal deformities in all three planes simultaneously. Measurement methods based on vertebral vectors proved to be just as accurate and reliable as conventional measurement methods for coronal and sagittal plane parameters. In addition, the horizontal plane display of the curves can be studied using the same vertebra vectors. Based on the vertebra vectors data, during the surgical treatment of spinal deformities, the diminution of the lateral translation of the vertebras seems to be more important in the results of the surgical correction than the correction of the axial rotation.

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Section: Introductionmentioning

confidence: 99%

Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results

Illés

Somoskeőy

2013

Eur Spine J

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“…Several authors [4, 5,7,8,19,20,24,32] have used a variety of geometrical formulae that take into account the diverse anatomical frames of the vertebrae as projected in coronal radiographs to develop a quantitative measurement of axial rotation, implicitly referred to the global referential system. Indeed, the concept of axial rotation of the scoliotic curve vertebrae requires a single referential system for all the vertebrae.…”

Section: Introductionmentioning

confidence: 99%

“…Subsequently, Grossiord et al [12] and Nash and Moe [21] showed that the position of the pedicle shadow with respect to those of the vertebral body wedges and the posterior arch provided a more sensitive index. They also showed that accurate calibration of the X-ray machine was most important, as the coronal view of the spine provides only a frontal projection of the vertebrae, and hence a qualitative evaluation of the axial rotation.Several authors [4, 5,7,8,19,20,24,32] have used a variety of geometrical formulae that take into account the diverse anatomical frames of the vertebrae as projected in coronal radiographs to develop a quantitative measurement of axial rotation, implicitly referred to the global referential system. Indeed, the concept of axial rotation of the scoliotic curve vertebrae requires a single referential system for all the vertebrae.…”

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confidence: 99%

Access to a three-dimensional measure of vertebral axial rotation

1998

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IntroductionThe spinal distortion that gives rise to a scoliotic curve includes both a rib hump and an axial rotation of the apical vertebra. The location and extent of axial rotation can provide considerable information on the nature of the deformity. The earliest method of detecting an axial rotation was from the lateral displacement of the shadow of the spinal process with respect to that of the vertebral body on coronal plain radiographs. Subsequently, Grossiord et al. [12] and Nash and Moe [21] showed that the position of the pedicle shadow with respect to those of the vertebral body wedges and the posterior arch provided a more sensitive index. They also showed that accurate calibration of the X-ray machine was most important, as the coronal view of the spine provides only a frontal projection of the vertebrae, and hence a qualitative evaluation of the axial rotation.Several authors [4, 5,7,8,19,20,24,32] have used a variety of geometrical formulae that take into account the diverse anatomical frames of the vertebrae as projected in coronal radiographs to develop a quantitative measurement of axial rotation, implicitly referred to the global referential system. Indeed, the concept of axial rotation of the scoliotic curve vertebrae requires a single referential system for all the vertebrae. The accuracy of these methods has been assessed [14,28,29,32,35] and the shadows of the anatomical features were found to be distorted [9, 25, 31 35]. These evaluations have also been compared to those drawn from CT scans and ultrasound images [1, 2,12,16,17,18,28], and it has been shown that the measurement technique must be standardized to allow the comparative assessment of findings [29].However, none of the above methods use sagittal data, consequently they do not produce a true three-dimensional (3D) measurement of the axial rotation of each vertebra. The 2D data provide what is referred to in this paper as "apparent rotation". True 3D measurements must also take into account the sagittal tilt of the vertebrae. This report analyses the concept of introduced rotation and its implications, and then describes a method of obtaining a true 3D evaluation of vertebral axial rotation.Abstract Scoliotic curvatures can only be assessed through three-dimensional (3D) procedures. Measurement of the axial vertebral rotation appears to be of primary importance for such techniques. Nevertheless, traditional methods are based only on 2D data, obtained through antero-posterior radiographic projections of the spine. A 3D method is described in this study, taking into account the sagittal tilt of the vertebrae. Only such a measurement provides a real 3D method for a true appraisal of the scoliotic spine. The practical implications are developed.

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“…The Cobb method was found suitable for measuring minor degrees of rotation (Mehta 1973). The methods of measuring rotation from the tip of processus spinosus (Cobb 1948) has been criticized (Nash & Moe 1969) as has the pedicle method of Nash & Moe (Benson et al 1976).…”

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confidence: 99%