The Effects of Adolescent Idiopathic Scoliosis on Axial Rotation of the Spine: A Study of Twisting Using Surface Topography

Abstract

Axial twisting of the spine has been previously shown to be affected by scoliosis with decreased motion and asymmetric twisting. Existing methods for evaluating twisting may be cumbersome, unreliable, or require radiation exposure. In this study, we present an automated surface topographic measurement tool to evaluate global axial rotation of the spine, along with two measurements: twisting range of motion (TROM) and twisting asymmetry index (TASI). The aim of this study is to evaluate the impact of scoliosis on axial range of motion. Adolescent idiopathic scoliosis (AIS) patients and asymptomatic controls were scanned in a topographic scanner while twisting maximally to the left and right. TROM was significantly lower for AIS patients compared to control patients (69.1° vs. 78.5°, p = 0.020). TASI was significantly higher for AIS patients compared to control patients (29.6 vs. 19.8, p = 0.023). After stratifying by scoliosis severity, both TROM and TASI were significantly different only between control and severe scoliosis patients (Cobb angle > 40°). AIS patients were then divided by their major curve region (thoracic, thoracolumbar, or lumbar). ANOVA and post hoc tests showed that only TROM is significantly different between thoracic AIS patients and control patients. Thus, we demonstrate that surface topographic scanning can be used to evaluate twisting in AIS patients.

Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility

“…Recent studies utilizing this system have shown a noteworthy distinction in axial motion between individuals with and without scoliosis. The research findings further indicate significant differences, both in cases of severe scoliosis compared to the control group and in cases of thoracic scoliosis compared to controls [58]. Another study conducted using the same system reveals that patients with severe structural deformity and restricted range of motion do not exhibit a decrease in their physical activity level, as indicated by validated patient activity questionnaires [59].…”

Exploring Correlations Between Pain and Deformity in Idiopathic Scoliosis With Validated Self-reported Pain Scores, Radiographic Measurements, and Trunk Surface Topographic Measurements

“…1C), shoulder volume asymmetry, centroid lateral displacement (Fig. 1B); range of motion (ROM) measures were also included: 10 coronal angle ROM, forward sagittal angle, C7 twisting ROM, C7 twisting asymmetry index (Fig. 3).…”

“…demonstrated reliability for assessing deformity, symmetry, and range of motion for IS, [9][10][11] and may be useful in objectively assessing a patient's deformity and its association with pain. A previous study identified that Scoliosis Research Society (SRS)-22r mental health and self-image domains correlate poorly with surface topographical measures of deformity; 12 however, the pain domain was not assessed.…”

“…The correlation between biopsychosocial factors, self-image, and pain in IS begs the question of whether there is an objective aspect of physical deformity that is linked to pain or if the correlation is more reliant on a patient’s perception of his or her image. Surface topography (ST) has demonstrated reliability for assessing deformity, symmetry, and range of motion for IS, 9–11 and may be useful in objectively assessing a patient’s deformity and its association with pain. A previous study identified that Scoliosis Research Society (SRS)-22r mental health and self-image domains correlate poorly with surface topographical measures of deformity; 12 however, the pain domain was not assessed.…”