Three-dimensional reconstructions of Lenke 1A curves

Abstract

BackgroundScoliosis is a 3D deformity that can be reconstructed through 2D antero-posterior and lateral radiographs, which provide an upper view of the deformed spine as well as regional planes matching all vertebrae of elective plane for each curve. The objective of this study is to explore whether all idiopathic scoliosis classified Lenke 1A have the same 3D representation made with regional planes.MethodsAll patients treated for idiopathic thoracic scoliosis during the growth period and classified Lenke 1A were included in this study conducted in the pediatric spinal orthopedic department of Centre des Massues. A photogrammetric technique was used to obtain a 3D reconstruction, from regional planes identified on radiographs made with the EOS system. Three regional planes are usually identified in asymptomatic spines: lumbar, dorsal, and cervical—none of them presenting rotation. In the studied group, the number of planes, the rotation, and the limit vertebrae of each plane were looked for.ResultsSixty-three patients were included (47 girls and 16 boys, mean age 11.3 years). The Cobb angle was meanly 36.5°. The scoliosis was reconstructed with three regional planes (57%) or four ones (43%, with the thoracic plane divided into two planes). Maximal rotation was found in the thoracic plane, especially when scoliosis was represented with four regional planes. The transition between planes 2 and 3 was mainly located between the fourth and sixth dorsal vertebrae.ConclusionThe use of an arbitrary regional plane representation of a 3D shape leads to conclude that there are two types of Lenke 1A scoliosis, which should be taken into account for designing the brace.

Adolescent and Juvenile Idiopathic Scoliosis: Which Patients Obtain Good Results with 12 Hours of Cheneau–Toulouse–Munster Nighttime Bracing?

“…For MT, a good sagittal C7 tilt balance in-brace was associated with success. However, various patterns of the main thoracic curves are classified in the same gross group, with different responses to brace treatment [ 22 ]. This finding suggests the brace prescriptor to use lateral bending with assessment of the sagittal alignment to obtain better CA reduction in brace [ 23 ].…”

Assessment of Maximum Spinal Deformity in Scoliosis: A Literature Review

“…There are interdependent relationships between these 3D descriptors and the Cobb angle in the coronal and sagittal planes. The PMC/BFP(z)-Cobb was generally 1°-6° greater than the coronal Cobb angle [29][30][31]37,[40][41][42] as shown in Table 1, but no significant correlation was observed [11]. The PMC-orientation was found to have progression in 71% subjects with adolescent idiopathic scoliosis (AIS) during an observation period of 22.8±10.8 months [5].…”

“…Radiographic technique was the main technique for acquiring the EAEP. Based on the 3D reconstruction of the spine or spinal curve, the EAEP could be determined by a triangle plane formed by the connecting lines between the centroids of two end and apical vertebrae of a specific curve (or the end limits and apex of a curve) [7,11,10,33,34].…”

“…The direction of the arrow represented the EAEP(z)-orientation, and the length of the arrow was proportional to the EAEP(z)-Cobb. For ensuring reasonable variables for analysis, only the EAEP(z)-orientation was considered in most studies [7,8,11,35,36].…”

“…Some techniques have been developed for acquiring these descriptors but no systematic investigation has been done. Although, these 3D descriptors have been applied in assessment [10][11][12][13][14] and 3D classification [8] of scoliosis, their specific role in management of scoliosis was unclear. Thus, this study aimed to systematically review: (1)…”