Three-dimensional vertebral wedging and pelvic asymmetries in the early stages of adolescent idiopathic scoliosis

Begon, Mickaël; Scherrer, Sophie-Anne; Coillard, Christine; Rivard, Charles‐Hilaire; Allard, Paul

doi:10.1016/j.spinee.2014.10.004

Cited by 27 publications

(26 citation statements)

References 54 publications

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“…As a three-dimensional (3D) deformation of the spine, IS does not only in uence the spine, but also appears to be caudally extended as pelvic abnormalities were often observed in IS [14]. Individual PRP is following the regional parameters of IS [15]. therefore, the Pre-bracing evaluation of IS should include the regional parameters as well as PRP.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic Rotation Parameters Related to In-Brace Correction in Patients with Idiopathic Scoliosis

Miao²,

Zhang

2020

Preprint

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BACKGROUND: To identify the pelvic parameters affecting in-brace correction (IBC) in patients with idiopathic scoliosis (IS). METHODS: Patients with IS receiving Chêneau brace treatment in our scoliosis center from January 2019 to November 2019 were retrospectively analyzed. Pelvic rotation parameters, including Pelvic incidence (PI), Sacral slope (SS), pelvic tilt (PT), L/R ratio, were collected. Other radiographic data, such as Risser sign, coronal and sagittal balance, curve location, kyphosis, lordosis of each patient was also recorded to analyze their correlations with IBC. Correlation analyses were performed to identify the classified variables influencing IBC. The principal component analysis was used to extract common factors of radiographic parameters to eliminate interaction effects. The linear regression equation was established using principal components, the variables influencing IBC were identified.RESULTS: A cohort of 44 patients with IS (36 girls and 8 boys) were included in the present study. The mean IBC was 49.87% (range, 3%∽100%). IBC of lumbar IS was negatively correlated with apical rotate factor (ARF, B=-0.385), mainly consisted of pelvic coronal plane rotation (PCPR, 0.449), cobb angle (CA,0.575), apical vertebral rotation (AVR, 0.918), and pelvic rotate factor (PRF, B=-0.387), mainly consisted of PT (0.861), PI (0.728), PCPR (-0.570). The regression equation of lumbar IS had statistical significance (F=6.500, P=0.005，R2=0.317). Whereas statistically significance was not found in the regression equation of thoracic IS (F=2.913, P=0.106). The remaining parameters were not related to IBC.CONCLUSIONS: For lumbar IS, ARF and PRF have negative effects on IBC, Coronal and sagittal rotation of the pelvis is related to IBC.

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Section: Discussionmentioning

confidence: 99%

“…The three-dimensional nature of IS necessitates a tridimensional assessment and management [16]. To achieve a satisfactory IBC, multiple sets of "three-point force" were used to correct deformities from threedimensional space [15]. As one of the stress points, the pelvis plays an important role in the IBC of lumbar IS.…”

Section: Discussionmentioning

confidence: 99%

Pelvic Rotation Parameters Related to In-Brace Correction in Patients with Idiopathic Scoliosis

Miao²,

Zhang

2020

Preprint

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“…Another method that has become increasingly popular in recent years is slot-scanning x-ray (EOS), which is used for examinations in scoliosis patients (15). First advantage of EOS is a software called sterEOS 3D, which offers the opportunity of visualizing the spinal deformity in all three planes (16).…”

Section: Discussionmentioning

confidence: 99%

Is a further reduction of radiation exposure in scoliosis monitoring achievable using flat detector and pulsed fluoroscopy technology? - A feasibility study on human specimen

Walter

Schaefer

Tsiflikas

2020

Preprint

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Background: In the case of scoliosis therapy, frequent radiological monitoring of the spine is necessary. However, x-ray requires high radiation doses; therefore digital pulsed fluoroscopy with flat detector technique can be used alternatively. The latest developments in this technology lead to further dose reduction with an improved image quality. To evaluate the new system, we asked if there is a difference in dose area product (DAP) concerning the opening area (OA) and image quality settings (IQS). Further we wanted to investigate the inter-observer reliability using an established scoring system and correlate the DAP with the point value. Methods Therefore, we examined 4 cadaver spines (T1 to sacrum) with the flat detector technique using digital pulsed fluoroscopy and simulated the abdominal soft tissues with water bags. The images were merged calculating whole spine images from several digital single images and evaluated by 3 different investigators (spine surgeon, experienced pediatric radiologist, assistant physician) using an established scoring system. For comparison and validation of our model, we used digital radiography images of the cadaver spines. Results The values for the DAP increased from the small OA (33%; 0.56 µGy·m²) to the maximum OA (100%; 0.82 µGy·m²) by 45% (p = .003) and from low IQS (0.57 µGy·m²) to high IQS (0.84 µGy·m²) by 48% (p = .028). The inter-observer reliability was strong (3 vs. 1: ρ = .818; 3 vs. 2: ρ = .742; 2 vs. 1: ρ = .586; p <.001), but there was no correlation between DAP and point value (ρ = -.053, p = .588). Despite the low DAP, the setting 33% OA achieved the best point values, therefore this setting is preferred. Conclusions Using a digital fluoroscopy system allows a significant reduction of radiation exposure for whole spine images by a factor of 7.5 (3.88 µGy·m² to 0.5 µGy·m²) compared to slot-scanning x-ray (EOS).

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“…Therefore, in patients with scoliosis, this can cause a vicious cycle of asymmetrical loading and vertebral wedge deformities [ 7 , 12 ]. Many researchers have shown that vertebral wedge deformities exist in patients with scoliosis [ 3 – 6 , 15 ]. Recent 3D morphometric studies revealed that the severity of wedge deformities correlated with the Cobb angle and that this wedge deformity was greater in the apical region [ 4 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent morphological analysis of the vertebrae in patients with AIS revealed that the vertebral bodies have three-dimensional (3D) deformities (e.g. wedging and torsion) and that these deformities are primarily oriented in the frontal plane [ 3 – 6 ]. It is still controversial whether these deformities are secondary change caused by asymmetrical vertebral loading or primary changes caused by aberrant asymmetrical vertebral growth [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Plasticity of vertebral wedge deformities in skeletally immature patients with adolescent idiopathic scoliosis after posterior corrective surgery

Makino

Kaito

Sakai

et al. 2016

BMC Musculoskelet Disord

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BackgroundVertebral bodies in patients with adolescent idiopathic scoliosis (AIS) usually have frontal wedge deformities. However, the plasticity of the deformed vertebrae in skeletally immature patients is unknown. The purpose of our study was to clarify the plasticity of vertebral deformities in skeletally immature patients with AIS by using in vivo three-dimensional (3D) analysis.MethodsTen female patients with AIS (mean age, 12.2 years; three patients, Lenke type 1; five patients, type 2; two patients, type 5) who underwent posterior fusion and whose Risser grade was ≤3 at surgery were included. Using computed tomography images (0.625-mm slice thickness) obtained 1 week and 1 year postoperatively, a total of seventy-three 3D bone models of vertebrae was made. The 3D bone models were made between the upper and lower end vertebrae within the main thoracic curve for patients with Lenke types 1 and 2 scoliosis, whereas they were made within the thoracolumbar/lumbar curve in patients with Lenke type 5 scoliosis. The height of the concave and convex sides in the anterior, middle and posterior parts of the vertebral bodies was measured using the original digital viewer, and the vertebral height ratio (VHR: concave/convex) was calculated. VHRs at 1 week and 1 year postoperatively were compared using the Wilcoxson signed-rank test. Differences were considered statistically significant at p < 0.05.ResultsVHR of the end vertebrae (n = 20) did not change postoperatively for any parts of the vertebral bodies. VHR of the vertebrae in the apical region (n = 28) also remained unchanged postoperatively. In contrast, VHR of the other vertebrae (n = 25) increased significantly in the anterior part postoperatively (from 0.938 to 0.961, p = 0.006).ConclusionsThe wedge deformity of vertebral bodies showed a reshaping potential towards a symmetrical configuration in the region other than end and apex, although no plasticity of the vertebrae was observed in the apical region even in skeletally immature patients with AIS.

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Three-dimensional vertebral wedging and pelvic asymmetries in the early stages of adolescent idiopathic scoliosis

Cited by 27 publications

References 54 publications

Pelvic Rotation Parameters Related to In-Brace Correction in Patients with Idiopathic Scoliosis

Pelvic Rotation Parameters Related to In-Brace Correction in Patients with Idiopathic Scoliosis

Is a further reduction of radiation exposure in scoliosis monitoring achievable using flat detector and pulsed fluoroscopy technology? - A feasibility study on human specimen

Plasticity of vertebral wedge deformities in skeletally immature patients with adolescent idiopathic scoliosis after posterior corrective surgery

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