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Michalik R, Kühlmann B, Wild M, Siebers HL, Migliorini F, Eschweiler J, Betsch M. The Effect of Breast Size on Spinal Posture. Aesthetic Plast Surg 2024; 48:1331-1338. [PMID: 36280605 PMCID: PMC11035396 DOI: 10.1007/s00266-022-03141-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/01/2022] [Indexed: 11/30/2022]
Abstract
Macromastia can cause various clinical symptoms, such as low back and shoulder pain as well as sacro-iliac disorders. Because of these symptoms, some women consider breast reduction surgery. So far there does not exist a clear correlation between breast size and back pain. Purpose of this study was to evaluate if increasing breast size has a measurable effect on women's posture using radiation free surface topography.A total of 100 women were grouped according to their breast cup size into four groups (Cup Size: A, B, C, D). All female subjects were measured with a surface topography system, and their spinal posture and pelvic position were analysed accordingly.Our results showed that cup size affects kyphotic angle (p = 0.027) and surface rotation (p = 0.039) significantly. Kyphotic angle increased with cup size. Multiple linear regression analysis, however, revealed that the body mass index has the greatest influence on woman's posture, showing significant correlation to kyphotic and lordotic angle (p < 0.01), as to trunk (p < 0.01) and pelvic inclination (p = 0.02).This is the first study that evaluates the influence of increasing breast size on posture using surface topography. The results match with previous studies using different measuring techniques. However, the great influence of BMI on posture is also confirmed. Therefore, in clinical practice these factors should be taken into account and be approached. Surface topography seems to be a promising tool to further investigate the influence of breast size on posture.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Roman Michalik
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Britta Kühlmann
- Department of Plastic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Michael Wild
- Department of Trauma and Orthopaedic Surgery, Klinikum Darmstadt, Darmstadt, Germany
| | - Hannah Lena Siebers
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marcel Betsch
- Department of Trauma Surgery and Orthopaedics, University Hospital Erlangen, Erlangen, Germany
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Vendeuvre T, Tabard-Fougère A, Armand S, Dayer R. Test characteristics of rasterstereography for the early diagnosis of adolescent idiopathic scoliosis. Bone Joint J 2023; 105-B:431-438. [PMID: 36924187 DOI: 10.1302/0301-620x.105b4.bjj-2021-1440.r3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
This study aimed to evaluate rasterstereography of the spine as a diagnostic test for adolescent idiopathic soliosis (AIS), and to compare its results with those obtained using a scoliometer. Adolescents suspected of AIS and scheduled for radiographs were included. Rasterstereographic scoliosis angle (SA), maximal vertebral surface rotation (ROT), and angle of trunk rotation (ATR) with a scoliometer were evaluated. The area under the curve (AUC) from receiver operating characteristic (ROC) plots were used to describe the discriminative ability of the SA, ROT, and ATR for scoliosis, defined as a Cobb angle > 10°. Test characteristics (sensitivity and specificity) were reported for the best threshold identified using the Youden method. AUC of SA, ATR, and ROT were compared using the bootstrap test for two correlated ROC curves method. Of 212 patients studied, 146 (69%) had an AIS. The AUC was 0.74 for scoliosis angle (threshold 12.5°, sensitivity 75%, specificity 65%), 0.65 for maximal vertebral surface rotation (threshold 7.5°, sensitivity 63%, specificity 64%), and 0.82 for angle of trunk rotation (threshold 5.5°, sensitivity 65%, specificity 80%). The AUC of ROT was significantly lower than that of ATR (p < 0.001) and SA (p < 0.001). The AUCs of ATR and SA were not significantly different (p = 0.115). The rasterstereographic scoliosis angle has better diagnostic characteristics than the angle of trunk rotation evaluated with a scoliometer, with similar AUCs and a higher sensitivity.
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Affiliation(s)
- Tanguy Vendeuvre
- Division of Pediatric Orthopaedics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Anne Tabard-Fougère
- Division of Pediatric Orthopaedics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Romain Dayer
- Division of Pediatric Orthopaedics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Applebaum A, Ference R, Cho W. Evaluating the role of surface topography in the surveillance of scoliosis. Spine Deform 2020; 8:397-404. [PMID: 31965557 DOI: 10.1007/s43390-019-00001-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/19/2019] [Indexed: 11/28/2022]
Abstract
STUDY DESIGN Literature review. OBJECTIVE To review the history, modern uses, limitations, and future direction of surface topography (ST) in surveillance of scoliosis. Spinal deformities, including scoliosis, can be characterized using measurements such as the Cobb angle, lateral curvature, and vertebral rotation. The gold standard for diagnosis and surveillance of such deformities utilizes radiographic images. To minimize repeated radiation exposure, many systems have been developed utilizing ST. ST measures local deviations of a surface from a flat plane. Applying this concept to spinal deformities, ST can non-radiographically study the 3-dimensional shape of the back. One ST system, rasterstereography, projects parallel white light lines onto a patient's back and analyzes line distortion with a camera. While radiography has long been considered the primary diagnostic tool for scoliosis, rasterstereography may possess alternative or complementary benefits in monitoring scoliosis and other diseases. METHODS A comprehensive literature review was performed on the history, development, and validity of ST. The advantages and limitations of this technique were compared to those of radiography. RESULTS While the initial goal of ST, designing a system to accurately reproduce the Cobb angle, was not successful, research efforts over the last 40 years have attempted to improve this correlation. ST technologies, including rasterstereography and the Formetric ST System, currently play important roles in scoliosis surveillance, research, and minimizing radiation exposure in longitudinal care of patients. Such technologies are also useful as an adjunct to X-rays for monitoring disease progression, especially in Parkinson's disease. CONCLUSION Despite its limitations, ST has proven useful across multiple fields of medicine. It is a safe and cost-effective tool for long-term surveillance of scoliosis and early detection of progressive disease. With technological improvements, the Formetric System will become a critical alternative in dynamic spinal motion and gait analysis. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Ariella Applebaum
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Ryan Ference
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Woojin Cho
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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Terheyden JH, Wetterkamp M, Gosheger G, Lange T, Schulze Bövingloh A, Schulte TL. Rasterstereography versus radiography for assessing shoulder balance in idiopathic scoliosis: A validation study relative to patients' self-image. J Back Musculoskelet Rehabil 2019; 31:1049-1057. [PMID: 29945339 DOI: 10.3233/bmr-170867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder imbalance is a problem for scoliosis patients. Rasterstereography uses radiation-free surface topography to follow up these patients. Its use for assessing shoulder level has not been investigated earlier. OBJECTIVE This study aimed to determine the accuracy of shoulder assessment using rasterstereography (versus radiography) and to analyze its relationship with patients' self-image. METHODS In a cross-sectional setting, the reliability and validity of five rasterstereographic shoulder variables were measured in comparison with six radiographic shoulder parameters, using correlation analysis. The patients' self-perception was documented using the Scoliosis Research Society-22 (SRS-22) questionnaire and Trunk Appearance Perception Scale (TAPS). RESULTS Forty patients were included in the study. The test-retest reliability of all rasterstereographic shoulder parameters was excellent (ICC > 0.95). The validity was moderate in comparison with six radiographic parameters (highest coefficient: 0.582). The radiographic and rasterstereographic shoulder levels correlated with the results in the SRS-22 questionnaire (highest coefficient: -0.463) and TAPS (highest coefficient: 0.413). CONCLUSIONS Rasterstereography is a reliable and valid method for assessing shoulder level in idiopathic scoliosis. The parameters can be recommended as a complement to radiography and clinical evaluation for follow-up purposes. Radiographic and rasterstereographic shoulder parameters are significantly related to patients' self-perception. Shoulder variables thus need to be considered in scoliosis patients.
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Affiliation(s)
| | - Mark Wetterkamp
- Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Georg Gosheger
- Department of Orthopaedics and Tumor Orthopaedics, Muenster University Hospital, 48149 Muenster, Germany
| | - Tobias Lange
- Department of Orthopaedics and Tumor Orthopaedics, Muenster University Hospital, 48149 Muenster, Germany
| | - Albert Schulze Bövingloh
- Department of Orthopaedics and Tumor Orthopaedics, Muenster University Hospital, 48149 Muenster, Germany
| | - Tobias L Schulte
- Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
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Beeck A, Quack V, Rath B, Wild M, Michalik R, Schenker H, Betsch M. Dynamic evaluation of simulated leg length inequalities and their effects on the musculoskeletal apparatus. Gait Posture 2019; 67:71-76. [PMID: 30292100 DOI: 10.1016/j.gaitpost.2018.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/18/2018] [Accepted: 09/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Leg length inequalities (LLI) are a common problem in medicine. So far, the diagnosis and treatment are performed under static conditions. Surface Topography (ST) is an optical, non-invasive technique that uses the principle of triangulation to measure spinal posture and pelvic position. This technique offers the opportunity to detect and treat LLIs and their effects under dynamic conditions. RESEARCH question The aim of the study is to show that ST can detect simulated LLIs under dynamic conditions and to prove if there are differences between the effects on the human body under static and dynamic conditions. METHODS In the clinical study a total of 30 test subjects were examined with a ST measuring device. LLIs (1 to 4 cm) were simulated using a custom- built sandal and insoles of various thickness. The pelvic obliquity, the surface rotation and lateral deviation of the spine were detected on a treadmill under static and dynamic conditions (3 km/h). RESULTS Under static and dynamic conditions LLIs lead to a significant increase of all measured parameters. The pelvic obliquity reaches a significant level of p < 0.0001 under static and p = 0.0001-0.0421 under dynamic conditions. However, for all examined parameters the magnitudes of the parameters under dynamic conditions were smaller than under static conditions. SIGNIFICANCE The study showed that simulated LLIs also have a significant effect on the human pelvis and spine under dynamic conditions, but with a smaller magnitude than under static conditions. The human individuum is a dynamic one. Because of that, for the future it should be of great interest to use dynamic measurements to detect and treat LLIs to provide an over correction of LLIs.
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Affiliation(s)
- Aylin Beeck
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany
| | - Valentin Quack
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany
| | - Björn Rath
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany
| | - Michael Wild
- Klinikum Darmstadt, Department of Orthopaedics, Trauma and Hand Surgery, Darmstadt, Germany
| | - Roman Michalik
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany
| | - Hanno Schenker
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany
| | - Marcel Betsch
- University Hospital RWTH Aachen, Department of Orthopaedics, Aachen, Germany.
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Jiang WW, Cheng CLK, Cheung JPY, Samartzis D, Lai KKL, To MKT, Zheng YP. Patterns of coronal curve changes in forward bending posture: a 3D ultrasound study of adolescent idiopathic scoliosis patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2139-2147. [PMID: 29943198 DOI: 10.1007/s00586-018-5646-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 05/26/2018] [Indexed: 01/29/2023]
Abstract
PURPOSE The Adam's forward bending test is the most commonly used approach to assess the spine deformity in adolescent idiopathic scoliosis (AIS) patients. However, there are noticeable differences in the hump appearance from standing to forward bending. This phenomenon has yet to be understood due to limitations of conventional radiographs. This study aimed to investigate effects of postural change in the spine deformity in the coronal plane of AIS patients using a 3D ultrasound imaging system. METHODS This was a prospective study that recruited 72 AIS patients at a single institute. All patients were scanned twice in the sitting and sitting forward bending postures. A coronal ultrasound image showing the spinal curvature was generated after each scan and the spinous process angle (SPA) representing the deformity was manually measured from it. Correlation of SPAs under sitting and sitting forward bending postures was analyzed. RESULTS In the comparison test, it was noted that there were three types of spine profile alternation after the postural change. In types I and II, the SPA angle numbers were the same before and after forward bending and only SPA values changed. In type III, the two curvatures were changed to one curvature in the forward bending posture. Moderate correlation was observed between the angles obtained in the two postures (r = 0.55, p < 0.001). CONCLUSIONS Spine deformities of AIS patients vary with different postures. The patterns of changes in sitting and sitting forward bending postures are highly subject dependent. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Wei Wei Jiang
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China.,Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Connie Lok Kan Cheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, HKU Shenzhen Hospital, Shenzhen, Guangdong, China.,The Duchess of Kent Children's Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, HKU Shenzhen Hospital, Shenzhen, Guangdong, China.,The Duchess of Kent Children's Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kelly Ka Lee Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Michael Kai Tsun To
- Department of Orthopaedics and Traumatology, HKU Shenzhen Hospital, Shenzhen, Guangdong, China. .,The Duchess of Kent Children's Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
| | - Yong Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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Lee WH, Kang H, Kim SY. Discrepancy between self-awareness and actual diagnosis and treatment of the conditions among adolescent with scoliosis in middle-school age. J Phys Ther Sci 2017; 29:567-571. [PMID: 28533586 PMCID: PMC5430249 DOI: 10.1589/jpts.29.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/15/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this research was to determine the awareness of the actual conditions of the diagnosis and treatment of scoliosis by focusing on middle-school students in order to provide a basis for active education and treatment of scoliosis. [Subjects and Methods] The survey was conducted among 4,782 students. The students performed Adam's forward bend test, and some of the students who showed predictive features of scoliosis were further examined for the spine structure with rasterstereography. [Results] The proportion of students with awareness about scoliosis appeared to be 71.47%. Among the students, 50.84% knew the definition of scoliosis and 4.37% were diagnosed as having scoliosis, of whom 46.37% underwent treatment. It was a significant difference between to get a diagnosis and the predictive scoliosis or the scoliosis. [Conclusion] The results showed that the students in the second grade of middle school had high awareness levels, but about 50% of them did not know the definition of scoliosis. More than 50% of them did not receive treatment after diagnosed as having scoliosis. Therefore, active education and school screening for scoliosis should be provided to adolescent students.
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Affiliation(s)
- Wan-Hee Lee
- Graduate School of Physical Therapy, Sahmyook University, Republic of Korea
| | - Hyojeong Kang
- Graduate School of Physical Therapy, Sahmyook University, Republic of Korea
| | - Seong Yeol Kim
- Graduate School of Physical Therapy, Kyungnam University, Republic of Korea
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Silva JS, Morita ÂK, Pachioni CAS, Fregonesi CEPT, Faria CRSD, Ferreira DMA. Idiopathic scoliosis: Static analysis of the influence of shim use on postural angles. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.002.ao10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Scoliosis is characterized as a three-dimensional deformity. In this scenario, the use of shims can promote correction of postural imbalances. Objective: To verify the static changes associated with unilateral manipulation of shims in idiopathic scoliosis. Methods: Two experimental groups composed of participants with scoliosis with double and single curves, and a control group of participants without scoliosis. 10 reflective markers were used, filmed for 15 seconds in the static position in three conditions (no shim; low shim of 1 cm, and high shim of 3 cm) on the right and left foot. The following postural angles were calculated: alpha 1, alpha 2, alpha 3, and alpha 4. Results: There were differences in the shim condition between the control group (CG) and experimental scoliosis with “S” (GES) for alpha 2 and 4 and Scoliosis “C” (GEC) for alpha 2. For shims under the right foot, there were differences between the control group and GES for alpha 4 and the GEC for alpha 1, 2 and 4, and between shims for the GES for alpha 3 and 4. Shims under the left foot were responsible for significant differences between the control group and the GES and GEC groups. Conclusion: These static postural changes indicate that scoliosis curves show adaptability and postural reorganization in response to manipulation with shims, and the greatest influence is seen in the lower segments, both in simple and double curves. According to the results it is concluded that residual scoliotic curvatures have flexibility that allows postural adjustment with shims.
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Validity and Reliability of Spine Rasterstereography in Patients With Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976) 2017; 42:98-105. [PMID: 27172281 DOI: 10.1097/brs.0000000000001679] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Test-retest study. OBJECTIVE This study aimed to evaluate the validity and reliability of rasterstereography in patients with adolescent idiopathic scoliosis (AIS) with a major curve Cobb angle (CA) between 10° and 40° for frontal, sagittal, and transverse parameters. SUMMARY OF BACKGROUND DATA Previous studies evaluating the validity and reliability of rasterstereography concluded that this technique had good accuracy compared with radiographs and a high intra- and interday reliability in healthy volunteers. To the best of our knowledge, the validity and reliability have not been assessed in AIS patients. MATERIALS Thirty-five adolescents with AIS (male = 13) aged 13.1 ± 2.0 years were included. To evaluate the validity of the scoliosis angle (SA) provided by rasterstereography, a comparison (t test, Pearson correlation) was performed with the CA obtained using 2D EOS® radiography (XR). Three rasterstereographic repeated measurements were independently performed by two operators on the same day (interrater reliability) and again by the first operator 1 week later (intrarater reliability). The variables of interest were the SA, lumbar lordosis, and thoracic kyphosis angle, trunk length, pelvic obliquity, and maximum, root mean square and amplitude of vertebral rotations. The data analyses used intraclass correlation coefficients (ICCs). RESULTS The CA and SA were strongly correlated (R = 0.70) and were nonsignificantly different (P = 0.60). The intrarater reliability (same day: ICC [1, 1], n = 35; 1 week later: ICC [1, 3], n = 28) and interrater reliability (ICC [3, 3], n = 16) were globally excellent (ICC > 0.75) except for the assessment of pelvic obliquity. CONCLUSION This study showed that the rasterstereographic system allows for the evaluation of AIS patients with a good validity compared with XR with an overall excellent intra- and interrater reliability. Based on these results, this automatic, fast, and noninvasive system can be used for monitoring the evolution of AIS in growing patients instead of repetitive radiographs, thereby reducing radiation exposure and decreasing costs. LEVEL OF EVIDENCE 4.
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10
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Noll C, Steitz V, Daentzer D. Influence of proprioceptive insoles on spinal curvature in patients with slight idiopathic scoliosis. Technol Health Care 2016; 25:143-151. [PMID: 27886017 DOI: 10.3233/thc-161271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Proprioceptive insoles are known to influence the functions of posture and gait by modulations of the sensory structures at the sole of the foot. Literature has shown that they could improve the position of the upper-body in patients with postural complaints of the musculoskeletal system. The aim of this study was to evaluate the influence of proprioceptive insoles on the spinal curvature in patients with slight idiopathic scoliosis. PATIENTS AND METHODS Eighteen patients were included in this prospective, single-centre, randomized study. All patients needed to have a relevant growth potential and suffered from a slight idiopathic scoliosis. Two groups were used, where group 1 performed physiotherapy twice a week, whereas group 2 was additionally supplied with proprioceptive insoles. Patients underwent three-dimensional rasterstereography for back-shape analysis. Furthermore, a conventional x-ray imaging of the spine was performed at the beginning and 1 year later to document the curvatures. RESULTS There was no statistical difference in the Cobb angles, and in almost all parameters of the rasterstereography, there was no statistically significant change between and within both groups. CONCLUSION According to the results of this study, there was no evidence of any statistical significant effect of proprioceptive insoles on spinal curvature in patients with slight idiopathic scoliosis.
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Affiliation(s)
- Christine Noll
- Orthopedic Department of Hannover Medical School, Spine Section, Hannover, Germany.,Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Dorothea Daentzer
- Orthopedic Department of Hannover Medical School, Spine Section, Hannover, Germany
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12
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Drerup B. Rasterstereographic measurement of scoliotic deformity. SCOLIOSIS 2014; 9:22. [PMID: 25520745 PMCID: PMC4268794 DOI: 10.1186/s13013-014-0022-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 11/26/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Back surface topography has gained acceptance in recent decades. At the same time, the motivation to use this technique has increased. From the view of the patient, the cosmetic aspect has played and still plays a major role as it provides a comprehensive documentation of cosmetic impairment. From the view of the medical practitioner, the aspect of reducing X-ray exposures in diagnosis and follow-up has been dominant and still prevails. Meanwhile, new aspects have emerged: due to the consequent three-dimensional view of the scoliotic condition, treatment success can be visualized convincingly. Clinical diagnosis is supported by information otherwise not supplied by X-rays, such as when functional examinations and diagnostic tests are recorded. METHODS Like rasterstereography, most techniques of actual back surface measurement refer to photogrammetry and the triangulation method. However, with respect to the particular clinical application, a wide spectrum of implementations exists. Applications in a clinic require high accuracy of measurement in a short time and comprehensive analysis providing data to be used to supplement and compare with radiographic data. This is exemplified by rasterstereography; the procedures of surface analysis and localization of landmarks using curvatures and the reconstruction of the spinal midline will be described. ORTHOPAEDIC RELEVANCE Based on rasterstereographic analysis, different geometrical measures that characterize the back surface are given and underlying skeletal structures described. Furthermore, in analogy to radiological projection, a 3-D reconstruction of the spinal midline is visualized by a frontal and lateral projection, allowing comparison with pertinent X-rays. CONCLUSIONS Surface topography and, in particular, rasterstereography provide reliable and consistent results that may be used to reduce X-ray exposure. Unfortunately, the correlation of shape parameters with the radiological Cobb angle is poor. However, the wealth of additional applications substantially enhances the spectrum of clinical value.
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Affiliation(s)
- Burkhard Drerup
- Bundesfachschule für Orthopaedietechnik, Schliepstrasse 6-8, Dortmund, Germany
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Knott P, Pappo E, Cameron M, Demauroy J, Rivard C, Kotwicki T, Zaina F, Wynne J, Stikeleather L, Bettany-Saltikov J, Grivas TB, Durmala J, Maruyama T, Negrini S, O'Brien JP, Rigo M. SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis. SCOLIOSIS 2014; 9:4. [PMID: 24782912 PMCID: PMC4002921 DOI: 10.1186/1748-7161-9-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 11/30/2022]
Abstract
This 2012 Consensus paper reviews the literature on side effects of x-ray exposure in the pediatric population as it relates to scoliosis evaluation and treatment. Alternative methods of spinal assessment and imaging are reviewed, and strategies for reducing the number of radiographs are developed. Using the Delphi technique, SOSORT members developed consensus statements that describe how often radiographs should be taken in each of the pediatric and adolescent sub-populations.
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Affiliation(s)
| | - Eden Pappo
- The 2012 SOSORT Conference, Milan, Italy
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Radcliff KE, Orozco F, Molby N, Chen E, Sidhu GS, Vaccaro AR, Ong A. Is pelvic obliquity related to degenerative scoliosis? Orthop Surg 2014; 5:171-6. [PMID: 24002833 DOI: 10.1111/os.12055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/05/2013] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The hypothesis of this study is that pelvic obliquity (PO) is associated with specific patterns of degenerative scoliosis. METHODS This study was a retrospective case series of consecutive patients undergoing fusion for lumbar conditions (degenerative scoliosis or spondylolisthesis). The discrepancy in the iliac crest height, coronal L1-S1 endplate angles, distance from L1 coronal bisector to the sacral center, number of degenerative scoliosis curves, and individual curve angulations were measured. RESULTS Limb length discrepancy was present in 87% of patients with a degenerative scoliosis. There were 116 patients with a single curve > 5° and PO > 2 cm. Of the patients with a single curve, the apex of scoliosis was opposite the high iliac crest side in 79% patients. There were 338 patients with a double curve. The apex of scoliosis was opposite the high iliac crest side in 48% of patients. CONCLUSION There were distinct patterns of limb length discrepancy corresponding to degenerative scoliotic curve morphology. In patients with single degenerative scoliotic curves, PO most commonly appeared to counteract the scoliotic curve and result in an overall decrease in trunk shift. This occurred because the high iliac crest was observed most commonly on the convex side of the scoliotic curve. This effect was not observed in double lumbar degenerative scoliotic curves.
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Affiliation(s)
- Kristen E Radcliff
- Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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Intra- and interday reliability of spine rasterstereography. BIOMED RESEARCH INTERNATIONAL 2013; 2013:745480. [PMID: 23819119 PMCID: PMC3684097 DOI: 10.1155/2013/745480] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/17/2013] [Indexed: 12/21/2022]
Abstract
To determine intra- and interday reliability of spine rasterstereographic system Formetric 4D with and without reflective markers. Twenty-six healthy volunteers (M group) had two markers placed in correspondence of vertebra prominens and intergluteal cleft, and 24 volunteers (NM group) were assessed without markers. All participants were analyzed two times in the same day and one time on a separate day. Trunk length, kyphotic angle, lordotic angle, pelvic inclination, kyphotic and lordotic apex, right and left lateral deviation, flèche cervicale and lombaire, trunk imbalance, pelvic tilt, inflection point, rotation correction, right and left surface rotation, pelvic torsion, and trunk torsion were measured. Intraclass correlation coefficient (ICC) and Cronbach Alpha (Cα) were calculated. In M group, for intra-, interday, and overall evaluations, the higher reliability coefficients were 0.971, 0.963, and 0.958 (ICC) and 0.987, 0.983, and 0.985 (Cα) for trunk length, kyphotic angle, and lordotic apex, respectively; while in NM group, they were 0.978, 0.982, and 0.972 and 0.989, 0.991, and 0.991 for trunk length. In M group, the lower values were 0.598, 0.515, and 0.534 (ICC) and 0.742, 0.682, and 0.784 (Cα) for trunk and pelvic torsion and in NM group 0.561, 0.537, and 0.461 and 0.731, 0.695, and 0.729 for left lateral deviation. The reliability of most parameters was excellent.
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Rasterstereographic Evaluation of Interobserver and Intraobserver Reliability in Postsurgical Adolescent Idiopathic Scoliosis Patients. ACTA ACUST UNITED AC 2013; 26:E143-9. [DOI: 10.1097/bsd.0b013e318281608c] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ferreira DMA, Barela AMF, Barela JÂ. Influência de calços na orientação postural de indivíduos com escoliose idiopática. FISIOTERAPIA EM MOVIMENTO 2013. [DOI: 10.1590/s0103-51502013000200011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: A relação entre a orientação dos segmentos e os ajustes que podem ser desencadeados por calços e palmilhas em pacientes escolióticos durante a manutenção da posição ortostática é pouco conhecida. OBJETIVO: Verificar alterações estáticas e associadas com mudanças unilaterais de calços na orientação postural de indivíduos com escoliose idiopática. MATERIAIS E MÉTODOS: Grupo experimental com dez indivíduos com escoliose idiopática com curva dupla (menor 10°) e grupo controle com dez indivíduos sem escoliose (faixa etária de 13 a 24 anos). Participantes foram filmados na posição ortostática sem calço, com calço baixo (1 cm) e com calço alto (3 cm); estes foram colocados sob o pé direito e pé esquerdo dos indivíduos. Em cada condição, o participante manteve a posição estática durante 15 segundos e marcadores refletivos foram colocados em pontos anatômicos específicos. Foram calculados ângulos posturais: torácico alto; torácico médio; toracolombar e lombar e ângulos segmentares: ombro; escápula; pelve e joelho. RESULTADOS: Na condição sem calço, diferenças foram observadas entre grupos para os ângulos posturais toracolombar e lombar e para o ângulo segmentar do ombro. Com calço baixo e alto, sob o pé direito, diferença foi observada entre calços para os ângulos lombar, da pelve e do joelho. Com calço baixo e alto, sob o pé esquerdo, diferença foi observada entre grupos para o ângulo toracolombar e entre calços para os ângulos da pelve e do joelho. CONCLUSÕES: A utilização de calço promove reorientação nas regiões mais baixas da coluna e nos segmentos da pelve e do joelho. Estes resultados sugerem que nas escolioses duplas, manipulação da base de apoio modifica o alinhamento do tronco que pode provocar reorganização das estruturas e busca de um novo arranjo entre segmentos em indivíduos com escoliose idiopática.
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Mangone M, Raimondi P, Paoloni M, Pellanera S, Di Michele A, Di Renzo S, Vanadia M, Dimaggio M, Murgia M, Santilli V. Vertebral rotation in adolescent idiopathic scoliosis calculated by radiograph and back surface analysis-based methods: correlation between the Raimondi method and rasterstereography. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22:367-71. [PMID: 23135792 DOI: 10.1007/s00586-012-2564-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 09/07/2012] [Accepted: 10/28/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of the present research is to evaluate the relationship between an X-ray-based method (i.e. the Raimondi method) and rasterstereography in the evaluation of vertebral rotation (VR) in a sample of adolescent idiopathic scoliosis (AIS) patients. METHODS A total of 25 patients (9 males; mean age 14 ± 3 years; mean height 160.7 ± 11.9 cm; mean weight 52.4 ± 10.7 kg) were considered for the present analysis. The mean Cobb angle was 30° ± 9°. The evaluation of VR on radiographs was made using the Raimondi method regolo (Marrapese Editore--Demi S.r.1., Rome). Rasterstereography was performed by means of Formetric 4D(®) (Diers International GmbH, Schlangenbad, Germany). Correlations between rasterstereographic and radiographic measurement of VR were calculated, both for the whole sample and for thoracic and lumbar spinal segments considered separately, as well as for subgroups of patients with a Cobb angle <30° and ≥ 30° using Spearman's correlation coefficient by rank (r (s)). RESULTS When applied to the entire spine, measurement of VR by means of the two methods highlighted a significant correlation in the whole group (r = 0.52; p < 0.0001), as well as in the <30° Cobb (r = 0.47; p = 0.0001) and ≥ 30° Cobb (r = 0.42; p < 0.0001) subgroups. A significant correlation was found also when lumbar and thoracic VR were considered as separated groups (r = 0.30, p = 0.024 and r = 0.47, p = 0.002, respectively). CONCLUSIONS Rasterstereographic evaluation of VR shows a good correlation with the Raimondi method, thereby confirming the possibility to use this non-invasive method for deformity assessment in AIS patients.
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Affiliation(s)
- Massimiliano Mangone
- Biomechanics and Movement Analysis Laboratory, Department of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Piazzale Aldo Moro, 5, 00185 Rome, Italy.
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The effect of simulating leg length inequality on spinal posture and pelvic position: a dynamic rasterstereographic analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 21:691-7. [PMID: 21769443 DOI: 10.1007/s00586-011-1912-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 06/29/2011] [Accepted: 07/05/2011] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Leg length inequalities (LLI) are a common finding. Rasterstereography offers a non-invasive, contact-free and reliable method to detect the effects of LLIs on spinal posture and pelvic position. MATERIALS AND METHODS A total of 115 subjects were rasterstereographically examined during different artificially created leg length inequalities (5-15 mm) using a platform. The pelvic obliquity and torsion and the lateral and frontal deviation of the spine, as well as the surface rotation, were measured. RESULTS Changes in platform height led to an increase of the pelvic tilt and torsion. Only minor changes in the spinal posture were found by different simulated leg length inequalities. CONCLUSIONS Our study showed that there was a correlation between an artificial leg length inequality up to 15 mm and pelvic tilt or torsion, but only minor changes in the spinal posture were measured. Further studies should investigate the effects of greater leg length inequalities on spine and pelvis.
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Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length, and trunk inclination: a reliability study. Spine (Phila Pa 1976) 2010; 35:1353-8. [PMID: 20505568 DOI: 10.1097/brs.0b013e3181cbc157] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN Determination of reliability with 3 investigators using a collective of healthy volunteers. OBJECTIVE To determine the reliability of rasterstereography 3-dimensional back surface analysis and reconstruction of the spine in healthy test subjects. SUMMARY OF BACKGROUND DATA Rasterstereography has been in clinical use since 1989 for patients with scoliosis and other spinal deformities and it significantly reduces the need for otherwise indispensable radiographs. The validity of this device has previously been examined in other studies. This study was performed to evaluate the reliability of rasterstereography for clinical application in diagnostic and follow-up examinations. METHODS Fifty-one healthy volunteers were examined rasterstereographically by 3 investigators. Each investigator made a series of 3 measurements of each participant in which 8 spine parameters including kyphotic angle ICT-ITL (max.), kyphotic angle VP-ITL, kyphotic angle VP-T12, lordotic angle ITL-ILS (max.), lordotic angle ITL-DM, lordotic angle T12-DM, trunk length VP-DM and trunk inclination were measured. Cronbach alpha was calculated. The influence of high or low body mass index on the accuracy of the technique was evaluated as well. RESULTS Cronbach alpha for the intratester-reliability of the kyphotic angle ICT-ITL (max.) for the 3 investigators has values between 0.921 and 0.992. The intertester-reliability for the same parameter is 0.979 (95% CI). In this study group a meaningful association between body mass index and reliability of the device was not found. CONCLUSION The reliability revealed very good results, both for intratester and for intertester reliability. The technique is well suited for analysis of the back in standing position. The body mass index has no influence on the reproducibility.
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Hasler C, Schmid C, Enggist A, Neuhaus C, Erb T. No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis. J Child Orthop 2010; 4:219-26. [PMID: 21629373 PMCID: PMC2866846 DOI: 10.1007/s11832-010-0258-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 03/31/2010] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Brace treatment is the gold standard for patients with mild adolescent idiopathic scoliosis (Cobb angle 20°-40°). However, negative psychosocial impacts, physical constraints and incompliance cause many patients and parents to seek for so-called holistic and apparently less harmful approaches within the field of complementary and alternative medicine (CAM). Osteopathy-manual interventions on the viscera and locomotor system-is widely used for scoliosis. There is, however, a complete lack of evidence regarding its efficacy. We, therefore, tested the hypothesis that osteopathy alters trunk morphology, a prerequisite to unload the concave side of the scoliosis, and that it halts curve progression. METHODS This was a prospective, controlled trial of 20 post-pubertal young women (20°-40° idiopathic scoliosis) randomly allocated to an observation (group 0) or osteopathic treatment (group 1). The latter comprised three sessions (5 weeks). Trunk morphology (clinical examination, video rasterstereography) and spine flexibility (MediMouse(®)) were assessed at a pre- and post-intervention with a 3-month interval (blinded examiner). We chose scoliometer measurement (rib hump, lumbar prominence) as the main outcome parameter. RESULTS Two patients in the treatment group refused further treatment and the final examination, as they felt no benefit after two osteopathic treatments. Regression analysis for repeat measurements (independent statistician) revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global spinal flexibility. CONCLUSIONS We found no evidence to support osteopathy in the treatment of mild adolescent idiopathic scoliosis. Therefore, we caution against abandoning the conventional standard of care for mild idiopathic scoliosis. As for other CAM therapies, the use of osteopathy as a treatment option for scoliosis still needs to be clearly defined.
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Affiliation(s)
- Carol Hasler
- />Orthopaedic Department, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
| | - Caius Schmid
- />Corpo Sana, Training and Therapy, Münchensteinerstrasse 220, 4053 Basel, Switzerland
| | - Andreas Enggist
- />Enggist Medical Fitness, Bahnhofstrasse 43, 9470 Buchs, Switzerland
| | - Conny Neuhaus
- />Division of Physiotherapy, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
| | - Thomas Erb
- />Division of Anaesthesiology, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
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Raster stereography versus radiography in the long-term follow-up of idiopathic scoliosis. ACTA ACUST UNITED AC 2008; 21:23-8. [PMID: 18418132 DOI: 10.1097/bsd.0b013e318057529b] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
STUDY DESIGN Raster-stereographic and radiographic evaluation of idiopathic scoliosis without braces in a retrospective longitudinal long-term follow-up study. OBJECTIVE To investigate the reliability and accuracy of raster stereography in comparison with radiography as the gold standard, using a longitudinal long-term study design in idiopathic scoliosis, to reduce the number of radiographs required during follow-up in scoliosis patients. SUMMARY OF BACKGROUND DATA It has been confirmed that raster stereography produces reliable data in patients with conservatively and surgically treated idiopathic scoliosis, up to a Cobb angle of 80 degrees. This means that the method can be used to replace radiography during the follow-up in these patients. However, no data have yet been published on the use of raster stereography in a longitudinal setting during a long-term follow-up period in comparison with radiography as the gold standard. METHODS Raster stereographs and digitized anterior-posterior radiographs of 16 patients with idiopathic scoliosis were studied retrospectively in a longitudinal study design, with a mean follow-up period of 8 years (range 3 to 10 y). Lateral vertebral deviation and vertebral rotation were measured between C7 and L4 using raster stereography and radiography, compared with Cobb angles, and correlated. RESULTS During the follow-up period, the Cobb angle increased on average by 13 degrees. The progression of lateral vertebral deviation measured using both techniques, and that of vertebral rotation measured with radiography, was greater than that of the Cobb angle, whereas that of raster-stereographic vertebral rotation was lower. However, there was an excellent correlation between the raster-stereographic and radiographic progression of these parameters (R2 >or=0.5). The mean difference between raster stereographs and radiographs was 3.21 mm for lateral vertebral deviation and 2.45 degrees for vertebral rotation. CONCLUSIONS Using the parameters of lateral vertebral deviation and vertebral rotation, raster stereography accurately reflects the radiographically measured progression of idiopathic scoliosis during the long-term follow-up, but these parameters are not directly comparable with the Cobb angle. In the follow-up of scoliosis patients, the authors would recommend a raster-stereographic examination every 3 to 6 months and a radiographic examination every 12 to 18 months only, provided that raster stereography does not show rapid deterioration of the scoliosis. The patient's radiation exposure can be reduced using this approach.
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