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Patel M, Liu XC, Tassone C, Escott B, Yang K, Thometz J. Correlation of transverse rotation of the spine using surface topography and 3D reconstructive radiography in children with idiopathic scoliosis. Spine Deform 2024; 12:1001-1008. [PMID: 38403800 DOI: 10.1007/s43390-024-00838-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/02/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE The relationship between axial surface rotation (ASR) measured by surface topography (ST) and axial vertebral rotation (AVR) measured by radiography in the transverse plane is not well defined. This study aimed to: (1) quantify ASR and AVR patterns and their magnitudes from T1 to L5; (2) determine the correlation or agreement between the ASR and AVR; and (3) investigate the relationship between axial rotation differences (ASR-AVR) and major Cobb angle. METHODS This is a retrospective study evaluating patients (age 8-18) with IS or spinal asymmetry with both radiographic and ST measurements. Demographics, descriptive analysis, and correlations and agreements between ASR and AVR were evaluated. A piecewise linear regression model was further created to relate rotational differences to Cobb angle. RESULTS Fifty-two subjects met inclusion criteria. Mean age was 14.1 ± 1.7 and 39 (75%) were female. Looking at patterns, AVR had maximal rotation at T8, while ASR had maximal rotation at T11 (r = 0.35, P = .006). Cobb angle was 24.1° ± 13.3° with AVR of - 1° ± 4.6° and scoliotic angle was 20.9° ± 11.5° with ASR of - 2.3° ± 6.6°. (ASR-AVR) vs Cobb angle was found to be very weakly correlated with a curve of less than 38.8° (r = 0.15, P = .001). CONCLUSION Our preliminary findings support that ASR measured by ST has a weak correlation with estimation of AVR by 3D radiographic reconstruction. This correlation may further help us to understand the application of transverse rotation in some clinical scenarios such as specific casting manipulation, padding mechanism in brace, and surgical correction of rib deformity.
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Affiliation(s)
- Milan Patel
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Xue-Cheng Liu
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA.
| | - Channing Tassone
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
| | - Benjamin Escott
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
| | - Kai Yang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John Thometz
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
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2
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Lai KKL, Lee TTY, Lau HHT, Chu WCW, Cheng JCY, Castelein RM, Schlösser TPC, Lam TP, Zheng YP. Monitoring of Curve Progression in Patients with Adolescent Idiopathic Scoliosis Using 3-D Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:384-393. [PMID: 38114347 DOI: 10.1016/j.ultrasmedbio.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim of the work described here was to determine whether 3-D ultrasound can provide results comparable to those of conventional X-ray examination in assessing curve progression in patients with adolescent idiopathic scoliosis (AIS). METHODS One hundred thirty-six participants with AIS (42 males and 94 females; age range: 10-18 y, mean age: 14.1 ± 1.9 y) with scoliosis of different severity (Cobb angle range: 10º- 85º, mean: of 24.3 ± 14.4º) were included. Each participant underwent biplanar low-dose X-ray EOS and 3-D ultrasound system scanning with the same posture on the same date. Participants underwent the second assessment at routine clinical follow-up. Manual measurements of scoliotic curvature on ultrasound coronal projection images and posterior-anterior radiographs were expressed as the ultrasound curve angle (UCA) and radiographic Cobb angle (RCA), respectively. RCA and UCA increments ≥5º represented a scoliosis progression detected by X-ray assessment and 3-D ultrasound assessment, respectively. RESULTS The sensitivity and specificity of UCA measurement in detecting scoliosis progression were 0.93 and 0.90, respectively. The negative likelihood ratio of the diagnostic test for scoliosis progression by the 3-D ultrasound imaging system was 0.08. CONCLUSION The 3-D ultrasound imaging method is a valid technique for detecting coronal curve progression as compared with conventional radiography in follow-up of AIS. Substituting conventional radiography with 3-D ultrasound is effective in reducing the radiation dose to which AIS patients are exposed during their follow-up examinations.
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Affiliation(s)
- Kelly Ka-Lee Lai
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy Tin-Yan Lee
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong
| | - Heidi Hin-Ting Lau
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jack Chun-Yiu Cheng
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - René Marten Castelein
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tom P C Schlösser
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tsz-Ping Lam
- SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong.
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Kaiser M, Brusa T, Bertsch M, Wyss M, Ćuković S, Meixner G, Koch VM. Extrinsic Calibration for a Modular 3D Scanning Quality Validation Platform with a 3D Checkerboard. SENSORS (BASEL, SWITZERLAND) 2024; 24:1575. [PMID: 38475112 DOI: 10.3390/s24051575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Optical 3D scanning applications are increasingly used in various medical fields. Setups involving multiple adjustable systems require repeated extrinsic calibration between patients. Existing calibration solutions are either not applicable to the medical field or require a time-consuming process with multiple captures and target poses. Here, we present an application with a 3D checkerboard (3Dcb) for extrinsic calibration with a single capture. The 3Dcb application can register captures with a reference to validate measurement quality. Furthermore, it can register captures from camera pairs for point-cloud stitching of static and dynamic scenes. Registering static captures from TIDA-00254 to its reference from a Photoneo MotionCam-3D resulted in an error (root mean square error ± standard deviation) of 0.02 mm ± 2.9 mm. Registering a pair of Photoneo MotionCam-3D cameras for dynamic captures resulted in an error of 2.2 mm ± 1.4 mm. These results show that our 3Dcb implementation provides registration for static and dynamic captures that is sufficiently accurate for clinical use. The implementation is also robust and can be used with cameras with comparatively low accuracy. In addition, we provide an extended overview of extrinsic calibration approaches and the application's code for completeness and service to fellow researchers.
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Affiliation(s)
- Mirko Kaiser
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2502 Biel, Switzerland
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Tobia Brusa
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2502 Biel, Switzerland
| | - Martin Bertsch
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2502 Biel, Switzerland
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Marco Wyss
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2502 Biel, Switzerland
| | - Saša Ćuković
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Gerrit Meixner
- Usability and Interaction Technology Lab, Heilbronn University, 74081 Heilbronn, Germany
| | - Volker M Koch
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2502 Biel, Switzerland
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Bassani T, Ignasiak D, Cina A, Galbusera F. Prediction of trunk muscle activation and spinal forces in adolescent idiopathic scoliosis during simulated trunk motion: A musculoskeletal modelling study. J Biomech 2024; 163:111918. [PMID: 38199948 DOI: 10.1016/j.jbiomech.2023.111918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
Due to lack of reference validation data, the common strategy in characterizing adolescent idiopathic scoliosis (AIS) by musculoskeletal modelling approach consists in adapting structure and parameters of validated body models of adult individuals with physiological alignments. Until now, only static postures have been replicated and investigated in AIS subjects. When aiming to simulate trunk motion, two critical factors need consideration: how distributing movement along the vertebral motion levels (lumbar spine rhythm), and if neglecting or accounting for the contribution of the stiffness of the motion segments (disc stiffness). The present study investigates the effect of three different lumbar spine rhythms and absence/presence of disc stiffness on trunk muscle imbalance in the lumbar region and on intervertebral lateral shear at different levels of the thoracolumbar/lumbar scoliotic curve, during simulated trunk motions in the three anatomical planes (flexion/extension, lateral bending, and axial rotation). A spine model with articulated ribcage previously developed in AnyBody software and adapted to replicate the spinal alignment in AIS subjects is employed. An existing dataset of 100 subjects with mild and moderate scoliosis is exploited. The results pointed out the significant impact of lumbar spine rhythm configuration and disc stiffness on changes in the evaluated outputs, as well as a relationship with scoliosis severity. Unfortunately, no optimal settings can be identified due to lack of reference validation data. According to that, extreme caution is recommended when aiming to adapt models of adult individuals with physiological alignments to adolescent subjects with scoliotic deformity.
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Affiliation(s)
- Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
| | - Dominika Ignasiak
- Institute for Biomechanics, Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | - Andrea Cina
- Spine Center, Schulthess Clinic, Zurich, Switzerland; Biomedical Data Science Lab, Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
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5
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Minotti M, Negrini S, Cina A, Galbusera F, Zaina F, Bassani T. Deep learning prediction of curve severity from rasterstereographic back images in adolescent idiopathic scoliosis. 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 2023:10.1007/s00586-023-08052-1. [PMID: 38055037 DOI: 10.1007/s00586-023-08052-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/18/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutional neural networks in directly predicting the Cobb angle from rasterstereographic images of the back surface in subjects with adolescent idiopathic scoliosis. METHODS Two datasets, comprising a total of 900 individuals, were utilized for model training (720 samples) and testing (180). Rasterstereographic scans were performed using the Formetric4D device. The true Cobb angle was obtained from radiographic examination. The best model configuration was identified by comparing different network architectures and hyperparameters through cross-validation in the training set. The performance of the developed model in predicting the Cobb angle was assessed on the test set. The accuracy in classifying scoliosis severity (non-scoliotic, mild, and moderate category) based on Cobb angle was evaluated as well. RESULTS The mean absolute error in predicting the Cobb angle was 6.1° ± 5.0°. Moderate correlation (r = 0.68) and a root-mean-square error of 8° between the predicted and true values was reported. The overall accuracy in classifying scoliosis severity was 59%. CONCLUSION Despite some improvement over previous approaches that relied on spine shape reconstruction, the performance of the present fully automatic application is below that of radiographic evaluation performed by human operators. The study confirms that rasterstereography cannot be considered a valid non-invasive alternative to radiographic examination for clinical purposes.
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Affiliation(s)
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", 20122, Milan, Italy
| | - Andrea Cina
- Spine Center, Schulthess Clinic, Zurich, Switzerland
- Biomedical Data Science Lab, Department of Health Sciences and Technologies, ETH Zurich, Zurich, Switzerland
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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Kaiser M, Brusa T, Wyss M, Ćuković S, Bertsch M, Taylor WR, Koch VM. Minimal Required Resolution to Capture the 3D Shape of the Human Back-A Practical Approach. SENSORS (BASEL, SWITZERLAND) 2023; 23:7808. [PMID: 37765865 PMCID: PMC10537399 DOI: 10.3390/s23187808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a prevalent musculoskeletal disorder that causes abnormal spinal deformities. The early screening of children and adolescents is crucial to identify and prevent the further progression of AIS. In clinical examinations, scoliometers are often used to noninvasively estimate the primary Cobb angle, and optical 3D scanning systems have also emerged as alternative noninvasive approaches for this purpose. The recent advances in low-cost 3D scanners have led to their use in several studies to estimate the primary Cobb angle or even internal spinal alignment. However, none of these studies demonstrate whether such a low-cost scanner satisfies the minimal requirements for capturing the relevant deformities of the human back. To practically quantify the minimal required spatial resolution and camera resolution to capture the geometry and shape of the deformities of the human back, we used multiple 3D scanning methodologies and systems. The results from an evaluation of 30 captures of AIS patients and 76 captures of healthy subjects showed that the minimal required spatial resolution is between 2 mm and 5 mm, depending on the chosen error tolerance. Therefore, a minimal camera resolution of 640 × 480 pixels is recommended for use in future studies.
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Affiliation(s)
- Mirko Kaiser
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2501 Biel, Switzerland
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Tobia Brusa
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2501 Biel, Switzerland
| | - Marco Wyss
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2501 Biel, Switzerland
| | - Saša Ćuković
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Martin Bertsch
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2501 Biel, Switzerland
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - William R. Taylor
- Laboratory for Movement Biomechanics, ETH Zurich, 8092 Zürich, Switzerland
| | - Volker M. Koch
- Biomedical Engineering Lab, Bern University of Applied Sciences, 2501 Biel, Switzerland
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7
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Mak THA, Liang R, Chim TW, Yip J. A Neural Network Approach for Inertial Measurement Unit-Based Estimation of Three-Dimensional Spinal Curvature. SENSORS (BASEL, SWITZERLAND) 2023; 23:6122. [PMID: 37447971 DOI: 10.3390/s23136122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
The spine is an important part of the human body. Thus, its curvature and shape are closely monitored, and treatment is required if abnormalities are detected. However, the current method of spinal examination mostly relies on two-dimensional static imaging, which does not provide real-time information on dynamic spinal behaviour. Therefore, this study explored an easier and more efficient method based on machine learning and sensors to determine the curvature of the spine. Fifteen participants were recruited and performed tests to generate data for training a neural network. This estimated the spinal curvature from the readings of three inertial measurement units and had an average absolute error of 0.261161 cm.
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Affiliation(s)
- T H Alex Mak
- Department of Computer Science, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Ruixin Liang
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
| | - T W Chim
- Department of Computer Science, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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Kaps D, Siebers HL, Betz U, Pfirrmann D, Eschweiler J, Hildebrand F, Betsch M, Huthwelker J, Wolf C, Drees P, Konradi J. Creation and Evaluation of a Severity Classification of Hyperkyphosis and Hypolordosis for Exercise Therapy. Life (Basel) 2023; 13:1392. [PMID: 37374174 DOI: 10.3390/life13061392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
The rise in the occurrence of musculoskeletal disorders, such as thoracic hyperkyphosis (THK) or lumbar hypolordosis (LHL), is a result of demographic changes. Exercise therapy is an effective approach that can reduce related disabilities and costs. To ensure successful therapy, an individualized exercise program adapted to the severity of the disorder is expedient. Nevertheless, appropriate classification systems are scarce. This project aimed to develop and evaluate a severity classification focused on exercise therapy for patients with THK or LHL. A multilevel severity classification was developed and evaluated by means of an online survey. Reference limits of spinal shape angles were established by data from video rasterstereography of 201 healthy participants. A mean kyphosis angle of 50.03° and an average lordosis angle of 40.72° were calculated as healthy references. The strength of the multilevel classification consisting of the combination of subjective pain and objective spinal shape factors was confirmed by the survey (70% agreement). In particular, the included pain parameters were considered relevant by 78% of the experts. Even though the results of the survey provide important evidence for further analyses and optimization options of the classification system, the current version is still acceptable as therapeutic support.
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Affiliation(s)
- David Kaps
- Center for Mental Health, Hospital Stuttgart-Bad Cannstatt Hospital, 70374 Stuttgart, Germany
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany
- Institute of Social Science, Media, and Sports, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
| | - Hannah L Siebers
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Daniel Pfirrmann
- Institute of Social Science, Media, and Sports, Johannes Gutenberg-University Mainz, 55128 Mainz, Germany
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany
| | - Marcel Betsch
- Department of Orthopedics and Trauma Surgery, University Hospital Erlangen of the University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Janine Huthwelker
- Department of Orthopaedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, 52074 Aachen, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation (IPTPR), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Sarnadskiy VN, Batorov DY, Shchuchkina OA. Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs. HIRURGIÂ POZVONOČNIKA (SPINE SURGERY) 2023. [DOI: 10.14531/ss2023.1.16-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Objective. To analyze the results of scoliosis diagnostics during the examination of the same group of schoolchildren by TODP and Formetriс topographs.Material and Methods. A total of 364 schoolchildren (197 girls and 167 boys, mean age 8.92 ± 1.9 years) were examined, divided into 3 age groups: 6–8 years old (n = 135, mean age 7.22 ± 0.7 years), 8–10 years old (n = 134 children, mean age 8.95 ± 0.56 years), 10–12 years old (n = 95 children, mean age 11.35 ± 1.59 years). Schoolchildren were examined in turn by computer optical topography (TODP, released in 2021, WTOPO 5.4-2021 software) and video raster stereography (Formetric 4D released in 2015, DICAM2.6.4 software). Three standard screening poses were used for TODP, and one pose with averaging 12 frames – for Formetric.Results. The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. For 9 structural scoliosis cases (according to TODP), the Formetric diagnosis coincided completely only in 2 cases and partially in 3 (55 %), and in 5 cases of compensatory scoliosis (according to TODP) it coincided completely in 3 cases and partially in 1 (80 %).Conclusion. According to the results of topographic screening of 364 schoolchildren using the TODP topograph, 3.8 % of scoliosis cases of 9° or more was detected, which corresponds to the average screening data in a number of countries around the world. Examination of the same schoolchildren using the Formetric topograph revealed 68.7 % of cases of scoliosis of 9° or more, which allows us to judge about overdiagnosis and conclude that Formetric is poorly suited for topographic screening of scoliosis in schoolchildren.
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Affiliation(s)
- V. N. Sarnadskiy
- LLC “Medical topographic systems “METOS”
31 Krylova str., office 54, Novosibirsk, 630091, Russia
| | - D. Yu. Batorov
- Hippocrates Polyclinic LLC
55b Aviastroitelei prospect, Dimitrovgrad, 433513, Russia
| | - O. A. Shchuchkina
- Polyclinic Hippocrates LLC
55b Aviastroitelei prospect, Dimitrovgrad, 433513, Russia
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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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Brandl A, Egner C, Schleip R. Reply to Kudus, A.L. Comment on "Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845". Life (Basel) 2022; 12:868. [PMID: 35743899 PMCID: PMC9225237 DOI: 10.3390/life12060868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
One comment [...].
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Affiliation(s)
- Andreas Brandl
- DIPLOMA Hochschule, 37242 Bad Sooden-Allendorf, Germany; (A.B.); (C.E.)
| | - Christoph Egner
- DIPLOMA Hochschule, 37242 Bad Sooden-Allendorf, Germany; (A.B.); (C.E.)
| | - Robert Schleip
- DIPLOMA Hochschule, 37242 Bad Sooden-Allendorf, Germany; (A.B.); (C.E.)
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80333 Munich, Germany
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Kudus AL. Comment on Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845. LIFE (BASEL, SWITZERLAND) 2022; 12:life12060864. [PMID: 35743895 PMCID: PMC9225180 DOI: 10.3390/life12060864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Alexander Leonard Kudus
- Faculty of Medicine, AMC Hospital, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
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Marin L, Lovecchio N, Pedrotti L, Manzoni F, Febbi M, Albanese I, Patanè P, Carnevale Pellino V, Vandoni M. Acute Effects of Self-Correction on Spine Deviation and Balance in Adolescent Girls with Idiopathic Scoliosis. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22051883. [PMID: 35271030 PMCID: PMC8914676 DOI: 10.3390/s22051883] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 05/07/2023]
Abstract
Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of spine and trunk with a higher incidence in girls. AIS alters and reduces postural control and balance. Self-correction movement (SCM) is a well-known non-invasive approach to ameliorate spine curve in AIS subjects. We aimed to evaluate the effects of SCM on the spine and on the balance of adolescents with AIS with a new non-invasive instrumentation. Methods: A total of 38 girls with AIS were recruited. To evaluate the acute effects of SCM and the oscillations of center of pressure (COP), we used LiDAR technology combined with a stabilometric platform to evaluate both changes in spinal curves and balance at the same time. Two tests were carried out simultaneously using the two instruments: before the execution of SCM, in the spontaneously assumed position of each subject (SP) and after the execution of SCM, during the achieved position (SC). Sway area, COP medio-lateral and antero-posterior directions, eccentricity of the ellipse and vertebral lateral deviation were recorded. The two conditions were compared with a Wilcoxon signed-rank test. Results: In general, all measures showed lower values in SC condition (p < 0.05), except the variation along the Y axis. Conclusions: Thanks to objective measured data, the therapists observed real-time changes during the performance of SCM, appreciating its efficacy on curve correction.
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Affiliation(s)
- Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Rehabilitation, Città di Pavia Hospital, 27100 Pavia, Italy
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
- Correspondence:
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, 24127 Bergamo, Italy;
| | - Luisella Pedrotti
- Orthopedics Unit, Department of Clinical Surgical Sciences, Diagnostic and Pediatrics, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatric Orthopedics, Città di Pavia Hospital, 27100 Pavia, Italy
| | - Federica Manzoni
- Epidemiological Observatory Unit, Health Protection Agency, 27100 Pavia, Italy;
| | - Massimiliano Febbi
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Ilaria Albanese
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Pamela Patanè
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
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Bassani T, Cina A, Ignasiak D, Barba N, Galbusera F. Accounting for Biomechanical Measures from Musculoskeletal Simulation of Upright Posture Does Not Enhance the Prediction of Curve Progression in Adolescent Idiopathic Scoliosis. Front Bioeng Biotechnol 2021; 9:703144. [PMID: 34568296 PMCID: PMC8460902 DOI: 10.3389/fbioe.2021.703144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/26/2021] [Indexed: 11/20/2022] Open
Abstract
A major clinical challenge in adolescent idiopathic scoliosis (AIS) is the difficulty of predicting curve progression at initial presentation. The early detection of progressive curves can offer the opportunity to better target effective non-operative treatments, reducing the need for surgery and the risks of related complications. Predictive models for the detection of scoliosis progression in subjects before growth spurt have been developed. These models accounted for geometrical parameters of the global spine and local descriptors of the scoliotic curve, but neglected contributions from biomechanical measurements such as trunk muscle activation and intervertebral loading, which could provide advantageous information. The present study exploits a musculoskeletal model of the thoracolumbar spine, developed in AnyBody software and adapted and validated for the subject-specific characterization of mild scoliosis. A dataset of 100 AIS subjects with mild scoliosis and in pre-pubertal age at first examination, and recognized as stable (60) or progressive (40) after at least 6-months follow-up period was exploited. Anthropometrical data and geometrical parameters of the spine at first examination, as well as biomechanical parameters from musculoskeletal simulation replicating relaxed upright posture were accounted for as predictors of the scoliosis progression. Predicted height and weight were used for model scaling because not available in the original dataset. Robust procedure for obtaining such parameters from radiographic images was developed by exploiting a comparable dataset with real values. Six predictive modelling approaches based on different algorithms for the binary classification of stable and progressive cases were compared. The best fitting approaches were exploited to evaluate the effect of accounting for the biomechanical parameters on the prediction of scoliosis progression. The performance of two sets of predictors was compared: accounting for anthropometrical and geometrical parameters only; considering in addition the biomechanical ones. Median accuracy of the best fitting algorithms ranged from 0.76 to 0.78. No differences were found in the classification performance by including or neglecting the biomechanical parameters. Median sensitivity was 0.75, and that of specificity ranged from 0.75 to 0.83. In conclusion, accounting for biomechanical measures did not enhance the prediction of curve progression, thus not supporting a potential clinical application at this stage.
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Affiliation(s)
- Tito Bassani
- LABS-Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Andrea Cina
- LABS-Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Noemi Barba
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Fabio Galbusera
- LABS-Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Kinel E, D'Amico M, Roncoletta P. 3D Quantitative Evaluation of Posture and Spine Proprioceptive Perception Through Instinctive Self-Correction Maneuver in Adolescent Idiopathic Scoliosis. Front Bioeng Biotechnol 2021; 9:663394. [PMID: 34141701 PMCID: PMC8204188 DOI: 10.3389/fbioe.2021.663394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background Conservative treatment in the adolescent idiopathic scoliosis (AIS) population is based on individual proprioceptive and motor control training. Such training includes physiotherapeutic scoliosis-specific exercises (PSSEs) stimulating the individual capacity to perceive and control his/her posture, particularly the shape of the spine. However, limited knowledge about basic proprioception capability in AIS patients is reported in the literature. Questions (1) How do AIS patients, who did not receive any previous specific postural education treatment, perceive their posture and 3D spine shape? Are they able to modify their posture and 3D spine shape correctly through an instinctive self-correction (ISCO) maneuver? (2) Are posture and ISCO maneuver ability gender dependent in AIS patients? (3) Do AIS patients present different posture and spine shape characteristics as well as different ISCO ability compared with the healthy young adult population? Methods Cross-sectional observational study. 132 (75 females, 57 males) AIS patients’ posture and 3D spine shape have been measured comparing indifferent orthostasis (IO) (neutral erect posture) to ISCO using a non-ionizing 3D optoelectronic stereophotogrammetric approach. Thirteen quantitative biomechanical parameters described the AIS patients body posture. The statistical analysis was performed using a multivariate approach to compare genders in IO, ISCO, and AIS patients vs. healthy young adults–previously published data (57 females, 64 males). Results Males (87.7%) and females (93.3%) of AIS patients were unable to modify posture and 3D spine shape globally. AIS patients gender differences were found in IO, ISCO, and the comparison vs. healthy young adults. When changes occurred, subjects could not focus and control their posture globally, but only in a few aspects at a time. Conclusion Self-correction maneuver producing an improvement in body posture and spine shape is not instinctive and must be trained. In such characteristics, AIS patients are not so dissimilar to healthy young adults. Sagittal plane control is the highest, but ISCO in AIS patients led to worsening in this plane. Control at the lumbar level is neglected in both genders. Such outcomes support the necessity of customized PSSEs to treat AIS patients. The 3D stereo-photogrammetric approach is effective in quantitatively describing the subject’s posture, motor control, and proprioception.
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Affiliation(s)
- Edyta Kinel
- Chair of Rehabilitation and Physiotherapy, Department of Rehabilitation, University of Medical Sciences, Poznań, Poland
| | - Moreno D'Amico
- SMART LAB (Skeleton Movement Analysis and Advanced Rehabilitation Technologies), Bioengineering & Biomedicine Company Srl, San Giovanni Teatino, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Piero Roncoletta
- SMART LAB (Skeleton Movement Analysis and Advanced Rehabilitation Technologies), Bioengineering & Biomedicine Company Srl, San Giovanni Teatino, Italy
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Lai KKL, Lee TTY, Lee MKS, Hui JCH, Zheng YP. Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis. SENSORS (BASEL, SWITZERLAND) 2021; 21:2858. [PMID: 33921592 PMCID: PMC8073843 DOI: 10.3390/s21082858] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/03/2022]
Abstract
To diagnose scoliosis, the standing radiograph with Cobb's method is the gold standard for clinical practice. Recently, three-dimensional (3D) ultrasound imaging, which is radiation-free and inexpensive, has been demonstrated to be reliable for the assessment of scoliosis and validated by several groups. A portable 3D ultrasound system for scoliosis assessment is very much demanded, as it can further extend its potential applications for scoliosis screening, diagnosis, monitoring, treatment outcome measurement, and progress prediction. The aim of this study was to investigate the reliability of a newly developed portable 3D ultrasound imaging system, Scolioscan Air, for scoliosis assessment using coronal images it generated. The system was comprised of a handheld probe and tablet PC linking with a USB cable, and the probe further included a palm-sized ultrasound module together with a low-profile optical spatial sensor. A plastic phantom with three different angle structures built-in was used to evaluate the accuracy of measurement by positioning in 10 different orientations. Then, 19 volunteers with scoliosis (13F and 6M; Age: 13.6 ± 3.2 years) with different severity of scoliosis were assessed. Each subject underwent scanning by a commercially available 3D ultrasound imaging system, Scolioscan, and the portable 3D ultrasound imaging system, with the same posture on the same date. The spinal process angles (SPA) were measured in the coronal images formed by both systems and compared with each other. The angle phantom measurement showed the measured angles well agreed with the designed values, 59.7 ± 2.9 vs. 60 degrees, 40.8 ± 1.9 vs. 40 degrees, and 20.9 ± 2.1 vs. 20 degrees. For the subject tests, results demonstrated that there was a very good agreement between the angles obtained by the two systems, with a strong correlation (R2 = 0.78) for the 29 curves measured. The absolute difference between the two data sets was 2.9 ± 1.8 degrees. In addition, there was a small mean difference of 1.2 degrees, and the differences were symmetrically distributed around the mean difference according to the Bland-Altman test. Scolioscan Air was sufficiently comparable to Scolioscan in scoliosis assessment, overcoming the space limitation of Scolioscan and thus providing wider applications. Further studies involving a larger number of subjects are worthwhile to demonstrate its potential clinical values for the management of scoliosis.
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Affiliation(s)
| | | | | | | | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong; (K.K.-L.L.); (T.T.-Y.L.); (M.K.-S.L.); (J.C.-H.H.)
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Galbusera F, Cina A, Panico M, Bassani T. The importance of curve severity, type and instrumentation strategy in the surgical correction of adolescent idiopathic scoliosis: an in silico clinical trial on 64 cases. Sci Rep 2021; 11:1799. [PMID: 33469069 PMCID: PMC7815774 DOI: 10.1038/s41598-021-81319-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022] Open
Abstract
Adolescent idiopathic scoliosis is a three-dimensional deformity of the spine which is frequently corrected with the implantation of instrumentation with generally good or excellent clinical results; mechanical post-operative complications such as implant loosening and breakage are however relatively frequent. The rate of complications is associated with a lack of consensus about the surgical decision-making process; choices about the instrumentation length, the anchoring implants and the degree of correction are indeed mostly based on personal views and previous experience of the surgeon. In this work, we performed an in silico clinical trial on a large number of subjects in order to clarify which factors have the highest importance in determining the risk of complications by quantitatively analysing the mechanical stresses and loads in the instrumentation after the correction maneuvers. The results of the simulations highlighted the fundamental role of the curve severity, also in its three-dimensional aspect, and of the instrumentation strategy, whereas the length of the fixation had a lower importance.
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Affiliation(s)
- Fabio Galbusera
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, via Galeazzi 4, 20161, Milan, Italy.
| | - Andrea Cina
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, via Galeazzi 4, 20161, Milan, Italy
| | - Matteo Panico
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, via Galeazzi 4, 20161, Milan, Italy.,Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Tito Bassani
- Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, via Galeazzi 4, 20161, Milan, Italy
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Barba N, Ignasiak D, Villa TMT, Galbusera F, Bassani T. Assessment of trunk muscle activation and intervertebral load in adolescent idiopathic scoliosis by musculoskeletal modelling approach. J Biomech 2020; 114:110154. [PMID: 33279818 DOI: 10.1016/j.jbiomech.2020.110154] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine, the aetiology and pathogenesis of which are poorly understood. Unfortunately, biomechanical data describing trunk muscle activation and intervertebral load, which can contribute to understanding the pathomechanics of the AIS spine, cannot be measured in vivo due to the invasiveness of the procedures. The present study provides the biomechanical characterization of the spinal loads in scoliotic subjects by exploiting musculoskeletal modelling approach, allowing for calculating biomechanical measures in an assigned posture. A spine model with articulated ribcage previously developed in AnyBody software was applied. The predicted outcomes were evaluated in the upright posture, depending on scoliosis severity and curve type, in a population of 132 scoliotic subjects with mild, moderate, and severe scoliosis. Radiographic-based three dimensional reconstruction of vertebral orientations and scaling of body segments and trunk muscle cross-section area guaranteed geometrical subject-specificity. Validation analysis supporting the application of the model was performed. Trunk muscles were found more activated in the convex side of the scoliotic curve, in agreement with reference in vivo measurements, with progressive increase with scoliosis severity. The intervertebral lateral shear was found positively correlated with the severity of the scoliosis, demonstrating that the transferred load is not a priori orthogonal to vertebral endplate in the frontal plane, and thus questioning the assumption of the 'follower load' approach in case of experimental or computational study on the scoliotic spine. The study opens the way for the subject-specific characterization of scoliosis in assigned loading and motion conditions.
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Affiliation(s)
- Noemi Barba
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | | | - Tomaso Maria Tobia Villa
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Fabio Galbusera
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. LABS - Laboratory of Biological Structures Mechanics
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. LABS - Laboratory of Biological Structures Mechanics..
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Pan F, Zhu R, Zander T, Lu S, Schmidt H. The sagittal sways of back lordosis and sacral orientation during still standing at different arm positions. J Biomech 2020; 114:110149. [PMID: 33271471 DOI: 10.1016/j.jbiomech.2020.110149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/29/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
Lumbo-pelvic parameters in the sagittal plane are normally measured from lateral radiographs obtained at a single time point during upright standing with arms held forward to expose anatomical bony structures. However, the human trunk naturally sways during still standing, which potentially alters the targeted parameters. We therefore aimed to investigate the effect of postural sway on lumbo-pelvic parameters during still standing at different arm positions. A non-radiological back measurement device was used to determine the absolute changes of back lordosis and sacral orientation during one-minute still standing while participants (10 males and 10 females without low back pain) held their arms at eight different positions. When the arms were freely hanging down at both sides, males displayed median values of 25.2° (range: 15.6-45.0°) and 7.4° (range: 2.0-26.7°) for back lordosis and sacral orientation, which were smaller than those of 33.1° (range: 11.9-41.9°) and 16.1° (range: 0.8-22.8°) for females, respectively (P < 0.05). At the same arm position, the median values were 2.7° (range: 1.3-5.2°) and 2.9° (range: 1.6-4.5°) for change of back lordosis and change of sacral orientation, respectively. Sex displayed no significant influence for both measures. Different arm positions non-significantly affected the change of back lordosis. When hands rested on horizontal bars, the change of sacral orientation was significantly less than during other arm positions (P < 0.05). Hence, back lordosis and sacral orientation inherently change during still standing, independently of sex and arm position, which could compromise the reliability of measurements at a single time point. When categorizing subjects into groups with normal or abnormal lumbo-pelvic balance, this variability should be taken into consideration.
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Affiliation(s)
- Fumin Pan
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China; Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Rui Zhu
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
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Krott NL, Wild M, Betsch M. Meta-analysis of the validity and reliability of rasterstereographic measurements of spinal posture. 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 2020; 29:2392-2401. [PMID: 32277336 DOI: 10.1007/s00586-020-06402-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We provide a meta-analysis for clinicians and researchers regarding reliability and validity of rasterstereographic measurement of the spinal posture. METHOD A comprehensive PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) literature search identified 19 eligible studies evaluating reliability and validity of static rasterstereographic measurements in healthy subjects and patients with different spinal pathologies. RESULTS Our meta-analysis suggests that rasterstereography is a reliable and valid instrument to assess spinal posture parameters, especially thoracic kyphosis, lumbar lordosis, and scoliosis, reliability overall effect sizes rs > .91, ps < .001, validity overall effect sizes rs > 70, ps < .001, when compared to traditional radiological imaging techniques. Validity is higher in scoliosis patients compared with healthy controls. Limitations are a lack of reported statistics of the included studies and small sample sizes. CONCLUSION The first meta-analysis on reliability and validity of rasterstereography shows satisfactory results. Rasterstereography thus presents a reliable and valid alternative to classic radiological imaging technique to assess and evaluate spinal posture in patients with spinal pathologies. Further studies are needed, focusing on the measurement properties of both static and dynamic rasterstereographic measurements.
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Affiliation(s)
- Nikolas Leon Krott
- Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany.
| | - Michael Wild
- Department of Orthopaedics Trauma and Hand Surgery, Klinikum Darmstadt, Darmstadt, Germany
| | - Marcel Betsch
- Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany
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21
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Benoist M. The Michel Benoist and Robert Mulholland yearly European spine journal review: a survey of the "medical" articles in European spine journal, 2019. 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 2020; 29:2-13. [PMID: 31893305 DOI: 10.1007/s00586-019-06246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
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Michoński J, Witkowski M, Glinkowska B, Sitnik R, Glinkowski W. Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224556. [PMID: 31752144 PMCID: PMC6888429 DOI: 10.3390/ijerph16224556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/27/2019] [Accepted: 11/13/2019] [Indexed: 12/20/2022]
Abstract
The influence of high-heel footwear on the lumbar lordosis angle, anterior pelvic tilt, and sacral tilt are inconsistently described in the literature. This study aimed to investigate the impact of medium-height heeled footwear on the static posture parameters of homogeneous young adult standing women. Heel geometry, data acquisition process, as well as data analysis and parameter extraction stage, were controlled. Seventy-six healthy young adult women with experience in wearing high-heeled shoes were enrolled. Data of fifty-three subjects were used for analysis due to exclusion criteria (scoliotic posture or missing measurement data). A custom structured light surface topography measurement system was used for posture parameters assessment. Three barefoot measurements were taken as a reference and tested for the reliability of the posture parameters. Two 30-degree wedges were used to imitate high-heel shoes to achieve a repeatable foot position. Our study confirmed the significant (p < 0.001) reduced vertical balance angle and pelvis inclination angle with large and medium-to-large effects, respectively, due to high-heel shoes. No significant differences were found in the kyphosis or lordosis angles. High-heeled shoes of medium height in young asymptomatic women can lead to a straightening effect associated with a reduced vertical balance angle and decreased pelvic inclination.
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Affiliation(s)
- Jakub Michoński
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Marcin Witkowski
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Bożena Glinkowska
- Department of Sports and Physical Education, Medical University of Warsaw, 00581 Warsaw, Poland;
| | - Robert Sitnik
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Wojciech Glinkowski
- Centre of Excellence “TeleOrto” for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, 00581 Warsaw, Poland
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00581 Warsaw, Poland
- Polish Telemedicine and eHealth Society, 03728 Warsaw, Poland
- Correspondence: ; Tel.: +48-601-230-577
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Wanke-Jellinek L, Heese O, Krenauer A, Würtinger C, Siepe CJ, Wiechert K, Mehren C. Is there any use? Validity of 4D rasterstereography compared to EOS 3D X-ray imaging in patients with degenerative disk disease. 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 2019; 28:2162-2168. [DOI: 10.1007/s00586-019-06082-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 06/12/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
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