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Tomaiuolo R, Banfi G, Messina C, Albano D, Gitto S, Sconfienza LM. Health technology assessment in musculoskeletal radiology: the case study of EOSedge™. LA RADIOLOGIA MEDICA 2024; 129:1076-1085. [PMID: 38856961 PMCID: PMC11252187 DOI: 10.1007/s11547-024-01832-9] [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: 12/03/2023] [Accepted: 05/30/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES Health technology assessment (HTA) is a systematic process used to evaluate the properties and effects of healthcare technologies within their intended use context. This paper describes the adoption of HTA process to assess the adoption of the EOSedge™ system in clinical practice. METHODS The EOSedge™ system is a digital radiography system that delivers whole-body, high-quality 2D/3D biplanar images covering the complete set of musculoskeletal and orthopedic exams. Full HTA model was chosen using the EUnetHTA Core Model® version 3.0. The HTA Core Model organizes the information into nine domains. Information was researched and obtained by consulting the manufacturers' user manuals, scientific literature, and institutional sites for regulatory aspects. RESULTS All nine domains of the EUnetHTA Core Model® helped conduct the HTA of the EOSedge, including (1) description and technical characteristics of the technology; (2) health problem and current clinical practice; (3) safety; (4) clinical effectiveness; (5) organizational aspects; (6) economic evaluation; (7) impact on the patient; (8) ethical aspects; and (9) legal aspects. CONCLUSIONS EOS technologies may be a viable alternative to conventional radiographs. EOSedge has the same intended use and similar indications for use, technological characteristics, and operation principles as the EOS System and provides significant dose reduction factors for whole spine imaging compared to the EOS System without compromising image quality. Regarding the impact of EOS imaging on patient outcomes, most studies aim to establish technical ability without evaluating their ability to improve patient outcomes; thus, more studies on this aspect are warranted.
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Affiliation(s)
- Rossella Tomaiuolo
- Vita-Salute San Raffaele University, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy
| | - Giuseppe Banfi
- Vita-Salute San Raffaele University, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Cristina Belgioioso 173, 20157, Milan, Italy.
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Brage K, Mussmann B, Geijer M, Larsen P, Jensen J. Clinical application of EOS imaging system: a scoping review protocol. JBI Evid Synth 2023; 21:1009-1015. [PMID: 36633464 DOI: 10.11124/jbies-22-00213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The objective of this scoping review is to examine and map the existing literature on the clinical application of the EOS imaging system and to identify related evidence gaps. INTRODUCTION The EOS imaging system was originally developed to conduct imaging for medical conditions, such as scoliosis and anisomelia. However, recent research suggests that the modality has other clinical uses that may benefit patients via reduced radiation dose and, thus, improve patient safety. INCLUSION CRITERIA This scoping review will consider all quantitative study designs, including systematic reviews and meta-analyses. Imaging phantom studies and conference abstracts will be excluded. METHODS Databases that will be searched include Embase, MEDLINE, CINAHL Complete, Scopus, Cochrane Library, Academic Search Premier, and OpenGrey. Relevant secondary material will be identified using citation searching (backwards and forwards) of included studies through Google Scholar. In addition, we will search by author name where more than 3 included studies from the same first author are identified. Articles published from 2003 in English, Danish, Norwegian, Swedish, French, and German will be included. Two independent reviewers will perform title/abstract screening, followed by full-text screening. Data extraction will include study type and design, age of participants, anatomical/physiological region, pathology, clinical endpoint, outcome measures, sample size, and clinical application. Data will be presented in tabular format and as a narrative summary. REVIEW REGISTRATION NUMBER Open Science Framework https://osf.io/yc85j/.
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Affiliation(s)
- Karen Brage
- Education of Radiography, UCL University College, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Bo Mussmann
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
| | - Mats Geijer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Palle Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Janni Jensen
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
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Simoni P, Negro G, Moeremans M, Leucio AD. The Adolescent Spine. Semin Musculoskelet Radiol 2022; 26:501-509. [PMID: 36103891 DOI: 10.1055/s-0042-1755392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is the most characteristic disorder of the adolescent spine. It is a three-dimensional (3D) disorder that occurs from 10 years of age and comprises 90% of all idiopathic scolioses. Imaging plays a central role in the diagnosis and follow-up of patients with AIS. Modern imaging offers 3D assessment of scoliosis with less radiation exposure. Imaging helps rule out occult conditions that cause spinal deformity. Various imaging methods are also used to assess skeletal maturity in patients with AIS, thus determining the growth spurt and risk of progression of scoliosis. This article provides a brief overview of the pathophysiology, biomechanics, clinical features, and modern imaging of AIS relevant to radiologists in clinical settings.
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Affiliation(s)
- Paolo Simoni
- Department of Pediatric Imaging, Reine Fabiola Children's University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Giulia Negro
- Department of Pediatric Imaging, Reine Fabiola Children's University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Marine Moeremans
- Department of Pediatric Imaging, Reine Fabiola Children's University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Alessandro De Leucio
- Department of Pediatric Imaging, Reine Fabiola Children's University Hospital, Université libre de Bruxelles, Brussels, Belgium
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Kelly C, Delakis I. Technical evaluation of a clinical, bi-planar, digital and upright X-ray imaging unit. J Med Radiat Sci 2021; 68:475-481. [PMID: 34096199 PMCID: PMC8655884 DOI: 10.1002/jmrs.519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/04/2021] [Accepted: 05/22/2021] [Indexed: 11/07/2022] Open
Abstract
We describe the technical evaluation of the commercially available, clinical, bi-planar, low dose, digital X-ray system (EOS System, EOS imaging, France). The unit is used for upright, weight-bearing musculoskeletal pathologies, in particular, in the spine and lower limbs. The evaluation incorporated tests on the X-ray generator performance, radiation/imaging field alignment, dose area product accuracy and image quality. The assessment methodology was based on objective parameters and required equipment readily available for technical evaluation of other radiological equipment. Results demonstrated that the system performs well within acceptable performance criteria with regard to X-ray generator performance, radiation/imaging field alignment and dose area product accuracy. In addition, results from the image-quality assessment were aligned with previously published work. The work presented in this article can be used for the technical evaluation of the EOS System at other clinical sites.
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Affiliation(s)
- Charlotte Kelly
- Radiology DepartmentSidra Medical and Research CenterDohaQatar
| | - Ioannis Delakis
- Radiology DepartmentSidra Medical and Research CenterDohaQatar
- Radiology DepartmentWeill Cornell Medical CollegeNYUSA
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Kerbrat A, Rivals I, Dupuy P, Dot G, Berg BI, Attali V, Schouman T. Biplanar Low-Dose Radiograph Is Suitable for Cephalometric Analysis in Patients Requiring 3D Evaluation of the Whole Skeleton. J Clin Med 2021; 10:5477. [PMID: 34884179 PMCID: PMC8658104 DOI: 10.3390/jcm10235477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The biplanar 2D/3D X-ray technology (BPXR) is a 2D/3D imaging system allowing simultaneous stereo-corresponding posteroanterior (PA) and lateral 2D views of the whole body. The aim of our study was to assess the feasibility of cephalometric analysis based on the BPXR lateral skull view to accurately characterize facial morphology. METHOD A total of 17 landmarks and 11 angles were placed and/or calculated on lateral BPXR and lateral cephalograms of 13 patients by three investigators. Five methods of angle identification were performed: the direct construction of straight lines on lateral cephalograms (LC-A) and on BPXR (BPXR-A), as well as the calculation of angles based on landmark identification on lateral cephalograms (LA-L) and on BPXR with the PA image (BPXR-LPA) or without (BPXR-L). Intra- and interoperator reliability of landmark identification and angle measurement of each method were calculated. To determine the most reliable method among the BPXR-based methods, their concordance with the reference method, LC-A, was evaluated. RESULTS Both imaging techniques had excellent intra- and interoperator reliability for landmark identification. On lateral BPXR, BPXR-A presented the best concordance with the reference method and a good intra- and interoperator reliability. CONCLUSION BPXR provides a lateral view of the skull suitable for cephalometric analysis with good reliability.
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Affiliation(s)
- Adeline Kerbrat
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
| | - Isabelle Rivals
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
- Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, 75231 Paris, France
| | - Pauline Dupuy
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
| | - Gauthier Dot
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
| | - Britt-Isabelle Berg
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland;
| | - Valérie Attali
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
- Service des Pathologies du Sommeil, Département R3S, Hôpital Pitié-Salpêtrière, AP-HP. Sorbonne Université, 75013 Paris, France
| | - Thomas Schouman
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
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Pasha S, Rajapaske CR, Reddy R, Diebo B, Knott P, Jones BC, Kumar D, Zhu W, Lou E, Shapira N, Noel P, Ho-Fung V, Jaramillo D. Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2021; 31:1273-1285. [PMID: 33517495 DOI: 10.1007/s00590-021-02883-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE We aimed to provide a perspective review of the available quantitative imaging modalities of the spine for prognostic evaluation of the adolescent idiopathic scoliosis (AIS). METHODS A technical description of the current imaging technologies for quantitative assessment of the pediatric spine with scoliosis was provided, and the pros and cons of each method were discussed. Imaging modalities that quantify the overall 3D alignment of the spine as well as the structural specification of the spinal bone, intervertebral disc, endplates, and ligaments as it pertains to development and progression of the idiopathic spinal deformities in adolescents were discussed. RESULTS Low-dose and microdose stereoradiography, ultrasound, and rasterstereography provide quantitative imaging of the 3D spinal alignment with low or no radiation in standing posture which allows repetitive imaging for early detection of the curve development. Quantitative magnetic resonance imaging, including ultrashort dual-echo time and T1-rho can provide quantitative assessment of the spinal tissues relevant to development of idiopathic spinal deformity in pediatric population. New computed tomography scans that uses dual-energy can provides high-resolution measure of the current-state of the bone quality and morphology as well as the osteogenic properties of the bone by quantitative evaluation of the bone marrow. CONCLUSION The presented imaging modalities can provide a wide spectrum of quantifiable information relevant to development and progression of the spinal deformity. Clinical application of these technologies can change the paradigm in clinical assessment of the pediatric scoliosis by improving our understanding of the pathogenesis of the idiopathic scoliosis.
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Affiliation(s)
- Saba Pasha
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
| | - Chamith R Rajapaske
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Ravinder Reddy
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Bassel Diebo
- State University of New York Downstate Medical Center, New York, USA
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, Chicago, USA
| | - Brandon C Jones
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Dushyant Kumar
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Winnie Zhu
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Edmond Lou
- Department of Electrical Computer Engineering, University of Alberta, Edmonton, Canada
| | - Nadav Shapira
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Peter Noel
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Victor Ho-Fung
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
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Boënnec R, Dujardin PA, Meunier B, Rafin JM, Sirinelli D, Brunereau L, Morel B. REDUCING PELVIS RADIOGRAPH EXPOSURE IN CHILDREN USING A DOSE SIMULATION X-RAY RESEARCH SOFTWARE. RADIATION PROTECTION DOSIMETRY 2021; 194:90-96. [PMID: 34109408 DOI: 10.1093/rpd/ncab083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 03/09/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
Pelvis radiography is a frequent X-ray examination. The objective of our study was to determine the minimum dose to be delivered without reducing the quality. We included 60 children having a pelvis X-ray in four groups that were equally represented by weight ranges. A software simulated, for each radiograph, six additional simulated photonic noise images corresponding to 100, 80, 64, 50, 40 and 32% of the initial dose. The 360 radiographs were blindly scored by two radiologists using a semi-quantitative Likert scale. There was no significant difference in scoring between the reference radiograph and simulated radiographs at 80% of the dose in children between 0 and 15 kg and over 35 kg. Inter-observer reproducibility was moderate to very good. Pelvis X-ray doses might be reduced by 20% in children in our institution. Software that produces simulated X-ray with decreasing dose might be a useful tool for an optimization process.
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Affiliation(s)
- Ronan Boënnec
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, Tours 37000, France
| | | | - Benjamin Meunier
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, Tours 37000, France
| | - Jean-Michel Rafin
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, Tours 37000, France
| | - Dominique Sirinelli
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, Tours 37000, France
| | - Laurent Brunereau
- Radiology Department, Trousseau Hospital, CHRU of Tours, Tours 37000, France
| | - Baptiste Morel
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, Tours 37000, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours 37000, France
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Guglielmi R, Di Chio T, Kaleeta Maalu JP, Aparisi Gómez MP, De Leucio A, Simoni P. Preoperative and Postoperative Imaging in Idiopathic Scoliosis: What the Surgeon Wants to Know. Semin Musculoskelet Radiol 2021; 25:155-166. [PMID: 34020475 DOI: 10.1055/s-0041-1724018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The term idiopathic scoliosis covers a broad spectrum of spinal deformities in the pediatric population without an underlying congenital anomaly of the spine. Depending on the age of presentation, it has both characteristic clinical and imaging features and a different prognosis. The radiologist should provide the surgeon with critical information to assess the degree of deformity and eventually plan surgery. Thoracic deformities and lung volume must also be part of the preoperative assessment. Imaging has a critical role in postsurgical follow-up and in surgical complications. This review highlights the importance of common terminology and measurement methods to avoid incongruences. The different imaging modalities are discussed with their indications and limitations. We pay special attention to imaging modalities that can help the surgeon assess skeletal maturation reliably and thus predict the prognosis of scoliosis. Radiation protection and the risk of cumulative radiation exposure in these patients is emphasized.
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Affiliation(s)
- Riccardo Guglielmi
- Institute of Radiology, Spital Thurgau AG, Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland
| | - Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | - Jean-Paul Kaleeta Maalu
- Orthopedic Surgery Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Alessandro De Leucio
- Diagnostic Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Paolo Simoni
- Diagnostic Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
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Is the Cranial Sagittal Vertical Axis (Cr-SVA) a Better Midterm Predictor of Clinical Results Than C7-SVA in Adult Patients Operated on Spinal Deformity After a Minimum 2-Year Follow-Up? Clin Spine Surg 2021; 34:E32-E38. [PMID: 32568865 DOI: 10.1097/bsd.0000000000001034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 05/22/2020] [Indexed: 01/22/2023]
Abstract
STUDY DESIGN This is nonconcurrent prospective study approved by the Institutional Research Ethics Committee. OBJECTIVE The purpose of this study is to determine if the cranial sagittal vertical axis (Cr-SVA) measured in full spine standing radiographs is a better predictor of clinical results than the C7 sagittal vertical axis (C7-SVA) in adult patients operated on spinal deformity with a minimum 2-year follow-up after surgery. SUMMARY OF BACKGROUND DATA The Cr-SVA has recently been described as a better predictor of health-related quality of life outcomes than the C7-SVA for patients with adult spinal deformity (ASD) before undergoing surgery. This has not been confirmed in patients after ASD surgery. METHODS Inclusion criteria were age at surgery more than 25 years and a minimum 2-year follow-up after a ≥5 level fusion for ASD. Full-length standing lateral radiographs (including nasion-inion line, spine, and femoral heads) and Scoliosis Research Society 22 Questionnaire and SF36 questionnaires were available for every patient at the final follow-up. The distance from the Cr-SVA to the posterior corner of S1 (Cr-SVA-S) and to the centers of the hip (Cr-SVA-H) was measured and also the C7-SVA, lumbar lordosis, pelvic incidence, pelvic tilt, and PI-LL. RESULTS Sixty-five patients (58 female individuals) operated on ASD in a single institution were included. Age at surgery was 61 years (26-67). The mean follow-up was 53 months (24-120). Spearman rank-order test showed several significant correlations. After multivariable analysis, only Cr-SVA-S and age persisted as predictors for Scoliosis Research Society (SRS) image scores, Cr-SVA-H for SRS satisfaction, Cr-SVA-H and age for SRS total scores, Cr-SVA-H and age for SF36 Physical Function, Cr-SVA-S for SF36 Role Physical, Cr-SVA-H for SF36 Bodily Pain, and Cr-SVA-H for SF36 Role Emotional. CONCLUSIONS The Cr-SVA measured in full spine standing radiographs seems to be a better predictor of health-related quality of life outcomes than the C7-SVA for adults operated on spinal deformity >2 years after surgery.
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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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Mussmann B, Jensen C, Bensen AS, Torfing T, Ovesen O, Overgaard S. Radiographic signs of acetabular retroversion using a low-dose slot-scanning radiographic system (EOS ®). Radiography (Lond) 2019; 25:e53-e57. [PMID: 31301791 DOI: 10.1016/j.radi.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/28/2018] [Accepted: 01/03/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Acetabular retroversion is assessed using pelvic X-ray. Cross-over-sign (COS), posterior-wall-sign (PWS) and ischial-spine-sign (ISS) are important radiographic signs of the condition. The pelvic area is sensitive to radiation and thus, possibilities to reduce dose should be considered. The purpose was to compare radiographic signs of acetabular retroversion on conventional pelvic anteroposterior (AP) X-rays with a low-dose slot-scanning system (EOS) in a sample of patients with retroversion of the acetabulum and to compare the radiation doses. METHODS 34 participants with radiographic signs of acetabular retroversion in one or both hips on conventional pelvic X-ray were consecutively recruited. Pelvic EOS-images were acquired in each patient and COS, PWS, ISS, COS-ratio and PWS-ratio was assessed. Radiation dose comparison of X-ray vs. EOS was performed using Dose-Area Products. RESULTS Retroversion was present in 57 out of 68 hips. The absolute agreement was 91%, 84% and 76% for COS, PWS and ISS, respectively. No statistically significant differences were present between COS-ratio and PWS-ratio in either modality and Bland-Altman limits of agreement were narrow. The mean radiation dose was 1053 mGy*cm2 in X-ray and 593 mGy*cm2 in EOS (p = 0.003). CONCLUSION The results indicate that pelvic EOS provides diagnostic qualities similar to conventional X-ray using 44% less radiation when radiographic signs of acetabular retroversion are assessed.
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Affiliation(s)
- B Mussmann
- Department of Radiology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
| | - C Jensen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark.
| | - A S Bensen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Orthopaedic Surgery, Aalborg University Hospital, DK-9000, Aalborg, Denmark.
| | - T Torfing
- Department of Radiology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
| | - O Ovesen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark.
| | - S Overgaard
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
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Ferràs-Tarragó J, Valencia JMM, Belmar PR, Vergara SP, Gómez PJ, Hermida JLB, Hermida PB, Hermida TB. Cobb angle measurement with a conventional convex echography probe and a smartphone. 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; 28:1955-1961. [PMID: 31201564 DOI: 10.1007/s00586-019-06030-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/05/2019] [Accepted: 06/10/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND CONTEXT Serial X-rays are needed during the follow-up of adolescent idiopathic scoliosis. They are done every 6 or 3 months in cases of high risk of progression. Thanks to the advances in ultrasound techniques, deformity measurement systems free from ionizing radiations have been validated, although spinal surgeons did not use them routinely due to the need of special software. OBJECTIVE The aim of our work is to assess the reproducibility and correlation of an ultrasound measuring system based on the positioning of the transverse processes. STUDY DESIGN Prospective, single center, randomized, triple blinded. METHODS Two independent researchers trained in ultrasound examined the spinal deformities of 31 children. The measurements were compared against those performed with an X-ray by three scoliosis expert surgeons. Statistics were performed by an independent researcher. Parametric methods were used. RESULTS We found a 95% [(0.91-0.97) p < 2.2e-16] correlation between the degree of scoliosis measured with the proposed ultrasound system and the 30 cm × 90 cm X-rays in standing position. There was an intra-observer reliability of 97% [r-squared = 0.97; CI 95% (0.95-0.98) p < 2.2e-16] and an inter-observer reliability of 95% [r-squared = 0.95; CI 95% (0.90-0.97) p < 2.2e-16]. CONCLUSIONS An approximation of the Cobb angle measure is possible with ultrasound by using the transverse processes as reference. This is a very rapid and simple system for assessing the principal spinal deformity measure in young people, although it does not allow estimating the associated axial or sagittal rotation. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Joan Ferràs-Tarragó
- La Fe Hospital, Valencia, Spain.
- , Jorge Juan Street, 14 Bis, 4th, 7th, Castellón de la Plana, Spain.
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Interrater reliability of three-dimensional reconstruction of the spine. DER ORTHOPADE 2019; 49:350-358. [DOI: 10.1007/s00132-019-03712-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Agreement Between Manual and Computerized Designation of Neutral Vertebra in Idiopathic Scoliosis. Spine Deform 2019; 6:644-650. [PMID: 30348338 DOI: 10.1016/j.jspd.2018.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 11/20/2022]
Abstract
STUDY DESIGN Survey-based cross-sectional study. OBJECTIVES To describe interobserver agreement among experienced spine surgeons in choosing neutral vertebra (NV) based on manual measurements from radiographs. Secondarily, to use axial vertebral rotation (AVR) values obtained from low-dose stereoradiography (SR) post-processing software (SterEOS 2D/3D) to separately designate the NV in subject cases and to compare manually derived and software-derived NV designations. SUMMARY OF BACKGROUND DATA Investigators have previously suggested that parameters such as Lenke classification, stable vertebra level, end vertebra level, and NV level be used to decide on fusion levels in adolescent idiopathic scoliosis (AIS). Studies have revealed suboptimal interobserver reliability in these vertebral designations. SR post-processing software may represent a useful tool for standardizing NV designation. METHODS Thirty-two subjects with idiopathic scoliosis and Lenke 1-4 curves were assessed. Experienced surgeons (range of 7-35 years in practice) assigned NV based on preoperative radiographs. Interobserver reliability was quantified using the Fleiss Kappa statistic. Surgeon responses were compared with NV designations made using AVR values provided by SR postprocessing software. Agreement between these values was quantified using percentage agreement. RESULTS Surgeons exhibited moderate agreement in choosing NV based on radiographs (Kappa 0.444). Surgeon responses agreed with the SR-derived NV in 26.9% of cases, lay within 1 level in 82.1% of cases, and lay within 2 levels in 97.5% of cases. Surgeons were more likely to choose distal to the SR NV rather than proximal. CONCLUSIONS Variability in instrumented level selection and outcomes in idiopathic scoliosis may be partially related to inconsistency in selection of the NV. The use of SR post-processing software may provide a more reliable method for choosing NV. LEVEL OF EVIDENCE Level II.
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Benoist M. The Michel Benoist and Robert Mulholland Yearly European Spine Journal Review: A survey of the "medical" articles in the European Spine Journal, 2018. 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; 28:10-20. [PMID: 30604295 DOI: 10.1007/s00586-018-5857-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
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