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Khani M, Cheriet F, Seoud L, Debanné P, Parent S, Labelle H. Changes in trunk appearance following surgical correction of adolescent idiopathic scoliosis. Spine Deform 2024; 12:1071-1077. [PMID: 38520644 DOI: 10.1007/s43390-024-00843-w] [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: 07/28/2023] [Accepted: 02/09/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To assess the postoperative appearance of the trunk in surgically treated scoliosis patients after a 2 year follow-up using reliable indices and compare the results with 6-month follow-up. METHODS Forty-six Adolescent Idiopathic Scoliosis (AIS) patients (female; preop mean age 14.4 ± 2.4 years) who underwent a posterior spinal fusion from 2009 to 2018 were included in this study. All had Lenke 1A thoracic curves, with surface topography taken preoperatively, 6 months and 2 years postoperatively. To assess spinal deformity, we measured the proximal thoracic, main thoracic and thoracolumbar/lumbar Cobb angles in the frontal plane from spinal X-rays and inclinometer angles in the thoracic and lumbar regions. To assess trunk deformity, Back Surface Rotation (BSR) and Trunk Lateral Shift (TLS) were computed along the trunk. We analysed the effect of age, height, weight, Cobb angle, length of follow-up, and surgical technique. We also compared correction rates (CRs) of the spinal and trunk measurements after 6 months and 2 years. RESULTS Good spinal correction was achieved, with Cobb angles decreasing in the whole cohort. CRs for TLS and BSR were positive (denoting improvement) for 76% and 48% of patients, respectively, after 2 years. Compared with 6 months, the mean TLS CR increased while there was no improvement for BSR on average. We found no significant association after 2 years between truncal index CRs and clinical variables (age, height, weight, preoperative Cobb angles) or surgical technique. However, there were significant correlations between the CRs of TLS and the main thoracic Cobb angle (r = 0.35), and between the CRs of BSR and thoracic inclinometer angle. CONCLUSION Although more than 55% of the TLS was corrected after 2 years of follow-up, the BSR remained stable over time and the persistence of rib hump on the back surface could be observed. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Maryam Khani
- Department of Computer and Software Engineering, Polytechnique Montréal, P.O. Box 6079, Montréal, QC, H3C 3A7, Canada.
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
| | - Farida Cheriet
- Department of Computer and Software Engineering, Polytechnique Montréal, P.O. Box 6079, Montréal, QC, H3C 3A7, Canada.
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada.
| | - Lama Seoud
- Department of Computer and Software Engineering, Polytechnique Montréal, P.O. Box 6079, Montréal, QC, H3C 3A7, Canada
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Philippe Debanné
- Department of Computer and Software Engineering, Polytechnique Montréal, P.O. Box 6079, Montréal, QC, H3C 3A7, Canada
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Stefan Parent
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Hubert Labelle
- Sainte Justine Hospital Research Center, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
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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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Mehta B, Chockalingam N, Shannon T, Jevtic N, Lazic F, Jasani V, Eddison N, Healy A, Needham R. Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility. SENSORS (BASEL, SWITZERLAND) 2023; 23:8485. [PMID: 37896577 PMCID: PMC10610923 DOI: 10.3390/s23208485] [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: 08/28/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
(1) Background: Frequent exposure to ionising radiation is often used to determine the diagnosis of adolescent idiopathic scoliosis (AIS), a lateral curvature of the spine in those aged between 10 and 18 years, and a treatment plan according to Cobb angle. This narrative review outlines the clinical utility of surface topography (ST), a radiation-free imaging modality. (2) Methods: Publicly available databases were searched to yield literature related to ST. Identified articles were classified based on the equipment used and in order of how it was developed, i.e., historical, recent developments, and state-of-the-art developments. (3) Conclusions: ST is a reliable cost-effective non-invasive technique that provides an alternative to radiation-based imaging to aid with the diagnosis and potential screening of AIS. Several scanning methods are available, which allows ST to be used in several clinical environments. Limitations of inter-reliability and differences of apparatus resulting in variations of data have been noted through this narrative review.
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Affiliation(s)
- Bhavna Mehta
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Thomas Shannon
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nikola Jevtic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Filip Lazic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Vinay Jasani
- Centre for Biomechanics, University Hospitals of North Midlands NHS Trust, Stoke on Trent ST4 6QG, UK;
| | - Nicola Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
- Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Robert Needham
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
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Joarder I, Taniguchi S, Mendoza A, Snow ME. Defining "successful" treatment outcomes in adolescent idiopathic scoliosis: a scoping review. 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; 32:1204-1244. [PMID: 36847911 DOI: 10.1007/s00586-023-07592-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/07/2023] [Accepted: 02/07/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis that affects children aged 10-18 years old, manifesting in a three-dimensional spinal deformity. This study aimed to explore outcome measures used in defining AIS treatment success. Particularly, analyzing the extent of qualitative and quantitative (radiographic and quality of life domains) measures to evaluate AIS and whether AIS treatment approaches (surgical, bracing and physiotherapy) influences outcomes used as proxies of treatment success. METHODS EMBASE and MEDLINE databases were used to conduct a systematic scoping review with 654 search queries. 158 papers met the inclusion criteria and were screened for data extraction. Extractable variables included: study characteristics, study participant characteristics, type of study, type of intervention approach and outcome measures. RESULTS All 158 studies measured quantitative outcomes. 61.38% of papers used radiographic outcomes whilst 38.62% of papers used quantitative quality of life outcomes to evaluate treatment success. Irrespective of treatment intervention utilized, the type of quantitative outcome measure recorded were similar in proportion. Moreover, of the radiographic outcome measures, the subcategory Cobb angle was predominantly used across all intervention approaches. For quantitative quality of life measures, questionnaires investigating multiple domains such as SRS were primarily used as proxies of AIS treatment success across all intervention approaches. CONCLUSION This study identified that no articles employed qualitative measures of describing the psychosocial implications of AIS in defining treatment success. Although quantitative measures have merit in clinical diagnoses and management, there is increasing value in using qualitative methods such as thematic analysis in guiding clinicians to develop a biopsychosocial approach for patient care.
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Affiliation(s)
- Ishraq Joarder
- Faculty of Medicine, University of British Columbia, #908 - 2233 Allison Road, Vancouver, BC, V6T 1T7, Canada.
| | - Seika Taniguchi
- Faculty of Medicine, University of British Columbia, #908 - 2233 Allison Road, Vancouver, BC, V6T 1T7, Canada
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White-Light Body Scanning Captures Three-Dimensional Shoulder Deformity After Displaced Diaphyseal Clavicle Fracture. J Orthop Trauma 2021; 35:e142-e147. [PMID: 32910627 DOI: 10.1097/bot.0000000000001957] [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] [Accepted: 08/28/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We sought to determine if white-light three-dimensional (3D) body scanning can identify clinically relevant shoulder girdle deformity after displaced diaphyseal clavicle fracture (DCF). METHODS Adult patients with DCF (OTA/AO 15A) were prospectively enrolled. Four subcutaneous osseous landmarks were used to measure shoulder girdle morphology of the injured and uninjured shoulder. Measurements were made both manually with a tape measure and digitally with a white-light 3D scanner. Bilateral radiographs were obtained, and clavicle length was recorded. Quick-Disabilities of the Arm, Shoulder, and Hand surveys were administered at injury and at 6 and 12 weeks. RESULTS Twenty-two patients were included in the study. At the initial visit, all patients had significant differences in deformity measurements between injured and uninjured shoulders as measured by 3D scanning. There was no difference between shoulders measured using manual measurements. At 6 and 12 weeks, shoulder asymmetry was significantly less in patients treated with surgery compared with nonoperative patients as measured by the 3D scanner alone. Clavicle shortening measured on 3D scanning had weak and moderate positive correlations to radiographs (R = 0.27) and manual measurements (R = 0.53), respectively. Patients treated with surgery had significant functional improvements by 6 weeks, and a similar improvement was not seen until 12 weeks in nonsurgical patients. CONCLUSION White-light 3D scanning was able to identify and monitor clinically relevant shoulder girdle deformity after DCF. This tool may become a useful adjunct to clinical examination and radiographic assessment, when determining clinically relevant deformity thresholds. In the future, quantifying and understanding shoulder deformity may inform clinical decision making in these patients. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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