Assessing kyphosis with SpineScan: another attempt to reduce our dependence on radiography

Assessment of reliability and validity of a handheld surface spine scanner for measuring trunk rotation in adolescent idiopathic scoliosis

PURPOSE

To assess the reliability and validity of a handheld scanner (SpineScan3D) for trunk rotation measurement in adolescent idiopathic scoliosis (AIS) subjects, as compared with Scoliometer.

METHODS

This was a cross-sectional study with AIS subjects recruited. Biplanar spine radiographs were performed using an EOS imaging system with coronal Cobb angle (CCA) determined. The angle of trunk rotation (ATR) was measured using Scoliometer. SpineScan3D was employed to assess the axial rotation of subjects' back at forward bending, recorded as surface tilt angle (STA). Intra- and inter-examiner repeats were conducted to evaluate the reliability of SpineScan3D.

RESULTS

97 AIS patients were recruited. Intra- and inter-examiner reliability of STA measures were good to excellent in major thoracic and lumbar curves (p < 0.001). A strong correlation was found between STA and ATR measures in both curve types (p < 0.001) with a standard error of the ATR estimate of between 1 and 2 degrees from linear regression models (R squared: 0.8-0.9, p < 0.001). A similar correlation with CCA was found for STA and ATR measures (r: 0.5-0.6, p < 0.002), which also demonstrated a similar sensitivity (72%-74%) and specificity (62%-77%) for diagnosing moderate to severe curves.

CONCLUSION

SpineScan3D is a handheld surface scanner with a potential of wide applications in subjects with AIS. The current study indicated that SpineScan3D is reliable and valid for measuring trunk rotation in AIS subjects, comparable to Scoliometer. Further studies are planned to investigate its measurements in coronal and sagittal planes and the potential of this device as a screening and monitoring tool.

TRIAL REGISTRATION NUMBER (DATE OF REGISTRATION)

HKUCTR-2288 (06 Dec 2017).

LEVEL OF EVIDENCE

Level III.

Effects of a postural cueing for head and neck posture on lumbar lordosis angles in healthy young and older adults: a preliminary study

Background

Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy.

Methods

Thirty-six young (24.0 ± 2.2 years, 14 females and 22 males) and 38 older (68.4 ± 5.9 years, 36 females and 2 males) healthy adults participated in this study. The four spinal regional angles—cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic forward inclination angle, were measured in standing and relaxed sitting postures to determine the effects of a postural cueing for the head and neck posture, “inclining head backward and performing chin tuck,” on lumbar lordosis angle.

Results

In the standing posture, the pelvic forward inclination angle in the older adult group was significantly smaller (P < 0.001, by ANOVA) than that in the young adult group and increased significantly (P < 0.001) in response to the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced in response to the postural cueing. However, the lumbar lordosis angle in response to the postural cueing increased significantly in both the standing position (P < 0.001) and sitting position (P < 0.001).

Conclusion

The results suggest that increasing the cervical anterior angle can increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic forward inclination to improve the lumbar lordosis angle. Furthermore, the change in head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new noninvasive body posture rehabilitation strategy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13018-022-03090-9.

Sagittal imbalance of the spine is associated with poor sitting posture among primary and secondary school students in China: a cross-sectional study

Background

Long-term poor posture may affect the morphological development of the spine. However, there is no definite answer as to how writing posture affects students’ spine. This study attempted to compare the sagittal curvature of the spine between sitting and standing postures in adolescents to reveal the variation rule of spinal sagittal curvature of students with learning posture, and to discover the key factors that may affect students’ spinal health.

Methods

1138 participants (male, 604; female, 534; age range, 6–18 years) from three schools in Tianjin, China, including 570 primary school students and 568 secondary school students. This study used SpineScan and PA200 Station Posture Assessment System to assess the sagittal curvature of the spine for three postures: sitting on a chair in upright position, seated at a desk while reading/writing, and standing in natural relaxed position. Analyze the difference between spine angle of the three postures and the correlation between the sagittal plane angle of the spine and body posture.

Results

The mean sagittal angle of the spine changed when the participants were in reading/writing position compared to standing position, with the lumbar lordosis angle significantly decreased (p < 0.05) and the thoracic kyphosis angle significantly increased (p < 0.05). The TKA and LLA angles were abnormal in 33 and 52% of students in reading/writing posture respectively. There was a significant correlation between sitting posture and standing spinal Angle and were positively correlated with the height of the teenager (p < 0.05). By contrast, a higher percentage of TKA and LLA subjects in the standard reading/writing posture reference range maintained normal spinal shape while standing.

Conclusions

The angle of thoracic kyphosis significantly increased from standing posture to upright sitting, reading/writing posture, while lumbar lordosis significantly decreased or even disappeared. There was a significant correlation between sagittal angle of spine in different postures. The poor sitting posture associated with sagittal angle abnormalities impact the shape of the spine such that sagittal imbalance was also observed when students in natural standing posture. Height is an important factor affecting the sitting spine shape of students.