1
|
Sowula PT, Izatt MT, Labrom RD, Askin GN, Little JP. Assessing progressive changes in axial plane vertebral deformity in adolescent idiopathic scoliosis using sequential magnetic resonance imaging. Eur Spine J 2024; 33:663-672. [PMID: 37962687 DOI: 10.1007/s00586-023-08004-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 09/24/2023] [Accepted: 10/14/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To understand how the axial plane deformity contributes to progression of the three-dimensional spinal deformity of Adolescent Idiopathic Scoliosis (AIS), with a main thoracic curve type, using a series of sequential magnetic resonance images (MRI). METHODS Twenty-seven AIS patients (at scan 1: mean 12.4 years (± 1.5), mean Cobb angle 29.1°(± 8.8°)) had 3 MRI scans (T4-L1) performed at intervals of mean 0.7 years (± 0.4). The outer profile of the superior and inferior endplates were traced on a reformatted axial image using ImageJ (NIH). Endplate AVR, and intravertebral rotation (IVR), defined as the difference between superior and inferior endplate AVR, was calculated for each vertebral level. RESULTS For all patients and scans, the mean AVR was greatest at the curve apex, with AVR diminishing in a caudal and cephalic direction from the apex. At scan 3 the mean apical AVR was 15.1°(± 4.6°) with a mean change in apical AVR between MRI 1 and 3 of 2.7°(± 2.9°). The increase in standing height between MRI 1 and 3 was mean 7.4 cm (± 4.6). Linear regression showed a positive correlation between apical AVR and Cobb angle (R2 = 0.57, P < 0.001), and a positive correlation between apical AVR and rib hump (R2 = 0.54, p < 0.001). The mean change in IVR was greater 3 vertebral levels cephalic and caudal to the apex (1.4°(± 4.1°) and 1.2°(± 2.0°), respectively), compared to the apex (0.4°(± 3.1°)). CONCLUSIONS AVR increased, during curve progression, most markedly at the curve apex. The greatest IVR was observed at the periapical levels, with the apex by contrast having only a modest degree of rotation, suggesting the periapical vertebral levels of the scoliosis deformity may be a significant driver in the progression of AIS.
Collapse
Affiliation(s)
- Pawel T Sowula
- Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia.
- Queensland Children's Hospital, Brisbane, Australia.
| | - Maree T Izatt
- Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia
- Queensland Children's Hospital, Brisbane, Australia
| | - Robert D Labrom
- Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia
- Queensland Children's Hospital, Brisbane, Australia
- Mater Hospital, Brisbane, Australia
| | - Geoffrey N Askin
- Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia
- Queensland Children's Hospital, Brisbane, Australia
- Mater Hospital, Brisbane, Australia
| | - J Paige Little
- Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children's Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia
| |
Collapse
|