Patrick Knott1, Peter Sturm2, Baron Lonner3, Patrick Cahill4, Marcel Betsch5, Richard McCarthy6, Michael Kelly7, Lawrence Lenke8, Randal Betz9. 1. Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL 60064, USA. Electronic address: Patrick.Knott@RosalindFranklin.edu. 2. Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229, USA. 3. Scoliosis Associates, 820 2nd Ave, New York, NY 10017, USA. 4. Children's Hospital of Philadelphia, Wood Center, Second Floor, 34th and Civic Center Blvd. Philadelphia, PA 19104, USA. 5. University of Aachen, Pauwelsstraße 30, Aachen, D-52074, Germany. 6. Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA. 7. Washington University Medical Center, 4901 Forest Park Ave, St. Louis, MO 63108, USA. 8. Columbia University Medical Center, Allen Hospital, 5141 Broadway, 3 Field West - 029, New York, NY 10034, USA. 9. Institute for Spine and Scoliosis, 3100 Princeton Pike, Lawrenceville, NJ 08648, USA.
Abstract
INTRODUCTION: In pediatric spinal deformity the gold standard for curve surveillance remains standing full-column radiographs, but repeated exposure to ionizing radiation motivates us to look for nonradiographic solutions. This study tests a modern system of surface topography (ST) to determine whether it is reliable and reproducible. METHODS: Patients from 6 pediatric spinal deformity clinics were recruited for enrollment. Inclusion criteria were age 8-18; diagnosis of scoliosis measuring ≥10 and <50 degrees or increased kyphosis of ≥45 degrees. Standing radiographs and ST scans (DIERS Formetric, Diers Medical Systems, Chicago, IL) were obtained on all patients and then measured and compared. A single investigator using a validated electronic measurement tool performed all radiographic measurements. Analysis of reproducibility and comparison of ST and radiographs were done. RESULTS: A total of 193 patients were enrolled (148 F [77%]). The mean age was 13.25 years (range 8-18). The scoliosis magnitude was as follows: thoracic average 22.7 ± 10 degrees; lumbar average 19.6 ± 9 degrees. The kyphosis magnitude was 54.0 ± 11 degrees. The reproducibility for each ST parameter for 3 repeated scans was strong (interclass correlation = 0.855-0.944). Comparison to radiographic measurements was strong in the thoracic (r = 0.7) and moderate in the lumbar curve (r = 0.5). There was an average difference of 5.8 degrees in the thoracic spine and 8.8 degrees in the lumbar spine between ST Cobb angle estimates and radiographs. Thoracic kyphosis also had a strong correlation (r = 0.8) with radiographs. CONCLUSIONS: Although the results are intended to measure similar aspects of deformity as the traditional Cobb angle, the measurement is not intended to be an exact estimation. The utility of ST is in the reproducible quantification of deformity after the initial radiograph has been taken. This has the potential to make longitudinal assessment of change in deformity without serial radiographs.
INTRODUCTION: In pediatric spinal deformity the gold standard for curve surveillance remains standing full-column radiographs, but repeated exposure to ionizing radiation motivates us to look for nonradiographic solutions. This study tests a modern system of surface topography (ST) to determine whether it is reliable and reproducible. METHODS:Patients from 6 pediatric spinal deformity clinics were recruited for enrollment. Inclusion criteria were age 8-18; diagnosis of scoliosis measuring ≥10 and <50 degrees or increased kyphosis of ≥45 degrees. Standing radiographs and ST scans (DIERS Formetric, Diers Medical Systems, Chicago, IL) were obtained on all patients and then measured and compared. A single investigator using a validated electronic measurement tool performed all radiographic measurements. Analysis of reproducibility and comparison of ST and radiographs were done. RESULTS: A total of 193 patients were enrolled (148 F [77%]). The mean age was 13.25 years (range 8-18). The scoliosis magnitude was as follows: thoracic average 22.7 ± 10 degrees; lumbar average 19.6 ± 9 degrees. The kyphosis magnitude was 54.0 ± 11 degrees. The reproducibility for each ST parameter for 3 repeated scans was strong (interclass correlation = 0.855-0.944). Comparison to radiographic measurements was strong in the thoracic (r = 0.7) and moderate in the lumbar curve (r = 0.5). There was an average difference of 5.8 degrees in the thoracic spine and 8.8 degrees in the lumbar spine between ST Cobb angle estimates and radiographs. Thoracic kyphosis also had a strong correlation (r = 0.8) with radiographs. CONCLUSIONS: Although the results are intended to measure similar aspects of deformity as the traditional Cobb angle, the measurement is not intended to be an exact estimation. The utility of ST is in the reproducible quantification of deformity after the initial radiograph has been taken. This has the potential to make longitudinal assessment of change in deformity without serial radiographs.
Authors: Andrea Manca; Marco Monticone; Lucia Cugusi; Carlo Doria; Paolo Tranquilli-Leali; Franca Deriu Journal: Eur Spine J Date: 2018-06-05 Impact factor: 3.134
Authors: Isis Juliene Rodrigues Leite Navarro; Cláudia T Candotti; Tássia S Furlanetto; Vinícius H Dutra; Maiane A do Amaral; Jefferson F Loss Journal: J Chiropr Med Date: 2020-09-03