Jihane Rouissi1, Robin Arvieu1, Arnaud Dubory1,2, Claudio Vergari3,4, Manon Bachy1,2, Raphaël Vialle5,6. 1. Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France. 2. Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, The MAMUTH Hospital-University, 26 avenue du Docteur Arnold Netter, F-75571 Cedex12, Paris, France. 3. Arts et Métiers, Paristech, Institut de Biomécanique Humaine Georges Charpak, 151 Boulevard de l'Hôpital, 75013, Paris, France. 4. School of Physics, University of Exeter, Stocker Road, Exeter, EX4 4QL, UK. 5. Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France. raphael.vialle@aphp.fr. 6. Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, The MAMUTH Hospital-University, 26 avenue du Docteur Arnold Netter, F-75571 Cedex12, Paris, France. raphael.vialle@aphp.fr.
Abstract
PURPOSE: Scoliosis with pelvic obliquity (PO) could be investigated with the EOS-CHAIR protocol as the most common deformity especially in patients with trunk hypotonia and quadriplegia. However, the intra-observer and inter-observer reliability of various angles assessing PO was not investigated with this new imaging protocol. METHODS: A retrospective cohort of 36 EOS frontal full-spine acquisitions made in sitting position was used. The sacroiliac pelvic obliquity angle, iliac crest pelvic obliquity angle, and ischiatic pelvic obliquity angle were assessed in an intra-observer and inter-observer study. RESULTS: The use of the EOS-CHAIR protocol was implemented satisfactory with a high acceptance rate by all caregivers and patients and their families. Intra-observer and inter-observer reliability was excellent for the three tested angular measurements. DISCUSSION: As for idiopathic scoliosis, we postulate the EOS system as being superior to standard radiographs to assess 3D spinal deformities in neuromuscular conditions. The EOS-CHAIR protocol improves preoperative comprehension of the lumbosacral junction anatomy in patients with poor standing or sitting postures. Our results show a very high reliability of three different angular measurements of the frontal pelvic obliquity in sitting position. Then it is possible to use one of these three angles as well as the others to assess frontal pelvic obliquity in neuromuscular patients. This frontal pelvic obliquity protocol in sitting position with the EOS-CHAIR is a validated measurement technique that needs to be used now to measure PO as a critical parameter of the global trunk balance in neuromuscular patients.
PURPOSE: Scoliosis with pelvic obliquity (PO) could be investigated with the EOS-CHAIR protocol as the most common deformity especially in patients with trunk hypotonia and quadriplegia. However, the intra-observer and inter-observer reliability of various angles assessing PO was not investigated with this new imaging protocol. METHODS: A retrospective cohort of 36 EOS frontal full-spine acquisitions made in sitting position was used. The sacroiliac pelvic obliquity angle, iliac crest pelvic obliquity angle, and ischiatic pelvic obliquity angle were assessed in an intra-observer and inter-observer study. RESULTS: The use of the EOS-CHAIR protocol was implemented satisfactory with a high acceptance rate by all caregivers and patients and their families. Intra-observer and inter-observer reliability was excellent for the three tested angular measurements. DISCUSSION: As for idiopathic scoliosis, we postulate the EOS system as being superior to standard radiographs to assess 3D spinal deformities in neuromuscular conditions. The EOS-CHAIR protocol improves preoperative comprehension of the lumbosacral junction anatomy in patients with poor standing or sitting postures. Our results show a very high reliability of three different angular measurements of the frontal pelvic obliquity in sitting position. Then it is possible to use one of these three angles as well as the others to assess frontal pelvic obliquity in neuromuscular patients. This frontal pelvic obliquity protocol in sitting position with the EOS-CHAIR is a validated measurement technique that needs to be used now to measure PO as a critical parameter of the global trunk balance in neuromuscular patients.
Entities:
Keywords:
CD reformatting; Eos system; Eos-chair; Neuromuscular scoliosis; Pelvic obliquity; Trunk imbalance
Authors: Joshua D Auerbach; David A Spiegel; Miltiadis H Zgonis; Sudheer C Reddy; Denis S Drummond; John P Dormans; John M Flynn Journal: Spine (Phila Pa 1976) Date: 2009-10-01 Impact factor: 3.468