STUDY DESIGN: An analysis of a standardized method of traction radiography for the evaluation of reducibility of scoliosis. OBJECTIVES: To determine whether and how preoperative fraction radiography can provide objective information and to compare traction radiography with supine side-bending radiography. SUMMARY OF BACKGROUND DATA: Flexibility of scoliosis deformity remains an arbitrary concept. No objective method of preoperative evaluation of reducibility has been established. METHODS: The utility of a standardized method of traction radiography was evaluated in 74 patients with idiopathic scoliosis who were aged 14-22 years and treated with Cotrel-Dubousset instrumentation. RESULTS: In thoracic curves, the postoperative Cobb angle was highly correlated with the preoperative Cobb angle in traction (r = 0.82). However, such correlation was much lower with lumbar curves (r = 0.54). The reducibility of the thoracic curve by traction as expressed by the ratio to the original curve was dependent on the magnitude of the original curve (P = 0.005), and this parameter proved less informative than the absolute angle values. Time-related analysis of 30 patients who were observed for more than 5 years revealed that the high correlation between the preoperative angle of thoracic curves in traction and their postoperative angle decreased with the follow-up time (r = 0.80-0.65). A comparison of traction radiography and supine side-bending radiography showed that these two tests were practically equivalent in terms of evaluating the reducibility of curves. CONCLUSION: The results provide an objective interpretation of traction radiographs for scoliosis.
STUDY DESIGN: An analysis of a standardized method of traction radiography for the evaluation of reducibility of scoliosis. OBJECTIVES: To determine whether and how preoperative fraction radiography can provide objective information and to compare traction radiography with supine side-bending radiography. SUMMARY OF BACKGROUND DATA: Flexibility of scoliosis deformity remains an arbitrary concept. No objective method of preoperative evaluation of reducibility has been established. METHODS: The utility of a standardized method of traction radiography was evaluated in 74 patients with idiopathic scoliosis who were aged 14-22 years and treated with Cotrel-Dubousset instrumentation. RESULTS: In thoracic curves, the postoperative Cobb angle was highly correlated with the preoperative Cobb angle in traction (r = 0.82). However, such correlation was much lower with lumbar curves (r = 0.54). The reducibility of the thoracic curve by traction as expressed by the ratio to the original curve was dependent on the magnitude of the original curve (P = 0.005), and this parameter proved less informative than the absolute angle values. Time-related analysis of 30 patients who were observed for more than 5 years revealed that the high correlation between the preoperative angle of thoracic curves in traction and their postoperative angle decreased with the follow-up time (r = 0.80-0.65). A comparison of traction radiography and supine side-bending radiography showed that these two tests were practically equivalent in terms of evaluating the reducibility of curves. CONCLUSION: The results provide an objective interpretation of traction radiographs for scoliosis.
Authors: Philippe Büchler; Marcelo Elias de Oliveria; Daniel Studer; Steffen Schumann; Guoyan Zheng; Jacques Schneider; Carol C Hasler Journal: Eur Spine J Date: 2014-05-30 Impact factor: 3.134