Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

Scoliosis

Marc A Asher¹  Douglas C Burton¹  Brandon B Carlson¹ 

[1] Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 3017, Kansas City, KS, 66160, USA

关键词: Scoliometer;    ATI;    Angle of trunk inclination;    Computed tomography;    Adolescent idiopathic scoliosis;   

Others  :  791404
DOI  :  10.1186/1748-7161-8-2

 received in 2012-10-25, accepted in 2013-01-09,  发布年份 2013

【 摘 要 】

Background

Cobb measurement of standing radiographs is the standard for clinical assessment of coronal spinal deformity. Angle of trunk inclination (ATI) is an accepted clinical measurement of trunk asymmetry, and has variable reported correlations with Cobb angles. Transverse plane spine deformity is most accurately measured using axial computed tomography. Aaro and Dahlbourn’s technique for quantifying apical vertebral rotation with respect to the sagittal plane (RAsag) is commonly reported in the literature. To our knowledge no study has correlated ATI with RAsag. The purpose of this study was to determine the relationship between commonly used measures of trunk and spine deformity.

Methods

Sixteen females that underwent preoperative apical vertebra(e) CT scans were retrospectively studied. Thoracic and thoracolumbar RAsag measurements were date-matched to clinically obtained ATI and Cobb measurements. Two-tailed Pearson correlations were calculated; α = 0.01.

Results

Median patient age was 14.6 years (11–19); BMI 19.4 (16.0-25.5). Curve patterns: Lenke 1 (5); 2 (5); 3 (1); 4 (1); 5 (2): 6 (2). Twenty-six curves (15T; 11TL) with complete, date-matched data points were analyzed. In thoracic curves, ATI correlated with Cobb (r = 0.711, P < 0.004) and RAsag (r = 0.730, P <0.003). ATI was inversely correlated with Cobb flexibility (r = −0.647, P < 0.01). In thoracolumbar curves, ATI correlated with Cobb (r = 0.789, P < 0.005), and RAsag (r = 0.771, P < 0.006) but not Cobb flexibility (r = −0.452, P = 0.190).

Conclusions

Trunk and spine thoracic and thoracolumbar transverse plane deformity are correlated, as are trunk transverse plane and spine coronal plane deformity. Increasing trunk deformity limits thoracic, but not thoracolumbar spine flexibility.

【 授权许可】

   
2013 Carlson et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Dubousset J: Three-dimensional analysis of the scoliotic deformity. Weinstein SL edition edition. New York: Raven; 1994:479-496. [The pediatric spine: principles and practice]
• [2]Cobb J: Outline for the study of scoliosis. Am Acad of Orthop Surg Instr Course Lect 1948, Volume V:261-275.
• [3]Benson DR, Schultz AB, Dewald RL, Benson DR, Schultz AB, Dewald RL: Roentgenographic evaluation of vertebral rotation. J Bone Joint Surg Am 1976, 58:1125-1129.
• [4]Bunnell WP: Vertebral rotation: simple method of measurment on routine radiographs. Orthop Trans 1985, 9:114.
• [5]Nash CL Jr, Moe JH, Nash CL Jr, Moe JH: A study of vertebral rotation. J Bone Joint Surg Am 1969, 51:223-229.
• [6]Perdriolle R, Vidal J, Perdriolle R, Vidal J: Morphology of scoliosis: three-dimensional evolution. Orthopedics 1987, 10:909-915.
• [7]Stokes IA, Bigalow LC, Moreland MS, Stokes IA, Bigalow LC, Moreland MS: Measurement of axial rotation of vertebrae in scoliosis. [see comment] [erratum appears in Spine. May;16(5):599–60; PMID: 2053012]. Spine 1991, 1986(11):213-218.
• [8]Suzuki S, Yamamuro T, Shikata J, Shimizu K, Iida H, Suzuki S, Yamamuro T, Shikata J, Shimizu K, Iida H: Ultrasound measurement of vertebral rotation in idiopathic scoliosis. J Bone Joint Surg Br 1989, 71:252-255.
• [9]Birchall D, Hughes DG, Hindle J, Robinson L, Williamson JB, Birchall D, Hughes DG, Hindle J, Robinson L, Williamson JB: Measurement of vertebral rotation in adolescent idiopathic scoliosis using three-dimensional magnetic resonance imaging. Spine 1997, 22:2403-2407.
• [10]Gocen S, Aksu MG, Baktirolu L, Ozcan O, Gocen S, Aksu MG, Baktirolu L, Ozcan O: Evaluation of computed tomographic methods to measure vertebral rotation in adolescent idiopathic scoliosis: an intraobserver and interobserver analysis. J Spinal Disord 1998, 11:210-214.
• [11]Ho EK, Upadhyay SS, Ferris L, Chan FL, Bacon-Shone J, Hsu LC, Leong JC, Ho EK, Upadhyay SS, Ferris L: A comparative study of computed tomographic and plain radiographic methods to measure vertebral rotation in adolescent idiopathic scoliosis. Spine 1992, 17:771-774.
• [12]Krismer M, Chen AM, Steinlechner M, Haid C, Lener M, Wimmer C, Krismer M, Chen AM, Steinlechner M, Haid C: Measurement of vertebral rotation: a comparison of two methods based on CT scans. J Spinal Disord 1999, 12:126-130.
• [13]Majdouline Y, Aubin CE, Robitaille M, Sarwark JF, Labelle H: Scoliosis correction objectives in adolescent idiopathic scoliosis. J Pediatr Orthop 2007, 27:775-781.
• [14]Patias P, Grivas TB, Kaspiris A, Aggouris C, Drakoutos E: A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices. Scoliosis 2010, 5:12. BioMed Central Full Text
• [15]Bunnell WP, Bunnell WP: An objective criterion for scoliosis screening. J Bone Joint Surg Am 1984, 66:1381-1387.
• [16]Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K, Lenke LG, Betz RR, Harms J: Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis.[see comment]. J Bone Joint Surg Am 2001, 83-A:1169-1181.
• [17]Aaro S, Dahlborn M: Estimation of vertebral rotation and the spinal and rib cage deformity in scoliosis by computer tomography. Spine 1981, 6:460-467.
• [18]Lee SM, Suk SI, Chung ER: Direct vertebral rotation: a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis. Spine 2004, 29:343-349.
• [19]Gondo H: Evaluation of spine and thoracic cage configuration change following Isola spinal instrumentation of adolescent idiopathic scoliosis (in Japanese; tables and abstract in English). J Jpn Scoliosis Soc 1996, 11:75-84.
• [20]Gondo H, Asher M: Mid-term effects of Isola instrumentation on the configuration of the spine and the thoracic cage in adolescent idiopathic scoliosis. In Research into spinal deformities 1. Edited by Sevastik J, Diab K. Amsterdam: Ios Press; 1997:433-436.
• [21]Wood KB, Olsewski JM, Schendel MJ, Boachie-Adjei O, Gupta M, Wood KB, Olsewski JM, Schendel MJ, Boachie-Adjei O, Gupta M: Rotational changes of the vertebral pelvic axis after sublaminar instrumentation in adolescent idiopathic scoliosis. Spine 1997, 22:51-57.
• [22]Wood KB, Transfeldt EE, Ogilvie JW, Schendel MJ, Bradford DS, Wood KB, Transfeldt EE, Ogilvie JW, Schendel MJ, Bradford DS: Rotational changes of the vertebral-pelvic axis following Cotrel-Dubousset instrumentation. Spine 1991, 16:S404-S408.
• [23]Kuklo TR, Potter BK, Lenke LG, Kuklo TR, Potter BK, Lenke LG: Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech 2005, 18:139-147.
• [24]Hwang SW, Samdani AF, Cahill PJ: The impact of segmental and en bloc derotation maneuvers on scoliosis correction and rib prominence in adolescent idiopathic scoliosis. J Neurosurg Spine 2012, 16:345-350.
• [25]Chen ZQ, Zhao YF, Bai YS, Liu KP, He SS, Wang CF, Zhang JT, Li M: Factors affecting curve flexibility in skeletally immature and mature idiopathic scoliosis. J Orthop Sci 2011, 16:133-138.
• [26]Grivas TB, Vasiliadis ES, Mihas C, Savvidou O: The effect of growth on the correlation between the spinal and rib cage deformity: implications on idiopathic scoliosis pathogenesis. Scoliosis 2007, 2:11. BioMed Central Full Text
• [27]Little DG, Song KM, Katz D, Herring JA: Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls. J Bone Joint Surg Am 2000, 82:685-693.
• [28]Cote P, Kreitz BG, Cassidy JD, Dzus AK, Martel J: A study of the diagnostic accuracy and reliability of the Scoliometer and Adam’s forward bend test. Spine 1998, 23:796-802. discussion 803