Top

European Spine Journal

Published in:

01-06-2013 | Original Article

Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results

Authors: Tamás Illés, Szabolcs Somoskeöy

Published in: European Spine Journal | Issue 6/2013

Abstract

Purpose

A new concept of vertebra vectors based on spinal three-dimensional (3D) reconstructions of images from the EOS system, a new low-dose X-ray imaging device, was recently proposed to facilitate interpretation of EOS 3D data, especially with regard to horizontal plane images. This retrospective study was aimed at the evaluation of the spinal layout visualized by EOS 3D and vertebra vectors before and after surgical correction, the comparison of scoliotic spine measurement values based on 3D vertebra vectors with measurements using conventional two-dimensional (2D) methods, and an evaluation of horizontal plane vector parameters for their relationship with the magnitude of scoliotic deformity.

Methods

95 patients with adolescent idiopathic scoliosis operated according to the Cotrel-Dubousset principle were subjected to EOS X-ray examinations pre- and postoperatively, followed by 3D reconstructions and generation of vertebra vectors in a calibrated coordinate system to calculate vector coordinates and parameters, as published earlier. Differences in values of conventional 2D Cobb methods and methods based on vertebra vectors were evaluated by means comparison T test and relationship of corresponding parameters was analysed by bivariate correlation. Relationship of horizontal plane vector parameters with the magnitude of scoliotic deformities and results of surgical correction were analysed by Pearson correlation and linear regression.

Results

In comparison to manual 2D methods, a very close relationship was detectable in vertebra vector-based curvature data for coronal curves (preop r 0.950, postop r 0.935) and thoracic kyphosis (preop r 0.893, postop r 0.896), while the found small difference in L1–L5 lordosis values (preop r 0.763, postop r 0.809) was shown to be strongly related to the magnitude of corresponding L5 wedge. The correlation analysis results revealed strong correlation between the magnitude of scoliosis and the lateral translation of apical vertebra in horizontal plane. The horizontal plane coordinates of the terminal and initial points of apical vertebra vectors represent this (r 0.701; r 0.667). Less strong correlation was detected in the axial rotation of apical vertebras and the magnitudes of the frontal curves (r 0.459).

Conclusions

Vertebra vectors provide a key opportunity to visualize spinal deformities in all three planes simultaneously. Measurement methods based on vertebral vectors proved to be just as accurate and reliable as conventional measurement methods for coronal and sagittal plane parameters. In addition, the horizontal plane display of the curves can be studied using the same vertebra vectors. Based on the vertebra vectors data, during the surgical treatment of spinal deformities, the diminution of the lateral translation of the vertebras seems to be more important in the results of the surgical correction than the correction of the axial rotation.

Greenspan A, Pugh J, Norman A et al (1978) Scoliotic index: a comparative evaluation of methods for the measurement of scoliosis. Bull Hosp Joint Dis 39:117–125PubMed

Diab K, Sevastik J, Hedlung R et al (1995) Applicability and accuracy of measurement of the scoliotic angle at the frontal plane by Cobb’s method, by Ferguson’s method and by a new method. Eur Spine J 4:291–295PubMedCrossRef

Chen YL, Chen WJ, Chiou WK (2007) An alternative method for measuring scoliosis curvature. Orthopedics 30:828–831PubMed

Ferguson A (1930) The study and treatment of scoliosis. South Med J 23:116–120CrossRef

Cobb J (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Instr Course Lect 5:261–275

Harrison DE, Cailliet R, Harrison DD et al (2001) Reliability of centroid, Cobb, and Harrison posterior tangent methods: which to choose for analysis of thoracic kyphosis. Spine 26:E227–E234PubMedCrossRef

Polly D, Kilkelly F, McHale K et al (1996) Measurement of lumbar lordosis: evaluation of intraobserver, interobserver, and technique variability. Spine 21:1530–1535PubMedCrossRef

Stotts AK, Smith JT, Santora SD et al (2002) Measurement of spinal kyphosis: implications for the management of Scheuermann’s kyphosis. Spine 27:2143–2146PubMedCrossRef

Hicks GE, George SZ, Nevitt MA et al (2006) Measurement of lumbar lordosis: inter-rater reliability, minimum detectable change and longitudinal variation. J Spinal Disord Tech 19:501–506PubMedCrossRef

10.

Mac-Thiong JM, Labelle H, Charlebois M et al (2003) Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine 28:1404–1409PubMed

11.

Nash CL Jr, Moe JH (1969) A study of vertebral rotation. J Bone Joint Surg Am 51:223–229PubMed

12.

Perdriolle R, Vidal J (1987) Morphology of scoliosis: three-dimensional evolution. Orthopaedics 10:909–915

13.

Mehta MH (1973) Radiographic estimation of vertebral rotation in scoliosis. J Bone Joint Surg Br 55:513–520PubMed

14.

Omeroğlu H, Ozekin O, Biçimoğlu A (1996) Measurement of vertebral rotation in idiopathic scoliosis using the Perdriolle torsionmeter: a clinical study on intraobserver and interobserver error. Eur Spine J 5:167–171PubMedCrossRef

15.

Aaro S, Dahlborn M (1981) Estimation of vertebral rotation and spine rib cage deformity in scoliosis by computer tomography. Spine 6:460–467PubMedCrossRef

16.

Krismer M, Chen AM, Steinlechner M et al (1999) Measurement of vertebral rotation: a comparison of two methods based on CT scans. J Spinal Disord 12:126–130PubMedCrossRef

17.

Göçen S, Aksu MG, Baktiroğlu L et al (1998) Evaluation of computer tomography methods to measure vertebral rotation in adolescent idiopathic scoliosis: an intraobserver and interobserver analysis. J Spinal Disord 11:210–214PubMed

18.

Stokes IA (1994) Three-dimensional terminology of spinal deformity. A report presented to the Scoliosis Research Society by the Scoliosis Research Society Working Group on 3-D Terminology of Spinal Deformity. Spine 19:236–248PubMedCrossRef

19.

“The Nobel Prize in Physics 1992”. Nobelprize.org. The Official Web Site of the Nobel Prize. http://nobelprize.org/nobel_prizes/physics/laureates/1992/index.html. Accessed 3 Nov 2011

20.

Charpak G (1981) La détection des particules. La Recherche 128:1384–1396

21.

Charpak G (1993) Electronic imaging of ionizing radiation with limited avalanches in gases. Rev Mod Phys 65:591–598CrossRef

22.

Kalifa G, Charpak G, Maccia C et al (1998) Evaluation of a new low-dose digital X-ray device: first dosimetric and clinical results in children. Pediatr Radiol 28:557–561PubMedCrossRef

23.

Dubousset J, Charpak G, Dorion I et al (2005) Le system EOS. Nouvelle Imagerie Osteo-Articulaire basse dose en position debout. E-mémoire de l’Académie National de Chirugie 4:22–27

24.

Dubousset J, Charpak G, Dorion I et al (2005) A new 2D and 3D imaging approach to musculoskeletal physiology and pathology with low-dose radiation and the standing position: the EOS system. Bull Acad Natl Med 189:287–297PubMed

25.

Le Bras A, Laporte S, Mitton D et al (2002) 3D detailed reconstruction of vertebrae with low dose digital stereoradiography. Stud Health Technol Inf 91:286–290

26.

Le Bras A, Laporte S, Mitton D et al (2003) A biplanar reconstruction method based on 2D and 3D contours: application to the distal femur. Comput Methods Biomech Biomed Eng 6:1–6CrossRef

27.

Illés T, Tunyogi-Csapó M, Somoskeöy S (2011) Breakthrough in three-dimensional scoliosis diagnosis—significance of horizontal plane view and vertebra vectors. Eur Spine J 20:135–143PubMedCrossRef

28.

Panjabi MM, White AA (1980) Basic biomechanics of spine. Neurosurgery 7:76–93PubMedCrossRef

29.

Vrtovec T, Pernus F, Likar B (2009) A review of methods for quantitative evaluation of axial vertebral rotation. Eur Spine J 18:1079–1090PubMedCrossRef

30.

Skalli W, Lavaste F, Descrimes JL (1995) Quantification of three-dimensional vertebral rotations in scoliosis: what are the true values? Spine 20:546–553PubMedCrossRef

31.

Ho EK, Upadhyay SS, Chan FL et al (1993) New methods of measuring vertebral rotation from computed tomographic scans. An intraobserver and interobserver study on girls with scoliosis. Spine 18:1173–1177PubMedCrossRef

32.

Yazici M, Acaroglu ER, Alanay A et al (2001) Measurement of vertebral rotation in standing versus supine position in adolescent idiopathic scoliosis. J Pediatr Orthop 21:252–256PubMed

33.

Dubousset J (1994) Three-dimensional analysis of the scoliotic deformity. In: Weinstein SL (ED) The pediatric spine: principles and practice. Raven Press Ltd., New York, pp 479–496

34.

Gille O, Champain N, Benchikh-El-Fegoun A et al (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine 32:568–573PubMedCrossRef

35.

Dumas R, Steib JP, Mitton D et al (2003) Three-dimensional quantitative segmental analysis of scoliosis corrected by the in situ contouring technique. Spine 28:1158–1162PubMed

36.

Masharawi Y, Salame K, Mirovsky Y et al (2008) Vertebral body shape variation in the thoracic and lumbar spine: characterization of its asymmetry and wedging. Clin Anat 21:46–54PubMedCrossRef

37.

Roaf R (1958) Rotation movements of the spine with special reference to scoliosis. J Bone Joint Surg Br 40:312–332PubMed

38.

Drevelle X, Lafon Y, Ebermeyer E et al (2010) Analysis of idiopathic scoliosis progression by using numerical simulation. Spine 35:E407–E412PubMed

Title: Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results
Authors: Tamás Illés
Szabolcs Somoskeöy
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 6/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2651-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2013

The impact of fluorescence guidance on spinal intradural tumour surgery

Denosumab: a potential new and innovative treatment option for aneurysmal bone cysts

The results of closing wedge osteotomy with posterior instrumented fusion for the surgical treatment of congenital kyphosis

Letter to editor concerning: “Intradural lumbar disc herniation: report of five cases with literature review”

Portable CT scanner-based navigation in lumbar pedicle screw insertion

Answer to the Letter to the Editor of A. Hidalgo-Ovejero concerning “Intradural lumbar disc herniation: report of five cases with literature review” (by L. G. Ducati, M. V. Silva, M. M. Brandão, F. R. Romero, M. A. Zanini; Eur Spine J. doi:10.1007/s00586-012-2631-2)