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Published in: Scoliosis and Spinal Disorders 1/2013

Open Access 01-12-2013 | Research

Comparison of trunk and spine deformity in adolescent idiopathic scoliosis

Authors: Brandon B Carlson, Douglas C Burton, Marc A Asher

Published in: Scoliosis and Spinal Disorders | Issue 1/2013

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Abstract

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.
Literature
1.
go back to reference Dubousset J: The pediatric spine: principles and practice. Three-dimensional analysis of the scoliotic deformity. 1994, New York: Raven, 479-496. Weinstein SL edition Dubousset J: The pediatric spine: principles and practice. Three-dimensional analysis of the scoliotic deformity. 1994, New York: Raven, 479-496. Weinstein SL edition
2.
go back to reference Cobb J: Outline for the study of scoliosis. Am Acad of Orthop Surg Instr Course Lect. 1948, Volume V: 261-275. Cobb J: Outline for the study of scoliosis. Am Acad of Orthop Surg Instr Course Lect. 1948, Volume V: 261-275.
3.
go back to reference 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.PubMed 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.PubMed
4.
go back to reference Bunnell WP: Vertebral rotation: simple method of measurment on routine radiographs. Orthop Trans. 1985, 9: 114- Bunnell WP: Vertebral rotation: simple method of measurment on routine radiographs. Orthop Trans. 1985, 9: 114-
5.
go back to reference Nash CL, Moe JH, Nash CL, Moe JH: A study of vertebral rotation. J Bone Joint Surg Am. 1969, 51: 223-229.PubMed Nash CL, Moe JH, Nash CL, Moe JH: A study of vertebral rotation. J Bone Joint Surg Am. 1969, 51: 223-229.PubMed
6.
go back to reference Perdriolle R, Vidal J, Perdriolle R, Vidal J: Morphology of scoliosis: three-dimensional evolution. Orthopedics. 1987, 10: 909-915.PubMed Perdriolle R, Vidal J, Perdriolle R, Vidal J: Morphology of scoliosis: three-dimensional evolution. Orthopedics. 1987, 10: 909-915.PubMed
7.
go back to reference 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. 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.
go back to reference 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.PubMed 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.PubMed
9.
go back to reference 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. 10.1097/00007632-199710150-00016.CrossRefPubMed 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. 10.1097/00007632-199710150-00016.CrossRefPubMed
10.
go back to reference 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.PubMed 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.PubMed
11.
go back to reference 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. 10.1097/00007632-199207000-00008.CrossRefPubMed 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. 10.1097/00007632-199207000-00008.CrossRefPubMed
12.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
13.
go back to reference Majdouline Y, Aubin CE, Robitaille M, Sarwark JF, Labelle H: Scoliosis correction objectives in adolescent idiopathic scoliosis. J Pediatr Orthop. 2007, 27: 775-781. 10.1097/BPO.0b013e31815588d8.CrossRefPubMed Majdouline Y, Aubin CE, Robitaille M, Sarwark JF, Labelle H: Scoliosis correction objectives in adolescent idiopathic scoliosis. J Pediatr Orthop. 2007, 27: 775-781. 10.1097/BPO.0b013e31815588d8.CrossRefPubMed
14.
go back to reference 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: 12-10.1186/1748-7161-5-12.CrossRefPubMedPubMedCentral 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: 12-10.1186/1748-7161-5-12.CrossRefPubMedPubMedCentral
15.
go back to reference Bunnell WP, Bunnell WP: An objective criterion for scoliosis screening. J Bone Joint Surg Am. 1984, 66: 1381-1387.PubMed Bunnell WP, Bunnell WP: An objective criterion for scoliosis screening. J Bone Joint Surg Am. 1984, 66: 1381-1387.PubMed
16.
go back to reference 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.PubMed 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.PubMed
17.
go back to reference 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. 10.1097/00007632-198109000-00007.CrossRefPubMed 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. 10.1097/00007632-198109000-00007.CrossRefPubMed
18.
go back to reference 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. 10.1097/01.BRS.0000109991.88149.19.CrossRefPubMed 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. 10.1097/01.BRS.0000109991.88149.19.CrossRefPubMed
19.
go back to reference 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. 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.
go back to reference Gondo H, Asher M: Mid-term effects of Isola instrumentation on the configuration of the spine and the thoracic cage in adolescent idiopathic scoliosis. Research into spinal deformities 1. Edited by: Sevastik J, Diab K. 1997, Amsterdam: Ios Press, 433-436. Gondo H, Asher M: Mid-term effects of Isola instrumentation on the configuration of the spine and the thoracic cage in adolescent idiopathic scoliosis. Research into spinal deformities 1. Edited by: Sevastik J, Diab K. 1997, Amsterdam: Ios Press, 433-436.
21.
go back to reference 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. 10.1097/00007632-199701010-00009.CrossRefPubMed 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. 10.1097/00007632-199701010-00009.CrossRefPubMed
22.
go back to reference 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. 10.1097/00007632-199108001-00018.CrossRefPubMed 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. 10.1097/00007632-199108001-00018.CrossRefPubMed
23.
go back to reference 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. 10.1097/01.bsd.0000159033.89623.bc.CrossRefPubMed 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. 10.1097/01.bsd.0000159033.89623.bc.CrossRefPubMed
24.
go back to reference 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. 10.3171/2011.11.SPINE11277.CrossRefPubMed 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. 10.3171/2011.11.SPINE11277.CrossRefPubMed
25.
go back to reference 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. 10.1007/s00776-011-0034-6.CrossRefPubMed 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. 10.1007/s00776-011-0034-6.CrossRefPubMed
26.
go back to reference 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: 11-10.1186/1748-7161-2-11.CrossRefPubMedPubMedCentral 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: 11-10.1186/1748-7161-2-11.CrossRefPubMedPubMedCentral
27.
go back to reference 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.PubMed 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.PubMed
28.
go back to reference 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. 10.1097/00007632-199804010-00011. discussion 803CrossRefPubMed 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. 10.1097/00007632-199804010-00011. discussion 803CrossRefPubMed
Metadata
Title
Comparison of trunk and spine deformity in adolescent idiopathic scoliosis
Authors
Brandon B Carlson
Douglas C Burton
Marc A Asher
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Scoliosis and Spinal Disorders / Issue 1/2013
Electronic ISSN: 2397-1789
DOI
https://doi.org/10.1186/1748-7161-8-2

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Reviewer acknowledgement 2012