9. THE ROLE OF EOS IMAGING SYSTEM TO EVALUATE MAXIMAL AXIAL VERTEBRA ROTATION IN ADOLESCENT IDIOPATHIC SCOLIOSIS
Main Article Content
Abstract
Background: Neglecting or misunderstanding the assessment of vertebral rotation can lead to inaccuracies during surgery. However, no assessment of vertebral rotation is totally reliable.
Purposes: This study evaluated the relationship between maximal axial vertebra rotation (maxAVR) and other clinical and radiological indexes, compared to apical vertebra rotation (AVR) in idiopathic adolescent scoliosis (AIS).
Methods: Forty consecutive patients of AIS with Cobb angle of major curve > 40° were included. They were scanned by an EOS imaging system and had trunk rotational angle (TRA) measured by scoliometer. The correlation between variables was assessed using Pearson’s correlation coefficient and loaded onto a meta-analysis model.
Results: There were (34 girls and 6 boys) with an average age of 13.8±1.6 years. AVR was maxAVR in only 47.5% (19/40) cases of the major curves and 42.3% (11/26) cases of the minor curves. The correlation between maxAVR and TRA was significantly higher than the correlation between AVR and TRA for the MT curves (p=0.0001) and TL/L curves (p=0.0001). On multivariate regression analysis, the magnitude of maxAVR showed a significant correlation with TRA (p=0.0002), Cobb angle (p=0.001), and coronal deformity angular ratio (C-DAR) (p=0.027).
Conclusions: The apical vertebra was not the most rotated in most cases. The correlation between maxAVR and TRA was significantly higher than the correlation between AVR and TRA. Moreover, the maxAVR was multivariately related to TRA, Cobb angle, and C-DAR.
Article Details
Keywords
Trunk rotational angle, Apical vertebral rotation, Maximal axial vertebral rotation, Coronal deformity angular ratio
References
[2] Addai D, Zarkos J, Bowey AJ (2020) Current concepts in the diagnosis and management of adolescent idiopathic scoliosis. Child’s Nerv Syst J 36:1111–1119.
[3] Choudhry MN, Ahmad Z, Verma R (2016) Adolescent idiopathic scoliosis. Open Orthop J 10(1):143–154.
[4] Cook C (2013) Coupling behavior of the lumbar spine: a literature review. Manip Physiol Ther J 11(3):137–145.
[5] Fujii R, Sakaura H, Mukai Y, Hosono N, Ishii T, Iwasaki M, Yoshikawa H, Sugamoto K (2014) Kinematics of the thoracic spine in trunk lateral bending: in vivo three-dimensional analysis. Spine J 14(9):1991–1999.
[6] Ilharreborde B, Ferrero E, Alison M, Mazda K (2016) EOS microdose protocol for the radiological follow-up of adolescent idiopathic scoliosis. Eur Spine J 25:526–531.
[7] József K, Schlégl AT, Burkus M, Márkus I, O’Sullivan I, Than P, Csapó MT (2022) Maximal axial vertebral rotation in adolescent idiopathic scoliosis: is the apical vertebra the most rotated? Glob Spine J 12(2):244–248.
[8] Labaki C, Otayek J, Massaad A, Bakouny Z, Karam M, Hanna C, Kassab A, Bizdikian AJ, Mjaess G, Karam A, Skalli W, Ghanem I, Assi A (2019) Is the apical vertebra the most rotated vertebra in the scoliotic curve? Neurosurg Spine J 31:873–879.
[9] Jankowski PP, Yaszay B, Cidambi KR, Bartley CE, Bastrom TP, Newton PO (2018) The relationship between apical vertebral rotation and truncal rotation in adolescent idiopathic scoliosis using 3D reconstructions. Spine Deform J 6(3):213–219.
[10] Yang JL, Huang ZF, Yin JQ, Deng YL, Xie XB, Li FB, Yang JF (2019) Predictive value of spinal cord function classification and sagittal deformity angular ratio for neurologic risk stratification in patients with severe and stiff kyphoscoliosis. World Neurosurg J 123–e796.