A novel technique to achieve maximal bending in flexibility assessment by slot-scanning digital radiography in scoliosis – The new gold standard?

Mishra, Neeraj; Ramlan, Azura Bin; Tang, Kiew Hoon; Yeo, Beatrice; Loo, Liang Hui; Lee, Nicole Kim Luan; Lim, Kwanghui

doi:10.1016/j.ejrad.2021.109805

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…The T1-45B can be applied to bending radiographs acquired in supine [5][6][7] or standing positions. 15 Of the 14 participants from the survey, 12 (86%) agreed that this method was useful, easy to learn, and immediately applicable to their clinical practice.…”

Section: Discussionmentioning

confidence: 98%

“…In turn, several studies have proposed methods to standardize and optimize the acquisition of the side bending spinal radiograph. Mishra et al 15 described a simple yet effective three-point support technique to achieve adequate bending radiographs using slot scanning digital radiography. He and Wong 16 concluded that curve magnitude and location are two important parameters in selecting the appropriate method for spinal flexibility assessment; they suggested traction method for severe curves, lateral bending method for moderate curves, fulcrum bending method for thoracic curves, and supine with lateral bending method for thoracolumbar and lumbar curves.…”

Section: Discussionmentioning

confidence: 99%

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How well do we assess the adequacy of bending films in scoliosis?

Lim,

Lee,

Yeo

et al. 2023

Bone Jt Open

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AimsTo determine whether side-bending films in scoliosis are assessed for adequacy in clinical practice; and to introduce a novel method for doing so.MethodsSix surgeons and eight radiographers were invited to participate in four online surveys. The generic survey comprised erect and left and right bending radiographs of eight individuals with scoliosis, with an average age of 14.6 years. Respondents were asked to indicate whether each bending film was optimal (adequate) or suboptimal. In the first survey, they were also asked if they currently assessed the adequacy of bending films. A similar second survey was sent out two weeks later, using the same eight cases but in a different order. In the third survey, a guide for assessing bending film adequacy was attached along with the radiographs to introduce the novel T1-45B method, in which the upper endplate of T1 must tilt ≥ 45° from baseline for the study to be considered optimal. A fourth and final survey was subsequently conducted for confirmation.ResultsOverall, 12 (86%) of 14 respondents did not use any criteria to assess the bending film adequacy; the remaining two each described a different invalidated method. In total, 12 (86%) of the respondents felt T1-45B was easy to learn and apply. There was fair to substantial intra-rater reliability (k = 0.25 to 0.88) which improved to fair to almost perfect (k = 0.38 to 0.88) post-introduction of the guide. Inter-rater reliability varied considerably among the rater groups but similarly increased following introduction of the guide (kS1 = 0.19 to 0.34, kS2 = 0.33 to 0.43 vs kS3 = 0.49 to 0.5, kS4 = 0.35 to 0.43).ConclusionMany surgeons and radiographers do not assess spinal bending films for adequacy. We propose that the change in the plane of the upper endplate of T1 on side-bending can be used in this evaluation. In the T1-45B method, a change of ≥ 45° on side bending qualifies as an adequate bend effort.Cite this article: Bone Jt Open 2023;4(9):689–695.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

How well do we assess the adequacy of bending films in scoliosis?

Lim,

Lee,

Yeo

et al. 2023

Bone Jt Open

Self Cite

View full text Add to dashboard Cite

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“…In preoperative evaluation and surgical planning, dynamic radiography provides information, such as the effects of gravity, spinal mobility, and instability. Recently, imaging techniques, including bending X-rays [14,15] and prone-traction radiography [16], have been introduced to predict motion in an operative position before surgery. Although dynamic plain radiography is available, including gravity and dynamic elements, it does remain a static image.…”

Section: Plain Radiographymentioning

confidence: 99%

Diagnostic Technology for Spine Pathology

et al. 2022

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Diagnostic techniques for spinal pathologies have been developed in accordance with advances in technology. Accurate diagnosis of spinal pathology is essential for appropriate management of spinal diseases. Since the development of X-rays in 1895 and computed tomography (CT) in 1967, several diagnostic imaging modalities have been utilized for detecting spinal pathologies, including radiography, CT, magnetic resonance imaging, and radionuclide imaging. In addition to diagnostic imaging technologies, electrodiagnostic tests, including electromyography and nerve conduction studies, play a significant role as diagnostic tools, as spinal diseases are mostly profoundly associated with pathologies of the neural structures, such as the spinal cord and nerve root, and extent of injury at the structure cannot be adequately detected by conventional imaging techniques. In patient-specific treatment strategies, usage of diagnostic modalities is of great importance; thus, we should be aware of the basic details and approaches of the different diagnostic modalities. In this review, the authors discuss the details of the technologies that aid in the diagnosis of spinal pathologies.

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A novel technique to achieve maximal bending in flexibility assessment by slot-scanning digital radiography in scoliosis – The new gold standard?

Cited by 2 publications

References 13 publications

How well do we assess the adequacy of bending films in scoliosis?

How well do we assess the adequacy of bending films in scoliosis?

Diagnostic Technology for Spine Pathology

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