Assessment of the axial plane deformity in subjects with adolescent idiopathic scoliosis and its relationship to the frontal and sagittal planes

Abstract

Purpose Investigate the axial plane deformity in the scoliotic segment and its relationship to the deformity in the frontal and sagittal planes. Methods Two hundred subjects with AIS (Cobb ≥ 20°) underwent low dose biplanar X-rays with 3D reconstruction of the spine and pelvis. All structural curves were considered and were distributed as follows: 142 thoracic (T), 70 thoracolumbar (TL), and 47 lumbar curves (L). Common 3D spino-pelvic and scoliosis parameters were collected such as: frontal Cobb; torsion index (TI); hypokyphosis/lordosis index (HI). Parameters were compared between each type of curvature and correlations were investigated between the 3 planes. Results Frontal Cobb was higher in all T (45 ± 19°) and TL (41 ± 15°) curves compared to L curves (35 ± 14°, p = 0.004). TI was higher in T curves when compared to TL and L curves (TI: 15 ± 8°, 9 ± 6°, 7 ± 5°, p < 0.001). HI was similar between curve types. T curves showed significant correlations between the 3 planes: Cobb vs. TI (r = 0.76), Cobb vs. HI (r = − 0.54) and HI vs. TI (r = − 0.42). The axial plane deformity was related to the frontal deformity and the type of curvature (adjusted-R 2 = 0.6). Conclusion Beside showing the most severe deformity frontally and axially compared to TL and L curves, the T curves showed strong correlations between the 3 planes of the deformity. Moreover, this study showed that the axial plane deformity cannot be fully determined by the frontal and sagittal deformities, which highlights the importance of 3D assessment in the setting of AIS.

Spine slenderness is not an early sign of progression in adolescent idiopathic scoliosis

“…Nevertheless, mechanical instabilities due to rotational effects could be more relevant than lateral buckling, since intervertebral rotations at end vertebrae and higher torsion moments have been previously described [28,29]. Vertebral axial rotation and rotational instability have indeed been pointed out as a prominent characteristics of the scoliotic deformity in adolescents [30][31][32][33], and torsional buckling could occur more easily in a slender spine [15]. This work presents some limitations.…”

Biomechanical changes in adolescent idiopathic scoliosis during walking: A protocol for systematic review and meta-analysis

“…Exclusion criteria: (1) patients who used orthoses to support walking or patients who had scoliosis correction surgery. (2) Mathematical modeling and finite element analysis were used for validation rather than a comparison of biomechanical characteristics as the main purpose of the study. (3) Duplicate publications.…”

“…It involves abnormalities in the coronal, sagittal, and axial positions, [1] where axial plane deformities cannot be determined solely by coronal and sagittal plane deformities. [2] The prevalence of AIS in adolescents (10-17 years old) is approximately 1 to 3%. [3,4] The prevalence var-number of scoliotic angles, and the extent and location of the affected spinal segments interact with each other.…”

Surgical Correction of a Double Major Adolescent Idiopathic Scoliosis Using Differential Rod Contouring, Derotation, and an Ultrasonic Bone Cutting Instrument, Including Technical Nuance: 2-Dimensional Operative Video

“…The debate on freehand vs navigate screw placement rages on 1 and the authors reasonably state that the decision should largely be left to individual practitioners, with speed and expertise favoring freehand placement and abnormal anatomy or early training level lending themselves better to navigated screw placement.…”

“…Adolescent idiopathic scoliosis is a 3-dimensional deformity of the spinal column affecting children between the age of 10 and 18 years. 1 Curve progression can be appreciated during the time interval associated with rapid skeletal growth. 2,3 A smaller subset of curves require operative intervention to halt the progression of the deformity as the child continues to grow.…”