Contribution of coronal vertebral and IVD wedging to Cobb angle changes in adolescent idiopathic scoliosis during growth

Cheung, Wing Ki; Cheung, Jason Pui Yin

doi:10.1186/s12891-022-05863-z

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…While there is no universally accepted theory explaining the pathogenesis of AIS, anterior column overgrowth is a frequently studied phenomenon, [69][70][71][72][73][74][75] with ongoing debate surrounding the cause-effect relationship with wedging and rotation. 76,77 Our included studies also reported sagittal wedging in lower junctional vertebrae and discs, which was associated with increases in Cobb angle.…”

Section: Sagittal Deformitymentioning

confidence: 99%

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Wan,

Wong,

et al. 2024

Bone Jt Open

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AimsThis systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis.MethodsA comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included.ResultsTorsion index (TI) and apical vertebral rotation (AVR) were identified as accurate predictors of curve progression in early visits. Initial TI > 3.7° and AVR > 5.8° were predictive of curve progression. Thoracic hypokyphosis was inconsistently observed in progressive curves with weak evidence. While sagittal wedging was observed in mild curves, there is insufficient evidence for its correlation with curve progression. In curves with initial Cobb angle < 25°, Cobb angle was a poor predictor for future curve progression. Prediction accuracy was improved by incorporating serial reconstructions in stepwise layers. However, a lack of post-hoc analysis was identified in studies involving geometrical models.ConclusionFor patients with mild curves, TI and AVR were identified as predictors of curve progression, with TI > 3.7° and AVR > 5.8° found to be important thresholds. Cobb angle acts as a poor predictor in mild curves, and more investigations are required to assess thoracic kyphosis and wedging as predictors. Cumulative reconstruction of radiographs improves prediction accuracy. Comprehensive analysis between progressive and non-progressive curves is recommended to extract meaningful thresholds for clinical prognostication.Cite this article: Bone Jt Open 2024;5(3):243–251.

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Section: Sagittal Deformitymentioning

confidence: 99%

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Wan,

Wong,

et al. 2024

Bone Jt Open

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Segmental deformity markers offer novel indicators of deformity progression risk in deformity-matched adolescent idiopathic scoliosis patients

Labrom,

Izatt,

Askin

et al. 2024

Spine Deform

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Purpose Identification of adolescent idiopathic scoliosis (AIS) patients with mild curvatures who pose significant risk of progressing to severe levels of curvatures is of paramount importance for clinical care. This study aimed to compare segmental deformity changes in AIS sub-cohorts that are dichotomised by progression status. Methods Thirty-six female participants with Lenke 1 AIS curves were investigated with sequential MRIs during growth. Scans were reformatted to measure orthogonal segmental parameters, including sagittal/coronal wedging angles and axial rotation angles. Participants were dichotomised by progression. Two-tailed, independent sample t-tests were used to compare sub-cohort multi-segmental and segmental deformity parameters. Measurements were compared at each scan number and variable rates of change were determined using actual time between measures. Results AIS progression status sub-cohorts were comparable at scan 1 for multi-segmental deformity parameters (e.g. major thoracic curve angle, rib hump, kyphosis) (P > 0.05). However, apical measures of coronal IVD wedging, axial IVD rotation and axial vertebral rotation were segmental parameters at scan 1 which were larger for participants whose AIS would later go on to clinically progress (all P < 0.05). Measures of segmental hypokyphosis were comparable between groups. As development was tracked at each subsequent scan, coronal and axial plane differences between groups increased in both magnitude and number of differences. Conclusion Initial disparity and then subsequent increasing magnitude of change of axial rotation may indicate a higher propensity to clinically progress in the future. This knowledge hopes to provide useful management information for AIS care providers and prognostic education for patients alike. Level of evidence II.

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Correlation between coronal wedge deformity and sagittal spinal curvature in adolescent idiopathic scoliosis: a retrospective analysis

Shen,

Qin,

Pan

et al. 2024

Sci Rep

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The correlation between the Cobb angle and the sagittal spinal curvature (SSC) in adolescent idiopathic scoliosis (AIS) has been reported in some previous studies, but few studies have reported on the relation of coronal wedge deformity (CWD) with sagittal curvature. This study aims to investigate the correlation between CWD and SSC in AIS patients. A retrospective analysis was conducted in 122 AIS patients treated at our hospital from January 2018 to November 2023. Correlation analysis was performed on the Cobb angle, total wedge angle(TW), apical vertebral wedge angle (APW), upper end-vertebral wedge angle (UW), lower end-vertebral wedge angle (LW), total affected structures, average wedge angle(AW), total vertebral wedge angle (TVW), average vertebral wedge angle (AVW), Vertebral Wedge Angle ratio (VWR), total disc wedge angle (TDW), average disc wedge angle (ADW), and disc wedge angle ratio (DWR). Furthermore, out of all cases which underwent lateral spinal radiographs, a correlation analysis between thoracic kyphosis (TK), lumbar lordosis (LL) and CWD was carried out on 102 patients. The Cobb angle exhibited a significant positive correlation with multiple CWD parameters ( P < 0.05). TK showed a significant negative correlation with the Cobb angle ( r = − 0.221, P = 0.026), TW ( r = − 0.199, P = 0.045), AW ( r = − 0.262, P = 0.008), TDW ( r = − 0.211, P = 0.033), and ADW ( r = − 0.278, P = 0.005). LL had no significant correlation with TK and other parameters ( P > 0.05). In mild and moderate AIS patients, CWD parameters were positively correlated with the Cobb angle and negatively correlated with thoracic SSC. This may indicate that it’s necessary to correct sagittal thoracic curvature when rectifying scoliosis in clinic. This research would not only provide new insights for clinical practice but also offer important evidence for early diagnosis and intervention.

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Contribution of coronal vertebral and IVD wedging to Cobb angle changes in adolescent idiopathic scoliosis during growth

Cited by 4 publications

References 22 publications

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Segmental deformity markers offer novel indicators of deformity progression risk in deformity-matched adolescent idiopathic scoliosis patients

Correlation between coronal wedge deformity and sagittal spinal curvature in adolescent idiopathic scoliosis: a retrospective analysis

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