Coronal trunk imbalance in idiopathic scoliosis: Does gravity line localisation confirm the physical findings?

Hernandez, Thibault; Thenard, Thomas; Vergari, Claudio; Robichon, Leopold; Skalli, Wafa; Vialle, Raphaël

doi:10.1016/j.otsr.2018.04.018

Cited by 15 publications

(14 citation statements)

References 17 publications

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“…7) where a cone is described of the spine only with the apex of the cone at the sacrum, in distinction to the cone of economy described by Dubousset 6 with the apex at the feet. The MCID from the confidence ellipse for coronal offset from this work confirms the previously published amount of ± 20 mm [11][12][13] . The sagittal offset is larger than the values previously quoted the literature 10 who, using a technique of measurements from a plumb line dropped behind the subject, recorded the sagittal balance (a difference of horizontal distance from the plumb line between that measured at the C7 and S2 vertebral levels) as 19.3 ± 17 mm.…”

Section: Discussionsupporting

confidence: 90%

“…Assessments of the range of normality in the measures of coronal and sagittal offset have been reported in the literature using a number of different measurement techniques [9][10][11][12][13] . The literature suggests that a coronal offset of 0 mm ± 28 mm (mean ± 95% CI) and a sagittal offset of between 90 mm of negative offset (C7 vertebral body or vertebra prominens (VP) posterior to the sacrum) and 61 mm of positive offset (C7 or VP anterior to the sacrum) (± 95% CI) would be accepted as representing a non-pathologic state [9][10][11][12][13] . However, these values are one dimensional, being reported separately from each other.…”

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confidence: 99%

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The resting coronal and sagittal stance position of the torso in adolescents with and without spinal deformity

Gardner

Archer

Berryman

et al. 2021

Sci Rep

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The purpose of this work is to identify the resting stance of the torso, defined as the position of the C7 vertebral body relative to the sacrum in a ‘birds eye view’, as the coronal and sagittal offset, in those without spinal deformity, those with pre and post-operative AIS, and those with Scheuermann's kyphosis (SK). Using ISIS2 surface topography, the coronal and sagittal offset were measured in a prospective manner in all groups. With bivariate ellipses, a mean and 95% confidence ellipse of the data was developed. Statistical analyses was performed to examine the distribution of the data from the groups. A graphical representation of the data was developed. There were 829 without spinal deformity, 289 in both the pre and post-operative with AIS and 59 with SK. The results showed that the mean coronal offset for all groups was between 2 and 6 mm and the sagittal offset was 12 and 26 mm. Statistically significance was seen for both measures between the non-scoliotic and both AIS groups, along with the pre-operative AIS coronal offset and post-operative AIS sagittal offset and the SK measures. However, all mean values were within the 95% confidence ellipse for all of the groups. Regardless of the size or type of spinal deformity, the position of the C7 vertebral body and sacrum remain within the 95% confidence ellipse of that seen in those without spinal deformity. This work defines the Minimally Clinically Important Difference for all of the groups.

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

The resting coronal and sagittal stance position of the torso in adolescents with and without spinal deformity

Gardner

Archer

Berryman

et al. 2021

Sci Rep

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“…1), and patients who did not respect this position were excluded. This significantly limits the uncertainty of the gravity line position, as was confirmed by validation studies on healthy subjects and scoliotic patients, which reported an uncertainty of the GL position lower than 9 mm [10,14].…”

Section: Discussionmentioning

confidence: 78%

“…Patient's gravity line (GL), vertebral axial rotations (VAR), and intervertebral axial rotations (IAR) were computed from the 3D reconstruction. The estimation of GL from 3D reconstruction of body envelope was validated on healthy and scoliotic patients [10], by comparison to a Wii Board, with a mean difference of 0.8 kg (SD 1.2) for the mass estimation and 0.5 mm (SD 1.2) for COM location, respectively.…”

Section: D Reconstructionmentioning

confidence: 99%

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Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

et al. 2019

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Study Design: Retrospective observational study. Objectives: To determine the mass distribution along the scoliotic trunk using barycentremetry and its relationship with vertebral axial rotation and torque. Summary of the Background Data: Deformity progression in adolescent idiopathic scoliosis (AIS) is not yet fully understood, but gravity load on the spine could play a role. Barycentremetry allows to characterize body mass distribution in standing position, which could provide a better understanding the mechanisms of progression. Methods: 81 subjects (27 healthy adolescents and 53 AIS patients) underwent biplanar radiography and 3D reconstruction of the spine and body envelope. Position of the gravity line was estimated, as well as trunk segmental centers of mass COMs at each vertebral level and resulting axial torques to each vertebra. Results: The COM of all trunk segments was less than 1 cm from the gravity line in the frontal plane for healthy subjects, and less than 1.5 cm for AIS patients. Vertebral axial torque was 0.7 AE 0.5 Nm in healthy subjects, 2.9 AE 2.1 Nm at the junctional vertebrae of AIS patients and 0.5 AE 0.5 at the apex. A strong association was found between high torque and high intervertebral rotation at junctions, with low torque and low intervertebral axial rotation at the apex. Conclusion: Results suggest that AIS patients can maintain the COM of each body segment close to their gravity line, irrespective of the severity and asymmetry of their deformity. Moreover, torque analysis shed some light on the importance of junctional vertebrae in the spinal deformity and, potentially, in the vicious cycle determining scoliosis progression. Level of Evidence: Level III.

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Treatment of a symptomatic patient with severe progressive odontoid invagination and Cervicothoracic scoliosis: A case report

Burger,

Pichler,

Muellner

et al. 2024

Clinical Case Reports

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Coronal trunk imbalance in idiopathic scoliosis: Does gravity line localisation confirm the physical findings?

Abstract: IV, retrospective study.

Cited by 15 publications

References 17 publications

The resting coronal and sagittal stance position of the torso in adolescents with and without spinal deformity

The resting coronal and sagittal stance position of the torso in adolescents with and without spinal deformity

Analysis of Center of Mass and Gravity-Induced Vertebral Axial Torque on the Scoliotic Spine by Barycentremetry

Treatment of a symptomatic patient with severe progressive odontoid invagination and Cervicothoracic scoliosis: A case report

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