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Evaluating the role of surface topography in the surveillance of scoliosis

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Abstract

Study design

Literature review.

Objective

To review the history, modern uses, limitations, and future direction of surface topography (ST) in surveillance of scoliosis.

Summary of background data

Spinal deformities, including scoliosis, can be characterized using measurements such as the Cobb angle, lateral curvature, and vertebral rotation. The gold standard for diagnosis and surveillance of such deformities utilizes radiographic images. To minimize repeated radiation exposure, many systems have been developed utilizing ST. ST measures local deviations of a surface from a flat plane. Applying this concept to spinal deformities, ST can non-radiographically study the 3-dimensional shape of the back. One ST system, rasterstereography, projects parallel white light lines onto a patient’s back and analyzes line distortion with a camera. While radiography has long been considered the primary diagnostic tool for scoliosis, rasterstereography may possess alternative or complementary benefits in monitoring scoliosis and other diseases.

Methods

A comprehensive literature review was performed on the history, development, and validity of ST. The advantages and limitations of this technique were compared to those of radiography.

Results

While the initial goal of ST, designing a system to accurately reproduce the Cobb angle, was not successful, research efforts over the last 40 years have attempted to improve this correlation. ST technologies, including rasterstereography and the Formetric ST System, currently play important roles in scoliosis surveillance, research, and minimizing radiation exposure in longitudinal care of patients. Such technologies are also useful as an adjunct to X-rays for monitoring disease progression, especially in Parkinson’s disease.

Conclusion

Despite its limitations, ST has proven useful across multiple fields of medicine. It is a safe and cost-effective tool for long-term surveillance of scoliosis and early detection of progressive disease. With technological improvements, the Formetric System will become a critical alternative in dynamic spinal motion and gait analysis.

Level of Evidence

N/A.

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Acknowledgements

We would like to acknowledge the Spine and Surface Topography Study Group (SSTSG).

Funding

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Ariella Applebaum, Ryan Ference & Woojin Cho

Authors
  1. Ariella Applebaum
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  2. Ryan Ference
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  3. Woojin Cho
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Contributions

Ariella Applebaum helped in acquisition, analysis, and interpretation of data for the work; review of various articles and drafting of the work; and final approval of the version to be published. Ryan Ference contributed to acquisition, analysis, and interpretation of data for the work; drafting of the work; and final approval of the version to be published. Woojin Cho was the chief PI for the study; made substantial contributions to the conception of the work; was involved in the revision of the paper for critically important content; and contributed to the final approval of the version to be submitted.

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Correspondence to Ariella Applebaum.

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Applebaum, A., Ference, R. & Cho, W. Evaluating the role of surface topography in the surveillance of scoliosis. Spine Deform 8, 397–404 (2020). https://doi.org/10.1007/s43390-019-00001-7

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