European Spine Journal

, Volume 14, Issue 2, pp 138–143 | Cite as

Visualisation of the brace effect on the spinal profile in idiopathic scoliosis

  • Alfred Schmitz
  • Roy König
  • Jörg Kandyba
  • Peter Pennekamp
  • Ottmar Schmitt
  • Ursula E. Jaeger
Original Article

Abstract

We studied the brace effect on the spinal profile in idiopathic scoliosis, using a MR procedure visualising the complete scoliotic spine in any vertical plane, while rotating it 180° on the longitudinal axis of the patient. Thirty-eight female patients (mean age, 14.5 years) were included in the study. Inclusion criteria were an idiopathic scoliosis, a Cobb angle greater than 20°, age of 10–17 years and bracing with a Chêneau brace. The brace effect was studied in 38 thoracic curves. The MR examinations were carried out in direct sequences, with and without brace. A reconstruction algorithm allows visualising the whole spine in vertical projections, with rotational steps of 2°, from −90° to 90°, referred to as MR animation. In various vertical MR projections, the changes of the curves were evaluated by measuring the Cobb angle. Additionally, a translation angle of the apical vertebra was determined, representing the lateral deviation of the apical vertebra from a defined midline. Testing the reproducibility of the Cobb angles, the standard deviation of the intra-individual differences was 1.7° and of the inter-individual differences, 2.1°. For the translation angles, the standard deviation of the intra-individual differences was 0.8° and of the inter-individual differences, 0.9°. With brace the mean Cobb angle of the thoracic curves was significantly reduced in the various vertical MR projections. The mean translation angle was also reduced. MR analysis showed that the brace effect is a translation process, straightening the profile of the scoliotic spine in all vertical planes. MR animation allows visualising the brace effect on the spine in scoliosis based on a 3D data set, without additional radiation exposure. It showed the straightening effect of the brace leading to a flattening of the sagittal spinal profile.

Keywords

Idiopathic scoliosis Brace treatment Magnetic resonance tomography 

References

  1. 1.
    Dickson RA, Weinstein SL (1999) Bracing (and screening)—yes or no? J Bone Joint Surg Br 81:193–198CrossRefPubMedGoogle Scholar
  2. 2.
    Do T, Fras C, Burke S, Widmann RF, Rawlins B, Boachie-Adjei O (2001) Clinical value of routine preoperative magnetic resonance imaging in adolescent idiopathic scoliosis. A prospective study of three hundred and twenty-seven patients. J Bone Joint Surg Am 83:577–579Google Scholar
  3. 3.
    du Peloux J, Fauchet R, Faucon B, Stagnara P (1965) The plan of choice for the radiologic examination of kyphoscolioses. Rev Chir Orthop Reparatrice Appar Mot 51:517–524PubMedGoogle Scholar
  4. 4.
    Hausmann ON, Boni T, Pfirrmann CW, Curt A, Min K (2003) Preoperative radiological and electrophysiological evaluation in 100 adolescent idiopathic scoliosis patients. Eur Spine J 12:501–506CrossRefPubMedGoogle Scholar
  5. 5.
    Konig R, Jaeger U, Ostertun B, Kandyba J, Wagner U, Gieseke J, Schild HH (1999) MR whole-spine recording: computer-assisted simulation of the conventional X-ray technique. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:258–261PubMedGoogle Scholar
  6. 6.
    Korovessis P, Kyrkos C, Piperos G, Soucacos PN (2000) Effects of thoracolumbosacral orthosis on spinal deformities, trunk asymmetry and frontal lower rib cage in adolescent idiopathic scoliosis. Spine 25:2064–2071CrossRefPubMedGoogle Scholar
  7. 7.
    Labelle H, Dansereau J, Bellefleur C, Poitras B (1996) Three-dimensional effect of the Boston brace on the thoracic spine and rib cage. Spine 21:59-64CrossRefPubMedGoogle Scholar
  8. 8.
    Perie D, Sales De Gauzy J, Sevely A, Hobatho MC (2001) In vivo geometrical evaluation of Chêneau-Toulouse-Munster brace effect on scoliotic spine using MRI method. Clin Biomech (Bristol, Avon) 16:129–137Google Scholar
  9. 9.
    Pruijs JE, Hageman MA, Keessen W, van der Meer R, van Wieringen JC (1994) Variation in Cobb angle measurements in scoliosis. Skeletal Radiol 23:517–520CrossRefPubMedGoogle Scholar
  10. 10.
    Schmitz A, Jaeger UE, Koenig R, Kandyba J, Wagner UA, Giesecke J, Schmitt O (2001) A new MRI technique for imaging scoliosis in the sagittal plane. Eur Spine J 10:114–117CrossRefPubMedGoogle Scholar
  11. 11.
    Torell G, Nachemson A, Haderspeck-Grib K, Schultz A (1985) Standing and supine Cobb measures in girls with idiopathic scoliosis. Spine 10:425–427PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Alfred Schmitz
    • 1
    • 3
  • Roy König
    • 2
  • Jörg Kandyba
    • 2
  • Peter Pennekamp
    • 1
  • Ottmar Schmitt
    • 1
  • Ursula E. Jaeger
    • 2
  1. 1.Department of OrthopaedicsUniversity of BonnBonnGermany
  2. 2.Department of RadiologyUniversity of BonnBonnGermany
  3. 3.Department of OrthopaedicsUniversity of BonnBonnGermany

Personalised recommendations