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Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis



In vitro studies showed that annulus fibrosus lose its integrity in idiopathic scoliosis. Shear-wave ultrasound elastography can be used for non-invasive measurement of shear-wave speed (SWS) in vivo in the annulus fibrosus, a parameter related to its mechanical properties. The main aim was to assess SWS in lumbar annulus fibrosus of scoliotic adolescents and compare it to healthy subjects.


SWS was measured in 180 lumbar IVDs (L3L4, L4L5, L5S1) of 30 healthy adolescents (13 ± 1.9 years old) and 30 adolescent idiopathic scoliosis patients (13 ± 2 years old, Cobb angle: 28.8° ± 10.4°). SWS was compared between the scoliosis and healthy control groups.


In healthy subjects, average SWS (all disc levels pooled) was 3.0 ± 0.3 m/s, whereas in scoliotic patients it was significantly higher at 3.5 ± 0.3 m/s (p = 0.0004; Mann-Whitney test). Differences were also significant at all disc levels. No difference was observed between males and females. No correlation was found with age, weight and height.


Non-invasive shear-wave ultrasound is a novel method of assessment to quantitative alteration of annulus fibrosus. These preliminary results are promising for considering shear-wave elastography as a biomechanical marker for assessment of idiopathic scoliosis.

Key Points

Adolescent idiopathic scoliosis may have an altered lumbar annulus fibrosus.

Shear-wave elastography can quantify lumbar annulus fibrosus mechanical properties.

Shear-wave speed was higher in scoliotic annulus than in healthy subjects.

Elastography showed potential as a biomechanical marker for characterizing disc alteration.

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Annulus Fibrosus


Intervertebral Disc


Magnetic Resonance Imaging


Shear-Wave Speed


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This study has received funding by the ParisTech BiomecAM chair program on subject-specific muskuloskeletal modelling for funding (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Proteor and Covea). The authors are also grateful to SOFCOT and DHU MAMUTH for funding and technical support. We would also like to thank Ms. Sonia Simoes, Ms. Marion Langlais and Trousseau’s hospital fellowship for their technical help.

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Correspondence to Tristan Langlais.

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The scientific guarantor of this publication is Wafa Skalli.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

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Written informed consent was obtained from parents of all minor subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in national congress.


• Prospective

• Diagnostic or prognostic study

• Performed at one institution

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Langlais, T., Vergari, C., Pietton, R. et al. Shear-wave elastography can evaluate annulus fibrosus alteration in adolescent scoliosis. Eur Radiol 28, 2830–2837 (2018).

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  • Scoliosis
  • Paediatrics
  • Spine
  • Elasticity imaging techniques
  • Annulus fibrosus