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The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement: a prospective study

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Abstract

Purpose

This study investigated whether ultrasound (U/S) is an alternative to radiography when measuring magnetically controlled growth rod (MCGR) length in order to reduce radiation exposure. Distractible spinal growth rods are the gold standard when treating early-onset scoliosis (EOS).

Methods

This was a prospective series. Patients were already undergoing EOS treatment using MCGRs. Forty-eight data points measured using radiography and U/S were compared. Each U/S data point was measured three times by three observers to assess intra- and inter-observer reliability. The radiation dose of the pre-lengthening and post-lengthening radiographs was recorded.

Results

The average rod lengths were 1.322 cm with U/S and 1.329 cm with radiography. The ICC (radiography vs. U/S) was 0.992 (95 % confidence interval (CI) 0.976, 1.000). The inter- and intra-rater reliability of U/S had an ICC of 0.987 (95 % CI 0.966, 1.000) and 0.983 (95 % CI 0.956, 1.000), respectively. The mean total effective radiation dose of the pre-lengthening and post-lengthening PA spinal radiographs was 0.26 mSv with a mean attributable lifetime cancer risk of one in 39,686 per lengthening.

Conclusion

U/S highly agrees with radiography when measuring MCGR length. It has a high inter- and intra-observer reliability and does not require radiation exposure. Although U/S allows accurate MCGR measurement and soft tissue assessment, patients will still need occasional radiographs to assess spine bony elements, overall spinal balance and scoliosis correction. Combining radiography and U/S allows patient monitoring and accurate MCGR measurement whilst decreasing patients’ radiation exposure.

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Acknowledgments

The authors would like to thank Jane Edwards for her invaluable help with radiation dose calculations and Suzanne Edwards for her assistance with statistical analysis.

Conflict of interest

W. W. Yoon, A. C. Chang, P. Tyler, S. Butt and S. Raniga have no conflicts of interest to declare. H. Noordeen is a consultant for Ellipse Technologies.

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Correspondence to Wai Weng Yoon.

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Yoon, W.W., Chang, A.C., Tyler, P. et al. The use of ultrasound in comparison to radiography in magnetically controlled growth rod lengthening measurement: a prospective study. Eur Spine J 24, 1422–1426 (2015). https://doi.org/10.1007/s00586-014-3589-z

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  • DOI: https://doi.org/10.1007/s00586-014-3589-z

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