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European Spine Journal

, Volume 28, Issue 9, pp 1970–1976 | Cite as

Quasi-automatic early detection of progressive idiopathic scoliosis from biplanar radiography: a preliminary validation

  • Claudio VergariEmail author
  • Laurent Gajny
  • Isabelle Courtois
  • Eric Ebermeyer
  • Kariman Abelin-Genevois
  • Youngwoo Kim
  • Tristan Langlais
  • Raphael Vialle
  • Ayman Assi
  • Ismat Ghanem
  • Jean Dubousset
  • Wafa Skalli
Original Article

Abstract

Purpose

To validate the predictive power and reliability of a novel quasi-automatic method to calculate the severity index of adolescent idiopathic scoliosis (AIS).

Methods

Fifty-five AIS patients were prospectively included (age 10–15, Cobb 16° ± 4°). Patients underwent low-dose biplanar X-rays, and a novel fast method for 3D reconstruction of the spine was performed. They were followed until skeletal maturity (stable patients) or brace prescription (progressive patients). The severity index was calculated at the first examination, based on 3D parameters of the scoliotic curve, and it was compared with the patient’s final outcome (progressive or stable). Three operators have repeated the 3D reconstruction twice for a subset of 30 patients to assess reproducibility (through Cohen’s kappa and intra-class correlation coefficient).

Results

Eighty-five percentage of the patients were correctly classified as stable or progressive by the severity index, with a sensitivity of 92% and specificity of 74%. Substantial intra-operator agreement and good inter-operator agreement were observed, with 80% of the progressive patients correctly detected at the first examination. The novel severity index assessment took less than 4 min of operator time.

Conclusions

The fast and semiautomatic method for 3D reconstruction developed in this work allowed for a fast and reliable calculation of the severity index. The method is fast and user friendly. Once extensively validated, this severity index could allow very early initiation of conservative treatment for progressive patients, thus increasing treatment efficacy and therefore reducing the need for corrective surgery.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Adolescent idiopathic scoliosis 3D reconstruction Reliability Feature extraction Severity index 

Notes

Acknowledgements

The authors are grateful to the ParisTech BiomecAM chair program on subject-specific musculoskeletal modeling (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Proteor and Covea).

Compliance with ethical standards

Conflict of interest

Wafa Skalli holds patents related to the EOS system and associated 3D reconstruction methods, with no personal financial benefit (royalties rewarded for research and education). Raphael Vialle received consulting fees from EOS Imaging unrelated to this study.

Supplementary material

586_2019_5998_MOESM1_ESM.pptx (141 kb)
Supplementary material 1 (PPTX 141 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Claudio Vergari
    • 1
    Email author
  • Laurent Gajny
    • 1
  • Isabelle Courtois
    • 2
  • Eric Ebermeyer
    • 2
  • Kariman Abelin-Genevois
    • 3
  • Youngwoo Kim
    • 1
  • Tristan Langlais
    • 4
  • Raphael Vialle
    • 4
  • Ayman Assi
    • 5
  • Ismat Ghanem
    • 5
  • Jean Dubousset
    • 1
  • Wafa Skalli
    • 1
  1. 1.LBM/Institut de Biomécanique Humaine Georges CharpakArts et Métiers ParisTechParisFrance
  2. 2.Unite RachisCHU - Hospital BellevueSaint-ÉtienneFrance
  3. 3.Department of Orthopaedic SurgeryCentre médico-chirurgical et de réadaptation des MassuesLyonFrance
  4. 4.Department of Paediatric Orthopaedics, Armand Trousseau Hospital, APHPSorbonne UniversityParisFrance
  5. 5.Laboratory of Biomechanics and Medical Imaging, Faculty of MedicineUniversity of Saint-JosephBeirutLebanon

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