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Assessing progressive changes in axial plane vertebral deformity in adolescent idiopathic scoliosis using sequential magnetic resonance imaging

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Abstract

Purpose

To understand how the axial plane deformity contributes to progression of the three-dimensional spinal deformity of Adolescent Idiopathic Scoliosis (AIS), with a main thoracic curve type, using a series of sequential magnetic resonance images (MRI).

Methods

Twenty-seven AIS patients (at scan 1: mean 12.4 years (± 1.5), mean Cobb angle 29.1°(± 8.8°)) had 3 MRI scans (T4-L1) performed at intervals of mean 0.7 years (± 0.4). The outer profile of the superior and inferior endplates were traced on a reformatted axial image using ImageJ (NIH). Endplate AVR, and intravertebral rotation (IVR), defined as the difference between superior and inferior endplate AVR, was calculated for each vertebral level.

Results

For all patients and scans, the mean AVR was greatest at the curve apex, with AVR diminishing in a caudal and cephalic direction from the apex. At scan 3 the mean apical AVR was 15.1°(± 4.6°) with a mean change in apical AVR between MRI 1 and 3 of 2.7°(± 2.9°). The increase in standing height between MRI 1 and 3 was mean 7.4 cm (± 4.6). Linear regression showed a positive correlation between apical AVR and Cobb angle (R2 = 0.57, P < 0.001), and a positive correlation between apical AVR and rib hump (R2 = 0.54, p < 0.001). The mean change in IVR was greater 3 vertebral levels cephalic and caudal to the apex (1.4°(± 4.1°) and 1.2°(± 2.0°), respectively), compared to the apex (0.4°(± 3.1°)).

Conclusions

AVR increased, during curve progression, most markedly at the curve apex. The greatest IVR was observed at the periapical levels, with the apex by contrast having only a modest degree of rotation, suggesting the periapical vertebral levels of the scoliosis deformity may be a significant driver in the progression of AIS.

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Funding

No funds were received in support of this work. Partial postgraduate scholarship funding for the first author was provided by Queensland X-Ray Ltd (Australia) and Children’s Health Queensland, Australia.

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Authors and Affiliations

  1. Biomechanics and Spine Research Group, Centre for Biomedical Technologies at the Centre for Children’s Health Research, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, 62 Graham St, South Brisbane, 4104, Australia

    Pawel T. Sowula, Maree T. Izatt, Robert D. Labrom, Geoffrey N. Askin & J. Paige Little

  2. Queensland Children’s Hospital, Brisbane, Australia

    Pawel T. Sowula, Maree T. Izatt, Robert D. Labrom & Geoffrey N. Askin

  3. Mater Hospital, Brisbane, Australia

    Robert D. Labrom & Geoffrey N. Askin

Authors
  1. Pawel T. Sowula
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  2. Maree T. Izatt
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  3. Robert D. Labrom
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  4. Geoffrey N. Askin
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  5. J. Paige Little
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Correspondence to Pawel T. Sowula.

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Ethical approval

Ethical approvals were obtained from the Mater Human Research Ethics Committee (HREC) (14/88/AM03), the Queensland University of Technology HREC (1200000281) and the Children’s Health Queensland HREC (SSA/14/QRCH/411).

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Sowula, P.T., Izatt, M.T., Labrom, R.D. et al. Assessing progressive changes in axial plane vertebral deformity in adolescent idiopathic scoliosis using sequential magnetic resonance imaging. Eur Spine J 33, 663–672 (2024). https://doi.org/10.1007/s00586-023-08004-9

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  • DOI: https://doi.org/10.1007/s00586-023-08004-9

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