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Quantifying a novel three-dimensional marker of scoliosis

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Abstract

Background

Scoliosis causes abnormal spinal curvature and torsional rotation of the vertebrae and has implications for human suffering and societal cost. In differential geometry, Writhe describes three-dimensional curvature. Differential geometric quantities can inform better diagnostic metrics of scoliotic deformity. This evaluation could help physicians and researchers study scoliosis and determine treatments.

Methods

Eight adult lumbar spine CT scans were analyzed in custom MATLAB programs to estimate Writhe and Cobb angle. Five patients exhibited scoliotic curvature, and three controls were asymptomatic. Vertebral centroids in three-dimensional space were determined, and Writhe was approximated. A T-test determined whether the affected spines had greater Writhe than the controls. Cohen’s D test was used to determine effect size.

Results

Writhe of scoliotic spines (5.4E-4 ± 2.7E-4) was significantly higher than non-scoliotic spines (8.2E-5 ± 1.1E-4; p = 0.008).

Conclusion

Writhe, a measure of curvature derived from 3D imaging, is significantly greater in scoliotic than in non-scoliotic spines. Future directions must include more subjects and examine writhe as a marker of scoliosis severity, progression, and response to treatment.

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Data availability

The data and custom MATLAB scripts used to segment vertebrae, determine the spine centerline, and evaluate Writheare available upon reasonable request to the corresponding author.

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Acknowledgements

The National Institutes of Health, the Catherine D. Sharpe Foundation, the Kevin and Bernadette McKenna Family Research Fund, and the EpiLog Project.

Funding

Funding for this work was received from the National Institutes of Health (R01AR071975), the Catherine D. Sharpe Foundation, and the Kevin and Bernadette McKenna Family Research Fund.

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Authors and Affiliations

  1. Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, 3rd Floor Silverstein Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Toren Arginteanu, Ryan S. Gallagher, Austin J. Borja, Gregory Glauser, Lachlan J. Smith & Neil R. Malhotra

  2. Translational Spine Research Lab of the University of Pennsylvania, 3450 Hamilton Walk, Stemmler Hall 110, Philadelphia, PA, 19104, USA

    Toren Arginteanu, Lachlan J. Smith & Neil R. Malhotra

  3. Department of Mathematics, David Rittenhouse Lab, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Toren Arginteanu & Dennis DeTurck

  4. Department of Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA

    Lachlan J. Smith & Neil R. Malhotra

  5. Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA

    Saba Pasha

Authors
  1. Toren Arginteanu
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  2. Ryan S. Gallagher
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  4. Gregory Glauser
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  7. Dennis DeTurck
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  8. Neil R. Malhotra
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Contributions

TA: Design, conception, data collection, analysis, figure and table creation, writing-original draft preparation, writing-critical revision, approval of final version, and accountable for work. RSG: Data analysis, figure and table creation, writing-original draft preparation, writing-critical revision, approval of final version, and accountable for work. AJB: Data analysis, figure and table creation, writing-original draft preparation, writing-critical revision, approval of final version, and accountable for work. GG: Data analysis, figure and table creation, writing-original draft preparation, writing-critical revision, approval of final version and accountable for work. LS: Data collection and analysis, writing- critical revision, approval of final version, and accountable for work. SP: Conception, data analysis, writing—critical revision, approval of final version, and accountable for work. DT: Design, conception, writing-critical revision, approval of final version, and accountable for work. NRM: Design, conception, data collection and analysis, writing–original draft preparation, writing – critical revision, approval of final version, and accountable for work.

Corresponding author

Correspondence to Neil R. Malhotra.

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Conflict of interest

The authors have no personal or institutional interest with regards to the authorship and/or publication of this manuscript. The manuscript submitted does not contain information about medical devices/drugs.

Ethical approval

This study was approved by the IRB at the Hospital of the University of Pennsylvania. IRB number for this study is: 830260. A waiver of informed consent was granted by the University of Pennsylvania IRB as this study was considered to be minimal risk to patients. All ethical guidelines and rules were followed to protect patient privacy.

Consent to participate

A waiver of informed consent was granted by the University of Pennsylvania IRB as this study was considered to be minimal risk to patients.

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Arginteanu, T., Gallagher, R.S., Borja, A.J. et al. Quantifying a novel three-dimensional marker of scoliosis. Spine Deform 12, 231–237 (2024). https://doi.org/10.1007/s43390-023-00752-4

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  • DOI: https://doi.org/10.1007/s43390-023-00752-4

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