Abstract
Purpose
Barycentremetry in adolescent idiopathic scoliosis (AIS) allows the distribution of masses and their loading of the spine to be studied. In particular, the axial torque on the spine has been studied in AIS, but not after surgical correction. Spinal axial torque was studied in AIS before and after surgery.
Methods
All AIS (Lenke 1 and 3) who underwent posterior spinal fusion surgery at our center in 2019 were included retrospectively. AIS underwent frontal and sagittal biplanar radiographs in the free-standing position before surgery, 4 months after surgery, and at the last follow-up. Their spine and external envelope were reconstructed with validated methods. Spinal axial torque at the apex and the upper and lower end vertebra was calculated. Finally, the preoperative and postoperative values were compared to a previously published reference corridor for asymptomatic subjects.
Results
Twenty-nine patients were included (54 ± 11° Cobb angle, 15 ± 2 years old at surgery). The surgical procedure decreased the Cobb angle by 36° ± 11° and decreased the spinal axial torque at the upper end vertebra by 2.5 N/m (95% CI = [1.9; 3]; p < 0.001), at the apex by 0.6 N/m (95% CI = [0.4; 1]; p = 0.004), at the lower end vertebra by 2 N/m (95% CI = [1.5; 2.8]; p < 0.001). Compared to 95th percentile of torque, which was previously evaluated in asymptomatic subjects, more than 90% of patients had higher values at the upper and lower end vertebrae before surgery. Postoperatively, 62% of patients still had higher torque at the upper end vertebra than asymptomatic subjects, while only 38% patients showed abnormal values at the lower junction.
Conclusion
Results of this study confirm that AIS patients show abnormally high spinal axial torque, especially at the end vertebrae, and that this parameter is normalized postoperatively for only a small number of patients.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This study has received funding from the BiomecAM chair program on subject-specific musculoskeletal modeling (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Covea, and Proteor).
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TL, WS, JD, CV: conception or design. TL, XdC, NM, SG: acquisition, analysis or interpretation of data. TL, CV: statistical analysis. TL, WS, XdC, NM, SG, LG, RV, JD, CV: draft or revised the work. TL, WS, XdC, NM, SG, LG, RV, JD, CV: approved final version.
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The authors did not receive support from any organization for the submitted work. Wafa Skalli has a patent related to biplanar X-rays and associated 3D reconstruction methods, with no personal financial benefit (royalties rewarded for research and education) licensed to EOS Imaging. Raphael Vialle reports personal fees and grants (unrelated to this study) from Stryker. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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Langlais, T., Skalli, W., du Cluzel, X. et al. Spinal axial torque assessment after surgical correction in adolescent idiopathic scoliosis: a new approach to 3D barycentremetry and mass distribution based on biplanar radiographs. Spine Deform 12, 689–697 (2024). https://doi.org/10.1007/s43390-023-00816-5
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DOI: https://doi.org/10.1007/s43390-023-00816-5