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Evaluation of the changes in waistline asymmetry using digital photography in adolescents with idiopathic thoracolumbar/lumbar scoliosis after corrective surgery

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Abstract

Purpose

Waist line asymmetry is a major cosmetic concern in patients with adolescent idiopathic scoliosis (AIS). The primary surgical goal in patients with AIS is to correct spinal deformities and prevent further progression while maintaining global alignment. Additionally, an important objective of surgical treatment is to address physical appearance by reducing asymmetry. This study aimed to evaluate changes in waistline asymmetry using digital photographs in adolescents with thoracolumbar/lumbar (TL/L) scoliosis who underwent corrective surgery.

Methods

We retrospectively analyzed the data of patients with Lenke types 5C and 6C AIS who underwent posterior fusion surgery with at least 2 years of follow-up. Waist line asymmetry was assessed using digital photography. The waist angle ratio (WAR), waist height angle (WHA), and waistline depth ratio (WLDR) were measured pre- and postoperatively. Radiographic parameters and the revised 22-item Scoliosis Research Society Questionnaire (SRS-22r) were also evaluated.

Results

Forty-two patients (40 females and 2 males; 34 with type 5C and 8 with type 6C) were included in the study. The WAR, WHA, and WLDR significantly improved after surgery (0.873 → 0.977, − 2.0° → 1.4°, and 0.321 → 0.899, respectively). Every waistline parameter moderately correlated with the apical vertebral translation of the TL/L curve (WAR: r =  − 0.398, WHA: r =  − 0.442, and WLDR: r =  − 0.692), whereas no correlations were observed with the TL/L curve magnitude. No correlations were observed between the photographic parameters and SRS-22r scores.

Conclusion

Lateral displacement of the apical vertebra on the TL/L curve correlated with waistline asymmetry. Preoperative waistline asymmetry improved with scoliosis correction.

Level of evidence

Level 4.

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Data availability

All data is available upon request.

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Acknowledgements

The authors would like to thank Ms. Nao Kuwahara, Ms. Tomoe Mabuchi, and Mr. Taku Nagao, Secretaries of the Department of Orthopedic Surgery, for their excellence in technical assistance during data collection.

Funding

TH and SO belong to the division as follows; Donated Fund Laboratory (Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Shizuoka, Japan). Meitoku medical institute Jyuzen memorial hospital, Shizuoka, Japan. Japan Medical Dynamic Marketing Inc, Tokyo, Japan. Medtronic Sofamor Danek Inc., Memphis, United States.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu & Yukihiro Matsuyama

  2. Division of Surgical Care, Morimachi, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan

    Tomohiro Banno

  3. Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan

    Tomohiko Hasegawa & Shin Oe

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  1. Tomohiro Banno
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  2. Yu Yamato
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  3. Tomohiko Hasegawa
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  10. Yukihiro Matsuyama
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Contributions

Conception or design of the work: Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama. Acquisition of data for the work: Tomohiro Banno, Yu Yamato, and Shin Oe. Analysis of data for the work: Tomohiro Banno. Interpretation of data for the work: Tomohiro Banno, and Yu Yamato. Drafting the work or revising it critically for important intellectual content: Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama. Final approval of the version to be published: Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: Tomohiro Banno, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, and Yukihiro Matsuyama.

Corresponding author

Correspondence to Tomohiro Banno.

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Conflict of interest

TB, YY, GY, HA, KI, TY, KK, and YM have nothing to disclose.

IRB approval

This study design was approved by the appropriate ethics review boards in Hamamatsu University School of Medicine (IRB No. 23-104).

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Banno, T., Yamato, Y., Hasegawa, T. et al. Evaluation of the changes in waistline asymmetry using digital photography in adolescents with idiopathic thoracolumbar/lumbar scoliosis after corrective surgery. Spine Deform (2024). https://doi.org/10.1007/s43390-024-00850-x

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