Abstract
Study Design
Validation study.
Objective
To evaluate a method of 3-dimensional (3D) reconstruction of the rib cage in a population of scoliotic patients.
Summary of Background Data
Evaluation of the thoracic cage clinical parameters would be helpful in the management of spinal deformities.
Methods
Biplanar X-rays were performed using the EOS system and the rib cage was reconstructed using a previously developed semi-automated method. Thoracic parameters were calculated from the 3D reconstructions: volume, frontal and sagittal diameters, 3D spinal penetration index (SPI), thoracic index, and rib hump. To test accuracy, the authors constructed biplanar projections from 3 computed tomography scans and then used these projected X-rays as material for stereoradiographic reconstructions. The models were then compared with volumetric objects reconstructed from these 3 computed tomography scans. To test intra-observer and interobserver reproducibility, 22 chests (mean Cobb angle, 28° [range, 17° to 45°]) were reconstructed twice by 3 operators. The 95% confidence interval was calculated for the study parameters.
Results
The mean signed point to surface distance was —1.6 mm. Interobserver reproducibility was 9 mm for maximum anteroposterior and lateral diameters, <0.8% for SPI, 5° for rib hump,.02 for thoracic index, and 450 cm for volume.
Conclusions
The results of the reproducibility study were satisfactory. The 95% confidence interval was <6% for the transverse diameters and < 10% for volume and SPI. The reported method of 3D reconstruction of the rib cage provides accurate and reproducible determinations of the investigated thoracic parameters in scoliotic patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Durmala J, Tomalak W, Kotwicki T. Function of the respiratory system in patients with idiopathic scoliosis: reasons for impairment and methods of evaluation. Stud Health Technol Inform 2008;135:237–45.
Erkula G, Sponseller PD, Kiter AE. Rib deformity in scoliosis. Eur Spine J 2003;12:281–7.
Lonner BS, Auerbach JD, Estreicher MB, et al. Pulmonary function changes after various anterior approaches in the treatment of adolescent idiopathic scoliosis. J Spinal Disord Tech 2009;22:551–8.
Motoyama EK, Yang CI, Deeney VF. Thoracic malformation with early-onset scoliosis: effect of serial VEPTR expansion thoracoplasty on lung growth and function in children. Paediatr Respir Rev 2009;10:12–7.
Qiu Y, Sun GQ, Zhu F, et al. Rib length discrepancy in patients with adolescent idiopathic scoliosis. Stud Health Technol Inform 2010;158:63–6.
Sanquirico G, Boccaccio R. Pulmonary modifications in thoracic deformations in kyphoscoliosis with special reference to stratigraphic picture. Ann Radiol Diagn (Bologna) 1952;24:346–73.
Takahashi S, Suzuki N, Asazuma T, et al. Factors of thoracic cage deformity that affect pulmonary function in adolescent idiopathic thoracic scoliosis. Spine (Phila Pa 1976) 2007;32:106–12.
Humbert L, De Guise JA, Aubert B, et al. 3D reconstruction of the spine from biplanar X-rays using parametric models based on transversal and longitudinal inferences. Med Eng Phys 2009;31:681–7.
Dansereau J, Stokes IA. Measurements of the three-dimensional shape of the rib cage. J Biomech 1988;21:893–901.
Jolivet E, Sandoz B, Laporte S, et al. Fast 3D reconstruction of the rib cage from biplanar radiographs. Med Biol Eng Comput 2010;48:821–8.
Mitton D, Zhao K, Bertrand S, et al. 3D reconstruction of the ribs from lateral and frontal X-rays in comparison to 3D CT-scan reconstruction. J Biomech 2008;41:706–10.
Dubousset J, Charpak G, Skalli W, et al. EOS stereo-radiography system: whole-body simultaneous anteroposterior and lateral radiographs with very low radiation dose. Rev Chir Orthop Reparatrice Appar Motil 2007;93:141–3.
Humbert L, Carlioz H, Baudoin A, et al. 3D Evaluation of the acetabular coverage assessed by biplanar X-rays or single anteroposterior X-ray compared with CT-scan. Comput Methods Biomech Biomed Eng 2008;11:257–62.
Dubousset J, Wicart P, Pomero V, et al. Spinal penetration index: new three-dimensional quantified reference for lordoscoliosis and other spinal deformities. J Orthop Sci 2003;8:41–9.
Sabourin M, Jolivet E, Miladi L, et al. Three-dimensional stereoradiographic modeling of rib cage before and after spinal growing rod procedures in early-onset scoliosis. Clin Biomech (Bristol, Avon) 2010;25:284–91.
Stocks J, Quanjer PH. Reference values for residual volume, functional residual capacity and total lung capacity. ATS Workshop on Lung Volume Measurements. Official Statement of The European Respiratory Society. Eur Respir J 1995;8:492–506.
Barrios C, Perez-Encinas C, Maruenda JI, Laguia M. Significant ventilatory functional restriction in adolescents with mild or moderate scoliosis during maximal exercise tolerance test. Spine (Phila Pa 1976) 2005;30:1610–5.
Aubin CE, Dansereau J, de Guise JA, Labelle H. Rib cage-spine coupling patterns involved in brace treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 1997;22:629–35.
Labelle H, Dansereau J, Bellefleur C, Poitras B. Three-dimensional effect of the Boston brace on the thoracic spine and rib cage. Spine (Phila Pa 1976) 1996;21:59–64.
Bernard JC, Deceuninck J, Kohn C. Vital capacity evolution in patients treated with the CMCR brace: statistical analysis of 90 scoliotic patients treated with the CMCR brace. Scoliosis 2011;6:19.
Author information
Authors and Affiliations
Corresponding author
Additional information
Author disclosures: AC (none); BI (none); BC (none); BA (none); RV (none); WS (none).
Rights and permissions
About this article
Cite this article
Courvoisier, A., Ilharreborde, B., Constantinou, B. et al. Evaluation of a Three-Dimensional Reconstruction Method of the Rib Cage of Mild Scoliotic Patients. Spine Deform 1, 321–327 (2013). https://doi.org/10.1016/j.jspd.2013.07.007
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.jspd.2013.07.007