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Trunk Growth in Early-Onset Idiopathic Scoliosis Measured With Biplanar Radiography

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Abstract

Study Design

Cross-sectional and longitudinal retrospective study.

Objectives

To measure thoracic dimensions and volume during growth in early-onset idiopathic scoliosis (EOIS) patients and to compare them to a population of asymptomatic adults and to the previous literature.

Summary of Background Data

Data on trunk growth for scoliotic children between 6 and 14 years of age is sparse in the literature.

Methods

Thirty-six patients (29 girls and 7 boys, between 3 and 14 years old, average Cobb angle 33°±15°) were included, all with a minimum two-year follow-up. Sixty-one asymptomatic girls and 54 asymptomatic adults were included as control groups. All subjects underwent biplanar radiography and 3D reconstruction of the spine, pelvis, and rib cage. EOIS patients repeated their radiologic examination every six months. Cobb angle, rib cage volume, anteroposterior and transverse diameters, thoracic index, thoracic perimeter, pelvic incidence, and T1–T12 and T1–S1 distance were calculated. Reproducibility of measurement was assessed.

Results

Measurement reliability in such young patients was comparable to previous studies in adolescents and adults. Geometrical parameters of EOIS patients increased linearly with age. For instance, rib cage volume in girls with EOIS increased from 2200 cm3 at six to seven years of age to 4100 cm3 at 13–14 years (65% of adult values, 294 cm3/y). Comparison with asymptomatic girls showed that EOIS could affect growth spurt. Longitudinal analysis on a cohort of six girls who had a follow-up of six years confirmed the cross-sectional data.

Conclusions

In this longitudinal and cross-sectional study, trunk growth between 3 and 14 years of age was characterized, for the first time, with biplanar radiography and 3D reconstruction. The results can be useful to estimate patient growth and thus have potential application in the surgical planning of EOIS patients.

Level of Evidence

Level II, retrospective study.

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Authors and Affiliations

  1. Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 151 bd de l’Hopital, Paris, 75013, France

    Claudio Vergari PhD, Nicolas Bocahut MD, MsC, Thibault Hernandez MD, MsC, Ayman Assi PhD & Wafa Skalli PhD

  2. Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris 7 University, 48 boulevard Sérurier, Paris, 75019, France

    Nicolas Bocahut MD, MsC & Brice Ilharreborde MD, PhD

  3. Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Sorbonne University, 26, avenue du Docteur Arnold-Netter, Paris, 75012, France

    Thibault Hernandez MD, MsC

  4. Faculty of Medicine, University of Saint-Joseph, Damascus street, Beirut, BP 17-5208 - Mar Mekhaël, Lebanon

    Ayman Assi PhD

Authors
  1. Claudio Vergari PhD
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  2. Nicolas Bocahut MD, MsC
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  3. Thibault Hernandez MD, MsC
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  4. Ayman Assi PhD
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  5. Wafa Skalli PhD
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  6. Brice Ilharreborde MD, PhD
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Corresponding author

Correspondence to Claudio Vergari PhD.

Additional information

Author disclosures: CV (none), NB (none), TH (none), AA (none), WS (grants from ParisTech Foundation, during the conduct of the study; in addition, WS has a patent related to the EOS system and associated 3D reconstruction methods, with no personal financial benefit [royalties rewarded for research and education] issued), BI (personal fees from Medtronic, ZimmerSpine, and Implanet, outside the submitted work).

IRB approval: Data collection was approved by the local ethical committee at the Robert Debré hospital, Paris, France.

Funding source: The authors are grateful to the ParisTech BiomecAM chair program on subject-specific musculoskeletal modeling (with the support of ParisTech and Yves Cotrel Foundations, Société Générale, Proteor and Covea).

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Vergari, C., Bocahut, N., Hernandez, T. et al. Trunk Growth in Early-Onset Idiopathic Scoliosis Measured With Biplanar Radiography. Spine Deform 7, 962–970 (2019). https://doi.org/10.1016/j.jspd.2019.04.001

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  • DOI: https://doi.org/10.1016/j.jspd.2019.04.001

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