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A comprehensive review of thoracic deformity parameters in scoliosis

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Abstract

Purpose

The combined spine and rib cage deformity in scoliosis is best described as a thoracic deformity, and recent advances in imaging have enabled better definition of three-dimensional (3D) deformity of the thorax in scoliosis. However, a comprehensive report that summarizes the published thorax deformity quantification parameter studies is lacking in the orthopaedic literature.

Methods

An extensive literature review on the quantification of thorax deformity was performed, and a total of 25 thorax deformity parameters were compiled into eight independent categories based on their similarities of deformity assessment.

Results

This review serves as the first comprehensive summary of radiographic and CT-based thorax deformity quantification measures.

Conclusions

Future work on the complex relationships between spine and ribcage deformity and the relationship with pulmonary function could help improve clinical interventions for scoliosis treatment.

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References

  1. Roaf R (1966) The basic anatomy of scoliosis. J Bone Joint Surg Br 48(4):786–792

    CAS  PubMed  Google Scholar 

  2. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83-A(8):1169–1181

    CAS  PubMed  Google Scholar 

  3. Stokes IA (1994) Three-dimensional terminology of spinal deformity. A report presented to the Scoliosis Research Society by the Scoliosis Research Society Working Group on 3-D terminology of spinal deformity. Spine 19(2):236–248

    Article  CAS  PubMed  Google Scholar 

  4. Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371(9623):1527–1537. doi:10.1016/S0140-6736(08)60658-3

    Article  PubMed  Google Scholar 

  5. Cobb JRM (1948) Outline For The Study of Scoliosis. Paper presented at the The American Academy of Orthopaedic Surgeons

  6. Easwar TR, Hong JY, Yang JH, Suh SW, Modi HN (2011) Does lateral vertebral translation correspond to Cobb angle and relate in the same way to axial vertebral rotation and rib hump index? A radiographic analysis on idiopathic scoliosis. Eur Spine J 20(7):1095–1105. doi:10.1007/s00586-011-1702-0

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Gervais J, Perie D, Parent S, Labelle H, Aubin CE (2012) MRI signal distribution within the intervertebral disc as a biomarker of adolescent idiopathic scoliosis and spondylolisthesis. BMC Musculoskeletal Disord 13:239. doi:10.1186/1471-2474-13-239

    Article  CAS  Google Scholar 

  8. Di Silvestre M, Lolli F, Bakaloudis G, Maredi E, Vommaro F, Pastorelli F (2013) Apical vertebral derotation in the posterior treatment of adolescent idiopathic scoliosis: myth or reality? Eur Spine J 22(2):313–323. doi:10.1007/s00586-012-2372-2

    Article  PubMed Central  PubMed  Google Scholar 

  9. Thulbourne T, Gillespie R (1976) The rib hump in idiopathic scoliosis. Measurement, analysis and response to treatment. J Bone Joint Surg Br 58(1):64–71

    CAS  PubMed  Google Scholar 

  10. Grivas TB, Vasiliadis ES, Mihas C, Savvidou O (2007) The effect of growth on the correlation between the spinal and rib cage deformity: implications on idiopathic scoliosis pathogenesis. Scoliosis 2:11. doi:10.1186/1748-7161-2-11

    Article  PubMed Central  PubMed  Google Scholar 

  11. Campbell RM Jr, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Alder ME, Duong HL, Surber JL (2003) The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am 85-A(3):399–408

    PubMed  Google Scholar 

  12. Campbell RM Jr, Adcox BM, Smith MD, Simmons JW 3rd, Cofer BR, Inscore SC, Grohman C (2007) The effect of mid-thoracic VEPTR opening wedge thoracostomy on cervical tilt associated with congenital thoracic scoliosis in patients with thoracic insufficiency syndrome. Spine 32(20):2171–2177. doi:10.1097/BRS.0b013e31814b2d6c

    Article  PubMed  Google Scholar 

  13. Youssef DOO JA, Patty CA, Scott MA, Price HL, Hamlin LF, Williams TL, Uribe JS, Deviren V (2013) Current status of adult spinal deformity. Global Spine J 1(3):51–62. doi:10.1055/s-0032-1326950

    Google Scholar 

  14. Bullmann V, Schulte TL, Schmidt C, Gosheger G, Osada N, Liljenqvist UR (2013) Pulmonary function after anterior double thoracotomy approach versus posterior surgery with costectomies in idiopathic thoracic scoliosis. Eur Spine J 22(Suppl 2):S164–S171. doi:10.1007/s00586-012-2316-x

    Article  PubMed  Google Scholar 

  15. Yang JH, Bhandarkar AW, Kasat NS, Suh SW, Hong JY, Modi HN, Hwang JH (2013) Isolated percutaneous thoracoplasty procedure for skeletally mature adolescent idiopathic scoliosis patients, with rib deformity as their only concern: short-term outcomes. Spine 38(1):37–43. doi:10.1097/BRS.0b013e3182784cdc

    Article  PubMed  Google Scholar 

  16. Shi Z, Wu Y, Huang J, Zhang Y, Chen J, Guo K, Li M, Ran B (2013) Pulmonary function after thoracoplasty and posterior correction for thoracic scoliosis patients. Int J Surg. doi:10.1016/j.ijsu.2013.05.035

    PubMed  Google Scholar 

  17. Ramirez N, Flynn JM, Serrano JA, Carlo S, Cornier AS (2009) The Vertical Expandable Prosthetic Titanium Rib in the treatment of spinal deformity due to progressive early onset scoliosis. J Pediatr Orthop B 18(4):197–203. doi:10.1097/BPB.0b013e32832bf5e0

    Article  PubMed  Google Scholar 

  18. Skaggs DL, Akbarnia BA, Flynn JM, Myung KS, Sponseller PD, Vitale MG, Approved by the Chest W, Spine Deformity Study Group tGSSGPOSoNA, the Scoliosis Research Society Growing Spine Study C (2013) A classification of growth friendly spine implants. J Pediatr Orthop. doi:10.1097/BPO.0000000000000073

    Google Scholar 

  19. Stokes OM, Luk KD (2013) The current status of bracing for patients with adolescent idiopathic scoliosis. Bone Joint J 95-B(10):1308–1316. doi:10.1302/0301-620X.95B10.31474

    Article  CAS  PubMed  Google Scholar 

  20. Aaro S, Dahlborn M (1981) Estimation of vertebral rotation and the spinal and rib cage deformity in scoliosis by computer tomography. Spine 6(5):460–467

    Article  CAS  PubMed  Google Scholar 

  21. Carlson BB, Burton DC, Asher MA (2013) Comparison of trunk and spine deformity in adolescent idiopathic scoliosis. Scoliosis 8(1):2. doi:10.1186/1748-7161-8-2

    Article  PubMed Central  PubMed  Google Scholar 

  22. Erkula G, Sponseller PD, Kiter AE (2003) Rib deformity in scoliosis. Eur Spine J 12(3):281–287. doi:10.1007/s00586-002-0523-6

    PubMed Central  PubMed  Google Scholar 

  23. Haller JA Jr, Kramer SS, Lietman SA (1987) Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg 22(10):904–906

    Article  PubMed  Google Scholar 

  24. Hong JY, Suh SW, Park HJ, Kim YH, Park JH, Park SY (2011) Correlations of adolescent idiopathic scoliosis and pectus excavatum. J Pediatr Orthop 31(8):870–874. doi:10.1097/BPO.0b013e31822da7d5

    Article  PubMed  Google Scholar 

  25. Kilda A, Basevicius A, Barauskas V, Lukosevicius S, Ragaisis D (2007) Radiological assessment of children with pectus excavatum. Indian J Pediatr 74(2):143–147

    Article  PubMed  Google Scholar 

  26. Kuklo TR, Potter BK, Lenke LG (2005) Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech 18(2):139–147

    Article  PubMed  Google Scholar 

  27. Mao SH, Qiu Y, Zhu ZZ, Zhu F, Liu Z, Wang B (2011) Clinical evaluation of the anterior chest wall deformity in thoracic adolescent idiopathic scoliosis. Spine. doi:10.1097/BRS.0b013e31823a05e6

    PubMed  Google Scholar 

  28. Mehta MH (1972) The rib-vertebra angle in the early diagnosis between resolving and progressive infantile scoliosis. J Bone Joint Surg Br 54(2):230–243

    CAS  PubMed  Google Scholar 

  29. Ohno K, Nakahira M, Takeuchi S, Shiokawa C, Moriuchi T, Harumoto K, Nakaoka T, Ueda M, Yoshida T, Tsujimoto K, Kinoshita H (2001) Indications for surgical treatment of funnel chest by chest radiograph. Pediatr Surg Int 17(8):591–595. doi:10.1007/s003830100000

    Article  CAS  PubMed  Google Scholar 

  30. Stokes IA (1989) Axial rotation component of thoracic scoliosis. J Orthop Res 7(5):702–708. doi:10.1002/jor.1100070511

    Article  CAS  PubMed  Google Scholar 

  31. Takahashi S, Suzuki N, Asazuma T, Kono K, Ono T, Toyama Y (2007) Factors of thoracic cage deformity that affect pulmonary function in adolescent idiopathic thoracic scoliosis. Spine 32(1):106–112

    Article  PubMed  Google Scholar 

  32. Williams AM, Crabbe DC (2003) Pectus deformities of the anterior chest wall. Paediatr Respir Rev 4(3):237–242

    Article  CAS  PubMed  Google Scholar 

  33. Grivas TB, de Mauroy JC, Negrini S, Kotwicki T, Zaina F, Wynne JH, Stokes IA, Knott P, Pizzetti P, Rigo M, Villagrasa M, Weiss HR, Maruyama T, members S (2010) Terminology-glossary including acronyms and quotations in use for the conservative spinal deformities treatment: 8th SOSORT consensus paper. Scoliosis 5:23. doi:10.1186/1748-7161-5-23

    Article  PubMed Central  PubMed  Google Scholar 

  34. Aaro S, Dahlborn M (1981) The longitudinal axis rotation of the apical vertebra, the vertebral, spinal, and rib cage deformity in idiopathic scoliosis studied by computer tomography. Spine 6(6):567–572

    Article  CAS  PubMed  Google Scholar 

  35. Campbell RM Jr (2013) VEPTR: past experience and the future of VEPTR principles. Eur Spine J 22(Suppl 2):S106–S117. doi:10.1007/s00586-013-2671-2

    Article  PubMed  Google Scholar 

  36. Mankin HJ, Graham JJ, Schack J (1964) Cardiopulmonary function in mild and moderate idiopathic scoliosis. J Bone Joint Surg Am 46:53–62

    CAS  PubMed  Google Scholar 

  37. Campbell RM Jr (2013) VEPTR: past experience and the future of VEPTR principles. Eur Spine J 22(Suppl 2):106–117. doi:10.1007/s00586-013-2671-2

    Article  PubMed Central  Google Scholar 

  38. Demura S, Bastrom TP, Schlechter J, Yaszay B, Newton PO, Harms Study G (2013) Should postoperative pulmonary function be a criterion that affects upper instrumented vertebra selection in adolescent idiopathic scoliosis surgery? Spine. doi:10.1097/BRS.0b013e3182a637a8

    Google Scholar 

  39. Lin MC, Liaw MY, Chen WJ, Cheng PT, Wong AM, Chiou WK (2001) Pulmonary function and spinal characteristics: their relationships in persons with idiopathic and postpoliomyelitic scoliosis. Arch Phys Med Rehabil 82(3):335–341. doi:10.1053/apmr.2001.21528

    Article  CAS  PubMed  Google Scholar 

  40. Upadhyay SS, Mullaji AB, Luk KD, Leong JC (1995) Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis. Spine 20(22):2415–2420

    Article  CAS  PubMed  Google Scholar 

  41. Upadhyay SS, Mullaji AB, Luk KD, Leong JC (1995) Evaluation of deformities and pulmonary function in adolescent idiopathic right thoracic scoliosis. Eur Spine J 4(5):274–279

    Article  CAS  PubMed  Google Scholar 

  42. Kalra MK, Quick P, Singh S, Sandborg M, Persson A (2013) Whole spine CT for evaluation of scoliosis in children: feasibility of sub-milliSievert scanning protocol. Acta Radiol 54(2):226–230. doi:10.1258/ar.2012.110625

    Article  PubMed  Google Scholar 

  43. Yazici M, Acaroglu ER, Alanay A, Deviren V, Cila A, Surat A (2001) Measurement of vertebral rotation in standing versus supine position in adolescent idiopathic scoliosis. J Pediatr Orthop 21(2):252–256

    CAS  PubMed  Google Scholar 

  44. Lee MC, Solomito M, Patel A (2013) Supine magnetic resonance imaging cobb measurements for idiopathic scoliosis are linearly related to measurements from standing plain radiographs. Spine 38(11):E656–E661. doi:10.1097/BRS.0b013e31828d255d

    Article  PubMed  Google Scholar 

  45. McKenna C, Wade R, Faria R, Yang H, Stirk L, Gummerson N, Sculpher M, Woolacott N (2012) EOS 2D/3D X-ray imaging system: a systematic review and economic evaluation. Health Technol Assess 16(14):1–188. doi:10.3310/hta16140

    CAS  Google Scholar 

  46. Al-Aubaidi Z, Lebel D, Oudjhane K, Zeller R (2013) Three-dimensional imaging of the spine using the EOS system: is it reliable? A comparative study using computed tomography imaging. J Pediatr Orthop B 22(5):409–412. doi:10.1097/BPB.0b013e328361ae5b

    Article  PubMed  Google Scholar 

  47. Glaser DA, Doan J, Newton PO (2012) Comparison of 3-dimensional spinal reconstruction accuracy: biplanar radiographs with EOS versus computed tomography. Spine 37(16):1391–1397. doi:10.1097/BRS.0b013e3182518a15

    Article  PubMed  Google Scholar 

  48. Humbert L, De Guise JA, Aubert B, Godbout B, Skalli W (2009) 3D reconstruction of the spine from biplanar X-rays using parametric models based on transversal and longitudinal inferences. Med Eng Phys 31(6):681–687. doi:10.1016/j.medengphy.2009.01.003

    Article  CAS  PubMed  Google Scholar 

  49. Ilharreborde B, Sebag G, Skalli W, Mazda K (2013) Adolescent idiopathic scoliosis treated with posteromedial translation: radiologic evaluation with a 3D low-dose system. Eur Spine J. doi:10.1007/s00586-013-2776-7

    Google Scholar 

  50. Ilharreborde B, Vidal C, Skalli W, Mazda K (2013) Sagittal alignment of the cervical spine in adolescent idiopathic scoliosis treated by posteromedial translation. Eur Spine J 22(2):330–337. doi:10.1007/s00586-012-2493-7

    Article  PubMed Central  PubMed  Google Scholar 

  51. Yang Y, Van Reeth E, Poh CL, Tan CH, Tham I (2013) A spatio-temporal based scheme for efficient registration-based segmentation of thoracic 4D MRI. IEEE J Biomed Health Inform. doi:10.1109/JBHI.2013.2282183

    Google Scholar 

  52. Bagci U, Foster B, Miller-Jaster K, Luna B, Dey B, Bishai WR, Jonsson CB, Jain S, Mollura DJ (2013) A computational pipeline for quantification of pulmonary infections in small animal models using serial PET-CT imaging. EJNMMI Res 3(1):55. doi:10.1186/2191-219X-3-55

    Article  PubMed Central  PubMed  Google Scholar 

  53. Li G, Citrin D, Camphausen K, Mueller B, Burman C, Mychalczak B, Miller RW, Song Y (2008) Advances in 4D medical imaging and 4D radiation therapy. Technol Cancer Res Treat 7(1):67–81

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge James Peters and Reese Juelg for creating the illustrations used in this paper.

Conflict of interest

None.

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Authors and Affiliations

  1. School of Biomedical Engineering, Science and Health Systems, Drexel University, 3141 Chestnut Street, Bossone 718, Philadelphia, PA, 19104, USA

    Jonathan A. Harris & Sriram Balasubramanian

  2. Division of Pulmonary Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Oscar H. Mayer

  3. Department of Orthopaedic Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Suken A. Shah

  4. Division of Orthopaedics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Robert M. Campbell Jr.

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  1. Jonathan A. Harris
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  2. Oscar H. Mayer
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  3. Suken A. Shah
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  5. Sriram Balasubramanian
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Correspondence to Sriram Balasubramanian.

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Harris, J.A., Mayer, O.H., Shah, S.A. et al. A comprehensive review of thoracic deformity parameters in scoliosis. Eur Spine J 23, 2594–2602 (2014). https://doi.org/10.1007/s00586-014-3580-8

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  • DOI: https://doi.org/10.1007/s00586-014-3580-8

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