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True 3D parameters of the spinal deformity in adolescent idiopathic scoliosis

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Abstract

Background

Spinal deformities in adolescent idiopathic scoliosis (AIS) are measured on 2D radiographs. Due to the 3D nature of the curve in AIS, such 2D measurements fail to differentiate between the true curve patterns, which in turn may adversly impact the clinical care and surgical planning. The use of 3D models of the spinal radiographs largely remains limited to the 3D measurements of the 2D parameters. The use of the true 3D variables of the spinal curves in describing the differences between the AIS patients is not fully explored.

Methods

A cohort of 141 Lenke 1 AIS with two-view spinal stereoradiographs and 3D models of the spines were included. The 3D model of the spine was used to determine the spinal centerlines. The writhe and torsion of the 3D centerlines, which, respectively, quantify the coiling and twist of the curve, were calculated using differential geometry. Patients were clustered based on the writhe and torsion values to determine the patient groups with significantly different 3D curve characteristics. The relationship between the writhe and torsion was statistically determined. The distribution of the writhe and torsion groups between the lumbar modifier types was determined.

Results

Two writhe and two torsion clusters were determined. Lumbar orientation of plane of maximum curvature (PMC) was significantly different between the torsion clusters and thoracic and lumbar PMC and thoracic Cobb angles were significantly different between the writhe groups, p < 0.05. More than 50% of the patients had high writhe and low torsion except for Lumbar modifier C that mainly belonged to the low writhe group.

Discussion

Two geometrical parameters of the spinal centerline determine true 3D characteristics of the scoliotic curves. The parameters were complimentary and weakly correlated, quantifying different characteristics of the scoliotic spines.

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Acknowledgements

SP acknowledges funding from the Scoliosis Research Society and National Institute of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin (NIAMS) (R21AR075971-01A1). We acknowledge Dr DeTurck and Mr Arginteanu contribution to the code development.

Funding

Funding was received from scoliosis research society and National Institute of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin (NIAMS) (R21AR075971-01A1) in forms of research grant to SP.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

    Saba Pasha

  2. CHU Sainte-Justine, Montreal, QC, Canada

    Jesse Shen & Samuel Kadoury

  3. Polytechnique Montreal, Montreal, QC, Canada

    Samuel Kadoury

Authors
  1. Saba Pasha
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  2. Jesse Shen
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  3. Samuel Kadoury
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Contributions

SP, SK, and JS made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. SP, SK, and JS drafted the work or revised it critically for important intellectual content. SP, SK, and JS approved the version to be published. SP, SK, and JS agree 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.

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Correspondence to Saba Pasha.

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All aspects of the research were approved by the ethical committee of the relevant hospital-research center.

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Authors declare no conflict of interest.

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A waiver of informed consent was received from the IRB for this retrospective study.

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Pasha, S., Shen, J. & Kadoury, S. True 3D parameters of the spinal deformity in adolescent idiopathic scoliosis. Spine Deform 9, 703–710 (2021). https://doi.org/10.1007/s43390-020-00254-7

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