Debanné Philippe, Pazos Valérie, Labelle Hubert, Cheriet Farida
Ecole Polytechnique de Montréal, Montréal, Canada.
Stud Health Technol Inform. 2010;158:72-7.
The value of the lateral bending test is important in the assessment of spinal curve mobility and prediction of surgical outcome in the treatment of adolescent idiopathic scoliosis (AIS). However, radiographic bending tests are unable to assess the reducibility of trunk asymmetry. This study aims to exploit surface topography measurement in order to evaluate the changes in shape of the trunk (a) between bending and neutral standing positions, and (b) between standing pre- and post-operative visits, in a cohort of adolescents with AIS having undergone surgical correction; and to correlate the differences measured in cases (a) and (b). Our cohort includes 13 patients with right thoracic AIS. Each patient had their 3D trunk surface digitized with a multi-head InSpeck system in standing posture (at the pre-op and post-op visits) and in maximum voluntary right and left bending (at the pre-op visit). We developed a novel trunk shape analysis method which produces a set of inclined trunk cross-sections allowing comparison between different postures. Two asymmetry indices, trunk rotation (TR) and back surface rotation (BSR), were computed in all cases and a statistical analysis was performed. Our correlation study (Pearson test) showed fair correlations in most cases between the changes in side-bending and those post-surgery, with the strongest relationship (p-value < 0.01) when combining the TR measurements from both bendings. These results provide evidence that the bending test can be used to assess trunk asymmetry reducibility. The proposed approach could provide a non-invasive trunk asymmetry reducibility test for routine clinical use in AIS surgery planning.
侧弯试验在评估青少年特发性脊柱侧凸（AIS）治疗中脊柱曲线活动度及预测手术效果方面具有重要价值。然而，影像学侧弯试验无法评估躯干不对称的可矫正性。本研究旨在利用表面地形测量技术，评估一组接受手术矫正的AIS青少年患者在（a）侧弯与中立站立位之间以及（b）术前和术后站立位之间躯干形状的变化；并关联（a）和（b）中测量的差异。我们的队列包括13例右胸弯AIS患者。每位患者在站立姿势（术前和术后访视）以及最大自主左右侧弯（术前访视）时，使用多头InSpeck系统对其三维躯干表面进行数字化。我们开发了一种新颖的躯干形状分析方法，该方法可生成一组倾斜的躯干横截面，以便在不同姿势之间进行比较。在所有病例中计算了两个不对称指数，即躯干旋转（TR）和后表面旋转（BSR），并进行了统计分析。我们的相关性研究（Pearson检验）表明，在大多数情况下，侧弯变化与术后变化之间存在适度相关性，当结合两次侧弯的TR测量值时，相关性最强（p值<0.01）。这些结果提供了证据，表明侧弯试验可用于评估躯干不对称的可矫正性。所提出的方法可为AIS手术规划的常规临床应用提供一种非侵入性的躯干不对称可矫正性测试。
