LABS, Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
III Spine Surgery - Scoliosis Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Eur Spine J. 2019 Mar;28(3):526-535. doi: 10.1007/s00586-018-05876-0. Epub 2019 Jan 7.
Aim of the study was to verify the accuracy of rasterstereography (RST), as radiation-free alternative to plain radiography (RAD) in the monitoring of spine deformity and scoliosis progression in juvenile and adolescent subjects with idiopathic scoliosis.
192 subjects underwent RST (by Formetric 4D device) and low-dose RAD (EOS Imaging, France) in the same session. A sub-group of 30 subjects, selected for conservative treatment with corrective bracing, was assessed at 6-months follow-up. The Cobb angles (CA) obtained by the 3D spine reconstruction from RAD were compared with those provided by RST. Thoracic kyphosis (TK) and lumbar lordosis (LL) were compared as well.
RST provided lower CA compared to RAD (15° vs. 33°, mean values). The average difference in measuring CA was 18°, and the correlation coefficient was 0.55. Comparable TK was observed, whereas LL resulted underestimated by RST compared to RAD (34° vs. 43°, average values). The within-subjects correlation, measuring the accuracy of RST in monitoring the scoliosis progression, was 0.3. Accuracy of RST in identifying increased or decreased CA was 67%. Sensitivity and specificity were 64% and 69%.
RST demonstrated moderate accuracy in measuring the scoliosis degree and low accuracy in monitoring the curve progression. Accordingly, it cannot be considered as a valid alternative to radiographic evaluation. However, since demonstrated capable of revealing the presence of spine deformity, it could be in principle considered for the early screening in large adolescent populations, but after accounting for a cost-benefit analysis with respect to other traditional approaches. These slides can be retrieved under Electronic Supplementary Material.
本研究旨在验证光栅体层摄影术（RST）的准确性，作为一种无辐射的替代方法，用于监测特发性脊柱侧凸青少年患者脊柱畸形和脊柱侧凸进展，该方法优于普通射线摄影术（RAD）。
192 名患者在同一次就诊中接受 RST（Formetric 4D 设备）和低剂量 RAD（EOS Imaging，法国）检查。选择 30 名接受矫正支具保守治疗的患者进行亚组 6 个月随访。通过 RAD 的 3D 脊柱重建获得的 Cobb 角（CA）与 RST 提供的 CA 进行比较。同时比较胸椎后凸角（TK）和腰椎前凸角（LL）。
与 RAD 相比，RST 提供的 CA 较低（15°比 33°，平均值）。测量 CA 的平均差值为 18°，相关系数为 0.55。观察到可比的 TK，而与 RAD 相比，RST 低估了 LL（34°比 43°，平均值）。测量 RST 监测脊柱侧凸进展准确性的受试者内相关性为 0.3。RST 识别 CA 增加或减少的准确性为 67%。敏感性和特异性分别为 64%和 69%。
RST 在测量脊柱侧凸程度方面具有中等准确性，在监测曲线进展方面准确性较低。因此，不能将其视为放射学评估的有效替代方法。然而，由于它能够显示脊柱畸形的存在，因此原则上可以考虑在大型青少年人群中进行早期筛查，但需要考虑与其他传统方法相比的成本效益分析。这些幻灯片可以在电子补充材料中检索到。
