Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
Department of Orthopedic Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, USA.
Spine Deform. 2021 Sep;9(5):1355-1362. doi: 10.1007/s43390-021-00349-9. Epub 2021 May 6.
With the goal of reducing radiation dosing for patients, we sought to compare the results of slot-scanning (EOS) standing flexibility radiographs to supine bending and fulcrum radiographs for surgical planning in adolescent idiopathic scoliosis (AIS). We hypothesized that slot-scanning standing bending radiographs provide similar mean curve flexibility as supine bending and fulcrum radiographs.
This is a retrospective review of 224 AIS patients with concomitant upright standing and flexibility images. Curve flexibility, defined the percent change in Cobb angle from standing upright to flexibility images, was used to compare the results of slot-scanning standing, supine and fulcrum radiographs. Statistical analysis utilized ANOVA one-way tests and two-sample t tests to detail differences as indicated.
A total of 256 imaging studies were included, 75 slot-scanning standing, 112 supine, and 69 fulcrum radiographs. Fulcrum images only investigated thoracic curves and were, therefore, excluded from proximal thoracic and lumbar flexibility comparisons. Relevant mean standing curve magnitudes were similar between the groups with some variance in thoracic curves between fulcrum and supine image series (p = 0.003). There was no statistical difference in curve flexibility for proximal thoracic curves (p = 0.389) and lumbar curves (p = 0.798). However, for thoracic curves, slot-scanning standing images result in less measured curve flexibility compared to supine (p = 1.00E-7) and fulcrum images (p = 2.84E-18). Furthermore, supine bending images resulted in less measured curve flexibility in comparison to fulcrum images (p = 2.85E-7).
Slot-scanning standing bending films show comparable results in curve flexibility as supine bending films for proximal thoracic and lumbar curves but may show reduced flexibility for thoracic curves when compared to supine or fulcrum bending films. Given lower radiation dosing, slot-scanning films could be substituted for traditional supine films for assessment of proximal thoracic and lumbar curve flexibility.
为了降低患者的辐射剂量，我们旨在比较槽式扫描（EOS）站立位弯曲位片与仰卧位弯曲位片和支点位片在青少年特发性脊柱侧凸（AIS）手术规划中的结果。我们假设槽式扫描站立位弯曲位片提供的平均曲线柔韧性与仰卧位弯曲位片和支点位片相似。
这是一项对 224 例伴有直立位和柔韧性图像的 AIS 患者的回顾性研究。通过比较槽式扫描站立位、仰卧位和支点位片的结果，用 Cobb 角从直立位到柔韧性图像的百分比变化来定义曲线柔韧性。采用方差分析单因素检验和两样本 t 检验对差异进行详细分析。
共纳入 256 项影像学研究，其中 75 项为槽式扫描站立位片，112 项为仰卧位片，69 项为支点位片。支点位片仅用于研究胸段曲线，因此在近端胸段和腰段柔韧性比较中被排除。各组的相关站立位曲线幅度相似，但胸段曲线在支点位片和仰卧位片系列之间存在一定差异（p=0.003）。近端胸段曲线（p=0.389）和腰段曲线（p=0.798）的曲线柔韧性无统计学差异。然而，对于胸段曲线，与仰卧位（p=1.00E-7）和支点位（p=2.84E-18）图像相比，槽式扫描站立位图像的测量曲线柔韧性较低。此外，与支点位片相比，仰卧位弯曲位片的测量曲线柔韧性较低（p=2.85E-7）。
对于近端胸段和腰段曲线，槽式扫描站立位弯曲位片与仰卧位弯曲位片在曲线柔韧性方面的结果相似，但与仰卧位或支点位弯曲位片相比，槽式扫描站立位片的胸段曲线柔韧性可能较低。由于辐射剂量较低，槽式扫描片可替代传统的仰卧位片，用于评估近端胸段和腰段曲线的柔韧性。
