Langlais Tristan, Vergari Claudio, Mainard Nicolas, du Cluzel Xavier, Baudoux Matthieu, Gajny Laurent, Abelin-Genevois Kariman, Bernard Jean Claude, Hu Zongshan, Cheng Jack Chun Yiu, Chu Winnie Chiu Wing, Assi Ayman, Karam Mohamad, Ghanem Ismat, Bassani Tito, Galbusera Fabio, Sconfienza Luca Maria, Brayda-Bruno Marco, Courtois Isabelle, Ebermeyer Eric, Vialle Raphael, Dubousset Jean, Skalli Wafa
Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France.
Service Orthopédie et Traumatologie, Hôpital des enfants, Toulouse III Université, Purpan Toulouse, France.
Spine Deform. 2025 Mar;13(2):551-560. doi: 10.1007/s43390-024-01001-y. Epub 2024 Nov 4.
Our objective was to analysis the barycentremetry, obtained from the external envelope reconstruction of biplanar radiographs, in adolescent idiopathic scoliosis (AIS) and to determine whether assessing would help predict the distinction between progressive and stable AIS at the early stage.
A retrospective study with a multicentre cohort of 205 AIS was conducted. All AIS underwent a biplanar X-ray between 2013 and 2020. Inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the barycentremetry parameters were computed, i.e., the center of mass position at the apex and the axial torque at the apex, the upper and lower junction. A severity index, helping to distinguish stable and progressive AIS, was computed on the first radiograph, and weighted according to these parameters. A clinical and radiographic monitoring determined if AIS were classified such a stable or progressive scoliosis.
One hundred and sixty-two AIS were included (i.e., 87 were classified as stable and 75 as progressive). The apex center of mass position was different between the stable and progressive AIS groups (6 mm, SD = 4 mm for the whole cohort; 5 mm, SD = 4 mm for stable AIS versus 7 mm, SD = 4 mm for progressive AIS; p = 0.02). In AIS thoracic, the specificity and positive predictive value of the severity index increased by 19% and 16%, respectively, by adding the apex vertebral axial torque.
Early assessment of the external envelope from biplanar X-ray reconstruction of idiopathic scoliosis showed that the apex centre of mass position was significantly different between progressive and stable scoliosis. The inclusion of the axial torque of the apex vertebra in the severity index is promising to help the clinician distinguish between stable and progressive thoracic AIS at an early stage.
II - Prognostic studies.
我们的目标是分析从双平面X线片的外部包络重建获得的重心测量法，用于青少年特发性脊柱侧凸（AIS），并确定评估是否有助于在早期预测进展性和稳定性AIS之间的差异。
对205例AIS的多中心队列进行回顾性研究。所有AIS患者在2013年至2020年期间接受了双平面X线检查。纳入标准为Cobb角在10°至25°之间；Risser征低于3级；年龄大于10岁；且未曾接受过治疗。进行了三维脊柱重建，并计算了重心测量参数，即顶点处的质心位置和顶点、上下交界处的轴向扭矩。在第一张X线片上计算了一个有助于区分稳定性和进展性AIS的严重程度指数，并根据这些参数进行加权。通过临床和影像学监测确定AIS是否被分类为稳定或进展性脊柱侧凸。
纳入了162例AIS患者（即87例被分类为稳定型，75例为进展型）。稳定型和进展型AIS组之间的顶点质心位置不同（整个队列中为6mm，标准差=4mm；稳定型AIS为5mm，标准差=4mm，进展型AIS为7mm，标准差=4mm；p=0.02）。在胸椎型AIS中，通过添加顶点椎体轴向扭矩，严重程度指数的特异性和阳性预测值分别提高了19%和16%。
对特发性脊柱侧凸双平面X线重建的外部包络进行早期评估显示，进展性和稳定性脊柱侧凸之间的顶点质心位置存在显著差异。在严重程度指数中纳入顶点椎体的轴向扭矩有望帮助临床医生在早期区分稳定型和进展型胸椎AIS。
II - 预后研究。
