Oquendo Yousi, Hollyer Ian, Maschhoff Clayton, Calderon Christian, DeBaun Malcolm, Langner Joanna, Javier Nadine, Bryson Xochitl, Richey Ann, Naz Hiba, Tileston Kali, Gardner Michael, Vorhies John S
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedic Surgery, Stanford University School of Medicine, 453 Quarry Rd, 3rd Floor, MC 5658, Palo Alto, CA, USA.
Spine Deform. 2025 Mar;13(2):529-537. doi: 10.1007/s43390-024-01007-6. Epub 2024 Dec 12.
Screening for adolescent idiopathic scoliosis (AIS) currently relies on clinical evaluations by trained practitioners, most commonly using a scoliometer. Modern structured light 3D scanning can generate high-quality 3D representations of surface anatomy using a mobile device. We hypothesized that a mobile-based 3D scanning system would provide accurate deformity assessments compared to a scoliometer.
Between August 2020 and June 2022, patients 10-18 years being evaluated for AIS in our clinic with a scoliosis radiograph obtained within 30 days of clinic evaluation and no history of spinal surgery were enrolled. Patients had 3D scans taken in the upright and forward bend positions, and the largest angle of trunk rotation (ATR) was measured by a scoliometer. Image processing software was used to analyze trunk shift (TS), coronal balance (CB), and clavicle angle (CL) in the upright position and the largest ATR in the forward bend position. 3D and scoliometer measurements were correlated to major curve magnitude. Multiple logistic regression models were created based on 3D and scoliometer measurements, controlling for demographic covariates.
Two hundred and fifty-eight patients were included in this study. Mean coronal major curve magnitude was 25.7° (range 0-100), and 59% had a thoracic major curve. There were good-to-excellent correlations between 3D and radiographic measures of TS, CB, and CL (r = 0.79, rs = 0.80, and r = 0.64, respectively, p < 0.001). Correlations between 3D and radiographic measures of largest lumbar and thoracic ATR also demonstrated good correlations (r = 0.64 for both, p < 0.001). Using Akaike's Information Criterion (AIC), a multivariable logistic regression model based on 3D scanning outperformed a scoliometer model.
Mobile device-based 3D scanning of TS, CB, and TS identifies clinically relevant scoliotic deformity and is more predictive of radiographic curve magnitude than scoliometer in this population. This new modality may facilitate scoliosis screening by decreasing the need for trained personnel or dedicated equipment and clinical space to perform screening tests.
II.
目前青少年特发性脊柱侧凸（AIS）的筛查依赖于训练有素的从业者进行临床评估，最常用的是脊柱侧凸测量仪。现代结构光3D扫描可以使用移动设备生成高质量的表面解剖结构3D模型。我们假设与脊柱侧凸测量仪相比，基于移动设备的3D扫描系统能提供更准确的畸形评估。
在2020年8月至2022年6月期间，纳入在我们诊所接受AIS评估的10 - 18岁患者，这些患者在诊所评估后30天内进行了脊柱侧凸X线检查且无脊柱手术史。患者在直立位和前屈位进行3D扫描，并用脊柱侧凸测量仪测量最大躯干旋转角度（ATR）。使用图像处理软件分析直立位的躯干偏移（TS）、冠状面平衡（CB）和锁骨角度（CL）以及前屈位的最大ATR。将3D测量值和脊柱侧凸测量仪测量值与主要弯曲程度进行相关性分析。基于3D测量值和脊柱侧凸测量仪测量值创建多因素逻辑回归模型，并对人口统计学协变量进行控制。
本研究共纳入258例患者。冠状面主要弯曲平均度数为25.7°（范围0 - 100），59%的患者为胸段主要弯曲。3D测量值与X线测量的TS、CB和CL之间存在良好至极好的相关性（r分别为0.79、rs为0.80和r为0.64，p < 0.001）。3D测量值与X线测量的最大腰段和胸段ATR之间也显示出良好的相关性（两者r均为0.64，p < 0.001）。使用赤池信息准则（AIC），基于3D扫描的多因素逻辑回归模型优于脊柱侧凸测量仪模型。
基于移动设备对TS、CB和CL进行3D扫描可识别出临床上相关的脊柱侧凸畸形，并且在该人群中比脊柱侧凸测量仪更能预测X线弯曲程度。这种新方法可能通过减少对训练有素的人员或专用设备以及临床空间的需求来促进脊柱侧凸筛查。
II级
