Tabard-Fougère Anne, Bonnefoy-Mazure Alice, Gavira Nathaly, Armand Stéphane, Dayer Romain
Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Eur Spine J. 2025 Aug 14. doi: 10.1007/s00586-025-09213-0.
Evaluating curve progression in adolescent idiopathic scoliosis (AIS) patients involves repeated exposure to radiation. Rasterstereography is reported to be a reliable, valid alternative to classic radiography. Few studies have evaluated rasterstereography's responsiveness in detecting curve progression over time or how brace treatment might influence these results.
The present study aimed to evaluate rasterstereography and scoliometer measurement responsiveness in detecting curve progression in a large cohort of AIS patients with a follow-up time of > 6 months and comparing brace-treated and non-braced patients.
We included consecutively AIS patients who underwent same-day rasterstereography, scoliometer and radiography evaluations from 2016 to 2018, with at least 6 months between visits. Each patient's major scoliosis curve was evaluated using their Cobb angle (CA) from radiography, their scoliosis angle (SA) from rasterstereography and their axial trunk rotation (ATR) angle from scoliometer measurement. Patients were separated into brace-treated and non-braced groups. Progressive curves were defined by an increase in CA ≥ 5°. The area under the curve (AUC) of non-parametric receiver operating characteristics (ROC) curves was used to assess responsiveness of SA and ATR in detecting progressive curves. We reported sensitivity and specificity.
One-hundred-and-eleven AIS patients (55 brace-treated, 56 non-braced) were evaluated, of whom 17 (16%) had progressive curves: 10/55 (18%) brace-treated and 7/56 (13%) non-braced patients. We found poor AUC and sensitivity (< 50%) in detecting progressive curves among brace-treated patients. However, we found a good AUC (> 75%) and moderate sensitivity (< 70%) in detecting progressive curves among non-braced patients.
Rasterstereography and scoliometer measurements both showed poor and moderate sensitivity in detecting curve progression in brace-treated and non-braced AIS patients, respectively. This suggests that rasterstereography should not be used to monitor curve progression among AIS patients to reduce their exposure to radiation, particularly among brace-treated patients. Presents results adds to ongoing debates about surface topography's role in AIS monitoring, particularly for braced patients where torso shape changes may confound measurements. Although rasterstereography and scoliometer lacks sufficient sensitivity to serve as a standalone monitoring tool, these results identify untreated patients as the most promising target population for future technological refinements of surface topography.
评估青少年特发性脊柱侧凸（AIS）患者的曲线进展需要反复接受辐射。据报道，光栅立体摄影是传统X线摄影的一种可靠、有效的替代方法。很少有研究评估光栅立体摄影在检测随时间变化的曲线进展方面的反应性，或者支具治疗可能如何影响这些结果。
本研究旨在评估光栅立体摄影和脊柱侧凸测量仪测量在检测一大群随访时间>6个月的AIS患者曲线进展方面的反应性，并比较接受支具治疗和未接受支具治疗的患者。
我们纳入了2016年至2018年连续接受同日光栅立体摄影、脊柱侧凸测量仪和X线摄影评估的AIS患者，两次就诊间隔至少6个月。使用X线摄影的Cobb角（CA）、光栅立体摄影的脊柱侧凸角（SA）和脊柱侧凸测量仪测量的轴向躯干旋转（ATR）角评估每位患者的主要脊柱侧凸曲线。患者分为支具治疗组和非支具治疗组。进展性曲线定义为CA增加≥5°。非参数接收器操作特征（ROC）曲线的曲线下面积（AUC）用于评估SA和ATR在检测进展性曲线方面的反应性。我们报告了敏感性和特异性。
对111例AIS患者（55例接受支具治疗，56例未接受支具治疗）进行了评估，其中17例（16%）有进展性曲线：10/55（18%）接受支具治疗的患者和7/56（13%）未接受支具治疗的患者。我们发现，在检测接受支具治疗的患者的进展性曲线方面，AUC和敏感性较差（<50%）。然而，我们发现，在检测未接受支具治疗的患者的进展性曲线方面，AUC良好（>75%）且敏感性中等（<70%）。
光栅立体摄影和脊柱侧凸测量仪测量在检测接受支具治疗和未接受支具治疗的AIS患者的曲线进展方面分别显示出较差和中等的敏感性。这表明，不应使用光栅立体摄影来监测AIS患者的曲线进展以减少其辐射暴露，特别是在接受支具治疗的患者中。本研究结果加剧了关于表面地形学在AIS监测中的作用的持续争论，特别是对于接受支具治疗的患者，躯干形状变化可能会混淆测量结果。尽管光栅立体摄影和脊柱侧凸测量仪缺乏足够的敏感性作为独立的监测工具，但这些结果确定未接受治疗的患者是未来表面地形学技术改进最有希望的目标人群。
