Abstract
Scoliosis is a three-dimensional trunk and spinal deformity. Patient evaluation is essential for the decision-making process and determines the selection of specific and adequate treatment. The diagnosis requires a radiological evaluation that exposes patients to radiation. This exposure reaches hazardous levels when numerous, repetitive radiographic studies are required for diagnostics, monitoring, and treatment. Technological improvements in radiographic devices have significantly reduced radiation exposure, but the risk for patients remains. Optical three-dimensional surface topography (3D ST) measurement systems that use surface topography (ST) to screen, diagnose, and monitor scoliosis are safer alternatives to radiography. The study aimed to show that the combination of plain X-ray and 3D ST scans allows for an approximate presentation of the vertebral column spinous processes line in space to determine the shape of the spine’s deformity in scoliosis patients. Twelve patients diagnosed with scoliosis, aged 13.1 ± 4.5 years (range: 9 to 20 years) (mean: Cobb angle 17.8°, SD: ±9.5°) were enrolled in the study. Patients were diagnosed using full-spine X-ray and whole torso 3D ST. The novel three-dimensional assessment of the spinous process lines by merging 3D ST and X-ray data in patients with scoliosis was implemented. The method’s expected uncertainty is less than 5 mm, which is better than the norm for a standard measurement tool. The presented accuracy level is considered adequate; the proposed solution is accurate enough to monitor the changes in the shape of scoliosis’s spinous processes line. The proposed method allows for a relatively precise calculation of the spinous process lines based on a three-dimensional point cloud obtained with a four-directional, three-dimensional structured light diagnostic system and a single X-ray image. The method may help reduce patients’ total radiation exposure and avoid one X-ray in the sagittal projection if biplanar radiograms are required for reconstructing the three-dimensional line of the spinous processes line.
Highlights
Scoliosis produces three-dimensional trunk and spinal deformity
The method was tested on 12 scoliosis cases
The superimposed spinous processes lines were determined by the acquired 3D surface topography (ST) data superimposed spinous processes lines were determined by the acquired 3D ST data (Fig(Figure 6)
Summary
Scoliosis produces three-dimensional trunk and spinal deformity. Patient evaluation is an essential point in the decision-making process and determines specific and adequate treatment. Scoliosis is usually diagnosed using radiography, which operates with a particular radiation dose [1,2]. Plain radiography is usually insufficient to show the three-dimensional shape of the vertebral column. Expense and radiation dose are reported as the main disadvantages of radiographic methods. Considering the elevated radiation exposure for scoliotic patients who require a periodic radiographic examination, a combined method is proposed for assessing the vertebral column shape expressed by the line of spinous processes. Methods are being sought to reduce the patient’s exposure to X-rays. Nash et al [3] estimated that the increase in risk due to X-ray radiation ranges from 3.4 to 15 per million if teenage patients with scoliosis are subjected to an average of 22 radiographs over three years. Ronckers et al [4,5] found that cancer mortality was 8%
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