Abstract
PurposeThere is no data that show if it is possible to determine if a curve is structural or non-structural or to assess flexibility of an adolescent idiopathic scoliosis (AIS) by recumbent images like a CT scan (CTS) instead of bending radiographs (BR). We investigated if the results of BR may be compared to those of CTS.MethodsWe retrospectively analyzed prospectively collected data of patients with AIS in whom a selective spinal fusion was performed and in whom a CTS, BR, and full spine x-rays were made preoperatively. We measured the Cobb angles of the main and the minor curve in full spine x-ray, BR, and CTS.ResultsAfter applying inclusion and exclusion criteria, 39 patients were included. We found a strong correlation (r = 0.806, p < 0.01) between the Cobb angle of the main curve in BR and the Cobb angle of the main curve in the CTS and between the Cobb angle of the minor curve in BR and the Cobb angle of the minor curve in the CTS (r = 0.601, p < 0.01). All patients with a minor curve of less than 25 degrees in the BR had a Cobb angle of less than 35 degrees in the CTS.ConclusionSpinal curves showed a significant correlation between bending radiographs and recumbent images (CTS). In our group of patients, a Cobb angle of the minor curve of less than 35 degrees in the CTS indicated that this minor curve was non-structural.
Highlights
Adolescent idiopathic scoliosis (AIS) is a deformity of the spine with an incidence of 5% [1]
Important for the success of a selective spinal fusion is the discrimination of structural and nonstructural curves of the total deformity according to the Lenke-Classification [3, 5] and to choose the appropriate lowest instrumented vertebra (LIV) [3, 4]
We identified 61 patients who were treated operatively for AIS in our institution between 05/2016 and 01/2020 and received a preoperative CT scan by diagnostic code
Summary
Adolescent idiopathic scoliosis (AIS) is a deformity of the spine with an incidence of 5% [1]. Patients with AIS who need an operative therapy may be treated with a selective spinal fusion. Important for the success of a selective spinal fusion is the discrimination of structural and nonstructural curves of the total deformity according to the Lenke-Classification [3, 5] and to choose the appropriate lowest instrumented vertebra (LIV) [3, 4]. To classify a deformity according to the Lenke classification, bending radiographs (BR) of the spine are mandatory. There are different types of bending radiographs: Push-prone radiographs (PPR) [8], fulcrum bending radiographs [6], supine side-bending radiographs [9], and radiographs with traction under General Anesthesia [10]. All types of BR lead to an additional
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