The radiographic method for evaluation of axial vertebral rotation - presentation of the new method.

Pavel Cerny,Iveta Pallova,Ivo Marik

doi:10.1186/1748-7161-9-11

Abstract

The objective of this study is to present a new radiographic method for the assessment of vertebral rotation from an antero-posterior view of conventional X-rays which is sufficiently precise in comparison with radiographic methods presently used in clinical practice (methods of Nash-Moe and Perdriolle). This method is based on the properties of the geometric shape of vertebrae and their shared dimensional proportions. It means that the relation between vertebral body width and height doesn’t change significantly within the entire thoracic and lumbar sections of the spine. In order to verify the method, we have constructed a special device for vertebral fixation. Subsequently, the X-ray pictures of individual human vertebrae with predefined rotation values (ranging from 0 degrees to 45 degrees by steps of 3 degrees) were radio-graphically measured and then compared with their actual axial rotation on the vertebral rotation device. All arithmetic averages correlate very closely with the actual values. The verification of axial vertebral rotation with the assistance of CT and MRI pictures of six scoliotic patients (in supine position) and the evaluation of axial vertebral rotation by both the new radiographic method and with the Perdriolle method proved the satisfactory accuracy of our method. The main advantage of the newly presented radiographic method is the uncomplicated measurement of vertebral rotation from AP projection of conventional X-ray pictures or from its printed copies. The gold standard of the new radiographic method is the evaluation of axial rotation of vertebrae to 30 degrees approximately and the shape of vertebral bodies without severe structural deformities. The new radiographic method seems to be suitable for use in clinical practice.

Highlights

There is a great need for knowledge about vertebral rotation in patients suffering from scoliosis in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions
The new radiographic method for the evaluation of axial vertebral rotation in the antero-posterior views of conventional X-rays was compared to other methods which are used in clinical practice
In the original paper the authors present their own new radiographic method that is sufficiently precise for clinical evaluation of the rotation of thoracic and the lumbar vertebrae in conventional X-rays

Summary

Introduction

There is a great need for knowledge about vertebral rotation in patients suffering from scoliosis in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions. There were many methods proposed and used to measure vertebral rotation such as radiography [6,2,7,8,9,10,11,12], CT [13,14,15,16], MRI methods [17] and ultrasound [18] Radiographic methods such as Nash’s and Moe’s [8], Perdriolle’s [9] and Raimondi’s [12] are still used by clinicians for measurement of the thoracic and lumbar vertebrae rotation in conventional X-rays. These methods are not sufficiently precise in comparison with measurements obtained in CT or MRI scans

Objectives

Methods

Results

Discussion

Conclusion