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Patterns of coronal curve changes in forward bending posture: a 3D ultrasound study of adolescent idiopathic scoliosis patients

Purpose The Adam’s forward bending test is the most commonly used approach to assess the spine deformity in adolescent idiopathic scoliosis (AIS) patients. However, there are noticeable differences in the hump appearance from standing to forward bending. This phenomenon has yet to be understood due...

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Published in:European spine journal 2018-09, Vol.27 (9), p.2139-2147
Main Authors: Jiang, Wei Wei, Cheng, Connie Lok Kan, Cheung, Jason Pui Yin, Samartzis, Dino, Lai, Kelly Ka Lee, To, Michael Kai Tsun, Zheng, Yong Ping
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container_title European spine journal
container_volume 27
creator Jiang, Wei Wei
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Samartzis, Dino
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description Purpose The Adam’s forward bending test is the most commonly used approach to assess the spine deformity in adolescent idiopathic scoliosis (AIS) patients. However, there are noticeable differences in the hump appearance from standing to forward bending. This phenomenon has yet to be understood due to limitations of conventional radiographs. This study aimed to investigate effects of postural change in the spine deformity in the coronal plane of AIS patients using a 3D ultrasound imaging system. Methods This was a prospective study that recruited 72 AIS patients at a single institute. All patients were scanned twice in the sitting and sitting forward bending postures. A coronal ultrasound image showing the spinal curvature was generated after each scan and the spinous process angle (SPA) representing the deformity was manually measured from it. Correlation of SPAs under sitting and sitting forward bending postures was analyzed. Results In the comparison test, it was noted that there were three types of spine profile alternation after the postural change. In types I and II, the SPA angle numbers were the same before and after forward bending and only SPA values changed. In type III, the two curvatures were changed to one curvature in the forward bending posture. Moderate correlation was observed between the angles obtained in the two postures ( r  = 0.55, p  
doi_str_mv 10.1007/s00586-018-5646-5
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However, there are noticeable differences in the hump appearance from standing to forward bending. This phenomenon has yet to be understood due to limitations of conventional radiographs. This study aimed to investigate effects of postural change in the spine deformity in the coronal plane of AIS patients using a 3D ultrasound imaging system. Methods This was a prospective study that recruited 72 AIS patients at a single institute. All patients were scanned twice in the sitting and sitting forward bending postures. A coronal ultrasound image showing the spinal curvature was generated after each scan and the spinous process angle (SPA) representing the deformity was manually measured from it. Correlation of SPAs under sitting and sitting forward bending postures was analyzed. Results In the comparison test, it was noted that there were three types of spine profile alternation after the postural change. In types I and II, the SPA angle numbers were the same before and after forward bending and only SPA values changed. In type III, the two curvatures were changed to one curvature in the forward bending posture. Moderate correlation was observed between the angles obtained in the two postures ( r  = 0.55, p  &lt; 0.001). Conclusions Spine deformities of AIS patients vary with different postures. The patterns of changes in sitting and sitting forward bending postures are highly subject dependent. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-018-5646-5</identifier><identifier>PMID: 29943198</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Medicine ; Medicine &amp; Public Health ; Neurosurgery ; Original Article ; Posture ; Radiography ; Scoliosis ; Spine ; Surgical Orthopedics ; Ultrasonic imaging ; Ultrasound</subject><ispartof>European spine journal, 2018-09, Vol.27 (9), p.2139-2147</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>European Spine Journal is a copyright of Springer, (2018). 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In types I and II, the SPA angle numbers were the same before and after forward bending and only SPA values changed. In type III, the two curvatures were changed to one curvature in the forward bending posture. Moderate correlation was observed between the angles obtained in the two postures ( r  = 0.55, p  &lt; 0.001). Conclusions Spine deformities of AIS patients vary with different postures. The patterns of changes in sitting and sitting forward bending postures are highly subject dependent. 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subjects Medicine
Medicine & Public Health
Neurosurgery
Original Article
Posture
Radiography
Scoliosis
Spine
Surgical Orthopedics
Ultrasonic imaging
Ultrasound
title Patterns of coronal curve changes in forward bending posture: a 3D ultrasound study of adolescent idiopathic scoliosis patients
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