Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results
Comparison of scoliosis measurements based on three-dimensional vertebra vectors and conventional two-dimensional measurements: advantages in evaluation of prognosis and surgical results
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DOI：
10.1007/s00586-012-2651-y
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发表时间：
2013-06-01
影响因子：
2.8
通讯作者：
Somoskeoey, Szabolcs
中科院分区：
文献类型：
--
作者：
Illes, Tamas;Somoskeoey, Szabolcs
最近提出了一个新的概念，脊椎向量的基础上脊柱三维（3D）重建的图像从EOS系统，一种新的低剂量X射线成像设备，以促进EOS 3D数据的解释，特别是关于水平面图像。本回顾性研究旨在评价手术矫正前后通过EOS 3D和椎骨向量可视化的脊柱布局，比较基于3D椎骨向量的脊柱侧凸测量值与使用传统二维（2D）方法的测量值，并评估水平面矢量参数与脊柱侧弯畸形程度的关系。95例青少年患者根据Cotrel-Dubousset原则手术的特发性脊柱侧凸患者在术前和术后接受EOS X射线检查，然后在校准的坐标系中进行3D重建和生成椎骨向量，以计算向量坐标和参数，如之前发表的。采用均数比较T检验评价传统二维Cobb方法与基于椎体向量的方法之间的差异，并采用双变量相关分析相应参数之间的关系。通过Pearson相关和线性回归分析水平平面向量参数与脊柱侧凸畸形程度和手术矫正结果的关系，与手动2D方法相比，基于椎体向量的冠状曲线曲率数据中检测到非常密切的关系（术前r 0.950，术后r 0.935）和胸椎后凸（术前r 0.893，术后r 0.896），而发现L1-L5脊柱前凸值差异较小（术前r 0.763，术后r 0.809）显示与相应L5楔块的大小密切相关。相关性分析结果显示，脊柱侧凸的程度与顶椎在水平面上的侧向平移有很强的相关性。顶椎向量的终点和起点的水平面坐标表示这一点（r 0.701; r 0.667）。在顶椎的轴向旋转和额曲线的幅度（r 0.459）检测到较弱的相关性。椎骨向量提供了一个关键的机会，同时在所有三个平面可视化脊柱畸形。基于椎体向量的测量方法被证明与传统的冠状面和矢状面参数测量方法一样准确可靠。此外，可以使用相同的椎骨向量来研究曲线的水平面显示。基于椎骨向量数据，在脊柱畸形的手术治疗期间，椎骨的侧向平移的减小似乎比轴向旋转的校正在手术矫正的结果中更重要。
A new concept of vertebra vectors based on spinal three-dimensional (3D) reconstructions of images from the EOS system, a new low-dose X-ray imaging device, was recently proposed to facilitate interpretation of EOS 3D data, especially with regard to horizontal plane images. This retrospective study was aimed at the evaluation of the spinal layout visualized by EOS 3D and vertebra vectors before and after surgical correction, the comparison of scoliotic spine measurement values based on 3D vertebra vectors with measurements using conventional two-dimensional (2D) methods, and an evaluation of horizontal plane vector parameters for their relationship with the magnitude of scoliotic deformity.95 patients with adolescent idiopathic scoliosis operated according to the Cotrel-Dubousset principle were subjected to EOS X-ray examinations pre- and postoperatively, followed by 3D reconstructions and generation of vertebra vectors in a calibrated coordinate system to calculate vector coordinates and parameters, as published earlier. Differences in values of conventional 2D Cobb methods and methods based on vertebra vectors were evaluated by means comparison T test and relationship of corresponding parameters was analysed by bivariate correlation. Relationship of horizontal plane vector parameters with the magnitude of scoliotic deformities and results of surgical correction were analysed by Pearson correlation and linear regression.In comparison to manual 2D methods, a very close relationship was detectable in vertebra vector-based curvature data for coronal curves (preop r 0.950, postop r 0.935) and thoracic kyphosis (preop r 0.893, postop r 0.896), while the found small difference in L1-L5 lordosis values (preop r 0.763, postop r 0.809) was shown to be strongly related to the magnitude of corresponding L5 wedge. The correlation analysis results revealed strong correlation between the magnitude of scoliosis and the lateral translation of apical vertebra in horizontal plane. The horizontal plane coordinates of the terminal and initial points of apical vertebra vectors represent this (r 0.701; r 0.667). Less strong correlation was detected in the axial rotation of apical vertebras and the magnitudes of the frontal curves (r 0.459).Vertebra vectors provide a key opportunity to visualize spinal deformities in all three planes simultaneously. Measurement methods based on vertebral vectors proved to be just as accurate and reliable as conventional measurement methods for coronal and sagittal plane parameters. In addition, the horizontal plane display of the curves can be studied using the same vertebra vectors. Based on the vertebra vectors data, during the surgical treatment of spinal deformities, the diminution of the lateral translation of the vertebras seems to be more important in the results of the surgical correction than the correction of the axial rotation.