Three-dimensional Subclassification of Lenke Type 1 Scoliotic Curves
Three-dimensional Subclassification of Lenke Type 1 Scoliotic Curves
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DOI：
10.1097/bsd.0b013e31816845bc
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发表时间：
2009-04-01
影响因子：
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通讯作者：
Labelle, Hubert
中科院分区：
文献类型：
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作者：
Duong, Luc;Mac-Thiong, Jean-Marc;Labelle, Hubert
研究设计：Lenke 1型青少年特发性脊柱侧凸（AIS）脊柱曲线的3-D形状变异性的前瞻性研究目的：确定Lenke 1型曲线的统计学3-D变异性，并评价可用于完善Lenke等人原始提案的临床参数，为AIS的全面3-D亚分类铺平道路。背景数据总结：在AIS中，已经提出了几种基于从正面和矢状面X射线中识别关键特征的分类系统，但这些仍然是对复杂的3-D畸形的过度简化，因为它仅基于2-D成像。临床3-D参数的变异性已在以前的研究中进行了研究，但从来没有被认为是在Lenke classification.Methods的背景下：68例AIS患者Lenke 1型曲线的X线照片进行了重建，在3维使用立体放射摄影技术，并提交给计算机算法来计算一组3-D参数，可用于表征的3-D曲线。结果：统计分析显示Lenke 1型曲线内的特定三维变形模式，主要使用最佳拟合平面或BFP（SD +/- 22.9，+/- 49.8）和几何扭转参数。没有显着的变化，发现使用最大曲率或PMC的平面。结论：计算机视觉的最新进展，促进了在标准的临床设置中引入3-D重建，并可以提供更多的信息对脊柱的行为在3-D空间。通常使用的3-D重建的直接结果将是能够评估3-D指数并根据Lenke等人的提议设计真实的3-D分类系统。
Study Design: Prospective study of the 3-D shape variability of spinal curve in Lenke type 1 adolescent idiopathic scoliosis (AIS).Objectives: To determine the statistical 3-D variability of Lenke type 1 curves and to evaluate clinical parameters that can be integrated to refine the Lenke et al original proposal, and to pave the road for a comprehensive 3-D subclassification of AIS.Summary of Background Data: Several classification systems based on the identification of key features from frontal and sagittal x-rays have been proposed in AIS, but these remain an oversimplification of the complex 3-D deformity because it is only based on 2-D imaging. Clinical 3-D parameter variability has been investigated in previous studies, but has never been considered in the context of the Lenke classification.Methods: Radiographs of 68 AIS patients with Lenke type 1 curves were reconstructed in 3-dimension using a stereo-radiographic technique and were submitted to a computer algorithm to compute a set of 3-D parameters that can be used to characterize the 3-D curve. Cluster analysis was performed to determine the statistical distribution of 3-D parameters among Lenke 1 curve types.Results: Statistical analysis shows specific 3-D deformation patterns within Lenke type 1 curves, mostly using the best-fit plane or BFP (SD +/- 22.9, +/- 49.8) and geometric torsion parameters. No significant variability was found using the plane of maximum curvature or PMC.Conclusions: Recent advances in computer vision facilitate the introduction of 3-D reconstruction in a standard clinical setting and can provide more information toward the spine behavior in 3-D space. A direct consequence of commonly used 3-D reconstruction would be to be able to evaluate 3-D indices and to devise a real 3-D classification system from the Lenke et al proposal.