Assessment of malalignment at early stage in adolescent idiopathic scoliosis: a longitudinal cohort study
Article dans une revue avec comité de lecture
Author
LANGLAIS, Tristan
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
1153000 Pôle Enfants [CHU Toulouse]
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
1153000 Pôle Enfants [CHU Toulouse]
ABELIN-GENEVOIS, Kariman
90015 Department of Orthopaedic Surgery
503981 Croix-Rouge française = French Red Cross
90015 Department of Orthopaedic Surgery
503981 Croix-Rouge française = French Red Cross
BERNARD, Jean-Claude
90015 Department of Orthopaedic Surgery
503981 Croix-Rouge française = French Red Cross
90015 Department of Orthopaedic Surgery
503981 Croix-Rouge française = French Red Cross
ASSI, Ayman
301405 Université Saint-Joseph de Beyrouth [USJ]
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
301405 Université Saint-Joseph de Beyrouth [USJ]
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
SCONFIENZA, Luca Maria
300694 Università degli Studi di Milano = University of Milan [UNIMI]
1004551 IRCCS Istituto Ortopedico Galeazzi
300694 Università degli Studi di Milano = University of Milan [UNIMI]
1004551 IRCCS Istituto Ortopedico Galeazzi
COURTOIS, Isabelle
51335 Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
51335 Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Date
2024-02Journal
European Spine JournalAbstract
Introduction
Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage.
Materials and methods
All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th–95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value.
Results
Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and −2.5°, whereas in AIS values were 0.3° and −0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%.
Conclusion
Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis.
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