Evolution observation of coronal and sagittal spinal curvatures in school children with non-invasive, non-radiating methods: Scoliometer and Debrunner Kyphometer

Abstract

Study design: A cross-sectional study Summary and background data: Both Scoliometer and Debrunner’s Kyphometer are validated and widely accepted as surface non-invasive, non-radiating measurement instruments for school screening programs for detection and measurement of scoliosis, thoracic kyphosis and lumbar lordosis. Objectives of the study: The authors have questioned if the prevalence of scoliosis and its distribution among gender and spinal levels has changed in the last 20 years; and if the additional measurement of sagittal spinal curvatures is of great importance just like the scoliosis is. Methods: This cross-sectional observational study was conducted in 2016 in a randomly selected school population in a metropolitan town in the south-western Europe. In 897 adolescents, aged 12-14 years the authors measured both coronal and sagittal spinal curvatures using the scoliometer to measure scoliosis and the Debrunner kyphometer to measure thoracic kyphosis and lumbar lordosis. Previously validated mathematical formulae were used to estimate with high accuracy the predicted Cobb angle. Leg discrepancy was evaluated and correlated with scoliosis. Results: The reliability of measurement with the Debrunner’s kyphometer and Scoliometer was high. There were 124 (13.8%) subjects with scoliosis curve-ATR/ value of ≥2o. The 99.94% were single-level curves, and 0.06% double curves. The right thoracic curve was the most frequent (49%), followed by the right thoracolumbar (19%); left lumbar (12%); left thoracic (8%); right lumbar (6%) and left thoracolumbar (6%). Girls showed higher prevalence than boys in right thoracic (P=0.009) and right thoracolumbar (P= 0.014) curves. In contrary, in 53 subjects (40 girls, 13 boys) with ATR>5o: no significant gender-related difference and right to left side localization of scoliosis was disclosed; there were 4 (7.5%) individuals with right thoracic ATR: 9 (17%) with left thoracic; 13 (25%) right thoracolumbar; 4 (7.5%) left thoracolumbar; 2 (4%) right lumbar and 10 (19%) left lumbar. There was a statistically significant positive correlation between right lumbar ATR and ipsilateral leg shortening (P=0.000). These findings are within previous similar school screening reports in this country in the last 20 years. Thoracic kyphosis increases linearly with lumbar lordosis. Boys showed greater thoracic kyphosis and less lumbar lordosis than girls. Fourteen (0.15%) individuals with Kyphometer values ≥55o were sent for radiological examination. Fifty three (5.9%) subjects (3.2% boys and 8.2% girls) with ATR ≥5° were sent for radiological examination. Conclusions: The authors recommend to physicians engaged in scoliosis screening programs to use the Debrunner Kyphometer and Scoliometer together with the mathematic formulas for accurate Cobb angle measurement. We believe that this method will reduce the cost of school screening programs, the over diagnosis, and the unnecessary exposure to radiation of young population in the future. *Correspondence to: Vasileios Syrimpeis, Orthopaedic Surgeon, Orthopaedic Department, General Hospital of Patras, Patras, Greece, Tel: 306976638786, E-mail: vsyrimpeis@gmail.com