Victoria Blouin, Victor Jullien, Olivier Chémaly, Marjolaine Roy-Beaudry, Sylvain Deschênes, Soraya Barchi, Marie-Lyne Nault, John M Flynn, Stefan Parent
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Raters assessed digital skeletal age (DSA), Sanders Simplified Skeletal Maturity (SSMS) and Thumb Ossification Composite Index (TOCI). 3D reconstructions of the spine and pelvis bones were performed for each stereoradiograph to measure nine clinically relevant spinal and pelvic 3D parameters.</p><p><strong>Results: </strong>Inter-rater and intra-rater reliabilities were excellent for DSA, SSMS and TOCI with both standard radiographs and HOW (ICC > 0.95). Strong correlation was found between ratings of both imaging types (ICC > 0.95). In the 3D reconstructions, kyphosis and sacral slope were slightly decreased in the HOW position, but within the clinical margin of error. All other parameters did not differ significantly between positions (p < 0.05).</p><p><strong>Conclusion: </strong>The results suggest that HOW stereoradiographs allow clinicians to assess skeletal maturity of the hand and wrist with adequate reliability and validity. We recommend that scoliosis clinics adopt the HOW position to assess skeletal maturity because there is no significant clinical impact on the spinal and pelvic evaluation, and on radiation exposure, cost or time.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A modified position for optimized skeletal maturity assessment of AIS patients and its impact on 3D spinal and pelvic parameters.\",\"authors\":\"Victoria Blouin, Victor Jullien, Olivier Chémaly, Marjolaine Roy-Beaudry, Sylvain Deschênes, Soraya Barchi, Marie-Lyne Nault, John M Flynn, Stefan Parent\",\"doi\":\"10.1007/s43390-024-00903-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>A hands-on-wall (HOW) position for low-dose stereoradiography of adolescent idiopathic scoliosis (AIS) patients would allow for skeletal maturity assessment of the hand and wrist. 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引用次数: 0
摘要
目的:对青少年特发性脊柱侧弯症(AIS)患者进行低剂量立体放射摄影时,采用手扶墙(HOW)姿势可对手部和腕部的骨骼成熟度进行评估。我们的目标有两个:确认使用 HOW 体位进行骨骼成熟度评估的可靠性和有效性,并将脊柱和骨盆三维参数与标准手-颊(HOC)立体放射摄影的参数进行比较:方法:70 名 AIS 患者在同一天连续接受了两次立体放射摄影以及一次标准手部和腕部放射摄影。患者被随机分配从 HOW 开始,然后进行 HOC,反之亦然。评分员评估数字骨骼年龄(DSA)、桑德斯简化骨骼成熟度(SSMS)和拇指骨化综合指数(TOCI)。对每张立体放射照片进行脊柱和骨盆骨骼的三维重建,以测量九个临床相关的脊柱和骨盆三维参数:DSA、SSMS和TOCI与标准X光片和HOW的评定者间和评定者内可靠性都很好(ICC>0.95)。两种成像类型的评分之间具有很强的相关性(ICC > 0.95)。在三维重建中,后凸和骶骨斜度在 HOW 位置下略有下降,但在临床误差范围内。所有其他参数在不同体位之间没有明显差异(P结果表明,HOW立体放射摄影可让临床医生以足够的可靠性和有效性评估手部和腕部的骨骼成熟度。我们建议脊柱侧弯诊所采用 HOW 体位来评估骨骼成熟度,因为这对脊柱和骨盆评估以及辐射暴露、成本或时间没有明显的临床影响。
A modified position for optimized skeletal maturity assessment of AIS patients and its impact on 3D spinal and pelvic parameters.
Purpose: A hands-on-wall (HOW) position for low-dose stereoradiography of adolescent idiopathic scoliosis (AIS) patients would allow for skeletal maturity assessment of the hand and wrist. Our aims were twofold: confirm the reliability and validity of skeletal maturity assessment using the HOW radiographs and compare the spinal and pelvic 3D parameters to those of standard hands-on-cheeks (HOC) stereoradiographs.
Methods: Seventy AIS patients underwent two successive stereoradiographs and a standard hand and wrist radiograph on the same day. Patients were randomly assigned to begin with HOW and follow with HOC, or vice versa. Raters assessed digital skeletal age (DSA), Sanders Simplified Skeletal Maturity (SSMS) and Thumb Ossification Composite Index (TOCI). 3D reconstructions of the spine and pelvis bones were performed for each stereoradiograph to measure nine clinically relevant spinal and pelvic 3D parameters.
Results: Inter-rater and intra-rater reliabilities were excellent for DSA, SSMS and TOCI with both standard radiographs and HOW (ICC > 0.95). Strong correlation was found between ratings of both imaging types (ICC > 0.95). In the 3D reconstructions, kyphosis and sacral slope were slightly decreased in the HOW position, but within the clinical margin of error. All other parameters did not differ significantly between positions (p < 0.05).
Conclusion: The results suggest that HOW stereoradiographs allow clinicians to assess skeletal maturity of the hand and wrist with adequate reliability and validity. We recommend that scoliosis clinics adopt the HOW position to assess skeletal maturity because there is no significant clinical impact on the spinal and pelvic evaluation, and on radiation exposure, cost or time.
期刊介绍:
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.