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RELATIONSHIP BETWEEN TORSO SURFACE ASYMMETRY AND SPINAL DEFORMITY DURING TREATMENT OF SCOLIOSIS WITH RIGID BRACE



Abstract

Spine and torso models were generated concurrently with x-rays for twenty-three patients undergoing scoliosis brace treatment. Clinical indices of spinal deformity and torso surface asymmetry indices were computed from models obtained when patient was first recruited and at approximately one year’s follow-up. Significant correction changes of the torso shape were detected in indices including orientation of cross-sectional principal axes of inertia (p=0.048) and Back Surface Rotation (p=0.08) though spinal corrections were from not significant to subtle (0.20_p_0.88). Trunk asymmetry should be assessed for an objective evaluation and understanding of the effect produced by a specific treatment.

To assess changes in torso geometry and spinal deformity during treatment of idiopathic scoliosis with rigid brace.

Relationship between torso surface geometry and spinal deformity when a rigid brace is applied is essential for better understanding of brace treatment mechanism and optimal application of external forces.

Three-dimensional torso surface models were generated concurrently with postero-anterior x-rays for twenty-three patients undergoing scoliosis brace treatment, when first recruited and at approximately one year’s follow-up. Torso asymmetry indices describing principal axis orientation, back surface rotation, and asymmetry of the centroid line, left and right half-areas and the spinous process line were computed. The statistical paired t-Test (95% CI) was performed to test the probability that no difference exist after one year of treatment in both spinal and torso asymmetry indices.

After one year follow-up patients showed a mean increase of only 2° for the major Cobb angle. This was consistent with not significant to subtle corrections found in clinical (p=0.88) and computed (p=0.75) Cobb angle, lateral deviation (p=0.20), orientation of plane of maximum deformity (p= 0.58) and maximum vertebral axial rotation (p=0.83). Furthermore, significant correction changes of the torso shape were detected in the orientation of cross-sectional principal axes (PAX) of inertia (p=0.048) and Back Surface Rotation (p=0.08).

Here we have shown that we can acquire 3D torso surface and reliably measured a set of indices of transverse torso asymmetry. Future work will look at indication of predictive potential of torso surface indices.

Funding: AHFMR, CIHR, Fraternal Order of Eagles, NSERC, GEOIDE.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada