The International Research Society of Spinal Deformities (IRSSD) and its contribution to science

From the time of its initial, informal meetings starting in 1980 to its formal creation in 1990, the IRSSD has met on a bi-annual basis to discuss all aspects of the spine and associated deformities. It has encouraged open discussion on all topics and, in particular, has tried to be the seed-bed for new ideas. The members are spread around the world and include people from all areas of academia as well as the most important people, the patients themselves. Most notably, application of the ideas and results of the research has always been at the forefront of the discussions. This paper was conceived with the idea of evaluating the impact made by the IRSSD over the last 30 years in the various areas and is intended to create discussion for the upcoming meeting in Montreal regarding future focus: "We are lost over the Atlantic Ocean but we are making good time.

Vertebral rotation measurement: a summary and comparison of common radiographic and CT methods

Current research has provided a more comprehensive understanding of Adolescent Idiopathic Scoliosis (AIS) as a three-dimensional spinal deformity, encompassing both lateral and rotational components. Apart from quantifying curve severity using the Cobb angle, vertebral rotation has become increasingly prominent in the study of scoliosis. It demonstrates significance in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions. In the past, the need for computer resources, digitizers and custom software limited studies of rotation to research performed after a patient left the scoliosis clinic. With advanced technology, however, rotation measurements are now more feasible. While numerous vertebral rotation measurement methods have been developed and tested, thorough comparisons of these are still relatively unexplored. This review discusses the advantages and disadvantages of six common measurement techniques based on technology most pertinent in clinical settings: radiography (Cobb, Nash-Moe, Perdriolle and Stokes' method) and computer tomography (CT) imaging (Aaro-Dahlborn and Ho's method). Better insight into the clinical suitability of rotation measurement methods currently available is presented, along with a discussion of critical concerns that should be addressed in future studies and development of new methods

Corotating Interaction Regions at High Latitudes

Ulysses observed a stable strong CIR from early 1992 through 1994 during its first journey into the southern hemisphere. After the rapid latitude scan in early 1995, Ulysses observed a weaker CIR from early 1996 to mid-1997 in the northern hemisphere as it traveled back to the ecliptic at the orbit of Jupiter. These two CIRs are the observational basis of the investigation into the latitudinal structure of CIRs. The first CIR was caused by an extension of the northern coronal hole into the southern hemisphere during declining solar activity, whereas the second CIR near solar minimum activity was caused by small warps in the streamer belt. The latitudinal structure is described through the presentation of three 26-day periods during the southern CIR. The first at ∼24°S shows the full plasma interaction region including fast and slow wind streams, the compressed shocked flows with embedded stream interface and heliospheric current sheet (HCS), and the forward and reverse shocks with associated accelerated ions and electrons. The second at 40°S exhibits only the reverse shock, accelerated particles, and the 26-day modulation of cosmic rays. The third at 60°S shows only the accelerated particles and modulated cosmic rays. The possible mechanisms for the access of the accelerated particles and the CIR-modulated cosmic rays to high latitudes above the plasma interaction region are presented. They include direct magnetic field connection across latitude due to stochastic field line weaving or to systematic weaving caused by solar differential rotation combined with non-radial expansion of the fast wind. Another possible mechanism is particle diffusion across the average magnetic field, which includes stochastic field line weaving. A constraint on connection to a distant portion of the CIR is energy loss in the solar wind, which is substantial for the relatively slow-moving accelerated ions. Finally, the weaker northern CIR is compared with the southern CIR. It is weak because the inclination of the streamer belt and HCS decreased as Ulysses traveled to lower latitudes so that the spacecraft remained at about the maximum latitudinal extent of the HCS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43797/1/11214_2004_Article_248214.pd

Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis.

Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS). As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL) method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting.To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI) measurements.Thirty curves (ranged 10.2°-68.2°) from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC). The validity of this method was analyzed by paired Student's t-test, Bland-Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05.The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K) >0.9, p<0.05) to measure the coronal curvature. Compared with Cobb method, COL method showed no significant difference (p<0.05) when measuring coronal curvature. Furthermore, Bland-Altman method demonstrated an agreement between these two methods, and Pearson's correlation coefficient (r) was high (r>0.9, p<0.05).The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the proposed ultrasound measurement in larger clinical trial and to optimize the ultrasound scanning and measuring procedure

3-D reconstructed ultrasound images of scoliotic spine.

<p>(a) Coronal plane; (b) Sagittal plane; (c) Transverse plane.</p

Bland–Altman plot assessing the agreement of coronal curvature measurements using ultrasound and MRI in the sample categories.

<p>(a) Level of apical vertebra in T1-T4; (b) Level of apical vertebra in T5-T8; (c) Level of apical vertebra in T9-T12; (d) Level of apical vertebra in L1-L5.</p

Clinical ultrasound system and ultrasound scan.

<p>(a) 3-D Ultrasound unit and a purpose-design couch; (b) Ultrasound scanning at supine position.</p

Bland–Altman plot assessing the agreement of coronal curvature measurements using ultrasound and MRI in the sample categories.

<p>(a) Cobb angle: 10.2°~68.2°; (b) Cobb angle: 10.0°~20.0°; (c) Cobb angle: 20.0°~45.0°; (d) Variation in selected UEV = 0; (e) Variation in selected UEV = 1; (f) Variation in selected UEV = 2; (g) Variation in selected LEV = 0; (h) Variation in selected LEV = 1; (i) Variation in selected LEV = 2. The central line represents mean differences (Bias); upper line shows mean+1.96SD and lower line mean-1.96SD. UEV: upper-end vertebra; LEV: lower-end vertebra.</p

Validation of coronal curvature assessments using ultrasound compared with MRI.

<p>UEV ^a: upper-end vertebra; LEV ^b: lower-end vertebra. The Bias, SD of bias and 95% Limits of Agreement are calculated from the Bland-Altman method.</p><p>Validation of coronal curvature assessments using ultrasound compared with MRI.</p