Begovic, H

Cheng, CLK

Cheung, JPY

Jiang, WW

Lai, KKL

Lee, TY

Samartzis, D

To, MKT

Zheng, YP

English

HKU Scholars Hub

by Scolioscan (E_Cobb 29.3 ± 11.8°, SPA 18.4 ± 8.5°), statisticallysignificant correlation (r = 0.816, p < 0.001) was found betweenE_Cobb and SPA. Correlation were 0.629 for upper thoraciccurves (UTC, defined as curves with apices at T6.5 or above);0.873 for upper spinal curves (USC, apices between T7 to T12.5);and 0.740 for lower spinal curves (LSC, apices at L1 or below) (allwith p < 0.001). Conversion formulae to predict E_Cobb fromSPA were [predicted E_Cobb = P_Cobb = 7.39 + 1.26 x SPA] forUSC and [P_Cobb = 10.08 + 0.96 x SPA] for LSC. For curves withE_Cobb below 30°, the absolute difference between P_Cobb andE_Cobb was ≤ 5° in 66.6% and 62.4% of USC and LSC; whileP_Cobb underestimated E_Cobb by > 5° in 6.0% and 7.2% ofUSC and LSC. In addition, tall stature was associated with stron-ger correlation between E_Cobb and SPA. Similar degree of cor-relation was seen between males and females or betweendifferent quartiles of BMI.Conclusions and significanceScolioscan gives satisfactory accuracy of measurement for curveswith (a) apices at T7 or lower, (b) E_Cobb < 30° and also for pa-tients with taller stature. Ultrasound for quantitative assessmentof spinal deformity in AIS can be considered in lieu of conven-tional radiographs, with results to be interpreted according tovarious degree of accuracy under different clinical conditions.O25A novel approach to sagittal profiling of adolescent idiopathicscoliosis using 3D ultrasoundTin-Yan Lee1, Jason Pui Yin Cheung2, Wei Wei Jiang1,3, Connie Lok Kan Cheng1,Kelly Ka-Lee Lai1, Haris Begovic1, Dino Samartzis2, Michael Kai Tsun To2,Yong-Ping Zheng11Department of Biomedical Engineering, The Hong Kong PolytechnicUniversity, Hong Kong, China; 2 Department of Orthopaedics andTraumatology, The University of Hong Kong, Hong Kong, SAR, China;3 College of Computer Science and Technology, Zhejiang University ofTechnology, Hangzhou, ChinaCorrespondence: Yong-Ping Zheng (ypzheng@ieee.org)Scoliosis and Spinal Disorders 2018, 13(Suppl 1):O25IntroductionSagittal profile differences between normal and scoliotic spineare needed to be investigated at the early stage to determinethe possibility of the development of vertebrae rotation [1].Though radiographic Cobb is the gold standard for assessingspinal sagittal curvature, X-ray is radioactive. Non-ionizing three-dimensional (3D) ultrasound had been demonstrated to be feas-ible in evaluating vertebrae features and coronal curvatures ofthe spine [2, 3, 4]. Yet no study has reported the reliability andaccuracy of 3D ultrasound on sagittal curvature analysis. In thisstudy, the reliability and validity of 3D ultrasound on assessingspinal sagittal curvature of patients with scoliosis wereinvestigated.MethodsTwenty-one AIS patients, both males and females (Age: 15.7±1.3years; Cobb’s angle range 11.1 to 41.9°), underwent 3D ultrasoundand EOS X-ray scanning of the spine. X-ray Cobb (XCA) was mea-sured on sagittal X-ray image (Fig. 1a), while spinous processes andlaminae of the vertebrae were identified from B-mode images. Sagit-tal images were then generated to measure the thoracic and lumbarultrasound spinous process angle (USSPA) (Fig. 1b) and ultrasoundlaminae angle (USLA) respectively (Fig. 1c). The reliability (intraclasscorrelation coefficients (ICC) for the intra- and inter-observer variabil-ity) and validity (linear regression analysis and Bland-Altman method,with mean absolute difference (MAD)) were tested for two ultra-sound angles as compared to the X-ray Cobb (XCA).ResultsThe ICC showed very reliable measurements of both ultrasoundmethods (ICC≥0.941). Moderate and significant linear correlationswere seen between the ultrasound methods and XCA (Thoracic(R2≥0.574) / Lumbar (R2≥0.635)) (Fig. 2) and the Bland-Altmanplot showed a good agreement between both ultrasound anglesand XCA (Fig. 3). The MADs of both ultrasound angles, correctedby the linear regression equations, and XCA showed no signifi-cant difference (MAD: USSPA 6.4±4.8°/6.1±4.4° and USLA 7.5±4.9°/5.3±4.2°; p≥0.326 for thoracic / lumbar respectively).ConclusionGood correlations were found between 3D ultrasound and Cobbangle, without differences in reliability and validity using spinousprocesses and laminae. Other than coronal deformity, sagittal de-formity of spine of AIS patient can also be assessed by non-ionizing and relatively inexpensive ultrasound imaging.Trial RegistrationN/AConsent to publishSigned informed consents were obtained from all subjects and ofthe guardians of patients aged below 18 prior to the start of thestudy. All patients (or parents of the subjects for those under 18years of age) provided informed consentReferences1. Schlösser TP, Shah SA, Reichard SJ, Rogers K, Vincken KL,Castelein RM. Differences in early sagittal plane alignment betweenthoracic and lumbar adolescent idiopathic scoliosis. Spine J2014;14(2):282-290.2. Chin KJ, Karmakar MK, Peng P. Ultrasonography of the adult thoracic andlumbar spine for central neuraxial blockade. Anesthesiology2011;114(6):1459-1485.3. Zheng YP, Lee TT, Lai KK, Yip BH, Zhou GQ, Jiang WW, Cheung JC, WongMS, Ng BK, Cheng JC, Lam TP. A reliability and validity study forScolioscan: a radiation-free scoliosis assessment system using 3D ultra-sound imaging. Scoliosis Spinal Disord. 2016;11:13.4. Brink RC, Wijdicks SPJ, Tromp IN, Schlösser TPC, Kruyt MC, Beek FJA,Castelein RM. A reliability and validity study for different coronalangles using ultrasound imaging in adolescent idiopathic scoliosis.Spine J 2017.Fig. 1 (abstract O25). a) Measurement of X-ray Cobb’s angle (XCA);b) Measurement of ultrasound spinous process angle (USSPA); c)Measurement of ultrasound laminae angle (USLA) (Thoracic andlumbar angles are defined by the angle between the blue and redlines respectively)Scoliosis and Spinal Disorders 2018, 13(Suppl 1):8 Page 12 of 31O26Is cortical function associated with postural control altered inadolescents with idiopathic scoliosis?Julie Lanthier1,2, Sarah Lippé2,3, Inga S Knoth2, Catherine Bluteau4,Martin Simoneau4,5, Carole Fortin1,21École de réadaptation, Faculté de médecine, Université de Montréal,Montreal, Quebec H3C 3J7, Canada; 2Centre de recherche, CHU Sainte-Justine, Montreal, Quebec H1T 1C5, Canada; 3Département depsychologie, Université de Montréal, Montreal, Quebec H3C 3J7, Canada;4Département de kinésiologie, Faculté de médecine, Université Laval,Quebec, Quebec G1V 0A6, Canada; 5Centre interdisciplinaire derecherche en réadaptation et intégration sociale (CIRRIS), Quebec,Quebec, G1M 2S8 CanadaCorrespondence: Carole Fortin (carole.fortin@umontreal.ca)Scoliosis and Spinal Disorders 2018, 13(Suppl 1):O26IntroductionAdolescent idiopathic scoliosis (AIS) is a multifactorial condition withunclear aetiology. Neurological impairments related to sensorimotorinformation processing have been suggested to play an importantrole in scoliosis mechanisms [1-3]. Previous studies have shownpoorer postural performance and difficulty in reweighting sen-sory inputs following sensory deprivation in AIS group com-pared to age-matched controls [4,5]. Electroencephalography(EEG) has been used to document cortical activity associatedwith postural control. This study uses EEG frequency domainanalysis to document cortical activity associated with posturalcontrol in adolescents with AIS compared to healthy control ad-olescents (CTRL).ObjectiveTo compare cortical activity associated with sensorimotor infor-mation processing related to postural control in open and closed-eyes conditions in adolescents with AIS and in CTRL.MethodsThirteen girls with a 15 to 45° AIS (13±1 years, 163±7 cm, 51±9 kg)and 14 age-matched CTRL girls (13±1 years, 158±11 cm, 50±9 kg)were recruited on two sites. EEG data was acquired using Elec-trical Geodesic systems. Participants stood in an upright standingposture with eyes open looking at an immobile fixation cross, ap-proximately 2 m in front of the participant, for two minutesfollowed by two minutes with eyes closed. Fast Fourier Transfor-mations (FFT) were performed to measure the power of the dif-ferent frequency bands in both conditions. Cortical regions ofinterest (ROI) were central (electrodes C3, C4), frontal (F3, F4),parietal (P3, P4), temporal (T3, T4) and occipital (O1, O2). Signifi-cant differences were computed with p<0.05.ResultsDuring the “eyes closed” condition, differences between the AISgroup and the CTRL group were found in beta and gamma fre-quency bands. The average power of beta signal was significantly lar-ger in AIS group at the frontal, parietal, temporal and occipital ROI(Fig. 1). Also, the average power of gamma frequency was signifi-cantly larger in AIS group at the central, frontal, parietal and tem-poral ROI (Fig. 2).Conclusions and significanceOur findings show enhanced beta and gamma frequency activity inadolescents with AIS compared to CTRL when holding a standingposition while eyes closed, suggesting that more attention and vigi-lance are required in adolescents with AIS to maintain balance [6].This may reflect less efficient cortical sensorimotor information pro-cessing associated with postural control in AIS. Future studies will as-sess if asymmetrical power within these ROI and frequency bandscould be related to spine deformation progression.References1. Simoneau M, Lamothe V, Hutin É, Mercier P, Teasdale N, Blouin J.Evidence for cognitive vestibular integration impairment in idiopathicscoliosis patients. BMC Neurosci. 2009; 10:102.2. Domenech J, Garcia-Marti G, Marti-Bonmati L, Barrios C, Tormos J.M, Pascuale-Leone A. Abnormal activation of the motor cortical network in idiopathicscoliosis demonstrated by functional MRI. Eur Spine J. 2011; 20 (7) :1069-78.Fig. 2 (abstract O25). a) Correlations (R2) and equations betweenthe X-ray Cobb’s angles (XCA) and the ultrasound spinous processangles (USSPA) for the thoracic and lumbar region; b) Correlations(R2) and equations between the X-ray Cobb’s angles (XCA) and theultrasound laminae angles (USLA) for the thoracic and lumbar regionFig. 3 (abstract O25). Bland-Altman plots that shows thedifferences between X-ray Cobb’s angles (XCA) and the sagittalultrasound angles corrected with the linear regression equations.a Ultrasound spinous process angle (USSPA) and b ultrasoundlaminae angle (USLA). SD: standard deviationScoliosis and Spinal Disorders 2018, 13(Suppl 1):8 Page 13 of 31

A novel approach to sagittal profiling of adolescent idiopathic scoliosis using 3D ultrasound

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A novel approach to sagittal profiling of adolescent idiopathic scoliosis using 3D ultrasound

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