Surface imaging of scoliosis
Surface imaging of scoliosis
The diagnosis and management of patients with spinal scoliosis requires accurate and precise quantitative assessments of the spinal curves, which has traditionally been per- formed with the use of 36" AP and lateral spine X-rays. The degree of deformity as well as progression of curvatures is critical in developing a subsequent treatment plan and determining the need for operative intervention. However, radiographs are costly, expose the patient to radiation, and require expert interpretation. Thus, screening programs for scoliosis have relied on crude physical assessments performed by minimally trained personnel.
Optical imaging methods for assessing topographical anatomy have the potential to assist in the assessment of spinal deformities. Ramirez, et al., at the University of Alberta have published the results of a clinical study using a support vector machines analysis of topographic data to determine scoliotic and kyphotic deformities of the spine (IEEE Transactions on Information Technology in Biomedicine 10: 84–91, 2006). Using a laser scanner to assess the topography of the back, they studied 111 subjects with idiopathic adolescent thoracic scoliosis. The patients had not been treated with bracing or surgery but did have X-ray measurements of their scoliotic curvatures. Specific parameters analyzed included trunk twist, shoulder angle, scapular angle, and waist asymmetry (Figure). Data analysis was then performed using support vector machines to classify the curvatures in terms of severity, and the accuracy of the determinations were then made with the radiographic Cobb angle as the gold standard, yielding a 69–85% agreement.
The appeal of this technology lies in its ability to quickly screen large numbers of adolescents using objective criteria and without any risk of exposure to radiation. Furthermore, unlike plain radiographs, the data obtained gives a three-dimensional assessment of the spine. Ultimately, such technology, merged into large databases, may improve our ability to screen or track adolescents with scoliosis.
