Abstract
Purpose: The purpose of this study was to evaluate the correlation between non-effort prone and bending radiographs in determining curve flexibility in adolescent idiopathic scoliosis (AIS). Methods: A retrospective review of AIS patients who underwent pre-operative full spine radiographic imaging from 2006 to 2019 was performed. The Cobb angle (CA) of proximal thoracic (PT), main thoracic (MT) and thoracolumbar/lumbar (TL/L) curves were measured and correlated on standing, prone and bending radiographs. Standing, bending, and prone measurements were correlated using Spearman’s analysis, and intra-rater reliability was evaluated using intraclass correlation analysis. Results: A total of 381 patients (74% female) with a mean age of 15.1 ± 2.5 years were identified. A strong correlation existed between the prone and bending CA for the PT (rs = 0.797, p < 0.01) and MT (rs = 0.779, p < 0.01) curve and a moderate correlation existed between the prone and bending TL/L curve (rs = 0.641, p < 0.01). For a non-structural PT curve, a prone CA < 25° correctly identified a bending CA < 25° 96.7% of the time (p < 0.005). For a non-structural MT curve, a prone CA < 35° correctly identified a bending CA < 25° 90.2% of the time (p < 0.005). For a non-structural TL/L curve, a prone CA < 35° correctly identified a bending CA < 25° 95% of the time (p < 0.005). Conclusion: Prone radiographs demonstrated a moderate to strong correlation with bending radiographs and may be used as a proxy for determining spinal flexibility, especially when bending films are deemed unreliable. Level of evidence: III.
Original language | English (US) |
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Pages (from-to) | 1063-1070 |
Number of pages | 8 |
Journal | Spine deformity |
Volume | 10 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2022 |
Externally published | Yes |
Keywords
- AIS
- Adolescent idiopathic scoliosis
- Bending
- Curve flexibility
- Posterior spinal fusion
- Prone
- Radiographs
ASJC Scopus subject areas
- Orthopedics and Sports Medicine