How Accurate Are Anatomical Surface Topography Parameters in Indicating the Presence of a Scoliosis?

Study Design: Retrospective analysis of a longitudinal cohort.

Objective: To identify the presence of scoliosis from surface data.

Summary Of Background Data: Identifying AIS can be difficult.

The relationship between minor coronal asymmetry of the spine and measures of spinal sagittal shape in adolescents without visible scoliosis.

The purpose of this work is to identify what features of overall spinal sagittal shape are associated with coronal asymmetry in those without scoliosis. Using a longitudinal analysis of Integrated Shape Imaging System 2 (ISIS2) surface topography images of those without scoliosis, measures of coronal asymmetry, along with measures of spinal sagittal shape (kyphosis, lordosis and sagittal imbalance, which is a measure of the position of the top of the thoracic spine relative to the sacrum) were analysed using linear mixed effect models (LMEM), which is a method of analysing the components of a complex model (such as that describing overall spinal shape), to ascertain the relative relationships between the parameters. Data was also analysed when subdivided for the anatomical level of coronal asymmetry (thoracic or thoracolumbar/lumbar pattern).

The anatomical growth of the thoracic cage in adolescents with specific reference to axial growth comparing the right and left hemithorax.

This study has demonstrated the changing volume of both the anterior and posterior thorax in normal adolescents (without spinal or thoracic deformity), differentiating for both sex and age, to further understand how the thorax grows, along with the differences in growth between the anterior and posterior thorax. The thorax was measured on axial CT slices at every vertebral level from T3 to T12 in a series of scans previous taken for routine clinical care. Measurements taken were the anteroposterior thoracic distance and the area of the anterior and posterior rib prominences on either side of the thorax.

The kyphosis-lordosis difference parameter and its utility in understanding the pathogenesis of adolescent idiopathic scoliosis.

Objective: The relationship of sagittal spinal shape in the pathogenesis of adolescent idiopathic scoliosis (AIS) is recognised. What is not clear is the relationship between the sagittal shape of those without scoliosis and the potential development of AIS, including the greater prevalence in females. The use of a new parameter, the kyphosis-lordosis (KL) difference, was developed to explore this further.

Statistical modelling of how the sagittal alignment of the cervical spine is affected by adolescent idiopathic scoliosis and how scoliosis surgery changes that.

The relationship between the sagittal shape of the cervical spine and that of the thoracolumbar spine is established in the normal spine. Adolescent idiopathic scoliosis (AIS) is recognised as a change in the shape of the spine in both the coronal and sagittal planes. The effects of AIS on the alignment of the cervical spine, including the effects of surgery, has been less well studied.

The use of statistical modelling to identify important parameters for the shape of the torso following surgery for adolescent idiopathic scoliosis.

The surgical strategy in adolescent idiopathic scoliosis (AIS) aims to recreate the symmetry of the torso. This requires the minimisation of both the size of the scoliosis and the angulation between the sides of the torso, along with the recreation of a normal thoracic kyphosis. This study uses predictive modelling to identify the significance of the value of the pre-operative parameters, and the change in the magnitude of the parameters as a result of an operation on the shape of the torso using the 'most prominent points'; two areas of maximum prominence on either side of the spine with x, y and z coordinates.

The resting coronal and sagittal stance position of the torso in adolescents with and without spinal deformity.

The purpose of this work is to identify the resting stance of the torso, defined as the position of the C7 vertebral body relative to the sacrum in a 'birds eye view', as the coronal and sagittal offset, in those without spinal deformity, those with pre and post-operative AIS, and those with Scheuermann's kyphosis (SK). Using ISIS2 surface topography, the coronal and sagittal offset were measured in a prospective manner in all groups. With bivariate ellipses, a mean and 95% confidence ellipse of the data was developed.

The variability in location of the most prominent points on the posterior torso of those without abnormal surface topography, those with Adolescent Idiopathic Scoliosis and those with Scheuermann's Kyphosis: a seven year longitudinal analysis.

The correction of adolescent scoliosis involves the recreation of torso symmetry. A symmetrical torso has equivalent areas of shape on either side of the midline. The posterior torso has two areas of prominence, known as the 'most prominent points' on either side of the midline which can be used as reference points to measure symmetry of the posterior torso.

The relationship between measures of spinal deformity and measures of thoracic trunk rotation.

Background: Adolescent idiopathic scoliosis (AIS) is associated with both asymmetry of the torso (rib hump) and vertebral body rotation (VBR). Current surgical techniques aim to reduce the VBR and rib hump. However, it is not clear how the vertebral rotation and thoracic asymmetry are linked.

A cluster analysis describing spine and torso shape in Lenke type 1 adolescent idiopathic scoliosis.

Purpose: The purpose of this work is to identify the variability and subtypes of the combined shape of the spine and torso in Lenke type 1 adolescent idiopathic scoliosis (AIS).

Methods: Using ISIS2 surface topography, measures of coronal deformity, kyphosis and skin angulation (as a measure of torso asymmetry) in a series of children with Lenke 1 convex to the right AIS were analyzed using k-means clustering techniques to describe the combined variability of shape in the spine and torso. Following this, a k-nearest neighbor algorithm was used to measure the ability to automatically identify the correct cluster for any particular datum.

The effectiveness of blood metal ions in identifying bilateral metal-on-metal total hip arthroplasty patients at risk of adverse reactions to metal debris.

We investigated whether blood metal ions could effectively identify bilateral metal-on-metal total hip arthroplasty (THA) patients at risk of adverse reactions to metal debris (ARMD). Whole blood metal ions were sampled in 50 patients with bilateral 36mm Corail-Pinnacle THAs. Patients were divided into ARMD (n=10) and non-ARMD groups (n=40), with optimal ion thresholds for identifying ARMD determined using receiver operating characteristic analysis.

The Development of Kyphosis and Lordosis in the Growing Spine.

Study Design: A longitudinal cohort study.

Objective: The aim of this study was to do the analysis of the development of kyphosis and lordosis in the growing spine.

Summary Of Background Data: Previous studies have measured kyphosis and lordosis in different ways with differing techniques.

Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis?

Background: Patient-reported outcomes are becoming increasingly recognised in the management of patients with adolescent idiopathic scoliosis (AIS). Integrated Shape Imaging System 2 (ISIS2) surface topography is a validated tool to assess AIS. Previous studies have failed to demonstrate strong correlations between AIS and patient-reported outcomes highlighting the need for additional objective surface parameters to define the deformities associated with AIS.

The effects of scoliosis and subsequent surgery on the shape of the torso.

Background: Adolescent idiopathic scoliosis (AIS) causes asymmetry of the torso, and this is often the primary concern of patients. Surgery aims to minimise the visual asymmetry. It is not clear how scoliosis makes the torso asymmetric or how scoliosis surgery changes that asymmetry when compared to the distribution of asymmetries seen in a non-scoliotic group of normal controls.

What is the variability in shoulder, axillae and waist position in a group of adolescents?

The clinical assessment of scoliosis is based on the recognition of asymmetry. It is not clear what the degree of asymmetry is in a population without scoliosis, which could make the differentiation between abnormal and normal uncertain. This study defines the range of normality in certain parameters of torso shape that are also associated with the clinical assessment of scoliosis.

Risk factors for failure of the 36 mm metal-on-metal Pinnacle total hip arthroplasty system: a retrospective single-centre cohort study.

Aims: To determine ten-year failure rates following 36 mm metal-on-metal (MoM) Pinnacle total hip arthroplasty (THA), and identify predictors of failure.

Patients And Methods: We retrospectively assessed a single-centre cohort of 569 primary 36 mm MoM Pinnacle THAs (all Corail stems) followed up since 2012 according to Medicines and Healthcare Products Regulation Agency recommendations. All-cause failure rates (all-cause revision, and non-revised cross-sectional imaging failures) were calculated, with predictors for failure identified using multivariable Cox regression.

Can blood metal ion levels be used to identify patients with bilateral Birmingham Hip Resurfacings who are at risk of adverse reactions to metal debris?

Aims: We investigated whether blood metal ion levels could effectively identify patients with bilateral Birmingham Hip Resurfacing (BHR) implants who have adverse reactions to metal debris (ARMD).

Patients And Methods: Metal ion levels in whole blood were measured in 185 patients with bilateral BHRs. Patients were divided into those with ARMD who either had undergone a revision for ARMD or had ARMD on imaging (n = 30), and those without ARMD (n = 155).

Erratum to: The use of growth standards and corrective formulae to calculate the height loss caused by idiopathic scoliosis.

[This corrects the article DOI: 10.1186/s13013-016-0068-9.].

The use of growth standards and corrective formulae to calculate the height loss caused by idiopathic scoliosis.

Background: Loss of trunk height caused by scoliosis has been previously assessed using different mathematical formulae. However, these are of differing algebraic construction and will give a range of values for the same size of scoliosis curve. As such, the following study attempted to determine the most valid published formulae for calculating height loss caused by idiopathic scoliosis based on reported growth charts.

The measurement of the normal thorax using the Haller index methodology at multiple vertebral levels.

The Haller index is a ratio of thoracic width and height, measured from an axial CT image and used to describe the internal dimensions of the thoracic cage. Although the Haller index for a normal thorax has been established (Haller et al. 1987; Daunt et al.

The Effectiveness of Blood Metal Ions in Identifying Patients with Unilateral Birmingham Hip Resurfacing and Corail-Pinnacle Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris.

Background: We investigated whether blood metal ions could effectively identify patients with metal-on-metal hip implants with two common designs (Birmingham Hip Resurfacing [BHR] and Corail-Pinnacle) who were at risk of adverse reactions to metal debris.

Methods: This single-center, prospective study involved 598 patients with unilateral hip implants (309 patients with the BHR implant and 289 patients with the Corail-Pinnacle implant) undergoing whole blood metal ion sampling at a mean time of 6.9 years.

Increased expression of inducible co-stimulator on CD4+ T-cells in the peripheral blood and synovial fluid of patients with failed hip arthroplasties.

Objectives: T-cells are considered to play an important role in the inflammatory response causing arthroplasty failure. The study objectives were to investigate the composition and distribution of CD4+ T-cell phenotypes in the peripheral blood (PB) and synovial fluid (SF) of patients undergoing revision surgery for failed metal-on-metal (MoM) and metal-on-polyethylene (MoP) hip arthroplasties, and in patients awaiting total hip arthroplasty.

Methods: In this prospective case-control study, PB and SF were obtained from 22 patients (23 hips) undergoing revision of MoM (n = 14) and MoP (n = 9) hip arthroplasties, with eight controls provided from primary hip osteoarthritis cases awaiting arthroplasty.

The utility of repeat ultrasound imaging in the follow-up of metal-on-metal hip arthroplasty patients.

Introduction: We assessed changes in metal-on-metal hip arthroplasties (MoMHAs) after repeat ultrasound examination.

Methods: This retrospective, single-centre cohort study involved all patients undergoing two ultrasound examinations of the same MoMHA. Between 2010 and 2014, 96 ultrasound examinations were performed in 48 MoMHAs (mean time between scans = 1.

Mid-term results for hip resurfacing in patients under 30 years old with childhood hip disorders.

The aim of our study was to assess survivorship and function in young patients with hip resurfacing for degenerative arthritis secondary to childhood hip diseases. Data was collected retrospectively using the institutional database and patient notes. Between 1999 and 2012, there were 156 hip resurfacings performed in 143 patients (82 females, 73 males).

Predicting high blood metal ion concentrations following hip resurfacing.

Purpose: To determine whether gender, femoral head size, acetabular inclination, and time since surgery predicted high blood metal ion concentrations following Birmingham Hip Resurfacing (BHR).

Methods: BHR patients with unilateral bearings at one specialist centre with blood cobalt and chromium concentrations measured up to May 2013 were included. This comprised a mixed (at-risk) group including symptomatic patients and asymptomatic individuals with specific clinical and/or radiological findings.