The Study: Radiation-free quantitative assessment of scoliosis: a multi center prospective study                  

The Facts:

a. The authors note that in order to evaluate the spinal curve progression in a scoliosis case you need accurate measurement methods.  

b. They note that there is a concern over the use of multiple radiographs to evaluate the curve progression when managing the scoliotic patient.  

c. In addition they note that the spine is a 3D structure but the curve evaluation is usually limited to the use of Cobb angles on plane film radiographs which is a 2D method. 

d. They wanted to evaluate the Ortelius800 which is a radiation free method of curve assessment. 

e. The study looked at 124 subjects with adult idiopathic scoliosis (AIS). 

f. All subjects received radiographic assessment of their scoliotic curves as well as  evaluation using the Ortelius 800. 

g. When operating  Ortelius 800 the operator uses a fingertip sensor. 

h. “The operator palpates the spinous processes of the vertebrae using the index and

middle fingers. Beginning with C7, the examiner records the positions of the spinous processes along the length of the spine by pressing on a footswitch.” 

i. The findings of the Ortelius 800 were compared to the radiographic measurements and were “found to be reliable for following mild and moderate idiopathic curves in both the coronal and sagittal planes, without exposing the patient to ionizing radiation.” 

j. The authors noted that the Ortelius 800 could be combined with radiography and would allow for a reduction in the number of radiographic studies over the course of care. They also noted that the proper case management would still require initial radiographs,  at every third follow up visit for evaluation and at other times should certain concerning changes indicating increased problems occur.  They also emphasize that: “…any change in the patient’s treatment protocol should still be based on radiographic control.”

 Take Home:

The Ortelius 800 appeared in this study to be capable of reducing the need for some of the radiographic studies required during the course of care for scoliotic patients.

 Reviewer's Comments:

There is an interest in using methods to evaluate the spine without the use of radiography. This method uses palpation with a finger sensor to record the information that is then used to generate the Cobb angles by the machine. However, it must be used in combination with radiographs to treat the case. Regular readers of Science In Brief may remember my previous comments regarding the possible use of ultrasound imaging to aid in spinal evaluation. Such methods might well serve to reduce the number of radiographic studies and allow for much more frequent evaluations of the spine. Chiropractic colleges could be at the forefront of introducing such alternative imaging procedures into clinical practice.   

 Reviewer:  Roger Coleman DC 

Editor: Mark R. Payne DC 

Reference: Ovadia D, Bar-On E, Gragniere B et al. Radiation-free quantitative assessment of scoliosis: a multi center prospective study. Eur Spine J. 2007 Jan;16(1):97-105. Epub 2006 May 17.

 Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16705434