The Study: Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis                  

The Facts: 

a. The authors note that the use of methods for adolescent scoliosis assessment that do not use ionizing radiation has been advocated. 

b. There is growing interest in the use of ultrasound for this use. 

c. The use of the center of lamina (COL) has been proposed for use in measuring the spinal curvatures in the coronal (frontal)  plane. 

d. However, the reliability and validity of this method for clinical use has not yet been determined. 

e. This study looked at 16 subjects who suffered from adolescent idiopathic scoliosis (AIS). 

f. They compared Cobb angles as measured through the use of MRI to the COL method measured using ultrasound. 

g. The two studies were performed on the same morning and usually within three hours of each other. 

h. Both the ultrasound and the MRI studies utilized full spine imaging and were performed in the supine position. 

i. The method used for the ultrasound imaging utilized a cut into “couch” (table) The interested reader can use the Full Text link below to see the images.)  

j. The ultrasound reconstructed a 3-D image. 

k. “Compared with Cobb method, COL method showed no significant difference (p<0.05) when measuring coronal curvature.” (emphasis ours)

 Take Home:

This type of ultrasound appears to be suitable for the measurement of scoliosis.

 Reviewer's Comments:

First, I’ve discussed this type of study before. In addition there are other similar studies. It appears from what I have seen, that in many cases this type of ultrasound could be used to study full spinel alignment. Exactly how accurate it might be in the type of work that doctors of chiropractic commonly perform we don’t know yet. However, as I have indicated previously, we need to be looking at this and other non-radiating technologies. For the chiropractic profession to not be concerned about the alignment of spines seems bizarre to me and we should be leading the efforts to evaluate the potential uses of non radiographic imaging. This type of approach might give almost instant feedback and allow for the development of better treatment strategies. If the chiropractic profession doesn’t do this, our competition will.  And as the technology improves they will develop better and better tools for this type of evaluation. So for those of you out there who are at chiropractic colleges and universities, I leave it to you. It would be great if we could improve on methods to measure and document the efficacy of the methods we use.

Reviewer: Roger Coleman DC 

Editor’s Comments: This study serves to help document the accuracy of 3D ultrasound imaging as compared to traditional MRI. Challenges will still remain in terms of adapting the technology for use in the upright imaging desired by most chiropractors. This study, and others like it, look like an excellent opportunity for our colleges to start taking the lead in new technologies which could benefit the entire profession and the patients we serve.  

Editor: Mark R. Payne DC 

Reference: Wang Q, Li M, Lou EH, Wong MS. Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis. PLoS One. 2015 Aug 12;10(8):e0135264. doi: 10.1371/journal.pone.0135264. eCollection 2015.

 Link to Abstract:  https://www.ncbi.nlm.nih.gov/pubmed/26266802

 Link to Full Text:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534204/