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Article: 3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Title3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction
Authors
KeywordsAdolescent idiopathic scoliosis
clinical studies
Cobb angles
hypokyphosis
machine learning
MEDLINE
prognosis
Prognostic Studies
progression
radiographs
reconstruction
rotation
stereoradiography
thoracic hypokyphosis
thoracic kyphosis
three-dimensional
vertebrae
Issue Date25-Mar-2024
PublisherBritish Editorial Society of Bone and Joint Surgery
Citation
Bone & Joint Open, 2024, v. 5, n. 3, p. 243-251 How to Cite?
Abstract

Aims

This systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis.

Methods

A comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included.

Results

Torsion index (TI) and apical vertebral rotation (AVR) were identified as accurate predictors of curve progression in early visits. Initial TI > 3.7° and AVR > 5.8° were predictive of curve progression. Thoracic hypokyphosis was inconsistently observed in progressive curves with weak evidence. While sagittal wedging was observed in mild curves, there is insufficient evidence for its correlation with curve progression. In curves with initial Cobb angle < 25°, Cobb angle was a poor predictor for future curve progression. Prediction accuracy was improved by incorporating serial reconstructions in stepwise layers. However, a lack of post-hoc analysis was identified in studies involving geometrical models.

Conclusion

For patients with mild curves, TI and AVR were identified as predictors of curve progression, with TI > 3.7° and AVR > 5.8° found to be important thresholds. Cobb angle acts as a poor predictor in mild curves, and more investigations are required to assess thoracic kyphosis and wedging as predictors. Cumulative reconstruction of radiographs improves prediction accuracy. Comprehensive analysis between progressive and non-progressive curves is recommended to extract meaningful thresholds for clinical prognostication.


Persistent Identifierhttp://hdl.handle.net/10722/342759
ISSN
2023 Impact Factor: 2.8
2023 SCImago Journal Rankings: 1.414
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWan, HTS-
dc.contributor.authorWong, DLL-
dc.contributor.authorTo, CHS-
dc.contributor.authorMeng, N-
dc.contributor.authorZhang, T-
dc.contributor.authorCheung, JPY-
dc.date.accessioned2024-04-24T02:46:57Z-
dc.date.available2024-04-24T02:46:57Z-
dc.date.issued2024-03-25-
dc.identifier.citationBone & Joint Open, 2024, v. 5, n. 3, p. 243-251-
dc.identifier.issn2633-1462-
dc.identifier.urihttp://hdl.handle.net/10722/342759-
dc.description.abstract<h2>Aims</h2><p>This systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis.</p><h2>Methods</h2><p>A comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included.</p><h2>Results</h2><p>Torsion index (TI) and apical vertebral rotation (AVR) were identified as accurate predictors of curve progression in early visits. Initial TI > 3.7° and AVR > 5.8° were predictive of curve progression. Thoracic hypokyphosis was inconsistently observed in progressive curves with weak evidence. While sagittal wedging was observed in mild curves, there is insufficient evidence for its correlation with curve progression. In curves with initial Cobb angle < 25°, Cobb angle was a poor predictor for future curve progression. Prediction accuracy was improved by incorporating serial reconstructions in stepwise layers. However, a lack of post-hoc analysis was identified in studies involving geometrical models.</p><h2>Conclusion</h2><p>For patients with mild curves, TI and AVR were identified as predictors of curve progression, with TI > 3.7° and AVR > 5.8° found to be important thresholds. Cobb angle acts as a poor predictor in mild curves, and more investigations are required to assess thoracic kyphosis and wedging as predictors. Cumulative reconstruction of radiographs improves prediction accuracy. Comprehensive analysis between progressive and non-progressive curves is recommended to extract meaningful thresholds for clinical prognostication.</p>-
dc.languageeng-
dc.publisherBritish Editorial Society of Bone and Joint Surgery-
dc.relation.ispartofBone & Joint Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdolescent idiopathic scoliosis-
dc.subjectclinical studies-
dc.subjectCobb angles-
dc.subjecthypokyphosis-
dc.subjectmachine learning-
dc.subjectMEDLINE-
dc.subjectprognosis-
dc.subjectPrognostic Studies-
dc.subjectprogression-
dc.subjectradiographs-
dc.subjectreconstruction-
dc.subjectrotation-
dc.subjectstereoradiography-
dc.subjectthoracic hypokyphosis-
dc.subjectthoracic kyphosis-
dc.subjectthree-dimensional-
dc.subjectvertebrae-
dc.title3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction-
dc.typeArticle-
dc.identifier.doi10.1302/2633-1462.53.BJO-2023-0176.R1-
dc.identifier.scopuseid_2-s2.0-85188834035-
dc.identifier.volume5-
dc.identifier.issue3-
dc.identifier.spage243-
dc.identifier.epage251-
dc.identifier.eissn2633-1462-
dc.identifier.isiWOS:001197403600001-
dc.identifier.issnl2633-1462-

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