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Retrospective reliability study of the coronal curvature measurement on ultrasound (US) imaging in adolescent idiopathic scoliosis (AIS).

Study Design: Retrospective reliability study of the coronal curvature measurement on ultrasound (US) imaging in adolescent idiopathic scoliosis (AIS). Objectives: To determine the intra- and inter-rater reliability and validity of the coronal curvature measurements obtained from US images. Summary of Background Data: Cobb angle measurements on radiographs are the usual method to diagnose and monitor the progression of scoliosis. Repeated ionizing radiation exposure is a frequent concern of patients and their families. Use of US imaging method to measure coronal curvature in children who have idiopathic scoliosis has not been clinically validated. Methods: The researchers scanned 26 subjects using a medical 3-dimensional US system. Spinal radiographs were obtained on the same day from the local scoliosis clinic. Three raters used the center of lamina method to measure the coronal curvature on the US images twice 1 week apart. The raters also measured the Cobb angle on the radiographs twice. Intra- and inter-rater reliability of the coronal curvature measurement from the US images was analyzed using intra-class correlation coefficients. The correlation coefficient of the US coronal curvature measurements was compared with the Cobb angles. Results: The intra-class correlation coefficient (2,1) values of intra- and inter-rater reliability on the US method were greater than 0.80. Standard error of measurement on both of the intra- and inter-rater US methods was less than 2.8°. The correlation coefficient between the US and radiographic methods ranged between 0.78 and 0.84 among 3 raters. Conclusions: The US method illustrated substantial intra- and inter-rater reliability. The measurement difference between radiography and the US method was within the range of clinically acceptable error (5°). The US method may be considered a radiation-free alternative to assess children with scoliosis of mild to moderate severity.

Stages of the surgical procedure for pinealectomy in chickens were identified. Groups of chickens were selected for each stage. Scoliosis development was identified from radiographs.

This study involved weekly radiographic examination of pinealectomized rats, hamsters, and chickens to observe the development of scoliosis.

Normal, sham, and groups of chickens subjected to pinealectomy from which serum melatonin levels were measured and correlated with scoliosis development in a period of 5 weeks.

The characteristics of the scoliosis that develops after pinealectomy in young chickens were determined from weekly posteroanterior radiographs. These data were compared with similar data collected from human patients with adolescent idiopathic scoliosis.

Trunk images of children with scoliosis were examined to determine features that contribute to the impression of trunk distortion. Twenty subjects with spinal deformity ranging from none to severe were photographed in a relaxed standing position. Seven blinded evaluators subjectively scored their impressions of the trunk appearance, shoulder-height difference, shoulder-angle asymmetry, decompensation, scapula asymmetry, waist crease, waist asymmetry, and pelvic asymmetry. Regression analysis was used with the latter seven features to predict overall impression. The seven measures of the deformity predicted 85% of the overall impression of trunk distortion; scapular asymmetry was the best predictor. Trunk deformity is the most obvious effect of scoliosis to the patients. Objective approaches to the assessment of this important but difficult-to-quantify aspect of idiopathic scoliosis are available and should be used to evaluate treatment outcomes.

Matched pairs of adolescent girls were used to compare serum melatonin levels in adolescent patients and control subjects with idiopathic scoliosis during the day and in the middle of the night.