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Three-dimensional easy morphological (3-DEMO) classification of scoliosis, part I.

Negrini S, Negrini A, Atanasio S, Santambrogio GC - Scoliosis (2006)

Bottom Line: Pathological data were compared with those of 20 normal volunteers.We found three classificatory parameters, which are fully described and discussed in this paper: Direction, the angle between spinal pathological and normal AP axis; Shift, the co-ordinates of the barycentre of the Top View ; Phase, the parameter describing the spatial evolution of the curve.Further studies are currently under way to compare this new system with the existing 3-D classifications, to obtain it using everyday clinical and x-rays data, and to develop a triage for clinical use.

View Article: PubMed Central - HTML - PubMed

Affiliation: ISICO (Italian Scientific Spine Institute) Milan, Italy. stefano.negrini@isico.it

ABSTRACT

Background: While scoliosis has, for a long time, been defined as a three-dimensional (3D) deformity, morphological classifications are confined to the two dimensions of radiographic assessments. The actually existing 3-D classification proposals have been developed in research laboratories and appear difficult to be understood by clinicians.

Aim of the study: The aim of this study was to use the results of a 3D evaluation to obtain a simple and clinically oriented morphological classification (3-DEMO) that might make it possible to distinguish among different populations of scoliotic patients.

Method: We used a large database of evaluations obtained through an optoelectronic system (AUSCAN) that gives a 3D reconstruction of the spine. The horizontal view was used, with a spinal reference system (Top View). An expert clinician evaluated the morphological reconstruction of 149 pathological spines in order to find parameters that could be used for classificatory ends. These were verified in a mathematical way and through computer simulations: some parameters had to be excluded. Pathological data were compared with those of 20 normal volunteers.

Results: We found three classificatory parameters, which are fully described and discussed in this paper: Direction, the angle between spinal pathological and normal AP axis; Shift, the co-ordinates of the barycentre of the Top View ; Phase, the parameter describing the spatial evolution of the curve. Using these parameters it was possible to distinguish normal and pathological spines, to classify our population and to differentiate scoliotic patients with identical AP classification but different 3D behaviors.

Conclusion: The 3-DEMO classification offers a new and simple way of viewing the spine through an auxiliary plane using a spinal reference system. Further studies are currently under way to compare this new system with the existing 3-D classifications, to obtain it using everyday clinical and x-rays data, and to develop a triage for clinical use.

No MeSH data available.


Related in: MedlinePlus

3D representation of an anatomically normal spine according to White and Panjabi (25), and its projections in the three spatial planes – according to the spinal Top View. The normal spine is straight in the frontal plane (xoy), while the sagittal (yoz) physiological curves (kyphosis and lordosis) make it appear, in the Top View (Horizontal – xoz), as a straight line and not as a point, as it would have been in case of absence of sagittal curves. Drawing the TopView from C7 to S1 in a normal situationwould make appear a line first moving backward from C7 to the apex of kyphosis, then forward to the apex of lordosis, and finally backward to the starting point (by definition, in the spinal Top View there is vertical coincidence of C7 and S1) in the middle of the graph.
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Figure 2: 3D representation of an anatomically normal spine according to White and Panjabi (25), and its projections in the three spatial planes – according to the spinal Top View. The normal spine is straight in the frontal plane (xoy), while the sagittal (yoz) physiological curves (kyphosis and lordosis) make it appear, in the Top View (Horizontal – xoz), as a straight line and not as a point, as it would have been in case of absence of sagittal curves. Drawing the TopView from C7 to S1 in a normal situationwould make appear a line first moving backward from C7 to the apex of kyphosis, then forward to the apex of lordosis, and finally backward to the starting point (by definition, in the spinal Top View there is vertical coincidence of C7 and S1) in the middle of the graph.

Mentions: The Cartesian reference system (Figure 1, 2), on to which the graphic representation of the spine of each subject is projected, is obtained rotating the global reference system to make it a spinal reference system. This is true when the vertical and spinal (C7-S1) axes are coincident, and the center of the reference system is coincident with S1. Measurements are expressed in millimetres.


Three-dimensional easy morphological (3-DEMO) classification of scoliosis, part I.

Negrini S, Negrini A, Atanasio S, Santambrogio GC - Scoliosis (2006)

3D representation of an anatomically normal spine according to White and Panjabi (25), and its projections in the three spatial planes – according to the spinal Top View. The normal spine is straight in the frontal plane (xoy), while the sagittal (yoz) physiological curves (kyphosis and lordosis) make it appear, in the Top View (Horizontal – xoz), as a straight line and not as a point, as it would have been in case of absence of sagittal curves. Drawing the TopView from C7 to S1 in a normal situationwould make appear a line first moving backward from C7 to the apex of kyphosis, then forward to the apex of lordosis, and finally backward to the starting point (by definition, in the spinal Top View there is vertical coincidence of C7 and S1) in the middle of the graph.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1764765&req=5

Figure 2: 3D representation of an anatomically normal spine according to White and Panjabi (25), and its projections in the three spatial planes – according to the spinal Top View. The normal spine is straight in the frontal plane (xoy), while the sagittal (yoz) physiological curves (kyphosis and lordosis) make it appear, in the Top View (Horizontal – xoz), as a straight line and not as a point, as it would have been in case of absence of sagittal curves. Drawing the TopView from C7 to S1 in a normal situationwould make appear a line first moving backward from C7 to the apex of kyphosis, then forward to the apex of lordosis, and finally backward to the starting point (by definition, in the spinal Top View there is vertical coincidence of C7 and S1) in the middle of the graph.
Mentions: The Cartesian reference system (Figure 1, 2), on to which the graphic representation of the spine of each subject is projected, is obtained rotating the global reference system to make it a spinal reference system. This is true when the vertical and spinal (C7-S1) axes are coincident, and the center of the reference system is coincident with S1. Measurements are expressed in millimetres.

Bottom Line: Pathological data were compared with those of 20 normal volunteers.We found three classificatory parameters, which are fully described and discussed in this paper: Direction, the angle between spinal pathological and normal AP axis; Shift, the co-ordinates of the barycentre of the Top View ; Phase, the parameter describing the spatial evolution of the curve.Further studies are currently under way to compare this new system with the existing 3-D classifications, to obtain it using everyday clinical and x-rays data, and to develop a triage for clinical use.

View Article: PubMed Central - HTML - PubMed

Affiliation: ISICO (Italian Scientific Spine Institute) Milan, Italy. stefano.negrini@isico.it

ABSTRACT

Background: While scoliosis has, for a long time, been defined as a three-dimensional (3D) deformity, morphological classifications are confined to the two dimensions of radiographic assessments. The actually existing 3-D classification proposals have been developed in research laboratories and appear difficult to be understood by clinicians.

Aim of the study: The aim of this study was to use the results of a 3D evaluation to obtain a simple and clinically oriented morphological classification (3-DEMO) that might make it possible to distinguish among different populations of scoliotic patients.

Method: We used a large database of evaluations obtained through an optoelectronic system (AUSCAN) that gives a 3D reconstruction of the spine. The horizontal view was used, with a spinal reference system (Top View). An expert clinician evaluated the morphological reconstruction of 149 pathological spines in order to find parameters that could be used for classificatory ends. These were verified in a mathematical way and through computer simulations: some parameters had to be excluded. Pathological data were compared with those of 20 normal volunteers.

Results: We found three classificatory parameters, which are fully described and discussed in this paper: Direction, the angle between spinal pathological and normal AP axis; Shift, the co-ordinates of the barycentre of the Top View ; Phase, the parameter describing the spatial evolution of the curve. Using these parameters it was possible to distinguish normal and pathological spines, to classify our population and to differentiate scoliotic patients with identical AP classification but different 3D behaviors.

Conclusion: The 3-DEMO classification offers a new and simple way of viewing the spine through an auxiliary plane using a spinal reference system. Further studies are currently under way to compare this new system with the existing 3-D classifications, to obtain it using everyday clinical and x-rays data, and to develop a triage for clinical use.

No MeSH data available.


Related in: MedlinePlus