Which side-bending X-ray position is better to evaluate the preoperative curve flexibility in adolescent idiopathic scoliosis patients, supine or prone?

Hirofumi Bekki, Katsumi Harimaya, Yoshihiro Matsumoto, Kenichi Kawaguchi, Mitsumasa Hayashida, Seiji Okada, Toshio Doi, Yasuharu Nakashima

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Study Design: Prospective cohort study. Purpose: The present study aimed to evaluate the difference in the preoperative curve flexibility between the supine and prone positions in patients with adolescent idiopathic scoliosis (AIS). Overview of Literature: In AIS, a side-bending view is necessary to differentiate a structural curve from a nonstructural curve using the Lenke classification system. However, there are no published studies about which position, supine or prone, is more effective when evaluating preoperative curve flexibility using side-bending X-ray images in AIS patients. Methods: Radiographs were analyzed for 32 AIS patients (26 females, six males) who underwent posterior correction and fusion of their main thoracic (MT) curves. Cobb angles of MT, proximal thoracic (PT), and thoracolumbar/lumbar (TL/L) curves were measured preoperatively using upright, supine (anteroposterior and side-bending), and prone (posteroanterior and side-bending) X-rays. Results: The average Cobb angles of PT, MT, and TL/L curves on preoperative upright/supine/prone X-rays were 29.1°/26.7°/26.6°, 60.7°/48.5°/48.2°, and 41.0°/32.6°/33.1°, respectively. The average Cobb angles of PT, MT, and TL/L curves on supine/prone sidebending X-rays were 19.2°/20.3°, 36.3°/36.4°, and 13.9°/15.7°, respectively. The flexibility rates of PT, MT, and TL/L curves in supine/ prone positions were 35.3%/32.5%, 40.6%/40.2%, and 71.7%/68.2%, respectively. Comparing flexibility rates in the prone position with those in the supine position in each case, the average ratios of PT, MT, and TL/L curves were found to be 1.0, 1.0, and 0.9, respectively. There were no statistically significant differences between supine and prone side-bending X-ray measurements. However, the Lenke classification in six of 32 patients (18.8%) differed between supine and prone positions because the TL/L curve in the supine position was slightly more flexible than in the prone position. Conclusions: Supine side-bending films may be suitable for the evaluation of preoperative curve flexibility in AIS, especially for lumbar modifier C.

Original languageEnglish
Pages (from-to)632-638
Number of pages7
JournalAsian Spine Journal
Volume12
Issue number4
DOIs
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Which side-bending X-ray position is better to evaluate the preoperative curve flexibility in adolescent idiopathic scoliosis patients, supine or prone?'. Together they form a unique fingerprint.

Cite this