Evaluation of a new real-time ultrasound method for measuring segmental rotation of vertebrae and ribs in scoliosis

This paper reports che further development of a real-time ultrasound method to measure each of segmental vertebral laminal rotation (LR) and rib rotat ion (CR) in 20 scoliosis school screening referrals [6]. The patients (17 g irls, 3 boys) lay prone on a couch with the forehead supported (mean Cobb a ngle 19 degrees, range 0-37 degrees, curve types: 5 thoracic: 5 thoracolumb ar; 6 lumbar: 3 double; I straight spine). Measurements of each of LR and R R were obtained twice by one observer (ASK). After walking around the room the child lay prone again and die measurements of LR and RR were repeated a gain twice. Pedicle and spinous process vertebral rotation (VR) were measur ed using the Perdriolle (T5-L4) and Bunnell (T1-4) templates respectively b y one observer (RGB). A computer programme was written to calculate the sum mated deformity at all levels for each of vertebrae and. A statistically si gnificant difference was revealed by level but not by measure or position. The 95% confidence limits for LR at each of the 18 levels (TI-SI) ranged fr om +/- 1.7 degrees to +/- 3.1 degrees mid RR from +/- 1.8 degrees to +/- 2. 8 degrees. Comparison of ultrasound LR against X-ray Vp shows statistically significant correlations at each of T7-L4, the scoliosis curves being main ly thoracolumbar lund lumbar. VR on AP standing spinal radiographs is great er than ultrasound LR measured ill the prone position. Summated ultrasound LR at T1-12 correlates significantly with summated ultrasound RR (p<0.001) with LR being greater than RR Data for each patient plotted by level clearl y reveal the rotational deformity of vertebrae and ribs the relation betwee n which is now being assessed for vertebral and costal pathomechanisms of a dolescent idiopathic scoliosis.