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Title: Analysis of sagittal profile of spine of adolescent idiopathic scoliosis using ultrasound
Authors: Lee, Tin Yan
Degree: Ph.D.
Issue Date: 2019
Abstract: Radiographic Cobb's angle is the gold standard for evaluation of spinal curvature, however, X-ray is ionizing and is not suggested for repeated scanning. In contrast, ultrasound is non-ionizing and inexpensive, thus more accessible. Ultrasound has been used to evaluate the coronal curvature and transverse vertebral rotation of the spine of patients with adolescent idiopathic scoliosis (AIS). However, no study has reported the reliability and accuracy of ultrasound on sagittal curvature analysis. Since AIS is a three dimensional deformity, the pattern of deformity in the coronal plane may be highly influenced by changes in the axial and sagittal planes due to the effect of coupling in different planes. In addition, characterizing the differences in sagittal profile between normal and scoliotic spines may also provide early detection of vertebrae rotation, and quantifying spinal curvatures in different planes is useful for preoperative planning, postoperative evaluation and monitoring curve progression, thus there is a huge potential of using ultrasound for evaluating the sagittal spinal curvature. The objective of this study was to investigate the feasibility of using ultrasound to evaluate sagittal spinal profile, it was divided into three phases: 1) Phantom study; 2) Human subjects study; and 3) Human subjects study for coronal-sagittal coupling, including the exploratory stage and validation stage. In the present study, sagittal ultrasound angles were demonstrated to be reliable and valid for assessing sagittal curvature in both phantom and human subject studies. As laminae were observed to have a better visualization in ultrasound images, and no significant differences were revealed in the ultrasound sagittal measurements obtained using spinous processes and laminae as demonstrated in the human subjects study, ultrasound laminae angle was recommended to be used for sagittal measurement in the future. The reliability of sagittal measurement using ultrasound demonstrated in this study suggested that 3D ultrasound imaging could be a potential non-ionizing tool for evaluating the sagittal profile of patients with AIS. The results of the study also showed that there was a certain level of coupling between the sagittal curvature and coronal curvature. Further studies are worthwhile to investigate whether such coupling has an indication of curve progression. Due to the radiation-free nature of ultrasound, it will also be very meaningful to conduct follow-up investigation of patients with AIS for monitoring sagittal profile changes.
Subjects: Hong Kong Polytechnic University -- Dissertations
Scoliosis in children -- Diagnosis
Sagittal curve
Spine -- Abnormalities
Musculoskeletal system -- Ultrasonic imaging
Pages: xviii, 178 pages : color illustrations
Appears in Collections:Thesis

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