title: A pilot study of scoliosis assessment using radiation free surface topography in children with GMFCS IV and V cerebral palsy.
abstract: BACKGROUND
  Prevalence of scoliosis in cerebral palsy (CP) parallels the extent of neurological impairment and causes significant morbidity. Monitoring is important but requires regular radiological investigation. Surface topography provides a non-radiological approach to scoliosis monitoring.
  
  
  OBJECTIVE
  To evaluate validity, reproducibility and feasibility of Quantec(®) scans to monitor scoliosis in children with severe CP.
  
  
  METHODS
  Twenty non-ambulant children with CP, Gross Motor Function Classification System (GMFCS) grade IV/V had clinical, radiological and Quantec spinal assessment. The children were supported during scans using a seating system specifically designed for this study. Validity was assessed by comparing Quantec (Q) angle with gold standard (Cobb angle), reproducibility analysed using Bland-Altman plots and feasibility assessed using a questionnaire.
  
  
  RESULTS
  Prevalence of scoliosis on radiological examination was 65%. Of these children, 85% had curves with Cobb angle less than 28°. Quantec scanning was feasible with appropriate postural support. Mean (and standard deviation) for differences between Cobb and Quantec (Q) angle were 0.02° (6.2°) and for Quantec inter-observer variability were 0.5° (5.8°).
  
  
  CONCLUSIONS
  Quantec scanning was feasible, reproducible and had good validity when compared with Cobb angle in a supportive seating system. To consolidate these findings a further study needs to be undertaken with larger number of children with Cobb angles between 25° and 45°.
authors.affiliation: Department of Community Paediatrics, Yorkshire and the Humber Deanery & Leeds Teaching Hospitals NHS trust, St James University Hospital, Leeds, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sadani
authors.forename: C
authors.initials: C
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Seal
authors.forename: B
authors.initials: B
authors.lastname: Bhakta
authors.forename: R
authors.initials: R
authors.lastname: Hall
authors.forename: M
authors.initials: M
authors.lastname: Levesley
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D010865:Pilot Projects; D004856:Postural Balance; D011859:Radiography; D015203:Reproducibility of Results; D012600:Scoliosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology