title: Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis.
abstract: BACKGROUND
  Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity.
  
  
  METHODS
  Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50°) participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20°) from the moderate (20° and over) spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body.
  
  
  RESULTS
  Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it) (F = 1.78, p = 0.101). Main effects of vertebral Positions (apex and above or below it) (F = 4.20, p = 0.015) and wedging Planes (F = 34.36, p<0.001) were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6°) than the superior group (2.9°, p = 0.019) and a significantly greater wedging (p≤0.03) along the sagittal plane (4.3°).
  
  
  CONCLUSIONS
  Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support the claim that scoliosis could be initiated through a hypokyphosis.
authors: Laboratoire d'ingénierie du mouvement, Department of Kinesiology, University of Montreal, Montreal, Quebec, Canada.
authors: Sophie-Anne
authors: SA
authors: Scherrer
authors: Mickaël
authors: M
authors: Begon
authors: Alberto
authors: A
authors: Leardini
authors: Christine
authors: C
authors: Coillard
authors: Charles-Hilaire
authors: CH
authors: Rivard
authors: Paul
authors: P
authors: Allard
mesh_terms: D000293:Adolescent; D059925:Anatomic Landmarks; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000473:pathology*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology
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