The correlation between the wedge-shaped vertebral body of the main curve and the severity of idiopathic scoliosis utilizing CT with 3D reconstruction
ZHANG Yi-qi
ZHOU Li-jin
ZHANG Yang-pu
HAN Chao-fan
YANG Jin-cai
LIU Yu-zeng
YIN Peng
WANG Jian-qiang
HAI Yong
Abstract：Objective To explore the correlation between the wedge-shaped vertebral body of the main curve and the severity of idiopathic scoliosis (IS) with the 3D reconstruction technology based on CT scan. Methods The morphological parameters of vertebra body were measured and analyzed using three-dimensional reconstruction technology in IS patients collected from January 2019 to September 2022. Patients were divided into severe group (n=49) and non-severe group (n=37) according to whether the Cobb's angle of the main curve was greater than 80°. Among them,45 were male and 41 were female,with an average age of (16.67±6.62) years. Morphological parameters including C-VHR,S-VHR and MCA-VHR were measured to explore the differences in anatomical parameters between the two groups. Student t test was used for statistical analysis and spearman analysis was used to explore the relationship between MCA-VHR and main curve Cobb's angle. MCA-VHR and main curve Cobb's angle were evaluated by receiver operator characteristic (ROC). Results No statistically significant difference was found between the two groups regarding age,Body Mass Index (BMI),or gender ratio (P>0.05). In terms of coronal parameters,the Cobb's angle of the main curve in the severe group was (114.3±29.13) °,while the non-severe group had an angle of (56.58±15.15) °(P<0.001). The apical vertebra translation in the severe group was (73.79±26.65) mm compared to (44.01±12.71) mm in the non-severe group (P<0.001). For sagittal parameters,there were statistically significant differences in the focal kyphosis angle between the two groups,with the severe group at (96.02±41.19) °and the non-severe group at (31.91±18.60) °(P<0.001). Regarding the three-dimensional vertebral parameters,the C-VHR in the severe group was lower at T9 (0.68±0.17) compared to the non-severe group at T8 (0.81±0.10). The MCA-VHR was (0.75±0.09) in the severe group and (0.86±0.05) in the non-severe group (P<0.001). Measurement of wedge deformation in the apical vertebra area revealed a value of (0.756±0.080) for the severe group and (0.854±0.058) for the non-severe group (P<0.001). The MCA-VHR was significantly reduced in the severe group and showed a strong negative correlation with the Cobb's angle of the primary curve (r=-0.605). The area under the curve (AUC) for MCA-VHR in identifying severe idiopathic scoliosis was 0.856,with a specificity of 89.2％ and a sensitivity of 71.4％. Conclusions The degree of wedge changes in the main curvature of IS is significantly correlated with Cobb's angle of the main curve,and the average degree of wedge changes in the main curve of severe IS is much higher than that in non-severe scoliosis patients. MCA-VHR may be a potential predictor of severe scoliosis,while further prospective studies are needed to clarify the predictive efficacy.
Keywords：ScoliosisTomographyX-ray computedVertebral body
Publication Date：2025-01-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 4-9 )