Body Surface Topography and Radiology in Adolescent Idiopathic Scoliosis (AIS): Is there a Correlation? : A Pilot Study Based on Clinical Photographs

Abstract

Background: Cosmesis is of paramount importance in adolescent idiopathic scoliosis. Conventional evaluation of scoliotic deformity is based on radiological parameters like Cobbs angle. However aesthetic parameters are the ones that are readily perceived by the patients, peers and parents. Patient Reported Outcome measures and self-image perception of these patients may not be dependent on radiological parameters alone. So there is a need to know whether there is a correlation between body surface topography and radiology in these patients.

Material and Methods: Cross-sectional, pilot study of 15 patients (10 thoracolumbar/lumbar and 5 thoracic curves. Clinical evaluation was done via Spinal Appearance Questionnaire, SRS 22 r questionnaire. Surgeon evaluation is done via the POTSI app and TRACES index. Body Surface Metrics were also calculated. Radiological parameters studied were Cobbs angle, apex deviation, Clavicle angle, Coracoid angle First Rib angle, T1 tilt and C7 Plumbline deviation.

Results POTSI had a strong correlation between SAQ (r value 0.735, p value 0.002). SAQ has a moderate correlation with cobbs angle of main curve (r value 0.519 p.0.047) and secondary curve (r value 0.539 p 0.038) SAQ had a moderate inverse correlation with SRS22r (r value-0.560, p=0.030) LWA-RWA has a moderate inverse correlation with Main Cobbs angle (0.551 p 0.033). WHA has a moderate correlation with Cobbs angle of main curve (0.545. p=0.036).  However there was also a moderate correlation between apex deviation of the lumbosacral fractional curve with the WHA (0.567, p value 0.035). AHA has a moderate correlation between clavicle angle (0.523, p value 0.046) and mild correlation with FRA (0.390) and coracoid angle (0.393) SHA had no significant correlation between any of the parameters studied.

Conclusion: Trunk aesthetic parameters should be given due importance in assessing children with Adolescent idiopathic Scoliosis. They have only moderate correlation with Cobbs angle. However, patients and surgeons perception of deformity has strong correlation. Studies on larger cohorts will be useful to validate the findings of the present study. Shoulder balance continues to be an enigma that requires further studies