Effects of the schroth exercise on idiopathic scoliosis: a ...
Examination of the breast asymmetry associated with adolescent idiopathic scoliosis using surface...
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ORAL PRESENTATION Open Access Examination of the breast asymmetry associated with adolescent idiopathic scoliosis using surface topography methods Alexandra Trovato 1* , Amin Komeili 1 , Lindsey Westover 2 , Eric Parent 3 , Marc Moreau 4 , Samer Adeeb 1 , Esteban Sepúlveda 1,5 From 10th International Conference on Conservative Management of Spinal Deformities - SOSORT 2013 Annual Meeting Chicago, IL, USA. 8-11 May 2013 Background Breast asymmetry in females is significantly more common in adolescent idiopathic scoliosis (AIS) than in non- scoliotic females [1]. Researchers and clinicians currently use the “Cobb angle” from radiographs as the standard assessment method for scoliosis. Since exposure to radia- tion has been shown to increase the risk of cancer [2], radiography is not the safest method of assessment. Unlike surface topography (ST), radiographic assessments do not measure cosmetic deformities associated with AIS, which is very important to patients and has a psychological impact on the quality of life [3]. Purpose The objectives of this study were to observe the association between AIS and breast asymmetry using a 3-dimensional, markerless ST analysis technique, and to present a novel approach to analyze breast asymmetry that is associated with AIS. Methods Torso ST scans of 25 females with AIS (Cobb angle: 36.5° ±14.0°, curve types: Lenke 1, 3, 5 and 6) were analyzed. The mean patient age was 15.4 ± 1.3 years (range: 13.5– 17.5). At the time of the scan, two patients were pre- menarchal and the remaining had experienced menarche 1.9±1.1 years prior to the scan. The best plane of symme- try was found by mirroring the scan about the sagittal plane. The mirrored torso was fitted to the observed torso such that the average deviation between the torsos was minimized. The relative deviation between the mirrored and observed torso was measured and displayed as a deviation colour map (DCM). The DCMs were visually appraised, resulting in five types of breast asymmetry. Results Breast asymmetry was identified in all patients through a qualitative assessment. All had deviations exceeding 3mm between sides. The patients were classified into five distinct groups based on their pattern of breast asymmetry. Conclusions and discussion All of the patients presented breast asymmetry that could be categorized into five groups. Future work includes the correlation of breast asymmetry classification to the type and severity of the scoliosis curve. This ST analysis techni- que provides a non-invasive and objective method to assess breast asymmetry in patients with AIS. Further work is required to test the reliability of this classification. Authors’ details 1 Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, USA. 2 Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, USA. 3 Department of Physical Therapy, University of Alberta, Edmonton, Alberta, USA. 4 Department of Surgery, University of Alberta, Edmonton, Alberta, USA. 5 Facultad de Minas, Universidad Nacional de Colombia, Colombia. * Correspondence: [email protected] 1 Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, USA Full list of author information is available at the end of the article Trovato et al. Scoliosis 2013, 8(Suppl 2):O39 http://www.scoliosisjournal.com/content/8/S2/O39 © 2013 Trovato et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Transcript of Examination of the breast asymmetry associated with adolescent idiopathic scoliosis using surface...
ORAL PRESENTATION Open Access
Examination of the breast asymmetry associatedwith adolescent idiopathic scoliosis using surfacetopography methodsAlexandra Trovato1*, Amin Komeili1, Lindsey Westover2, Eric Parent3, Marc Moreau4, Samer Adeeb1,Esteban Sepúlveda1,5
From 10th International Conference on Conservative Management of Spinal Deformities - SOSORT 2013Annual MeetingChicago, IL, USA. 8-11 May 2013
BackgroundBreast asymmetry in females is significantly more commonin adolescent idiopathic scoliosis (AIS) than in non-scoliotic females [1]. Researchers and clinicians currentlyuse the “Cobb angle” from radiographs as the standardassessment method for scoliosis. Since exposure to radia-tion has been shown to increase the risk of cancer [2],radiography is not the safest method of assessment. Unlikesurface topography (ST), radiographic assessments do notmeasure cosmetic deformities associated with AIS, whichis very important to patients and has a psychologicalimpact on the quality of life [3].
PurposeThe objectives of this study were to observe the associationbetween AIS and breast asymmetry using a 3-dimensional,markerless ST analysis technique, and to present a novelapproach to analyze breast asymmetry that is associatedwith AIS.
MethodsTorso ST scans of 25 females with AIS (Cobb angle: 36.5°±14.0°, curve types: Lenke 1, 3, 5 and 6) were analyzed.The mean patient age was 15.4 ± 1.3 years (range: 13.5–17.5). At the time of the scan, two patients were pre-menarchal and the remaining had experienced menarche1.9±1.1 years prior to the scan. The best plane of symme-try was found by mirroring the scan about the sagittal
plane. The mirrored torso was fitted to the observed torsosuch that the average deviation between the torsos wasminimized. The relative deviation between the mirroredand observed torso was measured and displayed as adeviation colour map (DCM). The DCMs were visuallyappraised, resulting in five types of breast asymmetry.
ResultsBreast asymmetry was identified in all patients througha qualitative assessment. All had deviations exceeding3mm between sides. The patients were classified into fivedistinct groups based on their pattern of breast asymmetry.
Conclusions and discussionAll of the patients presented breast asymmetry that couldbe categorized into five groups. Future work includes thecorrelation of breast asymmetry classification to the typeand severity of the scoliosis curve. This ST analysis techni-que provides a non-invasive and objective method toassess breast asymmetry in patients with AIS. Furtherwork is required to test the reliability of this classification.
Authors’ details1Department of Civil and Environmental Engineering, University of Alberta,Edmonton, Alberta, USA. 2Department of Mechanical Engineering, Universityof Alberta, Edmonton, Alberta, USA. 3Department of Physical Therapy,University of Alberta, Edmonton, Alberta, USA. 4Department of Surgery,University of Alberta, Edmonton, Alberta, USA. 5Facultad de Minas,Universidad Nacional de Colombia, Colombia.
* Correspondence: [email protected] of Civil and Environmental Engineering, University of Alberta,Edmonton, Alberta, USAFull list of author information is available at the end of the article
Trovato et al. Scoliosis 2013, 8(Suppl 2):O39http://www.scoliosisjournal.com/content/8/S2/O39
© 2013 Trovato et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.
Published: 18 September 2013
References1. Normeli H, Sevastik JA, Ljung G, et al: The symmetry of the breasts in
normal and scoliotic girls. Spine 1986, 11:749-752.2. Levy AR, Goldberg MS, Mayo NE, Hanley JA, Poitras B: Reducing the
lifetime risk of cancer from spinal radiographs among people withadolescent idiopathic scoliosis. Spine 1996, 21:1540-548.
3. Lai SM, Asher MA, Burton DC: Estimating SRS-22 quality of life measureswith SF-36: Application in idiopathic scoliosis. Spine 2006, 31:473-8.
doi:10.1186/1748-7161-8-S2-O39Cite this article as: Trovato et al.: Examination of the breast asymmetryassociated with adolescent idiopathic scoliosis using surfacetopography methods. Scoliosis 2013 8(Suppl 2):O39.
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Trovato et al. Scoliosis 2013, 8(Suppl 2):O39http://www.scoliosisjournal.com/content/8/S2/O39
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