Adolescent Idiopathic Scoliosis (AIS) Patient Positioning in EOS System®
Condition: Adolescent Idiopathic Scoliosis
MeSH terms: Scoliosis
Study type: Observational

Summary: 
      The EOS® imaging system, a new imaging modality which offers low dose, weight bearing and
      full body X-ray imaging, requires a new standing position where patients put their hands and
      forearms on the wall vertically for stability. Although this method provides enough support
      for the patients during the extended X-ray acquisition time, its impact on the postural
      balance and sagittal profile of the spine and sacro-pelvic parameters has not been evaluated.
      The goal of this study is to identify the impact of patients' arm positioning on the sagittal
      profile and postural balance of the patient and subsequently propose a standardized method
      for full spine X-ray acquisition in the EOS® imaging system.
    

Detailed description: 
      Spino-pelvic sagittal analysis and postural assessment are important parameters in adolescent
      idiopathic scoliosis (AIS) treatment and surgical planning.The three-dimensional (3D) shape
      of the spine is impacted by the patients' posture particularly in adolescents with flexible
      spinal curves. The latter highlights the importance of the patients' positioning during X-ray
      acquisition in order to avoid any misleading measurements that may adversely impact
      monitoring and surgical curve correction in AIS.

      Participating subjects will undergo two bi-planar X-rays in different positions. The
      positions will be instructed by the means of graphical presentation and verbal explanation by
      the radiology technician. The first standing position in the EOS® imaging system for full
      spinal X-ray acquisition will consist of putting both hands and forearms in front of the
      subject on the wall vertically. In the second position, knuckles are loosely placed on
      ipsi-lateral clavicles. Bi-planar X-rays will be taken in the EOS® imaging system for both
      positions.

      Moreover to compare the postural balance of the patient in the two described positions, a
      pressure mat will be placed in the EOS® system. The pressure mat will be calibrated with the
      EOS® system and permits to identify the position of the center of pressure (COP) with respect
      to the anatomical landmarks. The magnitude of pressure under the patients' feet will be
      measured during each X-ray and compared.
    

Intervention name(s): EOS® imaging system
Intervention type(s): Device
Intervention description(s): The EOS® imaging system is a low dose, 3-dimensional imaging system that provides weight bearing images which provide visual information with respect to the interaction between the joints and the rest of the musculoskeletal system, particularly the spine, hips and legs. The imaging system is used for clinical purposes with additional images captured as part of this study to collect data from subjects in two different arm positions during imaging.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Outpatient adolescent idiopathic scoliosis patients visiting the orthopedic clinic at
        Children's Hospital of Philadelphia who require bi-plannar full spine x-ray imaging for
        clinical purposes.
      
Keywords: Scoliosis; Postural balance; Lordosis; Kyphosis; X-rays