ICCBH2015 Poster Presentations (1) (201 abstracts)
Bone quality in severe adolescent idiopathic scoliosis -- quantitative computed tomography of lumbar spine vs high-resolution peripheral quantitative computed tomography of the distal radius: a pilot study
Fiona Wai Ping Yu 1, , Lin Shi 3 , Defeng Wang 4 , Vivian Wing Yin Hung 1, , Wing Yee Choy 1, , Steve Cheuk Ngai Hui 4 , Pak Yin Lee 4 , Elisa Man Shan Tam 1 , Tsz Ping Lam 1, , Lin Qin 1, , Bobby Kin Wah Ng 1 , Winnie Chiu Wing Chu 4 , James Griffith 3 & Jack Chun Yiu Cheng 1,
1Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong; 2Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong; 3Deartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong; 4Department of Imaging & Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Introduction and objective: Adolescent idiopathic scoliosis (AIS) is a structural spinal deformity characterized by 3D deformity with lateral curvature of ≧10° as measured by Cobb angle and is predominately seen in girlsaged between 10 and 16-years-old. Low bone mass has been found to be a significant prognostic factor for curve progression in AIS.
In our hospital, computed assisted navigation is used for intraoperative pedicle screw placement which will require pre-operative CT of whole spine. A set of calibration phantoms was used in all preoperative CT scanning so that the attenuation measured in the bone can be converted from Hounsfield units (HU) to bone mineral equivalents in mg/cm3. Both quantitative computed tomography (QCT) and high-resolution peripheral quantitative computed tomography (HR-pQCT) allow the study of cortical bone and trabecular bone separately and enable to acquire three-dimensional (3-D) volumetric BMD of each compartment. The objective of this study is to correlate the volumetric bone mineral density (vBMD) of central and appendicular skeleton using QCT and HR-pQCT.
Methods: In this pilot study, eight AIS girls aged 13–18 with planned operation (Cobb angle>45°) were recruited. Lumbar spine L1–L2 and non-dominant distal radius were measured by QCT and HR-pQCT respectively.
Results: The mean age was 15.6±2.2 years old and the mean Cobb angle was 62°±15°. Of the eight patients, 3 (37.5%) were osteopenia with z-score of femoral neck ≤−1. Using the Pearson correlation, significant correlation of the L1 vertebra and distal radius were found including the total vBMD (P=0.021), cortical vBMD (P=0.026) and trabecular vBMD (P=0.018). Besides, trabecular vBMD of L2 vertebra was significantly correlated with that of distal radius (P=0.021).
Conclusion: In conclusion, in this pilot study, the bone quality measured by QCT at L1 vertebra (central skeleton) was well correlated with that of HR-pQCT at non-dominant distal radius (appendicular skeleton). Further studies with larger number of patients should be carried out in the future to validate the findings which could provide better prognostication of curve progression and improve our understanding of the etiopathogenesis of AIS.
Disclosure: The authors declared no competing interests.
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