A radiographic evaluation of elasticity ın idiopathic scoliotic curves: are lateral bending films reliable enough to estimate curve elasticity?

Background

Assessment of the elasticity of scoliotic curves is an important factor to plan further treatment in idiopathic scoliosis.

Purpose

To assess curve elasticity obtained from PA standing lateral bending radiographs in comparison to those taken when maximal manual supine traction is applied to the wrists and ankles in patients with idiopathic scoliosis.

Patients and methods

Evaluation of the elasticity of the scoliotic curve was done in 96 patients with idiopathic scoliosis with supine radiographs under manual traction and standing lateral bending radiographs.

Results

Measurements taken from lateral bending radiographs provided more reliable estimates of the postoperative correction compared to radiographs using manual wrist to ankle traction. Lateral bending was a more effective method to assess lumbar and thoracolumbar curves. The two tests were simiIar in ability to evaluate the elasticity of thoracic curves. A lack of patient cooperation in movement was attributed to inadequate assessment of curve elasticity seen in some of the lateral bending radiographs.

Conclusion

The lateral bending test usually is superior to manual traction method. Both methods for estimation of curve elasticity may be recommended because of the frequent, lack of patient cooperation in the lateral bending test. This compliance issue may result in an underestimation of the actual achieved correction.