Accuracy of photogrammetry for detecting adolescent idiopathic scoliosis progression

BACKGROUND: The gold standard method of monitoring the evolution of scoliosis has been serial standing, posteroanterior, full-length spine radiographs with curvature measurements using the Cobb method. However, over the course of follow-up, patients can receive high radiation doses. Various studies have shown that repeated exposure to radiation in children and adolescents can be harmful to their health. PURPOSE: To determine the accuracy of photogrammetry in evaluating the progression of adolescent idiopathic scoliosis in comparison with radiography. STUDY DESIGN: Diagnostic study. PATIENT SAMPLE: Ninety adolescents subjected to radiographic follow-up of idiopathic scoliosis. OUTCOME MEASURES: The angle of scoliotic curvature was measured using the Cobb radiographic method and photogrammetry. An increase of 5 degrees or more between two radiographic exams was considered a progression of the curvature and was defined as the standard for calculations of sensitivity, specificity, predictive value, and accuracy of the photogrammetric method for measuring scoliosis progression. METHODS: Patients were subjected to radiographic and photogrammetric exams concomitantly and were reevaluated after an average of 8.6 months. The exams were analyzed separately and independently by two examiners for progression of scoliosis. RESULTS: The measurements of the curves at the beginning of the study were 39.5 +/- 16.7 degrees and 39.5 +/- 14.3 degrees for radiographic and photogrammetric exams, respectively (p=1.0). At the end of the study, the measurements of the curves were 40.2 +/- 16.2 degrees and 41.3 +/- 15.1 degrees for the radiographic and photogrammetric exams, respectively (p=.310). The photogrammetric method had an accuracy of 89% (Confidence interval [CI] 95%=82.5-95.5) for the detection of scoliosis progression, with a sensitivity of 94.4% (CI 95%=89.6-99.2), a specificity of 86.7% (CI 95%=79.7-93.7), a positive predictive value of 75.5% (CI 95%=66.6-84.4), a negative predictive value of 97.2% (CI 95%=93.8-100), and a Kappa index of 0.75 (CI 95%=66.1-83.9). The interclass correlation coefficient between the two methods was 0.74 (CI 95%=0.65-0.81; p=0). CONCLUSIONS: The photogrammetric method showed good performance for detecting the progression of adolescent idiopathic scoliosis in comparison with the radiographic exam method. (C) 2018 Elsevier Inc. All rights reserved.