• Tristan Langlais, Claudio Vergari, Gregoire Rougereau, Mathilde Gaume, Laurent Gajny, Kariman Abelin-Genevois, Jean Claude Bernard, Zongshan Hu, ChengJack Chun YiuJCYSH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China., ChuWinnie Chiu WingWCWDepartment of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China., Ayman Assi, Mohamad Karam, Ismat Ghanem, Tito Bassani, Fabio Galbusera, Luca Maria Sconfienza, Marco Brayda-Bruno, Isabelle Courtois, Eric Ebermeyer, Raphael Vialle, Jean Dubousset, and Wafa Skalli.
• Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France. tristanlanglais@yahoo.fr.
• Eur Spine J. 2024 Apr 1; 33 (4): 166516741665-1674.

IntroductionOur objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage.Materials And MethodsAll patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th-95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value.ResultsEighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and -2.5°, whereas in AIS values were 0.3° and -0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%.ConclusionAnalysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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