• Joan Ferràs-Tarragó, J M Morales Valencia, P Rubio Belmar, S Pérez Vergara, P Jordà Gómez, J L Bas Hermida, P Bas Hermida, and T Bas Hermida.
• La Fe Hospital, Valencia, Spain. cotferras@gmail.com.
• Eur Spine J. 2019 Sep 1; 28 (9): 1955-1961.

Background ContextSerial X-rays are needed during the follow-up of adolescent idiopathic scoliosis. They are done every 6 or 3 months in cases of high risk of progression. Thanks to the advances in ultrasound techniques, deformity measurement systems free from ionizing radiations have been validated, although spinal surgeons did not use them routinely due to the need of special software.ObjectiveThe aim of our work is to assess the reproducibility and correlation of an ultrasound measuring system based on the positioning of the transverse processes.Study DesignProspective, single center, randomized, triple blinded.MethodsTwo independent researchers trained in ultrasound examined the spinal deformities of 31 children. The measurements were compared against those performed with an X-ray by three scoliosis expert surgeons. Statistics were performed by an independent researcher. Parametric methods were used.ResultsWe found a 95% [(0.91-0.97) p < 2.2e-16] correlation between the degree of scoliosis measured with the proposed ultrasound system and the 30 cm × 90 cm X-rays in standing position. There was an intra-observer reliability of 97% [r-squared = 0.97; CI 95% (0.95-0.98) p < 2.2e-16] and an inter-observer reliability of 95% [r-squared = 0.95; CI 95% (0.90-0.97) p < 2.2e-16].ConclusionsAn approximation of the Cobb angle measure is possible with ultrasound by using the transverse processes as reference. This is a very rapid and simple system for assessing the principal spinal deformity measure in young people, although it does not allow estimating the associated axial or sagittal rotation. These slides can be retrieved under Electronic Supplementary Material.

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