Abstract and Introduction
Abstract
Study Design: A single-center prospective observational study.
Objective: To clarify the usefulness of a novel scoliosis screening method using a 3-dimensional (3D) human fitting application and a specific bodysuit.
Summary of Background Data: Several scoliosis screening methods, such as scoliometer and Moiré topography, are available for detecting scoliosis. In the present study, a novel screening method for scoliosis using a 3D human fitting application and a specific bodysuit was developed.
Patients and Methods: Patients with scoliosis or suspected scoliosis, patients with non-scoliosis, and healthy volunteers were enrolled. They were divided into "non-scoliosis" and "scoliosis" groups. The scoliosis group was further subdivided into "mild," "moderate," and "severe-scoliosis" groups. Patients' characteristics and Z values, which were calculated by a 3D virtual human body model created by a 3D human fitting application and a specific bodysuit to evaluate trunk asymmetry caused by scoliosis, were compared between the non-scoliosis and scoliosis groups or among the non, mild, moderate and severe-scoliosis groups. Finally, the optimal cutoff of the Z value was determined to detect moderate to severe scoliosis using receiver operating characteristic curve analysis.
Results: A total of 101 patients were included. The non-scoliosis group consisted of 47 patients, and the scoliosis group included 54 patients, with 11, 31, and 12 patients in the mild, moderate, and severe-scoliosis groups, respectively. The scoliosis group showed a significantly higher Z value than the non-scoliosis group. The moderate or severe-scoliosis group had a significantly higher Z value than the non or mild-scoliosis group. The receiver operating characteristic curve analysis revealed that the optimal cutoff of the Z value was 19.9 mm (sensitivity, 95.3% and specificity, 58.6%).
Conclusion: A novel scoliosis screening method consisting of a 3D human fitting application and a specific bodysuit may be useful for detecting moderate to severe scoliosis.
Introduction
Adolescent idiopathic scoliosis (AIS) presents in 1% to 4% of healthy adolescents.[1,2] The overall prevalence of AIS among school-age children (11–14 yr) in Japan has been reported to be 0.87%.[3]
Early detection of scoliosis during adolescence is crucial to initiate appropriate therapeutic intervention to halt the progression and avoid invasive surgical treatment. Several screening methods are available for detecting scoliosis. Adam's forward bending test is the simplest test and is widely used to evaluate spinal deformity.[4,5] However, the use of this test alone has been reported to be insufficient to detect scoliosis.[6] The scoliometer is an inclinometer for measuring axial trunk rotation during forward bending and is a useful and reliable device for detecting spinal deformity.[5,7] The scoliometer is also available as a smartphone application.[8,9] Moiré topography is a photographic method for detecting scoliosis deformity and is also used in school scoliosis screening.[10,11] Recently, 3-dimensional (3D) scanning using a structured optical scanner has been used to evaluate spinal deformity in patients with AIS.[12] Despite the usefulness of these scoliosis screening methods, these methods need trained examiners who can perform the screening tests and evaluate the results.[5,7,13,14] Therefore, developing a new tool for detecting scoliosis, which enables patients to screen themselves, would represent an advancement.
A 3D human fitting application, which is used with a highly stretchable bodysuit covered with random pattern fiducial markers, was developed by ZOZO, Inc., (Chiba, Japan) for this study. With a standard smartphone camera, subjects could produce a 3D virtual representation of their bodies in a few minutes. This study aimed to validate the usefulness of this novel screening method for scoliosis as a preliminary step toward the development of future self-screening applications for spinal deformity.
Spine. 2023;48(18):1289-1294. © 2023 Lippincott Williams & Wilkins
