Wednesday, September 26, 2018 2:00 PM – 3:00 PM Integrating Technology into Practice: 61. Clinical photographs in the assessment of adult spinal deformity: a comparison to radiographic parameters

BACKGROUND CONTEXT Adult spinal deformity (ASD) patients are exposed to a substantial radiation burden. Full spine imaging is not available in every clinic. A photographic method of deformity assessment would allow for less frequent radiographic assessment. PURPOSE To investigate whether people with large PI have increased correction following pedicle subtraction osteotomy. STUDY DESIGN/SETTING Prospective of photographic and X-ray analysis of ASD patients. PATIENT SAMPLE A total of 38 patients. OUTCOME MEASURES Pre- and postoperative alignment with global spinal parameters, photographic clinical TPA measurements. METHODS Standing full spine X-ray studies were obtained, and clinical photographs were taken with reflective markers placed overlying C2, T1, and S1, as well as the greater trochanter (GT, sagittal only) and each PSIS (coronal only). Linear regressions were performed between X-ray parameters and their photographic “equivalents.” In the sagittal plane, these included T1 pelvic angle (TPA: T1 body to femoral heads to S1) vs. TPA clinical (TPAc: T1 to GT to S1), and cervical pelvic angle (CPA: C2 body to femoral heads to S1) vs. CPA clinical (CPAc: C2 to GT to S1). In the coronal plane, regressions included pelvic obliquity (PO: iliac crest line and horizontal) vs. PO clinical (POc: PSIS line and horizontal) and T1 tilt (T1–S1 line and vertical) versus T1 tilt clinical (T1–S1 and vertical). The same regressions were repeated after stratifying into low ( 30) BMI groups. RESULTS Thirty-eight patients were enrolled. Sagittal deformity parameters were highly correlated (means: TPA 24.9°, TPAc 37.0°, r=.77; CPA 28.3°, CPAc 40.2°, r=.77; both p CONCLUSIONS Spinal deformity patients are exposed to a substantial radiation burden. A reliable method of deformity assessment based on clinical photographs would allow for less frequent radiographic assessment. Photographic measurements of spinal deformity were developed and compared to analogous radiographic parameters. They were found to be highly correlated in both the sagittal and coronal planes. Correlations were generally higher in patients with low BMI. Such measurements in clinical photographs could replace X-ray imaging in certain scenarios or they can be a substitute where full spine radiographs are unavailable. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.