Ortelius 800: Radiation Free Scoliosis Assessment
I recently came across an article in the Spine Journal which might be of interest to those who are concerned with the effects of frequent x-rays.
Volume 3, Issue 5 (Supplement), Pages 156-157 (September 2003)
A non-invasive approach for scoliosis assessment
Jean Dubousset , Dror Ovadia , Joseph Leitner , Bruno Fragniere ,
Manuel Rigo and Dalia Dickman
HYPOTHESIS: To investigate the correlation of spinal deformity
measurements with Ortelius 800 radiation-free system as compared to the standard radiographic measured Cobb angles. To assess Ortelius 800 clinical value while enabling a significant reduction of X-ray exposure.
METHODS: One hundred and two patients diagnosed with AIS from three different medical centers were measured with the Ortelius 800 system by the same standard protocol. The entire process required an average of 2 minutes. The Ortelius 800 measurements were correlated with the standard Cobb angle as measured on routine standing coronal and sagittal radiographs.
RESULTS: Two hundred and five coronal Cobb angles were measured for scoliosis with a mean of 18 degrees for thoracic curves and 17.7 degrees for lumbar curves and a median of 17.0 degrees for thoracic curves and 17 degrees for lumbar curves. Thirty-eight sagittal Cobb angles were measured with a mean of 36 degrees a median of 34.0 degrees. No statistical difference was found when comparing median (Fig. 1) of Cobb angles measured by Ortelius800. The Pearson's correlation coefficient was 0.85 in both the coronal plane and the sagittal plane (P value of<0.0001) (Fig. 2). The mean difference between Ortelius800 and radiograph measurements was 0.29 ([95%
confidence interval (−0.51; 1.09]). The Wilcoxon signed-ranks test for matched pairs shows no statistically significant difference betweeen the two measuring methods (P value=0.651)
DISCUSSION: The golden standard for scoliosis assessment is the
radiograph with Cobb angle measurement. The Ortelius800 provides a radiation-free method for scoliosis assessment in three planes (coronal, sagittal, apical) with simultaneous automatic calculation of the Cobb angle in both coronal and sagittal views.
CONCLUSIONS: The results reveal good correlation between the two measuring methods in both coronal and sagittal views. Comparison of results from the three independent sites and six independent examiners shows no significant difference. We propose the Ortelius 800 as a clinical tool for the routine follow-up measurements of AIS patients, thus enabling a significant reduction of radiation exposure.
I just found out about this myself (and also something called the Quantec System) but the Ortelius is not yet widely used and I haven't been able to find anyone who used the Quantec. The closest place to me that is using Ortelius 800 is the Shriners Hospital for Children in Philadelphia.
I mentioned the Ortelius 800 to our pediatric ortho, and he said that systems such as this one have been around for the past 20 years or so. He went on to say that the reason x-rays are still in use is because these other systems are not as accurate - they could be off by 5 degrees I thought to myself, so what if the measurement is off by 5 degrees !!! Measurements could be off by 5 degrees anyway ( with x-rays ) depending on who does the calculations. Apparently this one system he was talking about cost $150,000. I don't know if this would be considered a very large expenditure in the grand scheme of things - when you consider the cost to society at large of dealing with cancer.
The majority of scoliosis patients are young children and the effects of frequent exposure to x-rays will only be evident 30 or 40 years from now ( maybe sooner ). Thirty or forty years from now most of these doctors will either be retired or have passed away - they won't see the damage. Ionized radiation causes cellular mutations - who knows where that can lead. Speaking from personal experience, my daughter who just turned four, has had roughly 40 full spine x-rays in her young life. There MUST be a better way - I should rephrase that, there IS a better way but nobody cares.
Last edited by Celia; 01-13-2005 at 09:43 AM.
Here's another study supporting the Ortelius 800 Radiation Free Scoliosis Assessment:
An Innovative Diagnostic Procedure of Vertebral Deformities without Exposure to X-Rays.
Parisini P, Lolli F, Greggi T, Di Silvestre M, Cioni A, Giacomini S, Bakaloudis G.
Spine Surgery Department, Istituto Ortopedico Rizzoli, Bologna, Italy.
The objective of the study was to compare standard manual X-ray measurements of vertebral deformities and values obtained from the Ortelius 800. 52 patients (41 females and 11 males: mean age 20.35 years) with adolescent vertebral deformities, was studied. The patients were evaluated with standard radiographic views and the Ortelius 800. The parameters considered for the comparison were the angles of scoliosis and kyphosis and the values of global axial deformity, shoulder asymmetry and pelvic tilt. We also evaluated the modification of pelvic/shoulder angle after surgery (this parameter allows to evaluate vertebral rotation and can be derived only from the Ortelius 800). This study allowed us to conclude that there is a perfect agreement between measurements with the Ortelius 800 and those resulting from standard x-rays. The system has also proved to have the capability of quantifying changes in vertebral rotation.
PMID: 17108481 [PubMed - as supplied by publisher]
is it okay if I put up an animated avatar on my profile?
That would be cool! Sorry I don't know
Scoliosis MRI screening
I heard some people are getting Stand Up Mri Scoliosis screening scans I don't know the cost factor but no radiation at all which makes parents of children with scoliosis happy
I'm all for scientific progress and certainly a lot of good things have come about within the last century and I believe the doctors who started using MRI's in the application of medical imaging won a nobel prize a few years ago.....anyhoo take a look at this I don't want to sound like an alarmist but some things which we currently don't fully understand *might* prove to be harmful later on. It's important to always weigh the costs and benefits of these tests given that only 20 % of children are found to have something wrong:
Reviewed by Dr Sarah Burnett, consultant radiologist and Dr John Pillinger, GP
What is an MRI scan?
MRI (magnetic resonance imaging) is a fairly new technique that has been used since the beginning of the 1980s.
The MRI scan uses magnetic and radio waves, meaning that there is no exposure to X-rays or any other damaging forms of radiation.
How does an MRI scanner work?
The patient lies inside a large, cylinder-shaped magnet. Radio waves 10,000 to 30,000 times stronger than the magnetic field of the earth are then sent through the body. This affects the body's atoms, forcing the nuclei into a different position. As they move back into place they send out radio waves of their own. The scanner picks up these signals and a computer turns them into a picture. These pictures are based on the location and strength of the incoming signals.
Our body consists mainly of water, and water contains hydrogen atoms. For this reason, the nucleus of the hydrogen atom is often used to create an MRI scan in the manner described above.
What does an MRI scan show?
Using an MRI scanner, it is possible to make pictures of almost all the tissue in the body. The tissue that has the least hydrogen atoms (such as bones) turns out dark, while the tissue that has many hydrogen atoms (such as fatty tissue) looks much brighter. By changing the timing of the radiowave pulses it is possible to gain information about the different types of tissues that are present.
An MRI scan is also able to provide clear pictures of parts of the body that are surrounded by bone tissue, so the technique is useful when examining the brain and spinal cord.
Because the MRI scan gives very detailed pictures it is the best technique when it comes to finding tumours (benign or malignant abnormal growths) in the brain. If a tumour is present the scan can also be used to find out if it has spread into nearby brain tissue.
The technique also allows us to focus on other details in the brain. For example, it makes it possible to see the strands of abnormal tissue that occur if someone has multiple sclerosis and it is possible to see changes occurring when there is bleeding in the brain, or find out if the brain tissue has suffered lack of oxygen after a stroke.
The MRI scan is also able to show both the heart and the large blood vessels in the surrounding tissue. This makes it possible to detect heart defects that have been building up since birth, as well as changes in the thickness of the muscles around the heart following a heart attack. The method can also be used to examine the joints, spine and sometimes the soft parts of your body such as the liver, kidneys and spleen.
How does an MRI scan differ from a CT scan?
With an MRI scan it is possible to take pictures from almost every angle, whereas a CT scan only shows pictures horizontally. There is no ionizing radiation (X-rays) involved in producing an MRI scan. MRI scans are generally more detailed, too. The difference between normal and abnormal tissue is often clearer on the MRI scan than on the CT scan.
How is an MRI scan performed?
The scan is usually done as an outpatient procedure, which means that the patient can go home after the test. During the scan it is important to lie completely still. For this reason it might be necessary to give a child an anaesthetic before they are tested.
Since you are exposed to a powerful magnetic field during the MRI scan, it is important not to wear jewellery or any other metal objects.
It is also important for the patient to inform medical staff if they use electrical appliances, such as a hearing aid or pacemaker, or have any metal in their body such as surgical clips, but orthopaedic metalware such as artificial hips or bone screws is not normally a problem.
Is an MRI scan dangerous?
There are no known dangers or side effects connected to an MRI scan. The test is not painful; you cannot feel it. Since radiation is not used, the procedure can be repeated without problems. There is a small theoretical risk to the foetus in the first 12 weeks of pregnancy, and therefore scans are not performed on pregnant women during this time.
Because patients have to lie inside a large cylinder while the scans are being made some people get claustrophobic during the test. Patients who are afraid this might happen should talk to the doctor beforehand, who may give them some medication to help them relax.
The machine also makes a banging noise while it is working, which might be unpleasant.
Based on a text by Dr Carl J Brandt, GP
Last updated 04.10.2005
Last edited by Celia; 05-25-2007 at 08:38 AM.
Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008