SCOLIOSIS X-RAY IMAGING

What is the 3D X-ray Digital System?

Our 3D EOS X-ray digital machine contains the newest technology in scoliosis X-ray imaging. As such, it emits ‘low dose’ radiation that takes only 15 seconds to capture a full-standing image. Also, this machine achieves 80-90% less radiation exposure than older technology according to the manufacturer. This significant reduction in exposure, often up to 10 times less than conventional X-ray systems, is a pivotal advancement in patient safety and diagnostic precision.

The EOS imaging system is renowned for its ability to deliver high-quality images with considerably lower radiation doses. This is especially critical for patients requiring frequent imaging, such as those with scoliosis. The Children’s Hospital of Wisconsin was an early adopter of the EOS’s efficacy and safety.  It notes the substantial benefits over traditional methods.

With the growing number of U.S. facilities adopting EOS technology, it is becoming a more accessible option.  Especially, for those concerned with radiation exposure from conventional X-rays. Typically found in leading hospitals, EOS offers a safer diagnostic alternative required for accurate assessments.

This integration of cutting-edge technology and enhanced safety measures makes our 3D EOS X-ray machine an exemplary choice.  It aids patients and healthcare providers aiming to reduce potential radiation risks while providing detailed and reliable imaging results.

Whole-body imaging:

Unlike conventional X-ray machines that focus on specific areas of the body, the 3D EOS system captures comprehensive, full-body images in both 2D and 3D. This allows healthcare providers to assess the entire spine and skeletal system in a single scan, providing a more complete understanding of the patient’s condition.

3D reconstruction and analysis:

The 3D EOS X-ray machine utilizes advanced software algorithms to reconstruct detailed three-dimensional models of the spine and surrounding structures. This allows for precise measurement and assessment of spinal curvature, alignment, and other parameters. The three-dimensional visualization provides enhanced diagnostic capabilities and aids in treatment planning.

Improved accuracy and precision:

The high-resolution images produced by the 3D EOS X-ray machine enable healthcare professionals to make more accurate measurements and assessments. This leads to improved surgical planning, better monitoring of treatment progress, and more precise evaluation of the outcomes.

Time-efficient and patient-friendly:

The 3D EOS X-ray machine offers rapid image acquisition, reducing the time required for patients to stay in the imaging room. Additionally, the open design of the machine provides a more comfortable and less restrictive experience for patients, particularly those with mobility challenges or claustrophobia.

Conclusion

Overall, the 3D EOS X-ray digital machine stands out for its advanced imaging capabilities, reduced radiation dose, comprehensive assessment of the spine and skeletal system, and enhanced precision in diagnosis and treatment planning. It represents a significant advancement in imaging technology for evaluating and managing various spinal conditions, including scoliosis.  For adults with scoliosis, it is generally recommended to have an X-ray every five years.  However, if symptoms begin to worsen, a more frequent X-ray is recommended to effectively monitor the condition.

Why is it Important to Get Low Dose Radiation?

When discussing the impact of X-ray exposure on the human body, two primary theoretical models provide contrasting perspectives: the Linear threshold model and the Hormetic model.

Linear Threshold Model

The Linear threshold model, which is now considered somewhat outdated, traditionally posited a direct, no-threshold relationship between radiation exposure and the potential harm to human health. This model suggested that any amount of radiation, no matter how small, could lead to negative health effects without a safe exposure level.

Hormetic Model

On the other hand, the more recent Hormetic model introduces a new viewpoint. It suggests that lower doses of radiation might trigger beneficial biological responses. According to this model, such doses stimulate the body’s repair mechanisms, effectively preventing the cumulative damage usually associated with radiation exposure. This model challenges older views by proposing that small amounts of radiation could cause less harm than previously thought, and might even provide advantages.

These two models fundamentally differ in their assumptions about how radiation affects the body and the potential threshold levels considered safe for human exposure. The transition from the Linear threshold model to the Hormetic model marks a significant shift in understanding the biological impacts of X-ray exposure.

Results of Low Radiation Study

The study on radiation exposure in adolescent idiopathic scoliosis patients highlights a crucial concern: operative patients experience significantly higher radiation levels compared to those managed with braces or observation alone. Specifically, these patients are exposed to 8 to 14 times more radiation. This disparity underscores the importance of conservative treatments.

An alarming 78% of the annual radiation exposure for operative patients occurs during surgery, mainly due to intraoperative fluoroscopy and CT scans. This finding emphasizes the potential health risks associated with high radiation doses. Ultimately, the study reinforces the benefits of non-surgical interventions for scoliosis. By focusing on conservative treatments, patients can effectively manage their condition while minimizing harmful radiation exposure.

Recognizing the Symptoms of Scoliosis

Scoliosis is a condition characterized by an abnormal curve in the spine. Identifying its symptoms early can be crucial for effective treatment. Here are common signs to watch for if you suspect someone might have scoliosis:

Physical Imbalances

• Head Misalignment: The head may not be centered directly above the pelvis.
• Body Lean: Noticeable leaning of the body to one side.
• Ribcage and Hip Asymmetry: One side of the ribcage or hips may appear more prominent.
• Shoulder Disparities: Uneven shoulders, where one shoulder appears higher than the other, and shoulder blades that protrude.

Postural Changes

• Visible Curve in the Spine: In more severe cases, a curvature in the spine appears.
• Abnormal Walking Pattern: An uneven gait due to the body’s imbalanced alignment.

Pain and Discomfort

• Back Pain: Frequent or chronic pain in the back, which can vary in intensity.
• Muscle Tension: Tightness or spasms in the muscles surrounding the spine.

When to Seek Medical Advice

If you observe any of these symptoms, it’s crucial to consult a healthcare professional for a thorough examination. Early detection can significantly improve the management and treatment of scoliosis, ensuring a better quality of life.

What To Do If You Suspect Scoliosis

If you think you or a loved one might have scoliosis, it’s crucial to take immediate steps to address the condition. Here’s what you should do:

• Schedule a Doctor’s Appointment: First and foremost, book an appointment with a healthcare provider. A primary care physician can conduct an initial evaluation and refer you to a specialist if needed.
• Consult a Specialist: An orthopedic specialist or a spine specialist is well-equipped to diagnose and treat scoliosis. They can offer advanced diagnostics such as X-rays or MRI scans to confirm the presence and severity of scoliosis.
• Monitor Symptoms: Keep a close eye on any symptoms. Common signs include uneven shoulders, a visibly curved spine, and back pain. Documenting these can help your doctor make a more accurate diagnosis.
• Follow Recommended Treatments: Once diagnosed, adhere strictly to your treatment plan. This could range from physical therapy and braces to, in severe cases, surgical interventions.
• Seek Second Opinions: Don’t hesitate to get a second opinion to explore all possible treatment options. Consulting multiple specialists can provide a broader perspective on managing the condition.
• Stay Informed: Educate yourself about scoliosis. Websites like this one the Scoliosis Research Society and the National Scoliosis Foundation offer valuable resources.

By following these steps, you’ll be taking a proactive approach to managing scoliosis effectively. Always prioritize professional medical advice to ensure the best outcomes.

Understanding Idiopathic Scoliosis in Adults Versus Children

Idiopathic scoliosis is a condition characterized by abnormal curvature of the spine, and it affects both children and adults. However, the manifestation and progression differ significantly between these age groups.

Key Differences

1. Origin:

• Children: Idiopathic scoliosis in children often emerges during growth spurts in adolescence. The cause is unknown, which is why it’s termed “idiopathic.”
• Adults: In adults, idiopathic scoliosis typically represents a continuation of scoliosis that was either undiagnosed, untreated or ineffectively treated during childhood. Over time, the curve can worsen due to factors like aging, osteoporosis, or degenerative changes.

2. Symptoms:

• Children: Symptoms in children may not be immediately obvious. Often, signs like uneven shoulders or hips prompt further examination.
• Adults: Adults may experience more pronounced symptoms, including back pain, stiffness, posture changes, and visible spinal curvature. Pain is more common due to the added stress on the spine and surrounding muscles over years of compensation.

3. Progression:

• Children: The curvature often progresses rapidly during periods of growth. If detected early, bracing and other interventions can effectively halt or reduce further curvature.
• Adults: Progression in adults tends to be more gradual but can accelerate due to degenerative spinal disorders. Management focuses on alleviating pain and preventing further deterioration.

4. Treatment Approaches:

• Children: Treatments for children typically include observation, bracing, and, in severe cases, surgery. Early intervention can significantly alter the course of the condition.
• Adults: Adults are often treated with a combination of physical therapy, pain management, medications, and occasionally surgery. The goals are to manage symptoms and improve quality of life rather than curative measures.

Summary

While idiopathic scoliosis in both adults and children involves spinal curvature of unknown origin, adults often face more complex and symptomatic conditions due to the condition persisting and evolving over time. Recognizing these differences is crucial for effective management of scoliosis at various life stages.

How Many People in the US Are Affected by Scoliosis?

Scoliosis, a condition characterized by an abnormal curvature of the spine, impacts a substantial segment of the US population. Estimates suggest that between 6 million and 9 million Americans live with scoliosis. This condition is typically identified during childhood, although its severity varies widely among individuals.

While some individuals with mild scoliosis may not experience noticeable symptoms, others might suffer from back pain, spinal weakness, and even difficulties with breathing or maintaining a sitting posture for extended periods. Additionally, it’s worth noting that females are significantly more likely than males—by a factor of eight—to develop severe curvature that necessitates medical intervention.

Why is Scoliosis X-ray Imaging Conducted?

An X-ray will display your bones and how they relate to each other. In addition, an X-ray helps your doctor determine if a patient has a fracture of the spine, an infection, or a tumor. For over 100 years, doctors have continued to use X-rays to check bone alignments and to see whether certain shadows appear out of alignment. With this tool, doctors can get clues about the health of the spine. If your doctor thinks your problem emanates from degeneration of the spine, X-rays can determine if the space between your vertebrae has decreased, if bone spurs exist, or if hypertrophy (enlargement) of the facet joints.

To specifically diagnose idiopathic scoliosis, doctors look for predictable patterns such as right thoracic (middle back) scoliosis or left thoracolumbar (mid and low-back) scoliosis. In addition to X-rays, magnetic resonance images (MRIs) are often used. MRIs can show no evidence of significant abnormalities other than scoliosis itself. This imaging technique offers a comprehensive view, ensuring that no other underlying conditions are present.

“If no other related condition is present to suggest other scoliosis causes—such as neuromuscular or congenital—the doctor will diagnosis idiopathic scoliosis,” says Dr. Hostin. This exclusion is crucial because it helps to pinpoint idiopathic scoliosis accurately, distinguishing it from other types of scoliosis that may require different treatment approaches.

Diagnosis Verification

By combining X-ray and MRI results, doctors can assess both the alignment of the bones and any changes in the soft tissues. This thorough evaluation process ensures that idiopathic scoliosis is diagnosed accurately, allowing for a tailored treatment plan.

Specifically, in the context of scoliosis, X-rays serve an indispensable role. They enable physicians to measure Cobb angles, identify spinal and rib deformations, and closely monitor changes in curvature. This is crucial during adolescence, a phase when scoliosis can rapidly progress during growth spurts. Despite concerns about radiation exposure, it’s important to note that, according to the Health Physics Society, there is no conclusive evidence of radiation causing harm at the levels patients receive from diagnostic X-ray exams. Furthermore, a study specific to scoliosis radiology states, “Patients undergoing scoliosis radiography receive effective doses that are low in comparison with other types of radiographic examination.”

Understanding these details underscores the necessity of X-rays not just for general spinal health, but crucially in managing and monitoring scoliosis.

Conducting a Scoliosis X-ray

Having an X-ray taken is much like having your photograph taken. For instance, it is a quick and painless procedure. You will lie very still on a table or stand very still and hold certain positions while pictures are taken of your spine. Sometimes X-ray technicians will ask that you stand or sit in different positions. For example, the technician can take the X-ray while you bend forward (flexion), and another while you straighten your spine (extension). For example, doctors refer to this as a “flexion-extension” view of the spine. Moreover, these X-rays are compared to see if there is extra movement between the vertebrae, a condition called segmental instability.

For Patients in Pain

Our X-ray system will take the X-ray really fast, within 15 seconds. Also, the system can take 3D weight-bearing images that provide your physician with views of your spine or limb anatomy that are not available with 2D X-rays but become critical for diagnosing and treating complex orthopedic and spine conditions.

What are the Limitations of Scoliosis X-ray Imaging?

X-rays do not show the soft tissues-nerves, discs, and ligaments. Today, many tests can show the soft tissues much clearer, so doctors do not always have to rely on X-rays. However, X-rays provide a good starting point in evaluating the spine.

What X-ray Techniques Can Further Diagnose Patient Conditions?

Beyond the commonly used lateral bending scoliosis X-rays, healthcare professionals can further assess a patient’s spinal condition using additional X-ray techniques. One valuable method includes sagittal X-rays, which provide a side view of the spine. These images are particularly useful for examining the sagittal profile of the spine, offering detailed insight into its alignment and curvature.

To evaluate the flexibility of the spine, the technician will take sagittal images while the patient bends to the left and then to the right. This approach helps determine the range of motion and flexibility within the spine, crucial for devising appropriate treatment plans. Such comprehensive imaging techniques ensure a more accurate assessment of the spinal condition, aiding in more targeted and effective interventions. Two types of X-ray views are commonly necessary for monitoring scoliosis. First, a full spine view is captured, which can display either an anterior-to-posterior (AP) or a posterior-to-anterior (PA) view. This provides a comprehensive look at the spine from the front or back. The second required view is the sagittal view, which offers a detailed side perspective of the spine. These two x-ray angles together help healthcare professionals accurately assess the curvature and progression of scoliosis.

Getting Up-to-date X-rays for Adolescents

Up-to-date X-rays are crucial for effective scoliosis treatment in both adolescents and adults, though the reasons vary between the two groups. For adolescents, whose bodies are still growing, timely X-rays allow physicians to monitor the progression of spinal curvature accurately. Without current X-rays, there’s a risk of basing treatment on outdated information, which can lead to ineffective management or even worsening of the condition. Identifying specific curve patterns through recent X-rays is essential for making informed decisions, particularly when utilizing specialized treatment methods like the Schroth Method and Chêneau bracing.

Adolescents diagnosed with scoliosis often require frequent x-ray monitoring, especially during growth spurts. These periods of rapid growth can lead to quick changes or progression in the curvature of the spine. It’s crucial to obtain timely x-rays to ensure that any changes are accurately tracked and addressed promptly. While it’s important to minimize unnecessary radiation exposure, relying on outdated X-rays can result in inadequate treatment, which is not advisable for a growing adolescent.

Adult X-ray Frequency

In adults, the frequency of scoliosis monitoring via X-rays can extend to longer intervals because their spines are not changing as rapidly. However, when beginning a new treatment program, recent X-rays are still important. Today, a three or four-year-old image will not help a doctor — especially if the patient is experiencing pain. Updated imaging helps in assessing the current state of the spine accurately, which is necessary for tailoring an effective treatment strategy that addresses present issues rather than past conditions.

What are the Risks?

Our X-ray machine provides reduced radiation exposure to our patients. For example, the EOS X-ray system delivers 50% to 85% less radiation than traditional digital X-ray systems and 95% less dose than computed tomography (CT) scans. For patients who need to undergo frequent X-rays to monitor the progress of their condition, the system of choice is the EOS system of choice, delivering fast, safe, and high-quality images.

The vast majority of patients who get X-rays will never get enough radiation to worry about cancer. In addition, only patients who get hundreds of X-rays over many years need to worry about this risk. Furthermore, doctors will protect children and young adults from radiation exposure to the testicles and ovaries while undergoing treatment for scoliosis or a spinal condition. This is because the radiation may damage sperm and eggs. During X-rays, it is simple to protect these areas by shielding them with a lead apron or lead blanket.

In this day and age, with advancements in medical technology, opting for facilities like the Southwest Scoliosis and Spine Institute that use modern digital X-ray equipment can benefit the patient. These newer technologies are designed to minimize radiation exposure, making them a preferable option for anyone needing frequent X-rays. Always inquire about the technology used at your imaging center and choose the one that ensures maximum safety with minimal radiation exposure.

To further ensure the technician’s safety, it’s advisable to stand at least six feet away from the x-ray unit whenever possible. This reduces the radiation the technician is exposed to.

How Does the Scoliosis 3DC® Program Aim to Reduce X-ray Exposure While Managing Scoliosis?

At Scoliosis 3DC®, minimizing X-ray exposure is a critical part of our comprehensive scoliosis management strategy. We prioritize patient safety while ensuring accurate assessments and ongoing monitoring.

Baseline and Follow-Up X-Rays

To begin, we acquire precise baseline Cobb angle measurements via a scoliosis series x-ray of the full spine. This includes:

• An anterior-to-posterior (AP) or posterior-to-anterior (PA) view of the entire spine.
• A sagittal (side) view of the spine.

For subsequent check-ups, typically only a single AP or PA view is needed, reducing the overall number of X-rays required during treatment.

Tailored Frequency of X-Rays

The frequency of follow-up X-rays is customized based on each patient’s specific needs, including the severity of the curve and bone maturity, as indicated by the Risser sign. This personalized approach helps limit unnecessary radiation exposure.

Safety Precautions

When X-rays are necessary, we implement several safety measures to further reduce radiation exposure:

• Patients stand at least six feet away from the X-ray unit.
• Lead aprons are used to shield sensitive areas such as the breasts and pelvic region from radiation.

Use of Advanced Technology

We advocate for the use of modern digital x-ray equipment, which emits significantly less radiation than traditional radiography methods. This advanced technology is generally available at our facilities, providing an additional layer of safety for our patients.

Patient Advocacy

Informed patients are empowered patients. We educate everyone in our program to advocate for themselves regarding radiation safety during X-rays. This includes understanding the necessity of shielding and the benefits of digital x-ray technology.

By incorporating these measures, Scoliosis 3DC® ensures high-quality care while prioritizing the reduction of X-ray exposure, thus promoting better long-term health for our patients.