Traction versus supine side bending. Which technique best determines curve flexibility?

Area of Science:

• Orthopedics
• Radiology
• Spine Surgery

Background:

• Scoliosis management requires accurate assessment of spinal curve flexibility.
• Preoperative radiographic evaluation is crucial for surgical planning in scoliosis.

Purpose of the Study:

• To compare the effectiveness of traction radiographs versus supine side-bending radiographs in determining spinal curve flexibility.
• To identify which radiographic method provides a more accurate measure of flexibility for different degrees of scoliosis.

Main Methods:

• A prospective study involving 58 patients undergoing surgical management for scoliosis.
• Preoperative evaluation included both traction and supine side-bending radiographs using the Cobb method.
• Curves were analyzed in three groups: >60°, 50-60°, and <50° to compare flexibility measurements.

Main Results:

• For curves greater than 60 degrees, traction films demonstrated greater flexibility.
• For curves less than 50 degrees, side-bending films showed greater flexibility.
• In curves between 50-60 degrees, side-bending was more flexible in the thoracic spine, while both methods were equivalent in the lumbar spine.

Conclusions:

• Traction radiography is superior for assessing flexibility in larger scoliosis curves (>50 degrees).
• Side-bending radiography is more effective for evaluating flexibility in smaller scoliosis curves (<50 degrees).
• Radiographic method choice for flexibility assessment may depend on curve magnitude and spinal region.