At the annual conference of the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) in 2012 a consensus paper was presented that outlined the need for reducing X-ray exposure in the management of scoliosis, especially in the pediatric population.
Systematic full spine X-rays have traditionally been the “gold standard” for monitoring scoliosis for progression or improvement with treatment. It is still considered the most reliable method of analyzing the curvature and therefore cannot be completely eliminated in the care of scoliosis. Even though the exposure with modern x-ray equipment has significantly reduced radiation exposure, because a patient with scoliosis can be monitored over the course of a couple of years their position was that because of the potential health risks any unnecessary exposure should be eliminated, if possible.
Alternative Methods of Monitoring Scoliosis
Recommendations were made for both modifying how X-rays are taken as well as using other non-radiation methods for monitoring scoliosis over the course of care.
- Scoliometer – A simple handheld device that a doctor can use to measures the rotational component of a scoliosis. This instrument is good for screening for scoliosis and monitoring the progress of treatment. It can be used by both doctors and parents to monitor scoliosis.
There is now an iPhone app that can be used at home by parents to monitor a child’s scoliosis*
- Taking x-rays from the back instead of the front of the body – This significantly reduces the exposure of tissues that are more sensitive to radiation exposure such as breast and thyroid tissues without sacrificing the accuracy of the x-ray. The body blocks the majority of the radiation before it reaches these tissues significantly reducing the potential for adverse effects.
- Surface Topography – We use the Formetric System in our Offices to monitor our patients improvement on follow up. This advanced technology projects light beams across the back and has a camera at a 45 degree angle to capture a digital image of the lines on the back allowing for triangulation of the points to create a topographical image of the back that can be used to monitor the spine.
- MRI – When a scoliosis presents outside what is usual for an idiopathic scoliosis and it appears that a pathology may be contributing to a scoliosis a full spine weight bearing MRI of the spine may be recommended to rule out such things as a Chiari malformation, tonsillar ectopia, syringomyelia, a feathered spinal cord or other abnormalities that may be driving the scoliosis.
Click Here to view the Full Consensus Report
In all of our clinics we utilizing these alternative methods of monitoring your scoliosis on most of your follow up visits. As long as we see either stabilization or improvement in your scoliosis we won’t have to take an x-ray of your spine. By using these alternatives we can reduce your total x-ray exposure over the course of your care by 50% on average.
* The iPhone App is called Scoligauge and it used to be found in the iTunes app library, but now it says that it’s not available in the US. My guess is that it has been swept up in the FDA crack down on medical apps. In turn, Apple appears to be limiting sales of many medical apps in the US. In my opinion, that’s rather silly as this simple is devices is essentially just a level for the spine.
However, another Scoliometer device for the iPhone does seem to be available on the App Store in iTunes. It’s called Scoliometer by Dr. Kevin Lau from Health In Your Hands based in Singapore.
Click Here to learn how to accurately use a scoliometer to monitor your child’s scoliosis in our Free Book called Parent’s Guide to Scoliosis.