Idiopathic scoliosis is the most common deformation of the spine during child growth and may go unnoticed during its development for several years. Unpredictably can worsen requiring, in some cases, surgical intervention. Monitoring of the progression of the disease is done by periodically X-ray examination until skeletal maturity is reached.The cumulative X-ray dose to a given patient is dependent on the average number of x ray exposure, after diagnosis spinal radiographs usually taken are 12 for females, 10 for males. Back surface shape gives first early indication of scoliosis by asymmetry and deformities of the external surface of the trunk especially by parents usually complaining that something is not symmetric to back surface of the child.
Technique.
Patients were asked to stand naturally facing backwards with their back exposed from the neck to the pants. The clinical doctor captures with Apple’s lidars sensor on iPhone or iPad the whole surface of the patient’s back in standing position or in bending position. Capturing 3D back surface is done with third party app ( 3D scan app or Heges app or ScandyPro or any app -this is user’s preference-) downloaded from App Store that exploits Apples LiDAR sensor and is capable of exporting STL files. A final STL file is imported to scoliosis app and four kinds of asymmetry Indexes (AI) are being calculated and expressed in percentage. The weighted Average Asymmetry Index or global Asymmetry Index (AI) is the result of combination of three measured Indexes. In case the shape of the back surface is perfectly symmetric with respect to the median sagittal plane, then AI index is zero %, more surface deformity due to scoliosis at patient back’s shape means more deviation from perfect symmetry and greater value of AI.
The app might also help to
-establish diagnosis objectively by back surface topography by calculating only asymmetry index.
-indicate easily by a pathologic value of Asymmetry Index which patient should be referred thus reducing the missed cases.
-quantify the spine deformity objectively for evaluation cosmetic results.
-quick monitor objectively the progression and the severity of scoliosis avoiding unnecessary X-ray exposure especially at younger age, helping treatment decision.
-avoid buying cumbersome extra devices, only Apple’s devices with lidars sensor is needed.
-establish a massive reliable screening test of Scoliosis to paediatric population.
Disclaimer.
Regarding its plausibility no diagnosis is given. App might provide an early indication that further evaluation may be warranted by Speciality Doctor. Algorithm in App detects in surface Irregularity between left and right site of the back. Explicitly is announced that the app is for scientific reasons available and not for diagnosis or treatment. Clinical judgment and experience are required to properly use the software. App alone do not replace an M.D. All information received from the App output must be reviewed before any treatment. Medical experience are required to properly use the App. The software is not for primary image interpretation. Any influence to the operators in making decisions remains Surgeons own responsibility and experience. App does not dispense medical advice. Patient should seek a doctor’s advice in addition to using this app and or before making any medical decisions for themself. App does not claim that measures scoliosis it measure back asymmetry and gives a value that might be helpful. Although prediction might be made still is investigational and not proven by scientific papers, these are pending. Never substitute or replace doctors advice or change treatment modalities based on any measured Asymmetry Index. App indicated for assisting healthcare professionals for scientific reasons. Clinical judgment and experience are required to properly use app and further research is pending.
Please see relevant video tutorials https://www.orthopractis.com/scoliosis-app.