Edmonton Scoliosis Interdisciplinary Research Group

Projects

HEALTHY VOLUNTEERS REQUIRED FOR RESEARCH
Many of our projects involve comparing patients with Scoliosis to teenagers without Scoliosis.
We invite those interested to contribute to such projects to complete an enrollment form for Healthy Infants and Children Clinical Research Program (HICCUP)

Current Projects

A Study of the Reliability, Validity and Ability to Detect Changes of Quality of Life Questionnaires in Adolescents with Idiopathic Scoliosis and Adult Scoliosis
Principal Investigator: Eric Parent
The team has translated the Italian Spine Youth Quality of Life questionnaire to English. This questionnaire was developed based on the patients and parents preoccupations and scaled used modern methods. It is compared to questionnaires currently in use at our clinic, the Scoliosis Research Society 22r and the Spinal Appearance questionnaire, as well as to recently proposed new questionnaires (Body Image Disturbance questionnaire and Trunkal Anterior Asymmetry Scoliosis Questionnaire.)
Immediate Effects of Scoliosis Specific Exercises in Adolescents with Idiopathic Scoliosis Determined Using 3D Ultrasound Imaging
Principal Investigator: Eric Parent
Using 3D Ultrasound imaging, the spinal alignment (Curve angle, vertebra rotation and lateral vertebra displacements) is determined while performing 16 different exercises positions. This study aims to provide evidence for skeptics that patients can achieve important improvements in spinal alignments using the complex correction instructions provided by exercise therapists. This evidence may help develop improved teaching strategies.
Using Ultrasound and Health' Records to Non-Invasively Identify Cases with Curve Progression or not in Children with AIS
Principal Investigator: Edmond Lou
This study will develop and validate a model that uses ultrasound imaging and the frequency amplitude index (FAI) methods plus the patients' information, rather than radiographs, to detect cases with curve progression or not at a 6-month follow-up visit in children who have adolescent idiopathic scoliosis (AIS). The goal is to reduce the radiation exposure to children with AIS who have curves which do not progress.
A New Spinal Brace Design Concept for the Treatment of Adolescent Idiopathic Scoliosis (AIS)
Principal Investigator: Edmond Lou
The objectives of this study are to 1) develop a low cost real-time 3D ultrasound-camera system that is capable of imaging the spine and capturing the body's shape while the spine's alignment is manipulated by changing the brace pad locations and pressure levels during brace casting, 2) based on the optimal spinal alignment, fabricate an orthosis using the CAD/CAM method, 3) investigate the clinical and economic benefits, costs and effectiveness of the proposed ultrasound-camera assisted method versus the traditional orthosis manufacturing method and 4) investigate the effectiveness of 3D printed brace.
The Correlation of Brace Compliance and the In-Brace Correction to the Treatment Outcomes of Scoliosis Patients
Principal Investigator: Edmond Lou
Thirty new Adolescent Idiopathic Scoliosis (AIS) brace candidates will be recruited from the scoliosis clinics in both Edmonton and Ottawa. The objective of this study is to investigate the outcomes of the brace treatment for AIS and their relationship to brace compliance and the in-brace correction.
Using the EOS System to Validate 3D Ultrasound Measurements in Children with Adolescent Idiopathic Scoliosis (AIS)
Principal Investigator: Edmond Lou
The 3D ultrasound measurements such as the Cobb angle in the plane of maximum curvature, the vertebral rotation at the apex and the angle of the plane of maximum curvature have not been validated by in-vivo data. The goals of this study are 1) to validate the 3D reconstructed in-vivo ultrasound images and 2) to determine the reliability and accuracy of the 3D ultrasound measurements and compare them to the 3D information obtained from the EOS system, which is a new low dosage bi-planar x-ray system.
Using Ultrasound Images to Guide the Insertion of Pedicle Screws During Scoliosis Surgery
Principal Investigator: Edmond Lou
Spinal surgery is a complicated process which involves the insertion of pedicle screws into selected vertebrae. A misaligned pedicle screw can potentially cause permanent neurological spinal cord injury or even a life-threatening vascular injury. This project is to develop a non-ionizing radiation method to assist the positioning and aligning of pedicle screws during surgery.
Using AI to Automatically measure 3D Spinal Curvature on Ultrasound Images
Principal Investigator: Edmond Lou
Reconstruct 3D spinal images using EOS software on stereo-radiographs is time consuming. Using ultrasound to capture the 3D spinal curvature information is possible. However, it requires a significant amount of training to measure 3D parameters from ultrasound spinal images. This project is to apply artificial intelligence to fully automatically extract the 3D spinal curvature measurements from ultrasound images in real-time.

Using AI to predict the risk of progression for children who have adolescent idiopathic scoliosis
Principal Investigator: Edmond Lou
This study uses AI algorithms and patients' parameters to develop a model to predict the progression of AIS.

Using 3D Ultrasound Imaging and the Spatial Pressure Measurement System to Investigate Spinal Curve Response Imposed by a Simulated Brace
Principal Investigator: Edmond Lou
Existing ultrasound imaging technologies cannot monitor the 3D mechanical response of the spine to physical loadings in real time. This project is focused on the technical aspects required to investigate, advance, validate and integrate 3D ultrasound imaging processing tools synchronized with a 3D wireless spatial pressure control sensor network and a high-speed 3D body image capture system to investigate how mechanical loading affects the internal spinal alignment in real-time.

Projects completed in the last 5 years

A Systematic Review of Motor Control Deficits of the Torso in Adolescents with Idiopathic Scoliosis
Principal Investigator: Eric Parent
This review aims to document the deficits in torso motor control function affecting patients with idiopathic scoliosis which could be targeted using rehabilitation strategies (2018).

Fatigability and Recovery Characteristics in Torso Muscles of Adolescents with Idiopathic Scoliosis Compared to Health Controls
Principal Investigator: Eric Parent
This case control study aims to identify torso muscle fatigability deficits during isometric and dynamic rotation fatigue test using Biodex in adolescent with idiopathic scoliosis compared to healthy matched controls. A secondary objective is to determine if fatigability in patients may predict curve progression (2018).

A Systematic Review of the Reliability and Validity of Perceived Self-Image Questionnaires in Adolescent Idiopathic Scoliosis
Principal Investigator: Eric Parent
This systematic review aims to document the reliability and validity of all perceived self-image questionnaires published to date for use in adolescents with idiopathic scoliosis and appraise the quality of the publications using the COSMIN tool in order to formulate a recommendation about which questionnaire should be used clinically and in research (2018).

Intraoperative Image Guidance and Navigation in Adolescent Idiopathic Scoliosis Posterior Surgery: A Systematic Review on Screw-Related Complications and Breach Rates (Jan 2017)
Principal Investigator: Edmond Lou
Severe adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity requiring surgery to stop curve progression. Posterior spinal instrumentation and fusion with pedicle screws is the standard surgery for AIS curve correction. Vascular and neurologic complications related to screw-malpositioning are concerns in surgeries for AIS. Breach rates are reported at 15.7%, implant-related complications at 1.1% and neurologic deficit at 0.8%. Free-hand screw insertion remains the prevailing method of screw placement while image guidance has been suggested to improve placement accuracy. A systematic review was completed to compare the complications associated with each method.
Novel MRI Biomarkers of Intervertebral Disc Response to Loading (2016)
Principal Investigator: Eric Parent
This case control study aims to identify novel biomarkers that are patho-anatomically specific to low back pain by applying compression and traction and extracting quantitative parameters from T2-map images in patients with low back pain and matched healthy controls.
Can Ultrasound Determine the Optimum Pad Positioning During Brace Casting for Scoliosis (May 2015)
Principal Investigator: Edmond Lou
The use of the ultrasound system during brace casting provided a radiation-free method of determining the optimum level and location of pressure applied to obtain the best simulated in-brace correction. The average number of radiographs taken per subject in the interventional group was lower than the control group. Acceptable in-brace correction was attained sooner in the intervention group with less burden on the families and patients.
Using Ultrasound to Determine Spinal Curve Flexibility (May 2015)
Principal Investigator: Edmond Lou
Spinal flexibility of a patient with Adolescent Idiopathic Scoliosis (AIS) affects treatment outcomes. More flexible spines are better corrected in a brace as well as spine surgery. We are the first group to develop an ultrasound imaging method to measure spinal flexibility.
How Quantity and Quality of Brace Wear affect Brace Treatment Outcomes (Dec 2014)
Principal Investigator: Edmond Lou
The quantity and quality of brace usage are important factors in achieving successful brace treatment. The quantity of brace wear is the amount of brace wear time relative to the prescribed wear time; the quality of brace wear is the amount of time that the brace is worn at or above the prescribed tightness. The more time that brace was worn at the prescribed level; it more likely to have a better treatment result.
Markerless Surface Topography Measurements (September 2014)
Principal Investigator: S. Adeeb
Using data from the project above, a novel asymmetry analysis strategy was proposed to complete surface topography analyses without the use of markers placed on bony landmarks of patient achieving a high reliability. This asymmetry analysis allowed to categorize patients with scoliosis according to their curve severity, predict the location of curve apices and develop classification trees predicting whether patients experienced scoliosis curve progression over a one year interval.