ArticleSpine deformity2026
3D back surface asymmetry reflects radiographic deformity but not patient perception in Lenke type 1 adolescent idiopathic scoliosis.
Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAdolescent idiopathic scoliosis (AIS) is a complex, three-dimensional (3D) spinal deformity characterized by both coronal curvature and axial rotation. Traditional radiographic measurements primarily reflect the internal spinal alignment but do not fully capture external surface asymmetry or rotational components. Moreover, patients' perceptions of their trunk deformity often diverge from radiographic findings. This discrepancy may be attributed to various sources of bias in patient self-assessment. The present study aimed to investigate the relationship between preoperative 3D body surface measurements and body image perception in patients with AIS.
methodsWe conducted a retrospective analysis of patients diagnosed with Lenke type 1 AIS who were scheduled to undergo posterior spinal correction and fusion surgery at our institution between April 2022 and April 2024. Preoperative trunk asymmetry was assessed as the height difference of the 3D back surface using a 3D back scanner (Sanamedi, Tokyo, Japan). Radiographic parameters and patient-reported outcomes were compared with 3D surface measurements. Correlation analyses were performed using Pearson's correlation coefficient or Spearman's rank correlation coefficient, depending on the distribution of the data.
resultsA total of 52 female patients were included, with a mean age of 15.4 ± 2.3 years. Analysis of all cases indicated that 3D surface measurements were moderately correlated with the Cobb angle (ρ = 0.51, p < .001). In contrast, no significant correlations were found between 3D surface measurements and any domain of the Scoliosis Research Society-22 questionnaire. Weak to moderate correlations were observed in the Walter reed visual assessment scale (ρ = 0.29-0.40, p < .05).
conclusionThis study demonstrated that 3D surface measurements correlate with radiographic parameters, supporting their validity in assessing spinal deformity. Although 3D surface measurements showed statistically significant but weak to moderate correlations with radiographic parameters, discrepancies were observed between objective assessments and patients' subjective perception. Further research involving a broader range of deformity type is warranted to better clarify these relationships.
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