Rasterstereographic Analysis of Lateral Shift in Patients with Lumbar Disc Herniation: A Case Control Study.

OBJECTIVE: Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. SUMMARY OF BACKGROUND DATA: A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. METHODS: Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. RESULTS: The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). DISCUSSION: Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. CONCLUSION: The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.

Rasterstereographic evaluation of interobserver and intraobserver reliability in postsurgical adolescent idiopathic scoliosis patients.

STUDY DESIGN: Evaluation of rasterstereographic examinations in postsurgical adolescent scoliosis patients: a reliability study. OBJECTIVE: To investigate the interobserver and intraobserver reliability of rasterstereographic 3-dimensional back surface analysis and reconstruction of spine parameters including trunk length, trunk inclination, lateral deviation, kyphotic and lordotic angles in adolescent idiopathic scoliosis patients after scoliosis surgery. SUMMARY OF BACKGROUND DATA: The rasterstereography device formetric III 4D has been in routine clinical use for patients with scoliosis and other spinal deformities, reducing the patients' radiation exposure considerably. The reliability of this device has previously been examined in healthy volunteers but not in patients after scoliosis surgery. MATERIALS AND METHODS: Thirty-nine adolescent idiopathic scoliosis patients (32 women and 7 men) after scoliosis surgery with a mean age of 23.5 years (±10.6 y) were examined rasterstereographically by 5 investigators. Each investigator made a series of 3 measurements of each participating patient consecutively. The intraclass correlation coefficient (ICC) and the Pearson product moment correlation were calculated. In addition, the comparative analysis of the first and 15th measurements was assessed. RESULTS: The ICCs of all investigated parameters demonstrated very high interobserver and intraobserver reliability. The maximum ICC (0.988) for interobserver reliability of the 5 investigators was found for the trunk length and the minimum ICC (0.918) for lateral deviation. There were highly significant positive correlations between the first, second, and third measurements (r=0.994-0.697; P<0.001) for intraobserver reliability. Overall highly significant correlation was found comparing the results of the first and the 15th rasterstereographic measurement. CONCLUSIONS: The reliability of rasterstereography formetric III 4D in regard to the investigated parameters is excellent. The device can be used very efficiently by 1 or multiple investigators to analyze postsurgical adolescent idiopathic scoliosis patients in clinical practice, requiring only a single investigational exposure.

Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length, and trunk inclination: a reliability study.

STUDY DESIGN: Determination of reliability with 3 investigators using a collective of healthy volunteers. OBJECTIVE: To determine the reliability of rasterstereography 3-dimensional back surface analysis and reconstruction of the spine in healthy test subjects. SUMMARY OF BACKGROUND DATA: Rasterstereography has been in clinical use since 1989 for patients with scoliosis and other spinal deformities and it significantly reduces the need for otherwise indispensable radiographs. The validity of this device has previously been examined in other studies. This study was performed to evaluate the reliability of rasterstereography for clinical application in diagnostic and follow-up examinations. METHODS: Fifty-one healthy volunteers were examined rasterstereographically by 3 investigators. Each investigator made a series of 3 measurements of each participant in which 8 spine parameters including kyphotic angle ICT-ITL (max.), kyphotic angle VP-ITL, kyphotic angle VP-T12, lordotic angle ITL-ILS (max.), lordotic angle ITL-DM, lordotic angle T12-DM, trunk length VP-DM and trunk inclination were measured. Cronbach alpha was calculated. The influence of high or low body mass index on the accuracy of the technique was evaluated as well. RESULTS: Cronbach alpha for the intratester-reliability of the kyphotic angle ICT-ITL (max.) for the 3 investigators has values between 0.921 and 0.992. The intertester-reliability for the same parameter is 0.979 (95% CI). In this study group a meaningful association between body mass index and reliability of the device was not found. CONCLUSION: The reliability revealed very good results, both for intratester and for intertester reliability. The technique is well suited for analysis of the back in standing position. The body mass index has no influence on the reproducibility.

Angiomatosis retinae: (Enfermedad de Von Hippel) / Angiomatosis of the retina (Von Hippel Disease)

La angiomatosis de la retina ó Enfermedad de Von Hippel, es una patología que consiste en la presencia de un hamartoma angiomatoso que afecta al nervio óptico, retina o ambos, además de la posibilidad de afectación del Sistema Nervioso Central (SNC) y otros órganos, por lo cual entra dentro del grupo de las facomatosis. El siguiente es un reporte de un caso evaluado multidisciplinariamente en el Hospital Militar "Dr Carlos Arvelo" para descartar compromiso de un caso de Angiomatosis Retiniana referido a nuestro servicio