Paediatric Spinal Deformity

Paediatric spinal deformities are a class of orthopaedic conditions that have a profound effect on health related quality of life in children and youth and are a source of significant cost to the health care system.

Idiopathic Scoliosis (IS), the most prevalent sub-class of these conditions progresses during periods of rapid growth and development and is characterized by a complex three-dimensional (3D) curvature of the spine that is accompanied by structural disorientation of adjacent skeletal structures (pelvis/spine) and dysfunction of the postural, locomotor and respiratory systems.

Short term and long term clinical follow-up studies have revealed the need to further improve physical function, activity and health related quality of life (HRQL). Evaluation of outcomes following surgery has predominantly focused on the measurement of the structure of the spine and the development of measurement tools of HQRL. However, it is increasingly evident that although measures of HRQL provide a global perspective of clinical outcomes there still remains limited understanding of how structure, function and mobility are inter-connected and influence quality of life.

The specific objectives of this project are:

  • Develop new instruments and techniques that will inform the orthopaedic management of children and youth living with a Paediatric Spinal Deformity.
  • Generate new observations about the structure, function and mobility of the spine in children and youth living with a Paediatric Spinal Deformity.

To address the first objective of this study, Dr. Zabjek has developed an integrated structural medical imaging assessment. This has involved the concurrent measurement of ground reaction forces under the feet while a standing, weight bearing bi-planar x-ray image of the pelvis and spine is obtained. A Three Dimensional Skeletal Modelling Software developed by Dr. Zabjek’s research team has provided an opportunity to integrate the alignment of the ground reaction forces with the underlying skeletal structures. In parallel, a laboratory based functional assessment of posture and mobility was obtained. A preliminary study of children and youth living with Idiopathic Scoliosis has been completed.

This new model of biomechanical assessment provides an opportunity to further explore the complex inter-relationship between complex skeletal deformity of the pelvis, spine and thoracic cage with functional movement.