May 15, 2014
EDMONTON — Groundbreaking local research in ultrasound imaging means children with scoliosis can now receive accurate monitoring without the need of X-ray exams, a safe procedure that nevertheless exposes patients to small amounts of ionizing radiation.
Research scientist Edmond Lou and his Alberta Health Services (AHS) team, based at the Glenrose Rehabilitation Hospital and Stollery Children’s Hospital, are global pioneers in the use of ultrasound imaging to measure the severity of scoliosis — a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. Severe scoliosis can be disabling, as it reduces space in the chest for lungs to expand during breathing.
“While the idea of using ultrasound is not new — in fact, it dates back to the 1980s — it’s only in the last five years that the technology has evolved to the point where it can produce an image with the clarity we need for scoliosis care,” says Lou, also an assistant professor with the Faculty of Medicine and Dentistry at the University of Alberta.
“As well, the software capability to construct 3-D images from ultrasound data did not exist back then. We’ve developed proprietary software to process the data faster, which makes it easier for us to measure and visualize spinal curvature with ultrasound, so we can predict which curves are at higher risk to get worse. Ultrasound holds the promise of better fitting of braces and orthotics.”
Currently, children with scoliosis are monitored closely; X-rays are taken twice or more a year to gauge if the curve is getting worse. For mild cases, no treatment is necessary. Some children may need to wear a brace with pressure pads, while others may need surgery to straighten severe spinal curvature. About 1,300 adolescents are now in treatment for scoliosis locally, with 400 new cases diagnosed each year. Diagnosis typically occurs between ages 8 to 15.
A scoliosis checkup requires at least two X-rays, a front and a side view, to allow precise measurement and visualization of spinal curvature, which determines the course of treatment. With checkups every six months or more, it’s not unusual for teens with scoliosis, after years of monitoring, to have undergone dozens of X-rays.
“X-rays are safe but, if we can prevent patients in their formative years from being exposed to low levels of ionizing radiation, that’s preferable,” says Lou.
“The amazing work that Edmond and his team are doing with ultrasound imaging has led to a safe, reliable and easy-to-use tool that will dramatically improve the assessment and non-surgical management of children with scoliosis,” adds Jim Raso, Senior Consultant for Research and Technology at the Glenrose Rehabilitation Hospital and President of the International Research Society of Spinal Deformities.
Scoliosis patient Teva Quix says she prefers ultrasound monitoring to X-rays. “Yeah, because it’s a lot quicker,” says the 14-year-old Devon resident. “Plus I think it’s cool that you can see (your spine) in a different way than in the X-ray.”
Teva, reduced to wearing her brace only at night, will be free of it in six months.
“She gets very good care,” says father Rene Quix.
Ultrasound is also more cost-effective. An ultrasound machine costs $100,000 — compared to $500,000 for an X-ray unit. Meanwhile, as ultrasound research advances, the scoliosis clinic is in the process of acquiring an EOS dual X-ray system, which can capture front and side views of the spine simultaneously, with very low irradiation when compared to standard X-ray systems.
Exposure to ionizing radiation (X-rays), associated with monitoring of scoliosis, has been linked to an increased risk of breast cancer in females, who make up the majority of scoliosis cases.
At the end of June, Lou will make two podium presentations to share his research at the International Research Society of Spinal Deformities meeting in Sapporo, Japan, representing the local engineers and surgeons who comprise the scoliosis group at the Glenrose and Stollery hospitals. The Research Society is one of the leading research groups in the world and this is one of the major meetings for these researchers.
“Clinical research has its highest and greatest value when it comes to life and helps patients at the Glenrose,” says Wendy Dugas, President & CEO of the Glenrose Foundation. “Supporting Edmond’s scoliosis research is a perfect example of how we are committed to ensuring the Glenrose stays at the forefront of specialized rehabilitation by supporting trailblazing projects that translate science into interventions that improve care.”
Additional funding for the scoliosis team was provided by Edmonton Orthopaedic Research Committee; Women & Children’s Health Research Institute; Edmonton Civic Employee Charitable Assistance Fund; Northern Alberta Benefits Society for Scoliosis; and Natural Sciences and Engineering Research Council of Canada.
Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.
The Faculty of Medicine & Dentistry at the University of Alberta is one of the world’s top 100 medical schools where faculty members are committed to improving patient care through teaching and research.
The Glenrose Rehabilitation Hospital Foundation provides financial support to enhance patient care at the Glenrose Rehabilitation Hospital — the largest free-standing, tertiary rehabilitation hospital in Canada, located in Edmonton. The Foundation’s work includes fundraising for new capital projects, innovative technology, state-of-the-art equipment and leading-edge rehabilitation research and education.
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