METHODS: Twenty-nine asymptomatic subjects were enrolled prospectively (age: mean 34.31, range 23-50; 14 men, 15 women) from August 2016 to April 2017. Qualitative analysis of muscles was done using Goutallier's system on CT and MRI. Quantitative analysis entailed cross sectional area (CSA) on CT and MRI, Hounsfield unit (HU) on CT, fat fraction using two-point Dixon technique on MRI. Three readers independently analyzed the images; intra- and inter-observer agreements were measured. Linear regression and Spearman's analyses were used for correlation with demographic data.

OBJECTIVE: To determine whether the severity of the curve magnitude in Lenke 1 and 2 Adolescent Idiopathic Scoliosis (AIS) patients affects the distance and position of the aorta from the vertebra.

SUMMARY OF BACKGROUND DATA: There were studies that looked into the position of the aorta in scoliotic patients but none of them documented the change in distance of the aorta to the vertebra in relation to the magnitude of the scoliosis.

METHODS: Patients with Lenke 1 and 2 AIS who underwent posterior spinal fusion using pedicle screw construct and had a preoperative computed tomography (CT) scan performed were recruited. The radiological parameters measured on preoperative CT scan were: Aortic-Vertebral Distance (AVD), Entry-Aortic Distance (EAD), Aortic-Vertebral angle (AVA), Pedicle Aorta angle/Aortic Alpha angle (α angle), and Aortic Beta angle (β angle).

RESULTS: Thirty-nine patients were recruited. Significant moderate to strong positive correlation was found between AVD and Cobb angle from T8 to T12 vertebrae (r = 0.360 to 0.666). The EAD was generally small in the thoracic region (T4-T10) with mean EAD of less than 30 mm. Among all apical vertebrae, the mean AVD was 5.9 ± 2.2 mm with significant moderate-strong positive correlation to Cobb angle (r = 0.580). The mean α angle was 37.7 ± 8.7° with significant weak positive correlation with Cobb angle (r = 0.325).

CONCLUSION: The larger the scoliotic curve, the aorta was located further away from the apical vertebral wall. The aorta has less risk of injury from the left lateral pedicle screw breach in larger scoliotic curve at the apical region. The distance from the pedicle screw entry point to the wall of the aorta was generally small (less than 30 mm) in the thoracic region (T4-T10).

METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice.

RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic.

CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care.

METHODS: One hundred computed tomography scans of disease-free knees were analyzed. A 3-dimensional reconstructed image of the tibia was generated and aligned to its anatomic axis in the coronal and sagittal planes. The tibia was then rotationally aligned to the tibial plateau (tibial centroid axis) and PTS was measured from best-fit planes on the surface of the proximal tibia and individually for the medial and lateral plateaus. This was then repeated with the tibia rotationally aligned to the ankle (transmalleolar axis).

RESULTS: When rotationally aligned to the tibial plateau, the mean PTS, medial PTS, and lateral PTS were 11.2° ± 3.0 (range, 4.7°-17.7°), 11.3° ± 3.2 (range, 2.7°-19.7°), and 10.9° ± 3.7 (range, 3.5°-19.4°), respectively. When rotationally aligned to the ankle, the mean PTS, medial PTS, and lateral PTS were 11.4° ± 3.0 (range, 5.3°-19.3°), 13.9° ± 3.7 (range, 3.1°-24.4°), and 9.7° ± 3.6 (range, 0.8°-17.7°), respectively.