Adölesan İdiyopatik Skolyozda Omuz ve Pelvis Asimetrisi Koronal Eğrilik Derecesini Yansıtmamaktadır: Yapay Zekâ Tabanlı Radyografik Bir Analiz

Öz

Amaç: Bu çalışmada, adölesan idiyopatik skolyozda (AİS) omuz asimetrisi, pelvik oblisite ve yapay zekâ (YZ) tabanlı skolyoz yazılımı ile ölçülen kapsamlı spinal denge parametreleri arasındaki ilişkinin araştırılması amaçlanmıştır. Gereç ve yöntem: Bu retrospektif kesitsel çalışmaya AİS tanılı 131 hasta (64 kadın, 66 erkek, birinde cinsiyet belirtilmemiş; ortalama yaş 13.8±2.4 yıl; dağılım 10-18 yıl) dâhil edildi. Omuz asimetrisi açısı ve mesafesi, pelvik oblisite açısı ve mesafesi, primer eğrilik (PE) Cobb açısı, sekonder eğrilik (SE) Cobb açısı, koronal denge, sagittal denge, torakal kifoz, lomber lordoz, pelvik insidans, pelvik tilt ve sakral eğim hScoliosis YZ yazılımı (hevi.ai, İstanbul, Türkiye) ile otomatik olarak ölçüldü. İlişkilerin değerlendirilmesinde Spearman sıra korelasyonu ve Kruskal-Wallis testi kullanıldı; çoklu karşılaştırmalar için Bonferroni düzeltmesi uygulandı. Bulgular: Ortalama omuz asimetrisi açısı ve mesafesi sırasıyla 2.02±1.56° ve 10.34±7.59 mm, ortalama pelvik oblisite açısı ve mesafesi ise sırasıyla 2.17±1.54° ve 6.46±4.51 mm idi. Ne omuz asimetrisi ne de pelvik oblisite PE Cobb açısı (sırasıyla r=0.069, p=0.435 ve r=0.055, p=0.531), SE Cobb açısı veya koronal denge ile anlamlı korelasyon gösterdi. PE Cobb şiddet grupları arasında omuz veya pelvis asimetrisi açısından anlamlı fark saptanmadı (tümü p>0.05). Omuz asimetrisi torakal kifoz ile (r=0.194-0.202, p=0.030-0.036), pelvik oblisite ise sakral eğim ile (r=0.189-0.205, p=0.027-0.042) zayıf ilişki gösterdi; ancak 36 karşılaştırma için Bonferroni düzeltmesi sonrasında bu ilişkilerin hiçbiri anlamlılığını korumadı. Sonuç: AİS hastalarında klinik olarak gözlenebilen omuz ve pelvis asimetrisi, koronal spinal eğriliğin derecesini yansıtmamaktadır. Bu bulgular, görünür vücut asimetrisinin daha büyük bir Cobb açısına işaret ettiği yönündeki yaygın klinik varsayımı sorgulamakta ve eğriliğin doğru şekilde ölçülmesinde radyografik değerlendirmenin önemini vurgulamaktadır.

Anahtar Kelimeler

• adölesan idiyopatik skolyoz
• omuz asimetrisi
• pelvik oblisite
• Cobb açısı
• spinal denge
• yapay zekâ

Destekleyen Kurum

Yoktur. Bu araştırma için kamu, ticari veya kâr amacı gütmeyen herhangi bir kurumdan destek alınmamıştır.

Etik Beyan

Bu çalışma için Biruni Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu'ndan onay alınmıştır (tarih:30.03.2026 karar no:2024-BiAEKf19-S1 ). Çalışma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür. Retrospektif tasarım nedeniyle bilgilendirilmiş onam alınması koşulu aranmamıştır.

Teşekkür

yok

Shoulder and Pelvic Asymmetry Do Not Reflect Coronal Curve Magnitude in Adolescent Idiopathic Scoliosis: An Artificial Intelligence-Based Radiographic Analysis

Öz

Objectives: This study aimed to investigate the relationship between shoulder asymmetry, pelvic obliquity, and comprehensive spinal balance parameters measured by artificial intelligence (AI)-based scoliosis software in adolescent idiopathic scoliosis (AIS). Methods: One hundred thirty-one patients with AIS (64 female, 66 male, sex unspecified in one; mean age 13.8±2.4 years; range 10-18 years) were included in this retrospective cross-sectional study. Shoulder asymmetry angle and distance, pelvic obliquity angle and distance, primary curve (PC) Cobb angle, secondary curve (SC) Cobb angle, coronal balance, sagittal balance, thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope were automatically measured using the hScoliosis AI software (hevi.ai, Istanbul, Türkiye). Spearman rank correlation and Kruskal-Wallis analyses were used to assess associations, and the Bonferroni correction was applied for multiple comparisons. Results: Mean shoulder asymmetry angle and distance were 2.02±1.56° and 10.34±7.59 mm, respectively. Mean pelvic obliquity angle and distance were 2.17±1.54° and 6.46±4.51 mm, respectively. Neither shoulder asymmetry nor pelvic obliquity correlated significantly with PC Cobb angle (r=0.069, p=0.435 and r=0.055, p=0.531, respectively), SC Cobb angle, or coronal balance. No significant differences in shoulder or pelvic asymmetry were found across PC Cobb severity groups (all p>0.05). Shoulder asymmetry showed weak associations with thoracic kyphosis (r=0.194-0.202, p=0.030-0.036) and pelvic obliquity with sacral slope (r=0.189-0.205, p=0.027-0.042); however, none of these associations remained significant after Bonferroni correction for 36 comparisons. Conclusions: In patients with AIS, clinically observable shoulder and pelvic asymmetry do not reflect the magnitude of the coronal spinal curve. These findings challenge the common clinical assumption that visible body asymmetry indicates a larger Cobb angle and highlight the importance of radiographic assessment for accurate curve quantification.

Anahtar Kelimeler

• adolescent idiopathic scoliosis
• shoulder asymmetry
• pelvic obliquity
• Cobb angle
• spinal balance
• artificial intelligence

Destekleyen Kurum

None. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Etik Beyan

This study was approved by the Biruni University Non-Interventional Clinical Research Ethics Committee (date: 30.03.2026 , decision no: 2024-BiAEKf19-S1). The study was conducted in accordance with the principles of the Declaration of Helsinki. Owing to the retrospective design, the requirement for informed consent was waived.

Teşekkür

None

Kaynakça

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