Evaluation of bone strength in patients with adolescent idiopathic scoliosis using a multisite quantitative ultrasound device: a cross-sectional observational study

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a multifactorial disease whose pathogenetic and prognostic factors are yet to be disclosed. Reduced bone mineral density (BMD) was found in up to 30% of patients with AIS. Since the appropriateness of the use of dual-energy X-ray absorptiometry (DXA) for BMD is questioned in pediatric population, several authors introduced the assessment of bone strength using quantitative ultrasound (QUS) devices, which provide complementary information about bone properties. The aim of this study was to evaluate the bone strength in terms of speed of sound (SoS) on radius (m/s) and SoS tibia (m/s) in patients affected by AIS using a QUS device. METHODS: In this cross-sectional observational study, the bone strength parameter of SoS (m/s) was assessed on nondominant radius and tibia using a multisite QUS device in 134 outpatients (109 females and 25 males) aged 10-17, diagnosed with AIS in 2019. Results were compared to the percentiles by age and gender, previously defined on a local healthy pediatric population reported in a previous study. RESULTS: In general, SoS was significantly higher in females than in males (P=0.025). Both for radius and tibia sites the percentages of subjects under the 25th percentile of reference values were remarkable. CONCLUSIONS: Among the proposed factors implicated in AIS etiopathogenesis, bone strength appeared the only modifiable one (e.g., by diet or lifestyle variation). Omnisense™ (Sunlight Medical Ltd., Tel Aviv, Israel) Multisite QUS allows to measure bone strength through the evaluation of bone quality and could be proposed as a screening tool in patients during routine clinical examinations for AIS.