Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study
Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on hea...
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| description | Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated.
Ten patients (Cobb angle: 44.4±17.7 degrees) were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar/lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles.
The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar/lumbar than thoracic curvature angles. It is suggested that spinal curvature measurements are included in marker-based clinical gait analysis protocols in order to enable a deeper understanding of the biomechanical behavior of the healthy and pathological spine in dynamic situations as well as to comprehensively evaluate treatment effects. |
| doi_str_mv | 10.1371/journal.pone.0135689 |
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Ten patients (Cobb angle: 44.4±17.7 degrees) were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar/lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles.
The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar/lumbar than thoracic curvature angles. It is suggested that spinal curvature measurements are included in marker-based clinical gait analysis protocols in order to enable a deeper understanding of the biomechanical behavior of the healthy and pathological spine in dynamic situations as well as to comprehensively evaluate treatment effects.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0135689</identifier><identifier>PMID: 26270557</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Adolescent ; Adolescents ; Analysis ; Biomechanical engineering ; Biomechanical Phenomena ; Biomechanics ; Child ; Deformation ; Estimation accuracy ; Female ; Gait ; Humans ; Identification ; Kinematics ; Laboratories ; Linear Models ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - pathology ; Male ; Manipulative therapy ; Markers ; Mathematical analysis ; Medical imaging ; Motion capture ; NMR ; Nuclear magnetic resonance ; Patients ; Placement ; Radiography - instrumentation ; Regression Analysis ; Scoliosis ; Scoliosis - diagnostic imaging ; Scoliosis - pathology ; Skin ; Spinal curvature ; Spine ; Spine (lumbar) ; Studies ; Teenagers ; Thoracic Vertebrae - diagnostic imaging ; Thoracic Vertebrae - pathology ; Thorax ; Validity ; Vertebra ; Vertebrae</subject><ispartof>PloS one, 2015-08, Vol.10 (8), p.e0135689-e0135689</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Schmid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Schmid et al 2015 Schmid et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-47d54c596c7c976c01dea45aa0c6dbe01063184e1502bd910253c5f438173f9a3</citedby><cites>FETCH-LOGICAL-c758t-47d54c596c7c976c01dea45aa0c6dbe01063184e1502bd910253c5f438173f9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535911/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535911/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26270557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmid, Stefan</creatorcontrib><creatorcontrib>Studer, Daniel</creatorcontrib><creatorcontrib>Hasler, Carol-Claudius</creatorcontrib><creatorcontrib>Romkes, Jacqueline</creatorcontrib><creatorcontrib>Taylor, William R</creatorcontrib><creatorcontrib>Brunner, Reinald</creatorcontrib><creatorcontrib>Lorenzetti, Silvio</creatorcontrib><title>Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated.
Ten patients (Cobb angle: 44.4±17.7 degrees) were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar/lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles.
The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar/lumbar than thoracic curvature angles. It is suggested that spinal curvature measurements are included in marker-based clinical gait analysis protocols in order to enable a deeper understanding of the biomechanical behavior of the healthy and pathological spine in dynamic situations as well as to comprehensively evaluate treatment effects.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Analysis</subject><subject>Biomechanical engineering</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Child</subject><subject>Deformation</subject><subject>Estimation accuracy</subject><subject>Female</subject><subject>Gait</subject><subject>Humans</subject><subject>Identification</subject><subject>Kinematics</subject><subject>Laboratories</subject><subject>Linear Models</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - pathology</subject><subject>Male</subject><subject>Manipulative therapy</subject><subject>Markers</subject><subject>Mathematical analysis</subject><subject>Medical imaging</subject><subject>Motion capture</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Placement</subject><subject>Radiography - instrumentation</subject><subject>Regression Analysis</subject><subject>Scoliosis</subject><subject>Scoliosis - diagnostic imaging</subject><subject>Scoliosis - pathology</subject><subject>Skin</subject><subject>Spinal curvature</subject><subject>Spine</subject><subject>Spine (lumbar)</subject><subject>Studies</subject><subject>Teenagers</subject><subject>Thoracic Vertebrae - diagnostic imaging</subject><subject>Thoracic Vertebrae - pathology</subject><subject>Thorax</subject><subject>Validity</subject><subject>Vertebra</subject><subject>Vertebrae</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYqPwBggiISG4aPHfpOECqaoGVBqaWDdurVPHSd2lcbCdansFnhqnzaYG7QJFcqzj3_l8_Nknil5jNME0xZ82prU1VJPG1GqCMOXJNHsSneKMknFCEH16ND-JXji3QYjTaZI8j05IQlLEeXoa_bl2ui7j5Y2u4x9gb5R1cWFsvGx0EI_nrd2Bb62Kf7ZQe11oCV6bOt7jYbhaGwtSy3iWm0o5qWofL3JtGvDrEF1KU2njtPscz-r47LapAu71TsWXEKjSQrPHfJvfvYyeFVA59ar_j6Lrr2dX8-_j84tvi_nsfCxTPvVjluacSZ4lMpVZmkiEcwWMAyCZ5CuFMEoonjKFOSKrPMOIcCp5wegUp7TIgI6itwfdUIwTvY1O4BTRjCQsY4FYHIjcwEY0Vm_B3gkDWuwDxpYCrNeyUiKHVDEWSiESdVWtsgwIoZRCQhQJ1zKKvvS7tautyjuDLFQD0eFKrdeiNDvBOOUZ7gQ-9ALW_G6V82Krg89VBbUy7b5uRjlFSVf3u3_Qx0_XUyWEA-i6MGFf2YmKGQtmYUwQCdTkESp8udpqGd5coUN8kPBxkBAYr259Ca1zYrG8_H_24teQfX_ErhVUfu1M1XbP0A1BdgClNc5ZVTyYjJHoWubeDdG1jOhbJqS9Ob6gh6T7HqF_AR-DEUg</recordid><startdate>20150813</startdate><enddate>20150813</enddate><creator>Schmid, Stefan</creator><creator>Studer, Daniel</creator><creator>Hasler, Carol-Claudius</creator><creator>Romkes, Jacqueline</creator><creator>Taylor, William R</creator><creator>Brunner, Reinald</creator><creator>Lorenzetti, Silvio</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150813</creationdate><title>Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study</title><author>Schmid, Stefan ; Studer, Daniel ; Hasler, Carol-Claudius ; Romkes, Jacqueline ; Taylor, William R ; Brunner, Reinald ; Lorenzetti, Silvio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-47d54c596c7c976c01dea45aa0c6dbe01063184e1502bd910253c5f438173f9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Accuracy</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>Analysis</topic><topic>Biomechanical engineering</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Child</topic><topic>Deformation</topic><topic>Estimation accuracy</topic><topic>Female</topic><topic>Gait</topic><topic>Humans</topic><topic>Identification</topic><topic>Kinematics</topic><topic>Laboratories</topic><topic>Linear Models</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - pathology</topic><topic>Male</topic><topic>Manipulative therapy</topic><topic>Markers</topic><topic>Mathematical analysis</topic><topic>Medical imaging</topic><topic>Motion capture</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Placement</topic><topic>Radiography - instrumentation</topic><topic>Regression Analysis</topic><topic>Scoliosis</topic><topic>Scoliosis - diagnostic imaging</topic><topic>Scoliosis - pathology</topic><topic>Skin</topic><topic>Spinal curvature</topic><topic>Spine</topic><topic>Spine (lumbar)</topic><topic>Studies</topic><topic>Teenagers</topic><topic>Thoracic Vertebrae - diagnostic imaging</topic><topic>Thoracic Vertebrae - pathology</topic><topic>Thorax</topic><topic>Validity</topic><topic>Vertebra</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmid, Stefan</creatorcontrib><creatorcontrib>Studer, Daniel</creatorcontrib><creatorcontrib>Hasler, Carol-Claudius</creatorcontrib><creatorcontrib>Romkes, Jacqueline</creatorcontrib><creatorcontrib>Taylor, William R</creatorcontrib><creatorcontrib>Brunner, Reinald</creatorcontrib><creatorcontrib>Lorenzetti, Silvio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmid, Stefan</au><au>Studer, Daniel</au><au>Hasler, Carol-Claudius</au><au>Romkes, Jacqueline</au><au>Taylor, William R</au><au>Brunner, Reinald</au><au>Lorenzetti, Silvio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-08-13</date><risdate>2015</risdate><volume>10</volume><issue>8</issue><spage>e0135689</spage><epage>e0135689</epage><pages>e0135689-e0135689</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Although the relevance of understanding spinal kinematics during functional activities in patients with complex spinal deformities is undisputed among researchers and clinicians, evidence using skin marker-based motion capture systems is still limited to a handful of studies, mostly conducted on healthy subjects and using non-validated marker configurations. The current study therefore aimed to explore the validity of a previously developed enhanced trunk marker set for the static measurement of spinal curvature angles in patients with main thoracic adolescent idiopathic scoliosis. In addition, the impact of inaccurate marker placement on curvature angle calculation was investigated.
Ten patients (Cobb angle: 44.4±17.7 degrees) were equipped with radio-opaque markers on selected spinous processes and underwent a standard biplanar radiographic examination. Subsequently, radio-opaque markers were replaced with retro-reflective markers and the patients were measured statically using a Vicon motion capture system. Thoracolumbar/lumbar and thoracic curvature angles in the sagittal and frontal planes were calculated based on the centers of area of the vertebral bodies and radio-opaque markers as well as the three-dimensional position of the retro-reflective markers. To investigate curvature angle estimation accuracy, linear regression analyses among the respective parameters were used. The impact of inaccurate marker placement was explored using linear regression analyses among the radio-opaque marker- and spinous process-derived curvature angles.
The results demonstrate that curvatures angles in the sagittal plane can be measured with reasonable accuracy, whereas in the frontal plane, angles were systematically underestimated, mainly due to the positional and structural deformities of the scoliotic vertebrae. Inaccuracy of marker placement had a greater impact on thoracolumbar/lumbar than thoracic curvature angles. It is suggested that spinal curvature measurements are included in marker-based clinical gait analysis protocols in order to enable a deeper understanding of the biomechanical behavior of the healthy and pathological spine in dynamic situations as well as to comprehensively evaluate treatment effects.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26270557</pmid><doi>10.1371/journal.pone.0135689</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2015-08, Vol.10 (8), p.e0135689-e0135689 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Accuracy Adolescent Adolescents Analysis Biomechanical engineering Biomechanical Phenomena Biomechanics Child Deformation Estimation accuracy Female Gait Humans Identification Kinematics Laboratories Linear Models Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - pathology Male Manipulative therapy Markers Mathematical analysis Medical imaging Motion capture NMR Nuclear magnetic resonance Patients Placement Radiography - instrumentation Regression Analysis Scoliosis Scoliosis - diagnostic imaging Scoliosis - pathology Skin Spinal curvature Spine Spine (lumbar) Studies Teenagers Thoracic Vertebrae - diagnostic imaging Thoracic Vertebrae - pathology Thorax Validity Vertebra Vertebrae |
| title | Using Skin Markers for Spinal Curvature Quantification in Main Thoracic Adolescent Idiopathic Scoliosis: An Explorative Radiographic Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T12%3A01%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Using%20Skin%20Markers%20for%20Spinal%20Curvature%20Quantification%20in%20Main%20Thoracic%20Adolescent%20Idiopathic%20Scoliosis:%20An%20Explorative%20Radiographic%20Study&rft.jtitle=PloS%20one&rft.au=Schmid,%20Stefan&rft.date=2015-08-13&rft.volume=10&rft.issue=8&rft.spage=e0135689&rft.epage=e0135689&rft.pages=e0135689-e0135689&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0135689&rft_dat=%3Cgale_plos_%3EA425311202%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1703926494&rft_id=info:pmid/26270557&rft_galeid=A425311202&rft_doaj_id=oai_doaj_org_article_da7e44c7c2c04c59b99a22333a62e201&rfr_iscdi=true |