Comparison of 3D Ultrasonography, Surface Topography, and Radiography in Assessing Sagittal Spinal Parameters in Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis (AIS) requires repeated radiographic monitoring, accumulating ionizing radiation during a radiosensitive developmental period. This prospective pilot study compared sagittal thoracic kyphosis and lumbar lordosis measurements obtained via three-dimensional ultrasonography (Scolioscan), electromechanical surface topography (Spinal Mouse), and standing lateral radiography in 19 AIS patients (mean age 15.95 ± 3.67 years; Cobb angle >10°). Paired-samples t-tests, Pearson correlations, and Bland-Altman analyses were performed (matched n = 15 thoracic, n = 16 lumbar). In the thoracic region, neither device showed significant systematic bias versus radiography (Scolioscan mean difference 3.81 ± 9.77°, p = 0.154; Spinal Mouse +2.33 ± 6.40°, p = 0.180). Strong correlations were found between radiography and Spinal Mouse (r = 0.884, p < 0.001) and moderate correlation with Scolioscan (r = 0.689, p = 0.005). The direct inter-device correlation was also significant (r = 0.579, p = 0.024). In the lumbar region, Scolioscan underestimated lordosis by 14.51 ± 12.70° (p < 0.001), while Spinal Mouse showed no significant bias (4.06 ± 14.78°, p = 0.289). These preliminary findings suggest that Spinal Mouse offers clinically acceptable sagittal thoracic monitoring, while Scolioscan demonstrates systematic lumbar underestimation attributable to differing anatomical reference frameworks. Larger confirmatory studies are warranted.