# Long-Term Follow-Up for Child with Ataxia Telangiectasia Related Scoliosis Using Surface Topography: A Case Report

## TL;DR

This case report explores using surface topography to monitor scoliosis in a child with ataxia telangiectasia over four years, avoiding radiation exposure.

## Contribution

A novel monitoring paradigm combining MRI and surface topography is proposed for AT patients with scoliosis.

## Key findings

- Surface topography effectively tracked 3D spine curvature changes over four years in an AT patient.
- A novel paradigm combining MRI with serial ST imaging was developed to monitor curve progression.
- ST enabled informed treatment decisions without unnecessary radiographic imaging.

## Abstract

Background and Clinical Significance: Scoliosis prevalence in patients with ataxia telangiectasia (AT) is higher than in the general population. Scoliosis monitoring is traditionally performed using X-rays, but radiographic imaging is contraindicated in AT patients due to radiation sensitivity. Current guidelines suggest a diagnostic radiograph with subsequent Magnetic Resonance Imaging (MRI). In this report, we (1) evaluated the feasibility of using surface topography (ST) to observe 3D spine curvature trends in a long-term follow-up of a patient with scoliosis and AT, and (2) developed a novel paradigm for monitoring scoliosis in AT patients. Case presentation: A female patient (11 years old) with AT and scoliosis was monitored using ST in five visits over four years. Between subsequent visits, her ST measurements included average changes in thoracic scoliotic angle of 5.5° ± 4.9°, thoracolumbar scoliotic angle of 7.8° ± 5.5°, thoracic axial surface rotation (ASR) of 8.0° ± 8.5°, thoracolumbar ASR of 7.0° ± 4.5°, thoracic apical deviation of 6 mm (only measured in two visits), thoracolumbar apical deviation of 10 mm ± 2.4 mm, pelvic obliquity of 5.8 mm ± 3.9 mm, shoulder obliquity of 20 mm (only measured in two visits), coronal imbalance of 11.8 mm ± 9.7 mm, and kyphotic angle of 5.5° ± 5.4°. ST effectively monitored curve patterns throughout the 4-year treatment period, enabling informed treatment decisions by the provider, patient, and family. We also developed a novel paradigm combining diagnostic MRI with serial ST imaging every 6–12 months to monitor curve progression with supplemental MRI as needed. Conclusions: Our novel ST paradigm provides a feasible method for monitoring 3D scoliosis progression in AT patients while avoiding unnecessary radiographic imaging.