Prof. Zheng Yongping from the Hong Kong Polytechnic University is an international authority on ultrasound research. The advanced radiation-free ultrasound scoliosis assessment system invented by Prof. Zheng has yielded encouraging scientific results.
——Prof. LAM Tsz-ping, Department of Orthopaedics & Traumatology of the Chinese University of Hong Kong
About Faculty of Medicine of the Chinese University of Hong Kong
Source: The Prince of Wales Hospital
Since its establishment, the Faculty of Medicine of the Chinese University of Hong Kong has made outstanding achievements in teaching, researching and clinical diagnosising with the mission of providing quality medical education, enhancing clinical services and promoting the development of health sciences. The Prince of Wales Hospital is the teaching hospital of the Faculty of Medicine of The Chinese University of Hong Kong, responsible of training medical professionals and leading medical research.
Professor LAM Tsz-ping, Department of Orthopaedics & Traumatology of The Chinese University of Hong Kong, conducted a scoliosis study using the Scolioscan® ultrasound scoliosis assessment system.By incorporating the ultrasound assessment system into the screening programe, up to 42.5% of schoolchildren were able to avoid unnecessary X-ray exposure, which the results is satisfactory. Prof. Lam is currently conducting further clinical studies at the Prince of Wales Hospital, the Teaching Hospital of the Chinese University of Hong Kong.
Department of Orthopaedics & Traumatology of the Chinese University of Hong Kong
Doctor LAM Tsz-ping
Dr. Lam was awarded King Edward VII Scholarship and San Miguel Scholarship upon entry to the University of Hong Kong for undergraduate medical training. At postgraduate levels, he was awarded Fellowship of The Royal College of Surgeons of Edinburgh and The Hong Kong College of Orthopaedic Surgeons followed by sub-specialist training in Paediatric Orthopaedics. Dr Lam subsequently developed interests on undergraduate teaching, researches related to paediatric orthopaedics, scoliosis, adolescent bone health, Vitamin D and related areas as well as knowledge dissemination for promotion of bone health and Vit-D status among adolescents in Hong Kong.
Research efforts on the etiopathogenesis of adolescent idiopathic scoliosis, paediatric spine problems and adolescent bone health have earned Dr. Lam numerous awards including the AR Hodgson Award for Best Clinical Paper at the Hong Kong Orthopaedic Association Annual Congress both in 2013 and 2015, the Orthopaedic Basic Science Award at the Hong Kong Orthopaedic Association Annual Congress in 2013, etc.
Dr Lam has published over 50 publications in peer-reviewed international journals and over 350 conference presentations.
Their Pain Point and our Solution
Three-dimensional deformation affects cardiopulmonary function
The spine is an important pillar of the body. However, scoliosis affects many people in Hong Kong, especially women and schoolchildren. According to Prof. LAM Tsz-ping, Department of Orthopaedics & Traumatology of the Chinese University of Hong Kong, the incidence of scoliosis is only about 2% to 4% internationally, but among girls aged 10 to 14 in Hong Kong, the incidence rate is as high as 4.8%, which is a serious situation.
Many people think that scoliosis is just an “S” sign curvature, but it is much more distorted than people think. Prof. Lam explains: “The spine of a normal person should looks straight when viewed from behind, but when there is a side bend, the spine of a certain part will deviate from the body axis. In addition to the left side or right side bending of the spine, the position of the parietal vertebrae is also often distorted by rotation, with the possibility of bending forward or backward, scoliosis is in fact a complex state of three-dimensional deformation.”
Source: Sing Tao Daily
Prof. Lam said: “Scoliosis should not be treated without caution. Apart from the distortion of the body and the asymmetry of the chest, it can lead to persistent back pain and other complications in severe cases, which can have a wide range of health implications. If severe scoliosis occurs in the thoracic vertebra, the chest will be compressed and affect the cardiopulmonary function; if it is in the lumbar spine, this can lead to chronic back pain and the premature of back degeneration, which, combined with a distorted appearance, can lead to psychological and social difficulties.”
If the cause is unknown, test it as soon as possible
Apart from nature and nurture reason, Prof. Lam points out that there are many types of scoliosis: “It can be caused by post-traumatic stress disorder, infection, or by neuromuscular and congenital spinal dysplasia. About 80% of cases are adolescent idiopathic scoliosis (AIS). Unfortunately, the cause of this condition, which most commonly affects the spine of adolescents aged 10 to 14, is still unknown.”
Adolescent idiopathic scoliosis is hard to predict, although an early treatment will be resulted in a higher effectiveness, the early stage of lateral has no significant symptoms, only when it comes to moderately or severe level, the body show symptoms of left-right asymmetry. Therefore, the patient better frequently observe their shoulder, waist and hip to see whether are any symptoms of asymmetry, whether the shoulder blade is protruding, , whether the body is tilted, etc. If screened by a physician, a forward bending test should be performed, in which the physician will observe whether the rotation degree of parietal vertebrae is within 5 degrees or above. If so, a detailed examination should be performed, in order to confirm the presence of scoliosis In terms of treatment, Prof. Lam pointed out that the only effective way is to use orthopaedic braces or perform surgery. However, both treatments may cause inconvenience or affect the body.
“The braces are plastic shells for patients to wear. Patients have to wear them not only for more than 20 hours a day, but also for three to four years until the completion of growth. Wearing braces in Hong Kong, especially summer time, is miserable and the patients will be depressed.”
Prof. Lam pointed out that if the condition worsens, surgery of implanting fixation is necessary, which better be avoided. “In addition to implanting the fixation, oneself’s bone should be implanted and the spine will be merged with the bone. When the bone completely merged with the lateral part, it will become a strong individual and the trauma is extremely high. Complications such as bleeding, infection and nerve related problems may happened. As a result, early treatment of scoliosis become particularly important.”
Study the ultrasound assessment system to reduce the X-ray assessment
X-ray assessment is necessary for evaluating scoliosis in the past, children had to have regular visits to the hospital before they completed their growth during puberty. Up to a dozen times of assessments have to perform within three to five years. Even though modern X-ray systems emit less radiation, it still worries the parents of patients. Prof. Lam fully understand the situation and therefore he actively study on how to provide radiation-free scoliosis assessment. At last, with the help of radiation-free Ultrasound Scoliosis Assessment System Scolioscan®, invented by Prof. Zheng Yongping, Department of Biomedical Engineering of the Hong Kong Polytechnic University, an inspiring scientific research had been carried out.
The first study involved 952 patients with scoliosis. The Scolioscan® ultrasound scoliosis assessment system was used to measure the curvature of the scoliosis. The results showed that 80% of patients with scoliosis affects the thoracic spine were satisfied with the measurement, and 94% of patients with a mild to moderate level of curvature with less than 30 degrees were satisfied with the measurement.
The inclusion of Scolioscan®, an ultrasound scoliosis assessment system, in the screening programme for scoliosis of 442 schoolchildren enrolled in the Department of Health’s scoliosis screening service, helped to avoid unnecessary X-ray exposure in up to 42.5% of schoolchildren, the results were satisfactory. Dr. Lam made it clear that further rigorous scientific verification will be conducted after the epidemic is over, and he is confident that ultrasound will be widely used in screening for scoliosis and clinical treatment among schoolchildren.
Prof. Zheng pointed out that his newly developed ultrasound assessment system is small in size, which makes it easier to conduct screening activities in schools. It is also suitable for clinics with lesser space in Hong Kong. The system is currently being tested in clinical trials in Hong Kong and other countries, and Prof. Zheng’s team says they will continue to improve the technology in the future. “First thing to do is to automate the measurement, speed up the test results and reduce the burden of doctors. Then, to obtain a 3D model through the 3d ultrasound data, in order to have a deeper understanding of scoliosis. Finally, artificial intelligence will be added to help doctors determine the progression of spinal problems.
Prof. LAM Tsz-ping emphasized: “At present, there is no effective method to prevent scoliosis, and many treatment methods also need to be optimized. Students should pay attention to taking good care of their spine. The most important thing is to sit properly, strengthen muscles and practice stretching exercise. Keep in mind the CDEF tips — Calcium, vitamin D, Excercise, keep Fluid – so as to maintain healthy bones. It is also important to avoid excessive skeletal load. Students should avoid heavy schoolbags, remember to move yourself after a long period of studying, and stretch a little every 10-15 minutes. We hope that you can pay attention to the above information and you can maintain healthy bones and a strong spine naturally.
The content was translated based on the editorial coverage of “Sing Tao Daily” —— “CUHK Medical & Health Section ︳Breakthrough in zero radiation study, new measure of ultrasound, scoliosis assessment”, it has been granted authorization from Sing Tao Daily.