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EOS is the brand name of a device that is scientifically known as the bi-planar slot scanner. The low-radiation mechanism (90% less radiation exposure) of this device won the Nobel prize in physics.
What are the problems of the classical X-rays used in scoliosis imaging and follow up? How EOS can eliminate them?
Standard X-rays are still the most appropriate way for the diagnosis and follow-up of scoliosis and other spinal deformities. Scoliosis may be the only disease where X-rays are still used for advanced diagnosis and treatment.
That said, there are three major disadvantages of X-ray-based diagnosis and follow-up:
- Radiation exposure. Recent scientific studies show that the breast and endometrial cancer risk may be higher in scoliosis patients because of repeated X-rays. The scientific quality of these studies are not high enough to directly relate these two phenomena. However, it is a fact that the radiation exposure due to frequently taken X-rays have potential harmful effects. EOS provides 90 percent less radiation exposure compared to standard X-ray devices. Therefore, the amount of radiation emissivity decreases around 10 times for each radiograph. Additionally, a novel ultra-low dose mode of the EOS device decreases the radiation exposure seven-fold compared with the normal dose from EOS. Follow-up with such low doses provides a decrease in radiation exposure risks. Accurate results will be shown with scientific studies. Still, the best way to guard against radiation is not undergoing unnecessary X-rays.
- 2D image of a 3D deformity. The image in standard X-rays is like the shadow of your hand. The image will be two-dimensional and blurry. However, scoliosis is a three-dimensional deformity: the spine bends forward, left or right while rotating around itself. Therefore, three-dimensional evaluation is necessary. However, 3D evaluation is possible only with CTs. The evaluation and follow-up of scoliosis with CT is not appropriate except in certain special cases—namely because of increased radiation exposure through the CT. Also, scoliosis should be evaluated in standing position, which is not possible through a CT. Today, with the EOS device, it is possible to make the 3D evaluation of the scoliosis both with low dose radiation exposure and in standing position. It is believed that, EOS will open a new era to scientific studies on the cause, diagnosis and treatment of the scoliosis.
- Image quality. In standard X-rays the scatter of the light is not homogeneous, therefore, the image quality will not be the same throughout the image. The image quality in scoliosis is important since curve degrees are used to determine the need for surgery. EOS device scans the patients from head to toe, creating sharper images, and a uniform image quality. This enables more visible landmarks, allowing more precise measurements of curve degrees.
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