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Care, innovation, education and research

news item Monday, July 15, 2019 Monday, July 15, 2019 10:17 AM - Monday, July 15, 2019 10:17 AM

Radiation exposure for children with scoliosis can be reduced by 50 percent

Medical imaging plays a crucial role in helping to diagnose and treat medical conditions. For the spine and conditions like scoliosis, a sideways curvature of spine, there is an exciting technology that plays a key role in our ability to care for patients. It’s called the EOS® system, a low dose imaging system that allows for accurate evaluation and treatment planning of skeletal conditions.

Reducing radiation dose from imaging exams is an important movement in health care today, where radiation exposure from medical imaging has increased over the years. While the benefits of medical imaging greatly outweigh the risks, exposure from artificial sources should be limited as much as possible, particularly for children whose growing cells and tissues are more sensitive to the long-term effects of radiation.

At Shriners Hospitals for Children, patient safety and innovation are at the core of what we do. Many of the children we treat are diagnosed with medical conditions that require frequent X-rays, such as scoliosis. Due to this, we do our best to provide the safest imaging technologies with the least amount of radiation exposure. At Shriners Hospitals, we are proud to offer EOS imaging at a number of our locations.

The EOS system uses a Nobel Prize-winning detector that reduces radiation exposure 50–85% compared to traditional X-ray technology.1,2 For follow-up exams, often used to monitor the progression of scoliosis and other skeletal deformities, the EOS system uses a setting called Micro Dose to reduce radiation exposure another 5–7 times.3 A Micro Dose exam is comparable to one week of natural radiation on earth and is only available on the EOS system.3

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and is a condition that may benefit from the reduced radiation from an EOS exam. These patients require frequent medical imaging and may undergo as many as 4–6 X-ray exams every year.4 The EOS system can greatly reduce radiation exposure to these patients over the course of treatment. Health care providers should always do their best to reduce radiation exposure. The EOS system offers a safe way to image.

In addition to low dose exams, the EOS system can improve assessment accuracy using upright 3D models, which more precisely reflect the shape of the patient’s spine than 2D X-ray images.5 3D information can help a surgeon determine the most appropriate treatment plan. While surgery is never the first option for scoliosis, if the curve progresses beyond a certain degree, surgery may the best course of treatment. In that case, the EOS system has an associated surgical planning software that allows the surgeon to virtually simulate different scenarios to correct the spinal curve.

The EOS system is considered the standard of care in pediatric spinal deformity imaging because of low dose and Micro Dose technologies for younger patients requiring frequent imaging exams and ability to model conditions in 3D. Shriners Hospitals for Children is committed to providing the best and the safest treatment we can to our patients. We are proud to set the standard and offer our patients the latest medical imaging technologies, while lessening concerns surrounding the need for multiple X-rays.

Female scoliosis patient holding X-ray taken with EOS system


1 Dietrich TJ, Pfirrmann CW, Schwab A, Pankalla K, Buck FM. Comparison of radiation dose,workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol. 2013

2 Deschenes S., Charron G., Beaudoin G., Miron M., Labelle H. and Dubois J., “Diagnostic imaging of spinal deformities: Reducing patients radiation dose with a new slot-scanning x-ray imager” Spine, (avril 2010)

3 lharreborde B, Ferrero E, Alison M, Mazda K. EOS microdose protocol for the radiological follow-up of adolescent idiopatic scoliosis. Eur Spine J. April 2015.

4 Amazallag-Bellenger, Elisa, Idiopathic scoliosis in children and adolescents: assessment with a biplanar X-ray device, Insights Imaging, Oct 2014; 5 (5): 571-583. DOI: 10.1007/s13244-014-0354

5 Smith JS, Shaffrey CI, Bess S, Shamji MF, Brodke D, Lenke LG, Fehlings MG, Lafage V, Schwab F, Vaccaro AR, Ames CP. Recent and Emerging Advances in Spinal Deformity. Neurosurgery. 2017 Mar 1;80(3S):S70-S85 mily