nach oben

European Spine Journal

Erschienen in:

01.11.2013 | Review Article

Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review

verfasst von: S. Langensiepen, O. Semler, R. Sobottke, O. Fricke, J. Franklin, E. Schönau, P. Eysel

Erschienen in: European Spine Journal | Ausgabe 11/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Scoliosis of the vertebral column can be assessed with the Cobb angle (Cobb 1948). This examination is performed manually by measuring the angle on radiographs and is considered the gold standard. However, studies evaluating the reproducibility of this procedure have shown high variability in intra- and inter-observer agreement. Because of technical advancements, interests in new procedures to determine the Cobb angle has been renewed. This review aims to systematically investigate the reproducibility of various new techniques to determine the Cobb angle in idiopathic scoliosis and to assess whether new technical procedures are reasonable alternatives when compared to manual measurement of the Cobb angle.

Method

Systematic review. Studies examining procedures used to determine the Cobb angle were selected. Two review authors independently selected studies for inclusion, extracted data and assessed risk of bias. Statistical results of reliability and agreement were summarised and described.

Results

Eleven studies of new measuring procedures were included, all reporting the reproducibility. The new procedures can be divided into computer-assisted procedures, automatic procedures and smartphone apps.

Conclusions

All investigated measuring procedures showed high degrees of reliability. In general, digital procedures tend to be slightly better than manual ones. For all other measurement procedures (automatic or smartphone), results varied. Studies implementing vertebral pre-selection and observer training achieved better agreement.

Cobb JR (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Instr Course Lect 5:261–275

Romano M, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Kotwicki T, Maier-Hennes A, Negrini S (2012) Exercises for adolescent idiopathic scoliosis. Cochrane Database Syst Rev 8:CD007837. doi:10.1002/14651858.CD007837.pub2 PubMed

Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Vasiliadis ES (2010) Braces for idiopathic scoliosis in adolescents. Spine (Phila Pa 1976) 35(13):1285–1293. doi:10.1097/BRS.0b013e3181dc48f4

Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH (1990) Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am 72(3):320–327PubMed

Carman DL, Browne RH, Birch JG (1990) Measurement of scoliosis and kyphosis radiographs. Intraobserver and interobserver variation. J Bone Joint Surg Am 72(3):328–333PubMed

Srinivasalu S, Modi HN, Smehta S, Suh SW, Chen T, Murun T (2008) Cobb angle measurement of scoliosis using computer measurement of digitally acquired radiographs-intraobserver and interobserver variability. Asian Spine J 2(2):90–93. doi:10.4184/asj.2008.2.2.90 PubMedCrossRef

Corona J, Sanders JO, Luhmann SJ, Diab M, Vitale MG (2012) Reliability of radiographic measures for infantile idiopathic scoliosis. J Bone Joint Surg Am 94(12):e861–e868. doi:10.2106/JBJS.K.00311

Jones JK, Krow A, Hariharan S, Weekes L (2008) Measuring angles on digitalized radiographic images using Microsoft PowerPoint. West Indian Med J 57(1):14–19PubMed

Tanure MC, Pinheiro AP, Oliveira AS (2010) Reliability assessment of Cobb angle measurements using manual and digital methods. Spine J 10(9):769–774. doi:10.1016/j.spinee.2010.02.020 PubMedCrossRef

10.

Shea KG, Stevens PM, Nelson M, Smith JT, Masters KS, Yandow S (1998) A comparison of manual versus computer-assisted radiographic measurement. Intraobserver measurement variability for Cobb angles. Spine (Phila Pa 1976) 23(5):551–555CrossRef

11.

Cheung J, Wever DJ, Veldhuizen AG, Klein JP, Verdonck B, Nijlunsing R, Cool JC, Van Horn JR (2002) The reliability of quantitative analysis on digital images of the scoliotic spine. Eur Spine J 11(6):535–542. doi:10.1007/s00586-001-0381-7 PubMedCrossRef

12.

Chockalingam N, Dangerfield PH, Giakas G, Cochrane T, Dorgan JC (2002) Computer-assisted Cobb measurement of scoliosis. Eur Spine J 11(4):353–357. doi:10.1007/s00586-002-0386-x PubMedCrossRef

13.

Allen S, Parent E, Khorasani M, Hill DL, Lou E, Raso JV (2008) Validity and reliability of active shape models for the estimation of cobb angle in patients with adolescent idiopathic scoliosis. J Digit Imaging 21(2):208–218. doi:10.1007/s10278-007-9026-7 PubMedCrossRef

14.

Zhang J, Lou E, Hill DL, Raso JV, Wang Y, Le LH, Shi X (2010) Computer-aided assessment of scoliosis on posteroanterior radiographs. Med Biol Eng Comput 48(2):185–195. doi:10.1007/s11517-009-0556-7 PubMedCrossRef

15.

Shaw M, Adam CJ, Izatt MT, Licina P, Askin GN (2012) Use of the iPhone for Cobb angle measurement in scoliosis. Eur Spine J 21(6):1062–1068. doi:10.1007/s00586-011-2059-0 PubMedCrossRef

16.

Qiao J, Liu Z, Xu L, Wu T, Zheng X, Zhu Z, Zhu F, Qian B, Qiu Y (2012) Reliability analysis of a smartphone-aided measurement method for the Cobb angle of scoliosis. J Spinal Disord Tech 25(4):E88–E92. doi:10.1097/BSD.0b013e3182463964 PubMedCrossRef

17.

de Vet HC, Terwee CB, Knol DL, Bouter LM (2006) When to use agreement versus reliability measures. J Clin Epidemiol 59(10):1033–1039. doi:10.1016/j.jclinepi.2005.10.015 PubMedCrossRef

18.

Bartlett JW, Frost C (2008) Reliability, repeatability and reproducibility: analysis of measurement errors in continuous variables. Ultrasound Obstet Gynecol 31(4):466–475. doi:10.1002/uog.5256 PubMedCrossRef

19.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428PubMedCrossRef

20.

Streiner DL, Norman GR (2008) Health measurement scales a practical guide to their development and use, vol 4. Oxford University Press, Oxford

21.

Whiting P, Rutjes AW, Dinnes J, Reitsma J, Bossuyt PM, Kleijnen J (2004) Development and validation of methods for assessing the quality of diagnostic accuracy studies. Health Technol Assess 8(25):1–234 (pii: 98-27-99)

22.

Lucas NP, Macaskill P, Irwig L, Bogduk N (2010) The development of a quality appraisal tool for studies of diagnostic reliability (QAREL). J Clin Epidemiol 63(8):854–861. doi:10.1016/j.jclinepi.2009.10.002 PubMedCrossRef

23.

Zhang J, Lou E, Le LH, Hill DL, Raso JV, Wang Y (2009) Automatic Cobb measurement of scoliosis based on fuzzy Hough transform with vertebral shape prior. J Digit Imaging 22(5):463–472. doi:10.1007/s10278-008-9127-y PubMedCrossRef

24.

Zhang J, Lou E, Shi X, Wang Y, Hill DL, Raso JV, Le LH, Lv L (2010) A computer-aided Cobb angle measurement method and its reliability. J Spinal Disord Tech 23(6):383–387. doi:10.1097/BSD.0b013e3181bb9a3c PubMedCrossRef

25.

Goldberg MS, Poitras B, Mayo NE, Labelle H, Bourassa R, Cloutier R (1988) Observer variation in assessing spinal curvature and skeletal development in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 13(12):1371–1377CrossRef

26.

Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am 66(7):1061–1071PubMed

27.

Pruijs JE, Hageman MA, Keessen W, van der Meer R, van Wieringen JC (1994) Variation in Cobb angle measurements in scoliosis. Skeletal Radiol 23(7):517–520PubMedCrossRef

28.

Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310PubMedCrossRef

Titel: Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review
verfasst von: S. Langensiepen
O. Semler
R. Sobottke
O. Fricke
J. Franklin
E. Schönau
P. Eysel
Publikationsdatum: 01.11.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 11/2013
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-2693-9

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background

Method

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2013

Electromyographic characteristics of gait impairment in cervical spondylotic myelopathy

Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs

3D analysis of brace treatment in idiopathic scoliosis

An analysis of the anatomic features of the cervical spine using computed tomography to select safer screw insertion techniques

Monitoring the load on a telemeterised vertebral body replacement for a period of up to 65 months

CT angiography of anterior spinal artery in cervical spondylotic myelopathy