Skip to main content
Erschienen in: European Spine Journal 2/2016

01.02.2016 | Ideas and Technical Innovations

Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve

verfasst von: Samuel L. Schmid, F. M. Buck, T. Böni, M. Farshad

Erschienen in: European Spine Journal | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

The Cobb angle measurement is well established for the measurement of coronal deformity aspect of scoliotic curves. The effect of positional differences in relation to the apex side of the scoliosis is not yet fully quantified. While theoretically plausible that positioning error with rotation toward the apex of the scoliosis would decrease the Cobb angle, the relations are not investigated yet and were object of this study.

Materials and methods

Multiple measurements of the Cobb angle were performed, while turning a spine-pelvic cadaveric specimen with a right-sided thoracic scoliosis of 47° (in neutral position) from 45° to −45° in steps of 5° using biplanar radiography. Statistical methods were applied to find the critical position, in which measurement errors potentially become clinically relevant (Cobb angle deviation >5°).

Results

Turning the specimen to the right (toward the apex of the scoliosis) produced during the first −15° of rotation, a Cobb angle ranging from 47° to 45°. At −20°, the Cobb angle was 42°, at −25° rotation 37° and at −30° rotation 36°. Above −30° rotation, the measured Cobb angle decreased to 36° (77 % of the original Cobb angle). No relevant differences were found by rotating the specimen to the left (away from the apex) (47° at neutral rotation and 44° at maximal error rotation of +45°).

Conclusion

The influence of rotational misplacement of the patient at the time of image acquisition on Cobb angle measurements is negligible for a rotational misplacement of ±20° of rotation for a idiopathic right-sided thoracic scoliosis of 47°. Over 20° of rotational misplacement of the patient toward the apex of the scoliosis falsely decreases the Cobb angle.
Literatur
1.
Zurück zum Zitat Cobb JR (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Inst Course Lect 5:261–274 Cobb JR (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Inst Course Lect 5:261–274
2.
Zurück zum Zitat King HA, Moe JH, Bradford DS, Winter RB (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am 65(9):1302–1313 King HA, Moe JH, Bradford DS, Winter RB (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am 65(9):1302–1313
3.
Zurück zum Zitat Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83-A(8):1169–1181 Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83-A(8):1169–1181
4.
Zurück zum Zitat Gille O, Champain N, Benchikh-El-Fegoun A, Vital JM, Skalli W (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine (Phila Pa 1976) 32(5):568–573 Gille O, Champain N, Benchikh-El-Fegoun A, Vital JM, Skalli W (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine (Phila Pa 1976) 32(5):568–573
5.
Zurück zum Zitat Humbert L, De Guise JA, Aubert B, Godbout B, Skalli W (2009) 3D reconstruction of the spine from biplanar X-rays using parametric models based on transversal and longitudinal inferences. Med Eng Phys 31(6):681–687 Humbert L, De Guise JA, Aubert B, Godbout B, Skalli W (2009) 3D reconstruction of the spine from biplanar X-rays using parametric models based on transversal and longitudinal inferences. Med Eng Phys 31(6):681–687
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat Malfair D, Flemming AK, Dvorak MF, Munk PL, Vertinsky AT, Heran MK, Graeb DA (2010) Radiographic evaluation of scoliosis: review. AJR Am J Roentgenol 194(3 Suppl):S8–S22 Malfair D, Flemming AK, Dvorak MF, Munk PL, Vertinsky AT, Heran MK, Graeb DA (2010) Radiographic evaluation of scoliosis: review. AJR Am J Roentgenol 194(3 Suppl):S8–S22
8.
Zurück zum Zitat 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):517–520 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):517–520
9.
Zurück zum Zitat 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 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
10.
Zurück zum Zitat Schumpe G, Hofmann P, Rössler H (1984) Problematik der Verlaufskontrolle bei Skoliosepatienten. Z Orthop Unfall 122(3):243–254 Schumpe G, Hofmann P, Rössler H (1984) Problematik der Verlaufskontrolle bei Skoliosepatienten. Z Orthop Unfall 122(3):243–254
11.
Zurück zum Zitat Göçen S, Havitçioglu H (2001) Effect of rotation on frontal plane deformity in idiopathic scoliosis. Orthopedics 24(3):265–268 Göçen S, Havitçioglu H (2001) Effect of rotation on frontal plane deformity in idiopathic scoliosis. Orthopedics 24(3):265–268
12.
Zurück zum Zitat Stagnara P (1968) Medical observation and tests for scoliosis. Rev Lyon Med 17(9):391–401 Stagnara P (1968) Medical observation and tests for scoliosis. Rev Lyon Med 17(9):391–401
13.
Zurück zum Zitat du Peloux J, Fauchet R, Faucon B, Stagnara P (1965) Le plan d’élection pour l’examen radiologique des cyphoscolioses. Rev Chir Orthop 51:517–524PubMed du Peloux J, Fauchet R, Faucon B, Stagnara P (1965) Le plan d’élection pour l’examen radiologique des cyphoscolioses. Rev Chir Orthop 51:517–524PubMed
14.
Zurück zum Zitat Deschênes S, Charron G, Beaudoin G, Labelle H, Dubois J, Miron MC, Parent S (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine (Phila Pa 1976) 3(9):989–994 Deschênes S, Charron G, Beaudoin G, Labelle H, Dubois J, Miron MC, Parent S (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine (Phila Pa 1976) 3(9):989–994
15.
Zurück zum Zitat Glaser DA, Doan J, Newton PO (2012) Comparison of 3-dimensional spinal reconstruction accuracy: biplanar radiographs with EOS versus computed tomography. Spine (Phila Pa 1976) 37(16):1391–1397 Glaser DA, Doan J, Newton PO (2012) Comparison of 3-dimensional spinal reconstruction accuracy: biplanar radiographs with EOS versus computed tomography. Spine (Phila Pa 1976) 37(16):1391–1397
16.
Zurück zum Zitat Carreau J, Bastrom T, Petcharaporn M, Schulte C, Marks M, Illés T, Somoskeöy S, Newton PO (2014) Computer-generated, three-dimensional spine model from biplanar radiographs: a validity study in idiopathic scoliosis curves greater than 50 degrees. Spine Deform 2(2):81–88 Carreau J, Bastrom T, Petcharaporn M, Schulte C, Marks M, Illés T, Somoskeöy S, Newton PO (2014) Computer-generated, three-dimensional spine model from biplanar radiographs: a validity study in idiopathic scoliosis curves greater than 50 degrees. Spine Deform 2(2):81–88
17.
Zurück zum Zitat Kuklo TR, Potter BK, Schroeder TM, O’Brien MF (2006) Comparison of manual and digital measurements in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 15(11):1240–1246 Kuklo TR, Potter BK, Schroeder TM, O’Brien MF (2006) Comparison of manual and digital measurements in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 15(11):1240–1246
18.
19.
Zurück zum Zitat Krismer M, Sterzinger W, Haid C, Frischhut B, Bauer R (1996) Axial rotation measurement of scoliotic vertebrae by means of computed tomography scans. Spine (Phila Pa 1976) 21(5):576–581 Krismer M, Sterzinger W, Haid C, Frischhut B, Bauer R (1996) Axial rotation measurement of scoliotic vertebrae by means of computed tomography scans. Spine (Phila Pa 1976) 21(5):576–581
Metadaten
Titel
Radiographic measurement error of the scoliotic curve angle depending on positioning of the patient and the side of scoliotic curve
verfasst von
Samuel L. Schmid
F. M. Buck
T. Böni
M. Farshad
Publikationsdatum
01.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 2/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4259-5

Weitere Artikel der Ausgabe 2/2016

European Spine Journal 2/2016 Zur Ausgabe

Arthropedia

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

Update Orthopädie und Unfallchirurgie

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