Abstract
The aim of the study was to analyze four radiographic methods of calculating the loss of body height associated with scoliosis. Thirty patients with right thoracic idiopathic scoliosis were examined with standing postero-anterior radiographs. Cobb angles of the upper thoracic, main thoracic and lumbar curves were measured. The loss of body height due to scoliosis was measured directly on the radiographs and then calculated using the methods of Bjure, Kono, Stokes and Ylikoski, respectively. The reproducibility of calculations was tested. Detailed analysis of two patients with similar Cobb angle but different trunk height was performed. The mean Cobb angle of the main thoracic curve was 46° (21°-74°). The mean loss of body height was 23 mm (11-43 mm) calculated by method of Bjure, 7 mm (-24 to 46 mm) by Kono, 20 mm (5-47 mm) by Stokes, 14 mm (3-36 mm) by Ylikoski, versus 18 mm (3-50 mm) measured directly on radiographs. The overall difference between the loss of body heights was significant (p < 0.0001), with significant differences in pairs for: Bjure versus Kono (p < 0.0001), Stokes versus Kono (p = 0.0002), Kono versus measured (p = 0.0061) and Bjure versus Ylikoski (p = 0.0386). Strong linear correlation between the methods was found (r ≥ 0.92; p < 0.0001). High reproducibility of height loss calculations was noticed. The two patients with similar Cobb angle and different trunk height revealed similar height loss calculated, while different loss measured on radiographs. There existed no overall agreement between the four methods of calculation of the loss of body height associated with scoliosis. Calculations based on the Cobb angle produced inaccuracy and could be supplemented with data considering trunk size.
Highlights
Total body height in patients with scoliosis is diminished due to the spinal deformity
Thirty patients with right thoracic idiopathic scoliosis were examined with standing postero-anterior radiographs
There existed no overall agreement between the four methods of calculation of the loss of body height associated with scoliosis
Summary
Total body height in patients with scoliosis is diminished due to the spinal deformity. Corrected body height is needed to establish various clinical parameters such as normal values of blood pressure in children, lungs vital capacity (VC), growth charts, and body mass index (BMI). In 1968, Bjure et al [7, 8] developed an empirically based formula employing the Cobb angle for predicting proper body height in scoliotic patients. Presented approaches consisting of regression analysis of the radiological data for calculating the corrected body height in scoliotic patient. All of these methods relied on the Cobb angle to predict the true body height in patients with scoliosis. All methods employ sophisticated mathematical formulas which make their use in everyday clinical practice cumbersome. Potential for inaccuracy of the methods has been reported, because none of them consider the actual height of the subject with scoliosis [12]
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