Abstract
BackgroundScoliosis is a common deformity, and its severity is usually assessed by measuring the Cobb angle on the spinal X-ray film. The measurement of the Cobb angle is an important basis for selecting therapeutic methods and evaluating therapeutic effects. To measure and calculate the scoliosis Cobb angle by end vertebra tilt angle method (tilt angle method) and assess its accuracy and usability.MethodsIt is deduced that the Cobb angle is the sum of upper and lower end vertebra tilt angles through the law of plane geometry. The project included 32 patients with scoliosis who have received treatment in our hospital from June 2011 to July 2016, whose Cobb angles were measured at various segments (total 50). The measuring results of the tilt angle method and the classical method were compared, and the time spent for the measurement of the two groups was respectively recorded with an electronic stopwatch for comparison. The interference of line marking in imaging data pixel in the two groups was compared using Beyond Compare software.ResultsThe measuring results through PACS (picture archiving and communication systems) were regarded as the reference standard. There was no statistical difference for measuring the Cobb angle between the PACS method, end vertebra tilt angle method, and classical method. The end vertebra tilt angle method takes less measuring time than the classical method. The measuring error between the classical method and the tilt angle method showed no statistical significance for the difference.ConclusionThe scoliosis Cobb angle can be measured accurately and rapidly using the principle of the Cobb angle being equal to the sum of tilt angles of the upper and lower end vertebra, where in the film data of imaging will not be easily contaminated. Under special conditions, the average measuring error is ± 3°.
Highlights
Scoliosis is a common deformity, and its severity is usually assessed by measuring the Cobb angle on the spinal X-ray film
22 patients suffered from idiopathic scoliosis, 8 patients suffered from congenital scoliosis, and 2 patients suffered from neuromuscular scoliosis
After the upper and lower end vertebras and top vertebra were determined, three spine surgeons directly marked and measured the Cobb angle of the same scoliosis segment of the same patient using the classical method and tilt angle method, respectively, and recorded the time spent on each measurement method using an electronic stopwatch and calculated the average value
Summary
Scoliosis is a common deformity, and its severity is usually assessed by measuring the Cobb angle on the spinal X-ray film. The measurement of the Cobb angle is an important basis for selecting therapeutic methods and evaluating therapeutic effects. To measure and calculate the scoliosis Cobb angle by end vertebra tilt angle method (tilt angle method) and assess its accuracy and usability. The scoliosis Cobb angle is an important index of disease assessment. The classical method is used to determine the upper/lower end vertebras (UEV/LEV) on the whole spine anteroposterior X-ray film; draw a vertical line respectively at the upper/lower end vertebra endplate lines (UEVEL/LEVEL), and the included angle of the two vertical lines is the Cobb angle [1] (Fig. 1).
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