Objective. To analyze feasibility of computer optical topography in determining of pathogenetic effect of leg length inequality on posture and stereotypes of adaptive activity of the spine. Material and Methods. The study included 59 patients aged from 4 to 29 years with congenital and acquired lower limb shortening of 2–17 cm. Spatial characteristics of the trunk and the spine in orthostatic position were studied using 5–10 topographic images obtained at 10–20-second time intervals during prolonged standing for up to 5 minutes in the setting of fully or partially compensated leg length discrepancy. Topographic monitoring of the spine with marker was performed before and after surgical correction of limb shortenings. Results. Standing in orthostatic position was associated with alteration of spatial characteristics of the trunk, namely variations in orientation and shape of the trunk and the spine. The prolonged study of postural activity allows for instrumental evaluation of stereotypes of the spine adaptive activity and determination of changes in its kinematic lability using functional tests. Conclusion. Coefficients of variation of parameters describing deformity angles represent rigid properties of curvatures, and can serve as criteria of motor pathology in stereotypes of the spine postural activity. Pathogenetically, deformity rigidity and low kinematic lability of vertebral motor segments can be considered similar to the prolonged articular immobilization which leads to stiffness, myogenic contracture (functional scoliosis), and ankylosis (fixed scoliosis).