Scoliosis - measurement

 

X-ray - Coronal planes: 

 

• Identification of the curve apex and significant vertebrae is crucial for denoting the curve type, selecting the surgical approach and instrumentation system, and determining the optimal level for fusion. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As such scoliosis can be classified as: 
 

- cervical (apex between C2 and C6)

- cervicothoracic (C7–T1)

- thoracic (T2–T11) 

- thoracolumbar (T12–L1)
- lumbar (L2–L4)
- lumbosacral (L5 and below).

- lumbar (L2–L4)

- lumbosacral (L5 and below).

 

 

• Curve measurement is usually performed by the Cobb method. A Cobb angle is measured for each curve that is present. When comparing different radiographs the end vertebrae usually remain the same, although corrections might be needed over time.

 

 

 

 

 

 

 

 

 

 

 

Spinal asymmetry: < 10°

Mild scoliosis: 10 - 25%

Severe scoliosis: > 25%

 

 

 

 

Primary curves are the first to develop. Secondary curves develop afterwards as a means to balance the head and trunk over the pelvis, not only in the frontal but also in the sagittal plane

 

Structural curves (as opposed to nonstructural curves) cannot be corrected with side bending or traction. Nonstructural curves can be secondary curves or functional curves

 

• Risser stadium - Skeletal maturity 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X-ray - Sagittal planes:

 

• Sagittal balance: 

 

Normal sagittal balance is the alignment of C7 to the posterior superior aspect of the sacrum. The sagittal plumb line, as drawn from center of C7, should be ±2 cm from the sacral promontory. Positive sagittal balance, i.e., an anterior deviation of the C7 plumb line, is more significantly associated with pain and disability than curve magnitude, curve location, or coronal imbalance.

 

• Kyphosis meting : hoek tussen bovenste dekplaat van D1 en onderste dekplaat van D12. normaal 37°, tss 18° en 57°. Kyfosehoek volgens Stagnara (D3-D11) = 25°. Als D1 niet zichtbaar dan bovenste dekplaat van eerste zichtbare wervel.

• Lordose meting : hoek tussen bovenste dekplaat van L1 en bovenste dekplaat van S1. normaal 45°, tss 25° en 65°

• Sacrale inclinatie: hoek tussen de bovenste dekplaat van S1 en horizontale. Normaal tss 26° en 57° (gemiddeld tss 34° en 41°) + 8° bij staande opname.

 

 

Vertebral anomaly: