Traditionally, cobb angles have been measured using protractor and. Reducing a 60 degree scoliosis by 10 degrees represents a far greater accomplishment than reducing a 20 degree scoliosis down to 10 degrees. Scoliosis cobb angle scoliosis scoliosis scoliosis. As the cobb angle increases, the actual curvature of the spine becomes exponentially more severe.
In our study, we evaluated the radiographs of 23 patients, measuring the cobb angle in printed film and in digitalized form using pixviewer software. The spinal measurement software sms is an alternative to conveniently measure the true spines length. Two mask rcnn models as the core of a computeraided method were used to separately detect and segment the spine and all vertebral bodies on chest xrays, and the cobb angle of the spinal curve was measured from. Cobb angle is a measurement of the degree of sidetoside spinal curvature, which is a deformity you may know as scoliosis. To determine if bone density scanning dexa and the use of a computer software program can make accurate measurements of the curvatures of the spine cobb anglein patients with kyphosis and scoliosis compared to xrays of the spine. The cobb angle is also the preferred method of measuring posttraumatic kyphosis in a recent metaanalysis of traumatic spine fracture classifications. We have a huge discrepancy between the doctors measurements and the official radiology report from the childrens hospital of eastern ontario cheo. The severity definition for scoliosis is determined using the cobb angle as shown in table 1. Idiopathic scoliosis treatment depends on the accurate assessment of the cobb angle, which is usually performed manually. As such, it can be used to reduce costs for school screening programs. A software program to measure the threedimensional length.
The traditional uniplanar t1s1 measurement method is not reflecting the actual three dimensional curvature of a scoliotic spine and is therefore not accurate. Aldt does not show the severity of the cobb angle, however it is an easy way to gain another dimension which is useful. It is a twodimensional measurement of a threedimensional condition. Evaluation of a computeraided method for measuring the. There was no variation in the choice of the end vertebrae of the main curve. I am wondering if anyone has had any problem finding out the actual cobb angle of their curves. Demonstration of 2020 imagings opalrad chiropractic digital xray software tool cobb angle see all the opalrad chiro videos. Scoliosis cobb angle is a diagnostic tool that is utilized to measure the exact degree of side to side spinal curvature using an xray film. Measurement of scoliosis cobb angle by end vertebra tilt angle method jing wang1, jin zhang1, rui xu2, tie ge chen1, kai sheng zhou1 and hai hong zhang1 abstract background. Scoliosis involves all three dimensions of the spine. Fixed effect model analysis demonstrated that, although a statistically significant difference existed between the 3 methods of measuring the cobb angle p scoliosis when the spine has a sideways curvature of at least 10 degrees, which is measured by the cobb angle. Easyangle can measure the cobb angle on scoliosis in just two clicks.
Therefore, cobb angle measurement by surgimapspine software both in coronal and sagittal alignment may be more accurate when compared with those measured with the manual method. The doctor told us, at an appointment, that my daughters angles were t56 and l50. For instance, if a 30degree cobb angle is found in a 10yearold girl who has a lot of skeletal growth left, a brace is likely to be recommended. The statistical analysis showed an average variation in the cobb angle between the two methods of 1. Use of the iphone for cobb angle measurement in scoliosis ncbi. The most common quantification of scoliosis is the cobb angle 4. Use of the iphone for cobb angle measurement in scoliosis. Cobb angle measurements on digital radiographs using. To automatically measure the cobb angle and diagnose scoliosis on chest xrays, a computeraided method was proposed and the reliability and accuracy were evaluated. The cobbmeter is another alternative for measuring cobb angle in scoliosis. John r cobb, an american orthopedic surgeon, to measure the angle of spinal curves. Lines are drawn on the xray or a computer program assists to calculate the angle. Conclusion the computeraided method has potential for automatic cobb angle measurement and scoliosis diagnosis on chest xrays.
Katz participated in a panel discussion titled trends in adolescent idiopathic scoliosis concerning cobb angle vs. With this measurement, doctors are able to judge the severity of the scoliosis, assess the curve and recommend treatment options. The angle can inform doctors of the severity of scoliosis, whether the condition is. Cobb suggested that the angle of curvature be measured by drawing lines parallel to the upper border of the upper vertebral body and the lower border of the lowest vertebra of the structural curve, then erecting perpendiculars from these lines to cross each other, the angle between these perpendiculars being the angle of curvature. In addition, comparing the patients cobb angle to past exams can help determine whether or not the curve is getting progressively worse, as well as whether treatment is working or even needed.
Scoliosis is a common deformity, and its severity is usually assessed by measuring the cobb angle on the spinal xray film. A cobb angle describes the maximum distance from straight a scoliotic curve may be. Since the cobb angle and its progression are important components of determining scoliosis treatment, the variability of the angle is less than optimal. Measurement under a few degrees is and will continue to be difficult unless there can be a physical method of measurement thats accurate and then averaging over a period of time to account for daily movement. The 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. A cobb angle greater than 40 degrees denotes severe scoliosis. Cobb angle measurement of scoliosis using computer measurement of digitally acquired. While the cobb angle is the current standard for scoliosis measurement, its important to recognize three significant points. The cobb angle is the most widely used measurement to quantify the magnitude of spinal deformities, especially in the case of scoliosis, on plain radiographs. Most scoliosis curves are between 10 to 40 degrees in magnitude.
The coronal cobb angle is usually used for the assessment and treatment of scoliosis. Cobb angle used to measure scoliosis curves spinehealth. The cobb angle measurement is the gold standard of scoliosis evaluation endorsed by scoliosis research society. The objective measurement of spinal orthosis use for the treatment of adolescent. In 1948 he outlined how to measure the angle of the spinal curve, a method used worldwide to quantify spinal deformities. Treatment options include observation, braces, and surgery. Computerbased cobb angle measurement using deflection. Typically, curves under 20 degrees in adults are not worrisome. Measurement of scoliosis cobb angle by end vertebra tilt. Cobb angle measurement of spine from xray images using. Understanding cobb angles and what it means for scoliosis. The cobb angle is used on xray to measure the angle between the most angulated vertebras that make up the curvature. The cobb angle has proven itself to be a great diagnostic tool for patients with abnormal scoliosis, kyphosis and lordosis curvatures. Scoliosis severity is moderate when the cobb angle ranges from 20 to 40 degrees.
Manual measurements, however, can lead to observer variations, which depend on the correct selection of the curvature superior and inferior vertebrae in order to draw the needed lines for cobb angle measurements. To measure and calculate the scoliosis cobb angle by end vertebra tilt angle method tilt angle method and assess its accuracy and usability. Therefore the examiner performing the radiationfree measurement of the scoliotic cobb angle does not affect the system results 10. Measurement of cobbs angle by software anglespine pavel cerny. The cobb angle is best understood within the context of the individual patient. A scoliosis is defined as a lateral spinal curvature with a cobb angle of 10 or more 4. Pdf use of the iphone for cobb angle measurement in scoliosis. One week later he changed his reading to t52 and l49. In other words, a 40 degree cobb angle is more than twice as severe as a 20 degree cobb angle. Increased adoption of picture archiving and communication pacs systems within hospitals has reduced the need for manual measurement of scoliosis cobb angles in some cases, as spinal curves can be measured directly on digital radiographs using software tools built into the imaging viewing software. To develop a computeraided method that reduces the variability of cobb angle measurement for scoliosis assessment. Objective the aim of the study was to verify the method of ca measurements on digital radiographs using bunnell. The cobb angle is used to measure the curvature of the spine. A cobb angle in the range of 10 to 20 degrees is considered as mild scoliosis.
The cobb angle drives clinical decision making and is the primary measurement by which all natural history studies have been conducted. The variety of software used to assess radiographs might make the ca measurements cumbersome in everyday clinical practice. Iphone app use to cobb angle in adolescent idiopathic scoliosis. In this article, cobb angle measurement includes xray image processing that. This is a transparent online protractor, also helps you measure angles in a picture, you can easily measure the angle of any object around you, taking a picture and uploading it, then dragging the midpoint of the protractor to the vertex of the angle. The condition of a spine is associated with the spinal curve. Here is a general outline of cobb angle ranges and what they could indicate in idiopathic scoliosis found in children and adolescents. Cobb angle is used worldwide to measure and quantify the magnitude of spinal deformities, especially in the case of scoliosis. Background electronic rulers on computer screen are used to measure the cobb angle ca instead of traditional methods with rulers, protractors and pens.
In order to quantify and track the progression of scoliosis a standard measurement known as the cobb angle named after dr. Scoliosis is an abnormal sideways curvature of the spine with at least a 10 degree cobb angle. A deep neural network dnn was trained with vertebral patches extracted from spinal model radiographs. Measure cobb angle on scoliosis easyangle digital goniometer. Cobb angle measurement of kyphosis and scoliosis full. Scoliosis cobb angle scoliosis cobb angle is a diagnostic tool that is utilized to determine and measure the exact degree of sidetoside spinal curvature using an xray film. Measurement of scoliosis cobb angle by end vertebra tilt angle.
To compare the measurement of the cobb angle on printed radiographs and on scanned radiographs viewed through the software pixviewer. To measure the cobb angle, one must first decide which vertebrae are the endvertebrae of the curve deformity the vertebra whose endplates are most tilted towards each other lines are then drawn along the endplates, and the angle between the two lines, where they intersect, measured. It is used as the standard measurement to quantify and track the progression of scoliosis. Measurement of cobbs angle by software anglespine youtube. Cobb angle measurements on digital radiographs using bunnell scoliometer.
In cases where the curvature is not marked, then the lines will not intersect on the filmmonitor, in. Cobb angles were then measured on the digital images using standard measurement software. Pdf measurement of scoliosis cobb angle by end vertebra. However, it is still the main standard for diagnosis, monitoring, therapeutic planning, and epidemiologic analysis of scoliosis.
Reliability and reproducibility analysis of the cobb angle. The cobb angle of a scoliotic curve is the angle formed by the intersection of two lines, one parallel to. The interference of line marking in imaging data pixel in the two groups was compared using beyond compare software. The measurement of the cobb angle is an important basis for selecting therapeutic methods and evaluating therapeutic effects. Curves that are less than 10 degrees are not considered to represent scoliosis, but rather a minor spinal asymmetry. The cobb angle of the spinal curve was calculated automatically from the vertebral slopes predicted by the dnn.