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Table 1 Conventional clinical measurements used in the management of AIS patients

From: Application of different measures of skeletal maturity in initiating weaning from a brace for scoliosis: two case reports

Measurement

Description

Comment

Cobb angle

The degree of tilt between two vertebrae (caudal and cranial end vertebrae) that are the most tilted on radiological examination [5]

This expresses the magnitude of lateral deviation of the curve

Angle of rotation of apical vertebra

On X-ray, this is the most translated and rotated vertebra in the transverse plane. Measurement in these cases was with the Perdriolle torsiometer

Vertebral rotation tends to increase with increasing Cobb angle

Scoliometry

A scoliometer (in these cases, the Bunnell scoliometer) measures the angle of trunk rotation, not vertebral rotation. Readings are taken in the sitting, forward bending position, so it is recommended as it provides stable posture and eliminates limb discrepancy [4]

Scoliometer readings on their own may be misleading and are not related to radiological data (Cobb angle and apical rotation). Both modalities should be considered in planning and evaluation of scoliosis treatment [6]

Kyphosis and lordosis angles

These are measured on sagittal view X-rays using the Cobb method (T4-T12 for kyphosis; L1-L5 for lordosis)

These measurements are taken as scoliosis may be associated with loss of normal sagittal curves [7]

Peak Expiratory Flow (ml/s)

Subjects inhale maximally and then exhale forcibly and as quickly as possible into a spirometer (in this case, the Mini-Wright Peak Flow meter). Subjects blow into the meter three times, with 30s breaks between attempts. The best of three results is taken

Scoliosis leads to restrictive lung disease secondary to reduced chest wall compliance. Chest wall compliance and vital capacity are inversely correlated with Cobb angles >10 degrees. As Cobb angle and apical rotation increase, there is a decrease in peak expiratory flow, total lung capacity, vital capacity, and functional residual capacity [8]. Curves >40-50 degrees may cause cor pulmonale