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Choosing the most suitable treatment for the scoliosis relies heavily on accurate and reproducible spinal curvature measurement from radiographs. Our objective is to reduce the variability in spinal curvature measurement by reducing the user intervention and bias. In order to determine the reliability of the spinal curvature measurement as it is in the clinical measurement of scoliosis a methodological survey has been carried out that concludes with inter and intra observer error variation. The proposed method list out horizontal inclination of all the vertebrae's in terms of slopes using active contour models and morphological operators. This facilitates the radiologist to decide end vertebrae and hence inter/intra observer variation is completely eliminated. Tables 1 and 2 shows the observer error variation between manual and proposed methods in terms of mean and standard deviation.

Scoliosis is a 3-D deformity of spinal column, characterized by both lateral curvature and vertebral rotation. The disease can be caused by congenital, developmental, or degenerative problems; but most cases of scoliosis actually have no known cause, and this is known as idiopathic scoliosis. Vertebral rotation has become increasingly prominent in the study of scoliosis and the most deformed vertebra is named as apical vertebra. Apical vertebral deformity demonstrates significance in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions. Precise measurement of apical vertebral rotation in terms of grading is most valuable for the determination of reference value in normal and pathological conditions for better understanding of scoliosis. Routine quantitative evaluation of vertebral rotation is difficult and error prone due to limitations of observer characteristic and specific imaging property. This paper proposes automatic identification of the apical vertebra and its parameter that depends on the objective criteria of measurement using active contour models. The proposed technique is more accurate and is a reliable measurement compared to manual and computer-assisted system.