Vertebral rotation measurement: a summary and comparison of common radiographic and CT methods

Abstract

Current research has provided a more comprehensive understanding of Adolescent Idiopathic Scoliosis (AIS) as a three-dimensional spinal deformity, encompassing both lateral and rotational components. Apart from quantifying curve severity using the Cobb angle, vertebral rotation has become increasingly prominent in the study of scoliosis. It demonstrates significance in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions. In the past, the need for computer resources, digitizers and custom software limited studies of rotation to research performed after a patient left the scoliosis clinic. With advanced technology, however, rotation measurements are now more feasible. While numerous vertebral rotation measurement methods have been developed and tested, thorough comparisons of these are still relatively unexplored. This review discusses the advantages and disadvantages of six common measurement techniques based on technology most pertinent in clinical settings: radiography (Cobb, Nash-Moe, Perdriolle and Stokes' method) and computer tomography (CT) imaging (Aaro-Dahlborn and Ho's method). Better insight into the clinical suitability of rotation measurement methods currently available is presented, along with a discussion of critical concerns that should be addressed in future studies and development of new methods.

Three-Dimensional Assessment of the Scoliosis

“…The use of CT scan and MRI was proposed for measurement of rotation, but radiography is still the more commonly used method. (Lam 2008) …”

Functional Disorders in the Spine Deformations and Methods for their Correction

“…Степень сколиоза обычно оценивают при изучении обыч-ных рентгеновских снимков в переднезадней и боковой проекции [14]. Угол Кобба является наиболее широ-ко используемым методом в нашей стране [15][16][17]. Существует много методик, предложенных и применяе-мых для измерения ротации позвонков: рентгенография [18,19], компьютерная томография [20][21][22], магнит-но-резонансная томография [23,24], ультразвуковое исследование [25].…”

“…Угол Кобба является наиболее широ-ко используемым методом в нашей стране [15][16][17]. Существует много методик, предложенных и применяе-мых для измерения ротации позвонков: рентгенография [18,19], компьютерная томография [20][21][22], магнит-но-резонансная томография [23,24], ультразвуковое исследование [25]. Рентгенологические методы, такие как Nash и Moe [26], Perdriolle [27] и Raimondi [28], врачи до сих пор используют и для измерения враще-ния позвонков в грудном и поясничном отделе.…”

Eigenspine: Eigenvector Analysis of Spinal Deformities in Idiopathic Scoliosis

“…To this end, a number of other methods for assessing spinal deformity have been developed, including both manual and computerized methods. Examples include methods for axial vertebral rotation measurements [11,17], based on either 2D or 3D data, and methods for estimating both the position and the rotation of each vertebra [2,5,16].…”