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International Orthopaedics
Published in: International Orthopaedics 5/2017

Open Access 01-05-2017 | Original Paper

Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis

Authors: Ricarda Lechner, David Putzer, Dietmar Dammerer, Michael Liebensteiner, Christian Bach, Martin Thaler

Published in: International Orthopaedics | Issue 5/2017

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Abstract

Purpose

The Cobb angle as an objective measure is used to determine the progression of deformity, and is the basis in the planning of conservative and surgical treatment. However, studies have shown that the Cobb angle has two limitations: an inter- and intraobserver variability of the measurement is approximately 3–5 degrees, and high variability regarding the definition of the end vertebra. Scoliosis is a three-dimensional (3D) pathology, and 3D pathologies cannot be completely assessed by two-dimensional (2D) methods, like 2D radiography. The objective of this study was to determine the intraobserver and interobserver reliability of end vertebra definition and Cobb angle measurement using X-rays and 3D computer tomography (CT) reconstructions in scoliotic spines.

Methods

To assess interoberver variation the Cobb angle and the end vertebra were assessed by five observers in 55 patients using X-rays and 3D CT reconstructions. Definition of end vertebra and measurement of the Cobb angle was repeated two times with a three-week interval. Intraclass correlation coefficients (ICC) were used to determine the interobserver and intraobserver reliabilities. 95% prediction limits were provided for measurement errors.

Results

Intraclass correlation coefficient (ICC) showed excellent reliability for both methods. The measured Cobb angle was on average 9.2 degrees larger in the 3D CT group (72.8°, range 30–144) than on 2D radiography (63.6°, range 24–152).

Conclusions

In scoliosis treatment it is very essential to determine the curve magnitude, which is larger in a 3D measurement compared to 2D radiography.
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Metadata
Title
Comparison of two- and three-dimensional measurement of the Cobb angle in scoliosis
Authors
Ricarda Lechner
David Putzer
Dietmar Dammerer
Michael Liebensteiner
Christian Bach
Martin Thaler
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 5/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3359-0

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