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

Gabrielle C Lam1, Doug L Hill12, Lawrence H Le3, Jim V Raso12 and Edmond H Lou12*

Author Affiliations

1 Department of Surgery, University of Alberta, Edmonton, T6G 2B7, Canada

2 Department of Rehabilitation Technology, Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, T5G 0B7, Canada

3 Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, T6G 2B7, Canada

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Scoliosis 2008, 3:16  doi:10.1186/1748-7161-3-16

Published: 2 November 2008


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.