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Open Access Highly Accessed Review

A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices

Petros Patias1*, Theodoros B Grivas2, Angelos Kaspiris3, Costas Aggouris2 and Evangelos Drakoutos2

Author Affiliations

1 School of Surveying Engineering, Aristotle University of Thessaloniki, GR-541 24 Thessaloniki, Greece

2 Department of Trauma and Orthopaedics, "Tzanio" General Hospital of Piraeus - NHS, Tzani & Afendouli str, 18536, Piraeus, Greece

3 Orthopaedic Surgeon, Department of Trauma and Orthopaedics, "Thriasio" General Hospital - NHS, G. Gennimata Av. 19600, Magoula, Attica, Greece

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Scoliosis 2010, 5:12  doi:10.1186/1748-7161-5-12

Published: 29 June 2010

Abstract

Background

Although scoliosis is characterized by lateral deviation of the spine, a 3D deformation actually is responsible for geometric and morphologic changes in the trunk and rib cage. In a vast related medical literature, one can find quite a few scoliosis evaluation indices, which are based on back surface data and are generally measured along three planes. Regardless the large number of such indices, the literature is lacking a coherent presentation of the underlying metrics, the involved anatomic surface landmarks, the definition of planes and the definition of the related body axes. In addition, the long list of proposed scoliotic indices is rarely presented in cross-reference to each other. This creates a possibility of misunderstandings and sometimes irrational or even wrong use of these indices by the medical society.

Materials and methods

It is hoped that the current work contributes in clearing up the issue and gives rise to innovative ideas on how to assess the surface metrics in scoliosis. In particular, this paper presents a thorough study on the scoliosis evaluation indices, proposed by the medical society.

Results

More specifically, the referred indices are classified, according to the type of asymmetry they measure, according to the plane they refer to, according to the importance, and relevance or the level of scientific consensus they enjoy.

Conclusions

Surface metrics have very little correlation to Cobb angle measurements. Indices measured on different planes do not correlate to each other. Different indices exhibit quite diverging characteristics in terms of observer-induced errors, accuracy, sensitivity and specificity. Complicated positioning of the patient and ambiguous anatomical landmarks are the major error sources, which cause observer variations. Principles that should be followed when an index is proposed are presented.