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Scoliosis - important lines and angles

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Known idiopathic scoliosis

Patient Data

Age: 17 years
Gender: Female

Low dose standing (EOS) x-ray

x-ray

An S-shaped thoracolumbal scoliosis is noted without segmentation abnormalities. The saggital curvature of the spine is within limits of the normal range.

Measurement of the Cobb angle

x-ray

After the end vertebrae of both curves have been established, lines are aligned with their endplates, between which an approximately 30° Cobb angle can be measured for both deformities.

Coronal & saggital balance

x-ray

The sagittal and coronal balances are both within the normal range, the lines drawn form the middle of the C7 vertebra view pass through the midline at the level of the S1 on the coronal view, and within a 2 cm distance from the posterosuperior corner of the S1 segment on the sagittal view.

Evaluating pelvic tilt

x-ray

A resultant approximately 5° tilt of the pelvis to the left can be observed

Case Discussion

Typical case of idiopathic scoliosis demonstrating some key descriptors that are particularly helpful in assessing progression and the effect of therapy. 

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