Reliability and validity of inexpensive and easily administered anthropometric clinical evaluation methods of postural asymmetry measurement in adolescent idiopathic scoliosis: a systematic review
STUDY DESIGN A prospective study was conducted in a young homogenous adolescent population, with the use of the scoliometer. OBJECTIVES To create a mathematic formula that provides the accurate Cobb angle of idiopathic scoliosis with the use of the scoliometer only. SUMMARY OF BACKGROUND DATA The scoliometer is an accepted method for detection and evaluation of scoliosis during screening programs. To the author's knowledge, there are no previous methods and formulas to estimate the approximate Cobb angle using only the scoliometer. METHODS Several clinical (scoliometer value, age, and sex) and radiographic (Cobb angle, Perdriolle of and apical vertebra, Risser iliac apophysis classification) parameters from 442 (4.37%) of 10,109 screened adolescents who had a scoliometer value of at least 7 degrees were taken and correlated using the simple and multiple linear regression analysis. RESULTS Cobb angle and scoliometer value were statistically significantly correlated to each other. Two mathematic formulas were created to predict the Cobb angle of the thoracic and lumbar scoliosis, with similar sensitivity and accuracy. The thoracic and lumbar scoliometer values were statistic significantly correlated with the thoracic and lumbar Cobb angle (P = 0.0254 and P = 0.0015, respectively). The lumbar scoliometer value was significantly correlated with lumbar apical vertebra Perdriolle value. Also, the thoracic and lumbar Cobb angles were significantly correlated with thoracic and lumbar apical vertebra (P = 0.0001 and P = 0.0015, respectively). CONCLUSIONS In the present study, the authors have constructed two mathematic formulas, which provide accurately the scoliotic Cobb angle in young adolescents using only the scoliometer with a deviation of 5.63 degrees thoracic curves and 5.79 degrees for lumbar curves. The authors recommended that all physicians engaged in scoliosis screening programs use the scoliometer based on the mathematic formulas that the authors developed. They believe that this method will reduce the cost of school screening programs, the overdiagnosis, and the unnecessary exposure to irradiation of this young population in the future.