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KMID : 0388720030100030255
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Journal of Korean Society of Spine Surgery
2003 Volume.10 No. 3 p.255 ~ p.260
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The Change of Cobb Angle According To Position in Adolescent Idiopathic Scoliosis
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박원욱/Park, Weon Wook
이정섭/구자경/최영준/Lee, Jung Sub/Ku, Ja Gyung/Choi, Young Jun
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Abstract
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Study design : Consecutive, prospective, radiographic review of adolescent idiopathic scoliosis (AIS) patients. Objective : To analyze the change of Cobb angle according to position in AIS.
Sunu iary of Background Data : Cobb angle on standing radiographs was corrected spontaneously while the patients were in the sr spine position. However, there are few reports on Cobb angle in standing versus supine position in AIS.
Mate -ials and Methods : We checked AP plain radiographs of 101 AIS patients, 18 male and 83 female, in standing and supin position. Sixty-three cases were under Risser stage V and 38 were Risser stage V. In standing plain radiograph, 27 cases were in Cobb angle 10-19, 35 in 20-29,15 in 30-39 and 24 over 40.
According to curve pattern, 31 curves were classified as King type I, 32 as type II, 8 as type III, 11 as type IV, 17 as type V,1 thora olumbar curve and 1 lumbar curve. Cobb angle reduction was measured on AP radiographs from each group, according to se,(, maturation, Cobb angle and curve pattern.
Results : Average reduction of Cobb angle was 82 (range, 1-21), 6.4 for male and 8.6 for female (p=0.19). The reduction value according to maturation was 8.3 for the growing group and 8.0 for the grown group (p=0.73). The average reduction value in Cobb angle 10-19 was 5.4 (40.3%), 20-29 was 7.1 (30.9%), 30-39 was 8.6 (25.7/0) and over 40 was 12.8 (23.64,) (p=0.001). The reduction rate decreased in proportion to Cobb angle measured in standing position. The reduction value was 8 2 in King type I curves, 8.6 in type II, 9.1 in type III, 9.1 in type IV and 6.2 in type V (p=0238).
Conclusion : An average 8 Cobb angle reduction in supine position, compared with standing position, can influence treatment strates:y in AIS patients, because a Cobb angle change more than 5-6 is a threshold value to decide curve worsening. Thus, serial ´obb angle measurement should be performed in standing position.
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