Measurements

[DrStitzel]

You make a good case to other members of your profession that they shouldn't solely rely on Cobb Angle measurement. I hope they take note.

I'm fairly certain many of the orthopedic doctors in the US are basing treatment decisions (observation, bracing, and possibly even surgery) solely off cobb's angle, as well as many chiropractors.

[Goldfinch]

We certainly have plenty of common ground here I certainly agree that Cobb Angle measurement is "incomplete" on its own, and that working out new methods for the assessment and measurement of scoliotic curves is to be applauded.

Having spoken to my medical colleagues, I'm informed that any surgeon who decided on treatment for a scoliotic patient based purely on the Cobb Angle as read from an x-ray would be negligent in the extreme, especially if they proceeded to surgery. No respectable scoliosis consultant would do this; in fact, it's nigh on impossible, because scoliosis is a three dimensional deformity and bracing and surgery cannot be carried out based on one two dimensional measurement. Restoring sagittal and coronal balance is vitally important, thus a variety of factors and measurements are looked at together in context.

If you know that there are surgeons who make surgical decisions based solely on the Cobb, it might be a good idea to get your article more widely published so that the medics can see it too? It's something that should be brought to light. I know you're seeking to treat patients non-surgically here and obviously I applaud that as it is something I would like to see happen more, however I feel I must advise that any patients who go down the traditional medical route should ensure that they seek a consultant who is a member of the Scoliosis Research Society; there is no way an SRS surgeon would work based on just a Cobb Angle.

Well done for highlighting this issue, it's educational for all.

[DrStitzel]

Hi Goldfinch,

I think we got off the same page again. I'm not saying that any orthos in the US are performing surgery based solely on Cobb angle (and for all the NSF readers....I was intentionally using the term "Cobb's angle" to reinforce that it is simply one man's interpretation of how scoliosis should be measured). I'm suggesting that some orthos may be making the initial recommendation for surgery solely based off Cobb angle.

I am not trying to suggest that anybody is acting in an unprofessional or unethical manner.