Cobb angle
The Cobb angle is a measurement of bending disorders of the vertebral column such as scoliosis and traumatic deformities.
Definition and method
[edit | edit source]It is defined as the greatest angle at a particular region of the vertebral column, when measured from the superior endplate of a superior vertebra to the inferior endplate of an inferior vertebra.[1] However, the endplates are generally parallel for each vertebra, so not all sources include usage of a superior versus inferior endplate in the definition.[2]
Unless otherwise specified it is generally presumed to refer to angles in the coronal plane, such as projectional radiography in posteroanterior view. In contrast, a sagittal Cobb angle is one measured in the sagittal plane such as on lateral radiographs.[3]
Cobb angles are preferably measured while standing, since lying down decreases Cobb angles by around 7–10°.[4]
Uses
[edit | edit source]It is a common measurement of scoliosis.
The Cobb angle is also the preferred method of measuring post-traumatic kyphosis in a recent meta-analysis of traumatic spine fracture classifications.[5]
Severity
[edit | edit source]| Severity | Cobb angle |
|---|---|
| Not scoliosis | <10°[6] |
| Mild scoliosis | 10–30° |
| Moderate scoliosis | 30–45°[7] |
| Severe scoliosis | >45°[7] |
Those with Cobb angle of more than 60° usually have respiratory complications.[7]
Scoliosis cases with Cobb angles between 40 and 50 degrees at skeletal maturity progress at an average of 10 to 15 degrees during a normal lifetime. Cobb angles of more than 50 degrees at skeletal maturity progress at about 1 to 2 degrees per year.[8]
History
[edit | edit source]The Cobb angle is named after the American orthopedic surgeon John Robert Cobb (1903–1967). It was originally used to measure coronal plane deformity on radiographs with antero-posterior projection for the classification of scoliosis.[9] It has subsequently been adapted to classify sagittal plane deformity, especially in the setting of traumatic thoracolumbar spine fractures.
References
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- ^ Cobb JR. Outline for the study of scoliosis. The American Academy of Orthopedic Surgeons Instructional Course Lectures. Vol. 5. Ann Arbor, MI: Edwards; 1948.