Using the Cobb Angle to Measure Scoliosis Curvature

The Cobb angle is a universal standard used to measure the severity and degree of spinal abnormalities. At Ideal Spine, it’s one of the most critical tools we teach chiropractors, to assist them in evaluating the condition of each patient’s spinal alignment.

First outlined in 1948 by Dr. John Cobb, the Cobb angle is used to measure and track the progression of scoliosis and other spinal dysfunctions. The Cobb Angle is a useful tool that chiropractors and other healthcare professionals can use to determine the severity of a patient’s spinal abnormalities and ascertain the best course of treatment for them.

Measuring the Cobb Angle

To measure the Cobb angle, you’ll first need to x-ray the patient in a standing position. Typically, the x-rays are taken both from the front and the back. Having multiple images in multiple positions can help you more accurately compare and measure the spine’s curvature.

Once the images are ready for review, identify the most affected vertebra in the top of the spine. This vertebra, called the apical vertebra, is the bone with the most rotation. This simply means that the bone is the furthest away from the rest of the spinal column.

Once the top apical vertebra is identified, draw a line on the x-ray from the apical vertebra to the superior vertebral end plate.

Next, repeat this step with the most affected vertebra in the bottom of the spine. From these two parallel lines, draw two intersecting perpendicular lines.

Between the two perpendicular lines sits the Cobb angle. This angle can now be quantified and measured to both analyze existing spinal abnormalities and track the progression of curvature.

Using the Cobb Angle

Now that you know how to identify the Cobb angle on a patient, it’s important to also understand its significance.

An angle of 10 degrees is the bare minimum required to diagnose scoliosis. Curvature between 10 and 15 degrees typically does not require treatment, although sometimes chiropractic care and other non-invasive healthcare methodologies may be considered.

When curvature reaches 20 to 40 degrees, however, practitioners may recommend a back brace. Using a back brace can help correct spinal curvature and also prevent the curvature from becoming worse. Depending on the degree of curvature and the type of braces available, braces may need to be worn for as much as 20 hours a day or only at night.

Curvature of 40 to 50 degrees may require surgical correction. If surgery is necessary, a surgeon will fuse the vertebrae together so as to prevent future curvature from occurring. While surgery is never a desirable outcome, scoliosis operations are largely successful. In fact, teenagers that undergo corrective surgery are usually able to return to normal activity levels within less than six months.

Using the data available

Chiropractic BioPhysics (CBP) is a specialized chiropractic technique, emphasizing the importance of spinal health through quantifiable information like the Cobb angle. Top practitioners from across the world can use the techniques and tools developed at Ideal Spine to innovate and improve their patient care with a data-driven approach.

To learn more about Chiropractic BioPhysics or to find out if there’s an upcoming seminar near you, visit our website today.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See for providers in your area.

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