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  • cobb angle discrepansy

    On my Xrays from 2006 the top vertebra of my cobb angle was c5. In these newest Xrays the top vertebra of the cobb angle is c7. This makes no sense to me. I know it matters in terms of the cobb angle. Anyone have any info/explanations? When I take the cobb angle measurement on these new xrays and use c5 as the top vertebrae (the way it was measured in 2006) I get 50 degrees as the cobb angle, NOT 40 degrees. I'm not an MD but shouldn't they be consistant with the vertebrae they use??
    28 years old. Dx at age 14.

    1994 20T/20L
    1998 22T/20L
    2002 30T/28L
    2006 34T/28L
    2008 43T/34L

    considering surgery in the near future as the curvature is getting progressively worse and for pain management.

    XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

  • #2
    Originally posted by Mobee211
    On my Xrays from 2006 the top vertebra of my cobb angle was c5. In these newest Xrays the top vertebra of the cobb angle is c7. This makes no sense to me. I know it matters in terms of the cobb angle. Anyone have any info/explanations? When I take the cobb angle measurement on these new xrays and use c5 as the top vertebrae (the way it was measured in 2006) I get 50 degrees as the cobb angle, NOT 40 degrees. I'm not an MD but shouldn't they be consistant with the vertebrae they use??

    Who measured the two, Mobee, and what was their specialty?
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op ±53°, Post-op < 20°
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

    Comment


    • #3
      Originally posted by txmarinemom
      Who measured the two, Mobee, and what was their specialty?

      I am not sure who measured the curve in 2006 but I know it was a staff radiologist at my doc office. And in 2008 it was another staff radiologist (I know his name but cannot put on internet). I called my doc office and left a message to inquire about this.
      28 years old. Dx at age 14.

      1994 20T/20L
      1998 22T/20L
      2002 30T/28L
      2006 34T/28L
      2008 43T/34L

      considering surgery in the near future as the curvature is getting progressively worse and for pain management.

      XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

      Comment


      • #4
        Originally posted by Mobee211
        I am not sure who measured the curve in 2006 but I know it was a staff radiologist at my doc office. And in 2008 it was another staff radiologist (I know his name but cannot put on internet). I called my doc office and left a message to inquire about this.
        Therein lies at least one issue. An scoli ortho should be measuring, not a radiologist ...
        Fusion is NOT the end of the world.
        AIDS Walk Houston 2008 5K @ 33 days post op!


        41, dx'd JIS & Boston braced @ 10
        Pre-op ±53°, Post-op < 20°
        Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


        VIEW MY X-RAYS
        EMAIL ME

        Comment


        • #5
          thanks. i see the scoli specialist on 4/4. i was told at age 18 that my curve would never get any worse and i needed to not worry about it. yeesh. docs don't know everything!
          28 years old. Dx at age 14.

          1994 20T/20L
          1998 22T/20L
          2002 30T/28L
          2006 34T/28L
          2008 43T/34L

          considering surgery in the near future as the curvature is getting progressively worse and for pain management.

          XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

          Comment


          • #6
            Originally posted by Mobee211
            thanks. i see the scoli specialist on 4/4. i was told at age 18 that my curve would never get any worse and i needed to not worry about it. yeesh. docs don't know everything!
            A lot of us were told the same ... and that's what they thought. What they know now is leaps and bounds over 10 - even 5 - years ago.

            On the other hand, mine hung ready to win the "Ms. Most Likely to Go Far in Life" award for 25 years ... and never moved. (my surgery was purely because it hurt more and more over the years).

            It'll be interesting to see how one specialist reads the films. Good luck!

            Pam
            Fusion is NOT the end of the world.
            AIDS Walk Houston 2008 5K @ 33 days post op!


            41, dx'd JIS & Boston braced @ 10
            Pre-op ±53°, Post-op < 20°
            Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


            VIEW MY X-RAYS
            EMAIL ME

            Comment


            • #7
              Thanks. I will be interested to see what the scoli specialist says as well.
              28 years old. Dx at age 14.

              1994 20T/20L
              1998 22T/20L
              2002 30T/28L
              2006 34T/28L
              2008 43T/34L

              considering surgery in the near future as the curvature is getting progressively worse and for pain management.

              XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

              Comment


              • #8
                Pam,

                Why did you say a radiologist isn't the one who would read the x-rays the most accurate?
                Melissa
                From Bucks County, Pa., USA

                Mom to Matthew,19, Jessica, 17, and Nicole, 14
                Nicole had surgery with Dr. Dormans on 9/12/07 at Children's Hospital of Phila. She is fused T-2 - L-3

                Comment


                • #9
                  Originally posted by MATJESNIC
                  Pam,

                  Why did you say a radiologist isn't the one who would read the x-rays the most accurate?
                  Radiologists are as qualified to measure the angle as are orthopedic surgeons.

                  Amazing.

                  sharon
                  Sharon, mother of identical twin girls with scoliosis

                  No island of sanity.

                  Question: What do you call alternative medicine that works?
                  Answer: Medicine


                  "We are all African."

                  Comment


                  • #10
                    I think there is always some issue with which vertebrae to include at the top and bottom of the curve and scoliosis specialists are better at determining the correct vertebrae to use, as opposed to general radiologists. I think that is what Pam was getting at. In no way did she mean that radiologists cannot produce accurate measurements. I think she was just saying for the best results...always see a scoli specialist.
                    28 years old. Dx at age 14.

                    1994 20T/20L
                    1998 22T/20L
                    2002 30T/28L
                    2006 34T/28L
                    2008 43T/34L

                    considering surgery in the near future as the curvature is getting progressively worse and for pain management.

                    XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

                    Comment


                    • #11
                      Originally posted by Pooka1
                      Radiologists are as qualified to measure the angle as are orthopedic surgeons.

                      Amazing.

                      sharon

                      Yes, dear.
                      Fusion is NOT the end of the world.
                      AIDS Walk Houston 2008 5K @ 33 days post op!


                      41, dx'd JIS & Boston braced @ 10
                      Pre-op ±53°, Post-op < 20°
                      Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                      VIEW MY X-RAYS
                      EMAIL ME

                      Comment


                      • #12
                        Originally posted by MATJESNIC
                        Pam,

                        Why did you say a radiologist isn't the one who would read the x-rays the most accurate?
                        Melissa, radiologists - and garden variety orthos, for that matter (who practice scoli fusion between ACL repairs and rotator cuff tidy-ups) - don't have the experience of a scoli (or even spinal specialist).
                        Fusion is NOT the end of the world.
                        AIDS Walk Houston 2008 5K @ 33 days post op!


                        41, dx'd JIS & Boston braced @ 10
                        Pre-op ±53°, Post-op < 20°
                        Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                        VIEW MY X-RAYS
                        EMAIL ME

                        Comment


                        • #13
                          I agree with Pam on this one.

                          Although radiologists are qualified to measure curves it's difficult to get accurate/consistent readings because each radiologists/ortho/scoli specialits, etc. all measure differently so it's important for consisitency to have 1 person measure all the films.

                          From personal experiences Lorena's local pedi ortho measurements differ from the measurements @ Shriners Philly and for that matter Dr. D'Andrea, Dr. Betz, and Janets measurements (all @ Shriners Philly) differ, Dr. Betz always tend to be on the higher side.

                          That said ~ if two different radiologists measure the same curve chances are pretty hight the measurments will differ.

                          Just my two cents.
                          Amanda

                          Mom to Lorena 7 yrs old
                          Diagnosed 8/2005 ~ 26 Degree Curve
                          Progressed to 42 Degrees by Dec 05
                          Milwakee Brace 1/16/06 - 6/26/06
                          Vertebral Stapling on 6/26/06 @ Shriners in Philadelphia
                          26 Degree Post Op Curve
                          Last X-Rays December 07 ~ 26 Degree Curve
                          Email: domingo_amandapompa@msn.com
                          Website: www.vertebralstapling.com
                          YouTube Video: http://www.youtube.com/watch?v=n6GmX3K7FIs

                          Comment


                          • #14
                            Now my two cents -

                            If it was my child, I would not want a radiolgist to measure the curve - I would want an orthopedic surgeon to measure it.

                            My reasons:

                            When David was first diagnosed, there was a significant difference between the radiologist's reading and the orthopedic surgeon's reading. Being a novice, I questioned them both about it - even the radiologist said his was an "estimate". The surgeon said that the radiologist's reading was basically just to see if there WAS a scoliosis, knowing that the ortho would follow up with a precise measurement.

                            After that first x-ray, nobody except an orthopedic doctor has ever read David's x-rays in the past EIGHT YEARS. I assume there is a reason for this.

                            Also, if you think about it, a radiologist takes xrays of EVERYTHING - ankles, arms, other body parts - he or she is not a SPINE SPECIALIST.

                            I don't think this is even a matter of opinion to tell you the truth. An ortho surgeon should be reading the xrays.

                            Of course, that's just MY view.
                            mariaf305@yahoo.com
                            Mom to David, age 17, braced June 2000 to March 2004
                            Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

                            https://www.facebook.com/groups/ScoliosisTethering/

                            http://pediatricspinefoundation.org/

                            Comment


                            • #15
                              I agree with what you are saying Amanda - and actually the drs in Boston told me that if Nathan was measured at 24 by local radiologist, it was likely that it was higher (this was based on their experiences with other patients coming in for the first time). They actually only measured 1 degree higher - on the same x-ray. But our appt. was a month later, so they redid the x-rays and found he had progressed to 38 degrees - clearly a progression, even with the typical +/- 5.
                              Also, I believe that the +/- 5 is a big factor in determining progression because there can be variables, such as the person reading x-ray, and I understand that curves can even vary slightly throughout the day.

                              -Cara
                              Last edited by nate03; 03-25-2008, 09:23 AM. Reason: fix typos
                              Cara, Mom to Nathan
                              Diagnosed 24 deg. in July 2007, progressed to 38 deg. by August 2007
                              Boston Back Brace 8/07 – 12/07
                              VBS 12/10/07 Boston Children's Hospital
                              Dr. Hresko
                              40 Degrees before VBS
                              11 Degrees now!! (2012)

                              Nathan's VBS Video

                              www.vertebralstapling.com

                              Comment

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