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  1. #1
    Join Date
    Aug 2007
    Location
    Ottawa, Canada
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    370

    Exclamation Cobb Angle Measurement

    I am wondering if anyone has had any problem finding out the actual Cobb angle of their curves?

    We have a huge discrepancy between the doctor's measurements and the official radiology report from the Children's Hospital of Eastern Ontario (CHEO).

    The doctor told us, at an appointment, that my daughter's angles were T56 and L50. One week later he changed his reading to T52 and L49. The doctor recommended surgery in six months.

    The chiropractor measured the angles in front of us and got T45, L45.

    Today we now have the official radiology report from CHEO which states her angles are T42 and L38.

    The difference between these readings is huge. Our paediatrician has told us in the past to trust the radiology report (there has always been differences before between the doctor's reading and radiology).

    Has anyone else come across these discrepancies in the reading of Cobb Angles?
    Last edited by rtremb; 09-05-2007 at 08:44 PM.
    Ruth, 50 years old (s-shaped 30 degree scoliosis) with degenerative disc disease, married to Mike. Mother to two children - Son 18 and daughter 14. Both have idiopathic scoliosis. Son (T38, L29) has not needed surgery to date. Daughter (March 08 - T62, L63).

  2. #2
    Join Date
    Jan 2007
    Location
    Ontario, Canada
    Posts
    140
    I actually learned how to measure the cobb angle and always got a copy of the x-rays, more because I couldn't wait to find out what was happening with my sons spine. My results were within 5 degrees of what the doctors found. One time the radiologist made a mistake and found the curve hadn't changed at all when in fact it had increased significantly. I e-mailed the doctor and asked if he could remeasure and he did and he agreed there had been a mistake.
    I wouldn't hestitate to ask the surgeon to remeasure the x-rays. The results you are getting are quite different and do make the difference between possibly needing surgery or not.
    Is it possible to get another doctors opinion?
    My son had his surgery this year at Sick Kids in Toronto and for the most part it was a positive experience. Their ortho team is nothing but excellent. Maybe you could get a second opinion from them?
    By the way has your daughter finished growing and have her curves been steadily increasing?

    Ramona
    mom of Patrick, age 15 at time of surgery
    diagnosed July 2006 curves T58 L 38

    Nov. 2006 curves T72 L38
    also lordoscoliosis

    feb.2007 curves T79 L43

    Surgery May 16 2007
    fused T4 to L1

  3. #3
    Join Date
    Aug 2007
    Location
    Ottawa, Canada
    Posts
    370
    Ramona:

    Thanks for your post.

    These new Cobb angles from radiology are their second read on Esme's x-rays (the surgeon asked for a second read from them since the first read seemed so off). The surgeon has also done two readings as well!! We are a bit confused to say the least but we will keep trying to get to the bottom of it. We were very devastated when the doctor said Esme needed surgery so we are hopeful the radiology department has the right readings (wishful thinking!!). I will ask for a copy of Esme's x-rays from now on.....

    We are going to see Dr. Rivard in Montreal as soon as we can get an appointment - he has agreed to see our daughter Esme. Hopefully they will give us a less confusing read on her angles. We are hoping for a Spinecor brace.

    Our daughter's scoliosis is s-shaped and has been progressing steadily over the past 2+ years. She is not finished growing. The surgeon estimated she is a 0-1 Risser although he couldn't be sure since they didn't have the appropriate x-ray to show that clearly. She is premenarchial.

    Our son has an s-shaped scoliosis too and it looked like he was headed for surgery however we were fortunate - his curves seem to have stopped progressing and have even reduced a bit. He did not wear a brace. He is 17 this weekend so we are hoping his curves won't progress now.

    Glad to hear all went well with your son's surgery. It must be so hard to go through - I think it must really help if you have doctors you feel good about.
    Ruth, 50 years old (s-shaped 30 degree scoliosis) with degenerative disc disease, married to Mike. Mother to two children - Son 18 and daughter 14. Both have idiopathic scoliosis. Son (T38, L29) has not needed surgery to date. Daughter (March 08 - T62, L63).

  4. #4
    Join Date
    Aug 2007
    Location
    Ottawa, Canada
    Posts
    370
    At this point we are having to think the radiologist made an error when he read Esme's x-rays since three doctors have now measured her curves at or just over 50 degrees. The radiologist who read the x-rays is away until later in the month so we aren't able to get an explanation from him yet.
    Ruth, 50 years old (s-shaped 30 degree scoliosis) with degenerative disc disease, married to Mike. Mother to two children - Son 18 and daughter 14. Both have idiopathic scoliosis. Son (T38, L29) has not needed surgery to date. Daughter (March 08 - T62, L63).

  5. #5
    Join Date
    Aug 2007
    Location
    Ottawa, Canada
    Posts
    370
    Does anyone know an internet link that describes how to measure thoracolumbar curves?
    Ruth, 50 years old (s-shaped 30 degree scoliosis) with degenerative disc disease, married to Mike. Mother to two children - Son 18 and daughter 14. Both have idiopathic scoliosis. Son (T38, L29) has not needed surgery to date. Daughter (March 08 - T62, L63).

  6. #6
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,974
    This site might help you out... scroll down a little and it shows how to figure Cobb angles.

    http://www.pediatriceducation.org/2006/12/11

    The main problem with different people determining the angle is that they might choose different beginning and ending vertebrae, which would throw the whole thing off. Sometimes looking at the x-ray, it doesn't look like a definite "this is where to start" spot... and even just drawing the lines can lead to some error, so that is why they say give or take 5.

    You can probably pull up other links just by googling "how to measure cobb angles"--
    66 and still heartbroken...
    2007 52 w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15
    2014 DXd w/CMT (type 2)

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

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