The Cobb angle is a measurement of bending disorders of the
vertebral column
The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate in which the notochord (a flexible rod of uniform composition) found in all chordate ...
such as
scoliosis
Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
and traumatic deformities.
Definition and method
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
The spinal column, a defining synapomorphy shared by nearly all vertebrates, Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characterist ...
to the inferior endplate of an inferior vertebra. However, the endplates are generally parallel for each vertebra, so not all sources include usage of a superior versus inferior endplate in the definition.
Unless otherwise specified it is generally presumed to refer to angles in the
coronal plane
The coronal plane (also known as the frontal plane) is an anatomical plane that divides the body into dorsal and ventral sections. It is perpendicular to the sagittal and transverse planes.
Details
The coronal plane is an example of a longit ...
, such as
projectional radiography
Projectional radiography, also known as conventional radiography, is a form of radiography and medical imaging that produces two-dimensional images by x-ray radiation. The image acquisition is generally performed by radiographers, and the images ...
in posteroanterior view. In contrast, a ''sagittal Cobb angle'' is one measured in the
sagittal plane
The sagittal plane (; also known as the longitudinal plane) is an anatomical plane that divides the body into right and left sections. It is perpendicular to the transverse and coronal planes. The plane may be in the center of the body and div ...
such as on lateral radiographs.
Cobb angles are preferably measured while standing, since laying down decreases Cobb angles by around 7–10°.
Uses
It is a common measurement of
scoliosis
Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
.
The Cobb angle is also the preferred method of measuring post-traumatic
kyphosis in a recent
meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting m ...
of traumatic spine fracture classifications.
Severity
Those with Cobb angle of more than 60° usually have respiratory complications.
[
]Scoliosis
Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
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.
History
The Cobb angle is named after the American orthopedic surgeon John Robert Cobb (1903–1967), was originally used to measure coronal plane
The coronal plane (also known as the frontal plane) is an anatomical plane that divides the body into dorsal and ventral sections. It is perpendicular to the sagittal and transverse planes.
Details
The coronal plane is an example of a longit ...
deformity on radiographs with antero- posterior projection for the classification of scoliosis
Scoliosis is a condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped over three dimensions. In some, the degree of curve is stable, while in others, it increases over time. Mild scoliosis does not t ...
.[Cobb JR. Outline for the study of scoliosis. The American Academy of Orthopedic Surgeons Instructional Course Lectures. Vol. 5. Ann Arbor, MI: Edwards; 1948.] It has subsequently been adapted to classify sagittal plane deformity, especially in the setting of traumatic thoracolumbar spine fractures.
References
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Musculoskeletal radiographic signs