Measurement of spinal curvature: A comparison of two manual methods

Abstract

Aim: In correction of angular deformities of the spine, assessment of spinal curvature from radiographs is important. The methods used for such assessment vary from simple to sophisticated techniques depending on the facilities that are available. There is the need to use a simple, yet reliable method in a health care setting with limited resources. To ascertain the level of concordance between two manual methods of measuring the spinal curvature of spinal angular deformities. Method: The traditional protractor method and the goniometer method were used to measure the angle of curvature in seventy standard erect anteroposterior and lateral spine radiographs of patients who had thoracic and thoracolumbar scoliosis or kyphosis and were managed in 4 tertiary hospitals in Nigeria. Correlation analysis was then applied to determine the association between both methods, with the level of significance set at p<0.01. Result: A strong association between the two manual methods was obtained for both kyphosis and scoliosis (r= 0.99; p> 0.01). Measurement variability increased with magnitude of curvature. Conclusion: The traditional protractor method as well as the goniometer method has clinical utility but for practical purposes, the goniometer should be preferred to the protractor method of measuring spinal curvature because of its simplicity and that it obviates intrinsic sources of error associated with the latter.