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Cobb’s Angle in Scoliosis – Gold Standard or Golden Calf?

A Commentary on Scoliosis Outcome Assessments


Mark Morningstar, D.C. Bio  Clayton Stitzel, D.C. Bio


Journal of Pediatric, Maternal & Family Health – Chiropractic ~ Volume 2010 ~ Issue 1 ~ Pages 6-10




The purpose of this paper is to discuss why Cobb’s angle should not be the Gold Standard for radiographic evaluation of scoliosis. While Cobb’s angle has been the subject of numerous reliability studies, there are several disadvantages to be noted.  These disadvantages range from high inter-examiner variability to lack of validity.  Cobb’s angle is oftentimes only as good as the film it is drawn upon. There are various alternative methods that involve measuring the Cobb angle as well as its rotational component. Since chiropractors are particularly focused on obtaining radiographic evidence of treatment success, the profession at large should use radiographic analytical methods that provide more information on the presenting three-dimensional spine and spinal disorder.


Key WordsChiropractic, scoliosis, Cobb angle, radiograph, x-ray, mensuration


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