Radiological Evaluation of Spine Deformity in Scoliosis: A Comprehensive Review of Imaging Parameters and Diagnostic Modalities

Authors

  • Mahmoud Mohamed Mahrous Shamloul
  • Mahmoud MostafaTaha
  • Wael Abd Elrahman Elmesallamy
  • Mohamed Salah Mohamed

Keywords:

Scoliosis; Radiological evaluation; Cobb angle; Vertebral rotation; MRI; CT; Spinal deformity; Risser index; Coronal balance; Sagittal balance

Abstract


Background: Scoliosis is a complex three-dimensional spinal deformity that requires accurate radiological assessment for proper diagnosis, classification, treatment planning, and follow-up. Radiological evaluation plays a pivotal role in identifying curve characteristics, vertebral rotation, spinal balance, skeletal maturity, and associated abnormalities. Conventional radiography remains the cornerstone of scoliosis assessment, particularly through measurement of the Cobb angle and evaluation of coronal and sagittal alignment. Additional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) provide valuable information in selected cases, especially in patients with congenital anomalies, atypical curve patterns, neurologic manifestations, or preoperative planning. This review discusses the principal radiological parameters used in scoliosis evaluation, including identification of the apex, end vertebrae, stable vertebrae, vertebral rotation, structural versus nonstructural curves, shoulder balance, and skeletal maturity assessment. The indications and roles of advanced cross-sectional imaging techniques are also highlighted.

Downloads

Download data is not yet available.

References

1. Fatima, J., et al. (2021). "Spinal vertebrae localization and analysis on disproportionality in curvature using radiography—a comprehensive review." EURASIP Journal on Image and Video Processing 2021(1): 23.

2. Roussouly, P. (2019). The standing position: Its principles and spinopelvic relations. Spinal Anatomy: Modern Concepts, Springer: 113-125.

3. Dubousset, J. (2019). The pelvic vertebra, the cephalic vertebra and the concept of the chain of balance. Spinal Anatomy: Modern Concepts, Springer: 171-187.

4. Ross, J. S. and K. R. Moore (2025). Diagnostic Imaging: Spine-E-Book, Elsevier Health Sciences.

5. Wang, J., et al. (2018). "Measurement of scoliosis Cobb angle by end vertebra tilt angle method." Journal of orthopaedic surgery and research 13(1): 223.

6. Hardesty, C. K., et al. (2013). "Interobserver variability using a commercially available system of archived digital radiography with integrated computer-assisted measurements for scoliosis Cobb angles." Journal of Pediatric Orthopaedics 33(2): 163-169.

7. Giannoglou, V. and E. Stylianidis (2016). "Review of advances in Cobb angle calculation and image-based modelling techniques for spinal deformities." ISPRS Annals of the Photogrammetry, Remote Sensing and Spatial Information Sciences 3: 129-135.

8. Prestigiacomo, F., et al. (2022). "Intra-and inter-observer reliability of Cobb angle measurements in patients with adolescent idiopathic scoliosis." Spine deformity 10(1): 79-86.

9. Khodaei Jalalabadi, M. (2022). "Development of a Detection Model for Curve Progression in Adolescents with Idiopathic Scoliosis."

10. Patel, P. and A. G. King (2013). Scoliosis. Spine Surgery Basics, Springer: 261-286.

11. Negrini, A., et al. (2019). "Spinal coronal and sagittal balance in 584 healthy individuals during growth: normal plumb line values and their correlation with radiographic measurements." Physical Therapy 99(12): 1712-1718.

12. Boyer, L., et al. (2018). "Accuracy and precision of seven radiography-based measurement methods of vertebral axial rotation in adolescent idiopathic scoliosis." Spine deformity 6(4): 351-357.

13. Kim, J. K., et al. (2025). "Deep learning algorithm for the automatic assessment of axial vertebral rotation in patients with scoliosis using the Nash–Moe method." Scientific Reports 15(1): 26647.

14. Costa, L., et al. (2021). "Ossification and fusion of the vertebral ring apophysis as an important part of spinal maturation." Journal of Clinical Medicine 10(15): 3217.

15. Namikawa, T., et al. (2015). "Radiological assessment of shoulder balance following posterior spinal fusion for thoracic adolescent idiopathic scoliosis." Scoliosis 10(Suppl 2): S18.

16. Ng, S.-Y. and J. Bettany-Saltikov (2017). "Imaging in the diagnosis and monitoring of children with idiopathic scoliosis." The open orthopaedics journal 11: 1500.

17. Lacroix, M., et al. (2023). Scoliosis. Seminars in musculoskeletal radiology, Thieme Medical Publishers, Inc.

Downloads

Published

2024-12-07

How to Cite

1.
Mahrous Shamloul MM, MostafaTaha M, Elmesallamy WAE, Mohamed MS. Radiological Evaluation of Spine Deformity in Scoliosis: A Comprehensive Review of Imaging Parameters and Diagnostic Modalities. J Neonatal Surg [Internet]. 2024 Dec. 7 [cited 2026 May 17];13(1):2362-70. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10279

Issue

Vol. 13 (2024): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.