Evaluation of frontal radiographs of scoliotic spines--Part I. Measurement of position and orientation of vertebrae and assessment of clinical shape parameters.

A new method largely exploiting the shape information which may be obtained from frontal radiographs of scoliotic patients is presented. For a complete description of spinal deformity, six position parameters are needed for each vertebra. From a strictly mathematical point of view, none of them can be determined from a single standard radiograph. However, the four most important parameters can be measured if some reasonable assumptions are made. For a better interpretation, three of these parameters (lateral coordinate x, lateral tilt alpha and axial rotation rho) are plotted as a function of the fourth parameter, the longitudinal coordinate y. These functions may well be approximated by sinusoidal curves (or possibly by Fourier series). The data smoothing implied by this procedure improves the reliability of the data. The method has been tested with 478 radiographs of 113 patients (Cobb angles up to 52 degrees). The results are compared with scoliosis parameters which have been determined according to the conventional clinical rules. A particular advantage of approximation by a sinusoidal function lies in the direct relation of the curve parameters to common scoliosis parameters. Moreover, a mathematical analysis of the interrelations between different parameters--for example, between lateral deviation and axial rotation--is possible in this case.