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Cobb Angle App

Cobb method is considered the standard for measuring curve size in scoliosis. Cobb angles are always measured from the superior end plate of the most cephalad end vertebra to the inferior end plate of the most caudal end vertebra in the curve. Meticulous line drawings and precise measurements is paramount importance in order to quantify the magnitude of spinal deformities and monitor  scoliosis.

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Cobb method is considered the standard for measuring curve size in scoliosis. Cobb angles are always measured from the superior end plate of the most cephalad end vertebra to the inferior end plate of the most caudal end vertebra in the curve. Meticulous line drawings and precise measurements is paramount importance in order to quantify the magnitude of spinal deformities and monitor the success or failure of treatment for scoliosis.  
The CobbAngle App is medical software aimed for orthopaedic surgeons, providing tools that allow doctors to:
-Securely import medical images directly from the camera or stored photos  
-Offers a very convenient way to determine the most accurate possibly way at once. By marking four points at the same X-ray, at each spine the App calculates the Cobb angle. In cases where values are out of normal ranges, the scoliosis is categorized according to  measured angle as mild, moderate, severe. To simplify the process and to minimize inter-observer errors usually by not selecting the actual end vertebra, the app offers also in ext mode the ability to draw the vertical reference line through the patient’s sacrum and to identify more easily the end vertebrae (ext method).

Save the planned images, the measured values and results compared by normal reference databases, for later review or consultation.
    -The app also is independent from errors produced by image inclination. Especially developed module allows the user to measure accurately without to worry about the tilting of the picture or the X-ray.

 All information received from the software output must be clinically reviewed regarding its plausibility before patient treatment!  CobbAngleApp indicated for assisting healthcare professionals. Clinical judgment and experience are required to properly use the software. The software is not for primary image interpretation. 
 
In a busy everyday practice, the examiner have to draw lines 
 in X-rays  or in clinical settings ,this it is time consuming and cumbersome. Accessory instruments like protractors, hinged goniometers, well sharp pencils, rulers or even transparent papers must be available. The app offers a very convenient and also accurate way to perform most common radiographic measurements for spine, in a blink of an eye in front of your  screen. The build in feature of the app, allows results to be  categorized may help decide what could be considered normal or pathologic.
The app is not a simple goniometer, is an enhanced product which helps to monitor objectively the course of the treatment and evaluate optimally the spine. This App is particular useful especially in clinical settings where you need a quick results without losing time. Please see tutorial videos at the developer’s web site www.orthopractis.com

Reference databases

1.Cobb JR. Outline for the study of scoliosis. The American Academy of Orthopedic Surgeons Instructional Course Lectures. Vol. 5. Ann Arbor, MI: Edwards; 1948.

HOW TO MEASURE WITH THE COBBANGLEAPP

     The app offers a very convenient way to asses spinal deformity by measuring the Cobb angle. The first thing is to load one image from your photo library or capture a photo from x-rays photos of a patient. 

    The app offers two measuring methods, the simple (Sim.) and the extended (Ext.). By clicking the relevant option, the option is highlighted and the respective method is activated.

Simple method

First you aim to locate two points (P1,P2) over the inferior end plate of the most caudal end of the vertebra in the curve. By clicking the button “point” the point P1 over the left edge of the inferior end plate is marked. By the same manner locating the right edge of the inferior end plate the point P2 is also marked. The line P1P2 is drawn. By the same manner you mark the points P3, P4 for the superior end plate of the most cephalad end vertebra in the curve. Two Lines are drawn and two lines perpendicular to P1P2 line and to P3P4 line at the end-plates of the vertebra’s are drawn. The angle formed at the intersection of these line is the Cobb angle. Scoliosis is defined when a spinal curvature has a Cobb angle of 10 degrees or more. It is recommended to measure three curves in a.p. X-ray of a spine the Proximal Thoracic (PT), Main Thoracic (MT), and Thoracolumbar/Lumbar (TL/L) Curves.

Extended method

For accurate measurement the Cobb angle, one must first decide which vertebra are the end vertebra of the curve deformity. The App offers the extended method which helps minimize these source of errors, namely the identification of the end vertebra's. By clicking the button “point” you mark two points, point a (left) and point b (right) over the lateral edge of the superior end plate of the S1 vertebra (sacral end plate). A perpendicular to the middle distance of line ab is drawn (CSVL line). The erected vertical reference line (CSVL line) and the first vertebra from the curve, which deviated laterally from the vertical axis that is not intersected by the CSVL line, points to the eligible end vertebrae for measurement Cobb’s angle. Next you can measure the Cobb angle as it is mentioned above by the simple method.