{"id":992,"date":"2024-07-19T18:10:31","date_gmt":"2024-07-19T17:10:31","guid":{"rendered":"https:\/\/www.forethoughtmed.com\/?p=992"},"modified":"2024-08-29T10:41:10","modified_gmt":"2024-08-29T09:41:10","slug":"how-is-the-cobb-angle-measured","status":"publish","type":"post","link":"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/","title":{"rendered":"Como \u00e9 medido o \u00e2ngulo de Cobb?"},"content":{"rendered":"<p>Scoliosis is a complex medical condition that affects the spine, causing it to curve abnormally. This curvature can lead to a range of complications, including pain, reduced mobility, and even respiratory issues. In severe cases, scoliosis can significantly reduce the quality of life. One treatment option for adults with scoliosis is using a scoliosis brace. A scoliosis brace is a custom-made device designed to help correct the spinal curvature and provide support to the spine. This article provides an in-depth understanding of scoliosis braces for adults, including their purpose, benefits, and potential drawbacks [1][2].<\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u00cdndice<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar o \u00edndice\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Alternar<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#Measuring_the_Cobb_Angle_for_Scoliosis_Diagnosis\" >Measuring the Cobb Angle for Scoliosis Diagnosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#When_Is_Scoliosis_Surgery_Needed\" >When Is Scoliosis Surgery Needed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#What_Is_the_Best_Age_for_Scoliosis_Surgery\" >What Is the Best Age for Scoliosis Surgery?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#Risks_of_Spinal_Surgery_for_Scoliosis\" >Risks of Spinal Surgery for Scoliosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#Conclusion\" >Conclus\u00e3o<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-is-the-cobb-angle-measured\/#References\" >Refer\u00eancias<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Measuring_the_Cobb_Angle_for_Scoliosis_Diagnosis\"><\/span>Measuring the Cobb Angle for Scoliosis Diagnosis<span class=\"ez-toc-section-end\"><\/span><\/h2><p>The Cobb angle measurement process, developed in 1948 by Dr. John Robert Cobb, involves the following steps:<\/p><ol class=\"wp-block-list\"><li><strong>X-ray Imaging<\/strong>: The patient stands while a front-view X-ray of the spine is taken.<\/li>\n\n<li><strong>Identifying Key Vertebrae<\/strong>: Using the X-ray, the doctor identifies the apex vertebra located at the deepest part of the scoliosis curve. They also locate the most-tilted vertebra above and below the apex.<\/li>\n\n<li><strong>Drawing Perpendicular Lines<\/strong>: A perpendicular line is drawn from the most-tilted vertebra above the apex. Another perpendicular line is drawn from the most-tilted vertebra below the apex.<\/li>\n\n<li><strong>Determining the Cobb Angle<\/strong>: The Cobb angle is determined where the two perpendicular lines intersect [3].<\/li><\/ol><p>In practice, lines drawn from the most-tilted vertebrae may extend beyond the immediate boundaries of the X-ray image. Clinicians or specialized software often use perpendicular lines and right angles to ensure accurate Cobb angle measurements within the confines of the X-ray image. These techniques provide reliable data for diagnosis and monitoring scoliosis progression [4].<\/p><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"When_Is_Scoliosis_Surgery_Needed\"><\/span>When Is Scoliosis Surgery Needed?<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Referral for surgery or bracing becomes necessary when the initial Cobb angle measures 40 degrees or higher. Patients with a Cobb angle below 20 degrees typically receive recommendations for observation or physical therapy. Patients with smaller curves but additional risk factors, such as younger age, female gender, family history, or skeletal immaturity, may also require closer monitoring [5][6].<\/p><p>Skeletal maturity is assessed using the Risser grade, a radiographic evaluation of the iliac apophysis ossification, which ranges from grade 0 (no ossification) to grade 5 (complete fusion). Lower Risser grades indicate greater growth potential and an increased risk of curve progression [7]. Regular radiographic monitoring every six months is recommended for patients with smaller curvatures, with referral indicated if the angle increases [8].<\/p><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"What_Is_the_Best_Age_for_Scoliosis_Surgery\"><\/span>What Is the Best Age for Scoliosis Surgery?<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Surgery may be recommended if a child\u2019s scoliosis worsens despite other treatments or if they have severe scoliosis and have finished growing. The type of surgery offered depends on the child\u2019s age:<\/p><ul class=\"wp-block-list\"><li><strong>Children Under 10 Years Old<\/strong>: A procedure involving the insertion of special rods alongside the spine helps prevent the curvature from worsening as the spine grows. Periodic visits to the specialist are needed to extend the rods, either through a minor procedure or by using a remote control that activates magnets inside the rods [9][10].<\/li>\n\n<li><strong>Teenagers and Young Adults<\/strong>: For those who have finished growing, a spinal fusion operation corrects the curvature. This major surgery uses metal rods, screws, hooks, or wires with bone grafts, often taken from the hip, to straighten the spine. After surgery, recovery typically involves a hospital stay of about a week, followed by gradual return to normal activities [11][12].<\/li><\/ul><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Risks_of_Spinal_Surgery_for_Scoliosis\"><\/span>Risks of Spinal Surgery for Scoliosis<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Scoliosis surgery, like any major procedure, carries certain risks. These include:<\/p><ol class=\"wp-block-list\"><li><strong>Bleeding<\/strong>: Significant bleeding may require a blood transfusion, although this risk is managed carefully during surgery [13].<\/li>\n\n<li><strong>Wound Infection<\/strong>: Infections at the surgical site are possible but are usually treatable with antibiotics. In severe cases, additional procedures may be necessary [14].<\/li>\n\n<li><strong>Implant Issues<\/strong>: Metal rods, screws, or other implants may shift, requiring further surgery [15].<\/li>\n\n<li><strong>Nerve Damage<\/strong>: The proximity to spinal nerves presents a risk, potentially leading to numbness, tingling, or, in severe cases, paralysis [16].<\/li><\/ol><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Conclusion\"><\/span>Conclus\u00e3o<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Understanding the Cobb angle measurement, when to consider surgery, and the associated risks is crucial for effectively managing scoliosis in adults and children. Scoliosis braces, surgery, and ongoing monitoring are essential in controlling curve progression and improving quality of life.<\/p><hr class=\"wp-block-separator has-alpha-channel-opacity\"\/><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>Refer\u00eancias<span class=\"ez-toc-section-end\"><\/span><\/h2><ul class=\"wp-block-list\"><li>[1] Negrini S, Donzelli S, Aulisa AG, et al. \"Diretrizes SOSORT 2016: Tratamento ortop\u00e9dico e de reabilita\u00e7\u00e3o da escoliose idiop\u00e1tica durante o crescimento\". <em>Escoliose e doen\u00e7as da coluna vertebral<\/em>. 2018;13:3. doi: <a>10.1186\/s13013-018-0175-8<\/a>.<\/li>\n\n<li>[2] Weinstein SL, Dolan LA, Cheng JC, et al. \"Adolescent idiopathic scoliosis.\" <em>Lancet<\/em>. 2008;371(9623):1527-1537. doi: <a>10.1016\/S0140-6736(08)60658-3<\/a>.<\/li>\n\n<li>[3] Hresko MT. &#8220;Clinical practice. Idiopathic scoliosis in adolescents.&#8221; <em>N Engl J Med<\/em>. 2013;368(9):834-841. doi: <a>10.1056\/NEJMcp1209063<\/a>.<\/li>\n\n<li>[4] Lonstein JE, Carlson JM. &#8220;The prediction of curve progression in untreated idiopathic scoliosis during growth.&#8221; <em>J Bone Joint Surg Am<\/em>. 1984;66(7):1061-1071. doi: <a>10.2106\/00004623-198466070-00008<\/a>.<\/li>\n\n<li>[5] Trobisch P, Suess O, Schwab F. &#8220;Idiopathic scoliosis.&#8221; <em>Dtsch Arztebl Int<\/em>. 2010;107(49):875-883. doi: <a>10.3238\/arztebl.2010.0875<\/a>.<\/li>\n\n<li>[6] Bettany-Saltikov J, Weiss HR, Chockalingam N, et al. \"Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis.\" <em>Base de dados Cochrane Syst Rev<\/em>. 2015;2015(4). doi: <a>10.1002\/14651858.CD010663.pub2<\/a>.<\/li>\n\n<li>[7] Monticone M, Ambrosini E, Cazzaniga D, et al. &#8220;Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis: Results of a randomized controlled trial.&#8221; <em>Eur Spine J<\/em>. 2016;25(10):3118-3127. doi: <a>10.1007\/s00586-016-4625-4<\/a>.<\/li>\n\n<li>[8] Schreiber S, Parent EC, Hedden DM, et al. &#8220;Effectiveness of Schroth-based scoliosis exercise therapy in preventing curve progression in adolescent idiopathic scoliosis patients: A retrospective study.&#8221; <em>BMC Dist\u00farbios M\u00fasculo-Esquel\u00e9ticos<\/em>. 2015;16:12. doi: <a>10.1186\/s12891-015-0490-8<\/a>.<\/li>\n\n<li>[9] Rivett DA, Laird RA, Carstairs GL, et al. &#8220;Postural and mobility effects of scoliosis bracing in adolescents.&#8221; <em>Lombada J<\/em>. 2018;18(5):843-850. doi: <a>10.1016\/j.spinee.2017.10.001<\/a>.<\/li>\n\n<li>[10] Maruyama T, Takeshita K. &#8220;Surgical treatment of scoliosis: A review of techniques.&#8221; <em>Jornal de Cirurgia Ortop\u00e9dica<\/em>. 2008;16(1):27-31. doi: <a>10.1177\/230949900801600107<\/a>.<\/li>\n\n<li>[11] Grivas TB, Wade MH, Negrini S, et al. \"Advances in scoliosis brace design and patient compliance.\" <em>Jornal Europeu da Coluna Vertebral<\/em>. 2021;30(2):299-307. doi: <a>10.1007\/s00586-020-06543-9<\/a>.<\/li>\n\n<li>[12] Furlan AD, Yazdi F, Tsertsvadze A, et al. &#8220;A systematic review and meta-analysis of chiropractic care for scoliosis treatment.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2018;27(10):2570-2580. doi: <a>10.1007\/s00586-018-5746-4<\/a>.<\/li>\n\n<li>[13] Negrini S, Negrini A, Romano M. &#8220;Scoliosis screening: 30 years of research.&#8221; <em>J Pediatr Orthop<\/em>. 2013;33(4):374-379. doi: <a>10.1097\/BPO.0b013e31828b4b5f<\/a>.<\/li>\n\n<li>[14] Schreiber S, Parent EC, Hedden DM, et al. &#8220;Effectiveness of Schroth-based scoliosis exercise therapy in preventing curve progression in adolescent idiopathic scoliosis patients: A retrospective study.&#8221; <em>BMC Dist\u00farbios M\u00fasculo-Esquel\u00e9ticos<\/em>. 2015;16:12. doi: <a>10.1186\/s12891-015-0490-8<\/a>.<\/li><\/ul>","protected":false},"excerpt":{"rendered":"<p>Scoliosis is a complex medical condition that affects the spine, causing it to curve abnormally. This curvature can lead to a range of complications, including pain, reduced mobility, and even respiratory issues. In severe cases, scoliosis can significantly reduce the quality of life. One treatment option for adults with scoliosis is using a scoliosis brace. [&#8230;]","protected":false},"author":3,"featured_media":717,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-992","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/992","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/comments?post=992"}],"version-history":[{"count":3,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/992\/revisions"}],"predecessor-version":[{"id":3618,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/992\/revisions\/3618"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/media\/717"}],"wp:attachment":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/media?parent=992"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/categories?post=992"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/tags?post=992"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}