Iwahara et al developed 2 scores for quantifying the cosmetic appearance of a patient with adolescent idiopathic scoliosis. This can help monitor a patient over time and evaluate the outcome of an intervention. The authors are from Asahikawa Medical College in Japan.
The authors used Moire topography to document the three dimensional deformity.
Parameters:
(1) waistline height index
(2) hump index
(3) Cobb angle in degrees
waistline height index =
= (difference in the vertical height between the left and right waistline height in cm) / (sitting height in cm)
hump index =
= (height of the hump in cm above the non-humped side) / (transverse diameter of the chest)
where:
• The waistline is the maximum horizontal distance from the line connecting the axilla to the greater trochanter and the lateral side of the body.
• The difference in height between the two horizontal waistlines is the vertical distance between the two lines.
• The height of the hump is the difference between the two sides of the back when a person bends forward in cm. A ruler is placed horizontally across the back, with a ruler at right angles dropped to the non-hump side.
• Sitting height is the distance from the seat surface to the top of the head, with the top of the head level.
cosmesis score =
= 85.2 - (13.5 * (waistline height index)) - (165.9 * (hump index)) - (0.3 * (Cobb angle))
simple cosmesis score =
= 84.5 - (165.9 * (hump index)) - (0.4 * (Cobb angle))
Interpretation:
• The higher the cosmesis score, the better the appearance.
