Reproducibility of Newly Developed Spinal Topography Measurements for Scoliosis

Leah Rankine 1, Xue C Liu*, 1, Channing Tassone 1, Roger Lyon 1, Sergey Tarima 2, John Thometz 1
1 Department of Orthopaedic Surgery, Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
2 Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA

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© Rankine et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Musculoskeletal Functional Assessment Center, Children’s Hospital of Wisconsin, Department of Orthopaedic Surgery, 9000 W Wisconsin Ave, C360, Milwaukee, WI 53226, USA; Tel: (414) 337 7323; Fax: (414) 337 7337; E-mail:



In an effort to limit exposure to ionizing radiation and fully characterize three dimensional changes in the spine of patients with scoliosis reliable non-invasive methods of spinal back contour analysis (Milwaukee Topographic Scanner) (MTS) have been developed.

Study Design:

The current study compares spinal topography measurements among different subject positions and evaluates the reproducibility of the system for both inter-rater and intra-rater reliability.


A dummy cast (plastic cast) of one patient with adolescent idiopathic scoliosis was created in order to test the reliability of the MTS. The dummy cast was positioned and rotated in 3D while scanned by two investigators using the MTS. A total of twelve parameters including Q-angle (an analog to X-ray’s Cobb angle) were extracted.


All measurements of intra-rater and inter-rater reliability were excellent (Intraclass Correlation Coefficients ranging from 0.89 to 0.99) with the exception of Pelvic Tilt (intra-rater ICC is 0.61) and lordosis angle (inter-rater ICC is 0.82). No significant variability among investigators was observed for all tested metrics. No significant variability due to position was observed for the majority of back contour measurements but there were significant changes in the T1-S1 angle, T1-S1 deviation, T1-NC angle, T1-NC deviation, and Back Height metric (p< 0.05).


The MTS is a reliable method of raster stereography in the measurement of the back contour, which will help monitor the progression of children with idiopathic scoliosis and reduce the use of X-rays.

Keywords: Scoliosis, rastersterography, imaging, topography, reproducibility.