Magnetic Resonance Imaging. Magnetic resonance imaging (MRI) is an advanced imaging procedure that does not use radiation, as x-rays do. It is expensive, however, and not generally used for an initial diagnosis. MRI can, nevertheless, identify spinal cord and brain stem abnormalities, which some studies indicate may be more prevalent than previously believed in children with idiopathic scoliosis. It also may be particularly useful before surgery for detecting defects that could lead to potential complications.
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Protective Measures for Frequent X-Rays
Because frequent x-rays may be required for young children with scoliosis, parents should be sure that x-ray technicians take all necessary protective measures. Experts are concerned about the long-term effects of radiation on sensitive young organs, particularly about a possible increase in the risk for cancer. Studies have reported an increased risk for cancer in women and men who, because of scoliosis, had been exposed to diagnostic x-rays in their childhood and adolescence.
X-ray techniques have become safer in recent years, and technicians can reduce the hazards with the following simple measures:
- Directing x-ray beams through the patient from back to front, rather than the reverse
- Using x-ray filters that absorb some of the beam
- Using fast film to reduce exposure by two to six times
- Placing lead aprons or shields over parts of the body that are not being x-rayed
Determining the Extent of the Curve
There are various methods for determining and classifying the extent of the curve.
Cobb Method. The technique known as the Cobb method is used to calculate the degree of the curve.
- On an x-ray of the spine, the examiner draws two lines: One line extends out and up from the edge of the top vertebrae of the curve. The second line extends out and down from the bottom vertebrae.
- The technician then draws a perpendicular line between the two lines.
- Measuring the intersecting angle determines the degree of curvature.
The Cobb method is limited because it cannot fully determine the flexibility or the three-dimensional aspect of the spine. It is not as effective, then, in defining spinal rotation or kyphosis. It also tends to over-estimate the curve. Additional diagnostic tools are needed to make a more accurate diagnosis.
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Review Date: 04/06/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
