Spinal Deformity Assessment and Surgical Interventions

Spinal deformities, encompassing scoliosis, kyphosis and sagittal and coronal malalignments, present significant challenges for patients and clinicians worldwide. Precise assessment relies on measurement of angular parameters and global alignment in the coronal and sagittal planes, with particular attention to the Cobb angle, pelvic incidence, lumbar lordosis and sagittal vertical axis. Emerging imaging modalities permit three-dimensional reconstruction of the spine and adjacent structures, enhancing the accuracy of deformity quantification while reducing radiation exposure. Computational methods, including deep-learning algorithms, now support fully automated measurement of key angles, minimising observer variability and streamlining long-term monitoring. Classification systems for sagittal and coronal imbalance integrate regional curvature, compensatory mechanisms and pelvic geometry to inform personalised surgical planning. In operative management, strategies range from short-segment fusion and interbody techniques to multilevel osteotomies and long-segment fixation, all with the goal of restoring physiological alignment and preserving adjacent segments. Restoration of ideal spinopelvic parameters, guided by patient-specific factors such as pelvic incidence–lumbar lordosis mismatch, has been shown to reduce mechanical complications, improve functional outcomes and enhance quality of life. A multidisciplinary approach, combining advances in imaging, computational analysis and surgical technique, underpins modern best practice in the treatment of spinal deformity.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Spinal Deformity Assessment and Surgical Interventions publication trend

The graph below shows the total number of articles in spinal deformity assessment and surgical interventions across all publications each year (not limited to Nature Index journals).

Technical terms

Cobb angle: The angle between the endplates of the most tilted vertebrae above and below a spinal curve, used to quantify coronal deformity.

Sagittal balance: The alignment of spinal curvatures and pelvic orientation in the side view, critical for efficient posture and load distribution.

Pelvic incidence: A fixed anatomical parameter measuring the angle between the pelvic plate and the line perpendicular to the sacral endplate, determining ideal lumbar lordosis.

Coronal imbalance: Lateral displacement of the trunk relative to the pelvis, reflecting deviation in the frontal plane and guiding corrective planning.

References

1. Use of Artificial Intelligence in Cobb Angle Measurement for Scoliosis: Retrospective Reliability and Accuracy Study of a Mobile App. Journal of Medical Internet Research (2024).
2. Sagittal balance of the spine. European Spine Journal (2019).
3. Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms. European Spine Journal (2014).
4. Influence of pelvic incidence-lumbar lordosis mismatch on surgical outcomes of short-segment transforaminal lumbar interbody fusion. BMC Musculoskeletal Disorders (2015).
5. Cobb Angle Measurement of Spine from X‐Ray Images Using Convolutional Neural Network. Computational and Mathematical Methods in Medicine (2019).
6. EOS® biplanar X-ray imaging: Concept, developments, benefits, and limitations. Journal of Children's Orthopaedics (2016).
7. Classification of coronal imbalance in adult scoliosis and spine deformity: a treatment-oriented guideline. European Spine Journal (2018).