Validation of the concavity–convexity quotient as a new method to measure the magnitude of scoliosis

Gonzalo Mariscal; Jorge H Nuñez; Paulo Figueira; Ana Malo; Verónica Montiel; Miguel A López; Miguel Castro; Carlos Barrios; Pedro Domenech Fern

doi:10.4103/jcvjs.JCVJS_22_20

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ORIGINAL ARTICLE

Year : 2020 | Volume : 11 | Issue : 1 | Page : 31-35

Validation of the concavity–convexity quotient as a new method to measure the magnitude of scoliosis

Gonzalo Mariscal¹, Jorge H Nuñez², Paulo Figueira³, Ana Malo⁴, Verónica Montiel⁵, Miguel A López⁶, Miguel Castro⁷, Carlos Barrios¹, Pedro Domenech Fern⁸
¹ Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain
² Department of Traumatology and Orthopedic Surgery, University Hospital Sant Joan de Deu, L'Hospitalet de Llobregat; Spine Unit, Department of Traumatology and Orthopedic Surgery, Spine Unit, University Hospital of Mutua Terrassa, Terrassa, Spain
³ Department of Orthopedic Surgery, Curry Cabral Hospital, Lisbon, Portugal
⁴ Department of Traumatology and Orthopedic Surgery, University of Navarra Clinic, Pamplona, Spain
⁵ Department of Traumatology and Orthopedic Surgery, University Hospital Sant Joan de Deu, L'Hospitalet de Llobregat, Terrassa, Spain
⁶ Department of Mathematics, Polytechnic University School, Castilla-La Mancha University, Ciudad Real, Coruña, Spain
⁷ Departmet of Orthopedic Surgery, A Coruña University Hospital, Coruña, Spain
⁸ Department of Orthopedic Surgery, University and Polytechnic La Fe Hospital, Valencia, Spain

Correspondence Address:
Dr. Gonzalo Mariscal
Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Carrer De Quevedo, 2, 46001, Valencia
Spain

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jcvjs.JCVJS_22_20

Objectives: We propose a novel and simple method to determine the magnitude of the curve in scoliosis and its correlation with the Cobb angle. Methods: Using multiple rounds of nominal group technique and an established consensus-building methodology, a multidisciplinary research group identified a simple method to value the curve deformity based on the vertebral pedicles. Measurements: A mathematical study was performed to determine the relationship between the Cobb angle and the concavity–convexity quotient (CCQ). To evaluate the clinical correlation between the Cobb angle and CCQ, spine surgeons measured 48 curves (before and after follow-up) of congenital scoliosis. Results: This quotient reflects the ratio between the distance from the upper end of the most inclined upper vertebra to the lower end of the most inclined lower vertebra on the concave side (A-distance) and the corresponding distance on the convex side of the curve (B-distance). The existing mathematical relationship is based on changing the explicit coordinates to polar coordinates. Finally, the clinical correlation between the Cobb angle and CCQ was statistically significant (r = −0.688; P < 0.001 in first measure and r = −0.789; P < 0.001 in the second measure). Conclusions: Our study provides Level III evidence that CCQ represents a promising alternative or a complementary method to the traditional Cobb angle due to its simple and reliable ability to measure the magnitude of the curve.

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