Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung, Taiwan NEW MEASUREMENTS OF TRUNK ASYMMETRY SCORE RATHER THAN COBB ANGLE FOR THE COSMETIC ASPECT OF SCOLIOSIS Chin-Yi CHUO Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung, Taiwan

With Idiopathic Scoliosis … Neurologic deficits are very rare Syrinx, congenital Respiratory deficits are not seen till thoracic curve >90° Pain is unusual till onset of DJD Pre-emptive fusion, stress transfer For most cases- We are correcting the deformity. So it is a cosmetic surgery

A Tale of Two Girls Similar gross appearance: * R’t shoulder drop * Asymmetric waist line

The girl on the right : high Cobb angle with high deformity 9 L3 3

Deformity ≠ Cobb angle Similar gross appearance with big different Cobb angles

Trunk Asymmetry Score Rib cage tilt > 10 ° Thoracic shift >15% Thoracic containment: loss Shoulder drop > 2 cm Axial inclination >5 ° and hump height >1.5 cm all cause a noticeable loss of symmetry, while symmetry is beauty.

1.Rib Cage Tilt Angle from the vertical 7° Should be 0°

2.Thoracic Shift Should be 0% Widest point 21% %= (b-a)/2(a+b) a b 2nd Thoracic shift . It is the displacement of thoracic cage relative to pelvis and is measured similar to spondylolisthesis. The formula is here and normal should be 0 %. In this case 21% 21% %= (b-a)/2(a+b) Should be 0%

3.Thoracic Containment Not Contained

4.Shoulder drop

5. Axial inclination and hump height #278777 13+2♀ 5. Axial inclination and hump height 7 14°

none of the authors has any potential conflict of interest