Trunk distortion in adolescent idiopathic scoliosis

Trunk images of children with scoliosis were examined to determine features that contribute to the impression of trunk distortion. Twenty subjects wit h spinal deformity ranging from none to severe were photographed in a relax ed standing position. Seven blinded evaluators subjectively scored their im pressions of the trunk appearance, shoulder-height difference, shoulder-ang le asymmetry, decompensation, scapula asymmetry, waist crease, waist asymme try, and pelvic asymmerry. Regression analysis was used with the latter sev en features to predict overall impression. The seven measures of the deform ity predicted 85% of the overall impression of trunk distortion; scapular a symmetry was the best predictor. Trunk deformity is the most obvious effect of scoliosis to the patients. Objective approaches to the assessment of th is important but difficult-to-quantify aspect of idiopathic scoliosis are a vailable and should be used to evaluate treatment outcomes.