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A specific scoliosis classification correlating with brace treatment: description and reliability


To show the intra- and inter-observer reliability of a scoliosis classification system correlating with brace treatment.


Different classification systems have been used mainly correlating with surgical treatment. Few consider brace principles and design.


A new classification system was developed in order to define specific principles of correction with a brace. The classification includes clinical as well as radiological criteria. The radiological system differentiates five basic types called: imbalanced thoracic (or three curves pattern), true double double (or four curve pattern), balanced thoracic and false double (non 3 non 4), single lumbar and single thoracolumbar. The main criteria are the curve pattern according to SRS terminology, the balance/imbalance at the transitional point and the L4-5 counter-tilting. To test the intra-and inter-observer reliability of the classification, three observers (1 MD, 1 PT and 1 CPO) have measured (and one of them, the MD, re-measured) 51 AP radiographs including all the types.


The intra-observer Kappa value was 0.87 (acceptance > 0.70). The inter-observer Kappa values fluctuated from 0.61 to 0.71 with an average of 0.71 (acceptance > 0.70).


A specific scoliosis classification system that correlates with brace treatment has been proposed with an acceptable intra- and inter-observer reliability.

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Correspondence to M Rigo.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rigo, M., Villagrasa, M. & Gallo, D. A specific scoliosis classification correlating with brace treatment: description and reliability. Scoliosis 4 (Suppl 2), O23 (2009).

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