SagittalMeter Pro vs CobbAngleApp

SagittalMeter is an educative app to easily measure sagittal balance parameters, by directly placing your phone on the sagittal X-Rays. The sagittal balance is an imperative factor to take into consideration for all practitioners treating spine problems and particularly for surgeons during the pre-operative phase. The compensatory mechanisms of a sagittal unbalanced spine may prevent a successful surgery outcome. A fundamental understanding of a correct sagittal alignment is strongly recommended in determining the correct use of fusion or non fusion devices. SagittalMeter enables you to measure 3 fundamental angles which are essential to analyze sagittal alignment (for pre, per and post-operative phases): • Pelvic incidence (PI) • Pelvic tilt (PT) • Sacral slope (SS) Values of lumbar lordosis are also important parameters to describe sagittal balance, so with SagittalMeter you can measure both: • L1-S1 lordosis • L4-S1 lordosis You can do a complete sagittal balance analysis by using advanced mode which extends the previous values with the following measures: • Occipito-C2 angle • Spino-sacral angle (SSA), angle between line from C7/T1 center to S1 plateau center and surface of S1 plateau • C7/T1 slope • C7-C2 angle • Spino-cranial angle (CIA), angle between line from C2 Dens to C7/T1 center and surface of C7/T1 endplate What does it mean? If a patient appears to have sagittal imbalance, this needs to be taken into consideration in the pre-operative planning. Any surgical treatment option should aim at the re-establishment of an ‘economic’ posture, achieved with the restoration of the patient specific sagittal balance. Remembering all theoretical normal values is very important but is definitively not easy and can even be impossible. SagittalMeter gives you the possibility to measure all the parameters in a quick way and gives you the average theoretical normal values for an equivalent asymptomatic healthy patient. How much correction do I need to restore a good balance in daily practice? Before any kind of lumbar fusion including the segment L4 to S1 it is mandatory to analyse the spine balance. If the PT or the lumbar lordosis are not correlated with the value of the PI, an approximation of the amount of correction requested can be evaluated with the FBI technique: C7 translation angle + Femur obliquity angle + PT compensation angle. SagittalMeter enables you to evaluate the FBI index value to get an average correction value.

Cobb method is considered the standard for measuring curve size in scoliosis. Cobb angles are always measured from the superior end plate of the most cephalad end vertebra to the inferior end plate of the most caudal end vertebra in the curve. Meticulous line drawings and precise measurements is paramount importance in order to quantify the magnitude of spinal deformities and monitor the success or failure of treatment for scoliosis. The CobbAngleApp is medical software aimed for orthopaedic surgeons, providing tools that allow doctors to: -Securely import medical images directly from the camera or stored photos. -Offers a very convenient way to determine the most accurate possibly way at once. By marking four points at the same X-ray, at each spine the App calculates the Cobb angle. In cases where values are out of normal ranges, the scoliosis is categorized according to measured angle as mild, moderate, severe. To simplify the process and to minimize inter-observer errors usually by not selecting the actual end vertebra, the app offers also in ext mode the ability to draw the vertical reference line through the patient’s sacrum and to identify more easily the end vertebrae s (ext method). -Save the planned images, the measured values and results compared by normal reference databases, for later review or consultation. -The app also is independent from errors produced by image inclination. Especially developed module allows the user to measure accurately without to worry about the tilting of the picture or the X-ray. All information received from the software output must be clinically reviewed regarding its plausibility before patient treatment! CobbAngleApp indicated for assisting healthcare professionals. Clinical judgment and experience are required to properly use the software. The software is not for primary image interpretation. In a busy everyday practice, the examiner have to draw lines in X-rays or in clinical settings, this it is time consuming and cumbersome. Accessory instruments like protractors, hinged goniometers, well sharp pencils, rulers or even transparent papers must be available. The app offers a very convenient and also accurate way to perform most common radiographic measurements for spine, in a blink of an eye in front of your screen. The build in feature of the app, allows results to be categorized may help decide what could be considered normal or pathologic. The app is not a simple goniometer, is an enhanced product which helps to monitor objectively the course of the treatment and evaluate optimally the spine. This App is particular useful especially in clinical settings where you need a quick results without losing time. Please see tutorial videos at the developer’s web site www.orthopractis.com Reference databases 1. Cobb JR. Outline for the study of scoliosis. The American Academy of Orthopedic Surgeons Instructional Course Lectures. Vol. 5. Ann Arbor, MI: Edwards; 1948.