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Understanding Cobb Angle. Screening & Diagnosis

Almost every scoliosis appointment involves a discussion of “degrees” and “Cobb angle.” Understanding what this number means and what it doesn’t, helps families interpret x-rays and treatment decisions with more confidence.

What Is the Cobb Angle?

The Cobb angle is the standard way of measuring the size of a scoliosis curve. On an x-ray, clinicians identify the most tilted vertebra at the top and bottom of the curve and draw lines along their endplates. The angle where these lines intersect is the Cobb angle.

Severity Categories

While exact cut-offs vary slightly, Cobb angles are often grouped as:

  • Mild: 10–20 degrees.
  • Moderate: 21–40 degrees.
  • Severe: over 40–45 degrees.

These bands help guide monitoring and treatment recommendations.

Why One or Two Degrees Doesn't Change Everything

It’s important to remember that x-ray measurements have a small margin of error, often around 3–5 degrees. A change from 18° to 20° may not be clinically meaningful, whereas a change from 18° to 28° certainly is. At Dorsi, we always interpret numbers in context.

Growth and Cobb Angle

The same Cobb angle can mean different things at different ages:

  • A 20° curve in a nearly fully grown adolescent may need only observation.
  • A 20° curve in a 10-year-old with years of growth ahead may require bracing.

That’s why we pair Cobb angle with growth status and curve pattern when planning care. We utilise a special calculation to assess progression risk.

Monitoring Change

Dorsi Spinal Institute uses repeat imaging at safe intervals to track Cobb angle over time. We look for:

  • Stable curves: little or no change between scans.
  • Progressive curves: increases of 5° or more, especially over short periods.

Change, not just a single number, often drives decisions.

Explaining Results to Families

We believe numbers should never be a mystery. At Dorsi, clinicians sit down with families to show x-rays, explain Cobb measurements, and discuss what the current angle means practically, today and in the future.

Next Steps

If you’ve been told a Cobb angle but don’t fully understand its implications, bring your imaging to Dorsi Spinal Institute. We’ll translate technical details into clear, usable information and a tailored plan.

Related reading: see our blogs on official diagnosis, understanding your child’s diagnosis, and curve correction outcomes.

 

Written by

Dr Matthew ABJ Potts BSc MSc DC ISPRM
Clinical Director 
Doctor of Chiropractic 
Specialist Scoliosis Consultant 
Fellow of the British Scoliosis Society 
Member of the Scoliosis Association (UK)
Chair of the Clinical Advisory Board at Meloq AB
Member of the International Society of Physical and Rehabilitation Medicine
Editorial board member of international journals CICRJ & Rehabilitation Science

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Dorsi Spinal Ltd is registered with Companies House at 11 Malin Hill, Nottingham, England, NG1 1JQ in England & Wales. Company Number: 10252956.
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