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Updated: Nov 30, 2025

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Spinal postural alignment measurements using markerless digital photography.

Mitsumasa Hida1, Chikamune Wada2, Ryota Imai1

  • 1Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka City, Osaka, Japan.

Journal of Orthopaedic Surgery (Hong Kong)
|November 16, 2020
PubMed
Summary

A new markerless digital photography method accurately measures spinal posture alignment. This technique, the craniohorizontal angle in supine (CHAS), shows excellent correlation and reliability for hyperkyphosis assessment.

Keywords:
headkyphosisphotographposture

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Area of Science:

  • Biomedical Engineering
  • Radiology
  • Orthopedics

Background:

  • Accurate posture alignment measurement is crucial for preventing hyperkyphosis.
  • Existing methods may require repeated measurements or invasive techniques.

Purpose of the Study:

  • To develop and validate a markerless digital photography method for measuring spinal posture alignment.
  • To assess the correlation of the new method with existing noninvasive measurements.
  • To determine the validity and accuracy of the proposed technique for hyperkyphosis assessment.

Main Methods:

  • A markerless measurement technique using digital photography was developed.
  • The craniohorizontal angle in supine (CHAS) was calculated from digital images using ImageJ software.
  • Correlations with the kyphosis index (KI) and block method (BM) were investigated.
  • Intrarater reliability and Bland-Altman analyses were performed.

Main Results:

  • The craniohorizontal angle in supine (CHAS) demonstrated an excellent correlation with the kyphosis index (KI) and block method (BM).
  • Intra- and interrater reliability for CHAS measurements were found to be almost perfect.
  • Bland-Altman analysis indicated minor addition errors, suggesting the need for manual landmark confirmation.

Conclusions:

  • The craniohorizontal angle in supine (CHAS) offers an excellent correlation and reliability for spinal postural alignment measurement.
  • This markerless, non-invasive method is suitable for assessing spinal alignment in a supine position.
  • Manual confirmation of landmarks may enhance the accuracy of the CHAS method.