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Projectional distortion of the spine on traditional radiographic (x-rays) evalutation has long been know to be a source of error and uncertainty to the scoliosis clinician.  New 3-D imaging techniques are now demostrating how much and significant that projectional distortion changes the specific features of the scoliotic vertebrea at the apical and junctional zones.  Here is the full study. 

 

3D_alignment_in_asymptomatics.pdf

 

"The 3-D values confirm the large interindividual variability and pertinence of the well-established correlations between spinal and pelvic parameters. However, significant differences were found between 3-D and 2-D values. These findings would suggest that caution should be advised when using sagittal radiographs, especially for kyphosis."

 

"A better understanding of the 3-D aspects of posture will thereby become possible. This preliminary study opens the door to more extensive 3-D referential values, and original 3-D criteria to define posture and balance."