**7. Conclusions**

knowledge no similar studies using the Microscribe have been conducted that have measured similar variables so it was not possible to compare the results of this study with previous studies. In the frontal plane the key difference in height levels between specific key anatomical landmarks on the two sides of the back was at the level of the shoulders; the left shoulder acromion was found to be significantly higher than the right. Further, no statistically sig‐ nificant differences were found at the levels of the inferior scapular angle, the iliac crests and the PSIS. In males there were no statistically significant differences between the two sides of the back. However, at the PSIS level, the left PSIS showed a trend toward being

With regards to the measurement of the frontal plane spinal angles, the mean frontal plane angles values showed that overall healthy young females have relatively straight spines. As stated previously, in this current study the mean thoracic curvature value was *+*2.38° and the mean lumbar curve was *+*1.65°. This supports the textbook "Ideal" of adults having a rela‐ tively straight spine [1]. These results however differ to the results we obtained previously using the surface topography equipment ISIS to measure a similar cohort of young adult stu‐ dents [6]. In this study, the mean thoracic curvature value found was 16.1° *+* 6.9° and the mean lumbar curvature value was 13.4° *+* 6.9°. It is the authors belief that the differences in values obtained from the ISIS2 scanner and the microscribe digitizer are due to the fact that the ISIS2 scanner has previously been shown to overestimate the magnitude of small curves [26].

In our study and in this population of young asymptomatic adults we found a mean thoracic kyphosis of 29.37° and lumbar lordosis of −37.7° in the sagittal plane. These values support the values provided by the Scoliosis Research Society who suggest that the normal range of tho‐ racic kyphosis is between 20 and 40° on X‐ray measurement [18, 26]. Our results also support the study by Betz [27] who found that the normal range for lumbar lordosis on X‐ray ranged between −20 and −60°. Propst‐Proctor and Bleck and Stagnara et al. evaluated the sagittal pro‐ file of a group of normal subjects aged 20–29 years old [28, 29]. The mean values of thoracic kyphosis ranged from 30 to 50° and the mean values of lumbar lordosis was calculated to be

Bernhardt and Bridwell [30] conducted a segmental analysis of sagittal plane alignment of the normal thoracic and lumbar spines as well the thoracolumbar junction on X‐rays. Within this study a wide range of healthy subjects (n = 102) aged between 5 and 29 years old were included. The authors reported a mean value of thoracic kyphosis at 40°, and mean of lumbar lordosis at −44°. While the thoracic Kyphosis in our study support the results obtained in the Bernhardt study, the lumbar lordosis reported in the Bernhardt study is much higher than the mean lumbar lordosis in our study. This may possibly be attributed to the fact that Bernhardt

The Microscribe is a manual measurement tool and although is very easy to use in a research setting it is not really ideal to use in a clinical setting at the current time. More research

study included a wide range of ages comprised of children, adolescents and adults.

55° which was greater than the lumbar lordosis in our group of subjects.

higher than the right PSIS.

14 Innovations in Spinal Deformities and Postural Disorders

**6. Limitations**

Ranges for normality of back shape and posture suggest that overall young asymptomatic males and females are very symmetrical, with the exception of shoulder values in young females. The normative ranges provided should help clinicians decide when postural retrain‐ ing exercises or conservative treatment is warranted.

The results will also provide a normative database for clinicians (physiotherapists, chiro‐ practors, spinal surgeons) who routinely assess back posture. Additionally, this method of assessment will provide an evidenced based objective alternative to other crude methods of assessment or just "eyeballing" back posture during clinical evaluation. Accurate recording of intervention or efficacy of treatment, if scientifically based on reliable measures can be used to credibly validate treatment effectiveness.
