Leg length discrepancy and adolescent idiopathic scoliosis: clinical and radiological characteristics

Spine Deform. 2022 Mar;10(2):307-314. doi: 10.1007/s43390-021-00417-0. Epub 2021 Sep 28.


Purpose: This retrospective study aimed to present the clinical and radiological features of functional scoliosis due to LLD and LLD concurrent with AIS; it also aimed to define their relationships for differentiating functional scoliosis due to LLD and LLD concurrent with AIS.

Methods: This study was conducted as a single-center retrospective comparative study on 47 scoliosis patients with diagnosed LLD, aged 10-18 years. Cases with a diagnosis of structural LLD were divided into two groups according to the presence or absence of concurrent AIS. Data on demographics and the angle of trunk rotation on a sacral basis (ATRsacrum) were recorded. Limb length was clinically measured with a tape measure and clinical LLD (C-LLD) scoliometer test. Cobb angle, axial rotation, pelvic obliquity, and radiological LLD (R-LLD) were obtained from standing spine radiographs and measured by two blinded orthopedic spine surgeons.

Results: The prevalence of LLD was 6.7% in scoliosis patients in our study population. Cobb angle and apical rotation were higher in the LLD concurrent with AIS group than in the LLD group (p ≤ 0.05). The C-LLDscoliometer test results were strongly correlated with both C-LLDtape measure (r = 0.651; p = 0.000) and ATRsacrum (r = 0.688; p = 0.000).

Conclusion: LLD may develop as a result of adaptive changes due to scoliosis, or a concurrent condition to scoliosis. Cobb angle and apical rotation are the features that differentiate AIS from functional scoliosis in patients with LLD. The C-LLD scoliometer test can be an effective, practical, and useful method for measuring C-LLD, but its validity and reliability should be determined.

Trial registration: This study was retrospectively registered at ClinicalTrials.gov (number: NCT04713397, date of registration: 01/14/2021).

Level of evidence: III.

Keywords: Leg length discrepancy; Leg length discrepancy scoliometer test; Pelvic obliquity; Scoliosis.

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Leg
  • Reproducibility of Results
  • Retrospective Studies
  • Sacrum
  • Scoliosis* / surgery

Associated data

  • ClinicalTrials.gov/NCT04713397