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Spinal Frontiers · Clinical Practice · Measurement Apps

Measurement Apps: Cobb Angle and Sagittal Balance

Phone apps, automatic X-ray measurement, planning software and back-scan apps for scoliosis and sagittal balance, with whether each is cleared and validated.

22 apps and programs · 8 FDA-cleared · checked 1 Nov 2026

Apps and software for measuring Cobb angles, sagittal balance and trunk rotation: phone apps, automatic measurement in the hospital image system, planning software and back-scan apps. For each we show whether a regulator has cleared it and whether it has been validated in a published study. Your hospital's PACS measurements remain the reference.

Safety first: screening apps and parents

Some back-scan and scoliometer apps are sold directly to families. A normal reading at home can falsely reassure and delay a referral, particularly for curves close to bracing or surgical thresholds. Several apps claim to be "clinical-grade" without any published study, and some are sold alongside non-surgical "reversal" programmes. If a family uses one, treat the result as a prompt for clinical review, never as a substitute for it.

What the evidence says

  • Phone-based Cobb measurement can come close to PACS, but agreement between observers is wider than many expect: in one study the 95% limits were about ±8°. (Shaw 2012, Eur Spine J, PubMed)
  • A phone scoliometer is only as good as the forward-bend test: in a 2025 comparison a scoliometer detected half of the curves of 20° or more. (Rohde 2025, Spine Deform, PubMed)
  • Most scoliometer apps sold to the public have no published validation. (Naziri 2018, systematic review, PubMed)
  • General-purpose AI chatbots estimated Cobb angles within 5° in about 9 of 10 radiographs but were unreliable for Lenke classification and fusion levels; the authors advise against independent use. (Avcı 2026, Eur Spine J, PubMed)
  • Screening adolescents for scoliosis is contested: the US Preventive Services Task Force found the evidence insufficient, while specialist societies support screening. Apps sold to parents bypass that debate. (USPSTF 2018, JAMA, PubMed)

Patient images: photographing a monitor with a personal phone, or uploading an X-ray to an app or chatbot, moves health data off the hospital system. See Viewing Scans (DICOM) and Secure Messaging.

Phone apps for measuring X-rays

Apps that measure angles on a radiograph, either by laying the phone on the film or screen (tilt sensor) or by tapping landmarks on a photo of the image.

iPhoneNo clearance

SagittalMeter Pro

Jean-Charles Le Huec (developer named on the App Store)

Measures
Phone laid on a lateral radiograph or screen: pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, C7/T1 slope, Cobb angle and the developer's balance indices.
Cost
US$9.99
Published validation
  • Lee 2019, World Neurosurg: agreed with PACS measurements and was about 2.5 times faster (PubMed 30557655)
Regulatory status and details
Regulatory status
No clearance claimed; the listing describes it as educational.
Platform
iPhone
Still maintained
Yes: updated in 2025 and again in October.

Maker or store page →Source checked

Checked 1 Nov 2026

iPhoneStatus not confirmed

CobbMeter CE

Régis Rigal (R2MobileStudio)

Note: Not updated since 2017, so it may stop working on current iPhones.

Measures
Phone laid on the radiograph or screen (tilt sensor): Cobb angle, kyphosis, sacral slope.
Cost
US$8.99
Published validation
  • Jacquot 2012, Int Orthop: reliability for kyphosis (the developer is a co-author) (PubMed 22653103)
  • Ketenci 2021, Clin Orthop Surg: two smartphone apps against PACS in scoliosis (PubMed 33747380)
Regulatory status and details
Regulatory status
'CE' is part of the name, but the listing does not explain a CE marking (not confirmed).
Platform
iPhone
Still maintained
Last updated April 2017; recent reviews report crashes.

Maker or store page →Source checked

Checked 1 Nov 2026

iPhone and AndroidNo clearance

Cobb Angle App

Orthopractis (Greece)

Measures
Tap four points on a photographed X-ray; corrects for phone tilt and grades the curve.
Cost
US$5.99
Published validation
None found
Regulatory status and details
Regulatory status
No clearance claimed; the listing says it is not for primary image interpretation.
Platform
iPhone and Android
Still maintained
Yes: Android version updated October 2026.

Maker or store page →Source checked

Checked 1 Nov 2026

iPhoneNo clearance

SagittalBalanceApp

Orthopractis (Greece)

Measures
Tap landmarks on a lateral X-ray: pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, C7 plumb line.
Cost
US$8.99
Published validation
None found
Regulatory status and details
Regulatory status
No clearance claimed.
Platform
iPhone
Still maintained
Last updated April 2022.

Maker or store page →Source checked

Checked 1 Nov 2026

iPhone (iOS 17 or later)No clearance

Cobb Angle Pro Spine X-Ray

4AI Bilgi Teknolojileri (Turkey)

Note: The AI landmark suggestions are not validated: check every landmark yourself.

Measures
Manual Cobb angle with AI-suggested landmarks, sagittal vertical axis, goniometer.
Cost
Free to download, then a subscription (up to US$79.99 a year)
Published validation
None found
Regulatory status and details
Regulatory status
No clearance claimed.
Platform
iPhone (iOS 17 or later)
Still maintained
New in 2026; updated October.

Maker or store page →Source checked

Checked 1 Nov 2026

Automatic X-ray measurement (AI)

Software that runs inside the hospital's image system (PACS) and measures Cobb angles and alignment automatically. Bought by the hospital, not by individuals.

Hospital image system (PACS)FDA-cleared

BoneMetrics

Gleamer (Paris)

Measures
Cobb angles, pelvic obliquity, coronal balance, Risser grade; sagittal vertical axis, thoracic kyphosis, lumbar lordosis; pelvic incidence, pelvic tilt, sacral slope; limb measurements.
Cost
Hospital licence (price on request)
Published validation
  • Hayashi 2025, Skeletal Radiol: main-curve error 2.6° (authors include company staff) (PubMed 39688663)
  • Albano 2026, Eur Spine J: 12 alignment parameters on EOS images (PubMed 41974957)
Regulatory status and details
Regulatory status
FDA 510(k) K241593 (February 2025) for Cobb angle measurement from age 4. CE marked (class not stated on the maker's page). FDA record: K241593
Platform
Hospital image system (PACS); also via the Sectra Amplifier marketplace
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Hospital image system (PACS)CE marked

IB Lab SQUIRREL

ImageBiopsy Lab (Vienna)

Measures
Cobb angles, pelvic tilt, coronal balance and change between studies.
Cost
Hospital licence
Published validation
  • Chen 2024, J Clin Med: agreement with readers ICC 0.97 (two authors linked to the company) (PubMed 39064162)
Regulatory status and details
Regulatory status
CE marked under the EU MDR (2023; class not stated). No FDA clearance listed for this product.
Platform
Hospital image system (PACS)
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Siemens imaging platform / PACSFDA-cleared

OrthoMatic Spine (syngo Carbon Clinicals)

Siemens Healthineers

Measures
Automatic Cobb angles, coronal balance, kyphosis, lordosis and sagittal alignment from full-spine X-rays.
Cost
Hospital licence
Published validation
None found
Regulatory status and details
Regulatory status
FDA 510(k) K251059 (October 2025). FDA record: K251059
Platform
Siemens imaging platform / PACS
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Software and analysis serviceFDA-cleared

Spine CAMP

Medical Metrics (Houston)

Measures
Spinopelvic parameters and segmental motion on lateral and flexion–extension X-rays. Does not measure Cobb angles.
Cost
Licence or service
Published validation
None found
Regulatory status and details
Regulatory status
FDA 510(k) K221632 (2022) and K231668 (2023). FDA record: K221632 K231668
Platform
Software and analysis service
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Web, desktop and mobileStatus not confirmed

EOS Insight

ATEC (EOS imaging)

Measures
AI alignment measurements with editable landmarks, compared with normal values.
Cost
Supplied with EOS systems
Published validation
None found
Regulatory status and details
Regulatory status
Not stated on the maker's page (not confirmed).
Platform
Web, desktop and mobile; needs EOS images
Still maintained
Yes (launched 2024)

Maker or store page →Source checked

Checked 1 Nov 2026

Sagittal balance and planning software

Desktop and web software for full spinopelvic measurement and deformity planning.

WebStatus not confirmed

KEOPS

SMAIO (Lyon)

Measures
Sagittal and coronal parameters, linked to a large case database and SMAIO's planning tools and patient-specific rods.
Published validation
  • Maillot 2015, Eur Spine J: reproducibility of sagittal and scoliosis measurements (PubMed 25724685)
  • Rassi 2024, Spine Deform: reliability of KEOPS version 2 (PubMed 38865071)
Regulatory status and details
Regulatory status
KEOPS's own status is not stated on the pages checked. SMAIO's planning software Balance Analyzer 3D received FDA clearance in 2022 and has been CE marked since 2014.
Platform
Web
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Windows, Mac and webFDA-cleared

Surgimap

Nemaris (Globus Medical since 2018)

Note: Existing users can probably keep working, but treat it as legacy software and keep your own copy of measurements.

Measures
Full spinopelvic and cervical parameters, Cobb angles, osteotomy and implant planning.
Cost
Free (premium accounts offered)
Published validation
  • Lafage 2015, Spine J: validation of spinopelvic measurements (PubMed 26343243)
Regulatory status and details
Regulatory status
FDA 510(k) K141669. FDA record: K141669
Platform
Windows, Mac and web; iPhone companion app
Still maintained
No visible development: the website footer reads 2019 and the iPhone app was last updated in May 2020. A 2026 paper states that new-user registration has closed; Globus has not confirmed this publicly.

Maker or store page →Source checked

Checked 1 Nov 2026

Desktop (Python)No clearance

SpineForge Planner

B. B. Akbulut (Izmir)

Note: Download location not confirmed; the link goes to the paper.

Measures
Eight sagittal parameters; screw, rod (with STL export) and osteotomy planning.
Cost
Free, open source
Published validation
  • Akbulut 2026, Oper Neurosurg: ICC 0.89 or higher against Surgimap (PubMed 42200626)
Regulatory status and details
Regulatory status
Research software; no clearance.
Platform
Desktop (Python); reads DICOM
Still maintained
New (2026)

Maker or store page →Source checked

Checked 1 Nov 2026

Workstation and webFDA-cleared

VEA Align / spineEOS

ATEC (EOS imaging)

Measures
3D reconstruction of the spine, pelvic and sagittal parameters, Cobb angles, 3D surgical planning and patient-specific rod templates.
Cost
Supplied with EOS systems
Published validation
  • Ferrero 2018, Eur Spine J: first experience of spineEOS planning in AIS (PubMed 29693200)
  • Machida 2022, Spine Deform: 3D sterEOS against 2D EOS measurements (PubMed 35384609)
Regulatory status and details
Regulatory status
FDA 510(k) K251747 (August 2025). FDA record: K251747
Platform
Workstation and web; needs biplanar EOS images
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Web (cloud)FDA-cleared

UNiD Spine Analyzer

Medtronic (Medicrea)

Measures
Lordosis, kyphosis, pelvic parameters, sagittal vertical axis, Lenke classification; predicted compensation; patient-specific rod planning.
Cost
Linked to Medtronic implants
Published validation
None found
Regulatory status and details
Regulatory status
FDA 510(k) K251629 (August 2025) and K261289 (May 2026). FDA record: K251629 K261289
Platform
Web (cloud)
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Desktop / PACSCE marked

mediCAD 3D Spine (sagittal balance module)

mediCAD Hectec (Landshut)

Measures
Sacral slope, pelvic tilt, pelvic incidence, C7 plumb line, T1 and T9 tilt; fusion and osteotomy planning.
Cost
Licence; trial on request
Published validation
None found
Regulatory status and details
Regulatory status
CE marked according to the maker's 2023 brochure (class not stated); FDA status not stated.
Platform
Desktop / PACS
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

Back-scan and scoliometer apps

Radiation-free apps that scan the back or measure trunk rotation in the forward-bend test. Some are sold directly to parents.

iPhone (iOS 16 or later)FDA-cleared

Momentum Spine

Momentum Health (Montreal)

Note: Can be used by parents without a clinician. An estimate is not an X-ray: a reassuring result should not delay a clinical review.

Measures
A short video of the back becomes a 3D torso model; AI-estimated Cobb angle, shoulder and waist asymmetry, trunk shift.
Cost
Free app; subscription in the app
Published validation
  • Parent 2026, Spine Deform: early single-centre results of an AI surface-topography app (the abstract does not name the app) (PubMed 41615635)
Regulatory status and details
Regulatory status
FDA 510(k) K232023 (October 2023), cleared both for use at home by families and on prescription, from age 8. FDA record: K232023
Platform
iPhone (iOS 16 or later)
Still maintained
Yes

Maker or store page →Source checked

Checked 1 Nov 2026

iPhone with face-scanning cameraFDA-cleared

NSite Scoliosis Assessment App

NSite Medical (Menlo Park)

Measures
Back-surface asymmetry, giving a low or high risk of a Cobb angle above 20°.
Published validation
  • Rohde 2025, Spine Deform: sensitivity 96% and specificity 85% for curves of 20° or more (a scoliometer found 50%) (PubMed 40172834)
Regulatory status and details
Regulatory status
FDA 510(k) K230463 (November 2023), prescription use by healthcare professionals, ages 10 to 18. FDA record: K230463
Platform
iPhone with face-scanning camera
Still maintained
Not confirmed

Maker or store page →Source checked

Checked 1 Nov 2026

iPhone with depth camera or Structure SensorNo clearance

BackSCNR

BackSCNR Inc.

Measures
Back-surface topography and an estimated Cobb angle.
Cost
Free
Published validation
None found
Regulatory status and details
Regulatory status
None stated.
Platform
iPhone with depth camera or Structure Sensor; web
Still maintained
Updated July (latest listing)

Maker or store page →Source checked

Checked 1 Nov 2026

iPhoneNo clearance

Scoliometer: Scoliosis Test

Kevin Lau (chiropractor, Singapore)

Note: No published validation found. The same developer sells non-surgical scoliosis 'reversal' programmes.

Measures
Angle of trunk rotation in the forward-bend test.
Cost
US$12.99
Published validation
None found
Regulatory status and details
Regulatory status
None; marketed as 'clinical-grade'.
Platform
iPhone
Still maintained
Updated 2024 and since

Maker or store page →Source checked

Checked 1 Nov 2026

iPhoneNo clearance

Scoliometer (Spiral Spine)

Spiral Spine Inc.

Measures
Rib and trunk rotation.
Cost
US$4.99
Published validation
None found
Regulatory status and details
Regulatory status
None stated.
Platform
iPhone
Still maintained
Updated January (latest listing)

Maker or store page →Source checked

Checked 1 Nov 2026

iPhoneNo clearance

ScoliCheck

ScoliCare (Australia)

Measures
Angle of trunk rotation in the forward-bend test.
Cost
Free
Published validation
None found
Regulatory status and details
Regulatory status
None stated.
Platform
iPhone
Still maintained
Last update date not shown

Maker or store page →Source checked

Checked 1 Nov 2026

How we compile this page

Each entry records what the maker's page, the app store listing and the FDA database state, checked on the date shown, and the published validation studies we could find on PubMed. Studies written with the maker are marked. Inclusion is not an endorsement and NSpine has no commercial relationship with any of these companies. We re-check this page every quarter.

Left out or not yet confirmed:

  • TraumaCad (Brainlab): the current version's FDA clearance lists hip, knee, foot and ankle and upper limb only; whether spine tools remain is not confirmed.
  • ScolioTrack (Android) and Scoliometer HD are not listed: their store pages could not be checked or show frequent crash reports.
  • Scoligauge, an early validated scoliometer app (Franko 2012), is no longer in the app stores.
  • Measurement tools inside individual PACS viewers (for example Sectra or Agfa) and tools cleared only in China are not covered.
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