Computed tomography(CT) allows better imaging of bony architecture than plain films alone. Patients with a complex osseous deformity, x-rays alone are insufficient and the use of CT is necessary, especially when surgery is planned.

• The main purpose of performing computed tomography(CT) in a patient with scoliosis is to identify an underlying osseous cause
• Computed tomography allows better imaging of bony architecture than plain films alone^[1][2]
• Radiography is the method of choice for the initial diagnostic imaging evaluation
• X-rays are usually sufficient to exclude most congenital and developmental osseous anomalies, which account for most cases of scoliosis with an underlying pathologic origin
• Patients with a complex osseous deformity, radiography alone is inadequate and the use of CT is mandatory, especially when surgery is planned
• Multidetector CT with 3-D image reconstruction allows the visualization of complex osseous abnormalities of congenital scoliosis
• Three-dimensional reconstructions of computed tomography scans are more helpful than plain films in visualizing posterior vertebral anomalies associated with hemivertebra
• CT scan can be helpful especially when planning the surgical excision of hemivertebrae because it may depict unexpected osseous anomalies that were not clearly depicted at initial radiography
• Preoperative CT angiography is also useful for determining whether coexistent anomalous vascular conditions are present