الفهرس | Only 14 pages are availabe for public view |
Abstract Study design: This is a blinded multisurgeon study for measuring lateral whole spine radiographs by five observers on two occasions. Objectives: Determining the intraobserver and interobserver reliability of measurements of sagittal profile for thirty patients with severe thoracic adolescent idiopathic Scoliosis (AIS) to evaluate the reliability and reproducibility of the Lenke Classification System. Background data: Measuring the Sagittal profile in patients with severe AIS is not an easy task because of the visibility of the vertebral endplates in the thoracic region being obscured by soft tissue shadows and given that scoliosis is a 3 dimensional (D) deformity aggravates this problem even more. The Sagittal profile component of the Lenke Classification system has been studied by five observers with good experience in scoliosis surgery using radiographs that were not premeasured thus mimicking normal clinical conditions and trying to assess the reproducibility and reliability of the Sagittal profile which is a crucial component of the Lenke classification system. Methods: Five experienced Faculty spine surgeons familiar with Lenke classification system examined independently thirty standing long 30-inch cassette lateral radiographs of preoperative severe thoracic curves ≥ 50⁰ of AIS patients on two different occasions at three weeks apart. The radiographs were randomly ordered in each assessment. The parameters measured were the sagittal profile component of the Lenke classification system, vertebral endplate clarity and Measurability of the sagittal angle from D5 – D12. The other two components of the Lenke classification system were premeasured. Multiraterkappa statistics as well as average percentage of agreement was calculated. Also,Intraclass correlation coefficient (ICC) was also used to assess reliability. Results: the Interobserver reliability was found to be excellent in all sagittal parameters measured, namely the Sagittal angle D5 – D12, the vertebral endplate clarity and measurability of sagittal angle. Interobserver percentage of agreement was excellent (81.9 % to 99.9 %). The Intraobserver reliability was found to be substantial to excellent (Kappa coefficient 0.799,1.000). Intraobserver percentage of agreement was excellent (79.9 % to 99.9 %). |