الفهرس 
The Lenke classification system
MATERIALS AND METHODSOnly 14 pages are availabe for public view
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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 %).