Reproducibility of thoracic kyphosis measurements in patients with adolescent idiopathic scoliosis

Background Current surgical treatment for adolescent idiopathic scoliosis (AIS) involves correction in both the coronal and sagittal plane, and thorough assessment of these parameters is essential for evaluation of surgical results. However, various definitions of thoracic kyphosis (TK) have been proposed, and the intra- and inter-rater reproducibility of these measures has not been determined. As such, the purpose of the current study was to determine the intra- and inter-rater reproducibility of several TK measurements used in the assessment of AIS. Methods Twenty patients (90% females) surgically treated for AIS with alternate-level pedicle screw fixation were included in the study. Three raters independently evaluated pre- and postoperative standing lateral plain radiographs. For each radiograph, several definitions of TK were measured as well as L1–S1 and nonfixed lumbar lordosis. All variables were measured twice 14 days apart, and a mixed effects model was used to determine the repeatability coefficient (RC), which is a measure of the agreement between repeated measurements. Also, the intra- and inter-rater intra-class correlation coefficient (ICC) was determined as a measure of reliability. Results Preoperative median Cobb angle was 58° (range 41°–86°), and median surgical curve correction was 68% (range 49–87%). Overall intra-rater RC was highest for T2–T12 and nonfixed TK (11°) and lowest for T4–T12 and T5–T12 (8°). Inter-rater RC was highest for T1–T12, T1-nonfixed, and nonfixed TK (13°) and lowest for T5–T12 (9°). Agreement varied substantially between pre- and postoperative radiographs. Inter-rater ICC was highest for T4–T12 (0.92; 95% CI 0.88–0.95) and T5–T12 (0.92; 95% CI 0.88–0.95) and lowest for T1-nonfixed (0.80; 95% CI 0.72–0.88). Conclusions Considerable variation for all TK measurements was noted. Intra- and inter-rater reproducibility was best for T4–T12 and T5–T12. Future studies should consider adopting a relevant minimum difference as a limit for true change in TK. Electronic supplementary material The online version of this article (doi:10.1186/s13013-017-0112-4) contains supplementary material, which is available to authorized users.

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PID https://www.doi.org/10.1186/s13013-017-0112-4
PID pmc:PMC5320797
PID pmid:28251188
URL http://link.springer.com/content/pdf/10.1186/s13013-017-0112-4.pdf
URL https://link.springer.com/article/10.1186/s13013-017-0112-4
URL http://dx.doi.org/10.1186/s13013-017-0112-4
URL https://curis.ku.dk/portal/da/publications/reproducibility-of-thoracic-kyphosis-measurements-in-patients-with-adolescent-idiopathic-scoliosis(ed980406-da94-4350-b70a-b953465a7232).html
URL https://scoliosisjournal.biomedcentral.com/track/pdf/10.1186/s13013-017-0112-4
URL https://academic.microsoft.com/#/detail/2589847515
URL https://dx.doi.org/10.1186/s13013-017-0112-4
URL https://core.ac.uk/display/81058070
URL https://doi.org/10.1186/s13013-017-0112-4
URL https://curis.ku.dk/ws/files/196371620/s13013_017_0112_4.pdf
URL https://scoliosisjournal.biomedcentral.com/articles/10.1186/s13013-017-0112-4
URL https://www.ncbi.nlm.nih.gov/pubmed/28251188
URL http://hub.hku.hk/bitstream/10722/234740/1/content.pdf
URL http://hdl.handle.net/10722/234740
URL http://europepmc.org/articles/PMC5320797
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Access Right Open Access
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Author Jason Pui Yin Cheung, 0000-0002-7052-0875
Author Dennis Winge Hallager, 0000-0002-7439-5485
Author Søren Ohrt-Nissen, 0000-0002-8234-9948
Author Martin Gehrchen, 0000-0001-5523-2763
Author Kenny Kwan, 0000-0002-4034-8525
Author Kenneth Cheung, 0000-0001-8304-0419
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Collected From Europe PubMed Central; PubMed Central; ORCID; Datacite; Copenhagen University Research Information System; UnpayWall; HKU Scholars Hub; Crossref; Microsoft Academic Graph; CORE (RIOXX-UK Aggregator)
Hosted By Europe PubMed Central; SpringerOpen; Copenhagen University Research Information System; HKU Scholars Hub; Scoliosis and Spinal Disorders
Journal Scoliosis and Spinal Disorders, 12,
Publication Date 2017-02-21
Publisher BioMed Central
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Country China (People's Republic of); Denmark
Format application/pdf
Language English
Resource Type Other literature type; Article; UNKNOWN
system:type publication
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Source https://science-innovation-policy.openaire.eu/search/publication?articleId=dedup_wf_001::4951ef0b711fb2b1d10189c186210bb2
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Last Updated 21 December 2020, 22:21 (CET)
Created 21 December 2020, 22:21 (CET)