Validation of a new method for the radiological measurement of rod curvature in patients with spine deformity.

IF 1.6 Q3 CLINICAL NEUROLOGY
Spine deformity Pub Date : 2024-11-01 Epub Date: 2024-05-30 DOI:10.1007/s43390-024-00905-z
Daniel Larrieu, Alice Baroncini, Ayman Assi, Cecile Roscop, Louis Boissiere, Ibrahim Obeid
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引用次数: 0

Abstract

Purpose: The relationship between rod curvature and postoperative radiographic results is a debated topic. One of the reasons of the heterogeneity of the observed results might reside in the lack of a validated and widely employed method to measure the curvature of the rods. Aim of this study was to present and validate a novel method for rod measurement, which is based on routine X-rays and utilizes a regression algorithm that limits manual measurements and the related errors.

Methods: Data from 20 adolescent idiopathic scoliosis/Scheuermann kyphosis (AIS/SK) patients and 35 adult spine deformity (ASD) patients for analysis, with 112 rods in total. An orthogonal reference grid was overlaid on the lateral X-ray; seven points were then marked along each rod and their coordinates recorded in a table. Using these coordinates, a third-order polynomial regression was applied to obtain the rod curvature equation (correlation coefficients > 0.97). Three observers (one surgeon, one experienced and one inexperienced observer) independently applied the developed method to measure the rod angulation of the included patients and performed the measurements twice. The reliability of the method was evaluated in terms of intraclass correlation coefficient (ICC), Bland-Altmann plot and 2SR.

Results: The intra-observer ICCs for all measurements exceed 0.85, indicating an excellent correlation. For the AIS/SK group, the surgeon showed a slightly lower reliability compared to the other two evaluators (0.93 vs 0.98 and 0.98). However, the surgeon showed a higher reliability in measurements of the rods at the lumbar level, both for L1-S1 and L4-S1 (0.98 vs 0.96 and 0.89; 0.97 vs. 0.85 and 0.91, respectively). The variability also showed excellent results, with a mean variability ranging from 1.09° to 3.76°. The inter-observer ICCs for the three measurement groups showed an excellent reliability for the AIS/SK group (0.98). The reliability was slightly lower but still excellent for the lumbar measurements in ASD patients at L1-S1 (0.89) and L4-S1 (0.83). The results of the 2SR for each measured segment were 4.4° for T5-T11, 5.4° for L1-S1 and 5.5° for L4-S1.

Conclusion: The described method represents a reliable and reproducible way to measure rod curvature. This method is based on routine X-rays and utilizes a regression algorithm that limits manual measurements and the related errors.

脊柱畸形患者棒状弯曲放射学测量新方法的验证。
目的:骨棒曲率与术后放射成像结果之间的关系是一个备受争议的话题。观察到的结果存在差异的原因之一可能在于缺乏一种经过验证且广泛使用的方法来测量杆状物的曲率。本研究的目的是介绍并验证一种新型的杆状物测量方法,该方法以常规 X 光片为基础,利用回归算法限制人工测量和相关误差:方法:分析 20 名青少年特发性脊柱侧凸/舒尔曼脊柱侧凸(AIS/SK)患者和 35 名成人脊柱畸形(ASD)患者的数据,共 112 根测量棒。正交参考网格被覆盖在侧位 X 光片上,然后沿着每根杆标记七个点,并将其坐标记录在表格中。利用这些坐标,采用三阶多项式回归法得出杆曲率方程(相关系数大于 0.97)。三名观察者(一名外科医生、一名经验丰富的观察者和一名经验不足的观察者)独立应用所开发的方法测量纳入患者的杆角度,并进行了两次测量。通过类内相关系数(ICC)、布兰德-阿尔特曼图和 2SR 对该方法的可靠性进行了评估:结果:所有测量的观察者内部 ICC 均超过 0.85,表明相关性极佳。在 AIS/SK 组中,外科医生与其他两位评估者相比,可靠性略低(0.93 vs 0.98 和 0.98)。不过,外科医生在腰椎水平的棒材测量中表现出更高的可靠性,无论是 L1-S1 还是 L4-S1(分别为 0.98 vs 0.96 和 0.89;0.97 vs. 0.85 和 0.91)。变异性也显示出很好的结果,平均变异性在 1.09°到 3.76°之间。三个测量组的观察者间 ICC 显示,AIS/SK 组的可靠性极佳(0.98)。ASD 患者在 L1-S1 (0.89)和 L4-S1 (0.83)处的腰椎测量的可靠性稍低,但仍然很好。每个测量节段的 2SR 结果为:T5-T11 为 4.4°,L1-S1 为 5.4°,L4-S1 为 5.5°:所述方法是一种可靠且可重复的测量杆状弯曲度的方法。该方法以常规 X 射线为基础,采用回归算法,限制了人工测量和相关误差。
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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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