最小化观察者变异性对脊柱矢状参数测量影响的策略。

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY
Clinical Spine Surgery Pub Date : 2024-12-01 Epub Date: 2024-06-06 DOI:10.1097/BSD.0000000000001642
Adimilson Dos Santos Delgado, Bruna Souza Morais, Helton Luiz Aparecido Defino, Arlindo Neto Montagnoli
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引用次数: 0

摘要

研究设计探索性描述研究:评估观察者变异性对采用解剖和功能性脊柱分割方法测量胸椎后凸(TK)和腰椎前凸(LL)的影响:背景:脊柱手术规划的参数分析通常依赖于解剖参数。背景:脊柱手术规划的参数分析通常依赖于解剖参数,然而,纳入考虑椎体方向的功能参数对于最大限度地减少手术计算误差非常重要:作者开发的参数分析软件融合了传统方法和功能方法。所提出的方法包括根据脊柱模型拐点的法线计算出的功能性胸椎后凸和功能性腰椎前凸。使用合成的侧位 X 光片,通过计算机模拟观察者的变异性,生成 20 个地标集,复制 20 个观察者的注释。分析还包括 10 张临床 X 光片,由 3 位评委进行两次标注,间隔至少 1 周。脊柱弯曲角度是通过解剖和功能方法得出的。比较结果进行了统计分析:结果:对于合成 X 光片,拟议方法的变异性明显较小:结果:对于合成 X 光片,所建议的方法的变异性:TK(0.97)和功能性 LL(ICC>0.87)明显小于 TK(ICCC):椎体终板并不是测量脊柱矢状曲的最合适位置。地标位置的微小变化都会显著改变所测量的 Cobb 角。除了更个性化的分析外,所提出的方法在观察者变异性的影响方面具有很大的优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Strategies for Minimizing the Effects of Observer Variability on Sagittal Parameter Measurements of the Spine.

Study design: Exploratory-descriptive study.

Objective: Evaluate the influence of observer variability on the measurements of both thoracic kyphosis (TK) and lumbar lordosis (LL) obtained with anatomic and functional spinal segmentation methods.

Background: Parametric analysis for spinal surgery planning typically relies on anatomic parameters. However, incorporating functional parameters that consider the vertebrae orientation is important to minimizing surgical calculation errors.

Methods: The authors developed parametric analysis software that integrates traditional and functional methodologies. The proposed method included functional thoracic kyphosis and functional lumbar lordosis calculated from the lines normal to the inflection points of the spine model. Using a synthetic lateral X-ray, the observer variability was computer-simulated generating 20 landmark sets that replicate the annotations of 20 observers. The analysis also included 10 clinical X-rays, annotated twice by 3 judges with a minimum 1-week interval. The spinal curvature angles were derived using the anatomic and functional methods. Statistical analysis were performed for comparison.

Results: For the synthetic X-ray, the proposed method presented significantly less variability: TK (<±2.5 degrees, P =0.00023) and LL (<±5 degrees, P =0.00012). For the clinical X-rays, the interobserver reliability analysis yielded higher intraclass correlation coefficients (ICC) for functional TK (ICC>0.97) and functional LL (ICC>0.87) than for TK (ICC<0.91) and LL (ICC<0.89). Statistically significant differences were observed for both TK ( P =0.001) and LL ( P =0.030). Under the traditional method, observer variability led to measurement differences surpassing ±19 degrees, whereas differences with the proposed method were within ±10 degrees for both parameters.

Conclusion: The vertebral endplate is not the most suitable place to measure spinal sagittal curvatures. Small changes in landmark position significantly alter the measured Cobb angle. The proposed method offers a substantial advantage regarding the influence of observer variability, in addition to the more individualized analysis.

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来源期刊
Clinical Spine Surgery
Clinical Spine Surgery Medicine-Surgery
CiteScore
3.00
自引率
5.30%
发文量
236
期刊介绍: Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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