Seel Edward H, Verrill Clare L, Mehta Rajnikant L, Davies Evan M
Spinal Unit, Department of Orthopaedics and Trauma, Southampton University Hospitals NHS Trust, United Kingdom.
Spine (Phila Pa 1976). 2005 Apr 15;30(8):964-8. doi: 10.1097/01.brs.0000158952.43914.fb.
Statistical analysis of 3 techniques for measuring thoracolumbar kyphosis secondary to fracture.
To determine the reliability of using an Oxford Cobbometer and assess the most reliable measurement technique.
The reproducibility of Cobb angles for the assessment of saggital plane deformity on spine radiographs has been shown to have significant variability in both intra- and interobserver error.
Twenty-four lateral spine radiographs of patients with thoracic and lumbar vertebral fractures were measured on 2 separate occasions, in random order, by 4 blinded observers using the same Oxford Cobbometer and ruler.
Method 2, the angle from the inferior endplate of the vertebra above the fractured vertebra to the superior endplate of the vertebra below the fractured vertebra, had the greatest intraobserver and interobserver reliabilities (rho = 0.856-0.976 and rho = 0.95, respectively). The other 2 methods had lower reliabilities; however, all 3 methods were well above the statistically acceptable threshold of >0.8, and the intraobserver reliabilities with each observer was 99% overall. These reliabilities supersede results reported previously using the conventional Cobb technique. The absolute mean difference between readings and 95% limit of agreement also improves on previous data, 2 degrees and +/- 5.8 degrees , respectively.
Highest intraclass correlation coefficients were obtained using method 2. Using the Oxford Cobbometer to measure fracture kyphosis has higher reliability than the standard Cobb angle technique. It is easy and quick to use in a clinical setting.
对三种测量继发于骨折的胸腰椎后凸畸形的技术进行统计分析。
确定使用牛津 Cobb 量角器的可靠性，并评估最可靠的测量技术。
在脊柱 X 光片上评估矢状面畸形时，Cobb 角的可重复性已显示出观察者内和观察者间误差存在显著差异。
4 名不知情的观察者使用同一牛津 Cobb 量角器和尺子，以随机顺序在两个不同时间对 24 例胸腰椎骨折患者的脊柱侧位 X 光片进行测量。
方法 2，即从骨折椎体上方椎体的下终板到骨折椎体下方椎体的上终板的角度，具有最高的观察者内和观察者间可靠性（组内相关系数分别为 0.856 - 0.976 和 0.95）。其他两种方法的可靠性较低；然而，所有三种方法均远高于统计学可接受阈值>0.8，且每位观察者的观察者内可靠性总体为 99%。这些可靠性超过了先前使用传统 Cobb 技术报告的结果。读数之间的绝对平均差异和 95%一致性界限也优于先前数据，分别为 2°和±5.8°。
使用方法 2 获得了最高的组内相关系数。使用牛津 Cobb 量角器测量骨折后凸畸形比标准 Cobb 角技术具有更高的可靠性。在临床环境中使用简便快捷。
