Rigo Manuel D, Villagrasa Mónica, Gallo Dino
Institut Elena Salvá, Vía Augusta 185, 08021 Barcelona, Spain.
Ortholutions, Königsseestrasse 10, D-83022 Rosenheim, Germany.
Scoliosis. 2010 Jan 27;5(1):1. doi: 10.1186/1748-7161-5-1.
Spinal classification systems for scoliosis which were developed to correlate with surgical treatment historically have been used in brace treatment as well. Previously, there had not been a scoliosis classification system developed specifically to correlate with brace design and treatment. The purpose of this study is to show the intra- and inter- observer reliability of a new scoliosis classification system correlating with brace treatment.
An original classification system ("Rigo Classification") was developed in order to define specific principles of correction required for efficacious brace design and fabrication. The classification includes radiological as well as clinical criteria. The radiological criteria are utilized to differentiate five basic types of curvatures including: (I) imbalanced thoracic (or three curves pattern), (II) true double (or four curve pattern), (III) balanced thoracic and false double (non 3 non 4), (IV) single lumbar and (V) single thoracolumbar. In addition to the radiological criteria, the Rigo Classification incorporates the curve pattern according to SRS terminology, the balance/imbalance at the transitional point, and L4-5 counter-tilting. To test the intra-and inter-observer reliability of the Rigo Classification, three observers (1 MD, 1 PT and 1 CPO) measured (and one of them, the MD, re-measured) 51 AP radiographs including all curvature types.
The intra-observer Kappa value was 0.87 (acceptance >0.70). The inter-observer Kappa values fluctuated from 0.61 to 0.81 with an average of 0.71 (acceptance > 0.70).
A specific scoliosis classification which correlates with brace treatment has been proposed with an acceptable intra-and inter-observer reliability.
历史上为与手术治疗相关联而开发的脊柱侧弯分类系统也已用于支具治疗。此前，尚未开发出专门与支具设计和治疗相关联的脊柱侧弯分类系统。本研究的目的是展示一种与支具治疗相关的新脊柱侧弯分类系统在观察者内和观察者间的可靠性。
开发了一种原始分类系统（“里戈分类法”），以确定有效支具设计和制造所需的特定矫正原则。该分类包括放射学以及临床标准。放射学标准用于区分五种基本类型的弯曲，包括：（I）不平衡胸椎型（或三弯型），（II）真正双弯型（或四弯型），（III）平衡胸椎型和假性双弯型（非三非四型），（IV）单腰弯型，以及（V）单胸腰弯型。除放射学标准外，里戈分类法还纳入了根据脊柱侧弯研究学会（SRS）术语的弯曲模式、过渡点的平衡/不平衡以及L4 - 5反向倾斜。为测试里戈分类法在观察者内和观察者间的可靠性，三名观察者（1名医学博士、1名物理治疗师和1名认证假肢矫形器师）测量了（其中医学博士重新测量了一次）51张包括所有弯曲类型的前后位X线片。
观察者内卡帕值为0.87（可接受值>0.70）。观察者间卡帕值在0.61至0.81之间波动，平均为0.71（可接受值>0.70）。
已提出一种与支具治疗相关的特定脊柱侧弯分类法，其在观察者内和观察者间具有可接受的可靠性。
