Department of Orthopedics, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Gen Med. 2011;4:821-5. doi: 10.2147/IJGM.S25403. Epub 2011 Dec 8.
The aim of this study was to investigate the interobserver agreement of the Lenke and King classifications for adolescent idiopathic scoliosis, and to compare the results of surgery performed based on classification of the scoliosis according to each of these classification systems.
The study was conducted in Shohada Hospital in Tabriz, Iran, between 2009 and 2010. First, a reliability assessment was undertaken to assess interobserver agreement of the Lenke and King classifications for adolescent idiopathic scoliosis. Second, postoperative efficacy and safety of surgery performed based on the Lenke and King classifications were compared. Kappa coefficients of agreement were calculated to assess the agreement. Outcomes were compared using bivariate tests and repeated measures analysis of variance.
A low to moderate interobserver agreement was observed for the King classification; the Lenke classification yielded mostly high agreement coefficients. The outcome of surgery was not found to be substantially different between the two systems.
Based on the results, the Lenke classification method seems advantageous. This takes into consideration the Lenke classification's priority in providing details of curvatures in different anatomical surfaces to explain precise intensity of scoliosis, that it has higher interobserver agreement scores, and also that it leads to noninferior postoperative results compared with the King classification method.
本研究旨在探讨青少年特发性脊柱侧凸 Lenke 和 King 分型的观察者间一致性，并比较基于两种分型系统对脊柱侧凸进行分类后的手术结果。
本研究于 2009 年至 2010 年在伊朗大不里士沙赫达德医院进行。首先，进行可靠性评估以评估青少年特发性脊柱侧凸 Lenke 和 King 分型的观察者间一致性。其次，比较基于 Lenke 和 King 分型的手术的术后疗效和安全性。采用 Kappa 系数评估一致性。采用双变量检验和重复测量方差分析比较结果。
King 分型的观察者间一致性为低至中度；Lenke 分型产生的一致性系数大多较高。两种系统之间手术结果没有明显差异。
根据结果，Lenke 分型方法似乎具有优势。该方法优先考虑在不同解剖表面提供曲线的详细信息以解释脊柱侧凸的精确强度，具有更高的观察者间一致性评分，并且与 King 分型方法相比，术后结果非劣效。
