Schroeder J, Reer R, Braumann K M
Department of Sports Medicine, Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, University of Hamburg, Turmweg 2, Hamburg, 20148, Germany,
Eur Spine J. 2015 Feb;24(2):262-9. doi: 10.1007/s00586-014-3664-5. Epub 2014 Nov 26.
As reliability of raster stereography was proved only for sagittal plane parameters with repeated measures on the same day, the present study was aiming at investigating variability and reliability of back shape reconstruction for all dimensions (sagittal, frontal, transversal) and for different intervals.
For a sample of 20 healthy volunteers, intra-individual variability (SEM and CV%) and reliability (ICC ± 95% CI) were proved for sagittal (thoracic kyphosis, lumbar lordosis, pelvis tilt angle, and trunk inclination), frontal (pelvis torsion, pelvis and trunk imbalance, vertebral side deviation, and scoliosis angle), transversal (vertebral rotation), and functional (hyperextension) spine shape reconstruction parameters for different test-retest intervals (on the same day, between-day, between-week) by means of video raster stereography.
Reliability was high for the sagittal plane (pelvis tilt, kyphosis and lordosis angle, and trunk inclination: ICC > 0.90), and good to high for lumbar mobility (0.86 < ICC < 0.97). Apart from sagittal plane spinal alignment, there was a lack of certainty for a high reproducibility indicated by wider ICC confidence intervals. So, reliability was fair to high for vertebral side deviation and the scoliosis angle (0.71 < ICC < 0.95), and poor to good for vertebral rotation values as well as for frontal plane upper body and pelvis position parameters (0.65 < ICC < 0.92). Coefficients for the between-day and between-week interval were a little lower than for repeated measures on the same day. Variability (SEM) was less than 1.5° or 1.5 mm, except for trunk inclination. Relative variability (CV) was greater in global trunk position and pelvis parameters (35-98%) than in scoliosis (14-20%) or sagittal sway parameters (4-8 %).
Although we found a lower reproducibility for the frontal plane, raster stereography is considered to be a reliable method for the non-invasive, three-dimensional assessment of spinal alignment in normal non-scoliotic individuals in the sagittal plane and partly for scoliosis parameters, which fulfils scientific as well as practical recommendations for spine shape screening and monitoring, but cross-sectional or follow-up effect analyses should take into account the degree of reliability differing in various spine shape parameters. Further investigations should be conducted to analyse reliability in scoliosis patients with differing spinal deformities.
由于光栅立体摄影术的可靠性仅在矢状面参数上通过同一天的重复测量得到证实，本研究旨在调查背部形状重建在所有维度（矢状面、额状面、横断面）以及不同时间间隔下的变异性和可靠性。
对于20名健康志愿者的样本，通过视频光栅立体摄影术，对矢状面（胸椎后凸、腰椎前凸、骨盆倾斜角和躯干倾斜度）、额状面（骨盆扭转、骨盆与躯干失衡、椎体侧方偏移和脊柱侧弯角度）、横断面（椎体旋转）和功能性（过伸）脊柱形状重建参数在不同的重测间隔（同一天、不同天、不同周）下的个体内变异性（标准误和变异系数百分比）和可靠性（组内相关系数±95%置信区间）进行了验证。
矢状面的可靠性较高（骨盆倾斜、后凸和前凸角度以及躯干倾斜度：组内相关系数>0.90），腰椎活动度的可靠性为良好至高（0.86<组内相关系数<0.97）。除矢状面脊柱排列外，较宽的组内相关系数置信区间表明高重复性缺乏确定性。因此，椎体侧方偏移和脊柱侧弯角度的可靠性为中等至高（0.71<组内相关系数<0.95），椎体旋转值以及额状面上身和骨盆位置参数的可靠性为差至良好（0.65<组内相关系数<0.92）。不同天和不同周间隔的系数略低于同一天的重复测量。变异性（标准误）小于1.5°或1.5毫米，但躯干倾斜度除外。整体躯干位置和骨盆参数的相对变异性（变异系数）（35 - 98%）大于脊柱侧弯（14 - 20%）或矢状面摆动参数（4 - 8%）。
尽管我们发现额状面的重复性较低，但光栅立体摄影术被认为是一种可靠的方法，可用于对正常非脊柱侧弯个体的矢状面脊柱排列进行无创三维评估，部分用于脊柱侧弯参数评估，该方法满足了脊柱形状筛查和监测的科学及实际建议，但横断面或随访效应分析应考虑不同脊柱形状参数的可靠性程度差异。应进行进一步研究以分析不同脊柱畸形的脊柱侧弯患者的可靠性。
