Gladnick Brian P, Schreiber Joseph J, Ishmael Chad R, Bjerke-Kroll Benjamin T, Cunningham Matthew E
*Department of Orthopaedic Surgery, Hospital for Special Surgery †Weill Cornell Medical College, New York, NY.
Clin Spine Surg. 2017 Apr;30(3):E148-E151. doi: 10.1097/BSD.0000000000000070.
A prospective study of a new technique.
The aims of this study were to report a manual technique for measuring vertebral curves on digital spine radiographs, and to assess the agreement of this technique with that of digital software for measuring vertebral curves.
Modern picture archiving and communication systems (PACS) typically include software for evaluating radiographic measurements. However, in the outpatient spine setting, patients may present with radiographs stored on a physical disc, which may not include software for measuring vertebral curves. Certain smartphone applications may be used to determine curve magnitude; however, the need exists for an accurate manual technique to measure vertebral curves on digital radiographs in the absence of available analytic software or smartphone technology.
We prospectively reviewed anteroposterior and lateral spine radiographs of 24 spinal deformity patients. Two independent observers measured Cobb angles for: (1) the major coronal curve; (2) the thoracic kyphosis (T2-T12); and (3) the lumbar lordosis (T12-S1). Measurements were made: (1) digitally using our institution's PACS; and (2) by a manual technique, which involves placement of an adhesive Post-It note directly on the computer screen, transcribing the angle onto the Post-It note with a pencil, and measuring the angle with a handheld goniometer. Intraclass correlation coefficients (ICCs) were calculated to determine the agreement between the 2 methods.
For both observers, the agreement between the digital PACS and manual Post-It techniques was graded as excellent for both coronal and sagittal plane curves (all ICCs>0.9). Interobserver reliability between the 2 observers was also graded as excellent for both the PACS and Post-It techniques (all ICCs>0.9).
The Post-It technique for measuring Cobb angles demonstrated excellent agreement with the PACS system in our series of spinal deformity patients. Curves on digital radiographs can be accurately measured using a convenient manual technique.
一项关于新技术的前瞻性研究。
本研究的目的是报告一种用于在数字化脊柱X光片上测量椎体曲度的手工技术，并评估该技术与用于测量椎体曲度的数字软件之间的一致性。
现代图像存档与通信系统（PACS）通常包括用于评估放射学测量的软件。然而，在门诊脊柱诊疗环境中，患者可能会带来存储在实体光盘上的X光片，这些X光片可能不包括用于测量椎体曲度的软件。某些智能手机应用程序可用于确定曲度大小；然而，在没有可用分析软件或智能手机技术的情况下，仍需要一种准确的手工技术来在数字化X光片上测量椎体曲度。
我们前瞻性地回顾了24例脊柱畸形患者的前后位和侧位脊柱X光片。两名独立观察者测量以下 Cobb 角：（1）主要冠状面曲度；（2）胸椎后凸（T2 - T12）；（3）腰椎前凸（T12 - S1）。测量方法如下：（1）使用我们机构的PACS进行数字化测量；（2）采用手工技术，即将粘性便利贴直接贴在电脑屏幕上，用铅笔将角度转录到便利贴上，然后用手持量角器测量角度。计算组内相关系数（ICC）以确定两种方法之间的一致性。
对于两位观察者而言，数字PACS和手工便利贴技术在冠状面和矢状面曲度测量上的一致性均被评为优秀（所有ICC>0.9）。两位观察者之间的观察者间可靠性在PACS和便利贴技术方面也被评为优秀（所有ICC>0.9）。
在我们的脊柱畸形患者系列中，用于测量 Cobb 角的便利贴技术与PACS系统显示出极好的一致性。使用一种便捷的手工技术可以准确测量数字化X光片上的曲度。
