T1 骨盆角（TPA）的观察者间/内可靠性：一种用于评估整体矢状面畸形的新的影像学测量指标。
Inter/Intraobserver Reliability of T1 Pelvic Angle (TPA), a Novel Radiographic Measure for Global Sagittal Deformity.
机构信息
Department of Orthopaedic Surgery, Saint Louis University School of Medicine, Saint Louis, MO.
Department of Physical Therapy, Saint Louis University Doisy College of Health Sciences, Saint Louis, MO.
出版信息
Spine (Phila Pa 1976). 2018 Nov 1;43(21):E1290-E1296. doi: 10.1097/BRS.0000000000002689.
STUDY DESIGN
Reliability analysis.
OBJECTIVE
To assess intra- and interobserver agreement of the T1 pelvic angle (T1PA), a novel radiographic measure of spinal sagittal alignment. Orthopedic surgeons of various levels of experience measured the T1PA in a series of healthy adult volunteers. The relationship of the TIPA to pelvic position was also assessed.
SUMMARY OF BACKGROUND DATA
Recent literature suggests that the T1PA is a more reliable measure of global sagittal alignment than traditional measurements (i.e., sagittal vertical axis). Previous research focuses on postoperative patients with known spinal deformity. No published research exists evaluating the use of T1PA on healthy subjects without spinal deformity. The purpose of this study is: (1) to assess the reliability of measurements of the T1PA, (2) to examine its relationship to pelvic position.
METHODS
Seven evaluators of varying orthopedic experience measured the T1PA in 50 healthy adult volunteers. Subjects were radiographed in each of three pelvic positions: resting, maximal anterior pelvic rotation, and maximal posterior pelvic rotation. After a washout period, the measurement was repeated. Using intraclass correlation coefficients, the intra- and inter-rater agreement for the T1PA was measured. The collected data was also used to determine the accuracy of this measurement and its relationship to pelvic position.
RESULTS
A very high level of agreement was found in measurements of the T1PA (intraclass correlation coefficients r = 0.98). At each pelvic position, all examiners had excellent intrarater reliability, > 0.85. The inter-rater reliability, compared with a gold standard, consistently measured the T1PA within ± 2°. The data also shows that the T1PA changes with pelvic rotation.
CONCLUSION
T1PA is a reproducible and reliable measure of global sagittal alignment regardless of the level of training. The T1PA varies based on pelvic rotation; this variation must be taken into account when assigning an absolute target for correction.
LEVEL OF EVIDENCE
研究设计
可靠性分析。
目的
评估 T1 骨盆角（T1PA）的观察者内和观察者间一致性，这是一种新的脊柱矢状面排列的放射学测量方法。不同经验水平的矫形外科医生在一系列健康成年志愿者中测量了 T1PA。还评估了 TIPA 与骨盆位置的关系。
背景资料概要
最近的文献表明，T1PA 是一种比传统测量方法（即矢状垂直轴）更可靠的整体矢状面排列测量方法。之前的研究集中在已知脊柱畸形的术后患者。目前尚无评估 T1PA 在无脊柱畸形的健康受试者中使用的已发表研究。本研究的目的是：（1）评估 T1PA 测量的可靠性，（2）检查其与骨盆位置的关系。
方法
7 名具有不同矫形经验的评估者在 50 名健康成年志愿者中测量了 T1PA。在休息、最大前骨盆旋转和最大后骨盆旋转三种骨盆位置下对受试者进行了拍摄。在冲洗期后，重复了测量。使用组内相关系数，测量了 T1PA 的观察者内和观察者间一致性。收集的数据还用于确定该测量的准确性及其与骨盆位置的关系。
结果
在 T1PA 的测量中发现了非常高的一致性（组内相关系数 r=0.98）。在每个骨盆位置，所有检查者的内部分组可靠性均非常好，>0.85。与黄金标准相比，观察者间的可靠性始终在±2°内测量 T1PA。数据还表明，T1PA 随骨盆旋转而变化。
结论
T1PA 是一种可重复且可靠的整体矢状面排列测量方法，无论培训水平如何。T1PA 随骨盆旋转而变化；在为校正分配绝对目标时，必须考虑到这种变化。
证据水平
4 级。
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