Schoen Klinik München Harlaching, Spine Center, Munich, Germany.
Academic Teaching Hospital and Spine Research Institute Paracelsus Private Medical University Salzburg, Salzburg, Austria.
Eur Spine J. 2019 Sep;28(9):2162-2168. doi: 10.1007/s00586-019-06082-2. Epub 2019 Jul 22.
Previous studies of 4D rasterstereography show a high intra- and interday reliability. However, only few studies validate rasterstereography to conventional X-ray imaging. We utilized EOS X-ray imaging system (EOS Imaging, Paris, France) for accurate 3D spinal modeling and compared the results to parameters obtained by 4D rasterstereography. The aim of the present study was to validate 4D rasterstereography in patients with degenerative disk disease (DDD).
Thirty-four individuals with DDD (female = 22 and male = 12) were included. EOS X-ray images were analyzed to determine spinal [lumbar lordosis (LL) and thoracic kyphosis (TK)] and pelvic parameters [pelvic obliquity (PO) and pelvic axial rotation (PR)]. Patients received 4D rasterstereographic measurements on the same day as EOS imaging. Parameters obtained by rasterstereography were compared to those obtained by EOS X-ray imaging. We used Bland and Altman's test as well as Pearson test to validate rasterstereography. Additionally, we calculated interrater reliability of EOS X-ray analysis using the intraclass correlation coefficient (ICC).
Our data showed only weak correlation between 4D rasterstereography and EOS X-ray imaging for spinal parameters (LL and TK). Pelvic parameters (PO and PR) showed no correlation. Interrater correlation reliability for EOS analysis was excellent (ICC > 0.8).
Our data suggest that rasterstereographic systems are no reliable substitute for X-ray-based imaging systems in patients with degenerative disk disease. EOS imaging was shown to provide reliable and accurate spinal modeling. Based on our results, rasterstereographic imaging should be used with caution for evaluating spinal and pelvic parameters in patients with DDD. These slides can be retrieved under Electronic Supplementary Material.
先前的 4D 光栅立体摄影研究表明其具有较高的日内和日间可靠性。然而，只有少数研究将光栅立体摄影与传统的 X 射线成像进行了验证。我们利用 EOS X 射线成像系统（EOS Imaging，巴黎，法国）进行准确的 3D 脊柱建模，并将结果与通过 4D 光栅立体摄影获得的参数进行比较。本研究的目的是验证光栅立体摄影在退行性椎间盘疾病（DDD）患者中的应用。
纳入 34 名 DDD 患者（女性 22 名，男性 12 名）。对 EOS X 射线图像进行分析，以确定脊柱（腰椎前凸角[LL]和胸椎后凸角[TK]）和骨盆参数（骨盆倾斜角[PO]和骨盆轴向旋转[PR]）。患者在接受 EOS 成像的同日接受 4D 光栅立体摄影测量。将光栅立体摄影获得的参数与 EOS X 射线成像获得的参数进行比较。我们使用 Bland 和 Altman 检验以及 Pearson 检验来验证光栅立体摄影。此外，我们使用组内相关系数（ICC）计算 EOS X 射线分析的组内可靠性。
我们的数据表明，对于脊柱参数（LL 和 TK），4D 光栅立体摄影与 EOS X 射线成像之间仅存在微弱的相关性。骨盆参数（PO 和 PR）之间没有相关性。EOS 分析的组内相关性可靠性极好（ICC＞0.8）。
我们的数据表明，在退行性椎间盘疾病患者中，光栅立体摄影系统不是基于 X 射线成像系统的可靠替代方法。EOS 成像可提供可靠和准确的脊柱建模。基于我们的结果，在 DDD 患者中评估脊柱和骨盆参数时，应谨慎使用光栅立体摄影成像。这些幻灯片可在电子补充材料中检索。
