Bari Tanvir Johanning, Hallager Dennis Winge, Tøndevold Niklas, Karbo Ture, Hansen Lars Valentin, Dahl Benny, Gehrchen Martin
Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Spine Deform. 2019 Sep;7(5):771-778. doi: 10.1016/j.jspd.2018.12.002.
Reproducibility study.
To report the agreement and reliability for commonly used sagittal plane measurements.
Spinopelvic parameters and sagittal vertical axis (SVA) are commonly used parameters for preoperative planning and postoperative evaluation of patients with adult spinal deformity (ASD). Previous reproducibility studies have focused on describing the reliability using intraclass correlation coefficients (ICCs), thus quantifying the methods' ability to distinguish between individuals. To our knowledge, no previous study in patients with ASD has reported the measurement error in terms of limits of agreement. The current study aimed to report the agreement and reliability for measurements of pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and SVA in ASD patients.
In a consecutive, one-center cohort of 64 patients referred for ASD evaluation, a blinded test-retest study was performed. Reliability was assessed using ICCs, whereas 95% limits of agreement (LOAs) were used to quantify agreement.
We found "excellent" (ICC > 0.9) results in all analyses of reliability except for interrater PI, which was classified as "good" (ICC = 0.89). However, considerable interrater measurement error was observed for parameters depending on the angulation of the sacral end plate (95% LOA of ±11° and ±14° for SS and PI, respectively) compared with ±5° for PT and ±7 mm for SVA, which depends on the location of the sacral end plate. Intrarater agreement was only slightly better.
These are to our knowledge the first estimates of measurement error for sagittal spinopelvic parameters in ASD patients. Despite near excellent ICCs, we found considerable measurement error for parameters depending on the angulation rather than the location of the sacral end plate.
Level II.
重复性研究。
报告常用矢状面测量的一致性和可靠性。
脊柱骨盆参数和矢状垂直轴（SVA）是成人脊柱畸形（ASD）患者术前规划和术后评估的常用参数。以往的重复性研究主要集中在使用组内相关系数（ICC）来描述可靠性，从而量化方法区分个体的能力。据我们所知，之前没有关于ASD患者的研究报告过测量误差的一致性界限。本研究旨在报告ASD患者骨盆入射角（PI）、骨盆倾斜度（PT）、骶骨斜率（SS）和SVA测量的一致性和可靠性。
在一个连续的、单中心队列中，对64例因ASD评估而转诊的患者进行了一项双盲重测研究。使用ICC评估可靠性，而95%一致性界限（LOA）用于量化一致性。
除评估者间PI被归类为“良好”（ICC = 0.89）外，我们在所有可靠性分析中均发现“优秀”（ICC > 0.9）结果。然而，与PT的±5°和SVA的±7 mm相比，对于依赖于骶骨终板角度的参数，观察到了相当大的评估者间测量误差（SS和PI的95% LOA分别为±11°和±14°），SVA取决于骶骨终板的位置。评估者内一致性仅略好。
据我们所知，这些是ASD患者矢状面脊柱骨盆参数测量误差的首次估计。尽管ICC近乎优秀，但我们发现依赖于骶骨终板角度而非位置的参数存在相当大的测量误差。
二级。
