Zhu TingBiao, Wang YingSong, Xie JingMing, Zhang Ying, Zhao Zhi, Li Tao, Shi ZhiYue, Bi Ni
Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, People's Republic of China.
Eur Spine J. 2022 Jan;31(1):79-87. doi: 10.1007/s00586-021-07028-3. Epub 2021 Oct 24.
To develop a clinically feasible classification for severe spinal deformity based on X-ray features.
A total of 223 consecutive severe spinal deformity cases who underwent corrective operation were enrolled from 2004 to 2015 retrospectively. Based on X-ray features, a novel classification was developed containing three components: curve types, curve angle and apex location. There were five curve types as follows: single scoliosis (SS), kyphoscoliosis (KS), angular deformity (AD), long curve (LC), and double curves (DC). Curve angle subsection on coronal and sagittal planes including A:90-109, B:110-129, C:130-149, D: > 150. Apex location means the exact level of apex located. Reliability of the classification was tested.
The kappa values for inter-observer and intra-observer reliability of the curve types, curve angle, and apex level were larger than 0.80. X-ray classification for overall patients with severe spinal deformity showed that there were 101 SS cases, 47 KS, 46 AD, 19 LC and 10 DC. For the curve angle, there were grade A 123 cases, B 43, C 18, D 15 on coronal plane and grade A 38, B 17, C 16, and D 19 on sagittal plane. Apex location showed there were 27 patients at T7 or upper levels, 31 on T8, 58 on T9, 45 on T10, 18 on T11, and 44 at T12 or lower levels.
A novel classification for severe spinal deformity was described based on X-ray morphology. A high value for inter-observer and intra-observer reliability was shown. Each subgroup has its particular influence on decision-making and prognostic prediction.
基于X线特征制定一种临床可行的严重脊柱畸形分类方法。
回顾性纳入2004年至2015年连续接受矫正手术的223例严重脊柱畸形病例。基于X线特征，制定了一种包含三个要素的新分类方法：曲线类型、曲度角和顶点位置。曲线类型有以下五种：单发性脊柱侧凸（SS）、脊柱后凸侧凸（KS）、角状畸形（AD）、长曲线（LC）和双弯（DC）。冠状面和矢状面的曲度角分段包括：A：90-109，B：110-129，C：130-149，D：>150。顶点位置指顶点所在的确切节段。对该分类方法的可靠性进行了测试。
曲线类型、曲度角和顶点水平的观察者间及观察者内可靠性的kappa值均大于0.80。严重脊柱畸形总体患者的X线分类显示，有101例SS，47例KS，46例AD，19例LC和10例DC。曲度角方面，冠状面有A组123例、B组43例、C组18例、D组15例，矢状面有A组38例、B组17例、C组16例、D组19例。顶点位置显示，T7或更高节段有27例患者，T8有31例，T9有58例，T10有45例，T11有18例，T12或更低节段有44例。
基于X线形态描述了一种严重脊柱畸形的新分类方法。显示出观察者间和观察者内可靠性的高值。每个亚组对决策和预后预测都有其特定影响。
