Yamazato Camila Oda, Ribeiro Gustavo, Paula Fabio Chaud de, Soares Ramon Oliveira, Cruz Paulo Santa, Kanas Michel
Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Dec 13;57(2):321-326. doi: 10.1055/s-0041-1729581. eCollection 2022 Apr.
The present study aims to determine the intra- and inter-rater reliability and reproducibility of the Roussouly classification for lumbar lordosis types. A database of 104 panoramic, lateral radiographs of the spine of male individuals aged between 18 and 40 years old was used. Six examiners with different expertise levels measured spinopelvic angles and classified lordosis types according to the Roussouly classification using the Surgimap software (Nemaris Inc., New York, NY, USA). After a 1-month interval, the measurements were repeated, and the intra- and inter-rater agreement were calculated using the Fleiss Kappa test. The study revealed positive evidence regarding the reproducibility of the Roussouly classification, with reasonable to virtually perfect (0.307-0.827) intra-rater agreement, and moderate (0.43) to reasonable (0.369) inter-rater agreement according to the Fleiss kappa test. The most experienced examiners showed greater inter-rater agreement, ranging from substantial (0.619) to moderate (0.439). The Roussouly classification demonstrated good reliability and reproducibility, with intra- and inter-rater agreements at least reasonable, and reaching substantial to virtually perfect levels in some situations. Evaluators with highest expertise levels showed greater intra and inter-rater agreement.
本研究旨在确定腰椎前凸类型的鲁苏利分类法在评估者内和评估者间的可靠性及可重复性。使用了一个包含104张18至40岁男性脊柱全景侧位X线片的数据库。六名具有不同专业水平的检查者使用Surgimap软件（美国纽约州内马里斯公司）测量脊柱骨盆角度，并根据鲁苏利分类法对前凸类型进行分类。间隔1个月后重复测量，并使用弗赖斯kappa检验计算评估者内和评估者间的一致性。该研究揭示了关于鲁苏利分类法可重复性的积极证据，根据弗赖斯kappa检验，评估者内一致性为合理至几乎完美（0.307 - 0.827），评估者间一致性为中等（0.43）至合理（0.369）。经验最丰富的检查者表现出更高的评估者间一致性，范围从高度一致（0.619）到中等一致（0.439）。鲁苏利分类法显示出良好的可靠性和可重复性，评估者内和评估者间一致性至少合理，在某些情况下达到高度一致至几乎完美的水平。专业水平最高的评估者表现出更高的评估者内和评估者间一致性。
