Vendeuvre Tanguy, Tabard-Fougère Anne, Armand Stéphane, Dayer Romain
Division of Pediatric Orthopaedics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Bone Joint J. 2023 Mar 15;105-B(4):431-438. doi: 10.1302/0301-620X.105B4.BJJ-2021-1440.R3.
This study aimed to evaluate rasterstereography of the spine as a diagnostic test for adolescent idiopathic soliosis (AIS), and to compare its results with those obtained using a scoliometer. Adolescents suspected of AIS and scheduled for radiographs were included. Rasterstereographic scoliosis angle (SA), maximal vertebral surface rotation (ROT), and angle of trunk rotation (ATR) with a scoliometer were evaluated. The area under the curve (AUC) from receiver operating characteristic (ROC) plots were used to describe the discriminative ability of the SA, ROT, and ATR for scoliosis, defined as a Cobb angle > 10°. Test characteristics (sensitivity and specificity) were reported for the best threshold identified using the Youden method. AUC of SA, ATR, and ROT were compared using the bootstrap test for two correlated ROC curves method. Of 212 patients studied, 146 (69%) had an AIS. The AUC was 0.74 for scoliosis angle (threshold 12.5°, sensitivity 75%, specificity 65%), 0.65 for maximal vertebral surface rotation (threshold 7.5°, sensitivity 63%, specificity 64%), and 0.82 for angle of trunk rotation (threshold 5.5°, sensitivity 65%, specificity 80%). The AUC of ROT was significantly lower than that of ATR (p < 0.001) and SA (p < 0.001). The AUCs of ATR and SA were not significantly different (p = 0.115). The rasterstereographic scoliosis angle has better diagnostic characteristics than the angle of trunk rotation evaluated with a scoliometer, with similar AUCs and a higher sensitivity.
本研究旨在评估脊柱光栅立体摄影术作为青少年特发性脊柱侧凸（AIS）诊断测试的效果，并将其结果与使用脊柱侧凸测量仪获得的结果进行比较。纳入疑似AIS且计划进行X线摄影的青少年。评估了光栅立体摄影术的脊柱侧凸角度（SA）、最大椎体表面旋转度（ROT）以及使用脊柱侧凸测量仪测量的躯干旋转角度（ATR）。采用受试者工作特征（ROC）曲线下面积（AUC）来描述SA、ROT和ATR对脊柱侧凸（定义为Cobb角>10°）的鉴别能力。报告了使用尤登方法确定的最佳阈值的测试特征（敏感性和特异性）。使用两条相关ROC曲线的自抽样检验方法比较SA、ATR和ROT的AUC。在研究中的212例患者中，146例（69%）患有AIS。脊柱侧凸角度的AUC为0.74（阈值12.5°，敏感性75%，特异性65%），最大椎体表面旋转度的AUC为0.65（阈值7.5°，敏感性63%，特异性64%），躯干旋转角度的AUC为0.82（阈值5.5°，敏感性65%，特异性80%）。ROT的AUC显著低于ATR（p<0.001）和SA（p<0.001）。ATR和SA的AUC无显著差异（p=0.115）。光栅立体摄影术的脊柱侧凸角度比用脊柱侧凸测量仪评估的躯干旋转角度具有更好的诊断特征，AUC相似且敏感性更高。
