Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Pediatric Spine Study Group, Valley Forge, PA, USA.
Spine Deform. 2024 Mar;12(2):335-339. doi: 10.1007/s43390-023-00793-9. Epub 2023 Dec 26.
Large registries are increasingly at the forefront of modern pediatric spine research, with manual, centralized, trained radiographic measurement serving as the gold standard for spine research. However, there is limited data regarding the reliability of registry measurements which may be subject to differences in radiographic calibration. We undertook this study to evaluate reliability of T1-T12 height, L1-S1 height, and coronal balance measurements for a large registry of early onset scoliosis patients.
Three trained technicians from the Pediatric Spine Study Group measured 43 radiographs for T1-T12, L1-S1, and coronal balance using 3 different calibration techniques. All radiographs were AP views of patients with magnetically controlled growing rods with known diameters. The calibration techniques used a pre-export manually drawn line, a digital automatically generated computerized marker, and the diameter of a magnetically controlled growing rod. The intraclass correlation coefficient (ICC) was calculated to determine reliability.
1161 measurements were performed. For each of the three raters, coronal balance, T1-T12 height and L1-S1 height had excellent agreement regardless of the calibration technique (alpha 0.93-1.0). Among the parameters, coronal balance had the worst inter-rater reliability, whereas there was excellent interrater reliability regarding T1-T12 height and L1-S1 height (alpha 0.91-0.99).
There was excellent agreement among reviewers and between the 3 different calibration techniques. While calibration using rod diameter served as the gold standard, this data shows that other standard calibration methods were adequate and achieved excellent reliability for registry radiographs.
大型注册研究越来越处于现代儿科脊柱研究的前沿，手动、集中、经过培训的放射学测量是脊柱研究的金标准。然而，关于注册测量的可靠性数据有限，这些数据可能受到放射学校准差异的影响。我们进行这项研究是为了评估大型早发性脊柱侧凸患者注册研究中 T1-T12 高度、L1-S1 高度和冠状平衡测量的可靠性。
来自儿科脊柱研究小组的 3 名经过培训的技术人员使用 3 种不同的校准技术对 43 张 T1-T12、L1-S1 和冠状平衡的 X 光片进行测量。所有 X 光片均为具有已知直径的磁控生长棒患者的 AP 视图。使用的校准技术包括预导出的手动绘制线、数字自动生成的计算机化标记和磁控生长棒的直径。计算了组内相关系数（ICC）以确定可靠性。
共进行了 1161 次测量。对于每个 3 名评分者，无论使用何种校准技术，冠状平衡、T1-T12 高度和 L1-S1 高度的一致性均极佳（alpha 0.93-1.0）。在这些参数中，冠状平衡的组间可靠性最差，而 T1-T12 高度和 L1-S1 高度的组间可靠性极佳（alpha 0.91-0.99）。
评分者之间以及 3 种不同校准技术之间存在极好的一致性。虽然使用棒直径进行校准作为金标准，但这些数据表明其他标准校准方法也是足够的，并为注册 X 光片获得了极好的可靠性。
