A comparison of the reliability and vulnerability of 3D sterEOS and 2D EOS when measuring the sagittal spinal alignment of patients with adolescent idiopathic scoliosis.

dc.contributor.author

Machida, Masayoshi

dc.contributor.author

Rocos, Brett

dc.contributor.author

Zabjek, Karl

dc.contributor.author

Lebel, David E

dc.date.accessioned

2024-01-10T16:01:11Z

dc.date.available

2024-01-10T16:01:11Z

dc.date.issued

2022-09

dc.description.abstract

Purpose

An essential component of making the diagnosis of adolescent idiopathic scoliosis (AIS) is standing anteroposterior and lateral radiographs. Two-dimensional (2D) radiographs inevitably fail to reflect every plane of the three-dimensional (3D) deformity in scoliosis. We have tested the hypothesis that there is no difference in the assessment of the sagittal plane deformity when measured with either 2D or 3D EOS radiography.

Methods

A retrospective radiographic analysis was performed on patients diagnosed with AIS, with subdivided into three groups according to the coronal angular deformity (mild group: 45°-69°, moderate group: 70°-89°, and severe group: 90° +). The sagittal parameters were compared between manual measurement with 2D sterEOS and those made using computer-aided 3D reconstruction.

Results

Fifty-two patients were included in each group. The inter-study reliability when measuring the thoracic Kyphosis (TK) and lumbar lordosis (LL) between the two study modalities was excellent in mild group (ICC: 0.90, 95% CI 0.82 ~ 0.94 and ICC: 0.84, 95% CI 0.74 ~ 0.91), excellent in TK and fair in LL in moderate group (ICC: 0.76, 95% CI 0.61 ~ 0.85 and ICC: 0.70, 95% CI 0.53 ~ 0.81), and fair in TK and LL in severe group, respectively (ICC: 0.74, 95% CI 0.57 ~ 0.84 and ICC: 0.65, 95% CI 0.46 ~ 0.84). A Bland-Altman plot showed proportional bias in TK measurements in each group and LL in moderate group, which means the measured value is underestimated in 2D method when the angle is small.

Conclusion

3D sterEOS is less vulnerable to the influence of coronal plane than 2D EOS in evaluating the sagittal spinal parameters of patients with a coronal deformity exceeding 70°.

Level of evidence: 4

dc.identifier

10.1007/s43390-022-00499-4

dc.identifier.issn

2212-134X

dc.identifier.issn

2212-1358

dc.identifier.uri

https://hdl.handle.net/10161/29690

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

Spine deformity

dc.relation.isversionof

10.1007/s43390-022-00499-4

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Thoracic Vertebrae

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Humans

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Kyphosis

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Lordosis

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Scoliosis

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Retrospective Studies

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Reproducibility of Results

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Adolescent

dc.title

A comparison of the reliability and vulnerability of 3D sterEOS and 2D EOS when measuring the sagittal spinal alignment of patients with adolescent idiopathic scoliosis.

dc.type

Journal article

duke.contributor.orcid

Rocos, Brett|0000-0002-0808-5585

pubs.begin-page

1029

pubs.end-page

1034

pubs.issue

5

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

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Neurosurgery

pubs.publication-status

Published

pubs.volume

10

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