Reliability of cervical lordosis measurement techniques on long-cassette radiographs.
Eur Spine J
; 25(11): 3596-3601, 2016 11.
Article
in En
| MEDLINE
| ID: mdl-26707132
ABSTRACT
PURPOSE:
Lateral radiographs are commonly used to assess cervical sagittal alignment. Three assessment methods have been described and are commonly utilized in clinical practice. These methods are described for perfect lateral cervical radiographs, however in everyday practice radiograph quality varies. The aim of this study was to compare the reliability and reproducibility of 3 cervical lordosis (CL) measurement methods.METHODS:
Forty-four standing lateral radiographs were randomly chosen from a lateral long-cassette radiograph database. Measurements of CL were performed with Cobb method C2-C7 (CM), C2-C7 posterior tangent method (PTM), sum of posterior tangent method for each segment (SPTM). Three independent orthopaedic surgeons measured CL using the three methods on 44 lateral radiographs. One researcher used the three methods to measured CL three times at 4-week time intervals. Agreement between the methods as well as their intra- and interobserver reliability were tested and quantified by intraclass correlation coefficient (ICC) and median error for a single measurement (SEM). ICC of 0.75 or more reflected an excellent agreement/reliability. The results were compared with repeated ANOVA test, with p < 0.05 considered as significant.RESULTS:
All methods revealed excellent intra- and interobserver reliability. Agreement (ICC, SEM) between three methods was (0.89°, 3.44°), between CM and SPTM was (0.82°, 4.42°), between CM and PTM was (0.80°, 4.80°) and between PTM and SPTM was (0.99°, 1.10°). Mean values CL for a CM, PTM, SPTM were 10.5° ± 13.9°, 17.5° ± 15.6° and 17.7° ± 15.9° (p < 0.0001), respectively. The significant difference was between CM vs PTM (p < 0.0001) and CM vs SPTM (p < 0.0001), but not between PTM vs SPTM (p > 0.05).CONCLUSIONS:
All three methods appeared to be highly reliable. Although, high agreement between all measurement methods was shown, we do not recommend using Cobb measurement method interchangeably with PTM or SPTM within a single study as this could lead to error, whereas, such a comparison between tangent methods can be considered.Key words
Search on Google
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiography
/
Cervical Vertebrae
/
Lordosis
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
En
Journal:
Eur Spine J
Journal subject:
ORTOPEDIA
Year:
2016
Document type:
Article
Affiliation country:
Estados Unidos
Publication country:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY