Comparison of Manual and Digital Measurements in Adolescent Idiopathic Scoliosis

Kuklo, Timothy R.; Potter, Benjamin K.; Schroeder, Teresa M.; O’Brien, Michael F.

doi:10.1097/01.brs.0000217774.13433.a7

Cited by 109 publications

(67 citation statements)

References 14 publications

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“…Another potential weakness of our study is imaging was not standard between both study centers with one using all plain film radiography and the other using all digital imaging. While we had only one individual conduct all the radiographic measurements, two studies have demonstrated an intraobserver variability of less than 3°on both digital and manual measurements, whereas we consider a change of 5°as clinically important [11,17]. The usefulness of intraoperative radiographs in spine surgery has been well established with regard to analyzing implant placement.…”

Section: Discussionmentioning

confidence: 99%

Do Intraoperative Radiographs in Scoliosis Surgery Reflect Radiographic Result?

Lehman

Lenke

Helgeson³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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It is often difficult to predict postoperative radiographic curve magnitude and balance parameters while performing intraoperative correction during scoliosis surgery. We asked whether there was a radiographic correlation between intraoperative long-cassette scoliosis film and postoperative standing radiographs of adolescent idiopathic scoliosis with pedicle screw instrumentation. We retrospectively reviewed 44 patients with adolescent idiopathic scoliosis who underwent posterior instrumentation with pedicle screws. We made preoperative, intraoperative (after instrumentation and correction), and standing postoperative radiographic measurements (eg, curve magnitudes, coronal and sagittal balance, disc angles) and compared those for the intra-and postoperative radiographs. The intraoperative long-cassette scoliosis film correlated with the immediate postoperative standing film for all curve correction and balance parameters. The routine use of a long-cassette intraoperative scoliosis film provides the surgeon with a valuable tool to guide intraoperative decision-making and foreshadows the correction and balance obtained on the immediate postoperative film.

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Section: Discussionmentioning

confidence: 99%

Do Intraoperative Radiographs in Scoliosis Surgery Reflect Radiographic Result?

Lehman

Lenke

Helgeson³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Recently, digital computer measurement has been shown to have excellent intra-and inter-observer reliability and correlated well with manual measurements for most parameters of adolescent idiopathic scoliosis in the coronal plane [12]. Although the authors concluded that digital measurement is more accurate with preoperative and coronal measurements than with postoperative and sagittal measurements, they still felt that digital computer measurement is a valid technique [12]. The authors stressed that as digital radiography use becomes more frequent, the use of the digital measurement techniques will become increasing more common [12].…”

Section: Discussionmentioning

confidence: 85%

“…Although the authors concluded that digital measurement is more accurate with preoperative and coronal measurements than with postoperative and sagittal measurements, they still felt that digital computer measurement is a valid technique [12]. The authors stressed that as digital radiography use becomes more frequent, the use of the digital measurement techniques will become increasing more common [12]. The parallel development of a digital radiographic computer technique for the measurement of spino-pelvic alignment has also been studied for its intraand inter-observer variability, accuracy and reproducibility when compared to manually measured radiographs using the Cobb technique [1].…”

Section: Discussionmentioning

confidence: 98%

“…Recently, a computerized digital measurement technique for scoliosis demonstrated improved precision and good correlation with manually measured radiographs validating this methodology for the measurement of the spine in the coronal plane [12]. Similarly, the accuracy and reliability in the measurement of the spine in the sagittal plane is often more difficult due to variable measurement criteria, manual measurement errors, and difficulty visualizing measurement landmarks.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods

Dimar¹,

Carreon²,

Labelle

et al. 2008

Eur Spine J

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Sagittal imbalance is a significant factor in determining clinical treatment outcomes in patients with deformity. Measurement of sagittal alignment using the traditional Cobb technique is frequently hampered by difficulty in visualizing landmarks. This report compares traditional manual measurement techniques to a computerassisted sagittal plane measurement program which uses a radius arc methodology. The intra and inter-observer reliability of the computer program has been shown to be 0.92-0.99. Twenty-nine lateral 90 cm radiographs were measured by a computer program for an array of sagittal plane measurements. Ten experienced orthopedic spine surgeons manually measured the same parameters twice, at least 48 h apart, using a digital caliper and a standardized radiographic manual. Intraclass correlations were used to determine intra-and interobserver reliability between different manual measures and between manual measures and computer assisted-measures. The inter-observer reliability between manual measures was poor, ranging from -0.02 to 0.64 for the different sagittal measures. The intra-observer reliability in manual measures was better ranging from 0.40 to 0.93. Comparing manual to computer-assisted measures, the ICC ranged from 0.07 to 0.75. Surgeons agreed more often with each other than with the machine when measuring the lumbar curve, the thoracic curve, and the spinosacral angle. The reliability of the computer program is significantly higher for all measures except for lumbar lordosis. A computer-assisted program produces a reliable measurement of the sagittal profile of the spine by eliminating the need for distinctly visible endplates. The use of a radial arc methodology allows for infinite data points to be used along the spine to determine sagittal measurements. The integration of this technique with digital radiography's ability to adjust image contrast and brightness will enable the superior identification of key anatomical parameters normally not available for measurement on traditional radiographs, improving the consistency of sagittal measurement.

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“…The gold standard for diagnosis and monitoring of changes over time in AIS is represented by measurement of the Cobb angle on the standing posteroanterior full length spine radiograph [2], which provides a measure of the curvature of the spine in the frontal plane. A key factor to be evaluated in the assessment of the gravity of AIS [3], as well as for the planning and the analysis of orthopedic and surgical procedures [4] is represented by axial vertebral rotation (VR), defined as the rotation of a vertebra around its own longitudinal axis when projected onto the transverse image plane.…”

Section: Introductionmentioning

confidence: 99%

Vertebral rotation in adolescent idiopathic scoliosis calculated by radiograph and back surface analysis-based methods: correlation between the Raimondi method and rasterstereography

et al. 2012

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Purpose The aim of the present research is to evaluate the relationship between an X-ray-based method (i.e. the Raimondi method) and rasterstereography in the evaluation of vertebral rotation (VR) in a sample of adolescent idiopathic scoliosis (AIS) patients. Methods A total of 25 patients (9 males; mean age 14 ± 3 years; mean height 160.7 ± 11.9 cm; mean weight 52.4 ± 10.7 kg) were considered for the present analysis. The mean Cobb angle was 30°± 9°. The evaluation of VR on radiographs was made using the Raimondi method regolo (Marrapese Editore-Demi S.r.1., Rome). Rasterstereography was performed by means of Formetric 4D Ò (Diers International GmbH, Schlangenbad, Germany). Correlations between rasterstereographic and radiographic measurement of VR were calculated, both for the whole sample and for thoracic and lumbar spinal segments considered separately, as well as for subgroups of patients with a Cobb angle \30°and C30°using Spearman's correlation coefficient by rank (r s ). Results When applied to the entire spine, measurement of VR by means of the two methods highlighted a significant correlation in the whole group (r = 0.52; p \ 0.0001), as well as in the \30°Cobb (r = 0.47; p = 0.0001) and C30°Cobb (r = 0.42; p \ 0.0001) subgroups. A significant correlation was found also when lumbar and thoracic VR were considered as separated groups (r = 0.30, p = 0.024 and r = 0.47, p = 0.002, respectively).Conclusions Rasterstereographic evaluation of VR shows a good correlation with the Raimondi method, thereby confirming the possibility to use this non-invasive method for deformity assessment in AIS patients.

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Comparison of Manual and Digital Measurements in Adolescent Idiopathic Scoliosis

Cited by 109 publications

References 14 publications

Do Intraoperative Radiographs in Scoliosis Surgery Reflect Radiographic Result?

Do Intraoperative Radiographs in Scoliosis Surgery Reflect Radiographic Result?

Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods

Vertebral rotation in adolescent idiopathic scoliosis calculated by radiograph and back surface analysis-based methods: correlation between the Raimondi method and rasterstereography

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