Intraobserver and Interobserver Reliability of the Classification of Thoracic Adolescent Idiopathic Scoliosis*†

Lenke, Lawrence G.; Betz, Randal R.; Bridwell, Keith H.; Clements, David H.; Harms, Jürgen; Lowe, Thomas G.; Shufflebarger, Harry L.

doi:10.2106/00004623-199808000-00002

Cited by 178 publications

(94 citation statements)

References 14 publications

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“…The thoracic Cobb angle must be larger (20% or more) than the thoracolumbar/lumbar Cobb angle by a suggested ratio of 1.2 [10,22,31,32]. The lumbar curve which is nonstructural with side bending to less than 25°and a sagittal kyphosis T10-L2 of less than 20°is a better candidate [13,16]. A more flexible thoracolumbar/lumbar curve is one that will spontaneously correct upon selective fusion of the thoracic spine [22,31].…”

Section: Criteria Of Selective Thoracic Fusionmentioning

confidence: 99%

“…Regardless, many of the same considerations as for selective thoracic fusion apply to selective thoracolumbar/lumbar fusions such as careful selection of fusion levels, correction amount, and potential complications. Lenke Type 5 and 6 curves are thoracolumbar/lumbar major curves with minor thoracic curves [13,15,16]. If the thoracic curve side bends to less than 25°and the T10-L2 kyphosis is less than 20°, it is classified as Lenke Type 5 curve and selective thoracolumbar/lumbar fusion is possible.…”

Section: Selective Thoracolumbar/lumbar Fusionmentioning

confidence: 99%

“…The King Type II curve is known as the ''false double major'' pattern, because the lumbar curve shows less magnitude and more flexibility on side-bending films which suggests that it is a compensatory curve present only to maintain coronal balance in the setting of a fixed thoracic curve. The King Type II curve was later reclassified by Lenke et al [13][14][15] as Lenke 1C, 2C, 3C, and 4C curves. Controversy exists over the treatment of the compensatory lumbar curve in King Type II curves [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Fischer

Kim

2011

Eur Spine J

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Selective fusion of thoracic and thoracolumbar/ lumbar curves in adolescent idiopathic scoliosis is a concept critically debated in the literature. While some surgeons strongly believe that a more rigid and straighter spine provides predictably excellent outcomes, some surgeons recommend a mobile and less straight spine. This topic is a crucial part of surgical treatment of idiopathic scoliosis, particularly in young patients who will deal with the stress of the fusion mass at the proximal and distal junctions over many years. This study will review the literature on various aspects of selective fusion.

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Section: Criteria Of Selective Thoracic Fusionmentioning

confidence: 99%

Section: Selective Thoracolumbar/lumbar Fusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Fischer

Kim

2011

Eur Spine J

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“…Do ponto de vista acadêmico, o nosso trabalho tem o objetivo de levantar dados epidemiológicos sobre escoliose vertebral em nossos estado, assim como classificar as escolioses idiopáticas do adolescente (EIA) segundo Nery et al 13 , Lenke et al 14,15 , e Winter et al 16 . para escoliose congênita e neuromuscular ,respectivamente, para no futuro definir a melhor forma de tratamento.…”

Section: Introductionunclassified

Estudo descritivo sobre o primeiro mutirão no Brasil de cirurgias eletivas para tratamento de escoliose

et al. 2012

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RESUMOObjetivo: Descrever os resultados estatísticos do primeiro mutirão de cirurgias eletivas realizado no Brasil, não somente com o intuito de divulgar a iniciativa, mas, sobretudo, para que o conhecimento dessas ações possa incentivar outros estados e também outros mutirões no Espírito Santo. Método: Estudo descritivo observacional transversal, em que foram avaliados pessoas oriundas da Grande Vitória e do interior do estado do Espírito Santo com deformidades ou sintomas álgicos na região dorsal de origem osteomuscular, classificando-as de acordo com a idade, sexo e patologia, e quando diagnosticado escoliose, se possível classifica-la segundo King, Lenke, Winter et al. e Lounstein e Akbarnia, indicando-se tratamento. Resultados: Foram avaliados 169 pacientes, sendo 48 homens e 121 mulheres, com média de idade de 39,7 anos e 41,1 anos, respectivamente. Foi encontrado 25,4% de pacientes com doenças ortopédicas em geral, 36,1% de doenças específicas da coluna vertebral exceto escoliose e 38,5% de escoliose. Dos pacientes com escoliose, 81,5% eram idiopática do adolescente, com maioria classificada por King como tipo II e por Lenke como tipo I. Dentre outras etiologias da escoliose, a congênita mais comum foi a hemivertebra associada a barra contralateral quando classificado por Winter et al. e das neuromusculares o tipo 2B da classificação de Louenstein e Akbarnia. Conclusão: Nossos dados epidemiológicos corroboram com a literatura atual. Conseguimos alcançar um numero satisfatório de pacientes com doenças da coluna vertebral, determinar um tratamento e acompanhamento e, ainda, divulgar e orientar a população sobre tais doenças.Descritores: Escoliose/epidemiologia; Escólios/patologia; Escoliose/cirurgia; Doenças da coluna vertebral. King, Lenke, Winter et al. and Lounstein and Akbarnia, and ABSTRACT Objective: Describe the statistical results of the first campaign for elective surgeries performed in Brazil, not only in order to make the initiative public, but more importantly, so that the knowledge of these actions will encourage other States and also other collaborative efforts in Espírito Santo. Methods: Descriptive cross-sectional observational study, which evaluated people from Grande Vitória and from the State of Espirito Santo with deformities or dorsal pain of musculoskeletal origin, classifying them according to age, sex and pathology, and when the diagnosis was scoliosis, if possible classified according to

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“…The difficulty of reliably measuring anterior-posterior (AP) scoliosis radiographs by experienced spinal surgeons using the manual Cobb technique for the classification of scoliosis has already been established [3,4,17,20]. 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].…”

Section: Introductionmentioning

confidence: 99%

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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Intraobserver and Interobserver Reliability of the Classification of Thoracic Adolescent Idiopathic Scoliosis*†

Cited by 178 publications

References 14 publications

Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Estudo descritivo sobre o primeiro mutirão no Brasil de cirurgias eletivas para tratamento de escoliose

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

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