Radiographic Analysis of Lumbar Lordosis

Harrison, Deed E.; Harrison, Donald D.; Cailliet, René; Janik, Tadeusz J.; Holland, Burt

doi:10.1097/00007632-200106010-00003

Cited by 205 publications

(89 citation statements)

References 33 publications

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“…To the authors' knowledge, this is the first study assessing the reliability of a computer-assisted digital radiographic measurement method to calculate the Cobb angle in veterinary medicine, despite the method being one of the most commonly used in human medicine for assessment of kyphosis and scoliosis [18], [19]. We confirmed the hypothesis that the evaluation of the Cobb angle on digital radiographs is a feasible and reliable method to quantify the degree of spinal curvature in dogs.…”

Section: Discussionsupporting

confidence: 72%

Computer-Assisted Radiographic Calculation of Spinal Curvature in Brachycephalic “Screw-Tailed” Dog Breeds with Congenital Thoracic Vertebral Malformations: Reliability and Clinical Evaluation

et al. 2014

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The objectives of this study were: To investigate computer-assisted digital radiographic measurement of Cobb angles in dogs with congenital thoracic vertebral malformations, to determine its intra- and inter-observer reliability and its association with the presence of neurological deficits. Medical records were reviewed (2009–2013) to identify brachycephalic screw-tailed dog breeds with radiographic studies of the thoracic vertebral column and with at least one vertebral malformation present. Twenty-eight dogs were included in the study. The end vertebrae were defined as the cranial end plate of the vertebra cranial to the malformed vertebra and the caudal end plate of the vertebra caudal to the malformed vertebra. Three observers performed the measurements twice. Intraclass correlation coefficients were used to calculate the intra- and inter-observer reliabilities. The intraclass correlation coefficient was excellent for all intra- and inter-observer measurements using this method. There was a significant difference in the kyphotic Cobb angle between dogs with and without associated neurological deficits. The majority of dogs with neurological deficits had a kyphotic Cobb angle higher than 35°. No significant difference in the scoliotic Cobb angle was observed. We concluded that the computer assisted digital radiographic measurement of the Cobb angle for kyphosis and scoliosis is a valid, reproducible and reliable method to quantify the degree of spinal curvature in brachycephalic screw-tailed dog breeds with congenital thoracic vertebral malformations.

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Section: Discussionsupporting

confidence: 72%

Computer-Assisted Radiographic Calculation of Spinal Curvature in Brachycephalic “Screw-Tailed” Dog Breeds with Congenital Thoracic Vertebral Malformations: Reliability and Clinical Evaluation

et al. 2014

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“…Despite being considered the “gold standard” for the measurement of thoracic kyphosis (14), the Cobb method has some weaknesses that may be more evident in an adult population (6, 14–16). The primary problem is the effect of altered end plate angle on the measured kyphotic angle.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Kyphosis is Now Uncommon Amongst Children and Adolescents with Cystic Fibrosis

et al. 2014

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Historically, thoracic kyphosis has been reported to be common amongst patients with cystic fibrosis (CF). The mechanisms leading to the development of this abnormality of the chest wall are not fully understood. In order to explore the prevalence of the condition amongst children with CF in the early twenty-first century and to explore factors that might be contributing to its development, a retrospective cross sectional study was undertaken in a regional CF unit. Data were obtained from 74 children with CF aged 8–16 years attending for their annual review. Thoracic kyphosis was measured from lateral chest X-ray using an alternative Cobb method. Lung function, disease severity, and nutritional status were also recorded. Correlations between measures were explored using a multiple linear regression model. The range of Cobb angles measured was 5.4–44.3° with thoracic kyphosis identified in only two subjects. There was no correlation between age and thoracic kyphosis, however, there was a significant correlation between lung function and thoracic kyphosis (p = 0.004). Regression coefficient (b) was −0.26 (95% CI: −0.44, −0.08). The prevalence of thoracic kyphosis is significantly less amongst children with CF than previously reported. This appears likely to be associated with the overall improvements in pulmonary status. Studies of older populations may bring further understanding of increasing thoracic kyphosis in people with CF.

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“…Even when Cobb's method is used, different authors use different start and end points for measurements [30,38-41]. Another striking point is that the criteria as to what constitutes lumbar degenerative disease are often not expressly stated.…”

Section: Discussionmentioning

confidence: 99%

“…The use of computers for lumbar lordosis measurements has been shown to be at least equal, if not better, to the manual method [7,30,31]. Measurements were made from the top of L 1 to the bottom of L 5 as well as from the top of L 1 to the top of S 1 .…”

Section: Methodsmentioning

confidence: 99%

The association of spinal osteoarthritis with lumbar lordosis

Papadakis

Papadokostakis

Kampanis

et al. 2010

BMC Musculoskelet Disord

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BackgroundCareful review of published evidence has led to the postulate that the degree of lumbar lordosis may possibly influence the development and progression of spinal osteoarthritis, just as misalignment does in other joints. Spinal degeneration can ensue from the asymmetrical distribution of loads. The resultant lesions lead to a domino- like breakdown of the normal morphology, degenerative instability and deviation from the correct configuration. The aim of this study is to investigate whether a relationship exists between the sagittal alignment of the lumbar spine, as it is expressed by lordosis, and the presence of radiographic osteoarthritis.Methods112 female subjects, aged 40-72 years, were examined in the Outpatients Department of the Orthopedics' Clinic, University Hospital of Heraklion, Crete. Lumbar radiographs were examined on two separate occasions, independently, by two of the authors for the presence of osteoarthritis. Lordosis was measured from the top of L1 to the bottom of L5 as well as from the top of L1 to the top of S1. Furthermore, the angle between the bottom of L5 to the top of S1was also measured.Results and discussion49 women were diagnosed with radiographic osteoarthritis of the lumbar spine, while 63 women had no evidence of osteoarthritis and served as controls. The two groups were matched for age and body build, as it is expressed by BMI. No statistically significant differences were found in the lordotic angles between the two groupsConclusionsThere is no difference in lordosis between those affected with lumbar spine osteoarthritis and those who are disease free. It appears that osteoarthritis is not associated with the degree of lumbar lordosis.

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Radiographic Analysis of Lumbar Lordosis

Cited by 205 publications

References 33 publications

Computer-Assisted Radiographic Calculation of Spinal Curvature in Brachycephalic “Screw-Tailed” Dog Breeds with Congenital Thoracic Vertebral Malformations: Reliability and Clinical Evaluation

Computer-Assisted Radiographic Calculation of Spinal Curvature in Brachycephalic “Screw-Tailed” Dog Breeds with Congenital Thoracic Vertebral Malformations: Reliability and Clinical Evaluation

Thoracic Kyphosis is Now Uncommon Amongst Children and Adolescents with Cystic Fibrosis

The association of spinal osteoarthritis with lumbar lordosis

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