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Article: The reliability and diagnostic value of radiographic criteria in sagittal spine deformities: Comparison of the vertebral wedge ratio to the segmental Cobb angle

TitleThe reliability and diagnostic value of radiographic criteria in sagittal spine deformities: Comparison of the vertebral wedge ratio to the segmental Cobb angle
Authors
KeywordsCobb angle
Deformity
Diagnostic
Kyphosis
Lumbar
Postural roundback
Radiographic
Reliability
Sagittal
Scheuermann's
Thoracic
Thoracolumbar
Vertebra
Wedge ratio
Issue Date2007
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2007, v. 32 n. 16, p. E451-E459 How to Cite?
AbstractSTUDY DESIGN. A prospective, radiographic cohort study. OBJECTIVES. This study assessed the radiographic reliability and diagnostic value of the vertebral wedge ratio (WR) to the more segmental Cobb angle (CA) regarding sagittal spine deformities. SUMMARY OF BACKGROUND DATA. The use of the CA has been used to assist in the radiographic diagnosis of various sagittal spine deformities. However, the reliability and diagnostic aptitude of the CA remains speculative and may not be as receptive to individual variations of vertebral integrity in sagittal spine deformities. METHODS. Sixty patients (age range, 8-21 years) who were diagnosed with Scheuermann's kyphosis (Group 1; n = 16), with postural roundback (Group 2; n = 23), or who were regarded normal (Group 3; n = 21) were radiographically evaluated to assess the reliability and diagnostic potential of the vertebral WR (apex of the curve and 2 adjacent vertebrae) and segmental CA. Radiographic assessment was conducted by 3 independent blinded observers on 3 separate occasions. RESULTS. Very strong intraobserver (WR a = 0.85-0.99; CA a = 0.97-0.99) and interobserver (WR a = 0.79-0.89; CA a = 0.95) reliabilities were noted. A greater degree of WR reliability was noted in Group 1, whereas CA reliability remained consistent in all Groups. A statistically significant difference was found between all Groups in relation to vertebral WR and segmental CA (P < 0.05). Based on relative risk ratio analyses, an apex wedge ratio of ≤0.80 and/or a segmental Cobb angle of ≥20° is highly and significantly associated with Scheuermann's kyphosis. CONCLUSION. The segmental CA exhibited a higher degree of reliability than the vertebral WR. The apex vertebral WR exhibited the greatest amount of wedging in the Scheuermann's patients; whereas in the other groups it remained largely consistent with the adjacent vertebral WRs. An apex vertebral WR ≤0.80 and/or a segmental CA of ≥20° are highly associated with the clinical diagnosis of Scheuermann's kyphosis. If the segmental CA cannot be ascertained, the apex vertebral WR is a relatively strong reliable alternative, primarily with regards to Scheuermann's kyphosis. In addition, the type of deformity may potentially dictate the ideal measuring method. © 2007 Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/92943
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTayyab, NAen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorAltiok, Hen_HK
dc.contributor.authorShuff, CEen_HK
dc.contributor.authorLubicky, JPen_HK
dc.contributor.authorHerman, Jen_HK
dc.contributor.authorKhanna, Nen_HK
dc.date.accessioned2010-09-22T05:04:30Z-
dc.date.available2010-09-22T05:04:30Z-
dc.date.issued2007en_HK
dc.identifier.citationSpine, 2007, v. 32 n. 16, p. E451-E459en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92943-
dc.description.abstractSTUDY DESIGN. A prospective, radiographic cohort study. OBJECTIVES. This study assessed the radiographic reliability and diagnostic value of the vertebral wedge ratio (WR) to the more segmental Cobb angle (CA) regarding sagittal spine deformities. SUMMARY OF BACKGROUND DATA. The use of the CA has been used to assist in the radiographic diagnosis of various sagittal spine deformities. However, the reliability and diagnostic aptitude of the CA remains speculative and may not be as receptive to individual variations of vertebral integrity in sagittal spine deformities. METHODS. Sixty patients (age range, 8-21 years) who were diagnosed with Scheuermann's kyphosis (Group 1; n = 16), with postural roundback (Group 2; n = 23), or who were regarded normal (Group 3; n = 21) were radiographically evaluated to assess the reliability and diagnostic potential of the vertebral WR (apex of the curve and 2 adjacent vertebrae) and segmental CA. Radiographic assessment was conducted by 3 independent blinded observers on 3 separate occasions. RESULTS. Very strong intraobserver (WR a = 0.85-0.99; CA a = 0.97-0.99) and interobserver (WR a = 0.79-0.89; CA a = 0.95) reliabilities were noted. A greater degree of WR reliability was noted in Group 1, whereas CA reliability remained consistent in all Groups. A statistically significant difference was found between all Groups in relation to vertebral WR and segmental CA (P < 0.05). Based on relative risk ratio analyses, an apex wedge ratio of ≤0.80 and/or a segmental Cobb angle of ≥20° is highly and significantly associated with Scheuermann's kyphosis. CONCLUSION. The segmental CA exhibited a higher degree of reliability than the vertebral WR. The apex vertebral WR exhibited the greatest amount of wedging in the Scheuermann's patients; whereas in the other groups it remained largely consistent with the adjacent vertebral WRs. An apex vertebral WR ≤0.80 and/or a segmental CA of ≥20° are highly associated with the clinical diagnosis of Scheuermann's kyphosis. If the segmental CA cannot be ascertained, the apex vertebral WR is a relatively strong reliable alternative, primarily with regards to Scheuermann's kyphosis. In addition, the type of deformity may potentially dictate the ideal measuring method. © 2007 Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectCobb angleen_HK
dc.subjectDeformityen_HK
dc.subjectDiagnosticen_HK
dc.subjectKyphosisen_HK
dc.subjectLumbaren_HK
dc.subjectPostural roundbacken_HK
dc.subjectRadiographicen_HK
dc.subjectReliabilityen_HK
dc.subjectSagittalen_HK
dc.subjectScheuermann'sen_HK
dc.subjectThoracicen_HK
dc.subjectThoracolumbaren_HK
dc.subjectVertebraen_HK
dc.subjectWedge ratioen_HK
dc.titleThe reliability and diagnostic value of radiographic criteria in sagittal spine deformities: Comparison of the vertebral wedge ratio to the segmental Cobb angleen_HK
dc.typeArticleen_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e3180ca7d2den_HK
dc.identifier.pmid17632384-
dc.identifier.scopuseid_2-s2.0-34447527329en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447527329&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume32en_HK
dc.identifier.issue16en_HK
dc.identifier.spageE451en_HK
dc.identifier.epageE459en_HK
dc.identifier.eissn1528-1159-
dc.identifier.isiWOS:000248106000021-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTayyab, NA=17136154600en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridAltiok, H=6506389079en_HK
dc.identifier.scopusauthoridShuff, CE=8214893300en_HK
dc.identifier.scopusauthoridLubicky, JP=7004313450en_HK
dc.identifier.scopusauthoridHerman, J=7403275959en_HK
dc.identifier.scopusauthoridKhanna, N=22034938200en_HK

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