![]() Informed consent for data analysis was obtained from all subjects and/or families. This study was approved by the clinical research ethics committee of the People’s Hospital of Three Gorges University. All X-rays were printed for manual measurements, and the cranial and caudal end vertebrae were marked by the senior spine surgeon on the same radiographs to reduce the component of variability. Therefore, the aims of current study are to assess the interobserver and intraobserver reliability of Cobb angle measured by manual and computer-ancillary techniques using coronal and sagittal planes radiographs, and to compare the differences between the two methods.įrom February 2011 to January 2013, radiographs satisfying the following conditions were included in this study: Cobb angle not above 90° because large Cobb angle is often associated with vertebral superimposed image, no obvious thoracic kyphosis, T2, T5, and pelvis being seen clearly. ![]() Its reliable and reproducible measurements as well as their accurate communications are critical for clinical studies. SurgimapSpine software technique to measure Cobb angle is the most popular method used in our studies. ![]() ![]() However, there are a few studies about the measurement of pelvic morphology but no study based on computer-ancillary techniques as well as SurgimapSpine software method was found. For quantitative measurements of curvature, a study carried out with manual and digital measurement tools in 48 patients with scoliosis concluded that digital radiography did not improve the measurement accuracy. The intraobserver and interobserver reliability of the Cobb angle measured by different techniques such as manual and smart phone for coronal plane deformity has been well studied. Because the effects of the treatment are significant, it is important that the reliability of the measurements be well recorded to avoid major underestimation or overestimation of the changes that can be produced by observer error. Treatments are selected according to the degree of curvature or the progression of the curve beyond definite amounts. The Cobb angle has been used to choose the type of treatment, to evaluate progression of the curve, and to appraise the effectiveness of treatment. The Cobb method based on image remains the most important technique for assessment of spinal deformity in both coronal and sagittal planes worldwide. ConclusionĪlthough the differences between the two methods are very small, the results of this study indicate that the SurgimapSpine measurement is an equivalent measuring tool to the traditional manual in coronal Cobb angle, but is advantageous in spino-pelvic measurement in T2-T5, PT, PI, SS, and LL. The reliability of SurgimapSpine measures was significantly higher in all parameters except for the coronal Cobb angle where the difference was not significant ( P > 0.05). As for the interobserver reliability, measurements with SurgimapSpine tool had better ICC (0.71 to 0.98 vs 0.59 to 0.96) and Pearson’s coefficient (0.76 to 0.99 vs 0.60 to 0.97). No significant difference in intraobserver reliability was found between the two measurements ( P > 0.05). Further, for SurgimapSpine tool, the ICC ranged from 0.75 to 0.98. In the sagittal plane parameters, the ICC of intraobserver reliability for the manual measures varied from 0.65 (T2–T5 angle) to 0.95 (LL angle). There was no notable difference between the two tools ( P = 0.21) for the coronal Cobb angle. ![]() The means, standard deviations, intraclass and interclass correlation coefficient (ICC), and 95% confidence intervals (CI) were calculated. SPSS 16.0 software was used for statistical analyses. Parameters measured included pelvic incidence, sacral slope, pelvic tilt, Lumbar lordosis (LL), thoracic kyphosis, and coronal Cobb angle. Three examiners carried out the measurements independently under the settings of manual measurement on X-ray radiographies and SurgimapSpine software on the computer. Sixty-eight standard standing posteroanterior whole-spine radiographs were reviewed. We usually use SurgimapSpine software to measure the Cobb angle in our studies however, there are no reports till date on its reliability and reproducible measurements. Although many studies on reliability and reproducibility of measurement have been performed on coronal Cobb angle, few results about reliability and reproducibility are reported on sagittal alignment measurement including the pelvis. ![]()
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