Abstract
Introduction: For adolescent idiopathic scoliosis (AIS), an analysis of end vertebrae (EV), neutral vertebrae (NV), and stable vertebrae (SV) are used to determine the distal fusion level. These reliability has been reported, but the literature on reliability these analysis which classified by the curve type is very scent.
Our purpose is to clarified the reliability of EV, NV, and SV among thoracic and lumbar curves for adolescent idiopathic scoliosis.
Methods: We assessed twenty radiographs of AIS patients of thoracic curve and eighteen radiographs of AIS patients of lumbar curve. These radiographs were evaluated by two spine surgeons (one was senior fellow of the Japanese Society for Spine Surgety and Related Research and the other was senior resident). The observers attempted to identify the distal EV, NV, and SV. Interobserver and intraobserver reliability was assessed by means of Cohen's Kappa correlation coefficient, and raw percentages of agreement were recorded.
Results: Interobserver reliability of thoracic curve was moderate for determining the distal EV (k=0.49), NV (k=0.58), and SV (k=0.50). Interobserver reliability of lumbar curve was substantial for determining the distal EV (k=0.67), NV (k=0.45), and SV (k=0.61). Intraobserver reliability of thoracic curve by senior resident was almost perfect for determining the distal EV (k=0.92), NV (k=0.88), and SV (k=0.94) and that by senior fellow was substantial for determining the distal EV (k=0.48), NV (k=0.68), and SV (k=0.65). Intraobserver reliability of lumbar curve by senior resident was moderate for determining the distal EV (k=0.45), NV (k=0.42), and SV (k=0.64) and that by senior fellow was substantial for determining the distal EV (k=0.68), NV (k=0.57), and SV (k=0.61).
Conclusions: Radiographic determination of the EV, NV, and SV for AIS demonstrated has sufficient reliability.
