A new classification for coronal malalignment in adult spinal deformity: a validation and the role of lateral bending radiographs

European spine journal

article

Kazunori Hayashi¹  Louis Boissière¹  Derek T. Cawley¹  Daniel Larrieu¹  David Kieser⁵  Pedro Berjano⁶  Claudio Lamartina⁶  Munich Gupta⁷  Clément Silvestre⁸  Themi Protopsaltis⁹  Anouar Bourghli^1,10  Ferran Pellisé^1,11  Prokopis Annis^1,12  Elias C. Papadopoulos^1,13  Gaby Kreichati^1,14  Javier Pizones^1,15  Hiroaki Nakamura²  Christopher P. Ames^1,16  Ibrahim Obeid¹ 

[1] Spine Surgery Unit 1, Bordeaux University Pellegrin Hospital;Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine;Polyclinique Jean Villar;Department of Spine Surgery, Mater Private Hospital;Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago;IRCCS Istituto Ortopedico Galeazzi;Department of Orthopedic Surgery, Washington University in St. Louis;Department of Orthopedic Surgery, Centre Médico-Chirurgical de Réadaptation Des Massues;Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital;Orthopedic and Spinal Surgery Department, Kingdom Hospital;Spine Surgery Unit, Vall D’Hebron Hospital;Department of Orthopaedic Surgery, Royal Liverpool University Hospital;Orthopedic Department, School of Medicine, University of Athens;Department of Orthopedic Surgery, Saint Joseph University;Spine Surgery Unit, Hospital Universitario La Paz;Department of Neurological Surgery, University of California

关键词: Adult spinal deformity;    Coronal;    Malalignment;    Classifcation;    Validation study;   

DOI  :  10.1007/s00586-020-06513-5

来源: Springer

【 摘 要 】

Coronal malalignment (CM) causes pain, impairment of function and cosmetic problems for adult spinal deformity (ASD) patients in addition to sagittal malalignment. Certain types of CM are at risk of insufficient re-alignment after correction. However, CM has received minimal attention in the literature compared to sagittal malalignment. The purpose was to establish reliability for our recently published classification system of CM in ASD among spine surgeons. Fifteen readers were assigned 28 cases for classification, who represented CM with reference to their full-length standing anteroposterior and lateral radiographs. The assignment was repeated 2 weeks later, then a third assignment was done with reference to additional side bending radiographs (SBRs). Intra-, inter-rater reliability and contribution of SBRs were determined. Intra-rater reliability was calculated as 0.95, 0.86 and 0.73 for main curve types, subtypes with first modifier, and subtypes with two modifiers respectively. Inter-rater reliability averaged 0.91, 0.75 and 0.52. No differences in intra-rater reliability were shown between the four expert elaborators of the classification and other readers. SBRs helped to increase the concordance rate of second modifiers or changed to appropriate grading in cases graded type A in first modifier. Adequate intra- and inter-rater reliability was shown in the Obeid-CM classification with reference to full spine anteroposterior and lateral radiographs. While side bending radiographs did not improve the classification reliability, they contributed to a better understanding in certain cases. Surgeons should consider both the sagittal and coronal planes, and this system may allow better surgical decision making for CM.

【 授权许可】

Unknown