简体中文版脊柱侧凸研究学会22项患者量表的信度和效度

目的：评价简体中文版脊柱侧凸研究学会22项（SRS-22）患者量表的信度和效度。方法：对英文版SRS-22量表进行简体中文翻译和文化调适。将简体中文版SRS-22及SF-36量表寄给87例青少年特发性脊柱侧凸术后的患者，对寄回了调查表的63例（72．4％）患者寄第二份调查表，56例（88．9％）患者寄回了第二份调查表。对SRS-22量表内部一致性信度及重测信度的评价分别采用Cronbach’s α系数和组内相关系数（ICC）。同期效度通过与SF-36各维度的比较获得，评价指标为Pearson’s相关系数（r）。结果：第一份SRS-22量表治疗满意度维度的Cronbach’s α系数为0．65，其他4个维度的Cronbach’s α系数均大于0．7；第二份SRS-22量表5个维度的ICC值分别为0．74、0．78、0．86、0．81、0．84。与SF-36量表各维度的相关性：3个维度间的相关性极高，11个维度间的相关性高，相关性中等的维度有21个。结论：简体中文版SRS-22量表拥有良好的信度及同期效度，可用于对中国内地青少年特发性脊柱侧凸术后患者的临床评估。     

性别差异对青少年特发性脊柱侧凸SRS-22问卷评分的影响

 目的 探讨性别对青少年特发性脊柱侧凸SRS-22问卷评分的影响。方法 2007年10月至2009年4月,来自7个脊柱外科中心的298例青少年特发性脊 柱侧凸患者接受SRS-22简体中文版问卷调查,男62例,女236例;年龄12～20岁,平均15.7岁;冠状面Cobb角21°～106°,平均52.8°。男性患者中34例来自城 市,28例来自农村;女性患者中132例来自城市,104例来自农村。比较男性组和女性组年龄、冠状面Cobb角、城乡构成、SRS-22问卷中功能状况/活动能力、疼 痛、自我形象、心理状况四个维度及亚总分的差异。结果 男性组和女性组年龄、冠状面Cobb角及城乡构成的差异无统计学意义。男性组功能状况/活动能力 （18.5±3.0）分、疼痛（22.3±2.8）分、自我形象（16.7±3.6）分、心理状况（18.8±4.0）分、亚总分（76.3±8.3）分,女性组分别为（16.0±3.9）分、 （16.7±6.4）分、（15.2±3.7）分、（17.3±4.1）分、（65.1±8.6）分,两组差异有统计学意义。结论 男性青少年特发性脊柱侧凸患者的生存质量高于女 性,使用SRS-22问卷对青少年特发性脊柱侧凸患者生存质量进行评估时应将性别因素考虑在内。     

脊柱侧凸研究会-22问卷(SRS-22)中文版的信度及效度分析

目的 用中文版SRS-22问卷评估巾国青少年特发性脊柱侧凸患者的牛活质量,考察SRS-22问卷中文版的信度及效度.方法 根据国际生活质量评估计划的规定,将SRS-22问卷英文版译成中文,并由脊柱外科专家讨论后确定最终版本.共有126例青少年特发性脊梓侧凸患者完成了SRS-22问卷中文版测试,男35例,女91例;年龄10～20岁,平均14.5岁;Cobb角15°～58°,平均为33°.为了完成对该问卷重测信度的评估,35例患者1周后进行了第2次问卷调查.SRS-22问卷中义版各领域的内部一致性通过Cronbach'a系数榆验,使用相关性分析检验SRS-22中文版的重测信度并同时计算地板效应和天花板效应,最后对脊柱侧凸患者采用不同方式治疗后SRS-22问卷得分进行统计学分析.结果 SRS-22问卷中文版各领域的Cronbach'a系数分别为:功能状况/活动能力(0.49),疼痛(0.73),自我形象(0.67),心理状况(0.78),对治疗的满意度(0.48);重测信度分别为:功能状况/活动能力(0.80),疼痛(0.68),自我形象(0.82),心理状况(0.81),对治疗的满意度(0.78).SRS-22问卷中文版各领域均具有不同程度的天花板效应,术后患者功能状况/活动能力得分最低而对治疗的满意度得分较支具治疗高.结论 由于东西方医疗体制、人文文化及价值观等方面的差异,SRS-22问卷中义版仍存在一定的局限性,需要进行一定的改进以符合中国国情并进行更大规模的临床随访后方可用于中国青少年特发性脊柱侧凸患者生活质量的评估.     

当前城乡差异对青少年特发性脊柱侧凸患者术后SRS-22评分的影响

[目的]采用简体中文版脊柱侧凸研究学会22项(Scoliosis Research Society-22,SRS-22)量表对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者术后生存质量进行评估,探讨当前城乡差异对青少年特发性脊柱侧凸患者术后SRS-22量表评分的影响及其原因。[方法]将128例AIS术后患者分为两组,城市组68例(男14例,女54例),农村组60例(男11例,女49例),平均随访时间4.2年。两组在性别、年龄、随访时间、术前主弯Cobb角、末次随访残余Cobb角等方面差异无显著意义(P>0.05)。所有患者均填写一份简体中文版SRS-22量表,比较两组SRS-22量表中各个条目和各个维度得分以及总得分之间的差异。[结果]城市组与农村组在功能/活动度维度条目12、15、18,自我形象/外观维度条目4、6、10、14上的得分差异有统计学意义(P<0.05);城市组自我形象/外观维度的得分低于农村组(P<0.05);两组在功能/活动度、疼痛、精神健康、治疗满意度维度的得分及总得分方面差异无统计学意义(P>0.05)。[结论]当前城乡差异仍会对AIS患者术后SRS-22量表的评分结果产生影响且结果具有新的特征,使用SRS-22量表对青少年特发性脊柱侧凸患者术后生存质量进行评估时仍不能忽略当前城乡差异的影响。     

中文版SRS-22问卷在中国青少年特发性脊柱侧凸患者评价中的应用（跨文化修订和可信度分析）

[目的]将脊柱侧凸研究会问卷（SRS-22Questionnaire）引入中国，评价该问卷在中国青少年特发性脊柱侧凸患者中的测量特性。[方法]依据国际生活质量评价（the international quality of life assessment，IQOLA）计划规则，将SRS-22患者问卷翻译改编为中文，由专家组研究确定最终版本。使用该问卷对86例（男11例，女75例）正规支具治疗的青少年特发性脊柱侧凸患者进行初次测评，患儿年龄在10～18岁，平均13．9岁；侧凸角度在25&#176;～45&#176;，平均35．6&#176;。初测3～4周后，对其中30例患者进行重测。[结果]SRS-22问卷总体α系数为0．88，重测信度为0．97。问卷中的五个因素的α系数分别为：功能活动0．70，疼痛0．80，自我形象0．80，心理状况0．88，对治疗的满意程度0．81．重测信度分别为：功能活动0．85，疼痛0．96，自我形象0．96，心理状况0．95，对治疗的满意程度0．91。因素分析产生6个公共因素，结果累积解释方差贡献为72．29％。[结论]SRS-22问卷翻译改编成中文后具备合格的信度和效度，可以应用该问卷测量中国青少年特发性脊柱侧凸患者的生活质量。     

成人特发性脊柱侧凸患者SRS-22简体中文版问卷评分的影响因素分析

目的:探讨临床及影像学参数对成人特发性脊柱侧凸患者脊柱侧凸研究协会22项(SRS-22)量表简体中文版问卷评分的影响.方法:2008年1月～2012年12月109例无支具及手术治疗史的成人特发性脊柱侧凸患者接受SRS-22简体中文版的问卷调查.男17例,女92例;年龄19～40岁,平均24.8岁.冠状面主弯Cobb角16°～102°,平均37.3°.分析SRS-22各维度得分及亚总分与年龄、体重指数、主弯Cobb角及矢状面平衡间的相关性,并分别比较年轻(＜30岁)与年长(≥30岁)、小角度(Cobb角＜40°)与大角度(Cobb角≥40°)、胸弯与胸腰/腰弯以及男性与女性患者间SRS-22评分差异.结果:年龄与SRS-22亚总分、疼痛、心理状况及功能维度得分负相关(r分别为-0.35、-0.50、-0.31、-0.21,P＜0.05);体重指数与疼痛得分负相关(r=-0.23,P＜0.05);主弯Cobb角与SRS-22亚总分、自我形象及功能维度得分负相关(r分别为-0.31、-0.49、-0.30,P＜0.05);矢状面平衡与功能维度得分负相关(r=-0.26,P＜0.05).年长患者SRS-22亚总分、疼痛及心理得分低于年轻患者(P＜0.05).大角度患者SRS-22亚总分、自我形象及功能维度得分低于小角度患者(P＜0.05).胸弯患者自我形象及心理维度得分低于胸腰/腰弯患者(P＜0.05).女性患者的疼痛维度得分明显低于男性(P＜0.05),其余参数及得分无统计学差异.结论:年龄、侧凸Cobb角、体重指数、躯干矢状面平衡可影响成人特发性脊柱侧凸患者SRS-22简体中文版问卷不同维度得分.胸弯患者自我形象及心理受侧凸的影响较腰弯患者更大,女性患者对疼痛的耐受性低于男性.     

青少年特发性脊柱侧凸患者术后放射学参数和SRS-22评测结果的相关性研究

目的 探讨青少年特发性脊柱侧凸(AIS)术后患者放射学参数与SRS-22量表各维度得分的相关性.方法 95例术后患者(13男,82女)分为2组:胸弯组64例,胸腰弯/腰弯组31例,平均随访时问为2.8年.所有患者行脊柱全长正侧位检查,并填写一份SRS-22量表.在脊柱全长正侧位片上测量放射学参数,计算AIS患者放射学参数与SRS一22四个维度得分间的Spearman等级相关系数(rs).结果 脊柱力线偏移、胸椎后凸角和腰椎前凸角这三个参数与SRS-22各维度得分不存在相关性.胸腰弯/腰弯组的主侧凸残余Cobb角与SRS-22各维度得分同样不存在相关性.胸弯组主侧凸残余Cobb角与自我形象维度得分呈负相关(rs=-0.411,P=0.001).结论 主侧凸为胸弯的AIS术后患者残余Cobb角越大,其SRS-22量表自我形象维度的得分越低.应当尽可能多地矫正胸弯的畸形以改善患者的外观.     

青少年特发性脊柱侧凸患者术后生活质量的影响因素分析

[目的]分析各因素对青少年特发性脊柱侧凸患者术后生活质量的综合影响,为提高患者生活质量提供参考。[方法]选择2011年1月~2015年1月在本院手术的青少年特发性脊柱侧凸患者79例,之前均未接受任何治疗,详细统计患者性别、年龄、居住地、胸弯Cobb角、腰弯Cobb角、冠状面C_7铅垂线与骶骨正中线距离、矢状面C_7铅垂线与骶骨后上角距离、顶椎旋转度、双肩平衡等,采用SRS-30生活质量问卷进行评估,而后用多重线性回归模型预测各因素与青少年特发性脊柱侧凸患者术后生活质量的相关性。[结果]患者术后均获得不同程度改善,术后胸弯Cobb角平均20.7°,腰弯Cobb角平均12.8°,双肩高度差平均6.8 mm,C_7PL-CSVL平均13.7 mm,SVA平均22.9 mm,术后患者生活质量总分128.3分,各维度平均得分分别为疼痛(4.53)、心理(4.46)、功能/活动(3.73)、自我形象(4.28)、满意度(4.45)。男性患者在功能/活动维度(P=0.05)及满意度(P=0.037)上得分显著高于女性患者,城乡患者间得分无明显差异。[结论]不同影响因素对SRS-30问卷各个维度的影响权重各异,青少年特发性脊柱侧凸患者术后的生活质量是各个因素综合作用的结果。     

青少年特发性脊柱侧凸柔韧性影响因素分析及仰卧侧屈角度的预测

目的分析青少年特发性脊柱侧凸柔韧性影响因素,探讨预测指标,初步建立仰卧侧屈位Cobb角角度的预测模型。方法通过对青少年特发性脊柱侧凸150例患者（包括胸椎侧凸和胸腰段/腰椎侧凸共216个）的站立位脊柱全长正位X线片和仰卧侧屈位X线片资料进行回顾性研究,用仰卧侧屈位X线片矫正率作为柔韧性指标,与站立位冠状面Cobb角、年龄、性别、Risser征、是否主侧凸和侧凸位置6个指标进行Pearson或Spearman相关分析及多元线性回归,筛选相关因素;采用同样方法 ,分析6个指标与仰卧侧屈Cobb角的关系。结果站立位冠状面Cobb角（P〈0.01）和侧凸位置（P〈0.01）与柔韧度存在明显线性回归关系。站立位冠状面Cobb角（P〈0.01）、侧凸位置（P〈0.01）和是否主侧凸（P〈0.01）与仰卧侧屈Cobb角存在明显的线性回归关系。对青少年特发性脊柱侧凸,站立位冠状面Cobb角每增加10°,柔韧度约减少8%,胸椎侧凸柔韧性平均比胸腰段/腰椎侧凸低10%。站立位冠状面Cobb角〉45°的胸椎次侧凸和〉50°的胸腰段/腰椎次侧凸,成为结构性侧凸几率较大。结论站立位冠状面Cobb角和侧凸位置是显著影响青少年特发性脊柱侧凸柔韧度的因素,实验探讨了1种预测仰卧侧屈Cobb角角度的简单方法 ,解决了临床实际问题。     

简体中文版King健康问卷在膀胱过度活动症患者中应用的信度和效度分析

目的 评价简体中文版King健康问卷(KHQ)在膀胱过度活动症(OAB)患者中应用的信度和效度.方法 采用"WHO-QOL跨文化生活质量研究问卷翻译法"将英文版KHQ翻译成简体中文,随机抽取就诊于泌尿外科门诊的OAB患者,在第0周和第2周对其进行2次简体中文版KHQ问卷调查.通过Cronbach's α系数评价问卷的内部一致性;用组内相关系数(ICC)评价重测信度;计算各问题得分与所属领域得分的Spearman等级相关系数(rs)评价内容效度;用因子分析评价结构效度.结果 48例符合纳入标准的OAB患者参与本研究,40例完成2次调查,男7例,女33例,年龄(49.6±14.3)岁.KHQ各亚量表和各领域均具有较好的内部一致性(Cronbach's α:0.7l8～0.924)、中到高的重测信度(ICC:0.567～0.995,P<0.01)以及中到高的内容效度(r:0.462～0.964,P<0.01).因子分析法显示简体中文版KHQ具有可接受的结构效度.结论简体中文版KHQ具有较好的信度和效度,可作为评估OAB患者生活质量的专用量表.     

女性青少年特发性脊柱侧凸患者自我形象评估的相关影响因素分析

目的:探讨女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者自我形象评估的影响因素。方法:回顾性分析2010年9月～2011年3月在我院就诊的252例女性AIS患者,年龄12～18岁,平均14.5±1.8岁。均摄取患者站立位全脊柱正侧位X线片,并独立填写一份简体中文版SRS-22问卷。在站立位全脊柱正侧位X线片上测量Cobb角、顶椎旋转度、胸椎后凸角、腰椎前凸角、脊柱冠状面力线偏移及脊柱矢状面力线偏移等参数。采用相关分析研究各临床指标与自我形象评分的相关性。结果:患者平均Cobb角35.5°±12.8°;平均顶椎旋转度2.0°±0.7°;平均胸椎后凸角16.2°±9.0°;平均腰椎前凸角51.3°±9.8°;平均脊柱冠状面力线偏移1.2±0.7cm;平均脊柱矢状面力线偏移2.4±1.5cm;平均体重指数18.3±2.2;平均自我形象评分16.7±2.8分。胸弯和胸腰弯/腰弯的自我形象评分均与主弯Cobb角有相关性(r分别为-0.171,-0.225,P均<0.05);其中大角度胸弯组呈显著相关(r=-0.484,P=0.005)。而其他参数与患者自我形象评估均无明显相关性(P均>0.05)。结论:女性AIS患者的自我形象主要受主弯Cobb角的影响,其中大角度胸弯患者的自我形象受主弯Cobb角的影响最大。     

死亡应对量表的汉化及信效度检验

目的引进并翻译死亡应对量表并在肿瘤科护士中检验其信效度。方法按照Brislin翻译模式对英文版量表进行直译和回译,采用专家咨询及预试验对中文版量表进行初步检验;选取全国5所三级甲等肿瘤专科医院的446名肿瘤科护士进行信效度验证。结果中文版量表包括6个因子共28个条目,S-CVI为0.987,I-CVI为0.832~1.000;6个因子累积方差贡献率为60.800%。总量表的Cronbach′sα系数为0.905、折半信度为0.784、重测信度为0.973。结论中文版死亡应对量表具有良好信效度,可作为评估中国肿瘤科护士死亡应对能力的工具。     

Major influence of interobserver reliability on polytrauma identification with the Injury Severity Score (ISS): Time for a centralised coding in trauma registries?

ObjectiveThe Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding.MethodsInterobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers.ResultsConsidering a cutoff ISS ≥ 16, only 38/50 patients (76%) were uniformly identified as polytraumatised or not. Increasing the cut off to ≥20, this increased to 41/50 patients (82%). A difference in the AIS of ≥ 1 was present in 261 (16%) of possible codes. Excluding the vast majority of uninjured body regions, uniformly identical AIS severity values were attributed in 67/193 (35%) body regions, or 318/579 (55%) possible observer pairings.ConclusionInjury severity all too often is neither identified correctly nor consistently when using the AIS. This leads to wrong identification of severely injured patients using the ISS. Improving consistency of coding through centralisation is recommended before scores based on the AIS are to be used for interhospital benchmarking and resource allocation in the treatment of severely injured patients.     

Development and assessment of a digital X-ray software tool to determine vertebral rotation in adolescent idiopathic scoliosis

Background Context

The amount of vertebral rotation in the axial plane is of key importance in the prognosis and treatment of adolescent idiopathic scoliosis (AIS). Current methods to determine vertebral rotation are either designed for use in analogue plain radiographs and not useful in digital images, or lack measurement precision and are therefore less suitable for the follow-up of rotation in AIS patients.

Development of a Valid Simplified Chinese Version of the Oxford Hip Score in Patients With Hip Osteoarthritis

Background

Although the Oxford Hip Score has been translated and validated in several languages, there is currently no Chinese version of the outcomes measurement. Our study aims to crossculturally adapt and validate the Oxford Hip Score into a simplified Chinese version.

Questions/purposes

We tested the (1) reliability; (2) validity; and (3) responsiveness of the Chinese version of the Oxford Hip Score.

Methods

First we translated the Oxford Hip Score into simplified Chinese, then back into English, then held a consensus meeting to achieve the final simplified Chinese version. Then we evaluated the psychometric properties of Chinese version of the Oxford Hip Score in patients undergoing total hip arthroplasty (THA). All patients undergoing THA between July and December 2012 were invited to participate in this study; a total of 108 (79% of 136 invited) did so. To assess the test-retest validity, all participants completed the Chinese version of the Oxford Hip Score again with a 2-week interval. Pearson correlation coefficient was used to evaluate the construct validity between the Chinese version of the Oxford Hip Score and visual analog scale (VAS), Harris hip score, and eight individual domains of the SF-36. Responsiveness was demonstrated by comparing the pre- and postoperative scores of the Chinese version of the Oxford Hip Score.

Results

The test-retest reliability with intraclass correlation coefficient (0.937) and internal consistency with Cronbach’s alpha (0.91) were excellent. The Chinese version of the Oxford Hip Score correlated with the Harris hip score (0.89, p < 0.01), VAS (−0.79, p < 0.01), and Physical Functioning (0.79, p < 0.01) and Bodily Pain (0.70, p < 0.01) domains of SF-36, which suggested construct validity. No floor or ceiling effects were found. The effect size and standardized response mean values were 3.52 and 3.31, respectively, indicating good responsiveness.

Conclusions

The Chinese version of the Oxford Hip Score showed good reliability, validity, and responsiveness in evaluating standard Chinese-speaking patients with hip osteoarthritis undergoing THA. It can be used by clinical surgeons as a complement to the traditional outcome measures.     

护理教育欺凌行为量表的汉化及信效度检验

目的汉化护理教育欺凌行为量表并评价其在中国护生中的信效度.方法经Brislin模式翻译和文化调适形成中文版,对552名护生进行调查检验量表的信效度.结果中文版共18个条目,探索性因子分析提取4个公因子,累积方差贡献率为73.244％;验证性因子分析拟合较好(CFI=0.916,IFI = 0.918,RMSEA=0.0...     

Effect of bracing on the quality of life of adolescents with idiopathic scoliosis.

BACKGROUND CONTEXT: There is considerable controversy regarding the effectiveness of bracing for patients with adolescent idiopathic scoliosis (AIS). Furthermore, little work has focused on the effect of formal bracing on the health-related quality of life (QOL) of affected adolescents. PURPOSE: This study is an attempt to assess the QOL of adolescents with AIS who were treated with a brace in comparison to those who were not. STUDY DESIGN/SETTING: This is a questionnaire-based study of patients presenting to our institution for evaluation and treatment of AIS. The study was conducted at Columbia University and the New York Presbyterian Medical Center, New York, NY. PATIENT SAMPLE: A total of 136 patients with AIS who were being observed and 78 patients who were braced were included in this study. OUTCOME MEASURES: The Child Health Questionnaire (CHQ) and the American Academy of Orthopaedic Surgeons Pediatric Outcomes Data Collection Instrument (PODCI) were administered to 214 parents of adolescents undergoing evaluation for AIS. METHODS: Parents of AIS patients were administered the CHQ and PODCI to assess their child's QOL. Independent samples t tests were conducted to compare the QOL among braced versus observed patients. Univariate and multivariate analyses were conducted to determine the effect of gender, age, curvature and treatment type on QOL. RESULTS: There were few differences in QOL between braced versus observed patients, but boys tended to outscore the girls across most domains. Surprisingly, the QOL of adolescents undergoing bracing in this study was not significantly lower than age-adjusted norms. CONCLUSIONS: Brace wearing did not decrease the QOL of adolescents, compared with their observed counterparts, in our study population.     

Endoscopic surgery on the thoracolumbar junction of the spine

It is a measurement of Cobb’s angles between adolescent (AIS) and juvenile (JIS) idiopathic scoliosis who had stable curves (variation <5 degrees) in more than three visits. Main objective of this paper is to measure inter- and intra-observer reliability of measurements between AIS and JIS who had stable curves in regular follow-up. Twenty-nine JIS and 44 AIS patients who had stable curves without bracing were identified using PACS system. Two observers independently measured Cobb’s angle twice on first, during follow-up and final radiogram using computer-based digital radiogram. Both observers were given pre-decided level of upper and lower end plates. Inter- and intra-observer reliability of the measurement was calculated using Pearson correlation-coefficient test between JIS and AIS group. There was no significant difference in Cobb’s angle in all measurements by both observers either in JIS (p = 0.756, range 0.706–0.815; ANOVA) or AIS (p = 0.871, range 0.795–0.929; ANOVA) group which suggested that there is no significant difference in Cobb’s angle in repeated measurements. Intra-observer reliability for JIS (r = 0.600, range 0.521–0.751; Pearson test) was less than AIS (r = 0.969, range 0.943–0.984; Pearson test); and similarly, inter-observer reliability for JIS (r = 0.547, Pearson test) was also less than AIS (r = 0.961, Pearson test) which indicates that Cobb’s angle measurement is less reliable in patients who have juvenile idiopathic scoliosis. Using the identical condition for measurements in both the groups, we could find only one reason for less reliability in JIS group and that is poor demarcation of the vertebral end-plates in this group. This poor inter- and intra-observer reliability in JIS due to ill-defined endplates can be reduced by measuring all previous curves along with latest curves at the same time during the follow-up of patients with JIS to decide about the progression of curves and treatment options.     

Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis

Study design

Radiological reproducibility study.

Purpose

To assess intra and interobserver reliability of radiographic measurements for global sagittal balance parameters and sagittal spine curves, including cervical spine.

Summary of background data

Sagittal spine balance in adolescent idiopathic scoliosis (AIS) is a main issue and many studies have been reported, showing that coronal and sagittal deformities often involve sagittal cervical unbalance. Global sagittal balance aims to obtain a horizontal gaze and gravity line at top of hips when subject is in a static position, involving adjustment of each spine curvature in the sagittal plane. To our knowledge, no study did use a methodologically validated imaging analysis tool able to appreciate sagittal spine contours and distances in AIS and especially in the cervical region.

Methods

Lateral full-spine low-dose EOS radiographs were performed in 75 patients divided in three groups (control subjects, AIS, operated AIS). Three observers digitally analyzed twice each radiograph and 11 sagittal measures were collected for each image. Reliability was assessed calculating intraobserver Pearson’s r correlation coefficient, interobserver intra-class correlation coefficient (ICC) completed with a two-by-two Bland–Altman plot analysis.

Results

This measurement method has shown excellent intra and interobserver reliability in all parameters, sagittal curvatures, pelvic parameters and global sagittal balance.

Conclusions

This study validated a simple and efficient tool in AIS sagittal contour analysis. It defined new relevant landmarks allowing to characterize cervical segmental curvatures and cervical involvement in global balance.