Reliability of cervical lordosis measurement techniques on long-cassette radiographs.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Author(s): Janusz P;Janusz P;Janusz P; Tyrakowski M; Tyrakowski M; Yu H; Yu H; Siemionow K; Siemionow K
  • Source:
    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2016 Nov; Vol. 25 (11), pp. 3596-3601. Date of Electronic Publication: 2015 Dec 26.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9301980 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0932 (Electronic) Linking ISSN: 09406719 NLM ISO Abbreviation: Eur Spine J Subsets: MEDLINE
    • Publication Information:
      Original Publication: Heidelberg, Federal Republic of Germany : Springer-Verlag, c1992-
    • Subject Terms:
      Radiography*/methods ; Radiography*/standards; Cervical Vertebrae/*diagnostic imaging ; Lordosis/*diagnostic imaging; Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Female ; Humans ; Male ; Reproducibility of Results ; Young Adult
    • Abstract:
      Purpose: Lateral radiographs are commonly used to assess cervical sagittal alignment. Three assessment methods have been described and are commonly utilized in clinical practice. These methods are described for perfect lateral cervical radiographs, however in everyday practice radiograph quality varies. The aim of this study was to compare the reliability and reproducibility of 3 cervical lordosis (CL) measurement methods.
      Methods: Forty-four standing lateral radiographs were randomly chosen from a lateral long-cassette radiograph database. Measurements of CL were performed with: Cobb method C2-C7 (CM), C2-C7 posterior tangent method (PTM), sum of posterior tangent method for each segment (SPTM). Three independent orthopaedic surgeons measured CL using the three methods on 44 lateral radiographs. One researcher used the three methods to measured CL three times at 4-week time intervals. Agreement between the methods as well as their intra- and interobserver reliability were tested and quantified by intraclass correlation coefficient (ICC) and median error for a single measurement (SEM). ICC of 0.75 or more reflected an excellent agreement/reliability. The results were compared with repeated ANOVA test, with p < 0.05 considered as significant.
      Results: All methods revealed excellent intra- and interobserver reliability. Agreement (ICC, SEM) between three methods was (0.89°, 3.44°), between CM and SPTM was (0.82°, 4.42°), between CM and PTM was (0.80°, 4.80°) and between PTM and SPTM was (0.99°, 1.10°). Mean values CL for a CM, PTM, SPTM were 10.5° ± 13.9°, 17.5° ± 15.6° and 17.7° ± 15.9° (p < 0.0001), respectively. The significant difference was between CM vs PTM (p < 0.0001) and CM vs SPTM (p < 0.0001), but not between PTM vs SPTM (p > 0.05).
      Conclusions: All three methods appeared to be highly reliable. Although, high agreement between all measurement methods was shown, we do not recommend using Cobb measurement method interchangeably with PTM or SPTM within a single study as this could lead to error, whereas, such a comparison between tangent methods can be considered.
    • References:
      Spine (Phila Pa 1976). 2000 Feb 1;25(3):286-91. (PMID: 10703098)
      Spine (Phila Pa 1976). 2005 Feb 15;30(4):427-33. (PMID: 15706340)
      Eur Spine J. 2014 Jul;23 (7):1442-8. (PMID: 24395005)
      Spine (Phila Pa 1976). 1986 Jul-Aug;11(6):521-4. (PMID: 3787320)
      Spine (Phila Pa 1976). 2013 Apr 15;38(8):E458-63. (PMID: 23354112)
      Eur Spine J. 2015 Jan;24(1):57-62. (PMID: 25163548)
      Spine (Phila Pa 1976). 1997 Apr 15;22(8):859-64. (PMID: 9127918)
      Spine (Phila Pa 1976). 2006 Oct 15;31(22):2585-91; discussion 2592. (PMID: 17047548)
      Lancet. 1986 Feb 8;1(8476):307-10. (PMID: 2868172)
      J Neurosurg Spine. 2013 Aug;19(2):141-59. (PMID: 23768023)
      J Psychosom Res. 2010 Apr;68(4):319-23. (PMID: 20307697)
      Semin Arthritis Rheum. 1990 Aug;20(1):1-20. (PMID: 2218549)
      Stat Med. 2012 Dec 20;31(29):3972-81. (PMID: 22764084)
      Acta Orthop Scand. 1969;40(5):608-13. (PMID: 5378124)
      Spine (Phila Pa 1976). 2000 Aug 15;25(16):2072-8. (PMID: 10954638)
      Psychol Bull. 1979 Mar;86(2):420-8. (PMID: 18839484)
      Spine J. 2014 Sep 1;14 (9):1984-90. (PMID: 24333453)
      J Spinal Disord Tech. 2004 Aug;17 (4):301-5. (PMID: 15280759)
      J Strength Cond Res. 2005 Feb;19(1):231-40. (PMID: 15705040)
    • Contributed Indexing:
      Keywords: Cervical lordosis; Cervical lordosis measurement; Cobb method; Harrison method
    • Publication Date:
      Date Created: 20151229 Date Completed: 20171208 Latest Revision: 20181202
    • Publication Date:
      20250114
    • Accession Number:
      10.1007/s00586-015-4345-8
    • Accession Number:
      26707132