中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (48): 8993-8997.doi: 10.3969/j.issn.1673-8225.2010.48.016

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

无标记X射线片评价特发性脊柱侧凸不同大小Cobb角的一致性

盛文辉1,2，荀传辉1，吴  兵2，徐  韬1，郑新峰1，尚琦松2，盛伟斌1   

  1. 1新疆医科大学第一附属医院脊柱外科，新疆维吾尔自治区乌鲁木齐市  830054；2新疆石河子人民医院骨一科，新疆维吾尔自治区石河子市  832000
  • 出版日期:2010-11-26 发布日期:2010-11-26
  • 通讯作者: 盛伟斌，博士，教授，主任医师，新疆医科大学第一附属医院脊柱外科，新疆维吾尔自治区乌鲁木齐市 830054 wbsheng_xjmu@hotmail.com
  • 作者简介:盛文辉★，男，1970年生，新疆维吾尔自治区石河子市人，汉族，新疆医科大学在读硕士，副主任医师，主要从事脊柱外科方面的研究。 wyc_one@sina. com

Reliability assessment for idiopathic scoliosis different Cobb angles by X-ray

Sheng Wen-hui 1,2, Xun Chuan-hui1, Wu Bing2, Xu Tao1, Zheng Xin-feng1, Shang Qi-song2, Sheng Wei-bin1   

  1. 1 Department of Orthopaedic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumchi  832054, Xinjiang Uygur Autonomous Region, China; 2 First Department of Orthopedics, Shihezi People’s Hospital, Shihezi   832000, Xinjiang Uygur Autonomous Region, China
  • Online:2010-11-26 Published:2010-11-26
  • Contact: Sheng Wei-bin, Doctor, Professor, Chief physician, Department of Orthopaedic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumchi 832054, Xinjiang Uygur Autonomous Region, China wbsheng_xjmu@hotmail.com
  • About author:Sheng Wen-hui★, Studying for master’s degree, Associate chief physician, Department of Orthopaedic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumchi 832054, Xinjiang Uygur Autonomous Region, China; First Department of Orthopedics, Shihezi People’s Hospital, Shihezi 832000, Xinjiang Uygur Autonomous Region, China wyc_one@sina.com

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372

被引次数

3

摘要：

背景：Cobb角测量是影响特发性脊柱侧凸King、Lenke和PUMC分型一致性的重要因素之一。文献报道冠状面Cobb角测量一致性较好。但是，纳入研究的Cobb角范围较大，无法对比研究，亦无曲度大小对Cobb角测量一致性影响的报道。
目的：分析特发性脊柱侧凸曲度对Cobb角测量一致性的影响。
方法：4名骨科医师独立测量53例特发性脊柱侧凸患者的94个冠状面曲度，包括53个胸弯和41个胸腰弯/腰弯，2周后打乱排序重新测量。应用组间相关系数判定可靠性和可重复性。
结果与结论：94个侧凸角度测量误差平均7.3°(2°~27°)，一致性极佳，可信度及可重复性分别为0.972(95%可信区间0.962~0.980)和0.961~0.977。>45°~70°组41个侧凸，角度测量误差平均6.4°(2°~14°)，一致性最佳，可信度0.960(95%可信区间0.935~0.977)，可重复性0.914~0.930。20°~45°组31个侧凸，角度测量误差平均6.5°(2°~13°)；>70°组31个侧凸，角度测量误差平均10.1°(3°~27°)。两组均取得了好到极佳的可信度[0.933和0.926，95%可信区间(0.884~0.965和0.865~0.965)]和可重复性(0.854~0.912和0.864~0.950)。提示不同大小冠状面Cobb角的一致性结果相近，且角度越大，测量误差对一致性的影响越小。

关键词: 脊柱侧凸, 脊柱后凸, Cobb角, 诊断方法, 可靠性

Abstract:

BACKGROUND: The measurement of Cobb angles is one of the most important factors to affect the reliability of the King, Lenke, and PUMC classification system for idiopathic scoliosis. Studies show reliability of coronal Cobb angle measurements. However, the range of Cobb angles in studies is too wide to contrast the results of these studies. Moreover, relatively few studies have attempted to validate the reliability of different coronal Cobb angles.
OBJECTIVE: To determine the reliability and reproducibility of the different Cobb angles for idiopathic scoliosis.
METHODS: A total of 94 curves of 53 patients, including 53 main thoracic curves and 41 thoracolumbar/lumbar curves, were evaluated by four orthopedic surgeons independently. Two weeks later, the sequence of the X-ray films was re-ordered and re-measured. Reliability and reproducibility was quantified using intraclass correlation coefficient.
RESULTS AND CONCLUSION: Coronal Cobb angle measurement of total curves demonstrated excellent intraobserver reproducibility (0.961-0.977) and interobserver reliability (0.972, 95% confidence interval 0.919-0.964), and had a measurement error average 7.3° (range 20°-27°). The measurement average error was 6.4° (range 20°-14°) in 41 curves of Cobb angles from 46° to 70° and this curves demonstrated best reliability than other curves, intraobserver 0.914-0.930, interobserver 0.960 (95% confidence interval 0.935-0.977). The measurement error average was 6.5° (range 20°-13°) and 10.1° (range 30°-27°) in 31 curves of Cobb angles from 20° to 45°and more than 70° respectively. These two groups demonstrated excellent intraobserver reproducibility (0.854-0.912 and 0.864-0.950) and interobserver reliability (0.933 and 0.926, 95% confidence interval 0.884-0.965 and 0.865-0.965), respectively. Results of reliability were similar between different Cobb angles and measurement error for larger Cobb angles had very little effect to reliability.

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