Abstract：Objective To analyze the reliability of measurement of Cobb angle of the patients with congenital scoliosis.Methods Seventy-eight standard standing posteroanterior whole-spine radiographs of the patients with congenital scoliosis treated in Xijing hospital of Fourth Military Medical University from January 2010 to December 2013 were reviewed. Five doctors measured the Cobb angle twice by Digimizer software, with an interval of at least three weeks between the two measurements. The Results of the Cobb angle and deviations between the two measurements were recorded. Both intraobserver and interobserver agreements were assessed with the intraclass correlation coefficient (ICC).Results All ICC values representing intraobserver variability of observers ranged from 0.84 to 0.98. The biggest intraobserver indifference ranged from 20° to 57°, and there were 13 to 46 curves of which intraobserver indifference was more than 10° between five observers. The intraobserver variance was 8.5°. The ICC values representing intrerobserver variability of observers was 0.947. Interobserver ICC values in 81°-110° and ＞110° groups were 0.623 and 0.822, respectively.Conclusions Applying Cobb method as a measurement tool to evaluate the congenital scoliosis is reliable in term of intra-and interobserver variability. But there still exists big difference between intra-and interobserver, especially for severe scoliosis, the accuracy of Cobb method deserves questionable
杨卫周,陶惠人,黄景辉,李涛,沈超,陈博,张涛,刘明,沙鑫,罗卓荆. Cobb法测量先天性脊柱侧凸角度的可信度研究[J]. 中华解剖与临床杂志, 2014, 19(5): 367-370.
Yang Weizhou, Tao Huiren, Huang Jinghui, Li Tao, Shen Chao, Chen Bo, Zhang Tao, Liu Ming, Sha Xin, Luo Zhuojing. Reliability analysis of the Cobb angle for patients with congenital scoliosis. Chinese Journal of Anatomy and Clinics, 2014, 19(5): 367-370.
Langensiepen S, Semler O, Sobottke R, et al. Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review[J]. Eur Spine J, 2013, 22(11): 2360-2371.
[4]
Hwang JH, Hong JY, Suh SW, et al. A comparative analysis of 4 curvature measurement methods in early-onset scoliosis[J]. Spine (Phila Pa 1976), 2012, 37(20): E1273-E1281.
[5]
Corona J, Sanders JO, Luhmann SJ, et al. Reliability of radiographic measures for infantile idiopathic scoliosis[J]. J Bone Joint Surg Am, 2012, 94(12): e86.
Wu W, Liang J, Du Y, et al. Reliability and reproducibility analysis of the Cobb angle and assessing sagittal plane by computer-assisted and manual measurement tools[J]. BMC Musculoskelet Disord, 2014, 15(1): 33.
[8]
Facanha-Filho FA, Winter RB, Lonstein JE, et al. Measurement accuracy in congenital scoliosis[J]. J Bone Joint Surg Am, 2001, 83-A(1): 42-45.
[9]
Loder RT, Urquhart A, Steen H, et al. Variability in Cobb angle measurements in children with congenital scoliosis[J]. J Bone Joint Surg Br, 1995, 77(5): 768-770.
Qiao J, Liu Z, Xu L, et al. Reliability analysis of a smartphone-aided measurement method for the Cobb angle of scoliosis[J]. J Spinal Disord Tech, 2012, 25(4):E88-E92.
[12]
Wills BP, Auerbach JD, Zhu X, et al. Comparison of Cobb angle measurement of scoliosis radiographs with preselected end vertebrae: traditional versus digital acquisition[J]. Spine (Phila Pa 1976), 2007, 32(1): 98-105.
Kuklo TR, Potter BK, O′Brien MF, et al. Reliability analysis for digital adolescent idiopathic scoliosis measurements[J]. J Spinal Disord Tech, 2005, 18(2):152-159.
[15]
Srinivasalu S, Modi HN, Smehta S, et al. Cobb angle measurement of scoliosis using computer measurement of digitally acquired radiographs-intraobserver and interobserver variability[J]. Asian Spine J, 2008, 2(2): 90-93.
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