Kyphosis in fractures: evaluation of digital measuring

Objective: This study evaluates the manual and digital reliability and reproducibility of five methods of measuring deformity (kyphosis) in thoracolumbar burst fractures. Method: Ninety (90) tomographic images were evaluated and, in each case, kyphotic deformity was measured, both manually and digitally, through the five most relevant methods described in the literature. For the assessment of intraobserver error, 20 cases were measured again. Results: The results show that all five methods are highly reliable and digitally reproducible, with estimated error near or lower than that indicated in the intraobserver error analysis. Cobb's method had the highest concordance (96%) while the sagittal index had the lowest concordance (75%). It is also suggested that digital assessment is more reliable then the manual method. Conclusion: All tested methods are highly reliable and digitally reproducible.研究目的：本研究旨在评估胸腰椎爆裂骨折五种脊柱后凸（kyphosis）畸形测量方法的手动与数字化可靠性及可重复性。 研究方法：共计评估90幅断层成像图像，采用文献中报道的五种最具代表性的测量方法，分别以手动及数字化方式对每例样本的脊柱后凸畸形进行测量。为评估观察者内误差，选取20例样本进行重复测量。 研究结果：结果显示，五种测量方法均具备较高可靠性与数字化可重复性，估计误差接近或低于观察者内误差分析中所指示的阈值。其中Cobb法（Cobb's method）的一致性最高（96%），矢状位指数法（sagittal index）的一致性最低（75%）。此外，数字化测量的可靠性优于手动测量方式。 研究结论：所有受试测量方法均具备较高可靠性与数字化可重复性。