• Jae-Young Hong, Jin-Ho Hwang, Seung-Woo Suh, Jae-Hyuk Yang, Jung-Ryeol Kim, and Yoon-Gwang Bae.
• *Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea †Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea; and ‡Department of Orthopedics, Korea University Guro Hospital, Seoul, South Korea.
• Spine. 2015 Jun 15;40(12):E701-12.

Study DesignObservational study with 4 examiners.ObjectiveTo improve the reproducibility and reliability of coronal curvature measurements.Summary Of Background DataSeveral different methods have been developed to measure coronal curvature. Inverted digital luminescence radiography may be an additional technique to improve the reliability of measurement methods.MethodsA total of 114 whole spine posterior-anterior radiographs were collected to compare the reliability of 4 measurement methods used in early onset scoliosis. Each radiograph was measured twice by each of 4 examiners using 4 measurement methods with normal and inversion views. Data were analyzed to determine inter- and intraobserver reliabilities.ResultsFor all 4 methods, the overall intraobserver ICCs were greater than 0.926 and the interobserver ICCs were greater than 0.902, indicating excellent reliability. When intraobserver reliability was assessed in relation to scoliosis severity (<20°, 20°-40°, and >40°), the ICCs were higher for greater degrees of curvature; nonetheless, these values were in the excellent range for all methods and were higher for inversion (>0.908) than normal (>0.838) radiographs. For interobserver comparisons, the ICCs were better for the pedicle method (normal: >0.795, inversion: >0.831) than for the other methods (normal: >0.532, inversion: >0.590), with inverted digital luminescence radiography showing the higher ICCs.ConclusionInversion radiographs showed high reliability and may increase reliability in cases of less deformed spines. In addition, the pedicle method led to higher ICCs for all measurements regardless of severity, especially on inversion radiographs.Level Of Evidence2.

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