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
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Systematic review. ⋯ There is some evidence to suggest that MED performed by surgeons skilled in the technique in tertiary referral centres is as effective as OD.
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Review
Measuring procedures to determine the Cobb angle in idiopathic scoliosis: a systematic review.
Scoliosis of the vertebral column can be assessed with the Cobb angle (Cobb 1948). This examination is performed manually by measuring the angle on radiographs and is considered the gold standard. However, studies evaluating the reproducibility of this procedure have shown high variability in intra- and inter-observer agreement. Because of technical advancements, interests in new procedures to determine the Cobb angle has been renewed. This review aims to systematically investigate the reproducibility of various new techniques to determine the Cobb angle in idiopathic scoliosis and to assess whether new technical procedures are reasonable alternatives when compared to manual measurement of the Cobb angle. ⋯ All investigated measuring procedures showed high degrees of reliability. In general, digital procedures tend to be slightly better than manual ones. For all other measurement procedures (automatic or smartphone), results varied. Studies implementing vertebral pre-selection and observer training achieved better agreement.
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To analyze the relationship between the cervical spine and global spinal-pelvic alignment in young patients with idiopathic scoliosis based on a morphological classification, and to postulate the hypothesis that cervical kyphosis is a part of cervico-thoracic kyphosis in them. ⋯ The cervical kyphosis is correlated with global sagittal alignment, and is a part of cervico-thoracic sagittal deformity in young patients with idiopathic scoliosis. Despite the deformity in cervical alignment, the global spine could still be well-balanced with spontaneous adjustment. The correlation between our grouping based on the morphological characteristics of the sagittal alignments and Lenke Lumbar Modifier suggests that the coupled motion principle be appropriate to explain the modifications both in coronal and sagittal planes.
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Two-dimensional imaging is not adequate for evaluating ossification of the posterior longitudinal ligament (OPLL). This study was designed to evaluate the accuracy of a novel computed tomography (CT)-based three-dimensional (3D) analysis method that we had devised to measure volume changes in OPLL. ⋯ The 3D method used allowed detailed OPLL classification and quantification of change in the ossified volume. Thus, this method appears to be very useful for quantitative evaluation of OPLL with only minimal measurement error.
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Surgery for correction of sagittal imbalance has frequent adverse events and complications. The most frequent cause of failure is inadequate correction of imbalance. The aim of this study is to verify the accuracy of three published methods (exact method by Ondra, FBI method by Le Huec and spinofemoral angle method by Lamartina) to preoperatively calculate the needed correction. ⋯ The FBI and SFA methods obtain equivalent calculations of the amount of needed correction. The estimated correction angle with both methods is higher than that calculated with the exact trigonometric method. The difference between the latter and the former methods is equivalent to the observed excess of pelvic tilt.