title: Reliability of Coronal Curvature Measures in Premature Scoliosis: Comparison of 4 Methods Using Inverted Digital Luminescence Radiography.
abstract: METHODS
  Observational study with 4 examiners.
  
  
  OBJECTIVE
  To improve the reproducibility and reliability of coronal curvature measurements.
  
  
  BACKGROUND
  Several 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  For 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.
  
  
  CONCLUSIONS
  Inversion 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.
  
  
  METHODS
  2.
authors.affiliation: *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.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Hong
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Hwang
authors.forename: Seung-Woo
authors.initials: SW
authors.lastname: Suh
authors.forename: Jae-Hyuk
authors.initials: JH
authors.lastname: Yang
authors.forename: Jung-Ryeol
authors.initials: JR
authors.lastname: Kim
authors.forename: Yoon-Gwang
authors.initials: YG
authors.lastname: Bae
mesh_terms: D017668:Age of Onset; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012600:Scoliosis / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D013131:Spine / Q000000981:diagnostic imaging*