title: Intra and inter-observer reliability of determining degree of pelvic obliquity in neuromuscular scoliosis using the EOS-CHAIR® protocol.
abstract: OBJECTIVE
  Scoliosis with pelvic obliquity (PO) could be investigated with the EOS-CHAIR protocol as the most common deformity especially in patients with trunk hypotonia and quadriplegia. However, the intra-observer and inter-observer reliability of various angles assessing PO was not investigated with this new imaging protocol.
  
  
  METHODS
  A retrospective cohort of 36 EOS frontal full-spine acquisitions made in sitting position was used. The sacroiliac pelvic obliquity angle, iliac crest pelvic obliquity angle, and ischiatic pelvic obliquity angle were assessed in an intra-observer and inter-observer study.
  
  
  RESULTS
  The use of the EOS-CHAIR protocol was implemented satisfactory with a high acceptance rate by all caregivers and patients and their families. Intra-observer and inter-observer reliability was excellent for the three tested angular measurements.
  
  
  CONCLUSIONS
  As for idiopathic scoliosis, we postulate the EOS system as being superior to standard radiographs to assess 3D spinal deformities in neuromuscular conditions. The EOS-CHAIR protocol improves preoperative comprehension of the lumbosacral junction anatomy in patients with poor standing or sitting postures. Our results show a very high reliability of three different angular measurements of the frontal pelvic obliquity in sitting position. Then it is possible to use one of these three angles as well as the others to assess frontal pelvic obliquity in neuromuscular patients. This frontal pelvic obliquity protocol in sitting position with the EOS-CHAIR is a validated measurement technique that needs to be used now to measure PO as a critical parameter of the global trunk balance in neuromuscular patients.
authors.affiliation: Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France.
authors.forename: Jihane
authors.initials: J
authors.lastname: Rouissi
authors.affiliation: Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France.
authors.forename: Robin
authors.initials: R
authors.lastname: Arvieu
authors.affiliation: Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France.|Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, The MAMUTH Hospital-University, 26 avenue du Docteur Arnold Netter, F-75571 Cedex12, Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Dubory
authors.affiliation: Arts et Métiers, Paristech, Institut de Biomécanique Humaine Georges Charpak, 151 Boulevard de l'Hôpital, 75013, Paris, France.|School of Physics, University of Exeter, Stocker Road, Exeter, EX4 4QL, UK.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vergari
authors.affiliation: Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France.|Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, The MAMUTH Hospital-University, 26 avenue du Docteur Arnold Netter, F-75571 Cedex12, Paris, France.
authors.forename: Manon
authors.initials: M
authors.lastname: Bachy
authors.affiliation: Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie Paris, 26 avenue du Dr Arnold Netter, 75571Cedex 12, Paris, France. raphael.vialle@aphp.fr.|Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, The MAMUTH Hospital-University, 26 avenue du Docteur Arnold Netter, F-75571 Cedex12, Paris, France. raphael.vialle@aphp.fr.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Vialle
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009468:Neuromuscular Diseases / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012600:Scoliosis / Q000150:complications* / Q000175:diagnosis*; D013123:Spinal Fusion
keywords: CD reformatting; Eos system; Eos-chair; Neuromuscular scoliosis; Pelvic obliquity; Trunk imbalance