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A variability study of computerized sagittal sacral radiologic measures.

Zhi Wang1, Stefan Parent, Jacques A de Guise

  • 1Research Center, Sainte-Justine University Hospital Center, Montréal, Québec, Canada.

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Computer-assisted measurement of sacral morphology is reliable and repeatable in patients with spondylolisthesis. This technique can be recommended for evaluating sagittal sacral anatomy in research and clinical settings.

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Area of Science:

  • Radiographic imaging
  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Sacral morphology differences are observed in spondylolisthesis patients.
  • Computerized measurements are increasingly used for sagittal balance but their reliability in sacral morphology is unevaluated.
  • Key parameters include sacral table angle (STA), S1 superior and S2 inferior angles, and sacral kyphosis.

Purpose of the Study:

  • To evaluate inter- and intraobserver variability of computer-assisted sacral morphology measurements.
  • To investigate the accuracy of these measurements in a population with developmental L5-S1 spondylolisthesis.

Main Methods:

  • A radiographic study of 30 adolescents (10 asymptomatic, 10 low-grade, 10 high-grade L5-S1 spondylolisthesis).
  • Three surgeons performed computer-assisted measurements of sacral morphology on lateral radiographs at two separate occasions.
  • Intraclass correlation coefficients (ICCs) were used for statistical analysis.

Main Results:

  • High inter- and intraobserver reliability was found, with ICC values ranging from 0.951 to 0.995.
  • A slight, statistically insignificant decrease in ICC was noted in the high-grade spondylolisthesis group compared to controls.

Conclusions:

  • Computer-assisted angular measurement of sacral morphology is reliable and repeatable in L5-S1 spondylolisthesis, including cases with lumbosacral dysplasia.
  • This method is recommended for evaluating sagittal sacral anatomy in future clinical and research studies.