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Supine thoracolumbar sagittal spine alignment: comparing computerized tomography and plain radiographs
Matthew P Abdel1, William S Bodemer, Paul A Anderson
1Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Spine
|February 16, 2012
Summary
This study establishes supine reference Cobb angles for spinal sagittal alignment using plain radiographs and CT scans. Both imaging methods demonstrated excellent reliability for assessing spinal alignment in supine trauma patients.
Area of Science:
- Orthopedics
- Radiology
- Spine Surgery
Background:
- Limited research compares plain radiographs and CT scans for sagittal spine alignment.
- No prior studies have assessed supine patients for this comparison.
Purpose of the Study:
- To determine differences between plain radiographs and CT scans for supine sagittal alignment.
- To establish supine reference Cobb angles for both imaging modalities.
Main Methods:
- Fifty blunt trauma patients with routine thoracolumbar spine clearance were included.
- Spine surgeons measured sagittal alignment using the Cobb method (T4-L5) on supine plain radiographs and CT scans.
- Intraclass correlation coefficients (ICCs) assessed intraobserver, interobserver, and method reliability.
Main Results:
- Thoracic spine showed kyphosis, peaking at T6; lumbar spine showed a linear progression to lordosis at L5.
- High interobserver reliability was found for both plain radiographs (ICC: 0.902) and CT scans (ICC: 0.895).
- Excellent method reliability (plain radiographs vs. CT scans) was demonstrated (ICC: 0.808-0.817).
Conclusions:
- This study provides supine reference Cobb angles for sagittal spine alignment using plain radiographs and CT scans.
- Measurements from both imaging sources and across observers showed high reliability.
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