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EOS® is reliable to evaluate spinopelvic parameters: a validation study.

Mohammadreza Shakeri1, Seyed Mani Mahdavi1, Masih Rikhtehgar1

  • 1Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

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|February 6, 2024
PubMed
Summary

EOS® imaging provides reliable and comparable spinopelvic parameters, including Thoracic Kyphosis and Lumbar Lordosis, to conventional radiographs. This advanced system offers an effective alternative for spinal alignment assessment.

Keywords:
EOSReliabilitySagittal BalanceSpinopelvic parametersValidity

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Area of Science:

  • Orthopedic imaging
  • Spinal alignment assessment
  • Radiographic technology

Background:

  • Conventional sagittal and coronal radiographs are standard for spinal alignment but suffer from distortion and variable reliability.
  • EOS® is a low-dose biplanar system offering high-definition images, potentially overcoming distortion issues.

Purpose of the Study:

  • To evaluate and compare spinopelvic parameters using conventional C1S1 radiographs versus EOS® imaging.
  • To assess the intra- and inter-observer reliability of measurements obtained from both imaging modalities.

Main Methods:

  • Fifty patients underwent both conventional C1S1 and full-length EOS® spinal imaging.
  • Key spinopelvic parameters (TK, LL, PT, SS, PI, SVA) were measured twice by an orthopedic surgeon and once by a radiologist.
  • Interclass correlation coefficient (ICC) and coefficient of variation were used to assess reliability, with Bland-Altman plots for agreement.

Main Results:

  • EOS® imaging demonstrated high intra- and inter-observer reliability for all measured spinopelvic parameters (ICC range: 0.90-0.98).
  • Conventional radiographs also showed good reliability (ICC range: 0.87-0.98), with slight variations.
  • Low coefficients of variation indicated good intra-observer reliability for both methods, while inter-observer reliability varied.

Conclusions:

  • EOS® imaging is a reliable method for measuring spinopelvic parameters.
  • EOS® measurements are comparable to those from conventional lateral upright C1S1 radiographs.
  • EOS® offers a viable alternative for accurate spinal alignment assessment.