Are Both Preoperative Full-Spine 3Dimensional Computed Tomography Scans and X-Ray Films Necessary for Patients with Ankylosing Spondylitis Kyphosis?
Are Both Preoperative Full-Spine 3Dimensional Computed Tomography Scans and X-Ray Films Necessary for Patients with Ankylosing Spondylitis Kyphosis?
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DOI：
10.1111/os.13461
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发表时间：
2022-10
影响因子：
2.1
通讯作者：
Zhang, Xuesong
中科院分区：
文献类型：
--
作者：
Zhang, Zhen;Liu, Chao;Hu, Fanqi;You, Yonggang;Hu, Wenhao;Zhang, Xuesong
本研究旨在探讨重度强直性脊柱炎（AS）后凸畸形患者是否需要术前全脊柱三维计算机断层扫描（3D CT）和X线片。研究对象选自我院2017 - 2019年AS住院患者。共有42名患者入选本研究。在合成的二维（2D）侧位X线片和X线片上，测量了地球仪后凸（GK）、腰椎前凸（LL）、胸腰椎后凸（TLK）和胸椎后凸（TK）。测量第7胸椎角（T7）、第12胸椎角（T12）和第3腰椎角（L3）。随机抽取2名具有医学专业教育背景的研究人员进行测量方法的实施和测量数据的记录。两名研究人员独立完成，记录和评估测量数据的准确性和一致性。本研究使用组内相关系数（ICC）对42名受试者的合成2D侧位片和普通X线片进行分析，以评价检查者之间数据测量结果的一致性。通过上述GK、LL、TLK、TK、T7角、T12角和L3角参数的比较，评价术前全脊柱3D CT和X线片对于重度AS后凸畸形患者均是必要的。合成的2D侧位片上的GK、LL、TLK、TK、角度T7、角度T12、角度L3与X线片上的GK、LL、TLK、TK、角度T7、角度T12、角度L3之间无显著差异（P = 0.240、0.324、0.199、0.095、0.421、0.087、0.478）。在合成的2D侧位X线片上，两名研究者对GK、LL、TLK、TK、角度T7、角度T12、角度L3（0.977、0.969、0.986、0.945、0.947、0.915、0.857）的ICC的一致性极佳。Bland-Altman图表明，测试人员的测量结果是可靠和稳定的。通过估计脊柱矢状面不平衡程度和测量Cobb角，我们可以看出，对于严重AS后凸畸形的患者，术前将接受或已经接受脊柱3D CT检查的患者，不需要进行全长脊柱X线片。通过对脊柱矢状面失衡程度的评估和Cobbangle的测量，可以看出合成2D侧位片在评估AS后凸畸形患者的脊柱矢状面对线不良程度方面可以起到与普通X线片相同的作用。对于将接受或已经接受术前全脊柱3D CT的严重脊柱后凸畸形患者，可能不需要对患者进行全长脊柱X线片。
This study is aimed to investigate whether both pre‐operative full‐spine 3Dimensional computed tomography scan (3D CT) and X‐ray film were necessary for patients with severe ankylosing spondylitis (AS) kyphosis deformity. The research objects were selected from the inpatients with AS in our hospital from 2017 to 2019. A total of 42 patients were included in the study. On both the synthesized 2Dimensional (2D) lateral radiograph and X‐ray film, the globe kyphosis (GK), the lumber lordosis (LL), the thoracolumbar kyphosis (TLK) and the thoracic kyphosis (TK) were measured. And the angle seventh thoracic vertebra (T7), the angle twelfth thoracic vertebra (T12) and the angle third lumber vertebra (L3) were also measured. Two researchers with professional medical education were randomly selected to perform the measurement method and record the measurement data. Two researchers independently completed, recorded, and evaluated the accuracy and consistency of the measurement data. This study used intraclass correlation coefficient (ICC) to analyze the synthesized 2D lateral radiograph and general X‐ray film of 42 subjects by two researchers, in order to evaluate the consistency of data measurement results between the examiners. Through the comparison of the above parameters that the GK, LL, TLK, TK, angle T7, angle T12 and angle L3, the evaluation was made both pre‐operative full‐spine 3D CT and X‐ray film were necessary for patients with severe AS kyphosis deformity. There was no significant difference between the GK, LL, TLK, TK, angle T7, angle T12, angle L3 on the synthesized 2D lateral radiograph and that on X‐ray film (P = 0.240, 0.324, 0.199, 0.095, 0.421, 0.087, 0.478). Agreement two researchers was excellent with ICC of the GK, LL, TLK, TK, angle T7, angle T12, angle L3 (0.977, 0.969, 0.986, 0.945, 0.947, 0.915, 0.857) on the synthesized 2D lateral radiograph. The Bland–Altman plot results that the measurement results of examiners are reliable and stable. By estimating the degree of spinal sagittal imbalance and measuring the Cobb angle, we can see that full‐length spine radiographs of the patients are unnecessary for patients with severe AS kyphosis deformity who will or have undergone preoperative spine 3D CT. ByEstimating the degree of spinal sagittal imbalance and measuring the Cobbangle, we can see that Synthesized 2D lateral radiographs can play the samerole as general X‐ray films on estimating the degree of spinal sagittalmalalignment in patients with AS kyphosis deformities. Full‐length spineradiographs of the patients may be unnecessary for patients with severe ASkyphosis deformity who will or have undergone preoperative full spine 3D CT.
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DOI：
10.2106/00004623-199708000-00013
发表时间：
1997-08-01
影响因子：
5.3
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