What is the optimal cutoff value of the axis-line-angle technique for evaluating trunk imbalance in coronal plane?

Accurately evaluating the extent of trunk imbalance in the coronal plane is significant for patients before and after treatment. We preliminarily practiced a new method, axis-line-angle technique (ALAT), for evaluating coronal trunk imbalance with excellent intra-observer and interobserver reliabili...

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Bibliographic Details
Published in:The spine journal 2017-02, Vol.17 (2), p.230-235
Main Authors: Zhang, Rui-Fang, Fu, Yu-Chuan, Lu, Yi, Zhang, Xiao-Xia, Hu, Yu-Min, Zhou, Yong-Jin, Tian, Nai-Feng, He, Jia-Wei, Yan, Zhi-Han
Format: Article
Language:English
Subjects:
Adolescent
Central sacral vertical line
Child
Coronal balance
Female
Humans
Interobserver agreement
Kappa statistic
Male
Observer Variation
Radiography
Radiography, Thoracic - methods
Reproducibility of Results
Retrospective Studies
ROC Curve
Scoliosis - diagnostic imaging
Spine
Torso - diagnostic imaging
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Summary:Accurately evaluating the extent of trunk imbalance in the coronal plane is significant for patients before and after treatment. We preliminarily practiced a new method, axis-line-angle technique (ALAT), for evaluating coronal trunk imbalance with excellent intra-observer and interobserver reliability. Radiologists and surgeons were encouraged to use this method in clinical practice. However, the optimal cutoff value of the ALAT for determination of the extent of coronal trunk imbalance has not been calculated up to now. The purpose of this study was to identify the cutoff value of the ALAT that best predicts a positive measurement point to assess coronal balance or imbalance. A retrospective study at a university affiliated hospital was carried out. A total of 130 patients with C7-central sacral vertical line (CSVL) >0 mm and aged 10–18 years were recruited in this study from September 2013 to December 2014. Data were analyzed to determine the optimal cutoff value of the ALAT measurement. The C7-CSVL and ALAT measurements were conducted respectively twice on plain film within a 2-week interval by two radiologists. The optimal cutoff value of the ALAT was analyzed via receiver operating characteristic (ROC) curve. Comparison variables were performed with chi-square test between the C7-CSVL and ALAT measurements for evaluating trunk imbalance. Kappa agreement coefficient method was used to test the intra-observer and interobserver agreement of C7-CSVL and ALAT. The ROC curve area for the ALAT was 0.82 (95% confidence interval: 0.753–0.894, p.05). Intra-observer agreement values for the C7-CSVL measurements by observers 1 and 2 were 0.79 and 0.91 (p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2016.09.012