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目的:比较常用胸腰段骨折侧位X线片不同测量方法测量后凸角度的可信度及可重复性。方法:40例胸腰段爆裂骨折患者的侧位X线片,让3位脊柱外科医师应用6种测量方法测量后凸角度,(1)伤椎头侧邻近椎体上终板和尾侧邻近椎体下终板平行线的垂线夹角;(2)伤椎下终板和头侧邻近椎体上终板平行线的垂线夹角;(3)伤椎头侧和尾侧邻近椎体后壁平行线的垂线夹角;(4)伤椎头侧邻近椎体下终板和尾侧邻近椎体上终板平行线的垂线夹角;(5)伤椎上终板和下终板平行线的垂线夹角;(6)后凸比率,即伤椎头侧邻近椎体前下缘至尾侧邻近椎体前上缘距离(a)/伤椎头侧邻近椎体后下缘至尾侧邻近椎体后上缘距离(b)。以3周为间隔分别独自测量两次后凸角度,对测量结果进行统计学分析。结果:方法1组内相关系数高度一致(r=0.84~0.95),其次是方法4(r=0.75~0.90)。各种测量方法三位测量医师所得结果组内一致性(重复测量5°以内变化)为76%~98.5%,方法1显示较好的一致性(92.4%~98.5%)。配对检验显示,不同观察者之间,组间可信度相关系数为0.53~0.90,方法1显示最高组间可信度相关系数(0.85,范围0.75~0.92),其次是方法4(0.81,范围0.71~0.89)。结论:测量伤椎头侧椎体上终板和尾侧椎体下终板平行线的垂线夹角作为骨折椎体后凸角具有最佳组内和组间可信度。
OBJECTIVE: To compare the reliability and repeatability of kyphosis measured by different methods of lateral radiographs of thoracolumbar fractures. Methods: Forty patients with thoracolumbar burst fractures underwent lateral radiographs. Three spine surgeons used six measurement methods to measure the kyphosis angle. (1) The adjacent vertebral endplate and caudal proximal to the vertebral head (2) the vertical line between the lower endplate of vertebral body and the parallel plane of the upper endplate of the vertebral body adjacent to the vertebral body; (3) (4) vertical angle of the vertebral body adjacent to the vertebral endplate adjacent to the vertebral body and caudal proximal vertebral parallel plate; (5) vertebral endplate and (6) kyphosis ratio, that is, the vertebral head near the anteromedial edge of the vertebral body to the caudal margin of the anterior margin of the proximal margin (a) / adjacent vertebral head injury side After the lower edge to the caudal vertebral body adjacent to the upper edge of the distance (b). The kyphosis angle was measured twice at 3 weeks intervals separately, and the results were statistically analyzed. Results: The correlation coefficients of method 1 were highly consistent (r = 0.84-0.95), followed by method 4 (r = 0.75-0.90). Various measurement methods The results obtained by the three surveyors were consistent within the group (changes within 5 ° of repeated measurements) of 76% to 98.5%. Method 1 showed good agreement (92.4% to 98.5%). Paired test showed that the correlation coefficient between groups was 0.53-0.90 between different observers. Method 1 showed the highest correlation coefficient (0.85, range 0.75-0.92), followed by Method 4 (0.81, range 0.71 ~ 0.89). Conclusion: The vertical angle between the endplate of the vertebral body and the parallel plane of the caudal endplate in the caudal vertebral body has the best agreement between the two groups.