COMPARISON BETWEEN TWO METHODS OF MEASURING PELVIC OBLIQUITY IN CEREBRAL PALSY AND MYELOMENINGOCELE

ABSTRACT Objective: To evaluate the intra- and inter-observer reproducibility of the evaluation of the pelvic obliquity (PO) in patients with neuro-muscular deformities via the method that uses the iliac crests and the method that uses the upper endplate of S1 and to determine whe ther there is a relationship between the methods. Methods: The digitized panoramic radiographies of thirty patients with cerebral paralysis or myelomeningocelein outpatient monitoring were evaluated by four examiners: two experienced spinal surgeons and two fellows. Two radiographs were excluded because analysis was impossible. All exams were obtained in accordance with the periodic monitoring protocol in the sitting position, using digitized film and a film-focus distance of 110 cm Results: High intra- and inter-observer agreement was observed both for method that uses the iliac crests and the method that evaluates the S1 endplate. However, no significant relationship between the two methods was observed. Conclusions: The methods evaluated had good reproducibility and agreement among the observers. It was confirmed that, on account of the existent linear relation, it is possible to estimate the value of the iliac crest method knowing the value obtained by the S1 plateau multiplied by 0.76. There was no agreement between the iliac crest and S1 plateau PO evaluation methods. Level of evidence IV; Retrospective cross-sectional study. RESUMO Objetivo: Estimar a reprodutibilidade intra e interobservadores da avaliação da obliquidade pélvica (OP) nos pacientes com deformidades neuromusculares pelo método que usa as cristas ilíacas e pelo método que usa o platô superior de S1e avaliar se há relação entre os métodos. Métodos: Trinta radiografias panorâmicas digitalizadas de pacientes com paralisia cerebral e mielomeningocele acompanhados em ambulatório foram avaliadas por quatro examinadores, sendo dois cirurgiões de coluna experientes e doisfellows. Foram excluídas duas radiografias que impossibilitavam a análise. Todos os exames foram obtidos conforme protocolo de acompanhamento periódico, na posição sentada, em filme digitalizado e distância foco-filme de 110 cm. Resultados: Observou-se alta concordância intra e interobservadores tanto do método que usa as cristas ilíacas quanto do método que avalia o platô de S1. No entanto, não foi observada relação significativa entre os dois métodos. Conclusões: Os métodos avaliados apresentam boa reprodutibilidade e concordância entre os observa