Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis
Purpose To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT). Methods Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, con...
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| Veröffentlicht in: | Spine deformity 2023, Vol.11 (1), p.115-121 |
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| creator | Photopoulos, Gregory Hurry, Jennifer Murphy, Joshua Brooks, Jaysson Fitzgerald, Ryan Louer, Craig Shaw, Kenneth Smit, Kevin Miyanji, Firoz Parent, Stefan El-Hawary, Ron |
| description | Purpose
To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT).
Methods
Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, convex vertebral body heights, and concave vertebral body heights of the 3 apical vertebrae were measured. For each observer, there were a total of 90 measurements for vertebral body height and 75 measurements for all wedging types At least 14 days elapsed between first and second round measurements.
Results
From the pre-operative to the 4-year follow-up time-point, the total wedging angle over the 3 peri-apical levels fell from 30 ± 7° to 16 ± 6° (
p
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| doi_str_mv | 10.1007/s43390-022-00570-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2705751309</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2705751309</sourcerecordid><originalsourceid>FETCH-LOGICAL-c277t-47b3e0dd740a38fff6592f656fef8e015ef9e2c00fbe5ecc2afef34cf21bb0833</originalsourceid><addsrcrecordid>eNp9kEFv1DAQhS0EolXpH-CAfOQSOraTJjmiCgpSpUoIJG6W44x3XSVxmHFAe-Sf42VLj8xhZqT35knzCfFawTsF0F5xbUwPFWhdATRt2Z6Jc62VrpRpuudPe_39TFwyP0CprqtV17wUZ6bp-7av63Px-wtO0Q1xivkgU5Dkxph25NZ99NIxI_OMSz5KO0q_8l7Oadwml2NaZKA0S7dkpJhI_kTKOJCb5JDGg8yY90VYdpI32iEdZFzkimN0mUo2-zTFxJFfiRfBTYyXj_NCfPv44evNp-ru_vbzzfu7yuu2zVXdDgZhHNsanOlCCNdNr0u7Dhg6BNVg6FF7gDBgg95rVwRT-6DVMEBnzIV4e8pdKf3YkLOdI3ucJrdg2tjqtmBslIG-WPXJ6ikxEwa7UpwdHawCe6RvT_RtoW__0rdQjt485m_DjOPTyT_WxWBOBl6PWJDsQ9poKT__L_YPnYqUkQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2705751309</pqid></control><display><type>article</type><title>Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Photopoulos, Gregory ; Hurry, Jennifer ; Murphy, Joshua ; Brooks, Jaysson ; Fitzgerald, Ryan ; Louer, Craig ; Shaw, Kenneth ; Smit, Kevin ; Miyanji, Firoz ; Parent, Stefan ; El-Hawary, Ron</creator><creatorcontrib>Photopoulos, Gregory ; Hurry, Jennifer ; Murphy, Joshua ; Brooks, Jaysson ; Fitzgerald, Ryan ; Louer, Craig ; Shaw, Kenneth ; Smit, Kevin ; Miyanji, Firoz ; Parent, Stefan ; El-Hawary, Ron ; Pediatric Spine Study Group</creatorcontrib><description>Purpose
To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT).
Methods
Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, convex vertebral body heights, and concave vertebral body heights of the 3 apical vertebrae were measured. For each observer, there were a total of 90 measurements for vertebral body height and 75 measurements for all wedging types At least 14 days elapsed between first and second round measurements.
Results
From the pre-operative to the 4-year follow-up time-point, the total wedging angle over the 3 peri-apical levels fell from 30 ± 7° to 16 ± 6° (
p
< 0.001) and the difference between the convex and concave vertebral heights decreased from 9 ± 4 to 6 ± 3 mm (
p
< 0.001). Interobserver agreement for pre-operative vertebral body heights was good [ICC = 0.80; 95% CI (0.74–0.85)]. At 4-year follow-up there was a moderate agreement [ICC = 0.67 (0.59–0.74)]. There was a poor interobserver agreement for pre-operative wedging angle measurements [ICC = 0.41 (0.32–0.52)] and 4-year follow-up [ICC = 0.45 (0.36–0.56)]. The Limits of Agreement with the Mean (LOAM) for pre-op heights was ± 2.4 mm, similar to the follow-up ± 2.6 mm. When raters are averaged in random groups of two the agreement limits decrease to ± 1.8 mm pre-op and ± 1.6 mm at follow-up. Similarly for wedging angles, LOAM values among the 8 observers of ± 4.6° pre-op and ± 4.2° dropped to ± 2.7° for both pre-op and follow-up when random groups of two raters were averaged together. Intraobserver agreement ranged from good to excellent per individual (ICC = 0.84–0.94) for pre-operative vertebral body heights, but this decreased at 4-year follow-up (ICC = 0.52–0.88). Intraobserver agreement was low overall for wedging (pre-operative ICC = 0.41–0.71; 4-year follow-up ICC = 0.41–0.76).
Conclusion
Based on 8 individual observers, interobserver agreement ranged from good (pre-operative vertebral body heights) to moderate (4-year follow-up vertebral body heights) to poor (all wedging angles). To improve the reliability of the measurement of wedging angles, we recommend averaging the measurements of at least two observers.</description><identifier>ISSN: 2212-134X</identifier><identifier>EISSN: 2212-1358</identifier><identifier>DOI: 10.1007/s43390-022-00570-0</identifier><identifier>PMID: 35997944</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Case Series ; Child ; Humans ; Medicine ; Medicine & Public Health ; Orthopedics ; Radiography ; Reproducibility of Results ; Scoliosis - diagnostic imaging ; Scoliosis - surgery ; Thoracic Vertebrae - diagnostic imaging ; Thoracic Vertebrae - surgery ; Vertebral Body</subject><ispartof>Spine deformity, 2023, Vol.11 (1), p.115-121</ispartof><rights>The Author(s), under exclusive licence to Scoliosis Research Society 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Scoliosis Research Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c277t-47b3e0dd740a38fff6592f656fef8e015ef9e2c00fbe5ecc2afef34cf21bb0833</citedby><cites>FETCH-LOGICAL-c277t-47b3e0dd740a38fff6592f656fef8e015ef9e2c00fbe5ecc2afef34cf21bb0833</cites><orcidid>0000-0003-2172-6188</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43390-022-00570-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43390-022-00570-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35997944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Photopoulos, Gregory</creatorcontrib><creatorcontrib>Hurry, Jennifer</creatorcontrib><creatorcontrib>Murphy, Joshua</creatorcontrib><creatorcontrib>Brooks, Jaysson</creatorcontrib><creatorcontrib>Fitzgerald, Ryan</creatorcontrib><creatorcontrib>Louer, Craig</creatorcontrib><creatorcontrib>Shaw, Kenneth</creatorcontrib><creatorcontrib>Smit, Kevin</creatorcontrib><creatorcontrib>Miyanji, Firoz</creatorcontrib><creatorcontrib>Parent, Stefan</creatorcontrib><creatorcontrib>El-Hawary, Ron</creatorcontrib><creatorcontrib>Pediatric Spine Study Group</creatorcontrib><title>Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis</title><title>Spine deformity</title><addtitle>Spine Deform</addtitle><addtitle>Spine Deform</addtitle><description>Purpose
To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT).
Methods
Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, convex vertebral body heights, and concave vertebral body heights of the 3 apical vertebrae were measured. For each observer, there were a total of 90 measurements for vertebral body height and 75 measurements for all wedging types At least 14 days elapsed between first and second round measurements.
Results
From the pre-operative to the 4-year follow-up time-point, the total wedging angle over the 3 peri-apical levels fell from 30 ± 7° to 16 ± 6° (
p
< 0.001) and the difference between the convex and concave vertebral heights decreased from 9 ± 4 to 6 ± 3 mm (
p
< 0.001). Interobserver agreement for pre-operative vertebral body heights was good [ICC = 0.80; 95% CI (0.74–0.85)]. At 4-year follow-up there was a moderate agreement [ICC = 0.67 (0.59–0.74)]. There was a poor interobserver agreement for pre-operative wedging angle measurements [ICC = 0.41 (0.32–0.52)] and 4-year follow-up [ICC = 0.45 (0.36–0.56)]. The Limits of Agreement with the Mean (LOAM) for pre-op heights was ± 2.4 mm, similar to the follow-up ± 2.6 mm. When raters are averaged in random groups of two the agreement limits decrease to ± 1.8 mm pre-op and ± 1.6 mm at follow-up. Similarly for wedging angles, LOAM values among the 8 observers of ± 4.6° pre-op and ± 4.2° dropped to ± 2.7° for both pre-op and follow-up when random groups of two raters were averaged together. Intraobserver agreement ranged from good to excellent per individual (ICC = 0.84–0.94) for pre-operative vertebral body heights, but this decreased at 4-year follow-up (ICC = 0.52–0.88). Intraobserver agreement was low overall for wedging (pre-operative ICC = 0.41–0.71; 4-year follow-up ICC = 0.41–0.76).
Conclusion
Based on 8 individual observers, interobserver agreement ranged from good (pre-operative vertebral body heights) to moderate (4-year follow-up vertebral body heights) to poor (all wedging angles). To improve the reliability of the measurement of wedging angles, we recommend averaging the measurements of at least two observers.</description><subject>Case Series</subject><subject>Child</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Radiography</subject><subject>Reproducibility of Results</subject><subject>Scoliosis - diagnostic imaging</subject><subject>Scoliosis - surgery</subject><subject>Thoracic Vertebrae - diagnostic imaging</subject><subject>Thoracic Vertebrae - surgery</subject><subject>Vertebral Body</subject><issn>2212-134X</issn><issn>2212-1358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFv1DAQhS0EolXpH-CAfOQSOraTJjmiCgpSpUoIJG6W44x3XSVxmHFAe-Sf42VLj8xhZqT35knzCfFawTsF0F5xbUwPFWhdATRt2Z6Jc62VrpRpuudPe_39TFwyP0CprqtV17wUZ6bp-7av63Px-wtO0Q1xivkgU5Dkxph25NZ99NIxI_OMSz5KO0q_8l7Oadwml2NaZKA0S7dkpJhI_kTKOJCb5JDGg8yY90VYdpI32iEdZFzkimN0mUo2-zTFxJFfiRfBTYyXj_NCfPv44evNp-ru_vbzzfu7yuu2zVXdDgZhHNsanOlCCNdNr0u7Dhg6BNVg6FF7gDBgg95rVwRT-6DVMEBnzIV4e8pdKf3YkLOdI3ucJrdg2tjqtmBslIG-WPXJ6ikxEwa7UpwdHawCe6RvT_RtoW__0rdQjt485m_DjOPTyT_WxWBOBl6PWJDsQ9poKT__L_YPnYqUkQ</recordid><startdate>2023</startdate><enddate>2023</enddate><creator>Photopoulos, Gregory</creator><creator>Hurry, Jennifer</creator><creator>Murphy, Joshua</creator><creator>Brooks, Jaysson</creator><creator>Fitzgerald, Ryan</creator><creator>Louer, Craig</creator><creator>Shaw, Kenneth</creator><creator>Smit, Kevin</creator><creator>Miyanji, Firoz</creator><creator>Parent, Stefan</creator><creator>El-Hawary, Ron</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2172-6188</orcidid></search><sort><creationdate>2023</creationdate><title>Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis</title><author>Photopoulos, Gregory ; Hurry, Jennifer ; Murphy, Joshua ; Brooks, Jaysson ; Fitzgerald, Ryan ; Louer, Craig ; Shaw, Kenneth ; Smit, Kevin ; Miyanji, Firoz ; Parent, Stefan ; El-Hawary, Ron</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c277t-47b3e0dd740a38fff6592f656fef8e015ef9e2c00fbe5ecc2afef34cf21bb0833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Case Series</topic><topic>Child</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Radiography</topic><topic>Reproducibility of Results</topic><topic>Scoliosis - diagnostic imaging</topic><topic>Scoliosis - surgery</topic><topic>Thoracic Vertebrae - diagnostic imaging</topic><topic>Thoracic Vertebrae - surgery</topic><topic>Vertebral Body</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Photopoulos, Gregory</creatorcontrib><creatorcontrib>Hurry, Jennifer</creatorcontrib><creatorcontrib>Murphy, Joshua</creatorcontrib><creatorcontrib>Brooks, Jaysson</creatorcontrib><creatorcontrib>Fitzgerald, Ryan</creatorcontrib><creatorcontrib>Louer, Craig</creatorcontrib><creatorcontrib>Shaw, Kenneth</creatorcontrib><creatorcontrib>Smit, Kevin</creatorcontrib><creatorcontrib>Miyanji, Firoz</creatorcontrib><creatorcontrib>Parent, Stefan</creatorcontrib><creatorcontrib>El-Hawary, Ron</creatorcontrib><creatorcontrib>Pediatric Spine Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine deformity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Photopoulos, Gregory</au><au>Hurry, Jennifer</au><au>Murphy, Joshua</au><au>Brooks, Jaysson</au><au>Fitzgerald, Ryan</au><au>Louer, Craig</au><au>Shaw, Kenneth</au><au>Smit, Kevin</au><au>Miyanji, Firoz</au><au>Parent, Stefan</au><au>El-Hawary, Ron</au><aucorp>Pediatric Spine Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis</atitle><jtitle>Spine deformity</jtitle><stitle>Spine Deform</stitle><addtitle>Spine Deform</addtitle><date>2023</date><risdate>2023</risdate><volume>11</volume><issue>1</issue><spage>115</spage><epage>121</epage><pages>115-121</pages><issn>2212-134X</issn><eissn>2212-1358</eissn><abstract>Purpose
To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT).
Methods
Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, convex vertebral body heights, and concave vertebral body heights of the 3 apical vertebrae were measured. For each observer, there were a total of 90 measurements for vertebral body height and 75 measurements for all wedging types At least 14 days elapsed between first and second round measurements.
Results
From the pre-operative to the 4-year follow-up time-point, the total wedging angle over the 3 peri-apical levels fell from 30 ± 7° to 16 ± 6° (
p
< 0.001) and the difference between the convex and concave vertebral heights decreased from 9 ± 4 to 6 ± 3 mm (
p
< 0.001). Interobserver agreement for pre-operative vertebral body heights was good [ICC = 0.80; 95% CI (0.74–0.85)]. At 4-year follow-up there was a moderate agreement [ICC = 0.67 (0.59–0.74)]. There was a poor interobserver agreement for pre-operative wedging angle measurements [ICC = 0.41 (0.32–0.52)] and 4-year follow-up [ICC = 0.45 (0.36–0.56)]. The Limits of Agreement with the Mean (LOAM) for pre-op heights was ± 2.4 mm, similar to the follow-up ± 2.6 mm. When raters are averaged in random groups of two the agreement limits decrease to ± 1.8 mm pre-op and ± 1.6 mm at follow-up. Similarly for wedging angles, LOAM values among the 8 observers of ± 4.6° pre-op and ± 4.2° dropped to ± 2.7° for both pre-op and follow-up when random groups of two raters were averaged together. Intraobserver agreement ranged from good to excellent per individual (ICC = 0.84–0.94) for pre-operative vertebral body heights, but this decreased at 4-year follow-up (ICC = 0.52–0.88). Intraobserver agreement was low overall for wedging (pre-operative ICC = 0.41–0.71; 4-year follow-up ICC = 0.41–0.76).
Conclusion
Based on 8 individual observers, interobserver agreement ranged from good (pre-operative vertebral body heights) to moderate (4-year follow-up vertebral body heights) to poor (all wedging angles). To improve the reliability of the measurement of wedging angles, we recommend averaging the measurements of at least two observers.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35997944</pmid><doi>10.1007/s43390-022-00570-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2172-6188</orcidid></addata></record> |
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| subjects | Case Series Child Humans Medicine Medicine & Public Health Orthopedics Radiography Reproducibility of Results Scoliosis - diagnostic imaging Scoliosis - surgery Thoracic Vertebrae - diagnostic imaging Thoracic Vertebrae - surgery Vertebral Body |
| title | Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis |
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