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Reliability of semi-automated spinal measurement software

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Abstract

Purpose

In the treatment of patients with adult spinal deformity, analysis of spinopelvic balance is essential in clinical assessment and surgical planning. There is currently no gold standard for measurement, whether done by hand or with digital software. New semi-automated software exists that purports to increase efficiency, but its reliability is unknown in the literature.

Methods

Full spine X-rays were retrospectively reviewed from 25 adult patients seen between 2014 and 2017. Patients were included if they had > 5 cm of sagittal imbalance and radiographs of sufficient quality to perform balance measurements, without prior surgical spinal fusion and/or instrumentation. Spinopelvic parameters were measured in two radiographic programs: one with basic, non-spine-specific measurement tools (eUnity, Client Outlook, Waterloo, Canada); and a second with spine-specific semi-automated measurement tools (Sectra, Sectra AB, Linköping, Sweden). Balance parameters included SVA, PI, PT, and LL. Data were compared by examining inter-rater and inter-program reliability using interclass correlation coefficient (ICC).

Results

The subjects’ mean age was 67.9 ± 13.8 years old, and 32% were male. The inter-program reliability was strong, with ICC values greater than 0.91 for each parameter. Similarly, there was strong inter-observer reliability with ICC values greater than 0.88. These results persisted on delayed repeat measurement (p < 0.001 for all measurements).

Conclusion

There is excellent inter-observer and inter-program reliability between the basic PACS and semi-automated programs. These data demonstrate that the purported efficiency of semi-automated measurement programs does not come at the cost of measurement reliability.

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Funding

There was no internal or external funding provided for this project.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Stanford Medicine, 450 Broadway St, Redwood City, CA, 94063, USA

    Matthew Follett, Ning Liu, Todd Alamin & Kirkham B. Wood

  2. Department of Spine Surgery, Rothman Orthopaedic Institute, 925 Chestnut St, Philadelphia, PA, 19107, USA

    Brian Karamian

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  1. Matthew Follett
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  2. Brian Karamian
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  4. Todd Alamin
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  5. Kirkham B. Wood
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by all authors. The first draft of the manuscript was written by Matthew Follett and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kirkham B. Wood.

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The authors report no financial or non-financial conflicts of interest, and no sources of funding were used in conducting this study nor preparing the manuscript.

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The authors confirm that we are in compliance with the ethical standards of Spine Deformity. IRB approval was obtained prior to the initiation of this study. Patients signed informed consent regarding publishing their data and photographs.

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Follett, M., Karamian, B., Liu, N. et al. Reliability of semi-automated spinal measurement software. Spine Deform 12, 323–327 (2024). https://doi.org/10.1007/s43390-023-00795-7

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  • DOI: https://doi.org/10.1007/s43390-023-00795-7

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