The effects of rotation on radiological parameters in the spine

Christian Wong; Johanna Hall; Kasper Gosvig

doi:10.1177/0284185118780905

The effects of rotation on radiological parameters in the spine

Christian Wong, Johanna Hall, Kasper Gosvig

Department of Clinical Medicine

1 Citation (Scopus)

Abstract

BACKGROUND: Vertebral rotation in straight spines or in spines with small scoliosis may potentially affect measurement of radiological parameters in both the frontal and sagittal plane. This is important, since it could lead to potential misdiagnosis of scoliosis and other clinical consequences, and until now, this has not been examined.

PURPOSE: To examine the effect of axial vertebral rotation of the spine on measurement of common radiological parameters.

MATERIAL AND METHODS: Reconstructions from computed tomography scans of 40 consecutive included and anonymized patients with straight spines or small scoliosis. Fourteen sagittal and coronal reconstructions covering the whole pelvis and spine were executed. Radiographic parameters in both the frontal and sagittal plane were measured blinded and separately by three doctors. These parameters were evaluated for inter-rater reliability using intraclass correlation coefficient and mixed model analysis for the effects of rotation. The parameters were also analyzed sub-stratified according to "Lenke's classification" and 15 sub-categories of thoracic and lumbar Cobb's angle (CA).

RESULTS: Vertebral rotation in general does not have any significant effects in both the frontal and sagittal plane. However, there are significant effects on CA and spinopelvic radiologic parameters in extreme rotation or for larger scoliosis. Inter-rater reliability was very good to good.

CONCLUSION: In conclusion, axial spinal rotation does not influence common radiological parameters in the frontal and sagittal plane, except in cases of extreme rotation or large scoliosis for selected parameters; thus, this does not lead to potential misinterpretation in scoliosis diagnosis, treatment, or research.

Original language	English
Journal	Acta Radiologica
Volume	60
Issue number	3
Pages (from-to)	338-346
Number of pages	9
ISSN	0284-1851
DOIs	https://doi.org/10.1177/0284185118780905
Publication status	Published - 1 Mar 2019

Keywords

Adult
Anatomic Landmarks
Cross-Sectional Studies
Diagnosis, Differential
Female
Humans
Male
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Rotation
Scoliosis/diagnostic imaging
Tomography, X-Ray Computed/methods

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10.1177/0284185118780905

Cite this

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title = "The effects of rotation on radiological parameters in the spine",

abstract = "BACKGROUND: Vertebral rotation in straight spines or in spines with small scoliosis may potentially affect measurement of radiological parameters in both the frontal and sagittal plane. This is important, since it could lead to potential misdiagnosis of scoliosis and other clinical consequences, and until now, this has not been examined.PURPOSE: To examine the effect of axial vertebral rotation of the spine on measurement of common radiological parameters.MATERIAL AND METHODS: Reconstructions from computed tomography scans of 40 consecutive included and anonymized patients with straight spines or small scoliosis. Fourteen sagittal and coronal reconstructions covering the whole pelvis and spine were executed. Radiographic parameters in both the frontal and sagittal plane were measured blinded and separately by three doctors. These parameters were evaluated for inter-rater reliability using intraclass correlation coefficient and mixed model analysis for the effects of rotation. The parameters were also analyzed sub-stratified according to {"}Lenke's classification{"} and 15 sub-categories of thoracic and lumbar Cobb's angle (CA).RESULTS: Vertebral rotation in general does not have any significant effects in both the frontal and sagittal plane. However, there are significant effects on CA and spinopelvic radiologic parameters in extreme rotation or for larger scoliosis. Inter-rater reliability was very good to good.CONCLUSION: In conclusion, axial spinal rotation does not influence common radiological parameters in the frontal and sagittal plane, except in cases of extreme rotation or large scoliosis for selected parameters; thus, this does not lead to potential misinterpretation in scoliosis diagnosis, treatment, or research.",

keywords = "Adult, Anatomic Landmarks, Cross-Sectional Studies, Diagnosis, Differential, Female, Humans, Male, Radiographic Image Interpretation, Computer-Assisted, Reproducibility of Results, Rotation, Scoliosis/diagnostic imaging, Tomography, X-Ray Computed/methods",

author = "Christian Wong and Johanna Hall and Kasper Gosvig",

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doi = "10.1177/0284185118780905",

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T1 - The effects of rotation on radiological parameters in the spine

AU - Wong, Christian

AU - Hall, Johanna

AU - Gosvig, Kasper

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N2 - BACKGROUND: Vertebral rotation in straight spines or in spines with small scoliosis may potentially affect measurement of radiological parameters in both the frontal and sagittal plane. This is important, since it could lead to potential misdiagnosis of scoliosis and other clinical consequences, and until now, this has not been examined.PURPOSE: To examine the effect of axial vertebral rotation of the spine on measurement of common radiological parameters.MATERIAL AND METHODS: Reconstructions from computed tomography scans of 40 consecutive included and anonymized patients with straight spines or small scoliosis. Fourteen sagittal and coronal reconstructions covering the whole pelvis and spine were executed. Radiographic parameters in both the frontal and sagittal plane were measured blinded and separately by three doctors. These parameters were evaluated for inter-rater reliability using intraclass correlation coefficient and mixed model analysis for the effects of rotation. The parameters were also analyzed sub-stratified according to "Lenke's classification" and 15 sub-categories of thoracic and lumbar Cobb's angle (CA).RESULTS: Vertebral rotation in general does not have any significant effects in both the frontal and sagittal plane. However, there are significant effects on CA and spinopelvic radiologic parameters in extreme rotation or for larger scoliosis. Inter-rater reliability was very good to good.CONCLUSION: In conclusion, axial spinal rotation does not influence common radiological parameters in the frontal and sagittal plane, except in cases of extreme rotation or large scoliosis for selected parameters; thus, this does not lead to potential misinterpretation in scoliosis diagnosis, treatment, or research.

AB - BACKGROUND: Vertebral rotation in straight spines or in spines with small scoliosis may potentially affect measurement of radiological parameters in both the frontal and sagittal plane. This is important, since it could lead to potential misdiagnosis of scoliosis and other clinical consequences, and until now, this has not been examined.PURPOSE: To examine the effect of axial vertebral rotation of the spine on measurement of common radiological parameters.MATERIAL AND METHODS: Reconstructions from computed tomography scans of 40 consecutive included and anonymized patients with straight spines or small scoliosis. Fourteen sagittal and coronal reconstructions covering the whole pelvis and spine were executed. Radiographic parameters in both the frontal and sagittal plane were measured blinded and separately by three doctors. These parameters were evaluated for inter-rater reliability using intraclass correlation coefficient and mixed model analysis for the effects of rotation. The parameters were also analyzed sub-stratified according to "Lenke's classification" and 15 sub-categories of thoracic and lumbar Cobb's angle (CA).RESULTS: Vertebral rotation in general does not have any significant effects in both the frontal and sagittal plane. However, there are significant effects on CA and spinopelvic radiologic parameters in extreme rotation or for larger scoliosis. Inter-rater reliability was very good to good.CONCLUSION: In conclusion, axial spinal rotation does not influence common radiological parameters in the frontal and sagittal plane, except in cases of extreme rotation or large scoliosis for selected parameters; thus, this does not lead to potential misinterpretation in scoliosis diagnosis, treatment, or research.

KW - Adult

KW - Anatomic Landmarks

KW - Cross-Sectional Studies

KW - Diagnosis, Differential

KW - Female

KW - Humans

KW - Male

KW - Radiographic Image Interpretation, Computer-Assisted

KW - Reproducibility of Results

KW - Rotation

KW - Scoliosis/diagnostic imaging

KW - Tomography, X-Ray Computed/methods

U2 - 10.1177/0284185118780905

DO - 10.1177/0284185118780905

M3 - Journal article

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SN - 0365-5954

VL - 60

SP - 338

EP - 346

JO - Acta Radiologica - Series Diagnosis

JF - Acta Radiologica - Series Diagnosis

IS - 3

ER -

The effects of rotation on radiological parameters in the spine

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