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RISS 인기검색어
- 검색키워드
- 저자 : Claes Olerud (검색결과 3 건)
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Accuracy and Reliability of X-ray Measurements in the Cervical Spine
Catarina Marques,Emma Granström,Anna MacDowall,Nuno Canto Moreira,Martin Skeppholm,Claes Olerud 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2
Study Design: This study is a post hoc analysis of a multicenter prospective randomized controlled trial which compared artificial disc replacement and anterior cervical discectomy and fusion. Purpose: Useful radiographic parameters for assessing cervical alignment include the Cobb angles, T1 slope (T1S), occipitocervical inclination (OCI), K-line tilt (KLT), and cervical sagittal vertical axis (cSVA). This study aimed to determine measurement accuracy and reliability for these parameters. Overview of Literature: Various authors have assessed repeatability by comparing different methods of measurement, but knowledge of measurement error and minimal detectable change is scarce. Methods: We evaluated 758 lateral cervical radiographs. One medical student and one spine surgeon (i.e., measured ×2 within 4 weeks) independently measured the parameters obtaining 5,850 values. Standard error of measurement (SEm) and minimum detectable change (MDC) were calculated for each parameter. The accuracy and reliability of the Cobb angle measurements were calculated for the different types of angles: cervical lordosis, prosthesis angle, segmental angle with two bone surfaces (SABB), and segmental angle with one bone and one metal surface. Reliability was determined with intraclass correlation coefficient (ICC). Results: SEm was 1.8° and MDC was 5.0° for the Cobb angle, with an intraobserver/interobserver ICC of 0.958/0.886. All the different subtypes of Cobb angles had an ICC higher than 0.950, except SABB (intraobserver/interobserver ICC of 0.922/0.716). The most accurate and reliable measurement was for KLT. Conclusions: This study provides normative data on SEm and MDC for Cobb angles, T1S, KLT, OCI, and cSVA in cervical lateral radiographs. Reliability was excellent for all parameters except SABB (e.g., good).
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Nodoka Manabe,Augusto Covaro,Lukas Bobinski,Takachika Shimizu,Claes Olerud,Yohan Robinson 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.1
Study Design: Retrospective analysis of prospectively collected data. Purpose: To describe the radiological characteristics of the occipitocervical area in patients with ankylosing spondylitis (AS) using the novel measure X-angle and to describe the correlation between the ankylosed occipitoatlantoaxial (OAA) joint and thoracic kyphosis (TK). Overview of Literature: AS affects the axial skeleton, leading to progressive ankylosis of all vertebral segments. The effect of ankylosis on the upper cervical area of these patients is not well documented. Methods: All patients with complete ankylosis of the spinal column between C3 and T1, treated for cervical spinal fracture between 2007 and 2014, were eligible for inclusion in this study. The level of cervical fracture was identified. The T1–12 and T5–12 angles were measured using preoperative lateral radiography. The progressive degeneration of the C0-C1-C2 joints was evaluated via the new indicator X-angle, through the measurement of the angle of the C0-C1-C2 articulations in the coronal plane using computed tomography. Results: We included 86 consecutive patients with AS (67 males) aged 69±12 years. The patients were divided into two groups according to the degenerative change in the C0–C1 joint (62 patients with a mobile joint and 24 patients with an ankylosed joint). There was no significant difference between the two groups in terms of age (p =0.094) and level of fracture (p =0.949). The most commonly affected level was C6. There was no requirement for revision due to non-union in any of the patients. There was a statistically significant difference observed in the T1–12, T5–12, and X-angles (p =0.004, 0.001, and <0.001, respectively). TK was greater in the ankylosed joint group than in the mobile joint group. The X-angle was also greater in the ankylosed joint group because of the vertical destruction of the OAA joint. Conclusions: Thoracic hyperkyphosis resulted in degenerative changes in the C0-C1-C2 joint in patients with AS. The X-angle is a reliable method for measuring the integrity of the C0-C1-C2 joint in such patients.
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Luca Papavero,Gregor Schmeiser,Ralph Kothe,Bronek Boszczyk,Oliver Heese,Yoshiharu Kawaguchi,Anna MacDowall,Claes Olerud,Nikolaos Paidakakos,Anastasios Panagiotou,Tobias Pitzen,Marcus Richter,K. Daniel 대한척추신경외과학회 2020 Neurospine Vol.17 No.1
Objective: To validate with a prospective study a decision-supporting coding system for the surgical approach for multilevel degenerative cervical myelopathy. Methods: Ten cases were presented on an internet platform, including clinical and imaging data. A single-approach (G1), a choice between 2 (G2), or 3 approaches (G3) were options. Senior and junior spine surgeons analyzed 7 parameters: location and extension of the compression of the spinal cord, C-spine alignment and instability, general morbidity and bone diseases, and K-line and multilevel corpectomy. For each parameter, an anterior, posterior, or combined approach was suggested. The most frequent letter or the last letter (if C) of the resulting 7-letter code (7LC) suggested the surgical approach. Each surgeon performed 2 reads per case within 8 weeks. Results: G1: Interrater reliability between junior surgeons improved from the first read (κ=0.40) to the second (κ=0.76, p<0.001) but did not change between senior surgeons (κ=0.85). The intrarater reliability was similar for junior (κ=0.78) and senior (κ=0.71) surgeons. G2: Junior/senior surgeons agreed completely (58%/62%), partially (24%/23%), or did not agree (18%/15%) with the 7LC choice. G3: junior/senior surgeons agreed completely (50%/50%) or partially (50%/50%) with the 7LC choice. Conclusion: The 7LC showed good overall reliability. Junior surgeons went through a learning curve and converged to senior surgeons in the second read. The 7LC helps less experienced surgeons to analyze, in a structured manner, the relevant clinical and imaging parameters influencing the choice of the surgical approach, rather than simply pointing out the only correct one.
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