Radiation-free measurement tools to evaluate sagittal parameters in AIS patients: a reliability and validity study

  • Anne Tabard-FougèreEmail author
  • Alice Bonnefoy-Mazure
  • Amira Dhouib
  • Raimonda Valaikaite
  • Stéphane Armand
  • Romain Dayer
Original Article



This study aimed to evaluate the intra-rater reliability and validity in comparison with the two-dimensional radiography (XR) of inclinometer (INCL) and rasterstereography (RAST) for assessing spinal sagittal angles of AIS patients.


Fifty-one AIS patients (13.5 (2.0) years, girls = 32 (63%), Cobb angle = 23.0 (17.4)°) were included in this study. Three repeated measurements of thoracic kyphosis (TK) and lumbar lordosis (LL) were evaluated using the INCL and RAST by the same operator on the same day of the XR examination. Intraclass correlation coefficients (ICC) were used to evaluate the reliability of the INCL and RAST systems. Additionally, Pearson coefficients were computed between the XR and INCL systems and between the XR and RAST systems.


Reliability of each radiation-free system was excellent (ICC > 0.75 for INCL and RAST) for both the TK and LL parameters. The Pearson coefficients between each of the radiation-free systems and the XR were high to moderate for the TK (0.50 < RTK < 0.75 for INCL and RAST), high to moderate for the LL as measured with the RAST (0.50 < RLL < 0.75 for RAST) and low for the LL as measured with the INCL (RLL < 0.50 for INCL).


This study demonstrated that for the RAST and INCL in AIS patients, there was (1) an excellent reliability for the TK and LL, (2) a high-to-moderate validity for measuring the TK and (3) a moderate and low validity for measuring the LL, respectively. These radiation-free systems could be used for the clinical follow-up of AIS patients for the evaluation of the TK.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Rasterstereography Inclinometer Low-dose radiography Adolescent idiopathic scoliosis 



This study was supported by an institutional grant (Geneva University Hospitals, PRD 11-2013-I).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to this work.

Ethical approval

This work was approved by the local ethics committee (CER No. 13-255).

Supplementary material

586_2018_5875_MOESM1_ESM.pptx (1.3 mb)
Supplementary material 1 (PPTX 1335 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Willy Taillard Laboratory of KinesiologyGeneva University Hospitals and Geneva UniversityGenevaSwitzerland
  2. 2.Service of Pediatric Orthopaedics, Department of Child and AdolescentUniversity Hospital of GenevaGenevaSwitzerland
  3. 3.Pediatric Radiology Unit, Department of RadiologyUniversity Hospital of GenevaGenevaSwitzerland

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