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Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images

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Abstract

Purpose

An innovative low-dose X-ray biplanar imager (EOS®) allows measurement of the whole-body in standing-position which is necessary for the evaluation of spinal deformities.

Methods

A total of 60 asymptomatic subjects (ages 20–81 years) were evaluated using the 3D workflow called postural assessment and 2D measures. Subjects were measured twice each by two new observers following training, including: lordosis/kyphosis, pelvic parameters, sagittal-vertical axis, and spinal-sacral angle. Intra- and inter-observer reproducibility and similarity were compared between 2D and 3D measures.

Results

The intraclass correlation coefficient (ICC) was very high for the 3D measures (>0.9) and excellent for the 2D measures (>0.75). In all cases, the overall mean absolute difference between repeated 3D measures was less than 2°, or 2 mm. For all parameters, the inter- and intra-observer reproducibility in 3D measures were significantly superior to 2D measures (p < 0.03).

Conclusion

This study demonstrated that 3D measures have better reproducibility than 2D for sagittal balance.

Key Points

• Reproducibility of sagittal balance 2D/3D measurements was evaluated using EOS® full-body radiographs.

• Inter- and intra-observer reproducibility were significantly superior for 3D measures vs. 2D.

• 3D measures have better reproducibility than 2D for sagittal balance.

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Abbreviations

AP:

Anteroposterior

C7:

Seventh cervical vertebra

FBI:

Full-body index

ICC:

Intra-class correlation coefficient

PI:

Pelvic incidence

PT:

Pelvic tilt

QOL:

Quality of life

SS:

Sacral slope

SSA:

Spinal sacral angle

SVA:

Sagittal vertical axis

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Niigata Spine Surgery Center, 2-5-22 Nishi-machi Niigata, Niigata, 950-0165, Japan

    Masashi Okamoto, Shun Hatsushikano & Kazuhiro Hasegawa

  2. Ortho-Spine Department, Bordeaux University Hospital, Bordeaux, France

    Fouad Jabour, Kenichiro Sakai & J. C. Le Huec

Authors
  1. Masashi Okamoto
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  2. Fouad Jabour
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  3. Kenichiro Sakai
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  4. Shun Hatsushikano
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  5. J. C. Le Huec
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  6. Kazuhiro Hasegawa
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Corresponding author

Correspondence to Masashi Okamoto.

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Guarantor

The scientific guarantor of this publication is Masashi Okamoto.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• cross-sectional study

• multicentre study

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Cite this article

Okamoto, M., Jabour, F., Sakai, K. et al. Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images. Eur Radiol 28, 4570–4577 (2018). https://doi.org/10.1007/s00330-018-5485-0

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  • DOI: https://doi.org/10.1007/s00330-018-5485-0

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