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Development and initial validation of classification for severe spinal deformity based on X-ray features

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Abstract

Purpose

To develop a clinically feasible classification for severe spinal deformity based on X-ray features.

Methods

A total of 223 consecutive severe spinal deformity cases who underwent corrective operation were enrolled from 2004 to 2015 retrospectively. Based on X-ray features, a novel classification was developed containing three components: curve types, curve angle and apex location. There were five curve types as follows: single scoliosis (SS), kyphoscoliosis (KS), angular deformity (AD), long curve (LC), and double curves (DC). Curve angle subsection on coronal and sagittal planes including A:90–109, B:110–129, C:130–149, D: > 150. Apex location means the exact level of apex located. Reliability of the classification was tested.

Results

The kappa values for inter-observer and intra-observer reliability of the curve types, curve angle, and apex level were larger than 0.80. X-ray classification for overall patients with severe spinal deformity showed that there were 101 SS cases, 47 KS, 46 AD, 19 LC and 10 DC. For the curve angle, there were grade A 123 cases, B 43, C 18, D 15 on coronal plane and grade A 38, B 17, C 16, and D 19 on sagittal plane. Apex location showed there were 27 patients at T7 or upper levels, 31 on T8, 58 on T9, 45 on T10, 18 on T11, and 44 at T12 or lower levels.

Conclusion

A novel classification for severe spinal deformity was described based on X-ray morphology. A high value for inter-observer and intra-observer reliability was shown. Each subgroup has its particular influence on decision-making and prognostic prediction.

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Funding

The manuscript submitted does not contain information about medical device(s)/drug(s). This work was supported by Fund from the National Natural Science Foundation of China (Grant No 81860403) and the “Special and Joint Program” of Yunnan Provincial Science and Technology Department & Kunming Medical University [Grant No. 2017FE467(-009)].

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Authors and Affiliations

  1. Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, People’s Republic of China

    TingBiao Zhu, YingSong Wang, JingMing Xie, Ying Zhang, Zhi Zhao, Tao Li, ZhiYue Shi & Ni Bi

Authors
  1. TingBiao Zhu
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  2. YingSong Wang
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  3. JingMing Xie
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  4. Ying Zhang
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  5. Zhi Zhao
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  6. Tao Li
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  7. ZhiYue Shi
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  8. Ni Bi
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Corresponding author

Correspondence to JingMing Xie.

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Conflicts of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data and photographs.

Ethics approval

This study was approved by the Institutional Review Board (IRB) of the Second Affiliated Hospital of Kunming Medical University. All patients provided written informed consent for the operation and the related study.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Zhu, T., Wang, Y., Xie, J. et al. Development and initial validation of classification for severe spinal deformity based on X-ray features. Eur Spine J 31, 79–87 (2022). https://doi.org/10.1007/s00586-021-07028-3

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  • DOI: https://doi.org/10.1007/s00586-021-07028-3

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