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Surgimap软件测量青少年特发性脊柱侧凸Cobb角的可行性研究
蒋戚△,李博△,陈锴,周潇逸,翟骁,陈自强,李明*
0
(海军军医大学(第二军医大学)长海医院骨科脊柱外科, 上海 200433
共同第一作者
*通信作者)
摘要:
目的 探讨使用Surgimap软件测量青少年特发性脊柱侧凸(AIS)Cobb角的可行性与可重复性。方法 4名医师(1名副主任医师、3名住院医师)分别使用Surgimap软件和传统测量法对67例AIS患者术前标准站立位脊柱全长正侧位X线片的冠状位主弯Cobb角及矢状位胸椎后凸角(TK)、胸腰后凸角(TLK)、腰椎前凸角(LL)进行测量,记录并比较两种方法的测量时间。对4名医师使用Surgimap软件测量的结果进行一致性检验(可信度分析),对3名住院医师两次测量结果进行观察者内一致性检验(可重复性分析)。结果 使用Surgimap软件和传统测量法测量的主弯Cobb角分别为49.4°±8.2°和41.4°±15.6°,两种方法测量结果的绝对平均差值为8.29°±4.36°;测量时间分别为(5.2±0.7)min、(8.8±1.5)min,测量时间差为(3.6±0.9)min,差异有统计学意义(t=2.57,P<0.01)。可信度分析显示,4名医师使用Surgimap软件测量冠状位主弯Cobb角和矢状位TK、TLK、LL均有极佳或好的一致性(组内相关系数分别为0.972、0.924、0.875、0.962)。可重复性分析显示,3名住院医师前后2次使用Surgimap软件测量冠状位主弯Cobb角和矢状位TK、TLK、LL均有极佳或好的一致性(组内相关系数为0.875~0.984)。结论 Surgimap软件测量Cobb角优于传统测量法,具有效率高、学习曲线短、数据可统一导出等优势。
关键词:  青少年  特发性脊柱侧凸  Cobb角  Surgimap软件  传统测量
DOI:10.16781/j.0258-879x.2019.04.0372
投稿时间:2019-01-14修订日期:2019-04-19
基金项目:上海市科学技术委员会基金(17441900500).
Surgimap software measuring Cobb angle of adolescent idiopathic scoliosis: a feasibility study
JIANG Qi△,LI Bo△,CHEN Kai,ZHOU Xiao-yi,ZHAI Xiao,CHEN Zi-qiang,LI Ming*
(Department of Spine Surgery, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To explore the feasibility and repeatability of Surgimap software in measurement of Cobb angle of adolescent idiopathic scoliosis (AIS). Methods Four surgeons (1 associate chief physician and 3 residents) measured the coronal main curve Cobb angle and sagittal parameters (thoracic kyphosis[TK], thoracolumbar kyphosis[TLK] and lumbar lordosis[LL]) of 67 AIS patients using Surgimap software and traditional measurement method on standard standing position X-ray images before operation. The measurement time of the two methods was recorded and compared. The reliability analysis was performed for the measurement results of 4 surgeons, and the repeatability analysis was performed for 2 measurement results of 3 residents. Results The coronal main curve Cobb angles measured by Surgimap software and traditional measurement method were 49.4°±8.2° and 41.4°±15.6°, respectively, and the absolute average difference between the two methods was 8.29°±4.36°. The measurement time of Surgimap software and traditional measurement method was (5.2±0.7) min and (8.8±1.5) min, respectively, with the absolute average difference being (3.6±0.9) min, and the difference was significant (t=2.57, P<0.01). The reliability analysis showed that the coronal main curve Cobb angle, TK, TLK and LL measured by 4 surgeons using Surgimap software had excellent or good consistency (intraclass correlation coefficient[ICC]=0.972, 0.924, 0.875, 0.962). Repeatability analysis showed that the coronal main curve Cobb angle, TK, TLK and LL measured by 3 residents had excellent or good consistency using Surgimap software (ICC ranged from 0.875 to 0.984). Conclusion Surgimap software is superior to the traditional method in measuring Cobb angle, and has the advantages of high efficiency, short learning curve and unified data derivation.
Key words:  adolescent  idiopathic scoliosis  Cobb angle  Surgimap software  traditional measurement