Abstract
ABSTRACT Objective The objective of this study was to analyze the intraobserver and interobserver reliability of the Lenke classification among spine surgeons from the city of Salvador, Bahia. Methods Preoperative imaging (front, profile and lateral inclinations) examinations of 20 patients at the Outpatient Clinic of the of Santa Izabel Hospital Orthopedic Department, Salvador, Bahia, who had been diagnosed with adolescent idiopathic scoliosis, were selected to be evaluated by 15 spine surgeons two times at an interval of 30 days, for analysis of the intraobserver and interobserver reliability of the Lenke classification. The project was first submitted for ethical analysis to the Institutional Review Board of the Santa Izabel Hospital - Santa Casa de Misericórdia da Bahia / Prof. Dr. Celso Figueirôa and approved with voucher number 002650/2019. All the participants signed the Informed Consent Form (ICF). Results Analyzing the concordance using the Kappa index, interobserver reproducibilities of 0.755, 0.525 and 0.840 were obtained for the type of curve and the lumbar and sagittal modifiers, respectively, while the intraobserver reliabilities for the same parameters were 0.921, 0.370 and 0.929. Conclusion For the study population, the reliability of Lenke’s classification was moderate to almost perfect. Level of evidence III; Interobserver and intraobserver reliability.
Highlights
Preoperative imaging examinations of 20 patients at the Outpatient Clinic of the of Santa Izabel Hospital Orthopedic Department, Salvador, Bahia, who had been diagnosed with adolescent idiopathic scoliosis, were selected to be evaluated by 15 spine surgeons two times at an interval of 30 days, for analysis of the intraobserver and interobserver reliability of the Lenke classification
Idiopathic scoliosis is the main cause of spinal deformity
The prevalence of smaller curves is similar between the sexes, but curves greater than 10o are more common in girls, with a 4:1 ratio. It was described by Hippocrates, it was Galen who coined the term scoliosis, and the first classification system was described in 1948 by J
Summary
Idiopathic scoliosis is the main cause of spinal deformity. It is a three-dimensional deformity of the spine in which there is deformity in the coronal plane of more than 10°, hypo- or hyperkyphosis in the sagittal plane, and rotation in the axial plane. The prevalence of smaller curves is similar between the sexes, but curves greater than 10o are more common in girls, with a 4:1 ratio It was described by Hippocrates, it was Galen who coined the term scoliosis (along with kyphosis and lordosis), and the first classification system was described in 1948 by J. According to Lenke, each patient with scoliosis has three curves: proximal thoracic, main thoracic, and thoracolumbar/lumbar. In addition to the type of curve, the Lenke classification includes a lumbar modifier and a thoracic sagittal modifier. To define the lumbar modifier, pelvic obliquity must be corrected and the central vertical line of the sacrum be drawn in the coronal radiograph If this line passes between the pedicles of the apical lumbar vertebra, it receives modifier A.
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