Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Feb;18(2):212-7.
doi: 10.1007/s00586-008-0818-3. Epub 2008 Nov 18.

Assessment of lumbosacral kyphosis in spondylolisthesis: a computer-assisted reliability study of six measurement techniques

Panagiotis Glavas  1 , Jean-Marc Mac-Thiong, Stefan Parent, Jacques A de Guise, Hubert Labelle
Affiliations

Assessment of lumbosacral kyphosis in spondylolisthesis: a computer-assisted reliability study of six measurement techniques

Panagiotis Glavas et al. Eur Spine J. 2009 Feb.

Abstract

Although recognized as an important aspect in the management of spondylolisthesis, there is no consensus on the most reliable and optimal measure of lumbosacral kyphosis (LSK). Using a custom computer software, four raters evaluated 60 standing lateral radiographs of the lumbosacral spine during two sessions at a 1-week interval. The sample size consisted of 20 normal, 20 low and 20 high grade spondylolisthetic subjects. Six parameters were included for analysis: Boxall's slip angle, Dubousset's lumbosacral angle (LSA), the Spinal Deformity Study Group's (SDSG) LSA, dysplastic SDSG LSA, sagittal rotation (SR), kyphotic Cobb angle (k-Cobb). Intra- and inter-rater reliability for all parameters was assessed using intra-class correlation coefficients (ICC). Correlations between parameters and slip percentage were evaluated with Pearson coefficients. The intra-rater ICC's for all the parameters ranged between 0.81 and 0.97 and the inter-rater ICC's were between 0.74 and 0.98. All parameters except sagittal rotation showed a medium to large correlation with slip percentage. Dubousset's LSA and the k-Cobb showed the largest correlations (r= -0.78 and r= -0.50, respectively). SR was associated with the weakest correlation (r= -0.10). All other parameters had medium correlations with percent slip (r= 0.31-0.43). All measurement techniques provided excellent inter- and intra-rater reliability. Dubousset's LSA showed the strongest correlation with slip grade. This parameter can be used in the clinical setting with PACS software capabilities to assess LSK. A computer-assisted technique is recommended in order to increase the reliability of the measurement of LSK in spondylolisthesis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The six radiographic parameters of LSK that were evaluated (see text for details.) a Boxall’s slip angle; b Dubousset’s lumbosacral angle, LSA; c Spinal Deformity Study Group’s, SDSG LSA; d SDSG dysplastic LSA; e Sagittal rotation; f kyphotic Cobb angle
Fig. 2
Fig. 2
Dysplastic changes that can occur at the L5 and S1 vertebrae (dotted lines)
See this image and copyright information in PMC

References

    1. Amundson G, Edwards CC, Garfin SR, et al. Spondylolisthesis. In: Herkowitz HN, Garfin SR, Balderston RA, et al., editors. The spine. Philadelphia: W·B. Saunders; 1992. pp. 913–969.
    1. Antoniades SB, Hammerberg KW, Dewald RL. Sagittal plane configuration of the sacrum in spondylolisthesis. Spine. 2000;25:1085–1091. doi: 10.1097/00007632-200005010-00008. - DOI - PubMed
    1. Berthonnaud E, Dimnet J, Labelle H, et al. et al. Spondylolisthesis. In: O’Brien MF, Kuklo TR, Blanke KM, et al.et al., editors. Spinal deformity group radiographic measurement manual. Memphis: Medtronik Sofamor Danek; 2004. pp. 95–108.
    1. Boxall D, Bradford DS, Winter RB, et al. Management of severe spondylolisthesis in children and adolescents. J Bone Joint Surg Am. 1979;61:479–495. - PubMed
    1. Bradford DS, et al. Spondylolysis and spondylolisthesis. In: Lonstein JE, Winter RB, Bradford DS, et al., editors. Textbook of scoliosis and other spinal deformities. Philadelphia: W·B. Saunders; 1995. pp. 399–430.

Publication types