Measurement of lumbar lordosis. Evaluation of intraobserver, interobserver, and technique variability.

Abstract:

STUDY DESIGN:Sixty radiographs were measured on two separate occasions by three physicians using four different techniques to evaluate the reliability and reproducibility of the measurement of lumbar lordosis. OBJECTIVE:To evaluate clinical methods of measuring lumbar lordosis, determining intraobserver and interobserver reliability. SUMMARY OF BACKGROUND DATA:Several different methods are used to measure lumbar lordosis. The reliability and reproducibility of these has not been well studied. METHODS:Sixty lateral full spine radiographs were obtained, labeled, and the lumbar lordosis measured independently by three practitioners who routinely perform these measurements. Four measurement techniques were used. These included measurements from the inferior endplate of T12 to the superior endplate of S1; the superior endplate of L1 to the superior endplate of S1; the inferior endplate of T12 to the inferior endplate of L5; and the superior endplate of L1 to the inferior endplate of L5. The measurements then were repeated after relabeling. RESULTS:Intraobserver reliability coefficients ranged from 0.83 to 0.92, indicating excellent reproducibility. Ninety-two percent of repeat measures were within 10 degrees. High overall and pairwise agreement among the three observers also was present; the interobserver reliability coefficients ranged from 0.81 to 0.92. CONCLUSIONS:The measurement of lumbar lordosis is reproducible and reliable if the technique is specified and one accepts 10 degrees as acceptable variation. Factors that affect the reproducibility of measurement include end vertebra selection (especially with transitional segments) and vertebral endplate architecture.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Polly DW Jr,Kilkelly FX,McHale KA,Asplund LM,Mulligan M,Chang AS

doi

10.1097/00007632-199607010-00008

subject

Has Abstract

pub_date

1996-07-01 00:00:00

pages

1530-5; discussion 1535-6

issue

13

eissn

0362-2436

issn

1528-1159

journal_volume

21

pub_type

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