Rib Cage Measurement Reproducibility Using Biplanar Stereoradiographic 3D Reconstructions in Adolescent Idiopathic Scoliosis

Abstract

Study design: A reproducibility study of preoperative rib cage 3D measurements was conducted for patients with Adolescent Idiopathic Scoliosis (AIS). Objective: to assess the reliability of rib cage 3D reconstructions using biplanar stereoradiography in patients with AIS before surgery. Summary: no prior reliability study has been performed for preoperative 3D reconstructions of the rib cage by using stereoradiography in patients with preoperative AIS. Materials: this series includes 21 patients with Lenke 1 or 2 scoliosis (74°+ - 20). All patients underwent low-dose standing biplanar radiographs. Two operators performed reconstructions twice each. Intraoperator repeatability, interoperator reproducibility and Intraclass coefficients (ICC) were calculated and compared between groups. Results: The average rib cage volume was 4.7l L (SD ± 0.75 L). SDr was 0.19 L with a coefficient of variation of 4.1% ; ICC was 0.968. The thoracic index was 0.6 (SD ± 0.1). SDr was 0.03 with a coefficient of variation of 4.7 % and a ICC of 0.820. As for the Spinal Penetration Index (6.4% ; SD ± 2.4), SDr was 0.9 % with a coefficient of variation of 14.3 % and a ICC of 0.901. The 3D rib hump SDr (average 27° ± 8°) was 1.4°. The coefficient of variation and ICC were respectively 5.1% and 0.991. Conclusion: 3D reconstruction of the rib cage using biplanar stereoradiography is a reliable method to estimate preoperative thoracic parameters in patients with AIS.