Measurement of Spinopelvic Parameters on Standing Lateral Lumbar Radiographs: Validity and Reliability

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Abstract

Study Design:

This was a radiographic validity and reliability study.

Objective:

We assessed the validity and reliability of measurements made on standing lateral lumbar radiographs, compared with lateral whole-spine radiographs, for evaluating spinopelvic parameters and lumbar lordosis (LL).

Summary of Background Data:

A lateral whole-spine radiograph is the gold standard image for measurement of spinopelvic parameters. However, little evidence is available on the reliability of measurements made on such radiograph. A standing lateral lumbar radiograph is routinely obtained from patients with back pain and/or a disability. This image can include upper end plate of L1 vertebra, sacral dome and both femoral heads. Thus, this radiograph can be used for evaluation of spinopelvic parameters.

Materials and Methods:

We randomly selected 50 sets of digital radiographs (standing lateral lumbar and lateral whole-spine radiographs) from our database. Three experienced spinal surgeons independently measured LL, pelvic incidence, pelvic tilt, and sacral slope on all images. A paired t test and Pearson correlation was used to analyze the validity of the lateral lumbar radiograph. Interobserver and intraobserver reliabilities were assessed by intraclass correlation coefficient.

Results:

Thee spinopelvic parameters and LL measured on lateral lumbar radiographs were similar to those measured on lateral whole-spine radiographs (All P-values >0.05, Pearson correlation coefficients, 0.807–0.969). The intraobserver and interobserver reproducibilities of both measurement types were good-to-excellent.

Conclusions:

Spinopelvic parameters and LL values measured on lateral lumbar radiographs were reproducibly similar to those measured on lateral whole-spine radiographs. Use of a standing lateral lumbar radiograph is reasonable when spinopelvic parameters and LL are to be measured.

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