Scoliosis Research Society—Schwab Adult Spinal Deformity Classification

作者：Frank Schwab, Benjamin Ungar, Benjamin Blondel, Jacob M. Buchowski, Jeffrey D. Coe, Donald Deinlein, Christopher J. DeWald, Hossein Mehdian, Christopher I. Shaffrey, Clifford B. Tribus, Virginie Lafage · 发表于：Spine · 年份：2011 · DOI：10.1097/brs.0b013e31823e15e2 · 被引用次数：1326 · 研究领域：Scoliosis diagnosis and treatment、Spine and Intervertebral Disc Pathology、Hip disorders and treatments

STUDY DESIGN: Inter- and intra-rater variability study. OBJECTIVE: On the basis of a Scoliosis Research Society effort, this study seeks to determine whether the new adult spinal deformity (ASD) classification system is clear and reliable. SUMMARY OF BACKGROUND DATA: A classification of adult ASD can serve several purposes, including consistent characterization of a clinical entity, a basis for comparing different treatments, and recommended treatments. Although pediatric scoliosis classifications are well established, an ASD classification is still being developed. A previous classification developed by Schwab et al has met with clinical relevance but did not include pelvic parameters, which have shown substantial correlation with health-related quality of life measures in recent studies. METHODS: Initiated by the Scoliosis Research Society Adult Deformity Committee, this study revised a previously published classification to include pelvic parameters. Modifier cutoffs were determined using health-related quality of life analysis from a multicenter database of adult deformity patients. Nine readers graded 21 premarked cases twice each, approximately 1 week apart. Inter- and intra-rater variability and agreement were determined for curve type and each modifier separately. Fleiss' kappa was used for reliability measures, with values of 0.00 to 0.20 considered slight, 0.21 to 0.40 fair, 0.41 to 0.60 moderate, 0.61 to 0.80 substantial, and 0.81 to 1.00 almost perfect agreement. ...