An Inter‐ and Intra‐Rater Agreement Assessment of Two Novel Classification Systems for Coronal Imbalance in Adult Scoliosis and Spine Deformity

作者：Muradil Mardan, Mardan Mamat, Parhat Yasin, Xiaoyu Cai, Guo‐Jun Fan, Tao Xu, Bo Li, Pengbo Chen, Zeyu Lu, Weibin Sheng, Sheng‐Dan Jiang, Lei‐Sheng Jiang, Xin‐Feng Zheng · 发表于：Orthopaedic Surgery · 年份：2025 · DOI：10.1111/os.14356 · 被引用次数：2 · 研究领域：Scoliosis diagnosis and treatment、Spine and Intervertebral Disc Pathology、Cervical and Thoracic Myelopathy

OBJECTIVE: Coronal malalignment is a common feature of adult spinal deformity, and accurate classification is essential for diagnosis and treatment planning. However, variations in interpretation among clinicians can impact classification consistency. By assessing the reliability and applicability of these systems across different medical experts, this study seeks to establish a standardized approach to enhance clinical outcomes. This study aimed to evaluate the inter- and intra-observer agreement of two classification systems for coronal malalignment in adult spinal deformity patients, as proposed by Qiu et al. and Obeid et al. METHODS: We analyzed 70 cases of adult spinal deformity collected between January 1, 2010, and April 20, 2023, using the classification systems proposed by Qiu et al. and Obeid et al. To assess inter- and intra-rater agreement, the same group of researchers re-evaluated all cases in a random order after a 4-week interval. We used the kappa statistic (κ) for inter- and intra-rater agreement assessment. RESULTS: Qiu's classification system: Inter-rater agreement: Substantial agreement (κ = 0.76; 95% CI: 0.72-0.80) for Type A, Type B, and Type C. Intra-rater agreement: Nearly perfect agreement (κ = 0.83; 95% CI: 0.78-0.89) within raters for Type A, Type B, and Type C. Obeid's classification system: Inter-rater agreement: Almost perfect agreement (κ = 0.85; 95% CI: 0.83-0.87) for Type 0, Type 1, and Type 2. Complete system: Substantial agreement (κ = 0.68...