Reliability of sagittal vertical axis measurement and association with measures of age-related hyperkyphosis.
Wendy B Katzman, Neeta Parimi, Amy Gladin and 4 others
PMID 30568327WHAT IT FOUND
Sagittal vertical axis measurement was highly reliable in older adults with hyperkyphosis.
It did not track Cobb angle kyphosis, and more men than women had abnormal sagittal balance at a 5 cm threshold.
Key findings
01The SVA measurement was highly reliable: the same reader got ICC 0.95, and different readers got ICC 0.93.
02SVA was not associated with Cobb angle of kyphosis (r=-0.05, p=0.59).
03Using a 5 cm SVA threshold, 12 men (26.7%) and 5 women (7.5%) were classified as abnormal (p=0.006).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was selected to be able to join a group exercise trial, so it may not represent older adults who are more frail or symptomatic. SVA could not be measured on 2 scans because the C7 vertebra was not visible. Reliability was tested by reading the same radiographs more than once, not by taking separate radiographs. The radiographs did not include the pelvis, so pelvic parameters that can affect sagittal balance were not measured. SVA values were skewed in men, which may have affected gender comparisons.
Declared interests
Funded by a pilot study grant from NIH P50 AR063043 through the Office of Research in Women's Health and the National Institute of Arthritis and Musculoskeletal and Skin Disorders. Authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that a large Cobb angle means poor sagittal balance. Cobb angle and SVA had no significant association (r=-0.05, p=0.59), so they measure different aspects of hyperkyphosis.