Computerized Lenke classification of scoliotic spine.

A computer-aided approach was proposed to reduce the variability in the Lenke classification. At the first step, endplate inclination of each vertebra on both the coronal and sagittal radiographs was measured by a computerized system. The Cobb angles of the proximal thoracic, the main thoracic, and the thoracolumbar/lumbar curves were then automatically calculated in the standing and side-bending coronal planes and the standing sagittal plane. A computerized algorithm automatically classified the spinal type. The classification results of 37 scoliotic patients by five observers showed that with the computer aid, the average interobserver and intraobserver kappa values were improved from 0.77 to 0.88 and from 0.68 to 0.83, respectively. This computerized tool can assist in the Lenke classification of scoliosis.