Validation of spinal sagittal alignment with plain radiographs and the Debrunner Kyphometer

Validation of the Debrunner Kyphometer as a clinical non-radiological method for investigating spinal sagittal alignment was compared with standing lateral radiographs. The sample group (n=102) consisted of elite Alpine skiers (n=75) and a non-athletic population (n=27), mean age 17.7 (±1.4) years. Non-radiological and radiological measurements of the spinal sagittal kyphosis and lordosis range of motion were carried out in the erect standing position. Thoracic kyphosis measurements comparing the Debrunner Kyphometer with a radiological standard, showed a good level of agreement and a statistical significance (ICC 0.67, 95% CI: 0.26 to 0.83, p<0.001). Lumbar lordosis measurements showed poor levels of agreement in spite of being statistically significant (ICC 0.33, 95% CI: 0.13 to 0.50, p=0.001). There was no significant difference reported in the spinal alignment between skiers and controls using both radiological and non-radiological methods. Therefore, we conclude that due to the large variation in ranges between both methods, there is a limited value in using the Debrunner Kyphometer as a non-invasive method for the evaluation of spinal sagittal alignment. Key words: Debrunner Kyphometer, kyphosis, lordosis, radiological, spinal sagittal alignment.