Comparative analysis of the Spinometer mobile application and Surgimap system for measuring the sagittal balance parameters: inter-observer reliability test

The purpose of the study was to assess the reliability, accuracy and effectiveness of a mobile application SpinoMeter for measuring the sagittal balance of the spino-pelvic complex in comparison with the desktop preoperative planning system Surgimap. Methods SpinoMeter mobile application was developed in 2019 at the laboratory for Medical Decision Support Systems of Saratov State University. SpinoMeter is intended for measuring the actual and for calculating the optimal parameters of the sagittal balance of the spino-pelvic complex of a particular patient. Pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS) and pelvic tilt (PT) were measured with the help of Surgimap and SpinoMeter. Inter-observer reliability was assessed on X-rays in a standing position of 52 patients having consequences of injuries and pathology of the lumbar spine with imbalance syndrome. The research site was the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University. Measurements of the sagittal balance parameters were presented in tables and diagrams. For all data, the hypothesis of a normal distribution of the measurement results was tested using the Kolmogorov-Smirnov test. To test the hypothesis of homogeneity of the measurement results for normally distributed samples, the paired Student t-test was used. In the absence of a normal distribution, the Wilcoxon test was used for related samples. Results For PI, PT, SS and L1-S1 lordosis at a significance level of 5 %, the hypothesis of uniformity of measurements was confirmed. The average value of L4-S1 lordosis, measured by SpinoMeter, was shifted down relative to the measurements of this parameter by the Surgimap program. The shift did not exceed 0.7 %. Conclusion SpinoMeter mobile application is equivalent to the Surgimap system in terms of measuring the sagittal balance parameters based on radiographs in a standing position.