Can bending radiographs be useful for Lenke classification system of idiopathic scoliosis?

Methods The radiographs of 30 consecutive patients operated on because of IS were examined. Seven independent researchers assessed the X-rays, in 3 stages at one week intervals. Stage 1: Lenke type was determined on AP and lateral long film standing X-rays. Stage 2: Lenke type was established by use of AP and lateral standing X-rays, completed with supine traction films. Stage 3: Lenke type was indicated using AP and lateral standing, supine traction, and lateral bending films. The order of the radiographs, in each stage, was different and random. The results were determined by calculating the inter-observer and intra-observer agreement, and were quantified using two-rater and multi-rater kappa statistics.