The challenge of measuring spinopelvic parameters: inter-rater reliability before and after minimally invasive lumbar spondylodesis.
Inter-rater reliability
Intra-class correlation coefficient
Lumbar spondylodesis
Minimally invasive
Sagittal alignment
Sagittal balance
Spine surgery
Spinopelvic parameters
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
31 Jan 2022
31 Jan 2022
Historique:
received:
15
10
2021
accepted:
17
01
2022
entrez:
1
2
2022
pubmed:
2
2
2022
medline:
3
2
2022
Statut:
epublish
Résumé
The common manual measurement technique of spinal sagittal alignment on X-rays is susceptible to rater-dependent variability, which has not been adequately considered in previous publications. This study investigates the effect of those variations in the characterization of patients receiving lumbar spondylodesis. General alignment parameters on pre- and postoperative X-rays were evaluated by four raters in 43 prospectively sampled patients undergoing monolevel spondylodesis. The Intra-class Correlation Coefficient (ICC) for each rater pair and all raters together was calculated for inter-rater reliability. For the operation-induced change of the sagittal alignment in every patient the Wilcoxon test was applied to compare for each rater separately. The ICCs were "good" (>0.75) to "excellent" (>0.9) for all raters together and for 45 of the 48 single rater pairs (93.75%). All revealed a significant increase of the addressed segmental lordosis and disc height and no significant change for spinopelvic parameters and sagittal vertical axis from pre- to postoperative. The lumbar lordosis showed a significant increase through the operation of +2.5° (p = 0.014) and +3.7° (p = 0.015) in two raters and no difference for the other ones (+2.1°, p = 0.171; -2.2°, p = 0.522). The pre- to postoperative change of lumbar lordosis revealed different significance levels for different raters, although the ICCs were formally good. Accordingly, the evaluation by only one rater would lead to different conclusions. Due to this susceptibility of alignment measurements to rater-dependent variability, the exact evaluation process should be described in every publication and the consistency of significant results be validated through multiple raters. The trial was approved by the local ethics committee and listed at the national clinical trials register ( DRKS00004514 , date of registration: 08/11/2012).
Sections du résumé
BACKGROUND
BACKGROUND
The common manual measurement technique of spinal sagittal alignment on X-rays is susceptible to rater-dependent variability, which has not been adequately considered in previous publications. This study investigates the effect of those variations in the characterization of patients receiving lumbar spondylodesis.
METHODS
METHODS
General alignment parameters on pre- and postoperative X-rays were evaluated by four raters in 43 prospectively sampled patients undergoing monolevel spondylodesis. The Intra-class Correlation Coefficient (ICC) for each rater pair and all raters together was calculated for inter-rater reliability. For the operation-induced change of the sagittal alignment in every patient the Wilcoxon test was applied to compare for each rater separately.
RESULTS
RESULTS
The ICCs were "good" (>0.75) to "excellent" (>0.9) for all raters together and for 45 of the 48 single rater pairs (93.75%). All revealed a significant increase of the addressed segmental lordosis and disc height and no significant change for spinopelvic parameters and sagittal vertical axis from pre- to postoperative. The lumbar lordosis showed a significant increase through the operation of +2.5° (p = 0.014) and +3.7° (p = 0.015) in two raters and no difference for the other ones (+2.1°, p = 0.171; -2.2°, p = 0.522).
CONCLUSIONS
CONCLUSIONS
The pre- to postoperative change of lumbar lordosis revealed different significance levels for different raters, although the ICCs were formally good. Accordingly, the evaluation by only one rater would lead to different conclusions. Due to this susceptibility of alignment measurements to rater-dependent variability, the exact evaluation process should be described in every publication and the consistency of significant results be validated through multiple raters.
TRIALS REGISTRATION
BACKGROUND
The trial was approved by the local ethics committee and listed at the national clinical trials register ( DRKS00004514 , date of registration: 08/11/2012).
Identifiants
pubmed: 35101020
doi: 10.1186/s12891-022-05055-9
pii: 10.1186/s12891-022-05055-9
pmc: PMC8802499
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104Informations de copyright
© 2022. The Author(s).
Références
Spine J. 2017 Nov;17(11):1601-1610
pubmed: 28527756
Clin Spine Surg. 2017 Aug;30(7):291-296
pubmed: 28746123
World Neurosurg. 2018 Nov;119:e200-e208
pubmed: 30036716
Spine (Phila Pa 1976). 2017 Nov 1;42(21):1614-1621
pubmed: 28306640
Eur Spine J. 2014 Oct;23 Suppl 6:705-13
pubmed: 25228107
Eur Spine J. 2011 Sep;20 Suppl 5:669-80
pubmed: 21818597
Bull Acad Natl Med. 2005 Feb;189(2):287-97; discussion 297-300
pubmed: 16114859
Tutor Quant Methods Psychol. 2012;8(1):23-34
pubmed: 22833776
Rev Med Suisse. 2011 Dec 21;7(322):2470-4
pubmed: 22288284
Eur Spine J. 2011 Sep;20 Suppl 5:663-8
pubmed: 21809014
Asian Spine J. 2018 Aug;12(4):775-783
pubmed: 30060389
Eur Spine J. 2019 Sep;28(9):1889-1905
pubmed: 31332569
Spine J. 2012 May;12(5):433-46
pubmed: 22480531
Neurosurgery. 2015 Mar;76 Suppl 1:S42-56; discussion S56
pubmed: 25692368
Asian Spine J. 2019 Jul 09;:904-912
pubmed: 31281175
Neurol Med Chir (Tokyo). 2015;55(7):547-56
pubmed: 26119895
J Spinal Disord Tech. 2005 Feb;18(1):66-71
pubmed: 15687855
Spine J. 2015 Jul 01;15(7):1527-35
pubmed: 25725366
Clin Spine Surg. 2016 Mar;29(2):E87-92
pubmed: 26889997
Spine (Phila Pa 1976). 2015 May 15;40(10):703-9
pubmed: 25394314
J Pediatr Orthop. 2009 Mar;29(2):157-62
pubmed: 19352241
Eur Spine J. 2015 Jul;24(7):1574-81
pubmed: 25724685
Spine (Phila Pa 1976). 2010 Apr 20;35(9):989-94
pubmed: 20228703
Trials. 2015 Apr 09;16:142
pubmed: 25873233
J Chiropr Med. 2016 Jun;15(2):155-63
pubmed: 27330520
Spine (Phila Pa 1976). 1996 Jul 1;21(13):1530-5; discussion 1535-6
pubmed: 8817780
BMC Musculoskelet Disord. 2011 Apr 05;12:69
pubmed: 21466688
Spine (Phila Pa 1976). 2016 Jul 15;41(14):1167-1172
pubmed: 26863261
J Neurosurg Spine. 2012 Jun;16(6):547-64
pubmed: 22443546
J Clin Neurosci. 2017 Feb;36:76-79
pubmed: 27765562
Eur Spine J. 2006 Oct;15(10):1449-53
pubmed: 16596420
J Neurosurg Spine. 2011 Jul;15(1):92-6
pubmed: 21476802