Posterior disk displacement: Morphologic assessment and measurement reliability—lumbar spine

Cooley, Jeffrey; Danielson, Clark D.; Schultz, Gary D.; Hall, Timothy A.

doi:10.1067/mmt.2001.115266

Cited by 7 publications

(2 citation statements)

References 24 publications

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“…Out of 34 studies, only 17 reported reproducibility, and only one of these studies [48] used an appropriate statistical method – in that case, LOA. Eight of the remaining studies [8,33,34,38,48,52,55,57] used ICC, which is a measure of reliability, not agreement [45]. Furthermore, only one out of these eight studies reported an error estimate [55].…”

Section: Discussionmentioning

confidence: 99%

A method for quantitative measurement of lumbar intervertebral disc structures: an intra- and inter-rater agreement and reliability study

Tunset¹,

Kjær²,

Chreiteh³

et al. 2013

Chiropr Man Therap

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BackgroundThere is a shortage of agreement studies relevant for measuring changes over time in lumbar intervertebral disc structures. The objectives of this study were: 1) to develop a method for measurement of intervertebral disc height, anterior and posterior disc material and dural sac diameter using MRI, 2) to evaluate intra- and inter-rater agreement and reliability for the measurements included, and 3) to identify factors compromising agreement.MethodsMeasurements were performed on MRIs from 16 people with and 16 without lumbar disc herniation, purposefully chosen to represent all possible disc contours among participants in a general population study cohort. Using the new method, MRIs were measured twice by one rater and once by a second rater. Agreement on the sagittal start- and end-slice was evaluated using weighted Kappa. Length and volume measurements were conducted on available slices between intervertebral foramens, and cross-sectional areas (CSA) were calculated from length measurements and slice thickness. Results were reported as Bland and Altman’s limits of agreement (LOA) and intraclass correlation coefficients (ICC).ResultsWeighted Kappa (Kw (95% CI)) for start- and end-slice were: intra-: 0.82(0.60;0.97) & 0.71(0.43;0.93); inter-rater: 0.56(0.29;0.78) & 0.60(0.35;0.81). For length measurements, LOA ranged from [−1.0;1.0] mm to [−2.0;2.3] mm for intra-; and from [−1.1; 1.4] mm to [−2.6;2.0] mm for inter-rater. For volume measurements, LOA ranged from [−293;199] mm3 to [−582;382] mm3 for intra-, and from [−17;801] mm3 to [−450;713] mm3 for inter-rater. For CSAs, LOA ranged between [−21.3; 18.8] mm2 and [−31.2; 43.7] mm2 for intra-, and between [−10.8; 16.4] mm2 and [−64.6; 27.1] mm2 for inter-rater. In general, LOA as a proportion of mean values gradually decreased with increasing size of the measured structures. Agreement was compromised by difficulties in identifying the vertebral corners, the anterior and posterior boundaries of the intervertebral disc and the dural sac posterior boundary. With two exceptions, ICCs were above 0.81.ConclusionsLength measurements and calculated CSAs of disc morphology and dural sac diameter from MRIs showed acceptable intra- and inter-rater agreement and reliability. However, caution should be taken when measuring very small structures and defining anatomical landmarks.

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Section: Discussionmentioning

confidence: 99%

A method for quantitative measurement of lumbar intervertebral disc structures: an intra- and inter-rater agreement and reliability study

Tunset¹,

Kjær²,

Chreiteh³

et al. 2013

Chiropr Man Therap

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show abstract

“…Once digitized, the radiographic image is analyzed using a software program which provides measuring tools but still requires the clinician to manually select the fiducial points for measurement [19]. According to Cooley et al [7] a millimetric ruler is an acceptable alternative to digital measurement devices. Regardless of the method used, distortion of the image can occur, leading to erroneous results [31].…”

Section: Discussionmentioning

confidence: 99%

Effect of long-term axial spinal unloading on vertebral body height in adult thoracolumbar spine

Kermani

Soroush

2008

Eur Spine J

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The human spine is influenced by mechanical loads. To our knowledge, this is the first study to assess the effect of long-term axial unloading on morphology of healthy vertebras in adults. The objective of this study is to quantify the effects of long-term relative axial unloading on thoracolumbar vertebral body height in adults. In this study, 218 vertebras on 200 plain lateral radiograms of patients with thoracolumbar vertebral body fracture, which underwent long segment instrumentation and fusion and had a relative axial unloading on five vertebrae of thoracolumbar spine were evaluated. Anterior vertebral body height (AVBH) and posterior vertebral body height (PVBH) proximal and distal to the fractured vertebrae were measured before and at least 1 year after the unloading operative procedures. AVBH of the first distal adjacent vertebrae and summative AVBHs of the first distal and proximal adjacent vertebras to the fractured vertebrae were significantly increased after 1 year of unloading, whereas the PVBH changes were not noticeable and the mean of cumulative height of two levels of proximal and distal adjacent vertebras to the fractured vertebrae did not show significant difference. Vertebral body height of lumbar was more influenced by unloading when compared with thoracic spine. Long-term relative axial unloading can affect the height of healthy vertebral bodies in adult spine.

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Imaging of Adults with Low Back Pain in the Primary Care Setting

Sammer

Jarvik

Evidence-Based Imaging

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Posterior disk displacement: Morphologic assessment and measurement reliability—lumbar spine

Abstract: Different disk types demonstrated distinct size averages. Interexaminer agreement was good concerning disk assessment and measurements. Intraexaminer agreement was lower than expected. A millimetric ruler is an acceptable alternative to digital measurement devices.

Cited by 7 publications

References 24 publications

A method for quantitative measurement of lumbar intervertebral disc structures: an intra- and inter-rater agreement and reliability study

A method for quantitative measurement of lumbar intervertebral disc structures: an intra- and inter-rater agreement and reliability study

Effect of long-term axial spinal unloading on vertebral body height in adult thoracolumbar spine

Imaging of Adults with Low Back Pain in the Primary Care Setting

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