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European Spine Journal

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01-10-2012 | Original Article

Interobserver agreement in fusion status assessment after instrumental desis of the lower lumbar spine using 64-slice multidetector computed tomography: impact of observer experience

Authors: Borislav Laoutliev, Inger Havsteen, Birthe Højlund Bech, Eva Narvestad, Hanne Christensen, Anders Christensen

Published in: European Spine Journal | Issue 10/2012

Abstract

Purpose

Persistent lower back pain after instrumental posterolateral desis may arise from incomplete fusion. We investigate the impact of experience on interobserver agreement in fusion estimation.

Methods

Four independent observers, two residents and two musculoskeletal radiologists, reviewed dedicated lumbar 64-MDCT scans and scored vertebral levels 1–5 after Glassman’s grades, 1: solid bilateral fusion, 2: solid unilateral fusion, 3: partial bilateral fusion, 4: partial unilateral fusion, 5: non-fusion. We investigated two simplifying dichotomizations, solid bilateral fusion (Glassman 1) versus all others and uni- or bilateral fusion (Glassman 1–2) versus partial or non-fusion.

Results

Thirty-six patients with 61 operated lumbar levels were included. Interobserver agreement rates for four observers using Glassman’s system were fair (kappa 0.32), either dichotomization showed moderate agreement (kappa 0.53 and 0.59). Observer pairs had comparable prevalence adjusted interobserver agreement rates (residents: PABAK 0.67 and 0.54; consultants: PABAK 0.57 and 0.71).

Conclusions

Difference in observer experience seems of minor impact.

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Title: Interobserver agreement in fusion status assessment after instrumental desis of the lower lumbar spine using 64-slice multidetector computed tomography: impact of observer experience
Authors: Borislav Laoutliev
Inger Havsteen
Birthe Højlund Bech
Eva Narvestad
Hanne Christensen
Anders Christensen
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 10/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2192-4

At a glance: The STEP trials

Springer Medicine

Interobserver agreement in fusion status assessment after instrumental desis of the lower lumbar spine using 64-slice multidetector computed tomography: impact of observer experience

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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