Inter and intra-observer reliability of pelvic obliquity measurement methods in patients with neuromuscular scoliosis

Purpose Multiple fixation techniques exist for treating progressive neuromuscular scoliosis including pedicle screws, sublaminar bands/wires, hooks or a combination of instruments. Most sublaminar band constructs are supplemented with pedicle screws, hooks and/or sublaminar wires particularly at the top of the construct. There are no studies to date that describe an all/predominant sublaminar band construct. The purpose of this study was to investigate the outcomes of a sublaminar polyester band construct to treat neuromuscular scoliosis. Methods A retrospective review was conducted of 32 cases of neuromuscular scoliosis treated with posterior spinal fusion using a sublaminar band construct between 2013 and 2016 by a single surgeon at a single centre. Preoperative, immediate postoperative and two-year follow-up radiographs and clinical records were reviewed. Sagittal, coronal and pelvic obliquity correction was measured. Blood loss, length of surgery and complications were recorded. Results In all, 29 patients were included. Mean postoperative coronal plane correction was 57% (0% to 92%) and maintained at two-year follow-up. Mean sagittal balance was 2.3 cm (-2.5 to 6.4). Mean lumbar lordosis angle decreased by 7° (44° to 37°). Mean thoracic kyphosis angle increased by 9° (23° to 32°). Mean pelvic obliquity decreased by 50% (from 15° to 7°). There were four major complications (14%) and eight minor complications (21%). Mean blood loss was 1304 cc (250 cc to 2450 cc). Conclusion Sublaminar polyester band fixation constructs provide a viable option in correction of deformity in patients with neuromuscular scoliosis with comparable outcomes with what is reported with other constructs. Level of Evidence: V

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Reliability of pre-operative diffusion tensor imaging parameter measurements of the cervical spine in patients with cervical spondylotic myelopathy

Scientific Reports ◽

10.1038/s41598-020-74624-6 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Eugene Lee ◽

Joon Woo Lee ◽

Yun Jung Bae ◽

Hyo Jin Kim ◽

Yusuhn Kang ◽

...

Keyword(s):

Spinal Cord ◽

Diffusion Tensor Imaging ◽

Cervical Spondylotic Myelopathy ◽

Diffusion Tensor ◽

Intraclass Correlation ◽

Measurement Methods ◽

Retest Reliability ◽

Observer Reliability ◽

Spinal Cord Level ◽

Test Retest Reliability

Abstract The present study assessed test–retest and inter-observer reliability of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy (CSM), as well as the agreement among measurement methods. A total 34 patients (12 men, 22 women; mean age, 58.7 [range 45–79] years) who underwent surgical decompression for CSM, with pre-operative DTI scans available, were retrospectively enrolled. Four observers independently measured fractional anisotropy (FA) values twice, using three different measurement methods. Test–retest and inter-observer reliability was assessed using intraclass correlation coefficients (ICCs). Overall, inter-observer agreements varied according to spinal cord level and the measurement methods used, and ranged from poor to excellent agreement (ICC = 0.374–0.821), with relatively less agreement for the sagittal region of interest (ROI) method. The radiology resident and neuro-radiologist group showed excellent test–retest reliability at almost every spinal cord level (ICC = 0.887–0.997), but inter-observer agreements varied from fair to good (ICC = 0.404–0.747). Despite excellent test–retest reliability of the ROI measurements, FA measurements in patients with CSM varied widely in terms of inter-observer reliability. Therefore, DTI parameter data should be interpreted carefully when applied clinically.

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