Measurement Performance of a Computer Assisted Vertebral Motion Analysis System

被引:11
作者
Davis, Reginald J. [1 ]
Lee, David C. [2 ]
Wade, Chip [3 ]
Cheng, Boyle [4 ]
机构
[1] Greater Baltimore Med Ctr, Dept Neurosurg, Baltimore, MD USA
[2] Southern Neurol & Spinal Inst, Hattiesburg, MS USA
[3] Auburn Univ, Dept Ind & Syst Engn, 3310 Shelby Ctr, Auburn, AL 36849 USA
[4] Drexel Univ, Coll Med, Dept Neurosurg, Pittsburgh, PA USA
关键词
LUMBAR INSTABILITY; FLEXION/EXTENSION RADIOGRAPHS; MOTION ANALYSIS;
D O I
10.14444/2036
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Segmental instability of the lumbar spine is a significant cost within the US health care system; however current thresholds for indication of radiographic instability are not well defined. Purpose To determine the performance measurements of sagittal lumbar intervertebral measurements using computer-assisted measurements of the lumbar spine using motion sequences from a video-fluoroscopic technique. Study design Sensitivity, specificity, predictive values, prevalence, and test-retest reliability evaluation of digitized manual versus computer-assisted measurements of the lumbar spine. Patient sample A total of 2239 intervertebral levels from 509 symptomatic patients, and 287 intervertebral levels from 73 asymptomatic participants were retrospectively evaluated. Outcome measures Specificity, sensitivity, negative predictive value (NPV), diagnostic accuracy, and prevalence between the two measurement techniques; Measurements of Coefficient of repeatability (CR), limits of agreement (LOA), intraclass correlation coefficient (ICC; type 3,1), and standard error of measurement for both measurement techniques. Methods Asymptomatic individuals and symptomatic patients were all evaluated using both the Vertebral Motion Analysis (VMA) system and fluoroscopic flexion extension static radiographs (FE). The analysis was compared to known thresholds of 15% intervertebral translation (IVT, equivalent to 5.3mm assuming a 35mm vertebral body depth) and 25 degrees intervertebral rotation (IVR). Results The VMA measurements demonstrated greater specificity, % change in sensitivity, NPV, prevalence, and reliability compared with FE for radiographic evidence of instability. Specificity was 99.4% and 99.1% in the VMA compared to 98.3% and 98.2% in the FE for IVR and IVT, respectively. Sensitivity in this study was 41.2% and 44.6% greater in the VMA compared to the FE for IVR and IVT, respectively. NPV was 91% and 88% in the VMA compared to 62% and 66% in the FE for IVR and IVT, respectively. Prevalence was 12.3% and 11.9% for the VMA compared to 6.1% and 5.4% for the FE in IVR and IVT, respectively. Intra-observer IVR and IVT had a CR of 2.49 and 2.62, respectively. Inter-observer IVR and IVT had a CR of 1.99 and 2.81, respectively. Intra-subject (test/retest) CR were 2.49 and 3.11 for IVR and IVT, respectively. Conclusions The VMA system showed greater measurement performance in the detection of radiographic instability compared with FE radiographs.
引用
收藏
页数:13
相关论文
共 51 条
[1]  
American Medical Association, 2000, GUIDES EVALUATION PE, P379
[2]   LUMBOSACRAL SEGMENTAL MOTION IN NORMAL INDIVIDUALS - HAVE WE BEEN MEASURING INSTABILITY PROPERLY [J].
BODEN, SD ;
WIESEL, SW .
SPINE, 1990, 15 (06) :571-576
[3]   Diagnosis - Comparative accuracy: assessing new tests against existing diagnostic pathways [J].
Bossuyt, PM ;
Irwig, L ;
Craig, J ;
Glasziou, P .
BRITISH MEDICAL JOURNAL, 2006, 332 (7549) :1089-1092
[4]   An objective spinal motion imaging assessment (OSMIA): reliability, accuracy and exposure data [J].
Breen, AC ;
Muggleton, JM ;
Mellor, FE .
BMC MUSCULOSKELETAL DISORDERS, 2006, 7 (1)
[5]  
Bronfort G, 1994, P INT C SPIN MAN JUN, P35
[6]   MEASUREMENT OF SCOLIOSIS AND KYPHOSIS RADIOGRAPHS - INTRAOBSERVER AND INTEROBSERVER VARIATION [J].
CARMAN, DL ;
BROWNE, RH ;
BIRCH, JG .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1990, 72A (03) :328-333
[7]   Validation of new clinical quantitative analysis software applicable in spine orthopaedic studies [J].
Champain, S. ;
Benchikh, K. ;
Nogier, A. ;
Mazel, C. ;
Guise, J. De. ;
Skalli, W. .
EUROPEAN SPINE JOURNAL, 2006, 15 (06) :982-991
[8]   The reliability of quantitative analysis on digital images of the scoliotic spine [J].
Cheung, J ;
Wever, DJ ;
Veldhuizen, AG ;
Klein, JP ;
Verdonck, B ;
Nijlunsing, R ;
Cool, JC ;
Van Horn, JR .
EUROPEAN SPINE JOURNAL, 2002, 11 (06) :535-542
[9]   A systematic review of diagnostic imaging use for low back pain in the United States [J].
Dagenais, Simon ;
Galloway, Erin K. ;
Roffey, Darren M. .
SPINE JOURNAL, 2014, 14 (06) :1036-1048
[10]   Reliability analysis for manual measurement of coronal plane deformity in adolescent scoliosis. Are 30 x 90 cm plain films better than digitized small films? [J].
De Carvalho, Antonio ;
Vialle, Raphael ;
Thomsen, Laurent ;
Amzallag, Julien ;
Cluzel, Guillaume ;
le Pointe, Hubert Ducou ;
Mary, Pierre .
EUROPEAN SPINE JOURNAL, 2007, 16 (10) :1615-1620