用于确定腰骶部后外侧融合的影像学方法的可靠性分析
Reliability analysis of radiographic methods for determination of posterolateral lumbossacral fusion.
作者信息
Gotfryd Alberto Ofenhejm, Pomar Felipe de Moraes, Carneiro Neto Nicola Jorge, Franzin Fernando José, Rodrigues Luciano Miller Reis, Poletto Patricia Rios
机构信息
Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.
Faculdade de Medicina do ABC, Santo André, SP, Brazil.
出版信息
Einstein (Sao Paulo). 2014 Apr;12(2):198-203. doi: 10.1590/s1679-45082014ao2964.
OBJECTIVE
To analyze intra and interobserver agreement of two radiographic methods for evaluation of posterolateral lumbar arthrodesis.
METHODS
Twenty patients undergoing instrumented posterolateral fusion were evaluated by anteroposterior and dynamic lateral radiographs in maximal flexion and extension. The images were evaluated initially by 6 orthopedic surgeons, and after 8 weeks, reassessed by 4 of them, totaling 400 radiographic measurements. Intra and interobserver reliability were analyzed using the Kappa coefficient and Landis and Koch criteria.
RESULTS
Intra and interobserver agreement regarding anteroposterior radiographs were, respectively, 76 and 63%. On lateral views, these values were 78 and 84%, respectively. However, the Kappa analysis showed poor intra and interobserver agreement in most cases, regardless of the radiographic method used.
CONCLUSION
There was poor intra and interobserver agreement in the evaluation of lumbosacral fusion by plain film in anteroposterior and dynamic lateral views, with no statistical superiority between the methods.
目的
分析两种影像学方法评估腰椎后外侧融合术时观察者内和观察者间的一致性。
方法
对20例行器械辅助后外侧融合术的患者，在最大前屈和后伸位拍摄前后位及动态侧位X线片进行评估。最初由6名骨科医生对图像进行评估，8周后，其中4名医生重新评估，共进行400次影像学测量。采用Kappa系数以及Landis和Koch标准分析观察者内和观察者间的可靠性。
结果
前后位X线片的观察者内和观察者间一致性分别为76%和63%。侧位片上，这些值分别为78%和84%。然而，Kappa分析显示，无论使用何种影像学方法，在大多数情况下观察者内和观察者间的一致性都较差。
结论
在腰骶部融合的前后位及动态侧位平片评估中，观察者内和观察者间的一致性较差，两种方法之间无统计学上的优势。
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