Iclal Erdem Toslak, Lomasney Laurie M, Jones Nathaniel S, Wojewnik Bartosz, Aziz Amany, Alsabban Khalid, Adams William
1 Department of Radiology, Loyola University Medical Center, Maywood, IL, USA.
2 Department of Primary Care Sports Medicine, Loyola University Medical Center, Maywood, IL, USA.
Br J Radiol. 2017 Oct;90(1078):20170286. doi: 10.1259/bjr.20170286. Epub 2017 Aug 22.
To determine if visual spinal canal percentage of facet overlap could be used as a rapid visual pre-screening test to detect developmental bony spinal canal narrowing on lateral cervical radiographs.
Lateral cervical spine radiographs with radiology report documenting developmental narrowing of the spine canal were retrospectively identified. Cohort was supplemented with additional images without such documentation. Utilizing a radiology work station, one reader (Orthopaedics) calculated the Torg ratio at C3-C6. Two readers (Radiology, Primary Care Sports Medicine) visually estimated percentage (≥80, ≥90, 100%) of spinal canal overlaid by facet articulations C3-C6 for all cases independently. Statistical analysis included accuracy tests and kappa test for comparing the gold standard and inter-, intra-observer reliability, respectively.
96 lateral images were included; 25 had abnormal radiology reports. High specificity (range, 91-93%) and true negative predictive values (range, 88-93%) achieved consistent statistical significance for relationship between facet/canal overlap and Torg ratio for both combined and individual data points. Sensitivity values (range, 59-75%) showed a trend toward association, with statistical significance for only the C3 level at 80% overlap. Interobserver agreement was substantial. Intra-observer reliability was moderate to perfect.
Visual estimation of percentage of facet overlap of the spinal canal is a valid tool to identify individuals with potential developmental narrowing of the spinal canal as a screening prompt to select which patients may need formal calculation utilizing accepted metrics. Advances in knowledge Visual estimation of percentage of facet overlap from lateral radiographs can predict developmental narrowing of cervical spinal canal.
确定小关节重叠的视觉椎管百分比是否可作为一种快速视觉预筛查测试，以检测颈椎侧位X线片上的发育性骨性椎管狭窄。
回顾性识别有放射学报告记录椎管发育性狭窄的颈椎侧位X线片。队列中补充了没有此类记录的额外图像。一名阅片者（骨科医生）利用放射学工作站计算C3 - C6节段的Torg比率。两名阅片者（放射科医生、基层医疗运动医学医生）独立目测估计所有病例中C3 - C6节段小关节覆盖的椎管百分比（≥80%、≥90%、100%）。统计分析包括准确性测试和kappa测试，分别用于比较金标准以及观察者间和观察者内的可靠性。
纳入96张侧位图像；25张有异常放射学报告。对于合并数据点和单个数据点，小关节/椎管重叠与Torg比率之间的关系，高特异性（范围为91% - 93%）和真阴性预测值（范围为88% - 93%）均达到一致的统计学意义。敏感性值（范围为59% - 75%）显示出一种关联趋势，仅在80%重叠时C3节段具有统计学意义。观察者间一致性良好。观察者内可靠性为中等至完美。
目测估计椎管小关节重叠百分比是一种有效的工具，可用于识别可能存在椎管发育性狭窄的个体，作为一种筛查提示，以选择哪些患者可能需要使用公认指标进行正式计算。知识进展 从侧位X线片目测估计小关节重叠百分比可预测颈椎管发育性狭窄。
