Saleh Ifran, Hutami Witantra Dhamar, Librianto Didik, Prasetyo Marcel, Rahyussalim Ahmad Jabir, Hendriarto Andra, Noor Erwin Ardian, Rifki Aliyya
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central Public Hospital, Jakarta, Indonesia.
Department of Orthopaedic and Traumatology, Universitas Indonesia, Fatmawati Central General Hospital, Jakarta, Indonesia.
Global Spine J. 2025 Jan;15(1):241-250. doi: 10.1177/21925682241262713. Epub 2024 Jun 12.
Systematic review, expert opinion and Delphi technique, and validity and reliability studies.
We developed Jakarta Instability Score (JIS) to identify spinal instability and the need of fusion in degenerative lumbar spinal stenosis (LSS).
This study consisted of systematic review to find predictors of spinal instability, expert opinion and modified Delphi technique to develop JIS, and validity and reliability studies of the newly developed JIS.
A total of 54 studies were included in the systematic reviews to obtain predictors of spinal instability. Through expert opinion and modified Delphi technique, JIS was developed and consisted of the clinical component (back pain), dynamic radiograph component (dynamic translation and angulation), and MRI component (facet joint effusion), each of the component would be scored, and the total scoring would be from 0 to 14. The final scoring would classify patients into three groups: stable group (score of 0 to 4) in which the fusion is not needed, potentially unstable group (score of 5 to 8) in which the decision of fusion is based on surgeon's clinical judgment, and unstable group (score of 9 to 14) in which the fusion is needed. Final step of study concluded that this JIS had a high validity and reliability.
The newly developed JIS was a valid and reliable scoring system that could help to identify the presence of instability in LSS and can be used as a guideline to decide whether spinal fusion will be needed.
系统评价、专家意见与德尔菲技术以及效度和信度研究。
我们开发了雅加达不稳定评分（JIS），以识别退行性腰椎管狭窄症（LSS）中的脊柱不稳定情况以及融合的必要性。
本研究包括通过系统评价寻找脊柱不稳定的预测因素，通过专家意见和改良德尔菲技术开发JIS，以及对新开发的JIS进行效度和信度研究。
系统评价共纳入54项研究以获取脊柱不稳定的预测因素。通过专家意见和改良德尔菲技术，开发出了JIS，它由临床部分（背痛）、动态X线片部分（动态移位和角度）以及MRI部分（小关节积液）组成，每个部分都将进行评分，总评分范围为0至14分。最终评分将患者分为三组：稳定组（0至4分），无需融合；潜在不稳定组（5至8分），融合决策基于外科医生的临床判断；不稳定组（9至14分），需要融合。研究的最后一步得出结论，该JIS具有较高的效度和信度。
新开发的JIS是一个有效且可靠的评分系统，有助于识别LSS中不稳定的存在，并可作为决定是否需要脊柱融合的指导。
