Posterior disk displacement: Morphologic assessment and measurement reliability—lumbar spine

Background: Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic herniations exists. To design a study that evaluates for a causal relationship, preliminary data must be obtained relating to the si...

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Published inJournal of manipulative and physiological therapeutics Vol. 24; no. 5; pp. 317 - 326
Main Authors Cooley, Jeffrey R., Danielson, Clark D., Schultz, Gary D., Hall, Timothy A.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2001
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Abstract Background: Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic herniations exists. To design a study that evaluates for a causal relationship, preliminary data must be obtained relating to the size of different types of disk displacement. The reliability of chiropractic radiologists in assessing disks and a comparison of different measuring devices should also be evaluated. Objective: To identify average measurements for normal and displaced disks and to assess the reliability of measurements by chiropractic radiologists. Study Design: Intraobserver and interobserver reliability study assessing disk displacement on magnetic resonance scans. Methods: Three evaluators assessed the disks on 122 magnetic resonance scans from two imaging centers. Six categories were graded, and digitizer and ruler measurements were compared. Forty-four scans were reassessed for intraobserver agreement. Intraobserver and interobserver variations were measured with intraclass correlation coefficient and kappa statistical analysis. Measurement device correlation was assessed with Pearson's r. Results: Clear size differences between different types of disk displacement were noted. Interexaminer measurement reliability was 0.78 to 0.84. Agreement concerning the presence of disk displacement was 85% (κ = 0.68), and the classification of disk displacements was 76% (κ = 0.60). Intraexaminer measurement reliability was 0.40 to 0.49. Intraexaminer agreement concerning the presence of disk displacement was 76% (κ = 0.52), and the classification of disk displacements was 62% to 69% (κ = 0.38 to 0.46). Normal versus bulged disk distinctions demonstrated the most disagreement. The ruler and digitizer correlation coefficient was 0.968. Conclusions: Different disk types demonstrated distinct size averages. Interexaminer agreement was good concerning disk assessment and measurements. Intraexaminer agreement was lower than expected. A millimetric ruler is an acceptable alternative to digital measurement devices. (J Manipulative Physiol Ther 2001;24:317-26)
AbstractList BACKGROUNDMagnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic herniations exists. To design a study that evaluates for a causal relationship, preliminary data must be obtained relating to the size of different types of disk displacement. The reliability of chiropractic radiologists in assessing disks and a comparison of different measuring devices should also be evaluated.OBJECTIVETo identify average measurements for normal and displaced disks and to assess the reliability of measurements by chiropractic radiologists.STUDY DESIGNIntraobserver and interobserver reliability study assessing disk displacement on magnetic resonance scans.METHODSThree evaluators assessed the disks on 122 magnetic resonance scans from two imaging centers. Six categories were graded, and digitizer and ruler measurements were compared. Forty-four scans were reassessed for intraobserver agreement. Intraobserver and interobserver variations were measured with intraclass correlation coefficient and kappa statistical analysis. Measurement device correlation was assessed with Pearson's r.RESULTSClear size differences between different types of disk displacement were noted. Interexaminer measurement reliability was 0.78 to 0.84. Agreement concerning the presence of disk displacement was 85% (kappa = 0.68), and the classification of disk displacements was 76% (kappa = 0.60). Intraexaminer measurement reliability was 0.40 to 0.49. Intraexaminer agreement concerning the presence of disk displacement was 76% (kappa = 0.52), and the classification of disk displacements was 62% to 69% (kappa = 0.38 to 0.46). Normal versus bulged disk distinctions demonstrated the most disagreement. The ruler and digitizer correlation coefficient was 0.968.CONCLUSIONSDifferent disk types demonstrated distinct size averages. Interexaminer agreement was good concerning disk assessment and measurements. Intraexaminer agreement was lower than expected. A millimetric ruler is an acceptable alternative to digital measurement devices.
Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic herniations exists. To design a study that evaluates for a causal relationship, preliminary data must be obtained relating to the size of different types of disk displacement. The reliability of chiropractic radiologists in assessing disks and a comparison of different measuring devices should also be evaluated. To identify average measurements for normal and displaced disks and to assess the reliability of measurements by chiropractic radiologists. Intraobserver and interobserver reliability study assessing disk displacement on magnetic resonance scans. Three evaluators assessed the disks on 122 magnetic resonance scans from two imaging centers. Six categories were graded, and digitizer and ruler measurements were compared. Forty-four scans were reassessed for intraobserver agreement. Intraobserver and interobserver variations were measured with intraclass correlation coefficient and kappa statistical analysis. Measurement device correlation was assessed with Pearson's r. Clear size differences between different types of disk displacement were noted. Interexaminer measurement reliability was 0.78 to 0.84. Agreement concerning the presence of disk displacement was 85% (kappa = 0.68), and the classification of disk displacements was 76% (kappa = 0.60). Intraexaminer measurement reliability was 0.40 to 0.49. Intraexaminer agreement concerning the presence of disk displacement was 76% (kappa = 0.52), and the classification of disk displacements was 62% to 69% (kappa = 0.38 to 0.46). Normal versus bulged disk distinctions demonstrated the most disagreement. The ruler and digitizer correlation coefficient was 0.968. Different disk types demonstrated distinct size averages. Interexaminer agreement was good concerning disk assessment and measurements. Intraexaminer agreement was lower than expected. A millimetric ruler is an acceptable alternative to digital measurement devices.
Background: Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic herniations exists. To design a study that evaluates for a causal relationship, preliminary data must be obtained relating to the size of different types of disk displacement. The reliability of chiropractic radiologists in assessing disks and a comparison of different measuring devices should also be evaluated. Objective: To identify average measurements for normal and displaced disks and to assess the reliability of measurements by chiropractic radiologists. Study Design: Intraobserver and interobserver reliability study assessing disk displacement on magnetic resonance scans. Methods: Three evaluators assessed the disks on 122 magnetic resonance scans from two imaging centers. Six categories were graded, and digitizer and ruler measurements were compared. Forty-four scans were reassessed for intraobserver agreement. Intraobserver and interobserver variations were measured with intraclass correlation coefficient and kappa statistical analysis. Measurement device correlation was assessed with Pearson's r. Results: Clear size differences between different types of disk displacement were noted. Interexaminer measurement reliability was 0.78 to 0.84. Agreement concerning the presence of disk displacement was 85% (κ = 0.68), and the classification of disk displacements was 76% (κ = 0.60). Intraexaminer measurement reliability was 0.40 to 0.49. Intraexaminer agreement concerning the presence of disk displacement was 76% (κ = 0.52), and the classification of disk displacements was 62% to 69% (κ = 0.38 to 0.46). Normal versus bulged disk distinctions demonstrated the most disagreement. The ruler and digitizer correlation coefficient was 0.968. Conclusions: Different disk types demonstrated distinct size averages. Interexaminer agreement was good concerning disk assessment and measurements. Intraexaminer agreement was lower than expected. A millimetric ruler is an acceptable alternative to digital measurement devices. (J Manipulative Physiol Ther 2001;24:317-26)
Author Cooley, Jeffrey R.
Schultz, Gary D.
Hall, Timothy A.
Danielson, Clark D.
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Issue 5
Keywords Intervertebral Disk
Magnetic Resonance Imaging
Measurement Reliability
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Snippet Background: Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of...
Magnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of iatrogenic...
BACKGROUNDMagnetic resonance imaging is often used to assess for disk displacement after manipulation, but limited information about the true incidence of...
SourceID proquest
crossref
pubmed
elsevier
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Publisher
StartPage 317
SubjectTerms Adult
California
Chiropractic - statistics & numerical data
Female
Humans
Image Interpretation, Computer-Assisted
Intervertebral Disc Displacement - diagnostic imaging
Intervertebral Disc Displacement - etiology
Intervertebral Disc Displacement - pathology
Intervertebral Disk
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - pathology
Magnetic Resonance Imaging
Magnetic Resonance Imaging - instrumentation
Male
Manipulation, Spinal - adverse effects
Measurement Reliability
Observer Variation
Radiography
Reproducibility of Results
Retrospective Studies
Washington
Title Posterior disk displacement: Morphologic assessment and measurement reliability—lumbar spine
URI https://dx.doi.org/10.1067/mmt.2001.115266
https://www.ncbi.nlm.nih.gov/pubmed/11416821
https://search.proquest.com/docview/70928835
Volume 24
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